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Sonographic features of intestinal and biliary ascariasis in childhood: case report and review of the literature.

Despite the fact that Ascaris lumbricoides is one of the commonest intestinal infections in developing countries, there are very few reports in the literature about the sonographic findings of intestinal and biliary ascariasis in childhood. The clinical manifestations, diagnostic procedures and imaging appearance of intestinal and biliary ascariasis in two patients are discussed with a brief review of the literature.

Animals↗

Evolution of ascariasis in humans and pigs: a multi-disciplinary approach.

The nematode parasite Ascaris lumbricoides infects the digestive tracts of over 1.4 billion people worldwide, and its sister species, Ascaris suum, has infected a countless number of domesticated and feral pigs. It is generally thought that the putative ancestor to these worms infected either humans or pigs, but with the advent of domestication, they had ample opportunity to jump to a new host and subsequently specialize and evolve into a new species. While nuclear DNA makers decisively separate the two populations, mitochondrial sequences reveal that three major haplotypes are found in A. suum and in A. lumbricoides, indicating either occasional hybridization, causing introgression of gene trees, or retention of polymorphism dating back to the original ancestral species. This article provides an illustration of the combined contribution of parasitology, archaeoparasitology, genetics and paleogenetics to the history of ascariasis. We specifically investigate the molecular history of ascariasis in humans by sequencing DNA from the eggs of Ascaris found among ancient archeological remains. The findings of this paleogenetic survey will explain whether the three mitochondrial haplotypes result from recent hybridization and introgression, due to intensive human-pig interaction, or whether their co-occurrence predates pig husbandry, perhaps dating back to the common ancestor. We hope to show how human-pig interaction has shaped the recent evolutionary history of this disease, perhaps revealing the identify of the ancestral host.

Animals↗

A case of biliary ascariasis accompanied by cholelithiasis.

A 43-year-old Korean woman with biliary ascariasis accompanied by cholelithiasis is reported. Her chief complaints were abdominal pain, nausea, and vomiting. She had the past history of several attacks of abdominal pain in her childhood. Biliary stones were recovered from the left hepatic duct after cholecystectomy, which contained degenerated cuticle or body wall, and numerous eggs of Ascaris lumbricoides. It is strongly suggested that the biliary stones were formed from the dead Ascaris worm(s). This is a rare case of biliary ascariasis during the recent 5 years in Korea.

Adult↗

Biliary ascariasis: MR cholangiography findings in two cases.

We describe the imaging features of two cases of biliary ascariasis. Ultrasonography and CT showed no specific abnormal findings, but MR cholangiography clearly demonstrated an intraductal linear filling defect that led to the correct diagnosis. MR cholangiography is thus a useful technique for the diagnosis of biliary ascariasis.

Adult↗

Pulmonary ascariasis in tropical communities.

To determine the incidence of Loeffler's syndrome in a tropical region, a survey was conducted over a 1-year period in two locations in Colombia, South America, one inland and urban (Cali), the other rural and coastal (Guapi). Among 700 hospitalized patients, 12,000 patients coming to health centers, and 44 families with 328 members, 4 cases of Loeffler's syndrome were found--3 during the survey and 1 before it began. Only one was typical and of some severity. None of the family members developed a perceptible reaction to larvae, though surveillance was close and 83 new intestinal infections were documented. Infection rates for intestinal ascariasis were 25% to 30% in Cali, and 80% to 90% in Guapi. When infections in 30 families were eliminated, previous levels of infection were reached within 10 months. When undisturbed by treatment, the levels of intestinal infection remained stable or showed fluctuations which were not linked to climatic changes. In view of the high prevalence of infection and year-round transmission, which was assumed to occur frequently in the population, it is noteworthy that symptomatic pulmonary ascariasis appeared to be rare and complications from adult worms in heavy infections were uncommon. The findings suggest that frequent and uninterrupted contact between Ascaris lumbricoides and its host results in a high degree of natural tolerance and control.

Adolescent↗

Levamisole in ascariasis. A multicenter controlled evaluation.

