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Section 3. Summaries of Infectious Diseases

Ascaris lumbricoides Infections

Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures

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CLINICAL MANIFESTATIONS

Most infections with Ascaris lumbricoides are asymptomatic, although moderate to heavy infections may lead to malnutrition and nonspecific gastrointestinal tract symptoms. During the larval migratory phase, an acute transient pneumonitis (Löffler syndrome) associated with fever and marked eosinophilia may occur. Acute intestinal obstruction has been associated with heavy infections. Children are prone to this complication because of the small diameter of the intestinal lumen and their propensity to acquire large worm burdens. Worm migration can cause peritonitis, secondary to intestinal wall perforation, and common bile duct obstruction resulting in biliary colic, cholangitis, or pancreatitis. Adult worms can be stimulated to migrate by stressful conditions (eg, fever, illness, or anesthesia) and by some anthelmintic drugs. A lumbricoides has been found in the appendiceal lumen in patients with acute appendicitis.


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ETIOLOGY

A lumbricoides is the most prevalent of all human intestinal nematodes (roundworms), with more than 1 billion people infected worldwide.


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EPIDEMIOLOGY

Adult worms live in the lumen of the small intestine. Female worms produce approximately 200 000 eggs per day, which are excreted in stool and must incubate in soil for 2 to 3 weeks for an embryo to become infectious. Following ingestion of embryonated . . . [Go to Full Text]


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