Materiały źródłowe

• #1 Ascariasis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ascariasis/symptoms-causes/syc-20369593

  Most people infected with ascariasis have no signs or symptoms. […] Talk to your doctor if you have persistent abdominal pain, diarrhea or nausea. […] Ascariasis isn’t spread directly from person to person. […] The whole process from egg ingestion to egg deposits takes about two or three months. […] Risk factors for ascariasis include: […] Mild cases of ascariasis usually don’t cause complications. […] If you have a heavy infestation, potentially dangerous complications may include: […] The best defense against ascariasis is good hygiene and common sense.

• #2 Evaluation, Diagnosis and Treatment of Ascariasis: An Updated Review | IntechOpen

  https://www.intechopen.com/chapters/85272

  Ascaris lumbricoides (Round Worm) is the most common human helminth with a world wide distribution. […] Infections have no symptoms in more than 85 percent of cases specially if the number of cases are small. […] The best diagnostic test is still the stool examination demonstrating eggs as the Ascaris eggs are passed in stool in enormous numbers. […] It is important to note that stool can be negative while the worm migrates and matures. […] Detection of Ascaris antibody by indirect hemagglutination and ELISA test. […] Eosinophilia in early stage of infection. […] The larvae may be found in sputum and more often in gastric washing. […] X-ray Abdomen: Bolus of worms may be found with whirled appearance (whirlpool sign) in intestinal obstruction. […] Albendazole is the drug of choice for ascariasis with cure rate over 95% and gradual reduction of eggs in the next few weeks in 99.5%.

• #3 Ascariasis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ascariasis/diagnosis-treatment/drc-20369597

  To diagnose ascariasis, your doctor may review your symptoms and order tests. […] In heavy infestations, it’s possible to find worms after you cough or vomit. […] To diagnose ascariasis, your doctor will examine your stool for the tiny (microscopic) eggs and larvae. […] But eggs won’t appear in stool until at least 40 days after you’re infected. […] Your blood can be tested for the presence of an increased number of a certain type of white blood cell, called eosinophils. […] If you’re infested with worms, the mass of worms may be visible in an X-ray of the abdomen. […] An ultrasound may show worms in the pancreas or liver. […] Both types of tests create detailed images of the internal structures, which can help your doctor detect worms that are blocking ducts in the liver or pancreas. […] During the physical exam, your doctor may press on certain areas of the abdomen to check for pain or tenderness. He or she may also want a sample of stool for testing.

• #4 Ascariasis – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/908

  Diagnosis can be made in most cases by finding characteristic eggs in a stool sample. […] Key diagnostic factors include travel to, or immigration from, endemic areas with poor sanitation, hygiene, and agricultural practices. […] 1st tests to order include stool microscopy, chest x-ray, and abdominal x-ray. […] Emerging tests include antibodies to Ascaris lumbricoides, serum IgE, interleukin (IL)-4, IL-5, and IL-13, and urine-based gas liquid chromatography.

• #5 Ascariasis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ascariasis/diagnosis-treatment/drc-20369597

  To diagnose ascariasis, your doctor may review your symptoms and order tests. […] In heavy infestations, it’s possible to find worms after you cough or vomit. […] To diagnose ascariasis, your doctor will examine your stool for the tiny (microscopic) eggs and larvae. […] But eggs won’t appear in stool until at least 40 days after you’re infected. […] Your blood can be tested for the presence of an increased number of a certain type of white blood cell, called eosinophils. […] If you’re infested with worms, the mass of worms may be visible in an X-ray of the abdomen. […] An ultrasound may show worms in the pancreas or liver. […] Both types of tests create detailed images of the internal structures, which can help your doctor detect worms that are blocking ducts in the liver or pancreas. […] During the physical exam, your doctor may press on certain areas of the abdomen to check for pain or tenderness. He or she may also want a sample of stool for testing.

• #6 Ascariasis Differential Diagnoses

  https://emedicine.medscape.com/article/212510-differential

  Stool examination is not useful for diagnosis of pulmonary infection, since eggs are generally detected in the stool at least 40 days following pulmonary symptoms. A positive stool examination for Ascaris eggs at the time of respiratory symptoms does not establish a causal diagnosis of pulmonary ascariasis, since these eggs reflect infection acquired 2 to 12 months earlier.

• #7 CDC – DPDx – Ascariasis

  https://www.cdc.gov/dpdx/ascariasis/index.html

  Microscopic identification of eggs in the stool is the most common method for diagnosing intestinal ascariasis. The recommended procedure is as follows: Collect a stool specimen. Preserve the specimen in formalin or another fixative. Concentrate using the formalinethyl acetate sedimentation technique. Examine a wet mount of the sediment. […] Where concentration procedures are not available, a direct wet mount examination of the specimen is adequate for detecting moderate to heavy infections. For quantitative assessments of infection, various methods such as the Kato-Katz or quantitative fecal flotation can be used. […] Larvae can be identified in sputum or gastric aspirate during the pulmonary migration phase (examine fixed organisms for morphology). Adult worms are occasionally passed in the stool or through the mouth or nose and are recognizable by their macroscopic characteristics (e.g., presence of three lips). […] Molecular methods for the detection of egg/worm DNA in human stools are increasingly used in research settings, often in multi-parallel formats for detecting this and other soil-transmitted helminths.

• #8 Ascaris lumbricoides: Life cycle, Pathogenesis, Lab Diagnosis

  https://microbeonline.com/ascaris-lumbricoides-life-cycle-pathogenesis-and-lab-diagnosis/

  In the larval migration phase of infection, diagnosis can be made by finding the larvae in sputum or gastric washings; however, this is not a common finding. […] During the intestinal phase, the diagnosis is made by finding the eggs (unfertilized or fertilized) or adult worms in the stool. The eggs are most easily seen on a direct wet mount or a wet preparation of the concentration sediment. Zinc-sulfate flotation concentration method or formal-ether concentration method is commonly used to concentrate the stool sediment. […] Antibodies against Ascaris can be detected by the indirect hemagglutination method or by the immunofluorescent antibody (IFA) test. These tests are useful for the diagnosis of extraintestinal ascariasis like Loefflers syndrome.

• #9 Human Ascariasis: Diagnostics Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4630244/

  Soil-transmitted helminths (STHs) infect over one billion people worldwide. Ascariasis may mimic a number of conditions, and individual clinical diagnosis often requires a thorough work-up. Kato-Katz thick smears are the standard detection method for Ascaris and, despite low sensitivity, are often used for mapping and monitoring and evaluation of national control programmes. […] Although increased sampling (number of stools) and diagnostic (number of examinations per stool) efforts can improve sensitivity, Kato-Katz is less sensitive than other microscopy methods such as FLOTAC. Antibody-based diagnostics may be a sensitive diagnostic tool; however, their usefulness is limited to assessing transmission in areas aiming for elimination. […] Molecular diagnostics are highly sensitive and specific, but high costs limit their use to individual diagnosis, drug – efficacy studies and identification of Ascaris suum. Increased investments in research on Ascaris and other STHs are urgently required for the development of diagnostic assays to support efforts to reduce human suffering caused by these infections.

• #10 Human Ascariasis: Diagnostics Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4630244/

  Soil-transmitted helminths (STHs) infect over one billion people worldwide. Ascariasis may mimic a number of conditions, and individual clinical diagnosis often requires a thorough work-up. Kato-Katz thick smears are the standard detection method for Ascaris and, despite low sensitivity, are often used for mapping and monitoring and evaluation of national control programmes. […] Although increased sampling (number of stools) and diagnostic (number of examinations per stool) efforts can improve sensitivity, Kato-Katz is less sensitive than other microscopy methods such as FLOTAC. Antibody-based diagnostics may be a sensitive diagnostic tool; however, their usefulness is limited to assessing transmission in areas aiming for elimination. […] Molecular diagnostics are highly sensitive and specific, but high costs limit their use to individual diagnosis, drug – efficacy studies and identification of Ascaris suum. Increased investments in research on Ascaris and other STHs are urgently required for the development of diagnostic assays to support efforts to reduce human suffering caused by these infections.

