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Biliary ascariasis--endoscopic aspects. Report of 4 cases.

Retrograde cholangiography was carried out in 4 small children with suspected roundworm infestation of the biliary tree. An adult-sized side-viewing fibre-optic duodenoscope was employed, and a general anaesthetic was given in each case. Roundworms were frequently seen protruding from the papillary orifice when biliary infestation was present. Cannulation of the duodenal papilla was shown to be eminently feasible in these small children, whose average weight was 12,4 kg. The degree of infestation and the response to vermifuge therapy could be determined with precision by retrograde cholangiography. It is suggested that this procedure has a place in the management of the complicated case of biliary ascariasis, and that it should certainly be considered when surgery is contemplated.

Ascariasis

[Comparison of the sensitivity of complement-fixation test and latex-fixation test in the demonstration of a migration phase of ascariasis (Ascaris suum) in a non-specific host].

The authors compared the sensitiveness of the complement-fixation reaction and the latex-fixation test in the demonstration of a migration phase of ascariasis in a non-specific host (rabbit). The sensitiveness of the latex-fixation test was higher by the value of one dilution of the geometric series, on an average.

Animals

Ascariasis of the gall bladder. Report of two cases.

A radiological diagnosis of ascariasis of the gallbladder was made in two middle-aged women with high abdominal pain having biliary colic characteristics. In one case round worm was demonstrated by means of the intravenous cholangiography, but in the other the procedure was negative only the common bile duct being contrasted. Oral cholangiography made some days later permitted the visualization of the parasite in the gallbladder. The patients were treated by cholecistectomy and choledocostomy and the diagnosis was confirmed. The post-operative course was uneventful. There was Ascaris lumbricoides ova in the feces and the histological examination of the removed gallbladder showed large eosinophilic infiltration in both cases. The patients received levamisole some days after surgery.

Adult

Surgical aspects of intestinal ascariasis.

At the University College Hospital, Ibadan, Nigeria, a common differential diagnosis of acute abdomen is intestinal ascariasis. This condition mimics many causes of acute abdomen so that accurate pre-operative diagnosis depends mainly on a high index of suspicion.The purpose of this paper is to call attention to this condition which is prevalent in tropical countries, where preventive and social medicine have not reached their peak, and to review the pathological processes resulting from this disease.

Abdomen, Acute

Biliary ascariasis presenting in the United States.

Infestation of the bile ducts by the adult Ascaris lumbricoides roundworm is a common condition in many parts of the world. The most frequent clinical presentation is as upper abdominal colicky pain with a normal or only slightly raised serum bilirubin. In most cases these worms can be visualized by intravenous cholangiography because of the absence of obstructive jaundice and can therefore be specifically treated by nonsurgical methods. The radiographic appearance is diagnostic. This is the first report of such a case presenting in North America or the United Kingdom, where the importance of biliary ascariasis in endemic areas is not fully appreciated.

Adult

[Effectiveness of antigens from various developmental stages of Ascaris suum in the deomonstration of the migratory phase of experimental ascariasis in pigs].

Tests of the efficiency of antigens prepared from different developmental stages of Ascaris suum in indirect haemagglutination test in the course of proving the migration phase of experimental ascariasis in pigs show that the antigens prepared by ultrasound from the invasive larval stage of A. suum in comparison with antigens of sexually mature stages have higher serological activity. By using this antigen it is possible to prove specific antibodies in experimentally invaded pigs from 6 to 120 days after invasion as opposed to the other tested antigens (the detectability of antibodies from the 7th-8th day to the 64th day after invasion).

Animals

[Comparison of the sensitivity of the passive, indirect hemagglutination reaction and the latex fixation test in the demonstration of the migratory phase of experimental ascariasis (Ascaris suum) in swine].

The authoresses verified diagnostic sensitivity of two serological tests -passive indirect hemagglutination [IHA] reaction modified by the authoresses and latex-fixation test [LFT] when proving the post-invasion migratory phase of ascariasis [Ascaris suum] in experimentally infected swine. The IHA reaction was found to be more sensitive than the LFT in most cases [62.2%] by two to three values of the geometric series. The invasion can be detected by the IHA reaction from 7th to 120th day and by the LFT from 7th to 49th day after invasion.

Animals

An evaluation of levamisole for treatment of ascariasis.

Levamisole (Decaris, Belgium) was tested in Iran, Brazil, and in Mississippi and Louisiana for its efficacy as a single-dose oral treatment for Ascaris infections. Subjects were children ages 2 to 15 years, and numbers treated with levamisole and comparative anthelmintics are as follows: 453 with levamisole; 461 with piperazine citrate; 17 with pyrantel pamoate; and 19 with a placebo. Cure rates and total reduction in mean egg counts observed were 92% and 98% respectively for levamisole and 66% and 90% for piperazine. Sixteen of 17 treated with pyrantel pamoate were cured. In none of the drugs were there notable side reactions, but in all four studies side effects were more frequent with piperazine than with levamisole. Levamisole was found to be a well-tolerated, highly effective single-dose ascaricide. It should prove to be particularly useful for mass chemotherapy in Ascaris control programs.

Adolescent

Ectopic ascariasis: report of a case with adult worms in the kidney.

Six adult Ascaris lumbricoides were found in the pelvis and calyces of the left kidney of a 25-year-old woman in Mexico. Prior to death three worms had emerged from a subcutaneous abscess which at autopsy was found to communicate with the colon through fistulas to the upper ureter above an occluding calculus, and from the renal capsule to the skin near the left iliac crest.

Adult

Epidemiology and mass-treatment of ascariasis in six rural communities in central Iran.

In six villages near Isfahan in central Iran 1,455 persons were examined for intestinal parasites. Those with Ascaris infection were treated with pyrantel pamoate in a single dose of 10 mg/kg body weight and all stools passed during 48 hours after treatment were collected in plastic pans and screened for worms which were then sexed and measured. Ascaris infection rates, 87--95% in the six villages before treatment, were reduced to 1--8% (average 5%) and the mean number of eggs in the feces was reduced from 19/mg to less than 1/mg. All age groups and both sexes were about equally infected, and the average number of worms expelled by treatment ranged from 16 per infected person below 5 years of age to 31 per person 20--39 years of age. Mature and immature worms together were expelled from persons treated at all seasons, indicating that worms were acquired and lost continuously throughout the year. Fecal examination at 2, 4, 6, and 12 months after treatment showed that the prevalence at 12 months had returned to the original level (87% vs. 91%) but the average intensity as reflected in egg-counts had not (10 vs. 19/mg feces). The findings confirm the necessity of repeated treatment at 2- to 3-month intervals.

Adolescent