Current RMA Instruments
| Reasonable Hypothesis SOP | 9 of 2017 |
| Balance of Probabilities SOP | 10 of 2017 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 127.0
- ICD-10-AM Codes: B77.0 – B77.9
Brief description
Ascariasis is a parasitic intestinal roundworm infection that is common in impoverished rural areas in warm wet climates, including in remote communities in northern Australia. Transmission occurs primarily via ingestion of water or food contaminated with roundworm eggs. Poor hygiene facilitates the spread of infection, from soil contaminated by faeces, via hands. Most infections cause no symptoms.
Confirming the diagnosis
The diagnosis is established by stool microscopy for eggs, or via examination of adult worms, which may be passed per rectum. Eggs do not appear in the stool until at least 40 days after infection.
The relevant medical specialist is an infectious diseases physician.
Additional diagnoses covered by SOP
- Roundworm
- Infection with Ascaris lumbricoides or Ascaris suum.
Clinical onset
For asymptomatic ascariasis clinical onset will be at the time of diagnosis. Intestinal manifesations may develop, typically six to eight weeks after egg ingestion. These are generally nonspecific symptoms such as abdominal discomfort, anorexia, nausea, vomiting, and diarrhea. Macroscopically visible adult worms may be seen in the stool. Less commonly, there may be early pulmonary manifestations, lasting five to ten days. These include dry cough, shortness of breath, fever, wheezing, substernal discomfort, and blood-tinged sputum. Pulmonary symptoms, when present, typically develop 4 to 16 days after egg ingestion.
Clinical worsening
Treatment of ascariasis, using a single dose or a short course of an oral antihelminthic medication (a benzimidazole) is highly effective. Evidence of worsening of ascariasis may include the development of complications, such as bowel obstruction, biliary obstruction or pancreatitis.