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PubMed2006

[Ascariasis is a zoonosis in Denmark--secondary publication].

It has been claimed that Danish cases of human ascariasis have been acquired either during travel to other countries or through consumption of untreated food imported from areas where human ascariasis is endemic. An epidemiological survey in Viborg County indicated, however, that pigs are the primary source of the infection. Our population-genetic investigations have now confirmed this hypothesis. The main transmission route for human ascariasis in developed countries therefore seems to be from pigs to people; thus, it is essential that contact with pig manure be avoided, especially by young children.

Animals↗
PubMedDate not supplied

[Biliary ascariasis. Case report and review of the literature].

BACKGROUND: Ascaris lumbricoides is the most common nematode found in the human gastrointestinal tract with a greater prevalence found in developing tropical and subtropical countries. Most cases of ascariasis follow a benign course. In some cases the adult parasite can invade the biliary or pancreatic ducts and cause obstruction with development of cholecystitis, cholangitis, pancreatitis, and hepatic abscesses. We report a case of a patient with biliary ascariasis. CLINICAL CASE: A 40-year-old woman, born and residing in San Cristobal de las Casas, Chiapas, was admitted with right upper quadrant pain of 2-week duration. Pain was accompanied by nausea, vomiting and fever. Exploration revealed pain upon deep palpation of right hypochondria. Laboratory examinations demonstrated elevation of alkaline phosphatase without jaundice, leukocyte count of 14,300 and ultrasonography with ascaris within the gallbladder and intra- and extrahepatic ducts without evidence of dilatation. Medical treatment with mebendazol was begun orally; nevertheless, on the second day the patient reported an increase of the right hypochondria pain, vomiting and fever of 38 degrees C. Surgical treatment was decided upon. An open cholecystectomy was performed without evidence of parasites within the gallbladder. Expansion of the extrahepatic bile ducts was observed and a formal biliary exploration was carried out with extraction of 19 ascarids and colocalization of choledocostomy T-tube. At the third postoperative day, a T-tube cholangiography was done, showing residual ascarids in the biliary ducts that were resolved with a retrograde endoscopic cholangiopancreatography. The patient's evolution was without complications or fever and with adequate oral feeding posterior to biliary instrumentation. CONCLUSIONS: In obstructive biliary pathology, biliary ascariasis is a diagnosis that needs to be explored in our country. Knowledge of clinical symptoms, complications, and diagnostic and therapeutic options are of paramount importance for all health professionals in our country.

Adult↗
PubMedDate not supplied

Biliary ascariasis associated with chronic calcific pancreatitis of the tropics.

A case of biliary ascariasis associated with Chronic Calcific Pancreatitis of the tropics in a 50-year-old lady is reported. Although acute pancreatitis is a common complication of biliary ascariasis, there are no reports linking ascariasis to chronic pancreatitis. The association of these two entities in the present case is most probably coincidental as both these entities are not very uncommon in coastal Orissa.

Animals↗
PubMed1990

A critical assessment of abattoir surveillance as a screening test for swine ascariasis.

The following data on ascarid burden were collected on an individual basis for 380 hogs marketed in the fall of 1987: a series of fecal ascarid-egg counts during the growing period; the level of milk spot lesions on the liver at slaughter; and the number of ascarids in the small intestines at slaughter. The presence of milk spots had a high sensitivity, very low specificity, and a high negative predictive value as a screening test for ascariasis in individual hogs. Results were consistent whether ascariasis was measured as the presence of intestinal ascarids at slaughter (sensitivity 91%, specificity 22%, negative predictive value 82%), or by a positive fecal egg count during the hog's lifetime (sensitivity 96%, specificity 24%, negative predictive value 93%). The presence of milk spots does not necessarily indicate that an ascarid infection has been established in the small intestine. The absence of milk spots, however, is a reliable indicator of the absence of an established ascarid infection, provided that the prevalence of ascariasis is equal to or less than that observed in this study. The severity of the ascarid infection in an individual hog could not be ascertained by the number of milk spot lesions on the liver.

