Adventure Doc
keeping you healthy for life's adventures
Erik McLaughlin MD, MPH
Affiliates
ASCARIS LUMBRICOIDES
Basics:
Helminthitic infection of intestines that frequently are asymptomatic. Larger “worm burdens” may contribute to nutritional deficiency. Severe cases may cause bowel obstruction or bile/pancreatic duct obstruction, especially in children. Loeffler’s Syndrome (Tropical Pulmonary Eosinophelia) may occur as life cycle progresses through lungs.
Location:
Worldwide and common in moist tropical countries
Transmission/ Incubation:
Acquired by ingestion of infected eggs in uncooked produce, contaminated with infected human feces. Incubation period is dependent on life cycle (approx. 6 weeks).
Prevention:
Good sanitary practice, washing/cooking produce, education of locals to not defecate in fields
Diagnosis:
Evidence of Ascaris Eggs in fecal smear or passage of adult worms in feces/rectally
PRODUCT REVIEWS
Treatment:
Albendazole 400 mg orally one time dose (half dose for kids 12-24 months)
Fertilized eggs are oval or round and often covered by a rough coating (mammillated)
Ascaris Egg Fertilized (right) & Unfertilized (left)
images from
Fertilized Ascaris Eggs with Decorticated (no Mammillated shell) on right
Ascaris Egg Unfertilized with prominent Mammillations on the surface. Note the elongation of unfertilized eggs.
Adult Ascaris worm
Fertilized Ascaris Egg
This is acquired by eating soil infected with eggs of the worm or vegetables that have not been properly washed. Once the eggs are ingested, they become larvae (baby worms) and cut through the lining of the stomach and intestines to get into the blood stream. In the blood stream, the larvae travel to the lungs. Once in the lungs, they stop and grow for a few days. The larvae in the lungs can cause a cough and wheeze, know as Loeffler’s Syndrome. This cough causes the larvae to be brought up into the throat (with mucus) and swallowed back down into the stomach. Now, they grow into adult worms and begin to lay eggs which are passed in the infected person’s feces. When people defecate (poop) near their gardens, the eggs attach to the veggies. Children who eat dirt often get this, as well. Large “worm burdens” or large number of worms in the intestines can cause problems such as malnutrition, intestinal blockage and appendicitis. Treatment is with a drug called Albendazole.
