Case report
Erythema nodosum coexisting with ascariasis and pulmonary Chlamydia pneumoniae infection – case report

Erythema nodosum belongs to a group of relatively common hypodermis inflammation. It occurs mainly among women and particularly affects young ones. The etiology of the disease is not clear. Most frequently the changes appear on the surface of the front part of shank. Initially, red nodules change their color into dark brown and then into yellow and green color. Exanthema undergo neither dissolution nor cicatrisation. Regression is frequent. The case of erythema nodosum we presented, caused by Ascaris lumbricoides infection as well as by an early Chlamydia pneumoniae infection, is numbered as rarely described in literature. The exanthema initially appeared on the front side of both shanks with gradual tendency of progression towards tights and shoulders. The exanthema appeared as numerous, tender, not well-delineated from the surrounding area red and dark-brown bumps. The completed laboratory treatment showed a visibly increased ESR – 90/98, increased level CRP and a decreased level of iron. In the triple examination of feces towards parasites occurrence, numerous Ascaris lumbricoides’ eggs were discovered. Antibodies against Chlamydia pneumoniae in class IgA – positive which attested to an early pulmonary infection. Throat smear – physiological bacterial flora. Histopathological examination confirmed erythema nodosum. In the treatment we used Pyrantelum 3 pills once p.o. and antibiotics, observed a quick regression of skin changes.