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Ascaris lumbricoides
MOSAB NOURALDEIN MOHAMMED HAMAD
 Ascaris lumbricoides is the largest nematodes
parasitizing the human intestine .
 The name derived from Askaris means
intestinal worm and lubricus means
resembling with common earth worm .
Distribution
 Cosmopolitan , mainly affecting tropical
countries .
Epidemiology
 There are number of factors contribute to the high frequency of
infection with Ascaris lumbricoides , these include its :
1. Ubiquitous distribution
2. The high number of egg produced by fertilized female
3. The hard nature of the egg , which enable them to survive
unfavorable condition ( can survive in the absence of oxygen, live 2
year at 5-10 c, unaffected by desiccation for 2 to 3 weeks)
4. In favorable condition ( moist, sandy soil) they can survive for up
to 6 years .
Transmission
 Ingestion of embryonated egg ( containing
L2)from contaminated soil ,water or food.
Life cycle
Clinical feature
 Mostly its asymptomatic
 Symptomatic disease is usually related to :
 Larval stage : pulmonary disease
 Adult stage : intestinal disease
 Symptoms usually develop after 9 to 12 days
after ingestion of egg .
Pulmonary symptoms
 Caused by migratory larva
 Bronchospasms
 Dyspnea
 Wheezing
 Fever
 Non productive cough
 Chest pain
 Loeffler’s syndrome ( Eosinophilic pneumonia):
In severe cases patients dyspnea and a transient
patchy infiltrates seen on chest X-ray along with
peripheral eosinophilia .
Inestinal symptoms
 Caused by adult worm .
 Asymptomatic
 Abdominal pain
 Malnutrition and growth retardation
 Steatorrhea
 Intestinal obstruction
Extra intestinal complication
 Adult worm can enter the biliary tract , leading to cholecystitis ,
pancreatitis , intrahepatic abscess.
 Adult worm also can migrate to the pharynx and cause respiratory
obstruction
 Allergy :
May be due to toxic fluids ( ascarase or ascaron) released by adult worm
Laboratory diagnosis
 Egg detection in stool examination ( fertilized
or un fertilized )
 Larva detection in sputum
 Serologically by :
1. ELISA
2. IFAT
3. IHA
Other findings
 Eosinophilia
 Charcot Leyden crystals in sputum and stool .
 Egg can be detected in direct wet preparation
( Saline or iodine wet mount) , if not ,
sedimentation concentration techniques can
be used.
 Floatation techniques can not be use due to
heavy weigh of egg .
 Occasionally adult stage can be seen by naked
eye in sputum or stool .
Adult worm
Types of egg
 Unfertilized :
( with thick albuminous coat )
 Fertilized egg :
(With thin albuminous
Coat)
Character Fertilized Unfertilized
Shape Round Elongate
Size Smaller Larger
Albuminous cover Thin albuminous coat Thick albuminous coat
Floatation technique Float Does not float
Ovum Large unsegmented Small , unsegmented with
highly refracticle granules
 Decorticated egg ( without albuminous coat)
Prevention & control
 Treatment of patients ( albendazole or
mebendazole)
 Health education
 Using of untreated human feces as fertilizer
should be forbidden
 Improve the level of sanitation ( using latrines ,
washing hands before eating & after
defecation )
Contact:
Mosab Nouraldein Mohammed Hamad
Head of Medical Parasitology Department, Faculty of Health Sciences,
Elsheikh Abdallah Elbadri University, Sudan
Email: musab.noor13@gmail.com

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Ascaris lumbricoides

  • 2.  Ascaris lumbricoides is the largest nematodes parasitizing the human intestine .  The name derived from Askaris means intestinal worm and lubricus means resembling with common earth worm .
  • 3. Distribution  Cosmopolitan , mainly affecting tropical countries .
  • 4. Epidemiology  There are number of factors contribute to the high frequency of infection with Ascaris lumbricoides , these include its : 1. Ubiquitous distribution 2. The high number of egg produced by fertilized female 3. The hard nature of the egg , which enable them to survive unfavorable condition ( can survive in the absence of oxygen, live 2 year at 5-10 c, unaffected by desiccation for 2 to 3 weeks) 4. In favorable condition ( moist, sandy soil) they can survive for up to 6 years .
  • 5. Transmission  Ingestion of embryonated egg ( containing L2)from contaminated soil ,water or food.
  • 7. Clinical feature  Mostly its asymptomatic  Symptomatic disease is usually related to :  Larval stage : pulmonary disease  Adult stage : intestinal disease  Symptoms usually develop after 9 to 12 days after ingestion of egg .
  • 8. Pulmonary symptoms  Caused by migratory larva  Bronchospasms  Dyspnea  Wheezing  Fever  Non productive cough  Chest pain
  • 9.  Loeffler’s syndrome ( Eosinophilic pneumonia): In severe cases patients dyspnea and a transient patchy infiltrates seen on chest X-ray along with peripheral eosinophilia .
  • 10. Inestinal symptoms  Caused by adult worm .  Asymptomatic  Abdominal pain  Malnutrition and growth retardation  Steatorrhea  Intestinal obstruction
  • 11. Extra intestinal complication  Adult worm can enter the biliary tract , leading to cholecystitis , pancreatitis , intrahepatic abscess.  Adult worm also can migrate to the pharynx and cause respiratory obstruction  Allergy : May be due to toxic fluids ( ascarase or ascaron) released by adult worm
  • 12. Laboratory diagnosis  Egg detection in stool examination ( fertilized or un fertilized )  Larva detection in sputum  Serologically by : 1. ELISA 2. IFAT 3. IHA
  • 13. Other findings  Eosinophilia  Charcot Leyden crystals in sputum and stool .
  • 14.  Egg can be detected in direct wet preparation ( Saline or iodine wet mount) , if not , sedimentation concentration techniques can be used.  Floatation techniques can not be use due to heavy weigh of egg .  Occasionally adult stage can be seen by naked eye in sputum or stool .
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  • 18. Types of egg  Unfertilized : ( with thick albuminous coat )
  • 19.  Fertilized egg : (With thin albuminous Coat)
  • 20. Character Fertilized Unfertilized Shape Round Elongate Size Smaller Larger Albuminous cover Thin albuminous coat Thick albuminous coat Floatation technique Float Does not float Ovum Large unsegmented Small , unsegmented with highly refracticle granules
  • 21.  Decorticated egg ( without albuminous coat)
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  • 23. Prevention & control  Treatment of patients ( albendazole or mebendazole)  Health education  Using of untreated human feces as fertilizer should be forbidden  Improve the level of sanitation ( using latrines , washing hands before eating & after defecation )
  • 24. Contact: Mosab Nouraldein Mohammed Hamad Head of Medical Parasitology Department, Faculty of Health Sciences, Elsheikh Abdallah Elbadri University, Sudan Email: musab.noor13@gmail.com