Arreo, Dianne Faith C. Parasitology Summary Notes TOPIC: A.

lumbricoides

● Whitish or pinkish
COMMON NAMES: ● Has club-shaped esophagus
● Has smooth striated cuticles
● Giant roundworm ● Have a terminal mouth with three lips and
sensory papillae
● Large intestinal roundworm
Adult male
● Roundworm of man
➢ up to 30 cm
HISTORY
➢ creamy white pink tint
➢ 1758: Linnaeus named the parasite Ascaris
➢ Prominent incurved tail
lumbricoides (one of the 6 worms he named)
Adult female
➢ Late 17th century: first studied by Edward Tyson
➢ 22-35 cm
describing a detailed anatomy of the worm
➢ creamy white pink tint
➢ 1862: transmission by ingesting eggs is demonstrated
➢ Pencil lead thickness
by Casimir Joseph Davaine

➢ 1922: migration of larval stages around the body was

FERTILIZED EGG
discovered by Shimesu Koino

➢ A. lumbricoides eggs were found in human coprolites

Parameter Description
(fossilized feces) from Peru in 2277 BC and Brazil in

1660-1420 BC Size 40-75 µm by 30-50 µm

EPIDEMIOLOGY Shape Rounder than no

fertilized version
● 1.2 billion people globally have ascariasis

● 2000 die annually Embryo Undeveloped unicellular

embryo
● Endemic in Southeast Asia, Africa, Central
and South America
Shell Thick chitin
● 5-15 year-olds have highest intensities of
infection
Other features May be corticated or
● Highest cases are found in East Asia and decorticated
Pacific Islands.

● Prevalence in the Philippines: 80-90% in UNFERTILIZED EGG

certain high-risk groups like public elementary
school children
Parameter Description
● 27.7% prevalence among school-age
children
Size 85-95 µm by 38-45 µm;
● 30.9% among preschool children size variations possible
● Main factors/Risk of infection:
Shape Varies
➔ High density of human population
➔ use of night-soil as fertilizer
➔ Illiteracy Embryo Unembryonated;
➔ Poor health education on personal, amorphous mass of
family, and community hygiene protoplasm
➔ Poor sanitation

MORPHOLOGY
Shell Thin
● Has polymyarian type of somatic muscle
arrangement Other Usually corticated
● Large and cylindrical with tapering ends features
● Cells are numerous and project well into the
body cavity
Arreo, Dianne Faith C. Parasitology Summary Notes TOPIC: A. lumbricoides

INFECTIVE STAGE:fully embryonated egg Biliary ascariasis Severe colicky

abdominal pain, brought
Embryonated eggs can persist in the soil for up to about by the movement
10 years. Eggs are highly resistant and may remain of the worms
viable up to 6 years. inside the biliary duct

In the soil, it takes 2-3 weeks for the eggs to

become infective, under favorable conditions with
suitable temperature, moisture, and humidity. The
larvae undergo two molts to reach their 3rd stage
within the egg and become embryonated. Laboratory Diagnosis

LIFE CYCLE · Microscopic examination of stool samples

1. Embryonated eggs ingestion · Kato-Katz thick smears

2. Hatching in the lumen of the small intestine, releasing · X- rays

the larvae
· CT scans or MRI
3. Larvae migrate to the cecum or proximal colon, where
they penetrate the intestinal wall 4. Larvae enter the
venules towards the liver through the portal vein, to the
heart and pulmonary vessels where they break out of TREATMENT
capillaries to enter the air sacs
Albendazole 400 mg orally once
5. In the lungs the larvae undergo molting Mebendazole 100 mg orally twice daily for 3
days or 500 mg orally once
6. Molted larvae migrate to the larynx and oropharynx to
be swallowed into the digestive tract. Ivermectin 150-200 mcg/kg orally once
BENZIMIDAZOLES (albendazole,
mebendazole)

Pathogenesis and Clinical Manifestations

PREVENTION & CONTROL
Lung migration ➢ Host sensitization
resulting in allergic
1. thoroughly cooking food
manifestation
· Lung
infiltration 2. Provision of safe water
· Asthmatic
attacks 3. Environmental sanitation
· Edema of
the lips 4. Hygiene education
➢ Difficulty of breathing
➢ Fever similar to
pneumonia, as a result
5. Regular deworming
of penetration of larvae
in the air sacs

NICE TO KNOW FACTS

1. A. lumbricoides lacks circular muscles

Most frequent Vague abdominal pain
complain
2. An almost identical worm, often called A. suum,
During larval Eosinophilia (allergic occurs in pigs
migration reaction)
3. Migrating adult worms may cause symptomatic
Moderate infections ➢ Lactose intolerance occlusion of the biliary tract or oral expulsion
➢ Vitamin A
malabsorption 4. Larval migration may cause cough, dyspnoea,
haemoptysis and eosinophilic pneumonitis (Löffler's
Heavy infections Bowel obstruction due
syndrome).
to bolus formation
➢ Intussusception 5. Ascariasis eggs live up to 6 years
➢ Volvulus, that may
result in bowel infarction
and intestinal
perforation

Serious and fatal Erratic migration of

effects adult worms
- May be regurgitated
and vomited
- May escape through
the nostrils
- Rarely inhaled into the
trachea