Abattoirs↗
PubMed1989

Single dose therapy of ascariasis--a randomized comparison of mebendazole and pyrantel.

A multicentre, randomized trial was carried out to compare the efficacy of two single-dose treatments for ascariasis: mebendazole 200 mg, and pyrantel 10 mg/kg. Each centre enrolled 200 patients with a suspected diagnosis of ascariasis, 100 for each treatment, and the treatments were randomized for each centre. To confirm the diagnosis, stools were examined for eggs of Ascaris lumbricoides by Kato's thick smear method. Efficacy was evaluated by stool examination repeated three weeks after treatment by a "blind" technician using two methods, viz. Kato's thick smear method and the zinc sulfate flotation method. Cure was defined as absence of ascaris eggs in the stools by both methods. Of the 600 enrolled patients, 32 were excluded from analysis as their initial stool examination was negative, and 568 completed the trial: 284 on each treatment. The cure rate was 80 per cent in the mebendazole group and 90 per cent in the pyrantel group (P less than 0.01). Thus pyrantel was found to be significantly more efficacious than mebendazole for single-dose treatment of ascariasis.

Adolescent↗
PubMed1989

Biliary ascariasis.

The clinical presentation of 12 cases with biliary ascariasis is reported. Ultrasonography was employed to demonstrate worms in the gallbladder and common bile duct preoperatively. Ten cases were operated upon and operative findings were compared to assess the accuracy of sonography in biliary ascariasis. Our results show that ultrasonography can be relied upon for the demonstration of biliary tract ascariasis.

Adolescent↗
PubMedDate not supplied

Prevalence of ascariasis and ancylostomiasis in families: a collaborative inquiry.

A collaborative survey was carried out to estimate the prevalence of ascariasis and ancylostomiasis in random samples of 200 families in each of 3 different communities: a city slum (CS), an industrial township (IT), a farming village community (FVC). Stool examination was done by Kato's qualitative thick smear method. Ascariasis was prevalent in all the three communities; the percentage of families with multiple members infected varied from 50 to 91 per cent; the percentage of members infected within such a family varied from 48 to 74 per cent; the infection was highly prevalent (41-78%) in all age groups excepts adults in the IT. From 8 to 11 per cent of persons with ascariasis were negative on stool examination but passed worms after medication. Ancylostomiasis was arevelent mainly in the FVC and to a less extent in the IT; the percentage of families with multiple members infected was 83 per cent in the FVC and 17 per cent in the IT; the percentage of members infected within such a family was 54 per cent in the FVC and 58 per cent in the IT. All the persons surveyed received a single 10 mg/kg dose of pyrantel pamoate (Combantrin*, Pfizer) which was well tolerated.

Ancylostomiasis↗
PubMed1986

[Biliary ascariasis].

Biliary ascariasis is a complication of intestinal ascariasis. This results in characteristic findings in the intravenous cholangiocholecystogram and in the sonogram. Characteristic signs of biliary ascariasis are, in the longitudinal section, the "strip sign", "spaghetti sign", "inner tube sign", and in transverse section "a bull's eye in the triple O". The helminth can travel from out of the biliary duct system back into the intestines, so that control examinations can even be negative.

Ascariasis↗
PubMed1985

Biliary ascariasis. A common cause of biliary and pancreatic disease in an endemic area.

We prospectively evaluated the incidence, clinical features, radiographic findings, and course of biliary and pancreatic disease caused by ascariasis in an endemic area in India. Ascariasis was an etiologic factor in 40 (36.7%) of the 109 patients studied who had biliary and pancreatic diseases. Disease was prevalent in adult women and was associated with recurrent biliary colic in 38 patients (95%), recurrent pyogenic cholangitis in 27 patients (68%), acalculous cholecystitis in 9 patients (23%), and pancreatic disease in 6 patients (15%). Vomiting of roundworms during biliary colic occurred in 19 patients (48%) and often led to confirmation of biliary ascariasis by direct visualization of the biliary tree. Endoscopic retrograde cholangiopancreatography was an excellent diagnostic tool and often demonstrated worms in the dilated common bile duct and intrahepatic ducts. The worms moved actively into and out of the biliary tree from the duodenum. Thirty-six (90%) patients recovered on symptomatic treatment followed by anthelmintic therapy once acute symptoms subsided. Surgery was needed in 4 patients, as the worms were trapped in the ducts and had led to the formation of common bile duct and intrahepatic duct stones with the worm fragment as the nidus.