An analysis is presented of 10 clinical studies from various countries where levamisole 50--150 mg was compared to pyrantel, piperazine, and placebo in a total of 1,734 patients, mostly children (levamisole: 830, controls: 904), suffering from ascariasis either as a single infection or usually mixed with other nematode infections. Degree of infection and efficacy of treatment were determined by quantitative coproparasitological methods. Levamisole produced higher cure rates (91%) and egg reduction rates (98%) than pyrantel, piperazine, or placebo. The efficacy of levamisole was unrelated to the patients' sex and age, the severity of infection, the presence of another worm infection, the type of associated worm infections, or the egg-counting technique. The overall incidence of reported adverse reactions was lower after levamisole than after piperazine, pyrantel or placebo; abdominal pain and headache, the most frequent complaints after levamisole, were related to the initial severity of ascariasis. Follow-up examinations 6 months after treatment suggested that levamisole might delay reinfection.

Adolescent↗

Pulmonary ascariasis.

A case of pulmonary ascariasis is reported for the first time in Australia. Because of increasing immigration from countries which have a high incidence of ascariasis (especially those of South-East Asia), and increasing travel to Asian countries, the awareness of this infestation as a cause of respiratory disease may be of great importance.

Ascariasis↗

Absorption of vitamin A in children with ascariasis.

Absorption of labelled vitamin A was studied in normal children and in children with round-worm infestation. Absorption of the vitamin was significantly low in children with ascariasis. In two subjects, in whom the studies were repeated, absorption of vitamin A was significantly increased after antihelminthic treatment. These results suggest that ascariasis may aggravate vitamin A deficiency by interfering with the absorption of the vitamin.

Acetates↗

Evaluation of two years of mass chemotherapy against ascariasis in Hamadan, Islamic Republic of Iran.

OBJECTIVE: To evaluate the mass treatment of ascariasis in rural areas of Hamadan Province, Islamic Republic of Iran. METHODS: A control programme in rural areas of Hamadan Province, which began in November 1997, involved giving all persons a single dose of 400 mg albendazole at intervals of three months. The efficacy of the treatment was evaluated by the formalin-ether concentration technique for stool examination and by the Stoll quantitative method. FINDINGS: The average rate of infection with Ascaris before treatment was 53.3%, ranging from 40% in Hamadan district to 75% in Toysercan. Two areas, Malayer and Nahavand, were excluded from the programme because the infection rates were only 13% and 4%, respectively. After two years of mass treatment the infection rate had decreased to 6%. The proportion of positive cases excreting only unfertilized eggs increased to 32%. No side-effects of mass treatment were observed. CONCLUSION: Systematic mass treatment giving high coverage proved to be very effective in the control of ascariasis, notwithstanding a lack of other preventive measures.

Albendazole↗

[Ascariasis of the gallbladder. Report of 2 cases and review of the literature].

Two patients who complained of a clinical picture compatible with cholelithiasis; and in whom the diagnosis of ascariasis of the gallbladder was made sonographically, are reported. In the first patient, cholecystectomy was curative and corroborated the presence of the roundworm. In the second patient, piperazine citrate was given. A second sonogram performed after therapy showed no roundworm within the gallbladder; and the patient remains asymptomatic until now. The usefulness of ultrasonography in the diagnosis of gallbladder ascariasis, and during surveillance in those patients who are managed with medical therapy only, is emphasized.

Adult↗

[A case of massive ascariasis in the riverside sector of the Riñihue lake, Chile].

A case of massive ascariasis in a three and a half years old girl who eliminated 104 worms after treatment with mebendazole is reported from a riverside sector of Riñihue Lake, Chile. Chilean literature about intestinal massive ascariasis is reviewed. Worms showed 12-29 cm of length and 0.2-5.5 g of weight. Total worms weighted 155.8 g.

Adult↗

[Ascariasis pancreatitis. Endoscopic diagnosis and therapy].

Ascariasis lumbricoides is a parasitic disease of the human gastrointestinal tract. Migration of the worm through orifices and into ducts leads to such complications as cholangitis and pancreatitis; even bile duct perforation by Ascaris have been reported. Treatment of biliary ascariasis is usually surgical, although endoscopic removal of the worm has been successfully performed. We report on a case in whom an Ascaris worm in the common bile duct led to acute pancreatitis; the worm was successfully removed endoscopically after performing papillotomy.

Ampulla of Vater↗

Ascariasis, respiratory diseases and production indices in selected Prince Edward Island swine herds.

