ascariasis

chained_bear Also seen here. (Not for people who don't like bugs.) Apr 16, 2009

thegirl http://www.emedicine.com/med/topic172.htm

Ascariasis is the most common helminthic infection, with an estimated worldwide prevalence of 25% (>1.25 billion people). Usually asymptomatic, infections are most prevalent in tropical and developing countries, where they are perpetuated by contamination of soil by human feces or use of untreated feces as fertilizer. Symptomatic disease may be manifested by growth retardation, pneumonitis, intestinal obstruction, or hepatobiliary and pancreatic injury. In developing countries, ascariasis may exist as a zoonotic infection associated with exposure to pigs or pig manure.

Intestinal obstruction in children is the most commonly attributed fatal complication, resulting in 8000-100,000 deaths per year, according to the World Health Organization. Besides direct obstruction of the bowel lumen, toxins released by live or degenerating worms may result in bowel inflammation, ischemia, and fibrosis.

History:
Symptoms include cough, dyspnea, asthma, and chest pain (during the initial lung migration). This may be seasonal in some countries, such as Saudi Arabia.
Abdominal pain, distension, colic, nausea, anorexia, and intermittent diarrhea may be manifestations of partial or complete intestinal obstruction by adult worms.
Jaundice, nausea, vomiting, fever, and severe or radiating abdominal pain may suggest cholangitis, pancreatitis, or appendicitis.

Physical:
Rales, wheezes, and tachypnea may be present during pulmonary migration.
Abdominal distension is nonspecific but is often observed in children with worms.
Abdominal tenderness, especially in the right upper quadrant, hypogastrium, or right lower quadrant, may suggest complications of ascariasis.


Jan 6, 2007