Ascariasis natural history
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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 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.