Ascariasis natural history

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]

Overview

Ascariasis is often asymptomatic.^[1] Complications may arise when adult worms move to certain organs such as the bile duct, pancreas, or appendix.^[1] A high worm burden can also result in complications such as intestinal obstruction.^[2]

Natural History

The majority of people infected with Ascaris are asymptomatic although greater than 15% can experience some type of morbidity.^[1]

Complications

Complications of ascariasis include the following:^[3]^[2]^[4]

Biliary duct disease
Hepatic abscess
Intestinal obstruction associated with perforation, volvulus, and intussusception
Peritonitis
Pancreatitis
Acute appendicitis
Malabsorption and growth impairment from chronic infection with Ascaris lumbricoides
Interstitial nephritis and acute renal failure (rare)
Acute eosinophilic pneumonia resulting in respiratory distress (rare)

Prognosis

The prognosis is good and most cases of ascariasis are asymptomatic, but mortality can sometimes be as high as 60,000 per year in symptomatic patients.^[1] Mortality from ascariasis is usually as a result of complications from the infection, and approximately 4.6% of patients hospitalized with complications of ascariasis die from the infection.^[5]

Case fatality rates in published studies of >100 patients hospitalized due to any complication of ascariasis^[5]
Country	Period of study	Total number of patients	Number of deaths (N)	% Number of deaths
USA	1940s	202	6	3
South Africa	1958–1962	100	3	3
Brazil	1970s	454	44	9.7
Burma	1981–1983	641	18	2.8
Burma	1984–1986	226	6	2.6
India	1980s	876	38	4.3

References

↑ ^1.0 ^1.1 ^1.2 ^1.3 Durand, Marlene (2015). “Chapter 288:Intestinal Nematodes (Roundworms)”. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.
↑ ^2.0 ^2.1 Kliegman, Robert; Stanton, Bonita; St. Geme, Joseph; Schor, Nina (2016). “Chapter 291:Ascariasis (Ascaris lumbricoides)”. Nelson Textbook of Pediatrics Twentieth Edition. Elsevier. pp. 1733–1734. ISBN 978-1-4557-7566-8.
↑ Ferri, Fred (2017). “Chapter:Ascariasis”. Ferri’s Clinical Advisor 2017. Elsevier. pp. 117–117. ISBN 978-0-3232-8048-8.
↑ Kim, Kami; Weiss, Louis; Tanowitz, Herbert (2016). “Chapter 39:Parasitic Infections”. Murray and Nadel’s Textbook of Respiratory Medicine Sixth Edition. Elsevier. pp. 682–698. ISBN 978-1-4557-3383-5.
↑ ^5.0 ^5.1 de Silva NR, Chan MS, Bundy DA (1997). “Morbidity and mortality due to ascariasis: re-estimation and sensitivity analysis of global numbers at risk”. Trop Med Int Health. 2 (6): 519–28. PMID 9236818.

Template:WikiDoc Sources

[Principles_and_Practice-1] 1.0 ^1.1 ^1.2 ^1.3 Durand, Marlene (2015). “Chapter 288:Intestinal Nematodes (Roundworms)”. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases Updated Edition, Eighth Edition. Elsevier. pp. 3199–3207. ISBN 978-1-4557-4801-3.

[Nelson_Textbook_of_Pediatrics-2] 2.0 ^2.1 Kliegman, Robert; Stanton, Bonita; St. Geme, Joseph; Schor, Nina (2016). “Chapter 291:Ascariasis (Ascaris lumbricoides)”. Nelson Textbook of Pediatrics Twentieth Edition. Elsevier. pp. 1733–1734. ISBN 978-1-4557-7566-8.

[Ferri's_Clinical_Advisor-3] Ferri, Fred (2017). “Chapter:Ascariasis”. Ferri’s Clinical Advisor 2017. Elsevier. pp. 117–117. ISBN 978-0-3232-8048-8.

[Murray_and_Nadel's_Textbook_of_Respiratory_Medicine-4] Kim, Kami; Weiss, Louis; Tanowitz, Herbert (2016). “Chapter 39:Parasitic Infections”. Murray and Nadel’s Textbook of Respiratory Medicine Sixth Edition. Elsevier. pp. 682–698. ISBN 978-1-4557-3383-5.

[pmid9236818-5] 5.0 ^5.1 de Silva NR, Chan MS, Bundy DA (1997). “Morbidity and mortality due to ascariasis: re-estimation and sensitivity analysis of global numbers at risk”. Trop Med Int Health. 2 (6): 519–28. PMID 9236818.

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