Infection with adult Ascaris primarily occurs in the gastrointestinal system, but physical migrationother than this has been reported. To date, only a small number of cases have been reported to involvethe urinary system and no report of Ascariasis migration to the retroperitoneal space.This is a case of a 38-year-old female admitted as a case of perinephric abscess, renal mass right.Patient was initially managed conservatively with broad spectrum antibiotics and tube drainage, butwith the deteriorating condition, an exploratory laparotomy, with retroperitoneal exploration wasdone. During exploration, no colonic fistula was noted. The renal parenchyma was noted to bepinkish with a 1cm opening at the mid lateral pole associated with purulent discharge. Interestingly,a 6cm x 1cm wax-like, moving structure was found in the retroperitoneal space The object wasremoved with Debakey forceps and was determined to be Ascaris lumbricoides by histopathology.Fecal analysis of stool for ova and parasites was negative for Ascaris. The patient then had an uneventfulrecovery.Currently, there are only two theories on how Ascaris lumbricoides can be introduced into the urinarysystem. The first includes fistulation between the GI and urinary system and second by retrogrademigration of the adult worm through the urethra. Given the current data, the authors believe that thepatient experienced retrograde invasion of Ascaris through the urethra, and subsequently migrated tothe retroperitoneal space through fistulation.Ascariasis of the genitourinary tract is a rare condition. This is the first reported case of ascariasis inthe retroperitoneum.
Ascaris lumbricoides

No abstract available.
Ascaris lumbricoides* ; Ascaris* ; Diagnosis*

This study was undertaken to estimate the reinfection incidence of Ascaris lumbricoides after biannual blanket mass chemotherapy and to figure out the characteristic seasonal fluctuation pattern in a Korean rural village. A total of 612 residents from 4 Ri's of Hwasung Gun, Kyunggi Do, Korea was selected and divided into 6 groups according to hamlets, each of which consisted of about 100 inhabitants. Each group received blanket biannual mass chemotherapy with 10 mg/kg of pyrantel pamoate respectively in each month, during the period from April 1977 to September 1978 (Group A-April and October 1977 and April 1978, Group B-May and November 1977 and May l978, and so on). Beforehand Ascaris infection status was evaluated by examining eggs and worms expelled exactly after the first mass chemotherapy checked during the first 6 months and the reinfection incidences were estimated in follow-up examinations during next l2 months by the above two kinds of methods and by detection of young Ascaris positive cases. Young Ascaris was defined as worm shorter than l3 cm and lighter than 500 mg and considered to have introduced to human host during the period from the previous 2 months to 2 weeks. The results were summarized as follows: Beforehand infection rate with Ascaris were 42.3 percent (34.4-50.6 percent by group) by egg detection and 46.2 percent (36.2-51.9 percent by group) by worm detection methods in average. Number of worms per infected case was 2.7 (1.5-4.2 by group) in average. Reinfection rates estimated by egg detection ranged from 8.0 to 3l.5 percent (l6.9 percent in average) in the first follow-up period and from 14.0 to 20.0 percent (l7.5 percent in average) in the second follow-up. Seasonal fluctuation was found marked and there were roughly two peaks, of which the larger appeared from February to March and the smaller from August to September. Reinfection rates by worm detection method ranged from 20.6 to 34.9 percent(25.7 percent in average) and from 14.3 to 21.9 percent (19.6 percent in average) in respective follow-up examinations. Seasonal fluctuation was also observed and the peak incidence appeared one month earlier than those made by egg positive conversion. Number of worms per infected case decreased to 1.6 in average in both follow-up. Young Ascaris detection rates ranged from 6.0 to 12.9 percent (9.4 percent in average) and from 2.3 to 5.8 percent (3.8 percent in average) in respective follow-up. Seasonal fluctuation was also observed. From January to February, the positive rates were up to 12.9 percent and 12.7 percent respectively, which formed the higher peak. Lower one was observed during July to August. From the above results, the actual time of Ascaris reinfection were November to December for the higher peak and May to June for the lower one in Korean population. Pickled vegetable was suggested as a most probable source of Ascaris reinfection during late autumn to winter season.
parasitology-helminth-nematoda ; Ascaris lumbricoides ; reinfection ; epidemiology

