Pediatric Ascariasis Clinical Presentation

  • Author: William H Shoff, MD, DTM&H; Chief Editor: Russell W Steele, MD   more...
 
Updated: Sep 27, 2010
 

History

Most individuals are asymptomatic, even in communities where the prevalence is high. The most common manifestation is asymptomatic passage of an adult worm via the rectum, particularly in children in endemic areas. Rarely, an adult in a nonendemic area who is asymptomatic passes a worm via the rectum and may not be able to recount any significant exposure history. Less frequently, a worm migrates to the oropharynx and is coughed out. Ascaris eggs are often found in the stools of asymptomatic individuals in endemic areas. Some individuals with known significant worm burdens report anorexia, abdominal discomfort, and diarrhea; however, these symptoms cannot be directly attributed to ascariasis.

Pulmonary ascariasis

Symptoms develop 1-2 weeks after infection; they vary from none to life-threatening (rare), depending on sensitization or considerable migrating worm burden. Symptoms include chest pain (burning, aggravated by cough), cough (dry), dyspnea, fever, sputum (may be blood-tinged), and wheezing.

A massive infestation can lead to Löeffler syndrome (ie, transient eosinophilia, transient lung infiltrates); ascariasis remains the most common cause of this syndrome worldwide. In areas of continuous transmission, pulmonary symptoms tend to be less evident. Urticaria is present in 15% of patients and usually develops in the first 4-5 days of illness. Symptoms last 5-10 days but have been reported to last weeks in severe cases.

Intestinal obstruction

Partial or complete obstruction secondary to an entangled worm bolus can occur at any age; however, 85% of cases occur in children aged 1-5 years and most occur at terminal ileum, although they have been rarely reported in the duodenum. The worm bolus may also cause intussusception or volvulus. Severe, sharp, colicky abdominal pain with associated vomiting predominates. The vomit may contain worms. Other common symptoms include fever and diarrhea. Depending on the duration of symptoms and the presence of comorbid conditions (eg, malnutrition), the patient may present with or progress rapidly to sepsis, sepsis syndrome, and septic shock.

Complete obstruction may begin subsequent to the administration of an antihelminthic, particularly in the setting of acute abdominal pain or partial bowel obstruction. Specific concern surrounds the administration of pyrantel pamoate, which causes a spastic paralysis of the worms and accentuates the potential for an obstructive bolus. Complete obstruction has also been reported with piperazine (flaccid paralysis of worms) and mebendazole (single large dose).

In endemic countries, ascariasis accounts for 5-35% of intestinal obstruction cases, particularly in children.

Hepatobiliary and pancreatic ascariasis and other GI diseases

Migrating adult worms (most common), worm fragments, or eggs can cause acalculous cholecystitis, ascending cholangitis, appendicitis, biliary colic, gastric hemorrhage, granulomatous peritonitis, liver abscess, Meckel diverticulum inflammation, obstructive jaundice, pancreatitis, and peritonitis and/or peritoneal granulomatosis (ie, ductal and/or intestinal perforation or migration through perforation secondary to typhoid or tuberculosis). Imaging with CT scanning and ultrasonography reveals the etiology in many cases. The etiology may not be apparent until endoscopic retrograde cholangiopancreatography (ERCP) or surgery is performed.

Extra-GI conditions

Worms may migrate to the upper respiratory tract (ie, throat, nose, lacrimal ducts, and inner ear); to the vagina; and to the kidney, ureter, and bladder (via the vagina).

Experimental studies report that the migrating larvae can enter many tissues, including the brain, kidney, and lymph nodes, but cannot survive. Several case reports have suggested encephalopathy secondary to Ascaris larvae.

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Physical

Pulmonary ascariasis

In most cases, the lungs are clear or wheezing may be observed. In more severe cases, including ascaris pneumonia, a fever (≤ 102ºF), rales, and wheezing may be observed. Dullness to percussion and bronchial breathing are rare, even in severe cases. Signs may persist for several days.

Intestinal obstruction or partial obstruction

The patient appears ill, often with abnormal vital signs (eg, tachycardia, fever) and may be actively vomiting and reporting severe abdominal pain. The abdomen is moderately-to-severely tender in a diffuse or localized pattern, usually on the right side. A palpable mass (worm bolus) may be observed. Assess for increasing pain, tachycardia, tachypnea, fever, abdominal tenderness, and vomiting, all of which may indicate progression of the obstruction, the development of sepsis, or perforation.

