Ascariasis differential diagnosis: Difference between revisions
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[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Ascariasis]] | |||
{{CMG}}{{AE}}{{FB}} | {{CMG}}{{AE}}{{FB}} {{MMF}} | ||
==Overview== | ==Overview== | ||
Ascariasis can mimic other worm infections, and also gastrointestinal pathologies like peptic ulcer disease, intussusception in children, bile duct stone, etc.<ref name="pmid2260195">{{cite journal| author=Hamed AD, Akinola O| title=Intestinal ascariasis in the differential diagnosis of peptic ulcer disease. | journal=Trop Geogr Med | year= 1990 | volume= 42 | issue= 1 | pages= 37-40 | pmid=2260195 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2260195 }} </ref> | Ascariasis can mimic other worm infections, and also gastrointestinal pathologies like [[peptic ulcer disease]], [[intussusception]] in children, [[bile duct]] stone, etc.<ref name="pmid2260195">{{cite journal| author=Hamed AD, Akinola O| title=Intestinal ascariasis in the differential diagnosis of peptic ulcer disease. | journal=Trop Geogr Med | year= 1990 | volume= 42 | issue= 1 | pages= 37-40 | pmid=2260195 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2260195 }} </ref><ref name="pmid23078449">{{cite journal| author=Goel A, Lakshmi CP, Pottakkat B| title=Biliary ascariasis: mimicker of retained bile duct stone. | journal=Dig Endosc | year= 2012 | volume= 24 | issue= 6 | pages= 480 | pmid=23078449 | doi=10.1111/j.1443-1661.2012.01338.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23078449 }} </ref> | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
* Differential diagnosis of intestinal ascariasis | * Differential diagnosis of intestinal ascariasis | ||
# Peptic ulcer disease<ref name="pmid2260195">{{cite journal| author=Hamed AD, Akinola O| title=Intestinal ascariasis in the differential diagnosis of peptic ulcer disease. | journal=Trop Geogr Med | year= 1990 | volume= 42 | issue= 1 | pages= 37-40 | pmid=2260195 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2260195 }} </ref> | # [[Peptic ulcer disease]]<ref name="pmid2260195">{{cite journal| author=Hamed AD, Akinola O| title=Intestinal ascariasis in the differential diagnosis of peptic ulcer disease. | journal=Trop Geogr Med | year= 1990 | volume= 42 | issue= 1 | pages= 37-40 | pmid=2260195 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2260195 }} </ref> | ||
# Intestinal obstruction from Ascaris lumbricoides can mimic intussusception<ref name="pmid3979231">{{cite journal| author=Katz Y, Varsano D, Siegal B, Bar-Yochai A| title=Intestinal obstruction due to Ascaris lumbricoides mimicking intussusception. | journal=Dis Colon Rectum | year= 1985 | volume= 28 | issue= 4 | pages= 267-9 | pmid=3979231 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3979231 }} </ref> | # [[Intestinal obstruction]] from [[Ascaris lumbricoides]] can mimic [[intussusception]]<ref name="pmid3979231">{{cite journal| author=Katz Y, Varsano D, Siegal B, Bar-Yochai A| title=Intestinal obstruction due to Ascaris lumbricoides mimicking intussusception. | journal=Dis Colon Rectum | year= 1985 | volume= 28 | issue= 4 | pages= 267-9 | pmid=3979231 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3979231 }} </ref> | ||
* Differential diagnosis of biliary ascariasis | * Differential diagnosis of biliary ascariasis | ||
# Gallbladder cancer<ref name="pmid25308610">{{cite journal| author=Kong F, Xi H, Bai Y, Li Z| title=Ascaris infestation of biliary tree mimicking gallbladder cancer. | journal=Dig Liver Dis | year= 2015 | volume= 47 | issue= 2 | pages= e3 | pmid=25308610 | doi=10.1016/j.dld.2014.09.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25308610 }} </ref> | # [[Gallbladder cancer]]<ref name="pmid25308610">{{cite journal| author=Kong F, Xi H, Bai Y, Li Z| title=Ascaris infestation of biliary tree mimicking gallbladder cancer. | journal=Dig Liver Dis | year= 2015 | volume= 47 | issue= 2 | pages= e3 | pmid=25308610 | doi=10.1016/j.dld.2014.09.