• #11 Ascariasis – Helminthiases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.84.1.8.

  Standard ova and parasite examination of stool for microscopic detection of A lumbricoides eggs. For increased sensitivity 3 stool samples should be collected within 10 days (ideally every 48 h). Stool analysis does not detect immature worms or single male parasites (absence of eggs). In few cases ascariasis is diagnosed after the passage of an adult worm from the anus, mouth, or nose. […] Symptoms consistent with Ascaris pneumonitis can be found in other migratory parasitic infections including toxocariasis, hookworm infection, strongyloidiasis, schistosomiasis, and tropical pulmonary eosinophilia. […] The differential diagnosis for abdominal symptoms is quite broad and includes other GI helminths (eg, Trichuris, hookworms, tapeworms) and protozoa, as well as other causes of dyspepsia, abdominal pain, or biliary tract diseases.

• #12

  https://link.springer.com/article/10.1007/s40475-015-0064-9

  Sensitive, specific, user-friendly and cost-effective diagnostic tests are imperative for individual diagnosis and for planning, monitoring and evaluation (ME) of mass preventative chemotherapy programmes, and novel tools are needed, especially for measuring decreased infection intensities and drug efficacy. […] Similar to a number of parasite infections, individual diagnosis of ascariasis often depends on a thorough investigation that may include travel history or origin from endemic countries (when presenting in non-endemic areas) and clinical and laboratory examinations, including potentially serological, molecular and image-based diagnostics. […] Kato-Katz has low sensitivity for detection of A. lumbricoides in breastfed infants, who have more liquid stools and, if infected, lower EPGs than older children. Modified Wisconsin floatation and simple gravity sedimentation are more sensitive for infants than Kato-Katz, formal-ethyl acetate sedimentation or modified formal-ethyl acetate sedimentation.

• #13 Ascariasis: Symptoms, Causes & Transmission, Treatment

  https://my.clevelandclinic.org/health/diseases/14071-ascariasis

  A healthcare provider can diagnose the infection using a stool sample once the worms have reached your intestines. Theyll check for eggs or worms inside your poop. […] Ascariasis is harder to diagnose when the infection hasnt spread beyond your lungs yet. If your provider suspects an infection, they may order a chest X-ray to check for changes that may indicate the larvae inside your lungs. […] Other imaging tests including ultrasounds, computed tomography (CT) scans and MRIs (magnetic resonance imaging scans) can produce detailed images that show worms in places like your ducts. They can show how severe your infection is.

• #14 Ascariasis: Symptoms, Causes, Diagnosis & Treatment

  https://www.webmd.com/a-to-z-guides/ascariasis-facts

  If a doctor thinks you or your child has ascariasis, they may do: […] Stool tests. The doctor will send a poop sample to a lab, where technicians look for eggs or worms through a microscope. […] Imaging tests: […] X-rays can show large masses of worms in the belly or lungs. […] CT scans are special X-rays. They take pictures from different angles deep inside your body to look for worms. […] Ultrasound uses sound waves to make images. The doctor can use it to look for worms in your liver or pancreas. […] Endoscopy is a procedure where a camera attached to a long tube is put into your stomach and intestine through your mouth. It can show if worms are blocking the intestines, pylorus (a tube that connects your stomach and small intestine), pancreas and other parts of their gut. […] MRIs use magnets and sound waves to create images deep inside the body to see if worms are blocking any ducts.

• #15 Evaluation, Diagnosis and Treatment of Ascariasis: An Updated Review | IntechOpen

  https://www.intechopen.com/chapters/85272

  Ascaris lumbricoides (Round Worm) is the most common human helminth with a world wide distribution. […] Infections have no symptoms in more than 85 percent of cases specially if the number of cases are small. […] The best diagnostic test is still the stool examination demonstrating eggs as the Ascaris eggs are passed in stool in enormous numbers. […] It is important to note that stool can be negative while the worm migrates and matures. […] Detection of Ascaris antibody by indirect hemagglutination and ELISA test. […] Eosinophilia in early stage of infection. […] The larvae may be found in sputum and more often in gastric washing. […] X-ray Abdomen: Bolus of worms may be found with whirled appearance (whirlpool sign) in intestinal obstruction. […] Albendazole is the drug of choice for ascariasis with cure rate over 95% and gradual reduction of eggs in the next few weeks in 99.5%.

• #16 Ascariasis Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/212510-workup

  Adult A lumbricoides worms can be visualized in the stool or the patient may notice them when passed. […] Ascaris larvae may be observed in microscopic wet preparations of sputum during the pulmonary migration phase. […] Results will reveal peripheral eosinophilia during the tissue migration phase of the infection. […] Serum IgG and IgE are elevated during early infection, but this finding is not clinically useful. […] Images may show fleeting opacities during pulmonary migration. Bilateral, round infiltrates or ground glass opacities with ill-defined margins with variable sizes ranging from several millimeters to centimeters may be seen in patients with high eosinophilia. […] Plain radiographs may show aggregated worms in the intestine, especially in children. […] Endoscopic retrograde cholangiopancreatography (ERCP) has become a commonly used procedure for both diagnosis of ascariasis and removal of worms from the biliary tract.

• #17 Ascariasis Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/212510-workup

  Diagnosis of ascariasis is achieved through the microscopic detection of eggs in stool samples or by observing adult worms in the stool or emerging from the nose, mouth, or rectum. […] Occasionally, larvae may be found in sputum during the pulmonary phase. Adult worms can also be visualized in radiographic studies of the gastrointestinal tract. […] Eosinophilia may be pronounced while the larvae migrate through the lungs but typically decreases once the adult worms settle in the intestine. A chest X-ray taken during the pulmonary phase may reveal infiltrates, and when combined with eosinophilia, this can indicate the presence of Lffler syndrome. […] Visualization of large, brown 60 m X 50 m trilayered eggs is confirmatory. However, stool examination may be negative for ova for up to 40 days after infection because of the time needed for migration and maturation of the worm.

• #18

  https://journals.lww.com/sjga/fulltext/2001/07020/biliary_ascariasis__sonographic_diagnosis.5.aspx

  Ultrasonography is the procedure of choice for recognizing the presence of worms in the hepatobiliary tract. […] Sonography has been shown to have high diagnostic accuracy as noninvasive procedure in the work up of biliary ascariasis. […] The presence of ascaris in the bile ducts may also be detected by T tube, trans-hepatic and endoscopic retrograde cholangiography as smooth cylindrical radiolucent filling defects. […] Sonography is a simple, rapid and a noninvasive method for the diagnosis and follow-up of patients with biliary ascariasis.

• #19 Ascaris lumbricoides- Lab Diagnosis, Treatments, Prophylaxis

  https://microbenotes.com/ascaris-lumbricoides-lab-diagnosis-treatments-prophylaxis/

  Lab diagnosis of Ascaris lumbricoides […] Adult Worm […] In the case of heavy infection, the adult worm is possible to find in stool or sputum of the patient by the naked eye. […] Barium meal may reveal the presence of an adult worm in the small intestine. […] A plain abdominal film may reveal masses of worms in gas-filled loops of bowel in patients with intestinal obstruction. […] Pancreaticobiliary worms can be detected by ultrasound (more than 50% sensitive) and endoscopic retrograde cholangiopancreatography (ERCP; 90% sensitive. […] Larvae […] In the early stages of infection, when migrating larvae cause Loefflers syndrome, the diagnosis may be made by demonstrating the larvae in sputum, or more often in gastric washings. […] Eosinophilia may be present, especially during the larval migration through the lungs which supports the diagnosis. At this stage, no eggs are seen in feces. […] Chest X-ray may show patchy pulmonary infiltrates.

