Bongat, Jan Pearl B. N103, GROUP B1 Mrs.

Gina Batasin-in, RN, MN

ASCARIASIS Ascariasis is a human disease caused by the parasitic roundworm Ascaris lumbricoides.

Ascariasis occurs when worm eggs of the parasite Ascaris lumbricoides commonly found in soil and human feces are ingested. The eggs can be transmitted from contaminated food, drink, or soil. The roundworms range in size from 5.9 to 9.8 inches for adult males and 9.8 to 13.8 inches for adult females. The worms can grow to be as thick as a pencil and can live for 1 to 2 years. Ascariasis is frequently found in developing countries where sanitary conditions are poor or in areas where human feces are used as fertilizer. When the eggs are swallowed and passed into the intestine, they hatch into larvae. The larvae then begin to move through the body. Once they get through the intestinal wall, the larvae travel from the liver to the lungs through the bloodstream. During this stage, pulmonary symptoms such as coughing (even coughing up worms) may occur. In the lungs, the larvae climb up through the bronchial tubes to the throat, where they are swallowed. The larvae then return to the small intestine where they grow, mature, mate, and lay eggs. The worms reach maturity about 2 months after an egg is ingested from the soil. Adult worms live and remain in the small intestine. A female worm can produce up to 240,000 eggs in a day, which are then discharged into the feces and incubate in the soil for weeks. Children are particularly susceptible to ascariasis because they tend to put things in their mouths, including dirt, and they often have poorer hygiene habits than adults. Ascariasis is common in warmer or tropical climates, particularly in developing nations, where it can affect large segments of the population. Ascariasis is rare in the United States, due to strict sanitation rules and regulations.


In larval ascariasis. including: • • • • • • vomiting shortness of breath abdominal distention (swelling of the abdomen) severe stomach or abdominal pain intestinal blockage biliary tract blockage (includes the liver and gallbladder) First appearance of eggs in stools is 60–70 days. the more severe a child's symptoms are likely to be. Symptoms seen with mild infestation include: • • • • • worms in stool coughing up worms loss of appetite fever wheezing More severe infestations can result in more serious signs and symptoms. The final symptoms are gastrointestinal discomfort. and observation of live worms in stools. fever.SIGNS AND SYMPTOMS Although no symptoms may occur. Some patients may have pulmonary symptoms or neurological disorders during migration of the larvae. symptoms occur 4–16 days after infection. . colic and vomiting. Kids are more likely than adults to develop gastrointestinal symptoms because they have smaller intestines and are at greater risk of developing intestinal obstruction. the greater the number of worms involved in the infestation.

sometimes with whirled appearance (bolus of worms).Causes slow immobilization and death of the worms by selectively and irreversibly blocking uptake of glucose and other nutrients in susceptible adult intestine where helminths dwell. If used by itself it causes the worm to be passed out in the feces. TREATMENT The doctor will usually prescribe antiparasitic medication to be taken orally to kill the intestinal roundworms. which prevents migration when treatment is accomplished with weak drugs such as thiabendazole. 15–35 cm long filling defects. A child who has ascariasis should be evaluated for other intestinal parasites.A flaccid paralyzing agent that causes a blocking response of ascaris muscle to acetylcholine. Sometimes the stool will be re-examined about 3 weeks after treatment to check for eggs and worms. Dosage is 75 mg/kg (max 3. such as pinworm. may induce complete intestinal • • . surgical removal of the worms may be necessary (particularly in cases of intestinal or liver-related obstruction. Very rarely. Larvae may be found in gastric or respiratory secretions in pulmonary disease.DIAGNOSIS The diagnosis is usually incidental when the host passes a worm in the stool or vomit. Spastic (tetanic) paralyzing agents.Depolarizes ganglionic block of nicotinic neuromuscular transmission. On X-ray. Symptoms usually disappear within 1 week of starting treatment. Stool samples for ova and parasites will demonstrate Ascaris eggs. Pyrantel pamoate . or abdominal infection). Oral dosage is 100 mg 12 hourly for 3 days. Pharmaceutical drugs : • Mebendazole .5 g) as a single oral dose. resulting in spastic paralysis of the worm. in particular pyrantel pamoate. Piperazine . The narcotizing effect immobilizes the worm. Blood counts may demonstrate peripheral eosinophilia.

so it is usually combined with piperazine. Keep your child's fingernails short and clean. Dosage is 400 mg given as single oral dose (contraindicated during pregnancy and children under 2 years).• • • obstruction in a heavy worm load. the sudden death of the worms may cause bowel obstruction. immobilization. PREVENTION The most important measure of protection against ascariasis is the safe and sanitary disposal of human waste. These practices are recommended for all children: • • • • • • Try as much as possible to keep kids from putting things in their mouths. Albendazole A broad-spectrum antihelminthic agent that decreases ATP production in the worm. pajamas. Sterilize any contaminated clothing. Areas of the world that use human feces as fertilizer must thoroughly cook all foods or clean them with a proper iodine solution (particularly fruits and vegetables). Have your pets checked for worms regularly. Teach kids to wash hands thoroughly and frequently. especially after using the bathroom and before eating. requiring surgical intervention. and bedding. corticosteroids can treat some of the symptoms. such as inflammation. which can transmit eggs. Thiabendazole -This may cause migration of the worm into the esophagus. causing energy depletion. In some cases with severe infestation. Dosage is 11 mg/kg not to exceed 1 g as a single dose. . Kids who live in underdeveloped areas of the world may be prescribed a preventive deworming medication. Additional sanitation measures in or around your home may be necessary. and finally death. Also. Evaluate the source of the infection. Children who are adopted from developing nations are frequently screened for worms as a precautionary measure.

b.NURSING CARE Emphasize: • • • • • • Children and adults must be provided with clean. Careful disposal of stools. . In hospital. comfortable toilets. teach mother about: a. All infected persons must receive treatment. Proper hygiene and sanitation. Careful washing of toy. raw vegetables. Children must be taught to use tissue for each defecation Wash hands after defecation and before feeding.

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