Infection is spread by the fecal oral route. Diagnosis is made by finding adult worms in stool or with vomiting and by microscopic stool exam. Eggs in stool are easily recognized microscopically with Lugol's iodine stain Eosinophilia is common with moderate to large infestations Intestinal obstruction occurs in children with large numbers of worms. Common bile duct obstruction and intestinal wall perforation can also occur.
Initial infection is often asymptomatic.
The interval between ingestion and the development of egg-laying adults is 8 weeks. Untreated infections last 12-18 months, the life expectancy of adult worms. With a heavy worm load or intestinal obstruction piperazine citrate can be given through a nasogastric tube to parlyze the worms and allow them to pass with peristalsis. If surgery is needed, massaging the worms to eliminate the worms is preferable to opening the bowel. Careful handwashing is preventive as are standard precautions.