[Ascariasis; portal vein migration of numerous adult worms; necrotic foci of the liver of peculiar morphology; review of ascariasis, with special reference to the liver].
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Adult↗
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[Pulmonary ascariasis with eosinophilia in a case of ascariasis].
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Ascariasis↗
Control of the action of diguanyl, an alantic lactone, piperazine hydrate and piperazine phenylacetate in ascariasis; papa control activated in ascariasis and trichocephalosis.
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Anthelmintics↗
Ascariasis complicating a gunshot wound: case report and review of the complications of ascariasis.
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Ascariasis↗
Reduction in the incidence of biliary and other surgical complications of ascariasis according to the decrease of its national egg prevalence in Korea.
While various examples of rationale or benefits of ascariasis control could justify a necessity of control activity in a community, few practical index other than the egg prevalence or intensity of infection has been used to evaluate the efficacy obtained by the control activity. A literature-based retrospective study was undertaken to provide some numerical data on the decreasing morbidity of surgical ascariasis as a consequence of ascariasis control in Korea. A thorough review of literatures (1959-1990) on biliary and other surgical complications of ascariasis reported from general hospitals revealed that their incidence has been decreasing very proportionally to the national figures of its egg prevalence and worm burden. For example, according to the remarkable decreases of the prevalence of ascariasis, there is an evident decreasing tendency of the proportion (%) of biliary ascariasis cases among all biliary surgical patients and the proportion of biliary ascariasis cases among all biliary stone patients in general hospitals. It is highly suggested that the Korean people have been much benefited by the control activity of ascariasis executed at a national scale since 1960s, especially in terms of incidence of biliary and other surgical complications of ascariasis.
Ascariasis↗
Role of ascariasis in surgical abdominal emergencies in the Rangoon Children's Hospital, Burma.
Patients aged 1 month to 12 years admitted with an acute abdominal surgical condition comprising 226 cases with and 206 cases without ascariasis, recorded in the operation theatre registers and in-patients clinical sheets, were studied in relation to morbidity, duration of operation and hospital stay and mortality. Annually, 7.5% of laparotomies were due to complications of ascariasis. Operations for ascariasis accounted for 10.6% of all hospital admissions for an acute abdominal emergency. Also, ascariasis accounted for 26.3% of emergency operations. All operated biliary obstruction cases were due to ascariasis. Moreover, 20.4% of all cases of ascariasis with abdominal complications required operation. The mean ages at operation were higher in Ascaris-induced than in non-Ascaris-induced intestinal obstruction (5.1 vs 3 yr), intussusception (3.5 vs 1.2 yr) and volvulus (4.8 vs 1.7 yr). The durations of operation and hospital stay were longer and case fatality rates higher in Ascaris-induced than in non-Ascaris-induced cases. The importance of this study in relation to the socio-economic benefits of controlling ascariasis is discussed.
Abdomen, Acute↗
Clinical features and management of biliary ascariasis in a non-endemic area.
Biliary ascariasis is common in certain geographical areas of the world. In India, it is common in the Kashmir valley and only stray cases have been reported from other parts of the country. Between January 1995 and May 1997, 14 patients with biliary ascariasis were seen at our centre, which is more than 1000 km from the Kashmir valley. The mean (+/- SD) age of the patients was 31.7 (+/- 6.1) years and all were females. None of them had been to a place known to be endemic for biliary ascariasis. Four patients presented with acute cholangitis, eight with acute abdominal pain and vomiting, and the remaining two were diagnosed incidentally during surgery for gallstone disease. Barring these two patients, ultrasound examination of the abdomen diagnosed the condition accurately. In 10 patients, a part of the worm was visible outside the papilla of Vater. The roundworm was caught in a Dormia basket and could be extracted in nine patients. In one patient the worm migrated inside the bile duct while it was being caught in a Dormia basket. In this and two other patients, in whom the worm had migrated completely inside the bile duct, worms were removed with the help of a Dormia basket after endoscopic sphincterotomy. There were no complications of endoscopic therapy. In the two patients in whom biliary ascariasis was detected during surgery, the worms were removed after choledocholithotomy. On a mean follow-up of 13.8 months, only one patient had a recurrence of biliary ascariasis. It is concluded that biliary ascariasis is not an uncommon disease and must be considered as a possibility in patients presenting with acute cholangitis and biliary pain even in a non-endemic area. Ultrasonography is an excellent diagnostic tool and endoscopic management is very effective and safe in the treatment of these patients.
Abdominal Pain↗
Sonographic appearances in biliary ascariasis.