Adolescent↗
PubMed1965

Research on ascariasis immunity and immunodiagnosis.

The pattern of antibody response to Ascaris in the blood of experimentally infected human beings, pigs and laboratory animals indicates that immunity to ascariasis develops mainly under the effect of migrating larvae. The antibody can be demonstrated in the microprecipitation test on live larvae in vitro and in the agglutination test with carmine-adsorbed antigen. The antibodies can be detected 5-10 days after infection and remain in the blood for 90-100 days.The pattern observed in the increase in antibody titre permits the use of serological reactions both for diagnosis of the early phase of ascariasis and for investigation of a number of problems in the epidemiology of this infection. Application of immunological methods in mass surveys of the population makes it possible to correct existing conceptions of the duration of the season of infection, the extent of infection and the risk of infection in foci of ascariasis.

Animals↗
PubMedDate not supplied

[The effect of different factors on the epidemic process in ascariasis (exemplified by Tula Province)].

An epidemiological process in ascariasis in Tula Province within a 16-year period during which there were no significant socioeconomic changes is analyzed. Improved water consumption, the scope and level of waste-water disposal and sewage treatment along with intensive efforts to detect the foci of ascariasis and with the implementation of health-promoting measures in them are shown to have the most considerable influence on the reduction in the intensity of an epidemiological process in ascariasis. These findings may be useful in gaining some insight into the efficiency of health-promoting measures in the foci where sewage treatment is inadequate and water supply is poor.

Adolescent↗
PubMedDate not supplied

Biliary ascariasis. A case report.

Ascaris lumbricoides is a worldwide intestinal infestation that may cause various complications. Biliary ascariasis, however, is a rare condition. We describe a child with biliary ascariasis. The patient's clinical symptoms were pain, vomiting and abdominal tenderness, and she was thought to have acute appendicitis. However, laboratory examination revealed high serum alkaline phosphatase and amylase levels, and ultrasonography and percutaneous cholangiography demonstrated biliary ascariasis. The patient was successfully treated with mebendazole and antispasmolytic drugs.

Antinematodal Agents↗
PubMedDate not supplied

Peripheral and nasal eosinophilia and serum total immunoglobulin E levels in children with ascariasis.

In order to evaluate peripheral and nasal eosinophilia and serum total IgE levels in ascariasis, 30 children between two and 12 years of age whose fecal samples were found to contain Ascaris lumbricoides, and 30 children between 1.5 and 12 years of age who did not have ascaris in their fecal samples, were enrolled in the study. Peripheral eosinophil counts and serum total IgE levels were significantly higher in the study group, but there was no significant difference between the nasal eosinophil counts of the two groups. Since total serum IgE levels differ according to age, the patients and the control groups were also evaluated within three age-groups. Peripheral eosinophil counts and serum total IgE levels of patients with ascariasis in all age ranges were significantly higher, but nasal eosinophil values did not differ significantly. These results show that in ascariasia the presence of peripheral eosinophilia and high total serum IgE levels are similar to those in atopic diseases, and some allergic symptoms such as nasal itching can be caused by parasites. However, nasal itching does not correlate with nasal eosinophilia in ascariasis. This is an important feature in the differential diagnosis.

Animals↗
PubMed1997

Ascariasis and hookworm.

