Symptoms
The infection is usually asymptomatic. Transient pulmonary symptoms such as cough, dyspnea, asthma-like symptoms, Löffler syndrome with eosinophilic pulmonary infiltrates occur. The pulmonary symptoms are the result of the larvae migrating into the lungs. Other symptoms include fever, abdominal pain, nausea, and vomiting. Worm eggs are first found in the stool 7-9 weeks after infection
Causes
Roundworm (Ascaris lumbricoides).
Transmission
The worm eggs are ingested by eating food contaminated with soil, such as vegetables or drinking water. Children can become infected while playing on the ground. Smear infection by the anal-oral route is also possible. If the worm eggs are not exposed to strong sunlight or dry out, they remain infectious in the soil for years.
Epidemiology
With one billion people infected, it is the most common worm infection worldwide. Infection is clustered in tropical regions and in countries with poor hygienic infrastructure. In Europe, refugees and immigrants are most affected.
Complications
- Obstruction of the small intestine, bile ducts, pancreatic duct, or appendix by worm balls
- Intestinal obstruction (possibly with fatal outcome).
- Reinforcement of malnutrition due to malabsorption
- Abscess
- Inflammation of the pancreas or bile ducts
- Rarely: Allergy due to metabolic products of the worms
Risk factors
- Consumption of raw vegetables
- Poor hygienic conditions
Diagnosis
Diagnosis is made by detecting worm eggs or worms in the stool or by recording eosinophilia during larval migration into the lungs.
Differential Diagnosis
- Pneumonia
- Asthma
- Inflammation of the appendix
- Amoebiasis
- Infections caused by other nematodes
Drug therapy
Antihelminthics:
- Mebendazole (Vermox)
- Pyrantel (Cobantril)
- Albendazole (Zentel)
Prevention
- Proper hygiene, e.g., washing hands before eating.
- Vegetables and fruits thoroughly wash or even cook if possible.
- Do not use human feces or sewage sludge as fertilizer
Worth knowing
- The life cycle of the roundworm lasts about 60-70 days
- The worm eggs must be allowed to mature in the soil for 2-6 weeks to become infectious
- The worms survive 8 to about 18 months
