View source for Soil-transmitted helminthes

==Background==

==Clinical Features==
*Includes Ascaris roundworm, whipworm, and hookworms
*Morbidity is related to number of worms harbored in intestines
*Light infections often asymptomatic
*Heavier infections with variety of manifestations including GI symptoms (abdominal pain, diarrhea, blood in stool, rectal prolapse), malaise, weakness, impaired cognitive / physical development, malnutrition<ref>Wilcox S, Thomas S, Brown D, Nadel E.  “Gastrointestinal Parasite.”  The Journal of Emergency Medicine, 2007; 33(3):277-280</ref></ref>
*Hookworm and whipworm infestations also cause iron-deficiency anemia
**Adult worms attach to intestinal wall to feed, causing ongoing luminal blood loss
*'''Löffler’s syndrome'''
**Result of Ascaris or hookworm larval transit through the lungs
**Characterized by persistent non-productive cough, chest pain, wheezing, rales, pulmonary infiltrates on CXR and marked eosinophilia

==Differential Diagnosis==

==Workup==

==Management==
*[[Ascaris]]: albendazole 400 mg x 1 dose OR mebendazole 100 mg BID x 3 days (both high efficacy)

*[[Whipworm]] (Trichuris): albendazole 400 mg x 1 dose
**Historically treated with albendazole or mebendazole, but monotherapy has low efficacy against Trichuris especially in heavy infections; higher cure rate achieved with oxantel pamoate-albendazole combination compared to any monotherapy in recent RCT <ref>Speich B, Ame S, et al. "Oxantel Pamoate–Albendazole for Trichuris Trichiura Infection." New England Journal of Medicine, 2014; 370: 610-620.</ref>

*[[Hookworm]]: albendazole 400 mg x 1 dose (high efficacy) OR mebendazole 500 mg x 1 dose (low to moderate efficacy)

*Iron supplements in [[anemia]]

==Disposition==

==See Also==
*[[Worm Infections]]
*[[Travel Medicine]]

==External Links==

==Sources==
<references/>

[[Category:ID]]
[[Category:TropMed]]