Hepatobiliary disease

Upon presentation, the patient may appear ill, may have abnormal vital signs (eg, tachycardia, tachypnea, fever), and may be actively vomiting. These patients usually report abdominal pain (mild, moderate, or severe). Depending on the pathology, the symptoms may rapidly progress rapidly over hours, as follows:

  • Biliary colic: Fever and jaundice are often absent; the worms are usually in the ampullary orifice, and removal results in rapid improvement.
  • Acalculous cholecystitis: Pain and tenderness in right upper quadrant are reported. Jaundice may or may not be present. The pain often radiates to the back on the right (see Cholecystitis).
  • Ascending cholangitis: The patient is usually critically ill with fever, tachycardia, tachypnea, jaundice, severe pain, and severe right upper quadrant or diffuse abdominal tenderness. The liver is tender and enlarged.
  • Pancreatitis: Moderate or severe pain and tenderness in the epigastrium and the left upper quadrant is reported, along with associated vomiting of varying intensity. The pain often radiates to the back on the left (see Pancreatitis and Pancreatic Pseudocyst).
  • Hepatic abscess: Severe pain and tenderness is reported in the right upper quadrant. The liver is tender and enlarged.
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Causes

Ascariasis is caused by ingestion of an embryonated A lumbricoides egg or embryonated A suum egg (see Pathophysiology). Whether A suum and A lumbricoides are separate species remains controversial; however, evidence suggests that they may be distinct entities.

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Contributor Information and Disclosures
Author

William H Shoff, MD, DTM&H  Director, PENN Travel Medicine, Associate Professor, Department of Emergency Medicine, Hospital of the University of Pennsylvania

William H Shoff, MD, DTM&H is a member of the following medical societies: American College of Physicians, American Society of Tropical Medicine and Hygiene, International Society of Travel Medicine, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Glaxo Smith Kline None None; Glaxo Smith Kline Honoraria Speaking and teaching

Coauthor(s)

Catherine T Shoff, DO  Staff Physician, Departments of Pulmonary, Critical Care and Sleep Medicine, Director, Tri-Services Adult Cystic Fibrosis Ctr, Wilford Hall Medical Center, Assistant Professor of Medicine, Uniformed Services University of the Health Sciences

Catherine T Shoff, DO is a member of the following medical societies: American Academy of Sleep Medicine and American College of Chest Physicians

Disclosure: Nothing to disclose.

Michael E Greenberg, MD  MPH, Clinical Instructor, Department of Pediatrics, University of California at San Francisco

Michael E Greenberg, MD is a member of the following medical societies: Alpha Omega Alpha, Ambulatory Pediatric Association, American Academy of Pediatrics, and American Public Health Association

Disclosure: Nothing to disclose.

Suzanne Moore Shepherd, MD, MS, DTM&H, FACEP, FAAEM  Associate Professor, Education Officer, Department of Emergency Medicine, Hospital of the University of Pennsylvania; Director of Education and Research, PENN Travel Medicine

Suzanne Moore Shepherd, MD, MS, DTM&H, FACEP, FAAEM is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American Society of Tropical Medicine and Hygiene, International Society of Travel Medicine, Society for Academic Emergency Medicine, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael D Nissen, MBBS, FRACP, FRCPA  Associate Professor in Biomolecular, Biomedical Science & Health, Griffith University; Director of Infectious Diseases and Unit Head of Queensland Paediatric Infectious Laboratory, Sir Albert Sakzewski Viral Research Centre, Royal Children's Hospital

Michael D Nissen, MBBS, FRACP, FRCPA is a member of the following medical societies: American Academy of Pediatrics, American Society for Microbiology, Pediatric Infectious Diseases Society, Royal Australasian College of Physicians, and Royal College of Pathologists of Australasia

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Pharmacy Editor, eMedicine

Disclosure: Nothing to disclose.

Martin Weisse, MD  Program Director, Associate Professor, Department of Pediatrics, West Virginia University

Martin Weisse, MD is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; Sanofi Pasteur Honoraria Speaking and teaching; Baxter Healthcare Honoraria Speaking and teaching; Novartis Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

References

  1. Bethony J, Brooker S, Albonico M, et al. Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet. May 6 2006;367(9521):1521-32. [Medline].

