Ascaris spp

Identification may be by gross examination for adult helminths or, more commonly, by microscopic examination for protozoa, helminth eggs, and larvae. The diagnostic forms of some parasites, such as the eggs of Ascaris spp., are present on a regular basis. Other forms, such as malaria parasites, Taenia eggs, or Giardia cysts, vary from day to day. 

Santonin (130), a sesquiterpene lactone from Artemisia maritima (Asteraceae) has been used as an ascaricide, and is especially active against roundworms (Ascaris spp.). 

Wheezing or urticaria during the early migratory phase of infections with Ascaris spp., hookworm spp., Strongyloides stercoralis, and Schistosoma spp. (14). 

Within each class of helminths, the best-studied organisms are described (i.e. Hymenolepis diminuta. Schistosoma mansoni, Ascaris suum) to establish general principles. Important exceptions are noted where appropriate. Comments are primarily restricted to adult stages, which generally cause the most important pathology (with some notable exceptions, e.g.. Echinococcus spp. and Onchocerca volvulus) and represent the principal targets for chemotherapy. 

In practical terms this means that piperazine does not add to the anthelmintic effect of pyrantel on Ascaris as might be expected, but opposes it. For this reason it is usually recommended that concurrent use should be avoided, but direct clinical evidence confirming that combined use is ineffective seems to be lacking. It seems reasonable to extrapolate the results of these studies on Ascaris lumbricoides (roundworm) to the other gastrointestinal parasites for which pyrantel is used, i.e. Enterobius ver-micularis (threadworm or pinworm), Ancylostoma duodenale, Necator americanus (hookworm) and Trichostrongylus spp. However, no one seems to have studied this. 

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