Ascariasis

Last reviewed: 7 Jun 2022
Last updated: 26 May 2020

Summary

Definition

History and exam

Key diagnostic factors

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

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
Other diagnostic factors

Risk factors

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

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

Treatment algorithm

ACUTE

asymptomatic

pneumonitis

gastrointestinal symptoms

Contributors

Authors

Michael Cappello, MD

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.

Acknowledgements

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 reviewers

Yann Meunier, MD

Director

Stanford Health Promotion Network

Stanford School of Medicine

Palo Alto

CA

Disclosures

YM declares that he has no competing interests.

Mohammad Bagher Rokni, PhD

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.

  • Ascariasis images
  • Differentials

    • Asthma
    • Viral gastroenteritis
    • Amebiasis
    More Differentials
  • Guidelines

    • CDC yellow book 2020: Travel-related infectious diseases - helminths, soil-transmitted
    • CDC yellow book 2020: Travel-related infectious diseases - helminths, soil-transmitted
    More Guidelines
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