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Ascariasis (roundworm infection) is the most common helminthic infection. It occurs worldwide but is most common in tropical areas with poor sanitation and in areas where farmers use human stool as fertilizer. In the United States, it's more prevalent in the South, particularly among children younger than age 12.


Ascariasis is the common intestinal worm infection. It is found in association with poor personal hygiene, poor sanitation, and in places where human feces are used as fertilizer. Intake of food or drink contaminated with roundworm eggs causes infection.

The eggs release larvae within the intestine. The larvae then move through the bloodstream to the lungs, exit up through the large airways of the lungs, and are swallowed back into the stomach and intestines.

Symptoms and Signs

  • Passing worms in stool
  • Vomiting up worms
  • Worms exiting through the nose or mouth
  • Low-grade fever
  • Cough
  • Bloody sputum
  • Wheezing
  • Shortness of breath
  • Skin rash
  • Vomiting
  • Stomach pain
  • Diagnostic tests

    The key to diagnosis is identifying ova in the stools, or adult worms, which may be passed rectally or by mouth.


    Anthelmintic therapy, the primary treatment, uses mebendazole or albendazole. These are contraindicated in pregnancy and in heavy infections, in which ectopic migration can occur. Pyrantel pamoate and piperazine are safe in pregnancy.

    In intestinal obstruction, nasogastric (NG) suctioning controls vomiting. When suctioning can be discontinued, instill piperazine and clamp the nasogastric tube. If this is ineffective, surgery is probably needed. Endoscopic retrograde cholangiopancreatography and papillectomy may be required for helminth removal.


    Improved sanitation and hygiene in developing countries will reduce the risk in those areas. In areas where this disorder is common, routine or preventive (prophylactic) treatment with deworming medications may be advised.

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