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25308610 }} </ref> | ||
# Retained bile duct stone<ref name="pmid23078449">{{cite journal| author=Goel A, Lakshmi CP, Pottakkat B| title=Biliary ascariasis: mimicker of retained bile duct stone. | journal=Dig Endosc | year= 2012 | volume= 24 | issue= 6 | pages= 480 | pmid=23078449 | doi=10.1111/j.1443-1661.2012.01338.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23078449 }} </ref> | # Retained [[bile duct]] stone<ref name="pmid23078449">{{cite journal| author=Goel A, Lakshmi CP, Pottakkat B| title=Biliary ascariasis: mimicker of retained bile duct stone. | journal=Dig Endosc | year= 2012 | volume= 24 | issue= 6 | pages= 480 | pmid=23078449 | doi=10.1111/j.1443-1661.2012.01338.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23078449 }} </ref> | ||
* Other worm infections can sometimes have clinical presentations similar to that of Ascaris lumbricoides | * Other worm infections can sometimes have clinical presentations similar to that of [[Ascaris lumbricoides]] | ||
The table below summarizes the findings that differentiate from other nematode infections: | |||
{| class="wikitable" | {| class="wikitable" | ||
! colspan=" | ! colspan="8" |Differentiating ascariasis from other Nematode infections<ref name="Principles and Practice">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.</ref><ref name="Murray and Nadel's Textbook of Respiratory Medicine">{{cite book |last1=Kim |first1=Kami |last2=Weiss |first2=Louis |last3=Tanowitz |first3=Herbert |title=Murray and Nadel's Textbook of Respiratory Medicine Sixth Edition |publisher=Elsevier |date=2016 |pages=682-698 |chapter=Chapter 39:Parasitic Infections |isbn=978-1-4557-3383-5}}</ref><ref name="pmid21879805">{{cite journal| author=Serpytis M, Seinin D| title=Fatal case of ectopic enterobiasis: Enterobius vermicularis in the kidneys. | journal=Scand J Urol Nephrol | year= 2012 | volume= 46 | issue= 1 | pages= 70-2 | pmid=21879805 | doi=10.3109/00365599.2011.609834 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21879805 }} </ref> | ||
|- | |- | ||
|Nematode | ! style="background:#4479BA; color: #FFFFFF;" |Infection | ||
|Transmission | ! style="background:#4479BA; color: #FFFFFF;" |Nematode | ||
|Direct Person-Person Transmission | ! style="background:#4479BA; color: #FFFFFF;" |Transmission | ||
|Duration of Infection | ! style="background:#4479BA; color: #FFFFFF;" |Direct Person-Person Transmission | ||
|Pulmonary Manifestation | ! style="background:#4479BA; color: #FFFFFF;" |Duration of Infection | ||
|Location of Adult worm(s) | ! style="background:#4479BA; color: #FFFFFF;" |Pulmonary Manifestation | ||
|Treatment | ! style="background:#4479BA; color: #FFFFFF;" |Location of Adult worm(s) | ||
! style="background:#4479BA; color: #FFFFFF;" |Treatment | |||
|- | |- | ||
|Ascaris lumbricoides | | style="background:#DCDCDC;" align="center" |[[Ascariasis]] | ||
|Ingestion of infective ova | | style="background:#DCDCDC;" align="center" |[[Ascaris lumbricoides]] | ||
|Ingestion of infective [[ova]] | |||
|No | |No | ||
|1-2 years | |1-2 years | ||
| | | | ||
* | * [[Löffler's syndrome]] (usually about 9-12 days after exposure to [[ova]]) | ||
* Cough | * [[Cough]] | ||
* Substernal discomfort | * [[Substernal pain|Substernal]] discomfort | ||
* Crackles | * [[Crackles]] | ||
* Wheezing | * [[Wheezing]] | ||
* Transient opacities | * Transient [[Opacity|opacities]] | ||
|Free in the lumen of the small bowel | |Free air in the [[lumen]] of the [[small bowel]] | ||
(primarily jejunum) | (primarily [[jejunum]]) | ||
| | | | ||
* Albendazole | * [[Albendazole]] | ||
* Mebendazole | * [[Mebendazole]] | ||
* Pyrantel | * [[Pyrantel pamoate]] | ||
* Ivermectin | * [[Ivermectin]] | ||
* Levamisole | * [[Levamisole]] | ||
* Piperazine | * [[Piperazine]] | ||
|- | |||
| style="background:#DCDCDC;" align="center" |[[Strongyloidiasis]] | |||
| style="background:#DCDCDC;" align="center" |[[Strongyloides stercoralis]] | |||
|Filariform larvae penetrate [[skin]] or [[bowel]] [[mucosa]] | |||
|Yes | |||
| | |||
* Lifetime of the host | |||
| | |||
* [[Löffler's syndrome]] | |||
