Ascariasis

Ascariasis

Ascariasis is highly prevalent dieses caused by the largest nematode (round worm). Ascariss lumbricoides. When fresh from the intestine, it is light brown or pink in color but it gradually changes to white. It is most frequently seen in the stool Children .The male lumbricoides measures about 15 to 25 cm in length. The female is longer and stouter measuring 25 to 40 cm in length. The egg laying capacity of mature female ascariasis has been found to be enormous, liberating about 200, 000 eggs daily. The eggs liberated by a fertilized female pass out the human host with the faces and many remain alive for several days.

Infection

By swallowing ripe eggs (embryonated eggs) with raw vegetables culative on a soil fertilized by infected human excreta. Infection also occurs by drinking contaminated water. Among children playing in the contaminated soil, there is also hand to hand transfer of eggs by dirty fingers. Infection may also occur by inhalation of desiccated eggs in the dust reaching the pharynux and swallowed. A rhabditiform larva is desiccated eggs in the dust reaching the pharynx and swallowed. A rhabditiform larva is developed form unsegmented ovum within the egg-shell in 10 to 40 days in the soil. A rhabditiform larva is developed from (1st Juvenile Larva) is infective to man.

MOT and rout if migration
When ingested with food, drink or raw vegetables, the embryonated eggs pass down to the Duodenum where the digestive juices weaken the eggs-shell. Splitting of the egg-shell occurs and the rhabditiform larvae are liberated in the upper part of the small intestine. The newly hatched larvae burrow their way through the mucous membrane of the small intestine and are carried by the portal circulation. Breaking through the capillary wall they reach the lung alveoli. Form the lung alveoli the larvae crawl up the bronchi and trachea, then are propelled into larynx and are once more swallowed. The larvae pass down the oesophagus to the stomach and localized in the upper part of the intestine. The larvae pass down the oesophagus to the stomach and localize in the upper part of the intestine. The larvae on reaching habitat grow into adult worms and become sexually mature in about 6 to 10 weeks time. Four moulting of the larvae occur-one outside while within the eggs-shell, two in the lungs and one in the intestine . Symptoms of ascaris infection those produced by migrating larvae and those produced by the adult worms.

1. Symptoms due to the migrating larvae:
In heavy infections typical symptoms of pneumonia such as fever, cough and dyspnoea may appear. Urticarial rash and eosinophilia are seen in such cases. Disturbances have been reported due to their presence in the brain, spinal cord, heart and kidneys.

2. Symptoms due to the adult worms:
With the adult worms inhabiting the intestine the patient complains of abdominal pains, vomiting salivation. Often the patient grits his teeth in his sleep. When the adult worms migrate through the intestinal wall they severe peritonitis. Wandering Ascaris may enter the lumen of the appendix, causing appendicitis. Obstructive jaundice and acute haemorrhagic pancreatitis have been known to occur when the worm has entered into the biliary passage. At times it penetrates high up in the liver causing one or more abscesses. Treatment of ascariasis piperazine citrate syrup, Thiobendazole and mebendazole. Chinopodium oil is very much effective in Ascariasis.