Metazoa

Protozoa

Parasites

Helminths

(Flat)
Platyhelminths
(round)
Nemathelminths
Chilopoda

Metazoa

Pentastomida
Arthropods

Crustacea
Arachnida
Insecta

(Tapeworms,
Cestodes ribbon like)

Trematodes
Nematodes

(Flukes,
leaf like)

Cestodes

Cestodes
Cestodes
Taenia solium

Cysticercus, embryonated
egg or proglottid

Ingestion of infected pork;

ingestion of egg
(cysticercosis)

Pork-eating countries:
Africa, Southeast Asia,
China, Latin America

Taenia saginata

Cysticercus

Ingestion of cysticercus in
meat

Worldwide

Diphyllobothrium latum

Sparganum

Ingestion of sparganum in
fish

Worldwide

Echinococcus granulosus

Embryonated egg

Ingestion of eggs from

infected canines

Sheep-raising countries:
Europe, Asia, Africa,
Australia, United States

Echinococcus multilocularis Embryonated egg

Ingestion of eggs from

Canada, Northern United
infected animals, fecal-oral States, Central Europe
route

Hymenolepsis nana

Embryonated egg

Ingestion of eggs, fecal-oral Worldwide

route

Hymenolepsis diminuta

Cysticercus

Ingestion of infected beetle Worldwide

larvae in contaminated grain
products

Dipylidium caninum

Cysticercoid

Ingestion of infected fleas

Worldwide

Scolex

Scolex

Reproductive organ
1.common genital
pore; 2. uterus;
3. Vitelline glands
Cyclophyllidea
Tapeworm

Reproductive organ
1.common genital
pore; 2. uterus;
3. Vitelline glands
Pseudophyllidea
Tapeworm

Proglottid

Immature Proglottid

Cestodes

Cyclophyllidea

Taenia spp

Echinococcus
spp

Pseudophyllidia

Hymenolepis spp

Spirometra spp

Dipylidium spp

Diphyllobothrium
spp

Cestodes: Tapeworms

1- Taenia saginata/solium life cycle

1-A Beef tapeworm: Taenia saginata proglottid

Highly branched uterus (15-20 branches on each side)

Lateral genital pore

1-A Pork tapeworm: Taenia solium proglottid

Uterus contains 7-13 lateral branches on each side

Lateral genital pore
Shorter, more compact

T. solium

T. saginata

Cysticercosis : infection of people with the larval stage of T.

solium, the cysticercus, which normally infects pigs .

Larval stage, consists of a

scolex enclosed inside a
cyst

Taeniid egg

The eggs of T. saginata, T. solium and E. granulosus are undistinguishable in the lab

Rounded eggs, thick, radially striated shell, hexacanth embryo inside (oncosphere,
containing six hooklets)
Refractile

2- Echinococcus granulosus life cycle

2- Echinococcus granulosus adult worm: Hydatid disease

Scolex
Immature Proglottid

Strobila

Mature Proglottid

Gravid Proglottid

Scolex has 4 suckers and a

rostellum (similar to T. solium)

2- Echinococcus granulosus adult worm: Hydatid cyst

2- Echinococcus granulosus adult worm: Hydatid cyst

Germinal
layer
Hydatid
cyst wall

Brood capsule
filled with
protoscoleces

Inside each cyst grows

thousands of larvae
Cyst fluid

2- Echinococcus granulosus adult worm: Hydatid sand

Hydatid sand refers to the protoscoleces that have broken free

from the germinal layer and are floating freely in the fluid of
the cyst; it is seen after sedimentation by gravity.

Medically Important Cestodes

Trematodes

General Characteristics of
TREMATODES
Flat fleshy leaf shaped
Has 2 muscular suckers:
Ventral sucker=for attachment
Oral sucker= beginning of incomplete
digestive system

Hermaphroditic except Schistosomes

Require an intermediate host for
completion of life cycle = first ones
are mollusks (snails and clams)
Fluke eggs except Schistosomes= has
a lid called operculum at top of shell
to open and allow larval worm to find
its appropriate snail host

Typical Life cycle of TREMATODES

Metacercaria

Cercaria

Sporocyst/
redia

Adult

Unembryonated
Egg

Miracidium

Embryonated
Egg

Typical Life cycle of TREMATODES

egg->miracidium->sporocyst->redia->cercaria->(metacercaria)->adult

Phylum: Plathyhelminthes (The Flatworms)

Class Trematoda = Flukes
Trematode

Common
Name

Intermediate
Host

Biological
Vector

Reservoir Host

F. buski

Giant
intestinal
fluke

Snail

Water
plants
(water
chestnuts)

Pigs, dogs, rabbits

humans

F. hepatica

Sheep liver
fluke

Snail

Water
plants
(watercress
)

Sheep, cattle, humans

C. sinensis

Chinese liver
fluke

Snail,
freshwater
fish

Uncooked
fish

Dogs, cats, human

P. westermani

Lung fluke

Snail,
Uncooked
freshwater
crabs,
crabs, crayfish crayfish

Pigs, monkeys, humans

Schistosoma
spp.

