B77.81 Ascariasis pneumonia

Name of the Condition

• Ascariasis pneumonia

Summary

Ascariasis pneumonia is a parasitic infection caused by Ascaris lumbricoides that results in respiratory complications. This condition occurs when larvae migrate through the lungs during the early stages of infection, leading to inflammation and pulmonary symptoms. It is more common in regions with poor sanitation, where eggs from contaminated soil or feces are ingested. While many infections are asymptomatic, severe cases can cause respiratory distress requiring medical attention.

Causes

Ascariasis pneumonia is caused by the ingestion of Ascaris lumbricoides eggs, which hatch in the intestine and release larvae. These larvae migrate through the bloodstream to the lungs, where they penetrate alveolar walls and cause inflammation. The larvae are then coughed up and swallowed, maturing into adult worms in the small intestine. The pulmonary phase of migration is responsible for the pneumonia-like symptoms.

Risk Factors

• Living in or traveling to areas with poor sanitation and hygiene.
• Ingesting food or water contaminated with fecal matter.
• Lack of access to clean water or proper waste disposal.
• Occupational exposure, such as working in agriculture or handling soil.
• Children, who are more likely to engage in behaviors like eating dirt or not washing hands.

Symptoms

• Cough, often with or without sputum.
• Shortness of breath or wheezing.
• Chest discomfort or pain.
• Low-grade fever.
• In severe cases, respiratory distress or pneumonia-like findings on imaging.

Diagnosis

Diagnosis is typically based on a combination of clinical presentation, exposure history, and laboratory or imaging findings. Stool samples may be examined for eggs, though larvae in sputum or bronchoalveolar lavage can confirm pulmonary involvement. Imaging, such as chest X-rays, may show infiltrates or other signs of lung inflammation. Serological tests or eosinophilia may also support the diagnosis.

Treatment Options

Treatment usually involves anthelmintic medications, such as albendazole or mebendazole, to eliminate the worms. Supportive care, including rest and hydration, may be needed for respiratory symptoms. In severe cases, corticosteroids or bronchodilators may be used to manage inflammation or wheezing. Follow-up stool tests can confirm eradication of the parasite.

Prognosis and Follow-Up

Prognosis is generally good with appropriate treatment, especially in mild cases. Most patients recover fully without long-term respiratory issues. Follow-up may include monitoring for recurrence of symptoms or complications, particularly in endemic areas. Repeat stool testing may be recommended to ensure the infection has been cleared.

Complications

• Severe respiratory distress or pneumonia.
• Secondary bacterial infections in the lungs.
• Chronic cough or bronchitis.
• Rarely, larval migration to other organs.

Lifestyle & Prevention

• Practice good hand hygiene, especially after handling soil or before eating.
• Ensure food and water are clean and properly cooked.
• Avoid consuming raw vegetables or fruits that may be contaminated.
• Improve sanitation and waste disposal in living environments.
• Wear protective clothing when working with soil or in agricultural settings.

When to Seek Professional Help

Seek medical attention if you experience persistent cough, difficulty breathing, chest pain, or fever, especially after potential exposure to contaminated soil or in endemic regions. Prompt evaluation is important to prevent complications and initiate treatment.

Tips for Medical Coders

When coding for ascariasis pneumonia (B77.81), ensure documentation supports the respiratory manifestation of the infection. Note the presence of pulmonary symptoms, imaging findings, or larval detection in sputum/bronchoalveolar lavage. Differentiate from other causes of pneumonia, and verify that the code aligns with the clinical scenario and provider documentation.