Nematode Infections Follow-up

Updated: Jun 23, 2017
  • Author: Murat Hökelek, MD, PhD; Chief Editor: Mark R Wallace, MD, FACP, FIDSA  more...
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Further Outpatient Care

Patients who have undergone treatment for nematode infections should undergo follow-up stool studies at 2 weeks and re-treatment, if necessary.



Preventive measures are as follows:

  • Good hygiene and sanitation
  • Avoidance of sources of infection (eg, arthropod bites, rivers/streams, contaminated soils, consumption of raw or undercooked fish, snails, and slugs)
  • Public health activities such as vector control


Potential complications of nematode infections are as follows:

  • Vomiting worms - Ascariasis, Anisakiasis
  • Worm migration
    • Cholangitis (migration to common bile duct)
    • Pancreatitis (migration to pancreatic duct)
    • Appendicitis (migration to appendix)
    • Diverticulitis (migration to diverticula)
  • Liver abscess
  • Intestinal obstruction, volvulus
  • Intussusception
  • Bowel penetration
  • Anemia, hypoproteinemia - Hookworm
  • CNS infection - Strongyloides infection
  • Onchocerciasis - Blindness
  • Filariasis - Lymphatic destruction leading to severe edema (elephantiasis)
  • Anisakiasis - Rare complications include small bowel obstructions, ileal stenosis, intussusception, intestinal perforation, and pneumoperitoneum
  • Neurohelminthiasis - CNS migrations and infection
  • Visceral worms
    • Hepatitis
    • Splenomegaly
    • Pleuritis
    • Peritonitis
    • Eosinophilic granuloma
    • Other organ damage because larvae migrate for as long as 6 months


Light-to-moderate nematode infections carry a good prognosis. Prognosis depends on the organ infected and the extent of the infection.

Ascariasis should always be treated because of the risk of migrating adult worms.

Long-term diethylcarbamazine treatment and immunomonitoring of patients with filariae are essential in endemic areas to arrest and prevent pathology.

Angiostrongyliasis (rat lungworm disease) typically resolves without treatment. [2]


Patient Education

Avoid fecally contaminated food, water, and soil.

Avoid bites by arthropod vectors. Use insect repellants and other protective measures, eg, proper clothing.

Avoid rivers, streams, and soils known to be infected.