• #20

  https://link.springer.com/article/10.1007/s00261-022-03407-6

  To report the radiological features of intestinal ascariasis and to review the clinical implications of this re-emerging disease for adult population of the USA. […] The typical configuration of ascaris within the bowel loops was demonstrated on CT of the abdomen in 5 patients, small bowel examination with barium in 3, and by MR enterography in another 4 cases. […] Our study highlights the radiological appearances of intestinal ascariasis and the clinical implications of this resurging disease. The practicing radiologists should be aware of these findings, particularly when examining patients who have immigrated from or traveled to the endemic regions.

• #21 Biliary ascariasis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/biliary-ascariasis?lang=us

  Ascariasis is the commonest helminthic infection worldwide and estimated to affect nearly 1 billion people (25% of the population). […] The adult worm can appear as a longitudinal or curved filling defect within the intestinal lumen during a contrast follow through study. […] Identification of the long hyperechoic structure within the liver with hypoechoic center is highly suggestive. […] Best non-invasive method to detect biliary ascariasis. The worm appears as a hypointense structure within the hyperintense CBD. With 3T MRI identification of the „three line sign” in thick slab MRCP confirms the diagnosis. […] Gold standard but an invasive method. It is used also in the extraction of CBD worms. […] Endoscopic removal of CBD worms should be done under the umbrella of antihelminthic therapy.

• #22 Ascariasis Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/212510-workup

  Adult A lumbricoides worms can be visualized in the stool or the patient may notice them when passed. […] Ascaris larvae may be observed in microscopic wet preparations of sputum during the pulmonary migration phase. […] Results will reveal peripheral eosinophilia during the tissue migration phase of the infection. […] Serum IgG and IgE are elevated during early infection, but this finding is not clinically useful. […] Images may show fleeting opacities during pulmonary migration. Bilateral, round infiltrates or ground glass opacities with ill-defined margins with variable sizes ranging from several millimeters to centimeters may be seen in patients with high eosinophilia. […] Plain radiographs may show aggregated worms in the intestine, especially in children. […] Endoscopic retrograde cholangiopancreatography (ERCP) has become a commonly used procedure for both diagnosis of ascariasis and removal of worms from the biliary tract.

• #23 Ascariasis: Symptoms, Causes, Diagnosis & Treatment

  https://www.webmd.com/a-to-z-guides/ascariasis-facts

  If a doctor thinks you or your child has ascariasis, they may do: […] Stool tests. The doctor will send a poop sample to a lab, where technicians look for eggs or worms through a microscope. […] Imaging tests: […] X-rays can show large masses of worms in the belly or lungs. […] CT scans are special X-rays. They take pictures from different angles deep inside your body to look for worms. […] Ultrasound uses sound waves to make images. The doctor can use it to look for worms in your liver or pancreas. […] Endoscopy is a procedure where a camera attached to a long tube is put into your stomach and intestine through your mouth. It can show if worms are blocking the intestines, pylorus (a tube that connects your stomach and small intestine), pancreas and other parts of their gut. […] MRIs use magnets and sound waves to create images deep inside the body to see if worms are blocking any ducts.

• #24 Ascariasis Differential Diagnoses

  https://emedicine.medscape.com/article/212510-differential

  Stool examination is not useful for diagnosis of pulmonary infection, since eggs are generally detected in the stool at least 40 days following pulmonary symptoms. A positive stool examination for Ascaris eggs at the time of respiratory symptoms does not establish a causal diagnosis of pulmonary ascariasis, since these eggs reflect infection acquired 2 to 12 months earlier.

• #25 Ascariasis Differential Diagnoses

  https://emedicine.medscape.com/article/212510-differential

  Children from or in endemic areas are particularly prone to ascariasis infection and complications. In most cases, stool examination is positive for ova after a few weeks of infection. […] Pulmonary ascariasis should be high on the differential in individuals with no prior Ascaris exposure and potential egg ingestion within weeks prior to onset of respiratory symptoms (dry cough, dyspnea, fever, wheezing), characteristic radiographic findings (migratory bilateral round infiltrates), peripheral eosinophilia, and relevant epidemiologic exposure to eggs of A. lumbricoides or A. suum. The diagnosis may be definitively established via visualization of Ascaris larvae in respiratory secretions or gastric aspirates although this is rarely possible. Symptomatic pulmonary involvement is rare among individuals in highly endemic areas with ongoing exposure.

• #26 Ascariasis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/nematodes-roundworms/ascariasis

  Diagnosis is by identifying eggs or adult worms in stool, adult worms that migrate from the nose, mouth, or rectum, or rarely larvae in sputum during the pulmonary migration phase. […] Diagnosis of ascariasis is by microscopic detection of eggs in stool or gross visualization of adult worms in stool or emerging from the nose, mouth, or rectum. Occasionally, larvae can be found in sputum during the pulmonary phase. Adult worms may be seen in radiographic studies of the gastrointestinal tract. […] Diagnose by microscopic examination of the stool; occasionally, adult worms are seen migrating from the nose, mouth, or rectum.

• #27 Evaluation, Diagnosis and Treatment of Ascariasis: An Updated Review | IntechOpen

  https://www.intechopen.com/chapters/85272

  Ascaris lumbricoides (Round Worm) is the most common human helminth with a world wide distribution. […] Infections have no symptoms in more than 85 percent of cases specially if the number of cases are small. […] The best diagnostic test is still the stool examination demonstrating eggs as the Ascaris eggs are passed in stool in enormous numbers. […] It is important to note that stool can be negative while the worm migrates and matures. […] Detection of Ascaris antibody by indirect hemagglutination and ELISA test. […] Eosinophilia in early stage of infection. […] The larvae may be found in sputum and more often in gastric washing. […] X-ray Abdomen: Bolus of worms may be found with whirled appearance (whirlpool sign) in intestinal obstruction. […] Albendazole is the drug of choice for ascariasis with cure rate over 95% and gradual reduction of eggs in the next few weeks in 99.5%.

• #28 Ascariasis Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/212510-workup

  Diagnosis of ascariasis is achieved through the microscopic detection of eggs in stool samples or by observing adult worms in the stool or emerging from the nose, mouth, or rectum. […] Occasionally, larvae may be found in sputum during the pulmonary phase. Adult worms can also be visualized in radiographic studies of the gastrointestinal tract. […] Eosinophilia may be pronounced while the larvae migrate through the lungs but typically decreases once the adult worms settle in the intestine. A chest X-ray taken during the pulmonary phase may reveal infiltrates, and when combined with eosinophilia, this can indicate the presence of Lffler syndrome. […] Visualization of large, brown 60 m X 50 m trilayered eggs is confirmatory. However, stool examination may be negative for ova for up to 40 days after infection because of the time needed for migration and maturation of the worm.

• #29 Ascaris lumbricoides- Lab Diagnosis, Treatments, Prophylaxis

  https://microbenotes.com/ascaris-lumbricoides-lab-diagnosis-treatments-prophylaxis/

  Lab diagnosis of Ascaris lumbricoides […] Adult Worm […] In the case of heavy infection, the adult worm is possible to find in stool or sputum of the patient by the naked eye. […] Barium meal may reveal the presence of an adult worm in the small intestine. […] A plain abdominal film may reveal masses of worms in gas-filled loops of bowel in patients with intestinal obstruction. […] Pancreaticobiliary worms can be detected by ultrasound (more than 50% sensitive) and endoscopic retrograde cholangiopancreatography (ERCP; 90% sensitive. […] Larvae […] In the early stages of infection, when migrating larvae cause Loefflers syndrome, the diagnosis may be made by demonstrating the larvae in sputum, or more often in gastric washings. […] Eosinophilia may be present, especially during the larval migration through the lungs which supports the diagnosis. At this stage, no eggs are seen in feces. […] Chest X-ray may show patchy pulmonary infiltrates.