The levels of production, ascarid burden and respiratory disease were measured on 15 purposively selected swine herds, and the relationships between the various measures of ascarid burden were examined. On each farm 30 randomly selected pigs were weighed and rectal fecal samples were collected at approximately 11, 15, 19 and 22 weeks of age, and at slaughter. Fecal ascarid-egg counts and duration of infection were combined to calculate a composite measure of ascarid burden called "lifetime burden". At the abattoir the carcass weight and levels of anteroventral pneumonia, atrophic rhinitis, and liver lesions were recorded for each hog. The number of ascarids in the small intestines were counted. Study hogs were marketed at an average of 189 +/- 22 days. The average dressed carcass weight was 77.0 +/- 5.9 kg and the mean average daily gain was 0.519 +/- 0.071 kg/day. The percent of hogs with ascariasis varied widely among farms, no matter what measure of ascariasis was used; the percent with intestinal ascarids at slaughter ranged from 0% to 96%, the percent that shed ascarid eggs during their lifetime ranged from 0% to 100%, and the range for hogs with liver lesions ranged from 27% to 100%. Of the hogs slaughtered, 82% had milk spot lesions, 32% shed ascarid eggs during their lifetime and 35% had intestinal ascarids. The latter had an average of 12 intestinal ascarids. Anteroventral pneumonia occurred in 55% of the slaughtered hogs and 9% had atrophic rhinitis scores of five. The percent of hogs per farm with pneumonia ranged from 17% to 96%. The percent of hogs per farm with atrophic rhinitis scores of five ranged from 0% to 57%.

Analysis of Variance↗

Biliary ascariasis.

A patient with biliary ascariasis was observed. The diagnosis was strongly suggested on endoscopic cholangiography. X-ray examination of the small bowel confirmed intestinal infestation and the stools were positive for ascaris lumbricoides. The incidence, symptomatology, diagnostic features, complications and therapy of biliary ascariasis are briefly discussed.

Adult↗

[Biliary ascariasis. A case of massive infestation; the importance of the peroperative choledoscopy].

Ascariasis of the biliary tract is rare in France, but not infrequent in French Guyana and West Indies. The case reported shows a massive infestation of the biliary tract in a 14 years old child and demonstrated the interest of per-operative choledocoscopy for diagnosis and treatment. Ascariasis of the biliary tract is a threatening disease in relation with the associated complications.

Adolescent↗

Gastric ascariasis.

Despite the ubiquity and varied manifestations of Ascaris lumbricoides infestation in man, gastric ascariasis is rare. Herein, three patients are described all of whom presented with features of chronic intermittent gastric outlet obstruction caused by roundworms inhabiting the stomach. The ascarides were demonstrated in the stomach by radiology in two patients and by endoscopic examination in one. The possible explanations for the rarity of "gastric ascariasis" include the "housekeeping" peristaltic activity and the acid milieu of the stomach.

Adult↗

Tumoral form of ascariasis: report of a case.

The authors report a case of a tumoral form of ascariasis in a 7-year-old boy, simulating a benign neoplasm. Microscopic examination revealed a marked granulomatous inflammatory reaction associated with dense fibroblastic proliferation and abscess formation around viable, embryonated Ascaris lumbricoides eggs. Pathogenesis of this rare clinical form of ascariasis is discussed.

Abscess↗

Mass control of ascariasis with single oral doses of levamisole. A controlled comparison in 3,056 subjects between three incomplete population coverages.

Ninety-, 60-, and 40-percent population coverages with levamisole 2.5 mg/kg of body weight were compared for their effects on Ascaris lumbricoides, ancylostoma, Strongyloides stercoralis, and Trichuris trichiura infections. They were shown to be effective in maintaining a reduced prevalence of A. lumbricoides in the treated subjects for 9, 6, and 3 months, respectively. Nine months after treatment, the prevalence of ascariasis was still lower than before treatment both in the levamisole and in the control subjects, regardless of the population coverage. This was probably because the egg output had been reduced. It is concluded that mass treatment with single oral doses of levamisole repeated at 3-month intervals might help control ascariasis, and that population coverages between 60 and 90% might be appropriate. No clear-cut effects against hookworms could be shown, possibly because the first follow-up examinations were performed three months after treatment. No changes in the prevalence of S. stercoralis and T. trichiura could be demonstrated. There were no adverse exp

Administration, Oral↗