Ascariasis and hookworm (ancylostomiasis) remain the most common intestinal nematodes in the world with significant economic, social, and medical impact. An understanding of the transmission and pathogenesis of ascariasis and hookworm are necessary to recognize their clinical manifestations and to manage the pulmonary sequelae of infection. Transmission occurs predominantly in the tropics and rural areas where there is suboptimal sanitation, personal hygiene, and education regarding these parasites. Ascariasis generally occurs through hand-to-mouth ingestion of agricultural products or food contaminated with parasite eggs. Hookworm is transmitted through larval penetration of the skin. Larval pulmonary migration generally is asymptomatic. However, symptomatic pulmonary disease may occur with fever, cough, chest pain, hemoptysis, dyspnea, and wheezing due to (1) Loffler's syndrome, (2) the effects of larval tissue migration, (3) airway reactivity or bronchospasm, (4) infectious bacterial complications from parasitic migration and associated aspiration, and rarely (5) chronic eosinophilic pneumonia, transdiaphragmatic penetration, or symptoms of upper airway obstruction. Clinical evaluation shows pulmonary opacities on chest radiograph, peripheral blood eosinophilia, and larvae in respiratory or gastric secretions. Symptomatic treatment may be necessary with bronchodilators and systemic steroids or antibiotics for bacterial complications. The drug of choice is mebendazole (Vermox) 100 mg twice a day for 3 days. Alternatives include a single dose of pyrantel pamoate (Antiminth) 11 mg/kg (maximum dose, 1 g) or albendazole (Zentel) 400 mg orally once. Invermectin (Mectizan) is available through the World Health Organization, and, in the United States, through the manufacturer on a compassionate-use basis. Ivermectin is as effective as currently available drugs against Ascaris but shows only partial efficacy against hookworms, which infest humans. Preventive measures, improvement of sanitary facilities, education, and school screening may be important in the endemic areas to control these parasitic infections.

Animals↗
PubMed1996

Sonography of hepatobiliary ascariasis.

We present the real-time sonographic features of 19 surgically proven cases of hepatobiliary ascariasis, in which ultrasound examination was the primary modality used to achieve the diagnosis. All the patients presented with right upper quadrant abdominal symptoms. There were no false positive diagnoses. The "impacted worm" sign, reported here for the first time, presented in two patients as long curved, tubular, non-shadowing structures with echoluscent cores, in the distribution of the intrahepatic biliary ducts. Both of these patients died soon after surgery indicating poor prognosis in such cases. Two other patients are described in whom macerated round worms were seen as intraluminal, localized, soft tissue masses in the common duct mimicking a cholangiocarcinoma. Thus, biliary ascariasis must be added to the differential diagnosis of an intraluminal bile duct mass in patients from endemic areas.

Adolescent↗
PubMedDate not supplied

Ultrasound in the diagnosis of gallbladder ascariasis.

Ascariasis is the most common helminthic infection, but the invasion of worms into the gallbladder is quite rare. This report illustrates the ultrasonographic findings in gallbladder ascariasis of a typical echogenic structure which exhibits nondirectional movements and contains a central anechoic tube, along the long axis of the gallbladder. The role of ultrasound as a diagnostic tool and in the follow-up treatment is stressed.

Animals↗
PubMed1988

Effect of ascariasis and its treatment on drug absorption.

Ascariasis has been reported to impair the absorption of nutrients, vitamin A, and D-xylose, which is corrected on treatment. The effect of ascariasis and its treatment on the absorption of sulphadimidine and isoniazid has been investigated. There was no difference between drug absorption before and after the treatment or in comparison with a normal population.

Ascariasis↗
PubMed2001

Biliary ascariasis.

Biliary ascariasis is a less frequent, but important complication of ascaris infestation, because it may cause biliary colic, pyogenic cholangitis, and septicemia. Early diagnosis and treatment is important to prevent these complications. We present here a five-year-old girl with biliary ascariasis, whose main complaint was abdominal pain. After giving piperazin salt, multiple ascaris worms were seen in the stool within 10 days. She is at the follow-up without any complication.

Abdominal Pain↗