• #30 Ascariasis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ascariasis/diagnosis-treatment/drc-20369597

  To diagnose ascariasis, your doctor may review your symptoms and order tests. […] In heavy infestations, it’s possible to find worms after you cough or vomit. […] To diagnose ascariasis, your doctor will examine your stool for the tiny (microscopic) eggs and larvae. […] But eggs won’t appear in stool until at least 40 days after you’re infected. […] Your blood can be tested for the presence of an increased number of a certain type of white blood cell, called eosinophils. […] If you’re infested with worms, the mass of worms may be visible in an X-ray of the abdomen. […] An ultrasound may show worms in the pancreas or liver. […] Both types of tests create detailed images of the internal structures, which can help your doctor detect worms that are blocking ducts in the liver or pancreas. […] During the physical exam, your doctor may press on certain areas of the abdomen to check for pain or tenderness. He or she may also want a sample of stool for testing.

• #31 Ascariasis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/908

  Diagnosis can be made in most cases by finding characteristic eggs in a stool sample. […] Key diagnostic factors include the presence of risk factors. […] Other diagnostic factors include asymptomatic presentation, co-infection with other parasites, developmental delay, malnutrition, fever, cough, wheezing, dyspnoea, haemoptysis, hypoxia, tachypnoea, rhonchi, rales, retractions, urticarial skin lesions, abdominal pain, anorexia, dyspepsia, nausea, vomiting, diarrhoea, constipation, abdominal distension, reduced or absent bowel sounds, hypotension, RUQ tenderness, hepatomegaly, jaundice, and signs/symptoms of iron deficiency anaemia or kwashiorkor. […] 1st investigations to order include stool microscopy, chest x-ray, and abdominal x-ray. […] Emerging tests include antibodies to Ascaris lumbricoides, serum IgE, interleukin (IL)-4, IL-5, and IL-13, and urine-based gas liquid chromatography.

• #32 Ascariasis laboratory tests – wikidoc

  https://www.wikidoc.org/index.php/Ascariasis_laboratory_tests

  Ascariasis is frequently diagnosed in the laboratory via microscopic identification of eggs in the feces. […] The diagnosis of ascariasis can be done via the following methods: Microscopic identification of eggs in the stool is the common method for diagnosing ascariasis and simple smears are often adequate because of the high output of eggs produced daily by gravid female worms. Stool concentration procedures such as Kato-Katz thick smear or formalin-ethyl acetate sedimentation can also be done. Ascaris larvae can also be found in sputum or gastric aspirates during pulmonary migration, before eggs are present in feces. […] Polymerase chain reaction (PCR)- based assays can identify and quantify the DNA of Ascaris. […] Serology- This is more useful for epidemiologic purposes than for individual diagnosis because the IgG antibodies developed by patients cross react with the antigens from other helminths. […] Eosinophilia- This is a non-specific finding that is not used solely for diagnosis. Eosinophilia is usually more prominent during early infection but often subsides in established adult worm infestation in the intestines. Eosinophilia is often in the 5-10% range but can rise as high as 50%.

• #33 Ascaris lumbricoides- Lab Diagnosis, Treatments, Prophylaxis

  https://microbenotes.com/ascaris-lumbricoides-lab-diagnosis-treatments-prophylaxis/

  Microscopy […] The saline emulsion of stool is examined microscopically for the presence of eggs. Both fertilized and unfertilized eggs are usually present. […] If very few eggs are present the diagnosis may be easily missed so the concentration technique will increase the yield of diagnosis through microscopy. […] Eggs may be demonstrative in the bile obtained by duodenal aspirates. […] Blood examination […] A complete blood count may show eosinophilia in the early stage of invasion. […] Serological Tests […] Ascaris antibody can be detected by Indirect hemagglutination (IHA), Immunofluorescence antibody (IFA), Enzyme-linked immunosorbent assay (ELISA). […] Serodiagnosis is helpful in extraintestinal ascariasis like Loefflers syndrome.

• #34 Ascaris lumbricoides- Lab Diagnosis, Treatments, Prophylaxis

  https://microbenotes.com/ascaris-lumbricoides-lab-diagnosis-treatments-prophylaxis/

  Microscopy […] The saline emulsion of stool is examined microscopically for the presence of eggs. Both fertilized and unfertilized eggs are usually present. […] If very few eggs are present the diagnosis may be easily missed so the concentration technique will increase the yield of diagnosis through microscopy. […] Eggs may be demonstrative in the bile obtained by duodenal aspirates. […] Blood examination […] A complete blood count may show eosinophilia in the early stage of invasion. […] Serological Tests […] Ascaris antibody can be detected by Indirect hemagglutination (IHA), Immunofluorescence antibody (IFA), Enzyme-linked immunosorbent assay (ELISA). […] Serodiagnosis is helpful in extraintestinal ascariasis like Loefflers syndrome.

• #35 Ascaris lumbricoides- Lab Diagnosis, Treatments, Prophylaxis

  https://microbenotes.com/ascaris-lumbricoides-lab-diagnosis-treatments-prophylaxis/

  Microscopy […] The saline emulsion of stool is examined microscopically for the presence of eggs. Both fertilized and unfertilized eggs are usually present. […] If very few eggs are present the diagnosis may be easily missed so the concentration technique will increase the yield of diagnosis through microscopy. […] Eggs may be demonstrative in the bile obtained by duodenal aspirates. […] Blood examination […] A complete blood count may show eosinophilia in the early stage of invasion. […] Serological Tests […] Ascaris antibody can be detected by Indirect hemagglutination (IHA), Immunofluorescence antibody (IFA), Enzyme-linked immunosorbent assay (ELISA). […] Serodiagnosis is helpful in extraintestinal ascariasis like Loefflers syndrome.

• #36 Ascariasis Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/212510-workup

  Adult A lumbricoides worms can be visualized in the stool or the patient may notice them when passed. […] Ascaris larvae may be observed in microscopic wet preparations of sputum during the pulmonary migration phase. […] Results will reveal peripheral eosinophilia during the tissue migration phase of the infection. […] Serum IgG and IgE are elevated during early infection, but this finding is not clinically useful. […] Images may show fleeting opacities during pulmonary migration. Bilateral, round infiltrates or ground glass opacities with ill-defined margins with variable sizes ranging from several millimeters to centimeters may be seen in patients with high eosinophilia. […] Plain radiographs may show aggregated worms in the intestine, especially in children. […] Endoscopic retrograde cholangiopancreatography (ERCP) has become a commonly used procedure for both diagnosis of ascariasis and removal of worms from the biliary tract.

• #37 Ascariasis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/908

  Diagnosis can be made in most cases by finding characteristic eggs in a stool sample. […] Key diagnostic factors include the presence of risk factors. […] Other diagnostic factors include asymptomatic presentation, co-infection with other parasites, developmental delay, malnutrition, fever, cough, wheezing, dyspnoea, haemoptysis, hypoxia, tachypnoea, rhonchi, rales, retractions, urticarial skin lesions, abdominal pain, anorexia, dyspepsia, nausea, vomiting, diarrhoea, constipation, abdominal distension, reduced or absent bowel sounds, hypotension, RUQ tenderness, hepatomegaly, jaundice, and signs/symptoms of iron deficiency anaemia or kwashiorkor. […] 1st investigations to order include stool microscopy, chest x-ray, and abdominal x-ray. […] Emerging tests include antibodies to Ascaris lumbricoides, serum IgE, interleukin (IL)-4, IL-5, and IL-13, and urine-based gas liquid chromatography.