  2. Crompton DW. Ascaris and ascariasis. Adv Parasitol. 2001;48:285-375. [Medline].

  3. Lynch NR, Hagel IA, Palenque ME, Di Prisco MC, et al. Relationship between helminthic infection and IgE response in atopic and nonatopic children in a tropical environment. J Allergy Clin Immunol. Feb 1998;101(2 Pt 1):217-21. [Medline].

  4. Pinelli E, Willers SM, Hoek D, et al. Prevalence of antibodies against Ascaris suum and its association with allergic manifestations in 4-year-old children in The Netherlands: the PIAMA birth cohort study. Eur J Clin Microbiol Infect Dis. Nov 2009;28(11):1327-34. [Medline].

  5. Dold S, Heinrich J, Wichmann HE, Wjst M. Ascaris-specific IgE and allergic sensitization in a cohort of school children in the former East Germany. J Allergy Clin Immunol. Sep 1998;102(3):414-20. [Medline].

  6. Leonardi-Bee J, Pritchard D, Britton J. Asthma and current intestinal parasite infection: systematic review and meta-analysis. Am J Respir Crit Care Med. Sep 1 2006;174(5):514-23. [Medline].

  7. Hunninghake GM, Soto-Quiros ME, Avila L, et al. Sensitization to Ascaris lumbricoides and severity of childhood asthma in Costa Rica. J Allergy Clin Immunol. Mar 2007;119(3):654-61. [Medline].

  8. Cooper PJ, Chico ME, Rodrigues LC, et al. Reduced risk of atopy among school-age children infected with geohelminth parasites in a rural area of the tropics. J Allergy Clin Immunol. May 2003;111(5):995-1000. [Medline].

  9. Schafer T, Meyer T, Ring J, Wichmann HE, Heinrich J. Worm infestation and the negative association with eczema (atopic/nonatopic) and allergic sensitization. Allergy. Aug 2005;60(8):1014-20. [Medline].

  10. Albonico M, Bickle Q, Ramsan M, Montresor A, Savioli L, Taylor M. Efficacy of mebendazole and levamisole alone or in combination against intestinal nematode infections after repeated targeted mebendazole treatment in Zanzibar. Bull World Health Organ. 2003;81(5):343-52. [Medline]. [Full Text].

  11. Hesham Al-Mekhlafi M, Surin J, Atiya AS, Ariffin WA, Mohammed Mahdy AK, Che Abdullah H. Pattern and predictors of soil-transmitted helminth reinfection among aboriginal schoolchildren in rural Peninsular Malaysia. Acta Trop. Aug 2008;107(2):200-4. [Medline].

  12. Luoba AI, Wenzel Geissler P, Estambale B, et al. Earth-eating and reinfection with intestinal helminths among pregnant and lactating women in western Kenya. Trop Med Int Health. Mar 2005;10(3):220-7. [Medline].

  13. Sandouk F, Haffar S, Zada MM, Graham DY, et al. Pancreatic-biliary ascariasis: experience of 300 cases. Am J Gastroenterol. Dec 1997;92(12):2264-7. [Medline].

  14. Khuroo MS, Zargar SA, Mahajan R. Hepatobiliary and pancreatic ascariasis in India. Lancet. Jun 23 1990;335(8704):1503-6. [Medline].

  15. Sherman SC, Weber JM. The CT diagnosis of Ascariasis. J Emerg Med. May 2005;28(4):471-2. [Medline].

  16. Arya PK, Kukreti R, Arya M, Gupta SN. Magnetic resonace appearance of gall bladder ascariasis. Indian J Med Sci. May 2005;59(5):208-10. [Medline].

  17. World Health Organization. Report of the third global meeting on the partners for parasite control: Deworming for health and develpment. Geneva: WHO; November 2004. [Full Text].

  18. World Health Organization. Report of the WHO informal consultation on the use of praziquantel during pregnancy/lactation and albendazole/mebendazole in children under 24 months. Geneva: WHO; April 2002. [Full Text].

  19. Albonico M, Stoltzfus RJ, Savioli L. A controlled evaluation of two school-based anthelminthic chemotherapy regimens on intensity of intestinal helminth infections. Int J Epidemiol. Jun 1999;28(3):591-6. [Medline].

