Ascariasis differential diagnosis: Difference between revisions

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|1-2 years
|1-2 years
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* Loeffler syndrome (usually about 9-12 days after exposure to ova)
* Loffler syndrome (usually about 9-12 days after exposure to ova)
* Cough
* Cough
* Substernal discomfort
* Substernal discomfort
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* 1 year (Ancylostoma)
* 1 year (Ancylostoma)
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* Loeffler syndrome
* Loffler syndrome
* Transient opacities
* Transient opacities
|Attached to the mucosa of mid-upper portion of the small bowel
|Attached to the mucosa of mid-upper portion of the small bowel
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|Lifetime of the host
|Lifetime of the host
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* Loeffler syndrome
* Loffler syndrome
* Chronic cough
* Chronic cough
* Pneumonia or sepsis in hyperinfection
* Pneumonia or sepsis in hyperinfection

Revision as of 14:10, 7 March 2017

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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 can mimic other worm infections, and also gastrointestinal pathologies like peptic ulcer disease, intussusception in children, bile duct stone, etc.[1][2]

Differential Diagnosis

  • Differential diagnosis of intestinal ascariasis
  1. Peptic ulcer disease[1]
  2. Intestinal obstruction from Ascaris lumbricoides can mimic intussusception[3]
  • Differential diagnosis of biliary ascariasis
  1. Gallbladder cancer[4]
  2. Retained bile duct stone[2]
  • Other worm infections can sometimes have clinical presentations similar to that of Ascaris lumbricoides
Differentiating Ascaris lumbricoides infection from other Nematode infections[5][6]
Nematode Transmission Direct Person-Person Transmission Duration of Infection Pulmonary Manifestation Location of Adult worm(s) Treatment
Ascaris lumbricoides Ingestion of infective ova No 1-2 years
  • Loffler syndrome (usually about 9-12 days after exposure to ova)
  • Cough
  • Substernal discomfort
  • Crackles
  • Wheezing
  • Transient opacities
Free in the lumen of the small bowel

(primarily jejunum)

  • Albendazole
  • Mebendazole
  • Pyrantel
  • Ivermectin
  • Levamisole
  • Piperazine
Trichuris trichiura

(whipworm)

Ingestion of infective ova No 1-3 years No pulmonary migration, therefore, no pulmonary manifestation Anchored in the superficial mucosa of cecum and colon
  • Albendazole
  • Mebendazole
Hookworm (Necator americanus and Ancylostoma duodenale) Skin penetration by filariform larvae No
  • 3-5 years (Necator)
  • 1 year (Ancylostoma)
  • Loffler syndrome
  • Transient opacities
Attached to the mucosa of mid-upper portion of the small bowel
  • Albendazole
  • Mebendazole
  • Levamisole
  • Pyrantel
Strongyloides stercoralis Filariform larvae penetrates skin or bowel mucosa Yes Lifetime of the host
  • Loffler syndrome
  • Chronic cough
  • Pneumonia or sepsis in hyperinfection
Embedded in the mucosa of the duodenum, jejunum
  • Ivermectin
  • Albendazole
  • Thiabendazole
Enterobius vermicularis (pinworm) Ingestion of infective ova Yes 1 month Extraintestinal migration is very rare[7] Free in the lumen of cecum, appendix, adjacent colon
  • Albendazole
  • Mebendazole
  • Pyrantel
  • Ivermectin
  • Levamisole
  • Piperazine

References

  1. 1.0 1.1 Hamed AD, Akinola O (1990). "Intestinal ascariasis in the differential diagnosis of peptic ulcer disease". Trop Geogr Med. 42 (1): 37–40. PMID 2260195.
  2. 2.0 2.1 Goel A, Lakshmi CP, Pottakkat B (2012). "Biliary ascariasis: mimicker of retained bile duct stone". Dig Endosc. 24 (6): 480. doi:10.1111/j.1443-1661.2012.01338.x. PMID 23078449.
  3. Katz Y, Varsano D, Siegal B, Bar-Yochai A (1985). "Intestinal obstruction due to Ascaris lumbricoides mimicking intussusception". Dis Colon Rectum. 28 (4): 267–9. PMID 3979231.
  4. Kong F, Xi H, Bai Y, Li Z (2015). "Ascaris infestation of biliary tree mimicking gallbladder cancer". Dig Liver Dis. 47 (2): e3. doi:10.1016/j.dld.2014.09.012. PMID 25308610.
  5. 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.
  6. 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.
  7. Serpytis M, Seinin D (2012). "Fatal case of ectopic enterobiasis: Enterobius vermicularis in the kidneys". Scand J Urol Nephrol. 46 (1): 70–2. doi:10.3109/00365599.2011.609834. PMID 21879805.


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