• #38 Ascariasis laboratory tests – wikidoc

  https://www.wikidoc.org/index.php/Ascariasis_laboratory_tests

  Ascariasis is frequently diagnosed in the laboratory via microscopic identification of eggs in the feces. […] The diagnosis of ascariasis can be done via the following methods: Microscopic identification of eggs in the stool is the common method for diagnosing ascariasis and simple smears are often adequate because of the high output of eggs produced daily by gravid female worms. Stool concentration procedures such as Kato-Katz thick smear or formalin-ethyl acetate sedimentation can also be done. Ascaris larvae can also be found in sputum or gastric aspirates during pulmonary migration, before eggs are present in feces. […] Polymerase chain reaction (PCR)- based assays can identify and quantify the DNA of Ascaris. […] Serology- This is more useful for epidemiologic purposes than for individual diagnosis because the IgG antibodies developed by patients cross react with the antigens from other helminths. […] Eosinophilia- This is a non-specific finding that is not used solely for diagnosis. Eosinophilia is usually more prominent during early infection but often subsides in established adult worm infestation in the intestines. Eosinophilia is often in the 5-10% range but can rise as high as 50%.

• #39 Serological diagnosis of soil-transmitted helminth (Ascaris, Trichuris and hookworm) infections: A scoping review | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0012049

  Regarding human diagnosis, none of the existing assays has undergone extensive large-scale validation or integration into routine diagnostics for MDA programs. […] The current state of serological diagnosis for guiding STH prevention and control programs is limited. […] This scoping review identified factors that potentially contribute to the present limited implementation of serological assays in human MDA programs, despite their demonstrated potential in veterinary medicine.

• #40 Human Ascariasis: Diagnostics Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4630244/

  Statistical simulations indicate that McMaster and Kato-Katz provide reliable estimates of drug efficacy and are suitable for ME of control programmes. […] Mobile devices have been adapted for examination of Kato-Katz slides and can accurately diagnose helminth eggs in moderate- to high-intensity infections, with a sensitivity of 81 % for A. lumbricoides, but lower for other STHs. […] Detection of antibodies or antigens could provide a simpler, more rapid diagnosis of Ascaris infection than conventional stool microscopy. […] Few studies have evaluated the use of serological diagnosis of Ascaris at the community level. […] Detection of schistosome antigen in urine is highly sensitive and is available as a commercialised point-of-care test. […] Molecular diagnostic tools are highly sensitive and specific, and rapid advances are being made, resulting in reduced costs and improved techniques such as real-time quantitative PCR (qPCR) and multiplex assays.

• #41

  https://link.springer.com/article/10.1007/s40475-015-0064-9

  Detection of antibodies or antigens could provide a simpler, more rapid diagnosis of Ascaris infection than conventional stool microscopy. […] Few studies have evaluated the use of serological diagnosis of Ascaris at the community level. […] Detection of schistosome antigen in urine is highly sensitive and is available as a commercialised point-of-care test. […] Molecular diagnostic tools are highly sensitive and specific, and rapid advances are being made, resulting in reduced costs and improved techniques such as real-time quantitative PCR (qPCR) and multiplex assays. […] The significantly higher sensitivity of qPCR over stool microscopy typical for a number species is not always observed for Ascaris due to high egg output and technical challenges related to isolating parasite DNA from the resistant, four-layered Ascaris egg shell.

• #42 Ascariasis laboratory tests – wikidoc

  https://www.wikidoc.org/index.php/Ascariasis_laboratory_tests

  Ascariasis is frequently diagnosed in the laboratory via microscopic identification of eggs in the feces. […] The diagnosis of ascariasis can be done via the following methods: Microscopic identification of eggs in the stool is the common method for diagnosing ascariasis and simple smears are often adequate because of the high output of eggs produced daily by gravid female worms. Stool concentration procedures such as Kato-Katz thick smear or formalin-ethyl acetate sedimentation can also be done. Ascaris larvae can also be found in sputum or gastric aspirates during pulmonary migration, before eggs are present in feces. […] Polymerase chain reaction (PCR)- based assays can identify and quantify the DNA of Ascaris. […] Serology- This is more useful for epidemiologic purposes than for individual diagnosis because the IgG antibodies developed by patients cross react with the antigens from other helminths. […] Eosinophilia- This is a non-specific finding that is not used solely for diagnosis. Eosinophilia is usually more prominent during early infection but often subsides in established adult worm infestation in the intestines. Eosinophilia is often in the 5-10% range but can rise as high as 50%.

• #43

  https://link.springer.com/article/10.1007/s40475-015-0064-9

  Detection of antibodies or antigens could provide a simpler, more rapid diagnosis of Ascaris infection than conventional stool microscopy. […] Few studies have evaluated the use of serological diagnosis of Ascaris at the community level. […] Detection of schistosome antigen in urine is highly sensitive and is available as a commercialised point-of-care test. […] Molecular diagnostic tools are highly sensitive and specific, and rapid advances are being made, resulting in reduced costs and improved techniques such as real-time quantitative PCR (qPCR) and multiplex assays. […] The significantly higher sensitivity of qPCR over stool microscopy typical for a number species is not always observed for Ascaris due to high egg output and technical challenges related to isolating parasite DNA from the resistant, four-layered Ascaris egg shell.

• #44

  https://link.springer.com/article/10.1007/s40475-015-0064-9

  Detection of antibodies or antigens could provide a simpler, more rapid diagnosis of Ascaris infection than conventional stool microscopy. […] Few studies have evaluated the use of serological diagnosis of Ascaris at the community level. […] Detection of schistosome antigen in urine is highly sensitive and is available as a commercialised point-of-care test. […] Molecular diagnostic tools are highly sensitive and specific, and rapid advances are being made, resulting in reduced costs and improved techniques such as real-time quantitative PCR (qPCR) and multiplex assays. […] The significantly higher sensitivity of qPCR over stool microscopy typical for a number species is not always observed for Ascaris due to high egg output and technical challenges related to isolating parasite DNA from the resistant, four-layered Ascaris egg shell.

• #45 Human Ascariasis: Diagnostics Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4630244/

  The significantly higher sensitivity of qPCR over stool microscopy typical for a number species is not always observed for Ascaris due to high egg output and technical challenges related to isolating parasite DNA from the resistant, four-layered Ascaris egg shell. […] There is a paucity of data on novel, convenient diagnostics for ascariasis, even compared to other NTDs. Standardised protocols and validated diagnostics are required for assessing the epidemiological situation, burden of disease and drug efficacy.

• #46 Ascariasis in a 75-year-old man with small bowel volvulus: a case report | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06718-z

  The finding of a single worm and the low parasitic intensity (16 EPG) diagnosed using the FLOTAC technique confirmed that zoonotic cases developed a smaller number of adult worms in the intestine when infected with eggs from pig Ascaris, making the diagnosis even more difficult. […] In patients with bowel obstruction and with a no evident aetiology a complete bowel palpation during surgery and a pre or post-operative parasitological examination should be performed.

• #47 Human Ascariasis: Diagnostics Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4630244/

  Soil-transmitted helminths (STHs) infect over one billion people worldwide. Ascariasis may mimic a number of conditions, and individual clinical diagnosis often requires a thorough work-up. Kato-Katz thick smears are the standard detection method for Ascaris and, despite low sensitivity, are often used for mapping and monitoring and evaluation of national control programmes. […] Although increased sampling (number of stools) and diagnostic (number of examinations per stool) efforts can improve sensitivity, Kato-Katz is less sensitive than other microscopy methods such as FLOTAC. Antibody-based diagnostics may be a sensitive diagnostic tool; however, their usefulness is limited to assessing transmission in areas aiming for elimination. […] Molecular diagnostics are highly sensitive and specific, but high costs limit their use to individual diagnosis, drug – efficacy studies and identification of Ascaris suum. Increased investments in research on Ascaris and other STHs are urgently required for the development of diagnostic assays to support efforts to reduce human suffering caused by these infections.