  20. Fallah M, Mirarab A, Jamalian F. Evaluation of two years of mass chemotherapy against ascariasis in Hamadan, Islamic Republic of Iran. Bull World Health Organ. 2002;80(5):399-402. [Medline].

  21. Abebe W, Tsuji N, Kasuga-Aoki H. Species-specific proteins identified in Ascaris lumbricoides and Ascaris suum using two-dimensional electrophoresis. Parasitol Res. Sep 2002;88(9):868-71. [Medline].

  22. Akgun Y. Intestinal obstruction caused by Ascaris lumbricoides. Dis Colon Rectum. Oct 1996;39(10):1159-63. [Medline].

  23. American Academy of Pediatrics. Ascaris lumbricoides infections. In: Peter G, ed. Red Book: Report of the Committee on Infectious Diseases. 24th ed. Elk Grove Village, IL: AAP; 1997:142-3.

  24. Ash LR. Ascaris lumbricoides?. South Med J. Jan 2003;96(1):101-2. [Medline].

  25. Bapat SS, Pulikot AM. Hepato-cerebral complications in ascariasis. Indian Pediatr. Apr 2001;38(4):431-2. [Medline].

  26. Beckingham IJ, Cullis SN, Krige JE. Management of hepatobiliary and pancreatic Ascaris infestation in adults after failed medical treatment. Br J Surg. Jul 1998;85(7):907-10. [Medline].

  27. Beitia AO, Haller JO, Kantor A. CT findings in pediatric gastrointestinal ascariasis. Comput Med Imaging Graph. Jan-Feb 1997;21(1):47-9. [Medline].

  28. Bennett A, Guyatt H. Reducing intestinal nematode infection: efficacy of albendazole and mebendazole. Parasitol Today. Feb 2000;16(2):71-4. [Medline].

  29. Bergler-Czop B, Lis-Swiety A, Kaminska-Winciorek G, Brzezinska-Wcislo L. Erythema nodosum caused by ascariasis and Chlamydophila pneumoniae pulmonary infection--a case report. FEMS Immunol Med Microbiol. Dec 2009;57(3):236-8. [Medline].

  30. Borges CA, Costa-Cruz JM, Paula FM. Intestinal parasites inside public restrooms and buses from the city of Uberlândia, Minas Gerais, Brazil. Rev Inst Med Trop Sao Paulo. Jul-Aug 2009;51(4):223-5. [Medline].

  31. Brooker S, Clements AC, Bundy DA. Global epidemiology, ecology and control of soil-transmitted helminth infections. Adv Parasitol. 2006;62:221-61. [Medline].

  32. Bude RO, Bowerman RA. Case 20: Biliary ascariasis. Radiology. Mar 2000;214(3):844-7. [Medline].

  33. Carneiro FF, Cifuentes E, Tellez-Rojo MM, Romieu I. The risk of Ascaris lumbricoides infection in children as an environmental health indicator to guide preventive activities in Caparao and Alto Caparao, Brazil. Bull World Health Organ. 2002;80(1):40-6. [Medline].

  34. Cooper PJ, Chico M, Sandoval C, Espinel I, Guevara A, Levine MM. Human infection with Ascaris lumbricoides is associated with suppression of the interleukin-2 response to recombinant cholera toxin B subunit following vaccination with the live oral cholera vaccine CVD 103-HgR. Infect Immun. Mar 2001;69(3):1574-80. [Medline].

  35. Crompton DWT, Nesheim MC, Pawlowski ZS. Ascariasis and Its Prevention and Control. London, England: Taylor & Francis; 1989.

  36. de Silva NR, Brooker S, Hotez PJ. Soil-transmitted helminth infections: updating the global picture. Trends Parasitol. Dec 2003;19(12):547-51. [Medline].

  37. de Silva NR, Chan MS, Bundy DA. Morbidity and mortality due to ascariasis: re-estimation and sensitivity analysis of global numbers at risk. Trop Med Int Health. Jun 1997;2(6):519-28. [Medline].

  38. Gelpi AP, Mustafa A. Ascaris pneumonia. Am J Med. Mar 1968;44(3):377-89. [Medline].

  39. Gelpi AP, Mustafa A. Seasonal pneumonitis with eosinophilia. A study of larval ascariasis in Saudi Arabs. Am J Trop Med Hyg. Sep 1967;16(5):646-57. [Medline].

