Ascaris
lumbricoides and Trichuris trichiura
The
eggs of these roundworms are "sticky" and may be transmitted
to the mouth by hands, other body parts, fomites (inanimate objects),
or foods.
Ascariasis
and trichuriasis are the names of these infections. Ascariasis is
also known commonly as the "large roundworm" infection
and trichuriasis as "whip worm" infection.
Infection
with one or a few Ascaris sp. may be asymptomatic unless
noticed when passed in the feces, or, on occasion, crawling up into
the throat and trying to exit through the mouth or nose. Infection
from numerous worms may result in a pneumonitis during the migratory
phase when larvae that have hatched from the small intestine penetrate
into tissues and travel by way of lymph and blood to the lungs.
In the lungs, the larvae break out and ascend into the throat and
descend back down the small intestine where they grow.
Molting
(ecdysis) occurs at various points along this path and, typically
for roundworms, the male and female adults in the intestine are
5th-stage nematodes. Vague digestive tract discomfort accompanies
the intestinal infection. Some worms wander and may locate in diverse
sites throughout the body causing complications.
Treatment
with anthelmintics is likely to cause the intestinal adult worms
to wander.
Trichuris
sp. larvae do not migrate
after hatching but grow and mature in the intestine. Symptoms range
from inapparent through vague digestive tract distress to emaciation
with dry skin and diarrhea (usually mucoid). Toxic or allergic symptoms
may also occur.
Both
infections are diagnosed by finding the typical eggs in the patient's
feces; on occasion the larval or adult worms are found in the feces
or, especially for Ascaris sp., in the throat, mouth,
or nose.
Worms
are found in poorly treated sewage-fertilizer. Humans are infected
when produce is consumed raw. Infected food handlers may contaminate
a wide variety of foods.
Both
infections may self-cure after the larvae have matured into adults
or may require antihelmintic treatment. In severe cases, surgical
removal may be necessary. Allergic symptoms (especially but not
exclusively of the asthmatic sort) are common in long-lasting infections
or upon reinfection in Ascariasis.
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