• #48 Ascariasis differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Ascariasis_differential_diagnosis

  Ascariasis can mimic other worm infections, and also gastrointestinal pathologies like peptic ulcer disease, intussusception in children, bile duct stone, etc. […] Differential diagnosis of intestinal ascariasis […] Intestinal obstruction from Ascaris lumbricoides can mimic intussusception […] Other worm infections can sometimes have clinical presentations similar to that of Ascaris lumbricoides. […] The table below summarizes the findings that differentiate from other nematode infections: […] Ascariasis Ascaris lumbricoides Ingestion of infective ova No 1-2 years […] Lffler’s syndrome (usually about 9-12 days after exposure to ova) […] Cough […] Substernal discomfort […] Crackles […] Wheezing […] Transient opacities […] Free air in the lumen of the small bowel (primarily jejunum) […] Treatment Ascariasis: Albendazole, Mebendazole, Pyrantel pamoate, Ivermectin, Levamisole, Piperazine.

• #49 Ascariasis – Helminthiases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.84.1.8.

  Standard ova and parasite examination of stool for microscopic detection of A lumbricoides eggs. For increased sensitivity 3 stool samples should be collected within 10 days (ideally every 48 h). Stool analysis does not detect immature worms or single male parasites (absence of eggs). In few cases ascariasis is diagnosed after the passage of an adult worm from the anus, mouth, or nose. […] Symptoms consistent with Ascaris pneumonitis can be found in other migratory parasitic infections including toxocariasis, hookworm infection, strongyloidiasis, schistosomiasis, and tropical pulmonary eosinophilia. […] The differential diagnosis for abdominal symptoms is quite broad and includes other GI helminths (eg, Trichuris, hookworms, tapeworms) and protozoa, as well as other causes of dyspepsia, abdominal pain, or biliary tract diseases.

• #50 Ascariasis – Helminthiases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.84.1.8.

  Standard ova and parasite examination of stool for microscopic detection of A lumbricoides eggs. For increased sensitivity 3 stool samples should be collected within 10 days (ideally every 48 h). Stool analysis does not detect immature worms or single male parasites (absence of eggs). In few cases ascariasis is diagnosed after the passage of an adult worm from the anus, mouth, or nose. […] Symptoms consistent with Ascaris pneumonitis can be found in other migratory parasitic infections including toxocariasis, hookworm infection, strongyloidiasis, schistosomiasis, and tropical pulmonary eosinophilia. […] The differential diagnosis for abdominal symptoms is quite broad and includes other GI helminths (eg, Trichuris, hookworms, tapeworms) and protozoa, as well as other causes of dyspepsia, abdominal pain, or biliary tract diseases.

• #51 Ascariasis – Helminthiases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.84.1.8.

  Standard ova and parasite examination of stool for microscopic detection of A lumbricoides eggs. For increased sensitivity 3 stool samples should be collected within 10 days (ideally every 48 h). Stool analysis does not detect immature worms or single male parasites (absence of eggs). In few cases ascariasis is diagnosed after the passage of an adult worm from the anus, mouth, or nose. […] Symptoms consistent with Ascaris pneumonitis can be found in other migratory parasitic infections including toxocariasis, hookworm infection, strongyloidiasis, schistosomiasis, and tropical pulmonary eosinophilia. […] The differential diagnosis for abdominal symptoms is quite broad and includes other GI helminths (eg, Trichuris, hookworms, tapeworms) and protozoa, as well as other causes of dyspepsia, abdominal pain, or biliary tract diseases.

• #52 Ascariasis – Helminthiases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.84.1.8.

  Standard ova and parasite examination of stool for microscopic detection of A lumbricoides eggs. For increased sensitivity 3 stool samples should be collected within 10 days (ideally every 48 h). Stool analysis does not detect immature worms or single male parasites (absence of eggs). In few cases ascariasis is diagnosed after the passage of an adult worm from the anus, mouth, or nose. […] Symptoms consistent with Ascaris pneumonitis can be found in other migratory parasitic infections including toxocariasis, hookworm infection, strongyloidiasis, schistosomiasis, and tropical pulmonary eosinophilia. […] The differential diagnosis for abdominal symptoms is quite broad and includes other GI helminths (eg, Trichuris, hookworms, tapeworms) and protozoa, as well as other causes of dyspepsia, abdominal pain, or biliary tract diseases.

• #53 Ascariasis – Helminthiases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.84.1.8.

  Standard ova and parasite examination of stool for microscopic detection of A lumbricoides eggs. For increased sensitivity 3 stool samples should be collected within 10 days (ideally every 48 h). Stool analysis does not detect immature worms or single male parasites (absence of eggs). In few cases ascariasis is diagnosed after the passage of an adult worm from the anus, mouth, or nose. […] Symptoms consistent with Ascaris pneumonitis can be found in other migratory parasitic infections including toxocariasis, hookworm infection, strongyloidiasis, schistosomiasis, and tropical pulmonary eosinophilia. […] The differential diagnosis for abdominal symptoms is quite broad and includes other GI helminths (eg, Trichuris, hookworms, tapeworms) and protozoa, as well as other causes of dyspepsia, abdominal pain, or biliary tract diseases.

• #54 Ascariasis – Helminthiases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.84.1.8.

  Standard ova and parasite examination of stool for microscopic detection of A lumbricoides eggs. For increased sensitivity 3 stool samples should be collected within 10 days (ideally every 48 h). Stool analysis does not detect immature worms or single male parasites (absence of eggs). In few cases ascariasis is diagnosed after the passage of an adult worm from the anus, mouth, or nose. […] Symptoms consistent with Ascaris pneumonitis can be found in other migratory parasitic infections including toxocariasis, hookworm infection, strongyloidiasis, schistosomiasis, and tropical pulmonary eosinophilia. […] The differential diagnosis for abdominal symptoms is quite broad and includes other GI helminths (eg, Trichuris, hookworms, tapeworms) and protozoa, as well as other causes of dyspepsia, abdominal pain, or biliary tract diseases.

• #55 Ascariasis – Helminthiases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.84.1.8.

  Standard ova and parasite examination of stool for microscopic detection of A lumbricoides eggs. For increased sensitivity 3 stool samples should be collected within 10 days (ideally every 48 h). Stool analysis does not detect immature worms or single male parasites (absence of eggs). In few cases ascariasis is diagnosed after the passage of an adult worm from the anus, mouth, or nose. […] Symptoms consistent with Ascaris pneumonitis can be found in other migratory parasitic infections including toxocariasis, hookworm infection, strongyloidiasis, schistosomiasis, and tropical pulmonary eosinophilia. […] The differential diagnosis for abdominal symptoms is quite broad and includes other GI helminths (eg, Trichuris, hookworms, tapeworms) and protozoa, as well as other causes of dyspepsia, abdominal pain, or biliary tract diseases.

• #56 Ascariasis – Helminthiases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.84.1.8.

  Standard ova and parasite examination of stool for microscopic detection of A lumbricoides eggs. For increased sensitivity 3 stool samples should be collected within 10 days (ideally every 48 h). Stool analysis does not detect immature worms or single male parasites (absence of eggs). In few cases ascariasis is diagnosed after the passage of an adult worm from the anus, mouth, or nose. […] Symptoms consistent with Ascaris pneumonitis can be found in other migratory parasitic infections including toxocariasis, hookworm infection, strongyloidiasis, schistosomiasis, and tropical pulmonary eosinophilia. […] The differential diagnosis for abdominal symptoms is quite broad and includes other GI helminths (eg, Trichuris, hookworms, tapeworms) and protozoa, as well as other causes of dyspepsia, abdominal pain, or biliary tract diseases.

