ASCARIDÍASE.ppt

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ASPECTOS CLÍNICOS E DIAGNÓSTICO LABORATORIAL
Parasitologia – Profa. Nelma Esteves
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Geo-helmintíase cosmopolita
Regiões temperadas e tropicais
Ascaris lumbricoides: Estenoxeno (Homem)
 Ascaris suum (suínos): Infecção humana (Anderson, 1995)
 A.lumbricoides  A. suum  marcadores moleculares
 (Crompton, 2001)
Crompton, D.W.T. 2001. Ascaris and ascariasis. Advances in Parasitology 48: 285-373.
Andeson, T.J.C. 1995. Ascaris infections in humans from North America: molecular evidence
for cross-infection. Parasitology 110: 215-219.
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Mais frequente das helmintíases humanas 
 (~30% da população mundial)
 Fatores que influenciam a alta prevalência:
 - Grande produção de ovos pelas fêmeas (200 mil/dia/fêmea)
 - Viabilidade dos ovos no solo infectantes (muitos meses)
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Ascaris coletados principalmente de crianças, sul da India.
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VERMES ADULTOS
Fêmea: 20 a 35 cm
Macho: < 30 cm
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OVOS
Ovo fértil
Ovo embrionado
Ovo infértil
3 Membranas:
 Mais interna  glicosídeos esterificados
 Média  Quitinoprotéica
 Externa (mamilonada)  Mucopolissacarídeos e albumina
Ovo embrionado
descorticado
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 Meio externo  3 semanas
 Período de incubação 60 d
 Longevidade  1 a 2 anos
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 Larvas: Ciclo Pulmonar ou de Loos
 - Síndrome de Löeffler 
 Verme adulto:
 - Assintomáticos (maioria)
 - Ascaridíase intestinal Cólica intestinal 	periumbilical, anorexia, náusea, diarréia e 	emagrecimento.
 - Oclusão intestinal 
 - Localização ectópica
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Ascaris no colédoco
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Pesquisa de ovos nas fezes: 
 - Método de Hoffman
 - direto
 - Kato-Katz (Quantitativo: carga parasitária)
 Pesquisa de larvas no escarro;
 Rx c/ contraste (parasitismo unissexual–machos);
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Albendazol (Nitroimidazol): 
 dose única (400 mg/200mg)
 Mebendazol:
 100 mg V.O. 3 x dia/ 3 dias;
 Pamoato de pirantel (pirimidina):
 11 mg/Kg (máx. 1g);
Tetramisol / Levamisol:
 dose única (150 mg/80 mg)
Sais de piperazina: obstrução intestinal (150mg/Kg. máx. 3,5 g)
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