Ascariasis is a common intestinal parasitic disease in children. When infected with ascariasis, it often affects children's appetite and digestive function, hindering their growth and development. Both adult and larval roundworms can cause various symptoms due to their different habits, especially when the roundworms become agitated or form knots, leading to conditions such as biliary ascariasis, appendicitis caused by roundworms, and intestinal obstruction caused by roundworms. These conditions often cause significant pain and harm to the affected children.

bubble_chart Clinical Manifestations

1. Recurrent episodes of periumbilical pain, poor appetite, or infantile paroxia, sometimes accompanied by nausea, vomiting, mild diarrhea, or constipation, may also lead to malnutrition or anemia. Toxins produced by roundworms can cause children to appear listless or dysphoric, restless, with headaches, irritability, and disturbed sleep at night. If the number of Chinese Taxillus Herb (roundworms) is small, there may be no symptoms at all.
2. When larvae migrate to the lungs, they can cause eosinophilic pneumonia due to roundworms; if the larvae move to other parts of the body such as the liver, brain, or kidneys, they may also cause corresponding symptoms, such as liver abscess, meningitis, epilepsy, edema, and changes in urine. Allergic symptoms such as urticaria, cutaneous pruritus, and nasal mucosal irritation may also occur.
3. Roundworms have a tendency to migrate and burrow, and when agitated, they can cause biliary ascariasis or appendicitis due to roundworms. If there are many roundworms, they may form knots and cause intestinal obstruction. If treatment is deficient, these conditions can progress to intestinal perforation, intestinal necrosis, or peritonitis caused by roundworms.
4. There is a history of passing roundworms.

bubble_chart Auxiliary Examination

1. Ascaris eggs can be found in feces, and the flotation method can improve the detection rate.
2. Eosinophils are elevated in peripheral blood.

bubble_chart Treatment Measures

(1) Drug deworming

The following drugs can be selected:

1. Piperazine citrate (Anthelmintic): The dose is 150mg/(kg·d), with a maximum dose of 3g, administered once in the morning on an empty stomach or before bedtime for 2 consecutive days. If repeated use is necessary, a 2-week interval is required. Side effects are minimal, with occasional nausea, vomiting, abdominal pain, or urticaria. It is contraindicated in patients with liver or kidney diseases or a history of epilepsy.
2. Albendazole (Zentel): The dose is 400mg per dose, administered once as a draught. If repeated treatment is needed, a 3-week interval is required. Side effects are minimal, with occasional gastrointestinal discomfort, fever, rash, or headache, which disappear after discontinuation. It is contraindicated in children under 2 years old, and the dose should be halved for children under 12.
3. Levamisole: The dose is 1.5–2.5mg/kg per dose, administered once as a draught for 2 consecutive days. Side effects are rare, but caution is advised in patients with liver dysfunction or digestive ulcers.
4. Mebendazole: The dose is 200mg per dose, administered once as a draught for 3 consecutive days. Side effects are mild, with a few cases reporting dizziness, abdominal discomfort, diarrhea, etc.
5. Pyrantel pamoate (Antiminth, Pyrantel): The dose is 5–10mg/kg, administered once as a draught. Side effects include dizziness, abdominal discomfort, and abdominal pain, with occasional vomiting, diarrhea, or chills, usually requiring no special treatment. Administration should be postponed in cases of acute liver, kidney, or heart disease or fever.
6. Quisqualis Fruit: The dose is the patient’s age in years +1g, with a maximum of 10g. It should be boiled or stir-fried and administered on an empty stomach in the morning for 3 consecutive days.
7. Toosendanin: The dose is 50–100mg per dose for ages 2–4, 100–150mg per dose for ages 4–8, and 150–200mg per dose for ages 8 and above, administered once before bedtime. Side effects include occasional nausea, vomiting, diarrhea, and drowsiness. Caution is advised in patients with ulcers or heart disease.

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For biliary ascariasis or incomplete intestinal obstruction caused by roundworms, medical treatment can be applied. Mainly, sedatives and antispasmodics are used to alleviate the patient's suffering, along with fasting, fluid infusion, gastrointestinal decompression, and infection control. Deworming should be performed after the condition stabilizes. For mechanical intestinal obstruction, appendicitis, or peritonitis, urgent surgical consultation and intervention are required.

bubble_chart Prevention

1. Pay attention to personal hygiene, dietary hygiene, and environmental hygiene.
2. Kindergartens or primary schools can carry out deworming treatment on schedule to eliminate sources of infection.