Blood fluke

Snail

Primates, rodents,
domestic pets, livestock,
humans

None

Schistosomas : Life cycle

Schistosoma mansoni: Egg

o Elongated
o Refractile
o Characteristic shape,

with a prominent
lateral spine near
the posterior end
o Thin shell with an
embryo inside is
called miracidium
o The eggs are
excreted in stool

Schistosoma haematobium: Egg

o Elongated
o Refractile
o Conspicuous terminal

spine
o Embryo inside is
called miracidium.
o The eggs are shed in
urine.

Schistosoma japonicum: Egg

o Smaller and more rounded than

o
o

o
o

other species
Refractile
The spine of S. japonicum eggs is
smaller and less conspicuous
than other species.
Embryo inside is called
miracidium
The eggs are shed in stool.

Schistosoma spp: Eggs

UNOPERCULATED

Schistosoma
haematobium
(urine; eggs 115-170 x
45-65 micrometers)

S. mansoni

S. haematobium S. japonicum

Schistosoma japonicum
(feces; eggs 75-95 x 4565 micrometers)

Schistosoma mansoni
(feces; eggs 115-175 x
45-70 micrometers)

Trematode eggs

Nematodes

General Characteristics
Round in a cross section
Bilaterally symmetrical, cylindrical nonsegmented body
Sizes range from 1 mm to 1 meter
Organs: cuticle (usually thick), well developed
digestive system, others: nervous, excretory,
muscles, sexual
Develop by molting (L1-L5)
Separate sexes with the female usually larger

Nematodes of Medical Importance

Parasite

Common Name

Disease

Enterobius vermicularis

Pinworm

Enterobiasis

Ascaris lumbricoides

Roundworm

Ascariasis

Toxocara canis

Dog ascaris

Visceral larva migrans

Toxocara cati

Cat ascaris

Visceral larva migrans

Trichuris trichiura

Whipworm

Trichuriasis

Ancylostoma duodenale

Old World hookworm

Hookworm infection

Necator americanus

New World hookworm

Hookworm infection

Ancylostoma braziliense

Dog or cat hookworm

Cutaneous larva migrans

Strongyloides stercoralis

Threadworm

Strongyloidiasis

Trichinella spiralis

Trichinosis

Wuchereria bancrofti

Bancroft's filariasis

Filariasis

Brugia malayi

Malayan filariasis

Filariasis

Loa loa

African eye worm

Loiasis

Mansonella species

Mansonelliasis

Filariasis

Onchocerca volvulus

River blindness

Onchocerciasis

Dirofilaria immitis

Dog heartworm

Filariasis

Dracunculus medinensis

Guinea worm

Dracunculosis

Diagnosis
Intestinal nematodes
Adult worm usually in the intestines, and
diagnosis is by the presence of (most of the time)
eggs in stool specimens
Look at the size and shape of the egg, color and
thickness of the shell, and look for other
specialized structures, i.e. plugs, knobs, spines
and opercula

Filaridae
Presence of microfilariae in blood specimens or in
subcutaneous tissues and skin snips

I- Intestinal Nematodes
1- Enterobius vermicularis life cycle
1- Eggs are deposited at night by the
gravid females.
2- Eggs are ingested via person-toperson transmission through the
handling of contaminated surfaces
3- After ingestion, larvae hatch from
the eggs in the small intestine. The
adults then migrate to the colon. The
life span of the adults is about two
months. Adults mate in the colon, and
the males die after mating.
4- Gravid females migrate nocturnally
to the anus and deposit eggs in the
perianal area. The females die after
laying their eggs.
5- The larvae develop and the eggs
become infection within 4-6 hours.

I- Intestinal Nematodes
1- Enterobius vermicularis egg
50-60 m by 20-30 m
Oval, hyaline, refractile
Slightly flattened on
one side
Usually partiallyembryonated when
shed
Diagnosis: Scotchtape method

I- Intestinal Nematodes
1- Enterobius vermicularis

Cellulose/Scotch Tape Method

Cellulose tape is applied to the anus of a suspected
patient
Samples must be taken before the patients first
bowel movement, or before he has showered, etc
Eggs will adhere to the tape and are microscopically
observed at low magnification
3 swabbings, 1 a day, for 3 consecutive days may be
required

I- Intestinal Nematodes
1- Enterobius vermicularis adults

Female
copulatory spicule

Male

F: 8-13 mm long by 0.3-0.5 mm wide M: 2.5 mm long by 0.1-0.2 mm wide

Long pointed tail

Filled with eggs

Blunt posterior end with a single

copulatory spicule

I- Intestinal Nematodes
2- Trichuris trichiura life cycle

I- Intestinal Nematodes
2- Trichuris trichiura egg
50-55 m by 20-25 m
Barrel-shaped
Shell is made of
three layers

Thick-shelled
Bile stained
Possess a pair of polar
plugs at each end;
hyaline in nature
The eggs are
unembryonated when
passed in stool