Biliary ascariasis is as frequent a cause of adult biliary disease as gallstones in Kashmir Valley, India. In the present study, we prospectively evaluated the role of sonography in the diagnosis of biliary ascariasis and its utility in monitoring the exit of worms from the bile duct. Sonography was performed on 28 patients with biliary ascariasis proven by endoscopic retrograde cholangiopancreatography. The bile ducts were dilated on sonography in 26 patients. The characteristic sonographic features of worms in the bile duct were as follows: (a) a single, long, linear or curved echogenic structure without acoustic shadowing (2 patients); (b) multiple, long, linear, parallel echogenic strips, usually without acoustic shadowing (15 patients); (c) a thick, long, linear or curved, nonshadowing echogenic strip containing a central, longitudinal anechoic tube, probably representing the digestive tract of the worm (7 patients); and (d) characteristic movement of these long echogenic structures within the bile duct (8 patients). One patient with pancreatic ascariasis exhibited long, linear, nonshadowing echogenic strips in a dilated pancreatic duct. Other sonographic changes observed in these patients were (a) gallbladder distention (10 patients), edema of the gallbladder wall (8 patients), sludge within the gallbladder (11 patients), a coiled echogenic structure within the gallbladder (1 patient); (b) multiple liver abscesses (1 patient); and (c) edematous pancreatitis (4 patients). Sonography detected worms in the biliary tree in 24 of 28 patients (85.7%). Serial sonograms accurately demonstrated the spontaneous exit of worms in 18 patients and the persistence of worms in 3 patients. Sonography is a simple, rapid, and noninvasive method for diagnosis and follow-up of patients with biliary ascariasis.
Adolescent↗
Hepatobiliary and pancreatic ascariasis in India.
500 patients with hepatobiliary and pancreatic disease due to Ascaris lumbricoides infection were studied. 274 patients had duodenal ascariasis, 171 biliary ascariasis, 40 hepatic ascariasis, 8 gall bladder ascariasis, and 7 pancreatic ascariasis. Five clinical presentations were recognised: acute cholecystitis (64 patients), acute cholangitis (121), biliary colic (280), acute pancreatitis (31), and hepatic abscess (4). Ascarides in the duodenum (which were seen to invade only the ampullary orifice) induced either severe biliary colic or episodes of acute pancreatitis. 27 patients had pyogenic cholangitis and were managed by surgical (2) or endoscopic (25) biliary decompression and drainage. Removal of worms from the ampullary orifice and their extraction by mouth led to rapid relief of biliary colic (214 patients) and acute pancreatitis (16). 4 patients died (acute pancreatitis 2, pyogenic cholangitis 1, hepatic abscess 1). In 12 patients worms persisted in the biliary tree at 3 weeks; dead worms were removed from the biliary tree by surgery (5 patients) or with an endoscopic basket (7). Worms moved out of the ductal system in 211 patients. During a mean follow-up of 48 months (SD 14), 76 patients had worm re-invasion of the biliary tree due to ascaris re-infection. Intrahepatic duct and bile duct calculi developed in 7 patients in whom dead worms formed the nidus of stones.
Acute Disease↗
Gallbladder ascariasis: presentation and management.
BACKGROUND: As many as 1.5 billion people around the world harbour Ascaris lumbricoides in the digestive tract. Gallbladder ascariasis, although less common than bile duct ascariasis, is quite often seen in endemic areas. METHODS: Some 1300 patients with hepatobiliary ascariasis, admitted between October 1992 and June 1998, were analysed prospectively. The clinical features and outcome of 56 cases of gallbladder ascariasis are presented. RESULTS: Forty-seven patients were diagnosed by ultrasonography and nine were diagnosed at laparotomy. Only ten patients diagnosed by ultrasonography expelled the worms spontaneously, with resolution of symptoms and signs. The remaining 37 patients underwent cholecystectomy. CONCLUSION: Gallbladder ascariasis is a significant entity in endemic areas which usually requires cholecystectomy.
Ascariasis↗
Ascariasis: host-pathogen biology.
Ascaris lumbricoides is one of the most common intestinal parasites in humans. Daily global contamination of the soil by A. lumbricoides eggs is enormous (approximately 9 x 10(14) eggs/day). Physical factors, particularly temperature and moisture, are critical in determining the maturation of eggs to the infective stage and their survival. Transmission of the infection to humans, on the other hand, depends more on various socioeconomic factors. In theory, ascariasis is preventable; it is indeed on the way to disappearing completely in developed societies where there is a high standard of sanitation. Ascariasis remains a problem in developing countries, however, where methods of disposal of human excreta are inadequate. The intensity of invasion is regulated by specific and nonspecific responses of the host to migrating A. lumbricoides larvae. Whether or not ascariasis becomes symptomatic depends on the intensity of the infection, the nutritional and immunologic status of the host, and the possible complications that may arise. Host responses to A. lumbricoides are brisk during the larval migratory stage in which hypersensitivity reactions may become clinically manifest, whereas people are rather tolerant of intestinal infections with adult worms. The role of ascariasis in the prevalence of allergic asthma still remains unclear. Complications due to migration of adult worms into the biliary duct system and to intestinal obstructions are the major causes of acute morbidity and mortality in ascariasis.
