ASCARIASIS

(ROUNDWORM INFECTION)
An infection caused by a parasitic roundworm,
ascaris lumbricoides
 ETIOLOGIC AGENT
ASCARIS LUMBRICOIDES:
 They are elongated, cylindrical worms that are
tapred at the oral proportion and pointed at
the anal end
 They are creamy and pinkish yellow when
fresh
 COMPLICATIONS
Ω Biliary tract obstruction, patient develops
cholestatic jaundice
Ω Hepatic abscess and cholangitis
Ω Intestinal obstruction, perforation, peritonitis
Ω Malnutrition due to damage of the intestinal
mucosa impairing the absorption of the
nutrients
 EMBRYONATED STAGE SYMPTOMATOLOGY
1. EMBRYONATED STAGE
Soil contamination with human excreta
Contamination of food, water and other objects
Ingested to intestine
2. LARVAL STAGE
The larvae penetrate the wall of the intestine Nausea and vomiting, poor
(duodenum) appetite
The larvae picked up by lymphatics or blood Periumbical pain
stream
They are carried to the liver Right upper quadrant pain
They may reach the heart
Sometimes they are carried to the billiary tract

They may reach the stomach, esophagus, to the

upper resptiratory tract

They may stay in the capillaries of the lungs, to Cough, fever, rales, blood-tinged
the alveoli where they grow and molt for ten days sputum
 DEVELOPMENTAL STAGE SYMPTOMATOLOGY

From the alveoli, they migrate to the Nasal pruritus if larvae reach the nose
bronchioles, bronchi, trachea, epiglottis

Ascaris in the larvae stage maybe Colicky, periumbical pain aggravated by

swallowed of ingested cold stimulation (NAKAMURA sign)

3. ADULT

Adult ascaris stays in the small intestine Intestinal obstruction maybe caused by
bolus of entangled worms which may be
palpable

At times they become erratic that they go Severe abdominal pain associated with
to the stomach to the esophagus, and vomiting
sometimes to the common bile duct and gall
bladder

In the GIT, they copulate. The female lays

egg about 2 to 3 months after embryonated
eggs are ingested
 DIAGNOSTIC TESTS TREATMENT

Stool for ova Albendazole or

Abdominal X-ray mebendazole
Routine blood Piperazine citrate
counts Pyrantel pamoate
 NURSING INTERVENTION
Isolation of the patient
Preventive measures in each home and in the
community should be reinforced
All members of the family must be taught of
health matters
Availability of toilet facilities must be ensured
Importance of personal hygiene should be
explained
 PREVENTION
Improved sanitation and
hygienic practices
Improved nutrition
Deworming may be advised
 CANDIDIASIS
(MONILIASIS/CANDIDOSIS)

Is a mild superficial fungal infection

caused be genus candida
Infects the nails (onychomycosis),
the skin (diaper rash), mucous
membrane, particularly the
oropharynx (thrush), vagina
(monillasis), esophagus, and the GIT
 INFECTIOUS AGENT
CANDIDA ALBICANS
1. These organism are part of the normal flora of the GIT, mouth,
vagina, skin
2. They cause infection when;
a. There is rise in glucose as in DM
b. The person’s resistance is lowered especially when due to cancer
c. The person is taking an immunosuppresive drug, exposed to
radiation, aging or when infected with HIV
d. The level of estrogen rises in pregnant women
e. These organism are introduced systemically by IV or urinary
catheters, drug abuse, hyperlimentation, or surgery
f. Broad-expectrum antibiotics are used, as these depress flora and
allow candida microbes to proliferate
 SIGNS AND SYMPTOMS
Scaly skin
Nails are red and swollen
Oropharyngeal mucosa (thrush)
Patient feels retrosternal pain and regurgitation
Vaginal mucosa – white or yellow discharge with pruritus
and local excoriation; white or gray patches on vaginal walls
with local inflammation
Renal system – fever, flank pain, dysuria, hematuria, pyuria
Pulmonary – hemoptysis, fever, cough
Brain – headache, nuchal rigidity, seizures
Endocardium - systolic or diastolic murmur, fever, chest
pain
eyes – blurred vision, orbital or periorbital pain
 DIAGNOSTIC TEST

Stool culture
Gram staining of skin, vaginal
discharge or scraping
 TREATMENT PREVENTION

Nystatin, for oral Check high risk

thrush patient daily for
Clitrimasole, patchy areas of
fluconasole, irritation, sore
ketoconasole, for throat, and gum
mucous membrane bleeding
and vaginal infection Check vaginal
Fluconasole or discharge and note
amphoteric for the color, odor, and
systemic infection amount