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ETILOGIC AGENT

Ascariasis Lumbricoides

1. elongated, cylindrical worms (tapered at
the oral and pointed at the anal end)
2. Appear creamy and pinkish yellow
3. Can grow as thick as a pencil and live
for 1-2 years
4. A female worm can produce up to 230,
000 eggs per day, discharged into feces
and incubated in the soil for weeks.
MODE OF TRANSMISSION
Through contaminated fingers put into
the mouth
Ingestion of food and drinks
contaminated with embryonated eggs
PATHOGENESIS
Infection may start with the ingestion of
contaminated water or with eating raw
vegetables, especially if night soil is used
as fertilizer. After ingestion, ascariasis
lumbricoides hatches and releases larvae,
which penetrate the intestinal wall and reach
the lungs through the bloodstream. After ten
days in the pulmonary capillaries and alveoli,
the larvae migrate to the bronchioles, the
bronchi, trachea and epiglottis. They are then
swallowed and returned to the ingestione
where they matured and mate.
LIFE CYCLE OF ASCARIS
Developmental Stage Symptomatology
1. Embryonated ova

Soil contamination with
human excreta
Contamination of food,
water and other object
Ingested to intestine
Developmental Stage Symptomatology
2. Larval stage

The larvae penetrate the walls of
the intestine (duodenum)
The larvae are picked up by
lymphatics or blood stream
They are carried to the liver
Some may reach the heart
Sometimes they carried to the
biliary tract
May reach the stomach,
esophagus and then the URT
They may stay in capillaries of the
lungs.
From the alveoli, they migrate to
the bronchi, trachea, and epiglottis
Ascaris in the larvae stage may
swallowed or ingested.


Nausea and vomiting, poor
appetite
Periumilical pain

Right upper quadrant pain





Cough, fever, rales, blood-
tinged sputum
Nasal pruritus if larvae reach
the nose.

Developmental Stage Symptomatology
3. Adult
Adult ascaris stays in
the small intestine
At times they becomes
erratic that they go into
the stomach to the
esophagus and
sometimes to the
common bile duct and
the gall ladder.
In the GIT, they
copulate. The female
lays eggs about 2 to 3
months after
embryonated eggs are
ingested.

Colicky, periumbilical pain
aggravated by cold
stimulation (Nakamura
sign)

Intestinal obstruction may
be caused by a bolus of
entangled worms which
may be palpable

Severe abdominal pain
associated with vomiting.

DIAGNOSTIC TESTS

1. Stool for ova demonstration of
fertilized or unfertilized eggs in the
stools (Kato-Katz technique)
2. Abdominal x-rays densed shadow of
adult ascaris which looks like strands
of spaghetti (dot sign)
3. Routine blood counts significant
eosinophelia.
TREATMENT

1. Albendazole or mebendazole
15 cc as a single dose
2. Piperazine citrate 75 mg/kg
twice daily, orally
3. Pyrantel pamoate - 1mg/kg as a
single dose, orally.
NURSING INTERVENTIONS
1. Preventive measures in each home and in the
community should be enforced
Prevention
1. Improved sanitation and hygienic practices
2. Improved nutrition
3. Deworming may be advised
4. When travelling to areas where sanitation and
hygiene are poor, avoid water or food that may
be contaminated
2. All members of the family must be taught on
sanitary practices.
3. Availability of toilet facilitates must be ensured
4. Importance of personal hygiene should be
explained
5. Proper disposal of diapers should be emphasized to
others.