In the present study, the effect of primary infection to reinfection with Ascaris suum larvae was experimented in mouse model. Mice were challenged with l,000 infective stage eggs of Ascaris suum. The embryonated eggs were directly introduced into stomach of mice. Reinfection was performed at 50 days after the primary infection with same method as primary infection. Mice were sacrificed 3, 5, 7, 10, 15 and 20 days after infection in both groups respectively. Larvae collected from livers and lungs with Baermann's apparatus were enumerated and measured after sacrifice. Sera of mice were also collected at same time. The results of the experiment were as follows: With antigen prepared from coelomic fluid of adult Ascaris suum and sera collected from mice before reinfection, the production of antibody in experimental mice was confirmed by the gel-diffusion technique. In the livers of reinfected mice, the larvae were recovered up to 10 days after challenge, otherwhile in the primary infected mice, the larvae were observed up to 7 days. The maximum number of larvae were observed in the lungs of primary infected mice on 10 days after inoculation. In the lungs of reinfected mice, maximum number of larvae were recovered on 7 days after, only few larvae were recovered on 10 days after reinfection. As regards the growth of the larvae, the third stage larvae, over 500 micrometer in length, appeared in livers at 5 days after reinfection, but it couldn't be found on 7 days and 10 days after challenge. The third stage larvae continuously developed were observed in lungs of mice from 5 days after reinfection. In conclusion, it was found that development of larvae in livers of immune mice were probably repressed by the immune mechanisms being rised in livers and defence mechanism is also acting by interfering with the process of larval penetration into the lung from the liver.
parasitology-helminth-nematoda ; immunology ; Ascaris lumbricoides ; mouse

The epidemiological status of ascariasis was analyzed in 8 rural villages in Korea, through observation of its epidemiological parameters such as prevalence, worm burden and basic reproductive rate. Total 978 inhabitants were subjected to stool examination and recovery of worms after chemotherapy with pyrantel pamoate. The results were as follows: The worm positive rate in each village was 16.5-79.5%, while the egg positive rate was 9-18% lower, 3.3-66.7%. The average worm burden(among all inhabitants) ranged from 0.21 to 8.44 by villages and the frequency of cases with each worm burden showed negative binomial distributions with 'k' values of 0.38-0.54. The prevalence rates (worm) in each village was almost identical with the theoretical ones from Anderson and May's equation; p=1-(1+M(*)/k)**(-k), where 'p' is worm prevalence and 'M(*)' equilibrium average worm burden. The basic reproductive rate 'R' was calculated from 1.03 to 2.11. It is suggested that, although 'R' in lower endemic areas is approaching to the breakpoint of reinfection (R=1), control programs of ascariasis in Korea should be continued until it becomes below the level nationwidely.
parasitology-helminth-nematoda ; epidemiology ; Ascaris lumbricoides

In Ascaris lumbricoides infection, the faecal examination, undertaking for ova detection, is not always diagnostic. It is just because some of the infected cases has Ascaris worm(s) which do not produce eggs. In the present study, the authors attempted to analyse quantitatively the egg discharging patterns in Ascaris infected cases with low worm burden. The following results were obtained: In 1,861 Ascaris worms collected from 853 cases, the sex ratio was 1: 0.74 (female: male). Sex combinations in each burden of case were always fitted with theoretical values from the binomial distribution; (m+f)(n)= (0.426+0.574)(n). In each worm burden, their sex combination indicated different egg discharging patterns; false negative cases, unfertilized ova passers and fertilized ova passers. When the relative frequency of the above three egg discharging patterns was plotted to worm burden per case, a definite relationship was found. The cases with six or more worms have nil probability to be false negative case or unfertilized ova passer. Out of 853 cases, we found 129 false negative cases. The collected worms from 125 cases were morphologically analysed. It was found that 52% of them were infected with only male worm(s) and 24% were infected with young female worm(s). And in 8.8%, old female(s) with empty uterus were infected. The cause of 15.2% was remained unexplained, even though the collected worms were scrutinized.
parasitology-helminth-nematoda ; Ascaris lumbricoides ; egg ; epidemiology

The efficacy of reduced single doses of mebendazole against Ascaris lumbricoides infection was evaluated by cellophane thick smear and egg counting techinques, in two rural populations from December 1977 to March 1978. Total 191 infected cases were divided into five dose groups; 100 mg single dose, 200 mg single dose, 300 mg single dose, 400 mg and 600 mg in repeated doses. The cure rate of mebendazole in the treatment of Ascaris infection was remarkably high and satisfactory in every dose groups. The egg reduction rates were all over 98 percent in every dose groups. Side effects were observed during the treatment, mainly mild and transient gastrointestinal troubles, and not exacerbated by the increase of doses upto 300 mg in single dose. Above results confirmed that in case of mass chemotherapy of Ascaris infection, 100 mg or 200 mg of single dose treatment is sufficient to achieve the economic and acceptable method of treatment.
parasitology-helminth-nematoda ; Ascaris lumbricoides ; chemotherapy-mebendazole