• #57 Ascariasis differential diagnosis – wikidoc

  https://www.wikidoc.org/index.php/Ascariasis_differential_diagnosis

  Ascariasis can mimic other worm infections, and also gastrointestinal pathologies like peptic ulcer disease, intussusception in children, bile duct stone, etc. […] Differential diagnosis of intestinal ascariasis […] Intestinal obstruction from Ascaris lumbricoides can mimic intussusception […] Other worm infections can sometimes have clinical presentations similar to that of Ascaris lumbricoides. […] The table below summarizes the findings that differentiate from other nematode infections: […] Ascariasis Ascaris lumbricoides Ingestion of infective ova No 1-2 years […] Lffler’s syndrome (usually about 9-12 days after exposure to ova) […] Cough […] Substernal discomfort […] Crackles […] Wheezing […] Transient opacities […] Free air in the lumen of the small bowel (primarily jejunum) […] Treatment Ascariasis: Albendazole, Mebendazole, Pyrantel pamoate, Ivermectin, Levamisole, Piperazine.

• #58 Ascaris-mimicking common bile duct stone: A case report

  https://www.wjgnet.com/2307-8960/full/v8/i19/4499.htm

  In most cases, it is not difficult to differentiate common bile duct (CBD) stone from Ascaris infection because they are different disease entities and have different imaging findings. […] However, Ascaris infection can complicate diagnosis of choledocholithiasis. […] Diagnosis of hepatobiliary ascariasis can be made by visualizing the larvae in the biliary tree, as they may manifest as a cylindrical filling defect with or without movement on imaging studies. […] Although this was a rare case of CBD stone mimicking biliary ascariasis, it serves as a reminder that patients complaining of biliary colic or imaging finding of an elongated filling defect occupying the CBD should not be diagnosed by shape alone, and a CBD stone can mimic biliary Ascaris. […] Although CBD stone and Ascaris are not commonly discussed in the same differential diagnosis, they can be confused in cases with an elongated CBD stone.

• #59 Ascariasis – Helminthiases – Parasitic Diseases – Infectious Diseases – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.18.84.1.8.

  Standard ova and parasite examination of stool for microscopic detection of A lumbricoides eggs. For increased sensitivity 3 stool samples should be collected within 10 days (ideally every 48 h). Stool analysis does not detect immature worms or single male parasites (absence of eggs). In few cases ascariasis is diagnosed after the passage of an adult worm from the anus, mouth, or nose. […] Symptoms consistent with Ascaris pneumonitis can be found in other migratory parasitic infections including toxocariasis, hookworm infection, strongyloidiasis, schistosomiasis, and tropical pulmonary eosinophilia. […] The differential diagnosis for abdominal symptoms is quite broad and includes other GI helminths (eg, Trichuris, hookworms, tapeworms) and protozoa, as well as other causes of dyspepsia, abdominal pain, or biliary tract diseases.

• #60 Ascaris lumbricoides eggs or artefacts? A diagnostic conundrum | Parasitology | Cambridge Core

  https://www.cambridge.org/core/journals/parasitology/article/ascaris-lumbricoides-eggs-or-artefacts-a-diagnostic-conundrum/6933778B2EE36C17BA601DF0779E588F

  Due to the presence of artefacts in stool samples, the copromicroscopic diagnosis of Ascaris lumbricoides is not always straightforward, particularly in the case of fertilized decorticated eggs. […] Diagnosis of A. lumbricoides infections is based on the microscopic detection of eggs in stool. However, the morphological identification of A. lumbricoides eggs by stool microscopy is not always straightforward and requires specially trained laboratory personnel. […] Identification of artefacts (e.g. pollen, plant cells, psocid insects, etc.) is an integral part of the diagnosis process to avoid common misdiagnosis in the laboratory. […] To date, there are a variety of laboratory methods used to detect A. lumbricoides, but some are more prone to misdiagnosis than others. […] The Mini-FLOTAC technique has proven to be a reliable method for diagnosis of A. lumbricoides and other soil-transmitted helminths (STHs).

• #61 Ascariasis in a 75-year-old man with small bowel volvulus: a case report | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06718-z

  A computed tomography scan showed air-fluid levels and small bowel distension. […] Faecal examination revealed the presence of unfertilized Ascaris eggs with an intensity of 16 eggs per gram (EPG) of faeces. […] Therefore, in patients with bowel obstruction with no evident aetiology a helminthic infestation should be considered for an accurate diagnosis, especially in patients living in rural areas. […] The definitive diagnosis of ascariasis was achieved only during the surgery through the bowel palpation from the Treitz ligament to the ileocecal valve because the clinical manifestations of the patient were very heterogeneous (e.g. abdominal pain, nausea, vomiting, etc.) and not specific for a helminth infection. […] An accurate diagnosis can be made by finding the eggs or adult worms in the stool.

• #62 Evaluation, Diagnosis and Treatment of Ascariasis: An Updated Review | IntechOpen

  https://www.intechopen.com/chapters/85272

  Ascaris lumbricoides (Round Worm) is the most common human helminth with a world wide distribution. […] Infections have no symptoms in more than 85 percent of cases specially if the number of cases are small. […] The best diagnostic test is still the stool examination demonstrating eggs as the Ascaris eggs are passed in stool in enormous numbers. […] It is important to note that stool can be negative while the worm migrates and matures. […] Detection of Ascaris antibody by indirect hemagglutination and ELISA test. […] Eosinophilia in early stage of infection. […] The larvae may be found in sputum and more often in gastric washing. […] X-ray Abdomen: Bolus of worms may be found with whirled appearance (whirlpool sign) in intestinal obstruction. […] Albendazole is the drug of choice for ascariasis with cure rate over 95% and gradual reduction of eggs in the next few weeks in 99.5%.

• #63 Ascariasis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/ascariasis/diagnosis-treatment/drc-20369597

  To diagnose ascariasis, your doctor may review your symptoms and order tests. […] In heavy infestations, it’s possible to find worms after you cough or vomit. […] To diagnose ascariasis, your doctor will examine your stool for the tiny (microscopic) eggs and larvae. […] But eggs won’t appear in stool until at least 40 days after you’re infected. […] Your blood can be tested for the presence of an increased number of a certain type of white blood cell, called eosinophils. […] If you’re infested with worms, the mass of worms may be visible in an X-ray of the abdomen. […] An ultrasound may show worms in the pancreas or liver. […] Both types of tests create detailed images of the internal structures, which can help your doctor detect worms that are blocking ducts in the liver or pancreas. […] During the physical exam, your doctor may press on certain areas of the abdomen to check for pain or tenderness. He or she may also want a sample of stool for testing.

• #64 Ascaris lumbricoides eggs or artefacts? A diagnostic conundrum | Parasitology | Cambridge Core

  https://www.cambridge.org/core/journals/parasitology/article/ascaris-lumbricoides-eggs-or-artefacts-a-diagnostic-conundrum/6933778B2EE36C17BA601DF0779E588F

  Due to the presence of artefacts in stool samples, the copromicroscopic diagnosis of Ascaris lumbricoides is not always straightforward, particularly in the case of fertilized decorticated eggs. […] Diagnosis of A. lumbricoides infections is based on the microscopic detection of eggs in stool. However, the morphological identification of A. lumbricoides eggs by stool microscopy is not always straightforward and requires specially trained laboratory personnel. […] Identification of artefacts (e.g. pollen, plant cells, psocid insects, etc.) is an integral part of the diagnosis process to avoid common misdiagnosis in the laboratory. […] To date, there are a variety of laboratory methods used to detect A. lumbricoides, but some are more prone to misdiagnosis than others. […] The Mini-FLOTAC technique has proven to be a reliable method for diagnosis of A. lumbricoides and other soil-transmitted helminths (STHs).

• #65 Ascariasis in a 75-year-old man with small bowel volvulus: a case report | BMC Infectious Diseases | Full Text

  https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06718-z

  The finding of a single worm and the low parasitic intensity (16 EPG) diagnosed using the FLOTAC technique confirmed that zoonotic cases developed a smaller number of adult worms in the intestine when infected with eggs from pig Ascaris, making the diagnosis even more difficult. […] In patients with bowel obstruction and with a no evident aetiology a complete bowel palpation during surgery and a pre or post-operative parasitological examination should be performed.

