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Ascariasis
Intestinal parasite - ascariasis; Roundworm - ascariasis
Ascariasis is an infection with the parasitic roundworm Ascaris lumbricoides .
Causes
People get ascariasis by consuming food or drink that is contaminated with roundworm eggs. Ascariasis is the most common intestinal worm infection. It is related to poor personal hygiene and poor sanitation. People who live in places where human feces (stool) are used as fertilizer are also at risk for this disease.
Once consumed, the eggs hatch and release immature roundworms called larvae inside the small intestine. Within a few days, the larvae move through the bloodstream to the lungs. They travel up through the large airways of the lungs, and are swallowed back into the stomach and small intestine.
As the larvae move through the lungs they may cause an uncommon form of pneumonia called eosinophilic pneumonia. Eosinophils are a type of white blood cell. Once the larvae are back in the small intestine, they mature into adult roundworms. Adult worms live in the small intestine, where they lay eggs that are present in feces. They can live 10 to 24 months.
An estimated 1 billion people are infected worldwide. Ascariasis occurs in people of all ages, though children are affected more severely than adults.
Symptoms
Most of the time, there are no symptoms. If there are symptoms, they may include:
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Bloody sputum
(mucus coughed up by the lower airways)
Bloody sputum
Coughing up blood is the spitting up of blood or bloody mucus from the lungs and throat (respiratory tract). Hemoptysis is the medical term for cough...
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Cough,
wheezing
Wheezing
Wheezing is a high-pitched whistling sound during breathing. It occurs when air moves through narrowed breathing tubes in the lungs.
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Low-grade
fever
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
ImageRead Article Now Book Mark Article - Passing worms in stool
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Shortness of breath
Shortness of breath
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
ImageRead Article Now Book Mark Article - Skin rash
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Stomach pain
Stomach pain
Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.
ImageRead Article Now Book Mark Article - Vomiting or coughing up worms
- Worms leaving the body through the nose or mouth
Exams and Tests
The infected person may show signs of malnutrition. Tests to diagnose this condition include:
-
Abdominal x-ray
or other imaging tests
Abdominal x-ray
An abdominal x-ray is an imaging test to look at organs and structures in the abdomen. Organs include the spleen, stomach, and intestines. When the ...
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Complete blood count
Complete blood count
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
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Eosinophil count
Eosinophil count
An absolute eosinophil count is a blood test that measures the number of white blood cells called eosinophils. Eosinophils become active when you ha...
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Stool exam
to look for worms and worm eggs
Stool exam
Stool ova and parasites exam is a lab test to look for parasites or eggs (ova) in a stool sample. The parasites are associated with intestinal infec...
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Treatment
Treatment includes medicines that paralyze or kill intestinal parasitic worms.
If there is a blockage of the intestine caused by a large number of worms, a procedure called endoscopy may be used to remove the worms. In rare cases, surgery is needed.
Endoscopy
Endoscopy is a way of looking inside the body using a flexible tube that has a small camera and light on the end of it. This instrument is called an...
People who are treated for roundworms should be checked again in 3 months. This involves examining the stools to check for eggs of the worm. If eggs are present, treatment should be given again.
Outlook (Prognosis)
Most people recover from symptoms of the infection, even without treatment. But they may continue to carry the worms in their body.
Complications can be caused by adult worms that move to certain organs, such as the:
- Appendix
- Bile duct
- Pancreas
If the worms multiply, they can block the intestine.
Possible Complications
These complications may occur:
- Blockage in the bile ducts of the liver
- Blockage in the intestine
- Hole in the gut
When to Contact a Medical Professional
Call your health care provider if you have symptoms of ascariasis, particularly if you have traveled to an area where the disease is common. Also call:
- If symptoms get worse
- If symptoms do not improve with treatment
- If new symptoms occur
Prevention
Improved sanitation and hygiene in developing countries will reduce the risk in those areas. In places where ascariasis is common, people may be given deworming medicines as a preventive measure.
References
Bogitsh BJ, Carter CE. Intestinal nematodes. In: Bogitsh BJ, Carter CE, Oeltmann TN, eds. Human Parasitology . 4th ed. Waltham, MA: Elsevier Academic Press; 2012:chap 16.
Maguire JH. Intestinal nematodes (roundworms). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 288.
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Roundworm eggs - ascariasis - illustration
Roundworms are the most common type of worm infection. It is estimated that there are 4,000,000 cases in the United States at any time. Infection is more common in warm climates. Eggs are passed in the stool of infected animals and contaminate the soil. Ingestion of contaminated soil then leads to roundworm infection. (Image courtesy of the Centers for Disease Control and Prevention.)
Roundworm eggs - ascariasis
illustration
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Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
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Roundworm eggs - ascariasis - illustration
Roundworms are the most common type of worm infection. It is estimated that there are 4,000,000 cases in the United States at any time. Infection is more common in warm climates. Eggs are passed in the stool of infected animals and contaminate the soil. Ingestion of contaminated soil then leads to roundworm infection. (Image courtesy of the Centers for Disease Control and Prevention.)
Roundworm eggs - ascariasis
illustration
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Digestive system organs - illustration
The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.
Digestive system organs
illustration
Review Date: 11/14/2016
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