  40. Hui JY, Woo PC, Kan PS, Tang AP. A woman with ascites and abdominal masses. Lancet. Feb 12 2000;355(9203):546. [Medline].

  41. Inatomi Y, Murakami T, Tokunaga M, Ishiwata K, Nawa Y, Uchino M. Encephalopathy caused by visceral larva migrans due to Ascaris suum. J Neurol Sci. Apr 1 1999;164(2):195-9. [Medline].

  42. Ishiwata K, Shinohara A, Yagi K. Identification of tissue-embedded ascarid larvae by ribosomal DNA sequencing. Parasitol Res. Jan 2004;92(1):50-2. [Medline].

  43. Jat KR, Marwaha RK, Panigrahi I, Gupta K. Ascariasis-associated worm encephalopathy in a young child. Trop Doct. Apr 2009;39(2):113-4. [Medline].

  44. Jones JL, Schulkin J, Maguire JH. Therapy for common parasitic diseases in pregnancy in the United States: a review and a survey of obstetrician/gynecologists' level of knowledge about these diseases. Obstet Gynecol Surv. Jun 2005;60(6):386-93. [Medline].

  45. [Best Evidence] [Guideline] Keiser J, Utzinger J. Efficacy of current drugs against soil-transmitted helminth infections: systematic review and meta-analysis. JAMA. Apr 23 2008;299(16):1937-48. [Medline].

  46. Khuroo MS. Ascariasis. Gastroenterol Clin North Am. Sep 1996;25(3):553-77. [Medline].

  47. Kiafar C, Shah D, Wadas D, Gilani N. Intermittent obstruction of jejunostomy tube due to Ascaris lumbricoides infection. South Med J. Jun 2008;101(6):654-6. [Medline].

  48. Knopp S, Mohammed KA, Simba Khamis I, et al. Spatial distribution of soil-transmitted helminths, including Strongyloides stercoralis, among children in Zanzibar. Geospat Health. Nov 2008;3(1):47-56. [Medline].

  49. Knopp S, Mohammed KA, Simba Khamis I, et al. Spatial distribution of soil-transmitted helminths, including Strongyloides stercoralis, among children in Zanzibar. Geospat Health. Nov 2008;3(1):47-56. [Medline].

  50. Larrubia JR, Ladero JM, Mendoza JL, Morillas JD, Diaz-Rubio M. The role of sonography in the early diagnosis of biliopancreatic Ascaris infestation. J Clin Gastroenterol. Jan 1996;22(1):48-50. [Medline].

  51. Loreille O, Bouchet F. Evolution of ascariasis in humans and pigs: a multi-disciplinary approach. Mem Inst Oswaldo Cruz. 2003;98 Suppl 1:39-46. [Medline].

  52. Mao XQ, Sun DJ, Miyoshi A, Feng Z, Handzel ZT, Hopkin JM. The link between helminthic infection and atopy. Parasitol Today. May 2000;16(5):186-8. [Medline].

  53. Norhayati M, Oothuman P, Azizi O, Fatmah MS. Efficacy of single dose albendazole on the prevalence and intensity of infection of soil-transmitted helminths in Orang Asli children in Malaysia. Southeast Asian J Trop Med Public Health. Sep 1997;28(3):563-9. [Medline].

  54. Norhayati M, Oothuman P, Azizi O, Fatmah MS. Efficacy of single dose albendazole on the prevalence and intensity of infection of soil-transmitted helminths in Orang Asli children in Malaysia. Southeast Asian J Trop Med Public Health. Sep 1997;28(3):563-9. [Medline].

  55. O'Lorcain P, Holland CV. The public health importance of Ascaris lumbricoides. Parasitology. 2000;121 Suppl:S51-71. [Medline].

  56. Ochoa B. Surgical complications of ascariasis. World J Surg. Mar-Apr 1991;15(2):222-7. [Medline].

  57. Ozturk H, Ozturk H, Duran H, Otcu S. [Biliary ascaris-induced obstructive jaundice: a case of acute abdomen]. Ulus Travma Acil Cerrahi Derg. Jan 2009;15(1):88-90. [Medline].

  58. Reeder MM. The radiological and ultrasound evaluation of ascariasis of the gastrointestinal, biliary, and respiratory tracts. Semin Roentgenol. Jan 1998;33(1):57-78. [Medline].

