Esophageal space-occupying lesion caused by Ascaris lumbricoides

Ascaris lumbricoides is the largest intestinal nematode parasite of man,which can lead to various complications because of its mobility.As the esophagus is not normal habitat of Ascaris,the report of esophageal ascariasis is rare.An old female presented with dysphagia after an intake of several red bean buns and haw jellies.The barium meal examination revealed a spherical defect in the lower esophagus.Esophageal bezoar or esophageal carcinoma was considered at the beginning.The patient fasted,and received fluid replacement treatment as well as some oral drugs such as proton pump inhibitor and sodium bicarbonate.Then upper gastrointestinal endoscopy was done to further confirm the diagnosis and found a live Ascaris lumbricoides in the gastric antrum and two in the duodenal bulb.The conclusive diagnosis was ascariasis.The esophageal space-occupying lesion might be the entangled worm bolus.Anthelmitnic treatment with mebendazole improved patient's clinical manifestations along with normalization of the radiological findings during a 2-wk follow-up.Authors report herein this rare case of Ascaris lumbricoides in the esophagus,emphasizing the importance of awareness of this parasitic infection as it often presents with different and unspecific symptoms.

Eosinophilic cholecystitis caused by Ascaris lumbricoides

Eosinophilic cholecystitis is caused by the accumulation of eosinophils in the gallbladder wall and diagnosis is usually made based on histopahologic studies. The purpose of this paper is to comment on a case report published in World 3 GaslToenterol 2007 .July; 13 （27）： 3760-3762, about eosinophilic cholecystitis along with pericarditis without histopathological studies, which are considered necessary for its diagnosis.

Serum malondialdehyde level in patients infected with Ascaris lumbricoides

AIM:The aim of the study was to investigate the changes of serum malondialdehyde level, I.e; the oxidative stress hypothesis in patients infected with Ascaris lumbricoides.METHODS: Serum malondialdehyde activity was measured in 43 patients who were positive for intestinal parasite of Ascaris lumbricoides. Scores were obtained for the positives and their age-and sex-matched 60 Ascaris lumbricoides negative healthy controls.RESULTS: The difference between malondialdehyde levels of patients infected with Ascaris lumbricoides and control group was statistically significant both for females (P＜0.05)and for males (P＜0.05). In the patient and control groups,no correlation was found between age and malondialdehyde levels (P＞0.05) both in females and in males. In addition,no significant correlation could be found between malondialdehyde levels of both females and males for patients and control groups (P＞0.05).CONCLUSION: Malondialdehyde levels clearly increase in patients infected with Ascaris lumbricoides.

Identification and Functional Analysis of Differentially Expressed Genes of Ascaris suum Goeze,1782 from Ascaris lumbricoides Linnaeus, 1758

In order to provide further evidence to prove that Ascaris suum Goeze,1782 and Ascaris lumbricoides Linnaeus,1758 are really different species in taxonomy,and to identity A.suum larval migrans-related genes for diagnosis and prevention use,A.suum genes that were differentialy expressed from the same gender of A.lumbricoides were enriched by subtracting the same expressed genes using suppression subtractive hybridization （SSH） assay.Specificity of the selectively enriched cDNA was verified by Southern blot analysis.The female A.suum specific cDNA library was then constructed and sequenced.Basic local alignment search tool （BLAST） analysis of female A.suum specific cDNA identified 6 specific ESTs with tentative functions related to larva migrans.This study provided further evidence for differentiating A.suum from A.lumbricoides.Mining for the detailed information and application of the 6 ESTs are worth being done in the future studies.

THE EVALUATION OF THE EFFECT OF MEBENDAZOLE ON TREATING ASCARIS LUMBRICOIDES AND TRICHURIS TRICHURA INFECTION WITH TWO KINDS OF THERAPY

A total of 309 cases infected with ascariasis and trichuriasis were selected as subjects, of whom 177 cases received mebendazole tablet 500mg/d for the treatment of ascariasis and trichuriais,132 cases received mebendazole tablet 200mg/d for three days, Before and after the treatment, all the patients' feces were examined with Kato's technique, the results indicated that the cure rate of ascariasis was 71. 4% (70/98) in the experiment group and 78. 6% (66/84) in the control group respectively; There was no difference between the two groups (P > 0. 05 ). The cure rate of trichuriasis infection was 87. 5% (14/16 ) in the experimental group and 93. 3% (14/15 ) in the control group;There was also no difference between the two groups (P= 0. 401 ). But the cure rate of mixed infection of ascariasis and trichuriasis was 54. 0% (34/63) and 75. 8% (25/33) respectively; The cure rate of the experimental group was apparently lower than the that of the control group (P < 0. 05 ). The average reduced rate of egg count in per gram feces (E,P, G ) for ascariasis infection was 63. 6% (14/22) in the experimental group and 93. 8% (15/16) in the control group. In conclusion, to treat ascariasis and trichuriasis infection with mebendazole tablet should be used the three-day therapy with a total dose of 600mg or 1200mg.

