mental health , characteristic of mentally healthy person .pptx
Ascaris lumbricoides.pdf
1. CASE SCENARIO
17. A Ten-year old boy admitted in emergency department with severe
acute abdominal pain associated with nausea and vomiting. On
examination child was anemic and other signs of malnourishment are
present. Barium meal X-ray shows intestinal obstruction in the small
bowel. Stool examination on saline wet mount preparation shows oval
brown colored eggs with unsegmented ovum. Therapeutic laparotomy
was done and found lot of worms in the small intestine. On examination
they were identified as adult worms of Ascaris lumbricoides.
1. Morphological (identification features) of adult worm DRAW THE DIAGRAM
• Pinkish/creamy in color when freshly passed from the intestine, but gradually
fades in color and looks whitish.
• Female worm is longer (20-35 cms) than males Male worm (15-30 cms) in
length.
• Worms are cylindrical with tapering ends.
• Adult male’s posterior end is curved ventrally and forms a hook and carries
2 copulatory spicules
2. Role of stool examination in the diagnosis of Ascariasis DRAW DIAGRAM
EGG: Round/Oval in shape, bile-stained(brown color), Size 60x40 microns with
mamillated albuminous coat.
• Definitive diagnosis is possible
• Salt floatation technique is useful ,if load is low.
2. • Bile stained eggs are seen with unsegmented ovum
3. What is the infective stage and mode of infection of A.lumbricoides
• Infective stage: matured embryonated egg containing L2 larva
• Mode of infection: Ingestion of embryonated egg from contaminated food
and water
4. Clinical manifestations of migrating larvae & adult worms
• Larvae: Intense cellular reaction in the lung tissues with infiltration of
eosinophils, macrophages and epithelioid cells.
• Ascaris pneumonia: Low grade fever, dry cough, asthmatic wheezing,
urticaria and eosinophilia
• Loeffler’s Syndrome
• Adult worms: Acute abdominal pain, nausea, vomiting, malnourishment
5. What is Loeffler’s syndrome?
• It is due to migrating larvae through the lungs.
• Sputum is blood-tinged and larvae may occasionally be seen.
• Characterized by dry cough, dyspnea and transient patchy infiltrations on
Chest X-Ray along with massive eosinophilia.
6. Complications of Chronic Ascariasis.
• Small bowel obstruction, volvulus and intussusceptions mostly in children
7. Drug of choice for Ascariasis/Treatment for Ascariasis.
• Pyrantel pamoate (paralyzing the muscle and nerve cells of parasite) and
Piperazine citrate (Kill the parasites) for heavy infections and to prevent
ectopic migration of parasites and are cleared naturally in stool.
• Albendazole/Mebendazole may be used. But these are contraindicated
during pregnancy.
