Abstract
BACKGROUND: Ascariasis, caused by Ascaris lumbricoides, is a common parasitic infection predominantly affecting children and adolescents in developing countries.Clinical manifestations range from asymptomatic cases to complications such as cholangitis and pancreatitis. Despite the prevalence of ascariasis, atypical presentations in adults are rare and pose diagnostic challenges. CASE SUMMARY: This case report describes an unusual presentation of ascariasis in a 41-year-old male, with nonspecific gastrointestinal symptoms: abdominal pain, bloating, heartburn, and alternating diarrhea and constipation, which led to a misdiagnosis of chronic gastritis initially. Finally, multiple colon polyps were detected by colonoscopy. Histopathological examination of the polyps unexpectedly revealed Ascaris eggs, leading to the final diagnosis of ascariasis. CONCLUSION: This case highlight the importance of considering parasitic infections in patients with atypical gastrointestinal symptoms, even in the absence of typical risk factors. The incidental finding of Ascaris eggs within a colonic polyp is exceedingly rare, highlighting the need for thorough diagnostic evaluation in persistent, unexplained cases. This report contributes to the expanding knowledge of ascariasis presentation and diagnosis.