Parasitology Nematodes

HELMINTHES
Nematodes
Trematodes
Cestodes
NEMATODES
Generalities of Nematodes

Phylum ASCHELMINTHES
Round worms
Non-segmented, cylindrical in shape
Presence of the PSEUDOCOEL (houses
the organs)
CHINITINOUS like CUTICLE
Complete Digestive system
o Mouth
o Buccal cavity
o Esophagus muscular
o Intestine
o Rectum
o Anus
Reproductive structures tubular and
coiled
o Males: SPICULES, COPULATORY
BURSA
o Females: UTERUS, VAGINA,
OVARIES
No circulatory systems
Nematodes may be free-living or parasitic
Reproduction:
o Oviparous
Unembryonated egg /
unsegmented egg
o Oviviparous/ovoviparous
Embryonated egg /
Segmented egg
o Larviparous/viviparous
Larva
Chemoreceptors:
o Amphids
o Phasmids
Phasmid worms (With caudal
chemoreceptors)
o Class Phasmidia / Secernentia
Aphasmid worms(Without caudal
chemoreceptors)

o Class aphasmidia /
Adenophorea
Trichuris, Trichinella,
Capillaria
Dioecious Separate sexes
STAGES:
o Adult
o Larva (L1-L4)
Filariform larva
Possess uniform
muscular esophagus
Rhabditiform Larva
Possess expanded
and bulb like posterior
esophagus
o Egg / Ovum
Ascaris lumbrocoides

Giant intestinal roundworm

OVIPAROUS
SMALL INTESTINE
Whitish/pinkish
Soil transmitted helminthes
POOR SANITATION AREAS
Cuticle-fine striation
Lives for 1-2 years
TRIRADIATE LIPS / TRILOBATE LIPS
o Triangular in shape
Adult possess:
o PI-3 Pepsin inhibitor 3
o Phosphorylcholine
Final host : Man
Undergoes Hearth lung migration
Ova not found in stool does not mean no
infection (eggs are highly resistant)
o All male Ascaris lumbrocoides
infections
o All female Ascaris lumbrocoides
infections
others (Stay at larva = visceral larva
migrans)
o Toxocara cati - cat
o Toxocara canis - dog
o Ascaris suum pig

Diagnosis stage:
Unfertilized Ova

o Biggest
o Longer than wide
Fertilized Ova
o Smaller
o Embryonated in soil
Infective Stage:
Ingestion of Embryonated egg

Female
o 35cm
o Vulva
o LAYS 200,000 EGGS A DAY
o Larger
o Pointed posterior
Ova
Male :
o 30cm
o COPULATORY SPICULE
POSTERIOR
o 2 Spicules
o Shorter
o Curved tail

Unfertilized(Corticated or decorticated)
o Narrow, long, thin shelled,
unorganized, refractile granules in
all female infection
Fertilized
o Decorticated (Infective stage) or
Corticated (Thick transparent
hyaline shell); All embryonated are
decorticated
o 2 weeks to become larvae
Eggshell (layer)
LIPOIDAL VITELLINE MEMBRANE (ONLY
IN FERTILIZED)
GLYCOGEN (Fertilized or not)
COURSE MAMMILIATED ALBUMINOUS
LAYER (Corticated ova)
Pathogenesis:
Tissue reaction to larvae
Intestinal irritation to adult worms
Complication to intestinal migration

Pathology:
LUMINAL PARASITE
May be asymptomatic
Abdominal pain, vomiting, growth stunting
Intestinal obstruction that may lead to
intestinal perforation
Erratic worms may wander into other parts
of the body.
Larval stage:
o Eosinophilic Pneumonitis (Loefflers
Syndrome)
o Charcot Leyden Crystals

Diagnosis:
DFS
Kato Katz
Kato (Kato katz) Tech (DFS)
Treatment:
Albendazole drug of choice (lab)
Mebendazole drug of choice (lec)
Pyrantel Pamoate
Trichuris trichiura

