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 tests
1st tests to order
- stool microscopy
- chest x-ray
- abdominal x-ray
Tests to consider
- sputum/gastric aspirate microscopy
- CBC
- contrast study
- barium follow-through
- abdominal ultrasound
- abdominal CT
- ERCP
Emerging tests
- antibodies to Ascaris lumbricoides
- serum IgE
- interleukin (IL)-4, IL-5, and IL-13
- urine-based gas liquid chromatography
Treatment algorithm
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 declares that he has no competing interests.
Acknowledgements
Dr Michael Cappello would like to gratefully acknowledge Dr Samantha H. Johnston and Dr Claire Panosian, previous contributors to this topic.
Disclosures
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
World Health Organization. Soil-transmitted helminthiasis. Jan 2023 [internet publication].Full text
Centers for Disease Control and Prevention. Parasites - ascariasis: resources for health professionals. May 2020 [internet publication].Full text
World Health Organization. Preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups. September 2017 [internet publication].Full text
Khuroo MS. Ascariasis. Gastroenterol Clin North Am. 1996;25:553-577. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Asthma
- Viral gastroenteritis
- Amebiasis
More DifferentialsGuidelines
- CDC Yellow Book: health information for international travel - helminths, soil-transmitted
- Preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups
More Guidelines
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