Ascaris Infection

Caused by the nematode roundworm, Ascaris lumbricoides.
Common in eastern and south eastern Africa, southern and India, Pakistan, and Bangladesh.
Clinical pathological

-Oral infection may occur in children or adults when they eat some foods.
-Worms cross the intestinal wall and remain in the GI tract (intestine or stomach)
-Entry into the circulation may lead to systemic spread to other organs,


-For ex: liver, lungs, heart, brain and blood.
-Intestinal infection causes:
-Abdominal colicky pain and indigestion.
-Diarrhea.


-Dizzy
• Obstructive appendicitis.
• Intestinal obstruction due to inflammation and impaction of a ‘worm mass’ or intussusception that may present as
a mobile abdominal mass.
• Bleeding, leading to anemia.


• Lung infestation may cause severe pneumonitis.
• Bile duct or pancreatic infestation may cause:
• Bile duct strictures.
• Liver abscess.

Clinical Diagnosis
• Ova are demonstrated by examination of hot fresh stools.
• A plain AXR or barium meal may demonstrate radiolucent lines within a dense shadow, which represent individual worms.

Treatment
• Piperazine, one dual dose sachet repeated after 14 days (adults), one third sachet (age 3–12 months), two-thirds sachet (age 1–6y), 1 sachet (age >6y). Causes paralysis of roundworms and threadworms and permits their expulsion by peristalsis.


• Mebendazole, 100mg bd for 3 days (adults and children >2y).
• Immobilizes the worms by disrupting their transport systems.
Surgical


• Abdominal surgery is only indicated for obstruction or peritonitis.
• Any non-viable gut is resected.
• Biliary infestation may be treated by antispasmodics to allow the sphincter to relax and then kill the worm load with anthelminthic or removal by ERCP or laparotomy.

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