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Etiology, Epidemiology and Pathogenesis

The disease occurs worldwide but is concentrated in warm areas with poor sanitation, where it is maintained largely by the indiscriminate defecation and ingestion habits of children.

The life cycle of the ascariasis has a phase of larval migration through the lungs. Once the larva hatches, it migrates through the wall of the small intestine and is carried by the lymphatics and bloodstream to the lungs. Here it passes into an alveolus, ascends the respiratory tract, and is swallowed. It matures in the rejunum, where it remains as an adult worm. Disease may be caused by both the larva migrating through the lung and the adult worm in the intestine. Malabsorption may result with heavy worm loads.

Symptoms, Signs and Diagnosis

Fever, cough, wheezing, eosinophilia and migratory pulmonary infiltrants may be present during the larval migration through the lungs. Heavy intestinal infection may cause abdominal cramps and, occasionally, intestinal obstruction. Adult worms rarely obstruct the appendix or the biliary or pancreative ducts. Infection with the adult worm is usually diagnosed by finding eggs in the stool.

Prophylaxis and Treatment

Prevetion requires adequate sanitation and drug therapy.


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