  59. Rodriguez EJ, Gama MA, Ornstein SM, Anderson WD. Ascariasis causing small bowel volvulus. Radiographics. Sep-Oct 2003;23(5):1291-3. [Medline].

  60. Salman AB. Management of intestinal obstruction caused by ascariasis. J Pediatr Surg. Apr 1997;32(4):585-7. [Medline].

  61. Sandouk F, Anand BS, Graham DY. The whirlpool jet technique for removal of pancreatic duct ascaris. Gastrointest Endosc. Aug 1997;46(2):180-2. [Medline].

  62. Sarinas PS, Chitkara RK. Ascariasis and hookworm. Semin Respir Infect. Jun 1997;12(2):130-7. [Medline].

  63. Schulman A. Ultrasound appearances of intra- and extrahepatic biliary ascariasis. Abdom Imaging. Jan-Feb 1998;23(1):60-6. [Medline].

  64. Selimoglu MA, Ozturk CF, Ertekin V. A rare manifestation of ascariasis: encephalopathy. J Emerg Med. Jan 2005;28(1):87-8. [Medline].

  65. St Georgiev V. Pharmacotherapy of ascariasis. Expert Opin Pharmacother. Feb 2001;2(2):223-39. [Medline].

  66. Stephenson LS, Latham MC, Ottesen EA. Malnutrition and parasitic helminth infections. Parasitology. 2000;121 Suppl:S23-38. [Medline].

  67. Tiyo R, Guedes TA, Falavigna DL, Falavigna-Guilherme AL. Seasonal contamination of public squares and lawns by parasites with zoonotic potential in southern Brazil. J Helminthol. Mar 2008;82(1):1-6. [Medline].

  68. Tondon A, Choudhury SP, Sharma D. Hypertonic saline enema in gastrointestinal ascariasis. Indian J Pediatr. Sep-Oct 1999;66(5):675-80. [Medline].

  69. van Riet E, Wuhrer M, Wahyuni S, Retra K, Deelder AM, Tielens AG. Antibody responses to Ascaris-derived proteins and glycolipids: the role of phosphorylcholine. Parasite Immunol. Aug 2006;28(8):363-71. [Medline].

  70. Villamizar E, Mendez M, Bonilla E, et al. Ascaris lumbricoides infestation as a cause of intestinal obstruction in children: Experience with 87 cases. J Pediatr Surg. Jan 1996;31(1):201-4; discussion 204-5. [Medline].

  71. World Health Organization. Control of Ascariasis. 1967. WHO technical report series. [Full Text].

  72. World Health Organization. Prevention and control of schistosomiasis and soil-transmitted helminths. WHO; 2002. WHO technical report series. [Full Text].

  73. Zargar SA, Khuroo MS. Management of biliary ascariasis in children. Indian J Gastroenterol. Oct 1990;9(4):321. [Medline].

 
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The roundworm Ascaris lumbricoides causes ascariasis. Worms can reach 10-30 cm in length. Clinical disease results from effects of pulmonary larval migration, intestinal obstruction, or migration through the biliary tree.
Table 1. Major Soil-Transmitted Helminths[1, 2]
Parasite*DiseasePrevalence
A lumbricoidesCommon roundworm infection, ascariasis800 million to 1.4 billion
T trichiuraWhipworm infection, trichuriasis600 million to 1 billion
Necator americanus and



Ancylostoma duodenale



Hookworm infection580 million to 1.2 billion
Strongyloides stercoralisThreadworm infection, strongyloidiasis30-300 million
Enterobius vermicularisPinworm infection4-28% of children
Toxocara canis and



Toxocara cati



Visceral larva migrans and ocular larva migrans2-80% of children
*All major parasites are found in tropical, subtropical, and temperate climates.
Table 2. Minor Soil-Transmitted Helminths[1, 2]
Minor ParasiteDiseaseDistribution
Ancylostoma brazilienseCutaneous larva migransCostal regions worldwide
Uncinaria stenocephalaCutaneous larva migransCostal regions worldwide
Ancyclostoma caniumEosinophilic enteritisAustralia
Ancylostoma ceylanicumHookworm infectionAsia
Oesophagostomum bifurcumNodular worm infectionNorth America
Strongyloides fuelleborniSwollen belly syndromeWest Africa
Ternidens diminutusFalse hookworm infectionSouthern Africa
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