Assessment of albendazole efficacy against Ascaris lumbricoides at three sites of Andhra Pradesh,Odisha,and Kerala in India

Objective:To assess efficacy of albendazole against Ascaris(A.)lumbricoides among school-children at three sites of Rajahmundry,Sundergarh and Wayanad.Methods:Sites were selected based on soil-transmitted helminths prevalence,different sociocultural-geographical characteristics and operational feasibility.9-12 Years old children from 14 schools were included.The study was conducted in two rounds:baseline&follow up survey.All eligible children found positive for A.lumbricoides at baseline were administered supervised single tablet albendazole 400 mg under the National Deworming Day Initiative.During post-treatment follow-up survey,eligible children who provided second stool sample were included in the final analysis.Stool samples were examined using WHO recommended Kato-Katz technique.Efficacy was estimated based on cure rate(CR)and Fecal Egg Count Reduction Rate(FECRR)among children found positive in baseline and follow-up surveys.Results:328 Out of 625(52.5%)were found positive for A.lumbricoides in the baseline survey and 85 out of 178 samples(47.8%)during post-treatment follow-up survey.Overall,the estimated CR was 52.2%.FECRR(95%CI)for albendazole was 72.6%(79.2%-66.0%).The FECRR was highest in East Godaveri[89.7%(96.8%-82.6%)],followed by Sundergarh[86.4%(95.3%-77.5%)]and Wayanad[69%(81.7%-56.4%)].Conclusions:Our study confirmed overall reduction in FEC although with varying albendazole efficacy for A.lumbricoides infection at three different locations in India.However,these finding may be assessed in context of ongoing MDA under Filaria control program and further studies by in vivo as well as in vitro methods are required to reach to a conclusion on possible resistance if any.

A Far-Out Case of Ascariasis Causing Small Bowel Obstruction in Mauritius

Ascaris lumbricoides (A. lumbricoides), the soil-transmitted helminth is the most prevalent parasitic infection of the gastrointestinal tract in developing countries. Heavy worm loads mainly due to untreated worm infestations are often associated with increased risk of severe sequelae. We report the first complicated case of A. lumbricoides causing small bowel obstruction in a 9-year-old boy that necessitated surgical intervention on a tropical island in the Indian Ocean, where cases of Ascariasis are rarely encountered.

Intestinal ascariasis at pediatric emergency room in a developed country

Ascaris lumbricoides infection is rare among children in developed countries.Although large numbers of adult Ascaris in the small intestine can cause various abdominal symptoms,this infection remains asymptomatic until the number of worms in the intestine considerably increases in most cases.Ascaris causing bilious vomiting suggesting ileus is rare,especially in developed countries.A 6-year-old boy who lived in Japan,presented with abdominal colic,bilious vomiting at the pediatric emergency room.He appeared pale,and had no abdominal distention,tenderness,palpable abdominal mass,or findings of dehydration.He experienced bilious vomiting again during a physical examination.Laboratory tests showed mild elevation of white blood cells and C-reactive protein levels.Antigens of adenovirus,rotavirus,and norovirus were not detected from his stool,and stool culture showed normal flora.Ultrasonography showed multiple,round-shaped structures within the small intestine,and a tubular structure in a longitudinal scan of the small intestine.Capsule endoscopy showed a moving worm of Ascaris in the jejunum.Intestinal ascariasis should be considered as a cause of bilious vomiting in children,even at the emergency room in industrial countries.Ultrasound examination and capsule endoscopy are useful for diagnosis of pediatric intestinal ascariasis.

Life-threatening complications of ascariasis in trauma patients:a review of the literature

BACKGROUND:Ascariasis is one of the most common human parasitic infections worldwide. In some rare cases,ascariasis may cause serious consequences even sudden death. This study was undertaken to review the life-threatening complications of ascariasis in trauma patients reported in the literature.DATA SOURCES:Relevant articles about ascariasis and trauma were searched from Pubmed,Google scholar,Scirus,and Wanfang databases.RESULTS:Twenty-four patients with ascariasis were collected from 21 articles searched. Most of these patients were from tropical and subtropical countries. Of the 24 patients,12 were children. Their major complications occurred in the airway passage and digestive tract. There were 3 fatal cases in these patients. Twelve of the 24 patients described in 10 articles were reported in the last 10 years.CONCLUSIONS:Early diagnosis and prompt intervention are essential to minimize the high morbidity and mortality of these serious complications in trauma patients. Physicians should be aware of the possibility of Ascaris infection in a trauma patient from endemic area of ascariasis. History of Ascaris infection and routine examination of feces for Ascaris eggs may be helpful to make a correct diagnosis.