Ascaris lumbricoides  Protein coat/Albuminous layer:

outermost mamillated layer with a

 Most common intestinal roundworm tanning action
 Common name: Giant Intestinal  Embryonated: same as fertilized but
roundworm contains the larva of the embryo
 Infective stage: embryonated ova  Decorticated: lacks the albuminous
 Definitive host: man (no intermediate mamillated shell; usually seen in old
host needed) specimens; it may be fertilized or
 Main habitat: Lumen of the small unfertilized
intestine
 Life span: 12-17 months
 Diagnostic stage: unembryonated ova

Ova/eggs

Types of Eggs

A. Unfertilized: longer and narrower

2 layers of the egg shell
 Albuminoid layer
 Chorionic layer or true shell
 Filled with amorphous mass
 Lack the crescentic clear area

B. Fertilized: broadly ovoidal and thick

Adult: white, creamy or pinkish yellow when
3 layers:
freshly expelled and resembles earthworm
 Chorionic/true shell: chitinous
(lumbricus); head is provided with three
layer; secretory product of the egg
conspicuous lips which are finely denticulated,
 Vitelline layer: fertilization
each lip has minute twinned sensory papillae.
membrane; highly impermeable
membrane that protects the inner
embryo
 Diagnosis:

Stool examination may give negative results

due to the following

 During the early stage of infection

 During larval migration through the
A. Male blood stream - When only male worms
are present in the intestines
 10-31 cm - utilizes: DFS, KTS, Concentration Technique, and ELISA
 Usually shorter and slender
 ventrically curved posterior end with 2 Prevention:
spicules
 Sanitary disposal of human excreta
 genitalia: composed of a single, long
 Personal hygiene
tortuous tubule
 Avoid the use of night soil fertilizer
B. Female  Thorough cooking of food particularly
vegetables and washing of fruits
 35 cm long x 3-6 mm  Washing solution: aqueous iodine
 straight posterior end solution (200 parts/million)
 paired reproductive organs located in  kills infective egg and larva in 15 minutes
the 2/3 of the body
 oviparous Hookworms
 gravid uterus: 200,000 eggs

Disease: Ascariasis, Dooryard or Backyard Human Hookworms:

Infection a) Necator americanus: American
Pathology Hookworm, American murderer, and
New World Hookworm
a) Due to larval migration: b) Ancylostoma duodenale: Old World
 Ascaris pneumonitis: Damage to the Hookworm
pulmonary tissue (petechial c) Ancylostoma ceylanicum: Animal
hemorrhage) when larvae break out of Hookworms: (cause skin lesions or
the lung capillaries into the air sacs larval migrans in man)
 Symptoms manifested: asthmatic type d) Ancylostoma braziliense: Cat
of respiration; cough; bronchial rales Hookworm
(abnormal respiratory sound); urticarial e) Ancylostoma caninum: Dog Hookworm
rash (hives, vascular reaction of the
upper dermis; eosinophilia in the Developmental stages
circulatory blood) 1. Ova:
b) Due to adult worms:
 Diarrhea, vague abdominal pain, nausea ovoidal, colorless/hyaline and thin
and loss of appetite shelled; 56-60 μ x 34-40μ: 4-8 cell stage when
 Due to its erratic behavior: vomiting; passed in the feces (surrounded by a clear zone)
suffocation; intestinal obstruction,
appendicitis; acute pancreatitis; 2. Rhabditiform larva:
peritonitis (perforation of the bowel)
  Feeding stage, short and stout
 Has a long narrow buccal cavity
 Flask shaped esophagus
 Very small genital primordium

3. Filariform larva:

 Non-feeding
 Infective stage
 Mouth is close with a protecting sheath
 Longer and slender with a pointed
posterior end

HOOKWOR BUCCAL CAVITE COPULATPRY

M SPECIE BURSA
Necator 1 pair of semilunar - fused spicules:
americamus cutting plates, dorsal deep cleft
median tooth, deep - bipartite dorsal
pair of triangular rays
subventral lancents
Ancylostoma 2 pairs of fused ventral - unfused spicules:
duodenale teeth shallow cleft
- tripartite dorsal
rays
Ancylostoma 3 pairs of vental teeth - bursa is
caninum supported by long,
slender rays
Ancylostoma 1pair of larger outer - bursa is
braziliense teeh and 1 pair of very supported by short
inconspicuous median stubby rays
teeth

Characteristic of hookworm dentition Ancylostomiasis: Ancylostoma species

A. Necator americanus, semi-luna cutting plate

B. Ancylostoma braziliense: 2 pair of teeth
C. Ancylostoma caninum: 3 pairs of teeth
D. Ancylostoma duodenale: 2 pair of teeth

