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(Roundworm Infection)

Definition:
- Infection caused
by parasite
roundworm. It is
characterized by an
early pulmonary
invasion from larval
migration and a later
more prolonged
intestinal phase.
Etiologic Agent:
Ascaris lumbricoides
Transmitted through
contaminated fingers
put into the mouth.

Ingestion of food and
drinks contaminated
with embryonated eggs

Mode of Transmission:
Life Cycle:
Embryonated
ova

Larval stage

Adult

Clinical Manifestation in relation
to the life of the parasites:
When larvae penetrates wall of
duodenum nausea, vomiting, change in
appetite, malaise and abdominal pain
usually periumbilical.
When larvae reach the live vague right
upper quadrant pain
When larvae is filtered out by the
capillaries of the lungs blood tinged
sputum form tissue damage; Nasal
pruritus if larvae reached the nose.
When larvae is swallowed or ingested
colicky, periumbilical pain aggravated by
old stimulation (Nakamura sign)
When adult ascaris stays in the
small intestine intestinal
obstruction caused by bolus of
entangled worms which may be
palpable.

Adult ascaris become erratic and
they go to the stomach and
esophagus sever abdominal
pain associated with vomiting.

Adult ascaris at the common bile
duct and gall bladder jaundice.
Clinical Manifestation in relation
to the life of the parasites:
Complications:
Biliary tract obstruction
patient develops cholestatic
jaundice.
Hepatic abscess and
cholangitis.
Intestinal obstruction,
perforation and
peritonitis.
Malnutrition due to
damage of the intestinal
mucous impairing the
absorption of nutrients.
Diagnosis:
History of passing out adult worms or
patient occasionally vomits a worm.
Stool examination for detection of eggs in
the feces.
Kato Technics demonstration of the
typical fertilized or unfertilized eggs in the
stool.
Roentgenogram (abdominal x-ray)
a. Dense shadows of adult ascaris which
look like strands of spaghetti dot sign
b. Signs of intestinal obstruction if bolus
is big enough to cause a mechanical ileus.
Blood examination significant
eosinophilia.

Treatment:
Albendazole or
Mebendazole 15cc as
single dose orally
Piperazine Citrate
75mg/kg daily for 2
doses
Pyrantel Palmoate
11mg/kg as a single
dose orally.
Nursing Interventions:
Isolation is not needed.
Prevention measures in each home and in the
community should be enforced.
All members of the family must be taught of
health matters. Must be trained to wash their
hands before handling food, must be taught to
wash thoroughly all fruits and vegetables eaten
raw and must be taught about effective sewage
disposal.
Availability of toilet facilities must be ensured.
Importance of personal hygiene should be
explained.