Nematodes from tissues

Filariae, Toxocara spp., Trichinella

spiralis
 Filariae
Mansonella perstans D, N, B
Mansonella ozzardi D, N, B
Mansonella streptocerca SB

Loa loa: dme fugace de Calabar, eye D, B

Onchocerca volvulus: river blindness SB

Wuchereria bancrofti, Brugia malayi:
lymphatic filariae, elephantiasis N, B

D: day N: night B: blood SB: skin biopsy

 Filariae
Mansonella perstans Africa, South
America, Surinam
Mansonella ozzardi South America
Mansonella streptocerca West Africa

Loa loa West and Central Africa

Onchocerca volvulus Africa, South America

Wuchereria bancrofti Africa, South America,

Asia
Brugia malayi Asia
 Microfilariae that can be seen in peripheral blood
in Congo-Kinshasa, according to J. Sonnet and
J. Vandepitte.
Mansonella perstans Loa loa Wuchereria bancrofti

Periodicity day/night day night

Vector flies flies mosquitoes

(Culicoides spp.) (Chrysops spp.) (Culex, Anopheles, )

Size < 200 m > 250 (230) m > 250 m

Tail terminal nuclei terminal nuclei no terminal nuclei

Sheath no yes (not stained by yes (slightly stained by

Giemsa) Giemsa)
 Mansonella perstans
Small microfilaria whitout a sheath (approximately 200 x 4 to 5
m) with a blunt tail filled with nuclei (Thin film stained with
Giemsa).
Mansonella perstans and Loa loa
Loa loa is distinctly longer and thicker than M. perstans. In the
thick film the microfilaria of Loa loa show irregular coiling.
The sheath does not stain with Giemsa (Thick film stained with
Giemsa).
Courtesy CDC
Mansonella perstans and Loa loa
The complete microfilaria with its elegant and complex
convolutions is that of M. perstans. It is smaller and thinner
than the incomplete Loa loa microfilaria. The somatic nuclei of
M. perstans are visible as far as the rounded caudal end of the
microfilaria (Thick film stained with Giemsa).
 Loa loa
One or two herniae are typical for the species. The last
caudal nucleus is terminal (Thick film stained with
May-Grnwald-Giemsa).
 Loa loa
The sheath is seen here in the anterior and in the caudal end.
The sheath does not stain with Giemsa and stains poorly with
other stains. The tail is tapering gradually and there are nuclei
till the end (Thick film stained with May-Grnwald-Giemsa).
 Loa loa
The sheath is seen here in the anterior and in the caudal end.
The sheath stains poorly. The tail is tapering gradually and there
are nuclei till the end (Stained thick film).
 Loa loa
The sheath is seen here at the caudal end. The sheath stains poorly.
The tail is tapering gradually and there are nuclei till the end
(Stained thick film).
 Loa loa
Adult male removed from the eye. The male filaria is
smaller (up to 3,4 cm) than the female (5-7 cm)
(Unstained).

cm
 Loa loa
Tail with spicule from an adult male removed from the
eye (Unstained).
 Mansonella streptocerca
Slender microfilaria with rounded tip curved to form a
hook (Skin scarification stained with Giemsa).
 Mansonella streptocerca
Single row of distinctive somatic nuclei in the rounded caudal
end of the microfilaria. The latter is curved like a bishops staff
(Skin scarification stained with Giemsa).
 Mansonella ozzardi
In thick blood film. Irregular coiling. The last caudal
nucleus is subterminal and pointed. The caudal
cuticula is also pointed (Giemsa stain).
 Onchocerca volvulus
Extensively coiled microfilaria. The tail end is pointed
and does not contain nuclei (Skin scarification stained
with Giemsa).
 Wuchereria bancrofti
Graceful curves of the microfilaria in the thick film.
The sheath is clearly visible, especially at the cephalic
end (Thick film stained by Carazzis method).
 Wuchereria bancrofti
Cephalic end with sheath and caudal end of the
microfilaria. No nuclei in the pointed caudal end
(Thick film stained by Carazzis method).
 Wuchereria bancrofti
Cephalic end and tail with sheath of the microfilaria.
No nuclei in the pointed caudal end (Thin film stained
with May-Grnwald-Giemsa).
 Wuchereria bancrofti
Caudal end with sheath of the microfilaria. No nuclei
in the pointed caudal end (Thin film stained by May-
Grnwald-Giemsa).
 Wuchereria bancrofti
Caudal end of the microfilaria. No nuclei in the
pointed caudal end (Thin film stained by May-
Grnwald-Giemsa).
 Wuchereria bancrofti
Caudal end of the microfilaria. No nuclei in the
pointed caudal end (Thin film stained by May-
Grnwald-Giemsa).
 Wuchereria bancrofti
Taylor M.J. et al. 2005. The Lancet
365:2116-2121
Macrofilaricidal activity of doxycycline on W.
bancrofti.
Based on the depletion of the vital Wolbachia
endosymbionts bacteria.
 Brugia malayi
Coiled microfilaria in thick blood film. The nuclei are more or
less distinct. The last caudal nucleus is clearly separated from
the others and extends into the tip of the tail. The sheath is well
developed and stained red (Giemsa stain).
 Pseudomicrofilaria
(Helicospora?)
Blood accidentally contaminated with a fungus. The diameter
is much smaller than for microfilariae. Note the numerous
transverse septa (May-Grnwald-Giemsa stain).
 Global programme to eliminate
lymphatic filariasis
Elephantiasis
Resolution WHA50.29 in 1997
120 million patients in 83 countries
More than 1 billion (20 % of world population)
are at risk of acquiring the infection
90% Wuchereria bancrofti, most of the remainder
Brugia malayi
2-drug combinations (DEC + albendazole or
ivermectin + albendazole)
Courtesy WHO
 Larva migrans
Larva migrans cutanea: larbish, creeping eruption,
caused by hookworms of animals (cat, dog )
Ancylostoma ceylanicum, Ancylostoma
brasiliense,
Larva migrans visceralis: high eosinophilia with
variable symptomatology (general, eye invasion),
due to Toxocara canis, diagnosis by serology,

 Toxocara canis
Several adult worms, smaller than A. lumbricoides.

1 cm
 Dirofilaria immitis
Canine heart worm: nematode (filaria) of
dog in right ventricle and pulmonary artery.
Transmitted via mosquito bite (Aedes,
Anopheles, Culex).
Pseudo-tumor of the lung in man.

Hemmersbach-Miller M. Et al. 2005. Presse Med., 34:109-110.

Trichinella spiralis
Larva in muscle tissue following biopsy .
 Trichinella spiralis

Courtesy Gentilini M. & Duflo B.

 Free living nematodes
Free living nematodes are very common (Unstained).