References:
- Global Infectious Diseases and Epidemiology Online Network: Infectious Diseases of the Philippines, 2013 eBook Edition, ISBN 978-1-61755-582-4, by Stephen Berger. Accessed here.
| Agent | PARASITE - Nematoda. Phasmidea: Ascaris lumbricoides |
| Reservoir | Human Dog |
| Vector | None |
| Vehicle | Vegetables Fly |
| Incubation Period | 10 to 14 days (as early or late as 7 to 200 days) |
| Diagnostic Tests | Stool microscopy |
| Typical Adult Therapy | Albendazole 400 mg × 1 dose or Mebendazole 100 mg b.i.d. for 3 days |
| Typical Pediatric Therapy | Mebendazole 100 mg BID X 3 d (> age 2). |
| Clinical Hints | An acute illness characterized by cough, wheezing and eosinophilia; adult worms are associated with abdominal pain (occasionally obstruction), pancreatic or biliary disease; highest rates among children and in areas of crowding and poor sanitation. |
| Synonyms | Ascaris, Ascaris lumbricoides, Askariasis |
The pulmonary manifestations of ascariasis occur during the stage of larval migration through the lungs and resemble Loffler’s syndrome: cough, wheezing, pulmonary infiltration and eosinophilia.
- Children with heavy Ascaris infection experience impaired digestion and absorption of proteins, often with moderate steatorrhea.
- A mass of worms may block the lumen of the small bowel, resulting in acute intestinal obstruction, with vomiting, abdominal distention, cramps and occasionally hemorrhage, gangrene or perforation.
- Ileal volvulus and intussusception are also reported.
Worms may also invade and obstruct the biliary duct (pancreatic-biliary ascariasis), producing abdominal pain, which may be associated with ascending cholangitis, acute or recurrent pancreatitis, pancreatic pseudotumor or obstructive jaundice.
- The majority of patients with hepatobiliary and pancreatic ascariasis present with biliary colic.
- Choledocholithiasis, hepatolithiasis, liver abscess and cirrhosis are associated with the presence of dead, rather than viable worms.
- Aberrant worms may appear at umbilical and hernial fistulas, the fallopian tubes, ovaries, lower esophagus, urinary bladder, pleural space, trans-nasal or trans-ostomy feeding tubes, lungs, nose, paranasal sinuses and other sites.