Animals↗
Non-western patterns of biliary stones and the role of ascariasis.
Biliary calculi of a non-Western pattern were detected in 15 patients on real-time sonography performed over a 3-year period in a center serving a predominantly "Cape colored" (mixed race) population in South Africa. In two patients definite calculi were detected only in the common bile duct or gallbladder, but there was strong imaging and clinical evidence that the calculi were secondary to ascariasis. Twelve patients had intrahepatic calculi, predominantly left-sided, and evidence of past or present ascariasis. In at least five of the 12, biliary ascariasis was found at sonography or surgery. These fourteen patients reported recurrent, acute attacks of pain and cholangitis over a period of years. The symptoms were often difficult to distinguish clinically from those of uncomplicated intestinal or biliary ascariasis. The 15th patient had no evidence of ascariasis. Intrahepatic calculi were evenly distributed throughout both lobes and were clinically silent. Only one of the 13 patients with definite intrahepatic calculi had evidence of gallbladder calculi.
Adolescent↗
Biliary ascariasis as a cause of post-cholecystectomy syndrome in an endemic area.
BACKGROUND: Post-cholecystectomy syndrome encompasses numerous biliary, pancreatic and other entities. Biliary ascariasis is a common cause of adult biliary disease in an endemic area. Post-cholecystectomy biliary ascariasis, a cause of post- cholecystectomy syndrome although not yet defined is frequently seen in this part of the world. METHOD: Between Jan. 1990 and Jan. 2001, 104 cases of post-cholecystectomy biliary ascariasis were seen. Ultrasonography was found to be an excellent tool for diagnosing and monitoring of the worms inside the biliary tract. Endoscopic retrograde cholangiopancreatography had both diagnostic and therapeutic value. RESULTS: The majority (68.2%) of patients responded to conservative treatment. Surgical treatment was advocated in 18.2%, which included 2 patients with liver abscesses. Endoscopic extraction of worms was successful in 48.2%. CONCLUSION: Post-cholecystectomy biliary ascariasis as a cause of post-cholecystectomy syndrome needs to be included in the list of causes for post-cholecystectomy syndrome. Although the majority of patients respond to conservative treatment but endoscopic extraction or surgical intervention may be needed. Routine deworming of patients undergoing cholecystectomy both preoperatively and postoperatively should be done in all patients in endemic areas of ascariasis. Although this entity is rare in Europe and United States, due to population migration and increased travel, it is necessary for surgeons in these countries to be aware of this condition.
Adolescent↗
[Asthma and ascariasis in children aged two to ten living in a low income suburb].
OBJECTIVE: To assess the relation between children with asthma and ascariasis in the low income neighborhood of Pedregal, in Campina Grande (Paraíba, Brazil). MATERIAL AND METHOD: The International Study of Asthma and Allergies in Childhood (ISSAC) standard questionnaire was distributed to 1,095 children but only 742 of them answered it and provided stool samples for parasite examination. The cross-sectional study included those 742 children, whose age ranged from 2 to 10 years. The association between asthma and ascariasis was studied through Kappa rating. Demographic and clinic variants comparing the two groups were analyzed by chi-square test (chi(2)) or t Student test. RESULTS: Among the 742 children analyzed, 51.9% (385) were males and 48.1% (357) females. The prevalence of asthma was 59.7% (443) and that of ascariasis was 56.3% (418). The frequency of asthma in the ascariasis group (60.5%) was similar (chi(2)) = 0.27, p > 0.06) to the frequency of asthma in the non-infected group (58.6%). CONCLUSION: Despite the high prevalence of the diseases studied, there is no apparent relation between asthma and ascariasis in the population studied.
Ascariasis↗
Epidemiology of human geohelminth infections (ascariasis, trichuriasis and necatoriasis) in Lushui and Puer Counties, Yunnan Province, China.
Between April and June of 1998, the prevalence and intensity of geohelminth infections caused by hookworm, Ascaris and Trichuris were investigated in two rural Yunnan villages. In Liuku, a village of Lisu indigenous people in Lushui County, there was an overall geohelminth prevalence of 72% (48%, 43% and 16% for hookworm infection, ascariasis, and trichuriasis, respectively). The prevalence of ascariasis was greatest among preschool and school aged children, whereas the prevalence of trichuriasis was greatest among teenagers and the prevalence of hookworm increased until the age of 10-15 and then remained high throughout adulthood. In Linger, a village of Han Chinese, located in Puer County, there was an overall geohelminth prevalence of 77% (30%, 60% and 36% for hookworm infection, ascariasis, and trichuriasis, respectively). The differences in prevalence for hookworm and ascariasis were statistically significant. The prevalence of hookworm in Linger increased steadily with age and did not plateau, but there were no discernible patterns of prevalence versus age for either ascariasis or trichuriasis. Heavy trichuriasis infections were noted to occur in Linger. In both villages, more than 98% of the hookworm infections were of light and moderate intensity. Both by morphologic identification of third-stage infective larvae (L3) from eggs as well as identification of adult hookworms recovered from adult residents after treatment with quantrel, Necator americanus was identified as the exclusive hookworm in each village. Geohelminth infections caused by Ascaris, Trichuris and hookworm remain highly endemic to the rural areas of Yunnan Province in southwestern China.
