Ascariasis

Description

Ascariasis (as-kuh-RIE-uh-sis) is a type of worm infection. These worms are parasites that use your body as a host to mature from larvae or eggs to adult worms. The adult worms, which reproduce, can be more than a foot (30 centimeters) long.

One of the most common worm infections in people worldwide, ascariasis is uncommon in the united States. The majority of infected people have mild cases with no symptoms. But heavy infestation can cause serious symptoms and complications.

Ascariasis occurs more frequently in children than in tropical and subtropical regions around the world, especially in areas with poor sanitation and hygiene.

Symptoms

The majority of people who are infected with ascariasis have no signs or symptoms. Moderate to heavy infestations cause various signs or symptoms, depending on which part of your body that is affected.

In the lungs

After swallowing the small (microscopic) ascariasis eggs, which hatch in the small intestine and the larvae migrate through the bloodstream or the lymphatic system in the lungs. In this scenario, you may experience signs and symptoms similar to asthma or pneumonia, including:

  • Persistent cough
  • Shortness of breath
  • Wheezing

After spending 10 to 14 days in the lungs, the larvae travel to the throat, where to cough them and then swallow them.

In the intestines

The larvae mature into adult worms in the small intestine, and the adult worms typically live in the intestines until they die. In mild or moderate ascariasis, the infestation of the bowel can cause:

  • Vague abdominal pain
  • Nausea and vomiting
  • Diarrhea, or bloody stools

If you have a large number of worms in the intestine, which can be:

  • Severe abdominal pain
  • Fatigue
  • Vomiting
  • Weight loss or malnutrition
  • A worm in vomit or stool

When to see a doctor

Talk with your doctor if you have persistent abdominal pain, diarrhea or nausea.

Causes

Ascariasis is not transmitted directly from person to person. In its place, a person has to come in contact with soil mixed with human or pig feces that contain ascariasis eggs or infected water. In some developing countries, the human feces are used for fertilizer, or the lack of sanitary facilities allow human waste to the mix with the ground, in yards, ditches and fields. People can also get it from eating raw pork or chicken liver is infected.

Small children often play in the earth, and the infection can occur if they put their dirty fingers in his mouth. Unwashed fruits or vegetables grown in contaminated soils may also transmit the ascariasis eggs.

Life cycle of a worm

  • Ingestion. Small (microscopic) ascariasis eggs are not infectious, without coming in contact with the ground. People can accidentally ingest (swallow) - contaminated soil through the hand-to-mouth contact or by consumption of raw fruits or vegetables that have been grown in contaminated soils.
  • Of the migration. Larvae hatch from the eggs in the small intestine, and then go through the intestinal wall to travel to the heart and the lungs through the bloodstream or lymphatic system. After the maturation of about 10 to 14 days in the lungs, the larvae break in your airways and travel up to the throat, where they are coughed and swallowed.
  • Maturation. Once you are back in the intestines, the parasites grow in either male or female worms. Female worms can be more than 15 inches (40 centimeters) long and a little less than a quarter of an inch (6 millimeters) in diameter. Male worms are usually smaller.
  • Playback. Female worms can produce 200,000 eggs per day, if there are both female and male worms in the intestines, and eggs out of your body in the stool. The fertilized eggs should be on the ground for at least two to four weeks before they can infect.

The entire process — from the ingestion of egg-to-egg deposits — it takes about two or three months. Ascariasis worms can live inside the body of a year or two.

Risk factors

Risk factors for ascariasis include:

  • Age. Most of the people who have ascariasis 10 years of age or younger. Children in this age group may be at greater risk because they are more likely to play in the earth.
  • Warm weather. In the united States, ascariasis is most common in the Southeast. But it is more common in developing countries with warm temperatures throughout the year.
  • The lack of sanitation. Ascariasis is prevalent in developing countries where human feces can be mixed with the local soil.

Complications

Mild cases of ascariasis does not usually cause complications. If you have a heavy infestation, potentially dangerous complications may include:

  • The slow growth. Loss of appetite and poor absorption of digested food to put children with ascariasis at risk of not getting enough nutrition, which can delay the growth.
  • Intestinal obstruction and perforation. In heavy ascariasis infestation, a mass of worms can block a part of your bowel. This can cause severe abdominal cramps, and vomiting. The obstruction can even make a hole in the intestinal wall or the appendix, causing internal bleeding (hemorrhage) or appendicitis.
  • Through the locks. In some cases, the worms can block the straits of the ducts of their liver or pancreas, causing severe pain.

Prevention

The best defense against ascariasis is good hygiene and common sense. Follow these tips to avoid infection:

  • Practice good hygiene. Before handling food, always wash your hands with soap and water. Wash fruits and vegetables thoroughly.
  • Be careful when traveling. Use only bottled water and avoid raw vegetables unless you can peel and wash.

Ascariasis

Diagnosis

To diagnose ascariasis, your doctor may review your symptoms and the order of the tests.

In heavy infestations, it is possible to find worms after coughing or vomiting. Worms can come from other body orifices such as the mouth or the nose. If this happens to you, take the worm to your doctor so that he or she can identify and prescribe the proper treatment.

The analysis of feces

Mature woman ascariasis worms in the intestine begin to lay eggs. These eggs travel through your digestive system and in the long run can be found in the feces.

To diagnose ascariasis, your doctor will examine your stool for the small (microscopic) of the eggs and larvae. But the eggs do not appear in stool until at least 40 days after contracting the infection. And if you are infected with only male worms, do not have eggs.

Blood tests

Your blood can be tested for the presence of a greater number of a certain type of white blood cell called eosinophils. Ascariasis can raise your eosinophils, but you can also do it with other types of health problems.

Imaging tests

  • The x-rays. If you're infested with worms, the mass of worms may be visible in an x-ray of the abdomen. In some cases, a chest x-ray may reveal larvae in the lungs.
  • Ultrasound. An ultrasound can show the worms in the pancreas or the liver. This technology uses sound waves to create images of the internal organs.
  • computed tomography (CT) or Magnetic resonance (MR)s. Both types of evidence to create detailed images of the internal structures, which can help your doctor detect worms that are blocking the ducts in the liver or the pancreas. CT scans combine X-ray images taken from many angles. MRI uses radio waves and a strong magnetic field.

Treatment

Typically, only the infections that cause the symptoms must be treated. In some cases, ascariasis is going to resolve on its own.

Drugs

Anti-parasite medications are the first-line treatment against ascariasis. The most common are:

  • Albendazole (Albenza)
  • Ivermectin (Stromectol)
  • Mebendazole

These drugs, taken one to three days, kill the adult worms. The side effects include mild abdominal pain or diarrhea.

Pregnant women can take pyrantel pamoate.

Surgery

In cases of heavy infestation, surgery may be needed to remove the worms and repair the damage they've caused. Intestinal obstruction or holes, obstruction of bile ducts, and appendicitis are the complications that may require surgery.

Preparing for your appointment

Your family doctor may refer you to a medical doctor trained in disorders of the digestive system (gastroenterologist). You may need to see a surgeon if the worms have blocked intestines.

What you can do

Before your appointment, you can write down the answers to the following questions:

  • When did your symptoms begin?
  • Does anything make your symptoms better or worse?
  • Have you noticed that the worms in the stool or in vomit?
  • Have you traveled to developing countries lately?
  • What medications and supplements you are taking?

What to expect from your doctor

During the physical exam, your doctor may press on certain areas of the abdomen to detect the presence of pain or discomfort. He or she may also want a stool sample for analysis.

Symptoms and treatment of Ascariasis