Aka Trichocephalus trichiurius

OVIPAROUS
Whipworm
String of pearls esophagus
COLON (CECUM), ASCENDING COLON
Final Host : Man
TROPICAL AREAS
Usually accompanied by Ascariasis
Infective stage and Diagnosis Stage :
Embryonated Ova
Similar to ascariasis due to same
transmission and mode of transmission
Anterior Thread-like
o Burrows into the intestinal mucosa
pin fashion manner
o Long
Posterior
o Curve end (Fleshy)
Male:
o Single spicule
o Retractile sheath
o 30-45 micrometer
Female

o 60,000,000 in a life span of 2 years

o 35-50 micrometer
Non-striated boarder?
Ova
Embryonated in soil (2-3 weeks)
Football or barrel shaped JAPANESE
LANTERN
Protuberant bipolar mucus plugs
EMRYONATED IN CLAYISH SOIL
Pathology
Over 5,000 eggs Symptomatic
Over 20,000 eggs severe diarrhea
MAY CAUSE RECTAL PROLAPSE
Pin fashion manner
o Secretes TT47 (Pore forming
Protein)
MAY CAUSE PETICHEAL
HEMORRHAGE
IRON DEFIECIENCY ANEMIA

Diagnosis:
DFS
Kato Katz
Concentration techniques
Treatment:
Albendazole with ivermectin
Mebendazole
o Drug of choice (lec)
Albendazole
Enterobius vermicularis
Seatworm, pinworm, society worm, tiwa
LOWER ILEUM OR CECUM (LARGE
INTESTINE)
CEPHALIC ALAE (during migration)
CUTICULAR ALAR (WING-LIKE)
EXPANSIONS
PROMINENT POSTERIOR
ESOPHAGEAL BULB (FLASK SHAPED)
Final host: Man
Male:
o 2-5 millimeter by 0.1-0.2 millimeter
o Dies after fertilization
Female:

o 8-13mm by 0.4mm?
o Long pointed tail
o 4,627 16,888 eggs/ day
o Dies after deposition
o UTERI OF GRAVID
NOCTURNAL
Female deposits egg in the PERIANAL
AREA only during the night
Scotch tape swab
Ova
ASYMMETRICAL
D SHAPED
Plane? Concave
Seldom found in stool 5%
TRANSLUCENT SHELL
o Outer: Albuminous
o Inner:lipoidal
Air borne

Diagnostic stage:
LATERAL SPICULES
CEPHALIC ALAE
CUTICULAR ALAR (WING-LIKE)
EXPANSIONS
Infective stage:
Embryonated egg
o Ingestion
o Inhalation
o Retro-infection
o Autoinfection
Can be transferred thru breast milk
Pathology:
Enterobiasis or oxyuriasis
Nocturnal Pruritus ani, Insomnia,
Secondary Bacterial Infection, Loss of
appetite, abdominal pain, Vulvovaginitis,
Appendicitis.
Ectopic deposition of the eggs can occur
Familial disease
o Spreads easily
o Everyone in the family must be
treated
Retroinfection: balik larva
Common in cold area

Diagnosis:
Scotch tape swab
Swellengrebel
Grahamss technique
Petrolatum
Common in women than men
Cannot be controlled by sanitary disposal of
waste
Treatment:
Pyrantel pamoate
o Drug of choice (lab?)
o Secondary (lec)
Mebendazole
o Drug of choice (lec)
Albendazole
HOOKWORMS
STH
Oviparous
Blood sucking
o Causes anemia esp. in women
because of their menstruation
Attached to intestinal mucosa
Final host: man
SMALL INTESTINE
Undergoes heart lung migration
Dental pattern / buccal cavity
o To determine species
o For attachment
Eggs are indistinguishable
Male:
o Tail end expanded because of
copulatory bursa
Female:
o Straight and pointed tail end
Phasmid Caudal receptors
OVIPAROUS