Adolescent↗
[Epidemiological study on the influence of pig-derived Ascaris to the transmission of human ascariasis].
OBJECTIVE: An experimental epidemiological study was designed to investigate possible relations of pig-derived Ascaris to the transmission of human ascariasis which might be caused by cross-infection between the pig and humans. METHODS: In Xinjian County, Jiangxi province, two adjacent villages, Laozhi and Panzhi, with similar baseline of ascariasis in pig and human populations were selected as the study sites with a one-year longitudinal epidemiological follow-up study. People in the two villages received mass chemotherapy. Pigs received mass chemotherapy only in Panzhi village and was twice repeated with two months interval, while pigs in Laozhi village were not treated at all. In the following year after treatment on humans, ascariasis among villagers was studied cross-sectionally five times with Kato-katz technique. RESULTS: No significant difference of the re-infection patterns of human ascariasis was found between the two villages in terms of prevalence and intensity during the following year in all the five surveys (chi(2) < 0.658, F < 1.658 and P > 0.1). CONCLUSION: The results suggested that pig-derived Ascaris were mainly transmitted among pigs but had no important role on the transmission of human ascariasis. The results were in good accordance with the findings through a recent molecular genetic research on the local human-and pig-derived Ascaris worms. Possible confounding factors were discussed.
Animals↗
Human toxocariasis and ascariasis: concomitant parasitism in Srinagar, Kashmir, India.
Human toxocariasis caused by Toxocara canis is common in both developing and developed countries and leads to visceral larva migrans with high morbidity and mortality. Ascariasis caused by Ascaris lumbricoides, too has global distribution and in India, high prevalence rate has been reported in Kashmir (J & K State). Both nematode parasites, Toxocara canis and A. lumbricoides require similar biological and environmental conditions for the development of eggs in soil. Therefore, the present study was attempted to detect the antibody response to T. Canis excretory-secretory (ES) antigen by enzyme linked immunosorbent assay in patients attending Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir to assess the magnitude of human toxocariasis in Kashmir, the highly endemic area of ascariasis. Interestingly, it was observed that 38 (82.60%) out of 46 patients harbouring Ascaris Iumbricoides had positive antibody response to T. Canis ES antigen while none of the 15 normal healthy subjects from the same endemic zone, 25 from low endemic zone Chandigarh and 15 from other parasitic infections (hookworm, hydatidosis, cysticercosis) indicated detectable positive response. Majority of the ascariasis positive patients studied were in the age group of 21-40 years. However, one ascariasis patient studied in the age group of 1-10 years (4 years old) had also positive antibody response to T. Canis antigen. This study is the first report of human toxocariasis in Kashmir, India, an endemic zone for ascariasis and emphasizes the need for detailed epidemiological study for the ultimate prevention and control of this disease
Adolescent↗
A profile of ascariasis morbidity in Rangoon Children's Hospital, Burma.
The Rangoon Children's Hospital (RCH) inpatient summary returns from hospital wards from 1981 to 1983 and the surgical operation registers from 1983 to 1984 were studied and analysed in relation to ascariasis morbidity. The majority (57.7%) of clinical manifestations of ascariasis responsible for hospital admission were due to intestinal obstruction, the next most common manifestation was intestinal colic (33.0%). Mean ages for the two conditions were 5.9 years and 7.6 years, respectively. Hospital admissions due to ascariasis varied greatly by season and were significantly higher in the months of May, June and July. Ascariasis was responsible for about 3% of admissions to the hospital. Of the total ascariasis cases, 61.6% were treated in the surgical wards. Moreover, 57.6% of all the acute abdominal cases in the surgical wards were clinically diagnosed to be due to Ascaris lumbricoides infection. In 1983 and 1984, 43 cases of abdominal surgery were performed due to adult Ascaris worms, representing 16.7% of all the acute abdominal conditions operated. Of these 43 cases, intestinal obstruction constituted 65.1%, followed by appendicitis at 20.9%. The mean age of those undergoing surgery for Ascaris-induced abdominal complications was 6.8 years. The validity of some of the clinical data and the public health significance of this study are briefly discussed. The findings are also compared with those of other hospital-based studies.
Abdomen, Acute↗