• #66 Human Ascariasis: Diagnostics Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4630244/

  Soil-transmitted helminths (STHs) infect over one billion people worldwide. Ascariasis may mimic a number of conditions, and individual clinical diagnosis often requires a thorough work-up. Kato-Katz thick smears are the standard detection method for Ascaris and, despite low sensitivity, are often used for mapping and monitoring and evaluation of national control programmes. […] Although increased sampling (number of stools) and diagnostic (number of examinations per stool) efforts can improve sensitivity, Kato-Katz is less sensitive than other microscopy methods such as FLOTAC. Antibody-based diagnostics may be a sensitive diagnostic tool; however, their usefulness is limited to assessing transmission in areas aiming for elimination. […] Molecular diagnostics are highly sensitive and specific, but high costs limit their use to individual diagnosis, drug – efficacy studies and identification of Ascaris suum. Increased investments in research on Ascaris and other STHs are urgently required for the development of diagnostic assays to support efforts to reduce human suffering caused by these infections.

• #67 Ascariasis – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/nematodes-roundworms/ascariasis

  Diagnosis is by identifying eggs or adult worms in stool, adult worms that migrate from the nose, mouth, or rectum, or rarely larvae in sputum during the pulmonary migration phase. […] Diagnosis of ascariasis is by microscopic detection of eggs in stool or gross visualization of adult worms in stool or emerging from the nose, mouth, or rectum. Occasionally, larvae can be found in sputum during the pulmonary phase. Adult worms may be seen in radiographic studies of the gastrointestinal tract. […] Diagnose by microscopic examination of the stool; occasionally, adult worms are seen migrating from the nose, mouth, or rectum.

• #68 Human Ascariasis: Diagnostics Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4630244/

  Statistical simulations indicate that McMaster and Kato-Katz provide reliable estimates of drug efficacy and are suitable for ME of control programmes. […] Mobile devices have been adapted for examination of Kato-Katz slides and can accurately diagnose helminth eggs in moderate- to high-intensity infections, with a sensitivity of 81 % for A. lumbricoides, but lower for other STHs. […] Detection of antibodies or antigens could provide a simpler, more rapid diagnosis of Ascaris infection than conventional stool microscopy. […] Few studies have evaluated the use of serological diagnosis of Ascaris at the community level. […] Detection of schistosome antigen in urine is highly sensitive and is available as a commercialised point-of-care test. […] Molecular diagnostic tools are highly sensitive and specific, and rapid advances are being made, resulting in reduced costs and improved techniques such as real-time quantitative PCR (qPCR) and multiplex assays.

• #69

  https://link.springer.com/article/10.1007/s40475-015-0064-9

  Despite global efforts to control STH-related morbidity, only approximately 30 % of children worldwide in need of treatment are currently receiving preventive chemotherapy. Key factors for optimal planning, ME and surveillance of control programmes include accurate diagnostic tools and optimal survey protocols with appropriate sample sizes, number of repeated measurements and timing. […] There is a need for tests which compare adult worm expulsion (for up to a week), repeated Kato-Katz and/or other tests that estimate EPG, and PCR, to standardise analyses of current and future diagnostic methods.

• #70 Human Ascariasis: Diagnostics Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4630244/

  Soil-transmitted helminths (STHs) infect over one billion people worldwide. Ascariasis may mimic a number of conditions, and individual clinical diagnosis often requires a thorough work-up. Kato-Katz thick smears are the standard detection method for Ascaris and, despite low sensitivity, are often used for mapping and monitoring and evaluation of national control programmes. […] Although increased sampling (number of stools) and diagnostic (number of examinations per stool) efforts can improve sensitivity, Kato-Katz is less sensitive than other microscopy methods such as FLOTAC. Antibody-based diagnostics may be a sensitive diagnostic tool; however, their usefulness is limited to assessing transmission in areas aiming for elimination. […] Molecular diagnostics are highly sensitive and specific, but high costs limit their use to individual diagnosis, drug – efficacy studies and identification of Ascaris suum. Increased investments in research on Ascaris and other STHs are urgently required for the development of diagnostic assays to support efforts to reduce human suffering caused by these infections.

• #71 Human Ascariasis: Diagnostics Update

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4630244/

  Soil-transmitted helminths (STHs) infect over one billion people worldwide. Ascariasis may mimic a number of conditions, and individual clinical diagnosis often requires a thorough work-up. Kato-Katz thick smears are the standard detection method for Ascaris and, despite low sensitivity, are often used for mapping and monitoring and evaluation of national control programmes. […] Although increased sampling (number of stools) and diagnostic (number of examinations per stool) efforts can improve sensitivity, Kato-Katz is less sensitive than other microscopy methods such as FLOTAC. Antibody-based diagnostics may be a sensitive diagnostic tool; however, their usefulness is limited to assessing transmission in areas aiming for elimination. […] Molecular diagnostics are highly sensitive and specific, but high costs limit their use to individual diagnosis, drug – efficacy studies and identification of Ascaris suum. Increased investments in research on Ascaris and other STHs are urgently required for the development of diagnostic assays to support efforts to reduce human suffering caused by these infections.

• #72 Ascaris lumbricoides- Lab Diagnosis, Treatments, Prophylaxis

  https://microbenotes.com/ascaris-lumbricoides-lab-diagnosis-treatments-prophylaxis/

  Lab diagnosis of Ascaris lumbricoides […] Adult Worm […] In the case of heavy infection, the adult worm is possible to find in stool or sputum of the patient by the naked eye. […] Barium meal may reveal the presence of an adult worm in the small intestine. […] A plain abdominal film may reveal masses of worms in gas-filled loops of bowel in patients with intestinal obstruction. […] Pancreaticobiliary worms can be detected by ultrasound (more than 50% sensitive) and endoscopic retrograde cholangiopancreatography (ERCP; 90% sensitive. […] Larvae […] In the early stages of infection, when migrating larvae cause Loefflers syndrome, the diagnosis may be made by demonstrating the larvae in sputum, or more often in gastric washings. […] Eosinophilia may be present, especially during the larval migration through the lungs which supports the diagnosis. At this stage, no eggs are seen in feces. […] Chest X-ray may show patchy pulmonary infiltrates.

• #73 Ascaris lumbricoides), Molecular Detection – Diagnostic Tests | Diagnostiki Athinon

  https://athenslab.gr/en/diagnostikes-exetaseis/ascaris-lumbricoides-molecular-detection-1615

  Molecular testing for Ascaris (Ascaris lumbricoides) is used for fast, reliable, and safe laboratory diagnosis of ascariasis. […] The laboratory diagnosis of the disease includes the examination of the feces for the eggs of the parasite, while in the pulmonary form of the disease, larvae in sputum or gastric fluid can be sought. Rarely, adult worms can be found in the feces. […] The molecular testing of feces and other biological materials (sputum, gastric contents), allows the fast, specific, and sensitive method for the diagnosis of ascariasis. […] Molecular testing for Ascaris lumbricoides is performed by taking a specific type of sample and can be done:

• #74 Roundworms (Ascariasis) – Nurseslabs

  https://nurseslabs.com/roundworms-ascariasis/

  Diagnosis of roundworms is confirmed through the following: […] CBC count. Complete blood count (CBC) may show eosinophilia. […] Sputum analysis. Sputum analysis may reveal larvae or Charcot-Leyden crystals (collections of crystalloid composed of eosinophilic proteins). […] Stool exam. Stool examination findings are typically normal in the absence of previous infection (during the first 40 d); in the adult phase, stool examination findings include characteristic eggs; adult females lay about 200,000 eggs per day, aiding microscopic identification of characteristic eggs. […] Chest radiography. Chest radiography may reveal patchy infiltrates of eosinophilic pneumonia. […] Abdominal radiography. Abdominal radiography may reveal signs of bowel obstruction (e.g., air-fluid levels) or the cigar bundle appearance of a worm bolus.

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