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Roundworms, Intestinal

Gail Scully, MD, MPH Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Nonsegmented, elongated helminthic parasites (nematodes). The adult stage infects the human intestinal tract. Larval stages can exist elsewhere in the body. Eggs and/or larvae of rou...

DIAGNOSIS

HISTORY

  • E. vermicularis

    • Most infections are asymptomatic; nocturnal perianal itching is the most common symptom.

    • Abdominal pain possible with high parasite burden

  • T. trichiura

    • Symptomatic if heav...

TREATMENT

MEDICATION

First Line

  • E. vermicularis (pinworm): pyrantel pamoate 11 mg/kg PO once (max 1 g); with a repeat dose 2 weeks later or albendazole 400 mg PO or mebendazole 100 mg PO once, repeat do...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Reinfection is possible; immunity does not develop (5)[A]. 

Patient Monitoring

Follow-up stool studies at 2 weeks; retreat if necessary. Repeat Strongyloides serolo...

REFERENCES

1
Requena-Méndez A, Chiodini P, Bisoffi Z, et al. The laboratory diagnosis and follow up of strongyloidiasis: a systematic review. PLoS Negl Trop Dis.  2013;7(1):e2002. [View Abstract o...

ADDITIONAL READING

  • Speich B, Ame SM, Ali SM, et al. Oxantel pamoate–albendazole for Trichuris trichiura infection. N Engl J Med.  2014;370(7):610–620. [View Abstract on OvidMedline]

  • Ziegelbauer K,...

SEE ALSO

Intestinal Parasites; Roundworms, Tissue 

CODES

ICD10

  • B77.0 Ascariasis with intestinal complications

  • B77.9 Ascariasis, unspecified

ICD9

127.0 Ascariasis 

SNOMED

  • 187171000 Ascariasis with intestinal complications (disorder)

  • 2435008 Ascariasis (disord...

CLINICAL PEARLS

  • Ascariasis is the most common worldwide nematode infection.

  • E. vermicularis (pinworm) is the most common U.S. nematode infection.

  • Eosinophilia is best indicator of infection with N. amer...

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