* Chronic [[cough]] | |||
* [[Pneumonia]] or [[sepsis]] in hyperinfection | |||
|Embedded in the mucosa of the [[duodenum]], [[jejunum]] | |||
| | |||
* [[Ivermectin]] | |||
* [[Albendazole]] | |||
* [[Thiabendazole]] | |||
|- | |- | ||
|Trichuris trichiura | | style="background:#DCDCDC;" align="center" |[[Trichuriasis]] | ||
(whipworm) | | style="background:#DCDCDC;" align="center" |[[Trichuris trichiura]] | ||
|Ingestion of infective ova | ([[whipworm]]) | ||
|Ingestion of infective [[ova]] | |||
|No | |No | ||
|1-3 years | |1-3 years | ||
| | | | ||
* Albendazole | * No [[pulmonary]] migration, therefore, no pulmonary manifestation | ||
|Anchored in the superficial [[mucosa]] of [[cecum]] and [[colon]] | |||
| | |||
* [[Albendazole]] | |||
* Mebendazole | * [[Mebendazole]] | ||
|- | |- | ||
|Hookworm | | style="background:#DCDCDC;" align="center" |[[Hookworm Infection|Hookworm infection]] | ||
|Skin penetration by filariform larvae | | style="background:#DCDCDC;" align="center" |[[Necator americanus]] and [[Ancylostoma duodenale]] | ||
|[[Skin]] penetration by filariform larvae | |||
|No | |No | ||
| | | | ||
* 3-5 years (Necator) | * 3-5 years ([[Necator americanus|Necator]]) | ||
* 1 year (Ancylostoma) | * 1 year ([[Ancylostoma]]) | ||
| | | | ||
* | * [[Löffler's 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]] | ||
| | | | ||
* Albendazole | * [[Albendazole]] | ||
* Mebendazole | * [[Mebendazole]] | ||
* Levamisole | * [[Levamisole]] | ||
* Pyrantel | * [[Pyrantel pamoate]] | ||
|- | |- | ||
| | | style="background:#DCDCDC;" align="center" |[[Enterobiasis]] | ||
| | | style="background:#DCDCDC;" align="center" |[[Enterobius vermicularis]] | ||
([[pinworm]]) | |||
|Ingestion of infective [[ova]] | |||
|Yes | |Yes | ||
| | | | ||
* | * 1-month | ||
| | | | ||
* | * Extraintestinal migration is very rare | ||
|Free air in the lumen of [[cecum]], [[appendix]], adjacent [[colon]] | |||
|Free in the lumen of cecum, appendix, adjacent colon | |||
| | | | ||
* Albendazole | * [[Albendazole]] | ||
* Mebendazole | * [[Mebendazole]] | ||
* Pyrantel | * [[Pyrantel pamoate]] | ||
* Ivermectin | * [[Ivermectin]] | ||
* Levamisole | * [[Levamisole]] | ||
* Piperazine | * [[Piperazine]] | ||
|} | |} | ||
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Latest revision as of 20:28, 29 July 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2] Furqan M M. M.B.B.S[3]
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
- Peptic ulcer disease[1]
- Intestinal obstruction from Ascaris lumbricoides can mimic intussusception[3]
- Differential diagnosis of biliary ascariasis
- Gallbladder cancer[4]
- Retained bile duct stone[2]
- Other worm infections can sometimes have clinical presentations similar to that of Ascaris lumbricoides
The table below summarizes the findings that differentiate from other nematode infections:
| Differentiating ascariasis from other Nematode infections[5][6][7] | |||||||
|---|---|---|---|---|---|---|---|
| Infection | Nematode | Transmission | Direct Person-Person Transmission | Duration of Infection | Pulmonary Manifestation | Location of Adult worm(s) | Treatment |
| Ascariasis | Ascaris lumbricoides | Ingestion of infective ova | No | 1-2 years |
|
Free air in the lumen of the small bowel
(primarily jejunum) |
|
| Strongyloidiasis | Strongyloides stercoralis | Filariform larvae penetrate skin or bowel mucosa | Yes |
|
|
Embedded in the mucosa of the duodenum, jejunum | |
| Trichuriasis | Trichuris trichiura
(whipworm) |
Ingestion of infective ova | No | 1-3 years |
|
Anchored in the superficial mucosa of cecum and colon | |
| Hookworm infection | Necator americanus and Ancylostoma duodenale | Skin penetration by filariform larvae | No |
|
|
Attached to the mucosa of mid-upper portion of the small bowel | |
| Enterobiasis | Enterobius vermicularis
(pinworm) |
Ingestion of infective ova | Yes |
|
|
Free air in the lumen of cecum, appendix, adjacent colon | |
References
- ↑ 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.
- ↑ 2.0 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.