Last reviewed: August 2020
Last updated: May  2020

Summary

Definition

History and exam

Key diagnostic factors

  • travel to, or immigration from, endemic areas with poor sanitation, hygiene, and agricultural practices

Other diagnostic factors

  • asymptomatic
  • co-infection with other parasites
  • developmental delay
  • malnutrition
  • fever
  • cough
  • wheezing
  • dyspnea
  • hemoptysis
  • hypoxia
  • tachypnea
  • rhonchi, rales
  • retractions
  • urticarial skin lesions
  • abdominal pain
  • anorexia
  • dyspepsia
  • nausea
  • vomiting
  • diarrhea
  • constipation
  • abdominal distension
  • reduced or absent bowel sounds
  • hypotension
  • RUQ tenderness
  • hepatomegaly
  • jaundice
  • signs/symptoms of iron deficiency anemia or kwashiorkor

Risk factors

  • history of travel to or residence in endemic areas
  • children <14 years
  • poverty
  • poor sanitation
  • poor hygiene
  • warm climate
  • contact with pigs

Diagnostic investigations

1st investigations to order

  • stool microscopy
  • chest x-ray
  • abdominal x-ray
More 1st investigations to order

Investigations to consider

  • sputum/gastric aspirate microscopy
  • CBC
  • contrast study
  • barium follow-through
  • abdominal ultrasound
  • abdominal CT
  • ERCP
More investigations to consider

Emerging tests

  • antibodies to Ascaris lumbricoides
  • serum IgE
  • interleukin (IL)-4, IL-5, and IL-13
  • urine-based gas liquid chromatography
More emerging tests

Treatment algorithm

Contributors

Professor of Pediatrics, Microbial Pathogenesis, and Public Health

Yale School of Medicine

New Haven

CT

Disclosures

MC has provided a day of consulting services to Janssen Pharmaceuticals, manufacturers of mebendazole for the treatment of soil transmitted helminth infections. MC does not currently receive consulting fees or research support.

Dr Michael Cappello would like to gratefully acknowledge Dr Samantha H. Johnston and Dr Claire Panosian, previous contributors to this topic. SHJ owns a share in a company (Merck & Co., Inc.) that produces ivermectin, an alternative therapy for ascariasis. CP declares that she has no competing interests.

Peer reviewersVIEW ALL

Director

Stanford Health Promotion Network

Stanford School of Medicine

Palo Alto

CA

Disclosures

YM declares that he has no competing interests.

Associate Professor

Department of Medical Parasitology and Mycology

School of Public Health

Tehran University of Medical Sciences

Iran

Disclosures

MBR declares that he has no competing interests.

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