Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content +++ Key Features ++ Abdominal cramps and discomfort Large, white or reddish, round worms, or ova in the feces Ascaris lumbricoides infection is caused by contact with eggs or larvae that thrive in the moist soil of the tropics and subtropics Children infected with these worms are at increased risk for malnutrition, stunted growth, intellectual disability, and cognitive and education deficits Larvae hatch, penetrate the intestinal wall, enter the venous system, reach the alveoli, are coughed up the trachea and swallowed, returning to the small intestine, where they mature Female lays thousands of eggs daily +++ Clinical Findings ++ Most infections are asymptomatic Moderate to heavy infections are associated with abdominal pain, weight loss, anorexia, diarrhea, and vomiting, and may lead to malnutrition Acute transient eosinophilic pneumonitis (Löffler syndrome) may occur during the larval migratory phase Appendicitis, common bile duct obstruction (resulting in biliary colic, cholangitis, or pancreatitis), or peritonitis can be caused by worm migration +++ Diagnosis ++ Large roundworms (1.5–4 cm) are observed in the stool or by microscopic detection of the ova on stool examination +++ Treatment ++ Highly effective regimens include Albendazole (400 mg in a single dose, or 200 mg in children 1–2 years of age) Mebendazole (100 mg twice a day for 3 days or 500 mg once) Pyrantel pamoate (a single dose of 11 mg/kg; maximum 1 g) Piperazine (150 mg/kg initially, followed by six doses of 65 mg/kg every 12 hours by nasogastric tube) Used in cases of intestinal or biliary obstruction Can be used to paralyze the worms and help relieve obstruction Surgical removal is occasionally required GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessPediatrics 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessPediatrics Full Site: One-Year Individual Subscription $595 USD Buy Now View All Subscription Options