Ascariasis

Definition

Ascariasis is an infection caused by a parasitic roundworm, Ascaris lumbricoides.

Causes

Ascariasis is the most common intestinal worm infection. It is found in association with poor personal hygiene, poor sanitation, and in places where human feces are used as fertilizer. Intake of food or drink contaminated with roundworm eggs causes infection.

The eggs hatch and release larvae within the intestine. The larvae then move through the bloodstream to the lungs, exit up through the large airways of the lungs, and are swallowed back into the stomach and intestines.

During movement through the lungs the larvae may produce an uncommon form of pneumonia called eosinophilic pneumonia. Once back in the intestines, they mature into adult roundworms. Adult worms live in the intestine where they lay eggs that are present in feces.

It is estimated that 1 billion people are infected worldwide. Ascariasis occurs in all ages, though children seem to be affected more severely than adults.

Symptoms

Most of the time, there are no symptoms. However, symptoms may include:

• Passing worms in stool
• Vomiting up worms
• Worms exiting through the nose or mouth
• Low-grade fever
• Cough
• Bloody sputum
• Wheezing
• Shortness of breath
• Skin rash
• Vomiting
• Stomach pain

Exams and Tests

The patient may show signs of malnutrition. Tests to diagnose this condition include:

• Stool ova and parasites exam
• Abdominal x-ray
• Routine blood counts

Treatment

Treatment includes medications that paralyze or kill intestinal parasitic worms, such as albendazole or mebendazole. If there is a blockage of the intestine caused by a large number of worms, endoscopy or, rarely, surgery may be needed.

Outlook (Prognosis)

Most people recover from the infection, even without treatment. However, complications may be caused by adult worms that move to certain organs or multiply and cause a blockage in the intestine.

Possible Complications

• Biliary (liver secretion) tract obstruction
• Perforation (hole) in gut
• Blockage in the intestine

When to Contact a Medical Professional

Call your health care provider if you have symptoms suggestive of this disease, particularly if you have traveled to areas which may be affected. Also call if symptoms worsen, do not improve with treatment or if new symptoms occur.

Prevention

Improved sanitation and hygiene in developing countries will reduce the risk in those areas. In areas where this disorder is common, routine or preventive (prophylactic) treatment with deworming medications may be advised.