Ascaris Lumbricoides Follow-up

Updated: May 18, 2016
  • Author: Aaron Dora-Laskey, MD; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Follow-up

Further Outpatient Care

Primary care follow up is suggested to confirm cure.

Presumptive administration of albendazole to all immigrants at risk for parasitosis has been suggested and shown to save lives and money. However, current recommendations do not include its implementation.

Follow-up stool ova and parasite microscopic testing is warranted post treatment to ensure clearance of parasite infection and as well to monitor for re-infection, which can be common.

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Further Inpatient Care

Further inpatient care is warranted for patients with complications due to worm migration.

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Deterrence/Prevention

Screening programs for the carrier state may assist in eradication in endemic areas.

Given the association with poverty and malnutrition, long-term control will require sustained economic growth in developing countries and the creation of sanitation and education systems including those to reduce the use of human feces for fertilizer.

Many nations have such high rates of Ascaris infection that they empirically treat some age groups without testing. Medication choices and the frequency of testing vary from country to country, but data are favorable for reducing the load of parasites in the community and as well for reducing individual morbidity and mortality associated with infection.

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Complications

Complications may be attributed to larval migration typically involving the lungs, and intestinal tract producing vague symptoms but may as well involve the kidneys, brain, and heart.

Severe complications later in disease are usually attributable to mechanical obstruction of intestines or biliary tree secondary to high worm burden.

Complications may arise early in disease due to allergic reaction to Ascaris infection (urticaria).

Malnutrition, anemia, growth, and developmental retardation (subject to some debate)

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Prognosis

The prognosis for ascariasis is excellent. However, in higher worm burden infections, serious complications such as obstruction are more common.

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Patient Education

Recommend good personal hygiene and food handling techniques: discriminate defecation, hand-washing, cleaning fruits and vegetables, and avoiding soil consumption. Educational programs should also address the use of human feces as fertilizer, a practice that persists in many communities internationally.

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