Helminths (human) Ascaris lumbricoides

Notes

A]. General notes on helminths

  • Classification of human helminths

_Kingdom: metazoan

_Phyla: Platyhelminthes (in which the class of cestodea and trematodea belong)  and nemahelminthes (in which the class of nematodea belongs).

  • The class cestodea are worms that are tape-like, segmented, have hooks or suckers, have no alimentary canal and are hermaphrodite. They include the following: Taenia solium, Taenia saginata, Hymenolepis spp. Diphyllobothrium latum and Echinoccocus granulosus.
  • The class nematodea (round worms), unsegmented, sexually differentiated, have no hooks or suckers. They include the following: Ascaris, Trichuris, Necator, Strongyloides stercoralis, americanus, Anchylostoma duodenale, Anchylostoma braziliense and Anchylostoma caninum The above named nematodes are also known as Soil-Transmitted Helminths (STH). Other group of nematodes are filarial nematodes and they include:
  • The class trematodea (flukes) are leaf-like, unsegmented, except Schistosoma, have suckers (no hooks) and no anus. They include the following: Fasciola hepatica, Schistosoma mansoni and Schistosoma japonicum.
  • The outer segment of the metazoan, cuticle or integument, is resistant to intestinal enzyme digestion.
Symptoms

Ascaris lumbricoides

  • Mostly there are no symptoms
  • Abdominal pain
  • Nausea and vomiting
  • Worms in stool or vomit
  • Diarrhea or bloody stools
  • Fatigue
  • Loeffler’s syndrome (caused by migration of numerous larvae through the lungs characterized by:

_cough

_wheezing

_eosinophilia

_hemoptysis)

  • Weight loss or retarded growth in children
  • Malnutrition
  • Shortness of breath
  • Intestinal obstruction (in severe cases)
Diagnosis
  • Stool for ova
Management

Either,

Over 2 years: (children and adults): _Tabs/susp Albendazole 400mg stat

Or;

_Tabs Levamizole Adults: 120mg stat. Children 1-4 years: 40mg stat.  5-15 years: 80mg stat.

Or;

_Tabs Mebendazole 100mg BD x 3/7 or 500mg stat.

Or;

Tabs / susp Pyrantel pamoate 10mg/kg stat

Or;

Rarely:

   _Tabs Praziquantel 10mg/kg stat

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