I- Intestinal Nematodes
3- Ascaris lumbricoides life cycle
Adult worms 1 live in the lumen of the small
intestine. A female may produce up to 240,000
eggs per day, in the feces 2. Fertile eggs
embryonate and become infective 3, depending
on the environmental conditions (optimum:
moist, warm, shaded soil). After infective eggs
are swallowed 4, the larvae hatch 5, invade the
intestinal mucosa, and are carried via the
portal, then systemic circulation to the lungs 6.
The larvae mature further in the lungs (10-14
days), penetrate the alveolar walls, ascend the
bronchial tree to the throat, and are
swallowed 7. Upon reaching the small
intestine, they develop into adult worms .
Between 2 and 3 months are required from
ingestion of the infective eggs to oviposition by
the adult female. Adult worms can live 1 to 2
years.

I- Intestinal Nematodes
3- Ascaris lumbricoides fertilized eggs
Larvae hatching from an egg

Fertilized eggs are rounded and contain an embryo

Have a thick shell with an external albuminous/mammillated layer
that is often stained brown by bile
Fertile eggs range from 45 to 75 m in length by 50 m wide

I- Intestinal Nematodes
3- Ascaris lumbricoides
fertilized/Unfertilized eggs

I- Intestinal Nematodes
4- Hookworms life cycle

Necator americanus

Ancylostoma duodenale

I- Intestinal Nematodes
4- Hookworms eggs

Ancylostoma duodenale and Necator americanus

Eggs are thin shelled, colorless/non-bile stained (hyaline)

and refractile
Measure 60-75 m by 35-40 m

Developing larvae (internal cleavage) is usually at 4-8 cell

stage and pulls away from the shell leaving an empty space

I- Intestinal Nematodes
5- Strongyloides sterocoralis life cycle

I- Intestinal Nematodes
5- S. sterocoralis Filariform (L3) Larvae
Infective stage

Up to 600 m long
Tail is notched

I- Intestinal Nematodes
5- S. sterocoralis First-stage Rhabditiform
Larvae (L1)
Diagnostic stage
While the Filariform is long
and thick, the Rhabditiod
form is short and stumpy

buccal canal

genital primordium

180-380 m long
Short buccal canal (shorter
than that of hookworms)

A rhabditoid esophagus
Prominent genital
primordium

Pointed tail

esophagus

Medically Important metazoan

1 Metagonimus yokogawai
2 Heterophyes heyterophyes
3 Opisthorchis felineus
4 Clonorchis sinensis
5 Taenia
6 Hymenolepis nana
7 Enterobius vermicularis
8 Trichuris trichuria
9 Ascaris lumbricides (fertile)
10 Hookworm
11 Diphyllobothrium latum
12 Hymenolepis diminuta
13 Paragonimus westermani
14 Trichostrongylus
15 Ascaris lumbricoides (infertile)
16 Schistosoma japonicum
17 Schistosoma haematobium
18 Schistosoma mansoni
19 Fasciola hepatica
20 Fasciolopsis buski

II- Blood and Tissue Nematodes

1-Trichinella spiralis: Life cycle

II- Blood and Tissue Nematodes

1-T. spiralis: Larvae in muscle section

The encysted larvae

is both the infective
and diagnostic stage
Elongated in shape
Measures 0.3-0.6 by
0.2-0.3 mm

Marked eosinophilia

II- Blood and Tissue Nematodes

2-The Filaridae ex Life cycle Wuchereria bancrofti

The Filaridae
Tail

Wuchereria
bancrofti

Nuclei

Sheath

Dont reach the tip

Present

Tapered

Two at the tip

(arranged in
tandem)

Present

Tapered

All over

Present

Tapered to a
point

Brugia malayi

Appearance

Loa loa

W. bancrofti and B. malayi have a nocturnal pattern, and so for

diagnosis examine a thick blood smear from night blood, can see
both the microfilariae and the adult worms. Loa loa have a diurnal
pattern and are diagnosed using blood from a day sample

Microfilaria
Brugia malayi

Wuchereria bancrofti

Loa loa

W. bancrofti
240-320 m depending on if they
are stained in a blood smear or
preserved in 2% formalin
Sheathed, gently curved body
Tail tapered to a point
Nuclear column is loosely packed
and nuclei dont extend to the point
of the tail

B. malayi

175-230 m in blood smears, longer (240-300

m) in 2% formalin
Sheathed
Tapered tail with a significant gap between
the terminal and subterminal nuclei

L. loa
230-250 m long in
stained blood smears and
270-300 m in 2%
formalin
Sheathed
Tapered tail with nuclei
extending all the way to
the tip of the tail

Differentiation of microfilariae. Identification of microfilariae is based on the

presence of a sheath covering the larvae, as well as the distribution of nuclei in
the tail region. A, W. bancrofti; B, B. malayi; C, L. loa; D, O. volvulus; E,
Mansonella perstans; F, Mansonella streptocerca; G, Mansonella ozzardi.

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