Epidemiological studies on the reinfection pattern of Ascaris lumbricoides were undertaken by means of blanket mass chemotherapy and worm collection in a rural village in Korea, during 1977~1980. The study objectives were to determine the age(sex)-specific reinfection rate during 2, 4, 6 and 12 months through repeated mass chemotherapy with pyrantel pamoate, and to observe the familial aggregation tendency of the reinfected cases. The results obtained are as follows: The age(sex)-reinfection curve revealed that the reinfection rate is much higher in younger individuals than in olders in all of 4 kinds of interval chemotherapy groups. The highest reinfection rate and the highest burden of reinfected worms were observed in preschool childen, followed by primary school students. Such fluctuation in the age-specific reinfection rates was more pronounced in males than in females. There was noted a significant tendency of familial aggregation among the reinfected cases. It is suggested that reinfection occurs never randomly but preferably to the members of certain household families. From these reinfection analyses, it is inferred that the principal mode of A. lumbricoides transmission in the surveyed rural area is likely to be of 'dooryard type', in which case childen and certain family members are more preferably reinfected. It is also suggested that the preschool childen should be included in the primary targets of mass control programme.
parasitology-helminth-nematoda ; Ascaris lumbricoides ; epidemiology ; reinfection

The epidemiological relationship between the current prevalence and monthly reinfection rate of Ascaris lumbricoides was observed in rural communities in Korea by measns of blanket mass chemotherapy and worm collection for measurement of the prevalence and reinfection rates. During the period from 1975 to 1980, a total of 4,466 inhabitants in 10 different localities were treated with 10 mg/kg of pyrantel pamoate and 2 days' whole stools were collected from 2,547 inhabitants. The stools were examined for the presence of expelled adult and/or young worms, which represent the prevalence and reinfection rates for past 2 months respectively. After then, the obtained rates were correlated each other applying the time-prevalence curve proposed by Hayashi. It was observed that the prevalence (overall worm positive rate) and worm burden per individual ranged by areas from 13.6 to 72.3% and 1.4-10.2 respectively. The calculated monthly reinfection rates (X) (from young worm positive rates) according to areas were in the range, 2.6~16.2%, and clearly correlated with the current prevalence (Y) under the equation, Y=1-(1-X)(7.2) where 7.2 is time in month. The equation means that after one time mass chemotherapy the period needed to attain equilibrium of prevalence again would be about 7~8 months. And it is inferred that the majority of reinfected worms in human host turn over every 7~8 months.
parasitology-helminth-nematoda ; Ascaris lumbricoides ; epidemiology ; reinfection

The giant roundworm Ascaris infects pigs and people worldwide and causes serious diseases. The taxonomic relationship between Ascaris suum and Ascaris lumbricoides is still unclear. The purpose of the present study was to investigate the genetic diversity and population genetic structure of 258 Ascaris specimens from humans and pigs from 6 sympatric regions in Ascaris-endemic regions of China using existing simple sequence repeat data. The microsatellite markers showed a high level of allelic richness and genetic diversity in the samples. Each of the populations demonstrated excess homozygosity (Ho < He, Fis > 0). According to a genetic differentiation index (Fst=0.0593), there was a high-level of gene flow in the Ascaris populations. A hierarchical analysis on molecular variance revealed remarkably high levels of variation within the populations. Moreover, a population structure analysis indicated that Ascaris populations fell into 3 main genetic clusters, interpreted as A. suum, A. lumbricoides, and a hybrid of the species. We speculated that humans can be infected with A. lumbricoides, A. suum, and the hybrid, but pigs were mainly infected with A. suum. This study provided new information on the genetic diversity and population structure of Ascaris from human and pigs in China, which can be used for designing Ascaris control strategies. It can also be beneficial to understand the introgression of host affiliation.
Ascaris lumbricoides ; Ascaris suum ; Ascaris ; China ; Gene Flow ; Genetic Structures ; Genetic Variation ; Humans ; Microsatellite Repeats ; Swine