Ascariasis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]

Overview

Differential Diagnosis

Differentiating Ascaris from other Nematodes[1]
Nematode Transmission Direct Person-Person Transmission Duration of Infection Pulmonary Manifestation Location of Adult worm(s) Treatment
Ascaris lumbricoides Ingestion of infective ova No 1-2 years
  • Loeffler syndrome (usually about 9-12 days after exposure to ova)
  • Cough
  • Substernal discomfort
  • Crackles
  • Wheezing
  • Transient opacities
Free in the lumen of the small bowel

(primarily jejunum)

  • Albendazole
  • Mebendazole
  • Pyrantel
  • Ivermectin
  • Levamisole
  • Piperazine
Trichuris trichiura

(whipworm)

Ingestion of infective ova No 1-3 years No pulmonary migration, therefore, no pulmonary manifestation Anchored in the superficial mucosa of cecum and colon
  • Albendazole
  • Mebendazole
Hookworm (Necator americanus and Ancylostoma duodenale) Skin penetration by filariform larvae No
  • 3-5 years (Necator)
  • 1 year (Ancylostoma)
  • Loeffler syndrome
  • Transient opacities
Attached to the mucosa of mid-upper portion of the small bowel
  • Albendazole
  • Mebendazole
  • Levamisole
  • Pyrantel
Strongyloides stercoralis Filariform larvae penetrates skin or bowel mucosa Yes Lifetime of the host
  • Loeffler syndrome
  • Chronic cough
  • Pneumonia or sepsis in hyperinfection
Embedded in the mucosa of the duodenum, jejunum
  • Ivermectin
  • Albendazole
  • Thiabendazole
Enterobius vermicularis (pinworm) Ingestion of infective ova Yes 1 month No pulmonary migration, therefore, no pulmonary manifestation Free in the lumen of cecum, appendix, adjacent colon
  • Albendazole
  • Mebendazole
  • Pyrantel
  • Ivermectin
  • Levamisole
  • Piperazine

References

  1. 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.


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