Ancyclostoma
duodenale

Necator
americanu
s

AKA

Old world
hookworm

Morpholog
y

Slightly larger

New world
hookworm,
American
murderer

Curvature

C-shaped

Small,
cylindrical,
fusiform,
whitish,
caudal
bursa
S-shaped

Life span

5-7 years

4-20 years

Teeth

2 pairs ventral
teeth

Disease

Ancyclostomiasi
s, miners
anemia

Male

Tripartite and
tridigitate dorsal
rays
Copulatory
spicules are not
fused

Semi-lunar
cutting
plane
Necatoriasis
,
uncinariasis
, tropical
anemia,
Laziness
Fused and
barbed
copulatory
bursa
Bipartite /
bidigitate
dorsal rays

Larva
Rhabditiform Larva

Filariform Larva

First stage larva (L1)

Second stage larva

(L3)
Non-feeding stage

Feeding stage /
vegetative stage
Open mouth

Closed mouth

Shorter and robust

Longer and slender

Not infective

Infective (Skin
penetration)
Causes
maculopapular lesion
ground itch
Papulovesicular
eruption for 2 weeks,
itching, edema
erythemia

Ova

Single
Thin
Transparent hyaline shell
Unsegmented during oviposition
Life cycle similar to ascaris

Lungs
Ancyclostoma caninum
o Dog
o 3 pairs of teeth
Ancyclostoma braziliense
o Cat
o 2 pairs of teeth
NA 0 pairs of teeth
AB 1 pair of teeth (lab) 2 (Lec)
AC 3 pairs of teeth
AD 2 pairs of teeth

Larval migration
Bronchitis
Pneumonitis
Pathology
Cutaneous phase : Ground Itch
Pulmonary phase : Wakanas disease
(Pneumonitis)
Intestinal phase : Blood loss (IDA),
Abdominal Pain, Diarrhea, Eosinophilia
Diagnosis:
DFS
Kato Tech

 Zinc Sulfate Centrifugation

Harada Mori (Larval stages L1 and L2)
Formalin Ether
Hook worm

Treatment:
Albendazole
o Drug of choice (Lec)
Mebendazole
Pyrantel pamoate
Strongyloides stercoralis

THREADWORM
OVOVIPAROUS
Strongyloidiasis
Adult parasitic Lives in tunnels in the
mucosa of the small intestine
Fecally transmitted and STH (SANDY?)
Heart lung migration
Eggs are rarely seen
Forms:
o Parasitic
o Free-living
Parasitic stage
o Male : Unknown
o Female: Parthenogenetic
Phasmid caudal receptor
3 diff. cycles
o Direct
o Indirect
o Autoinfection
Eggs are rarely seen because they usually
hatch in the small intestine

Rhabditiform
Larva

Filariform
Larva

Ova

Strongyloide
s
Long buccal
Shoty buccal
Cabity; Small cavity; large
Genital
genital
Primordium
primordium
Sheathed;
Unsheathed;
Pointed tail;
with
short
notched/bifid
esophagus
tail end; longer
esophagus
Eggs are all
Similar to
alike; Ovoid
hookworms
with thin shell but not
containing 2-8 commonly
germ cell.
seen in feces;
eggs are ovoid
with
developed
larva Chinese
Lantern Ova

Pathology:
Honey form appearance of intestinal
mucosa
Hyper infection and dissemination
Larva currens
Cochin China Diarrhea / Vietnam Diarrhea
Infective stage:
Filariform larva
Skin penetration
Diagnosis:

FECT: Larva
Baermann technique
Beales string test
Harada mori
Entero test
Serologic Tests ELISA
Larva in feces and occasionally Sputum

Treatment:

 Ivermectin with albendazole (lec)

HARADA MORI
10 days
Research lab
Culture of larval stage
Require a moisten filter paper
o Favor of hatching of ova
Materials:
o Slides and coverslips
o 15 ml centrifuge tube conical tube
o Pipets
o Filter paper
o Application stick
o Forceps
o Fresh stool
Steps:
o Cut narrow strip tapered end
o Smear 0.5 1g in the center
Kasing laki lang ng match
head
o 3-4 ml DH2O @ RT (25-280C) for 10
days
o Get a portion
10x objective observe for
larva