ASCARIASIS

DIAGNOSIS,TREATMENT &

OTHER ROUND WORMS

Sreejaya T S
205
LABORATORY DIAGNOSIS
• Detection of the parasite
• egg detection
• adult worm detection
• larva detection

• Serology(antibody detection)

• Other methods- CBC

Detection of the parasite
• egg detection
• stool examination by saline &iodine wet mount- both fertilized and
unfertilized egg
• concentration techniques by sedimentation-if direct stool microscopy is
negative
• floatation method not preffered- unfertilized egg don’t float
• adult worm detection
• detected in stool or sputum - by naked eye
• Barium meal x-ray of the GIT- trolley car lines- when two worms lying
parallel
• USG or cholangiography- extra intestinal sites
• larva detection
• sputum/gastric aspirates - larvae
found during the early pulmonary
migratory phase,before egg appear
in the stool
Serology
• Antibodies can be detected by,
ELISA
IFA (indirect immunofluorescent antibody test)
IHA (indirect hemagglutination test)
Macro precipitation test using larva serology is useful:
• pulmonary phase ( incase stool microscopy fails)
• for seroepidemiological purpose
• helpful in extra intestinal ascariasis like Loeffler’s syndrome
other methods
• eosinophilia - early lung stage ,but disappears later
• charcot leydon crystals in sputum & stool

prevention
• preventing fecal contamination of soil
• avoid eating raw vegetables
• improvement of personal hygiene
• treatment of infected person especially the children
Treatment
• Antiparasitic drugs
• treated early to prevent potentially serious complications
• albendazole(400mg once), mebendazole(100g twice daily for 3 days or
500mg once)
• alternative drugs,
ivermectin(150-200mg/kg once)
& nitazoxamide
• in pregnancy- pyrantel pamoate is safe
• Symptomatic treatment
• partial intestinal obstruction - nasogastric suction,iv fluid administration
• complete obstruction - immediate surgical intervention
 Other Round worms
TOXOCARA
• Toxocara canis(in dogs) and T.cati(in cats)- natural parasites
• cause visceral larva migrans in humans
• transmission of larvae
in puppies - by transplacentally or lactogenically
kittens- only lactogenic
• older animals are infected by ingestion of mature eggs in soil or of larvae by
eating infected rodents,birds or other paratenic hosts
• eggs are shed in feces become infective in 2-3 weeks
• human infection is by ingestionof eggs
• larva hatch out in the small intestine→ penetrate the mucosa→ reach the
liver,lungs or other viscera
• they do not develop any further
• most infections are asymptomatic
• in young children,visceral larva migrans develops
• characterised by fever hepatomegaly,cough,pulmonary infiltrates,high
eosinophilia,and hyperglobulinemia
• in some cases eye is affected-ophthalmic larva migrans
Baylisascaris
• Baylisascaris procyonis an ascaris parasite of raccoons in North America
• cause visceral larva migrans,ophthalmic larva migrans & neural larva
migrans
• complications- blindness & central nervous system lesions ranging from
minor neuropsychiatric conditions to seizures,coma,and death
THANK YOU