Pathology:

a) Due to larval stage:

 Ground itch/Coolle itch/Dew itch
 Dermatitis at the site of entrance of
Disease: filariform HOOKWORM SPECIE
 Intense itching, edema and erythema and
Necatoriasis/Uncinariasis: Necator americanus
later papulovesicular eruption
2.) Creeping eruption/Cutaneous larval a) Ground itch and creeping eruption -
migrans/Plumber's itch/Duck Hunter's itch characteristic of the lesion and the history
 Due to the exposure of the skin to the of skin contact with soil
filariform larvae of A. braziliense and A b) Recovery of eggs - DFS, KTS, Brine
caninum, occasionally of N. americanus and flotation and FECT
A duodenale. c) Harada Mori culture technique
 "Serpiginous tunnel" in the stratum
Treatment
germinativum of the skin
a) Mebendazole, Pyrantel pamoate, Oxantel
3.) Pumonary lesions: Wakana disease
b) Severe anemia- raise the hemoglobin level
 Petechial hemorrhages with eosinophilic to about 70-80 g/l. Iron therapy (Ferrous
and leukocytic infiltration that induces sulfate, 200 mg 3x a day for 3 months)
cough and pyrexia
Prevention:

a) Sanitary disposal of feces

b) Avoid sites where infected dogs and cats
may defecate
c) Eradicating the infection in dogs and cats by
periodic ant helminthic treatment
d) personal hygiene such as use of shoes or
b) Due to adult worm slippers
1. Hookworm anemia e) Avoiding ingestion of raw vegetable
 C
 Chronic blood loss due to continuous STRONGYLOIDES STERCORALIS
o
mechanical suction of blood from the mmon name:
intestinal mucosa and the presence of  Definitive host: man
bleeding areas left by the adult as they  Habitat: Upper small intestines
transfer to new areas (duodenum)
 Blood loss:  2 species: S. stercoralis, S. fuellerborni
o N. americanus: 0.03-0.05 ml/day
o A duodenale: 0.16-0.34 ml/day Developmental stages:
 Blood picture: "Mycrocytic Hypochromic 1. Ova
Anemia"
 ovoidal thin shelled, transparent,
resembles a Chinese lantern
 not found in feces except in diarrhea and
hyperistalsis
 contains a fully developed embryo
2. Rhabditiform larvae
2. Hypoalbuminemia
 Flask-shaped & stout esophagus
 Loss of protein due to a combined loss of  Short buccal cavity
blood and lymph and the protein loss is as  Conspicuous genital primordium
well in excess of the loss of RBC
3. Filariform larvae
Diagnosis:
  Non-feeding stage with a long and delicate anemia, eosinophilia, protein losing
esophagus enteropathy
 Forked or notched tail 4. Death in immuno-compromised patients
due to heavy autoinfection or larval
migration throughout the body

Diagnosis: DFS, stool culture (Harada mori filter

paper tech) rhabditiform larvae in feces;
Enterotest; Baermann, ELISA

4. Adult Treatment: Thiabendazole - ovicidal & larvicidal

Albendazole - 400 mg/day for 3 days
 well - developed buccal capsule
 no teeth, no cutting plates  Strongyloidiasis is difficult to treat
 b  Internal infection can continue for years
Enterebius vermicularis
u because of autoinfection
t bears a crown of chitinous, leaf-like
processes  Synonym: Oxyuris vermicularis
 Common name: pin worm, seat worm
 Main habitat: cecum and appendix
1. Parasitic  Definitive host: man
 inhabits the intestine of host  Reservoir host: dogs and cats
 female is a delicate filiform worm  Infective stage: embryonated egg
 esophagus: occupies 1/3 of the anterior  Disease: Enterobiasis, Oxyuriasis
part (longer) 2. Adult
 Parthenogenetic
 Small, spindle-shaped, relatively stout with
2. Free-living dorsoventral bladder-like expansions of
 Exists in the environment cuticle called the "cephalic alae"/"lateral
 buccal cavity: slightly larger that of the wings"
parasitic male worm  Have an oral end and three lips, hour glass-
 adult female: shorter, smaller shaped esophagus
 shorter esophagus a) Male: 2-5 mm long, strongly curved
pointed tail which is used for copulation,
Transmission: skin penetration; autoinfection spicule is conspicuous
Disease: Cochin-china diarrhea; b) Female: 8-13 mm in length by 0.4 mm;
Strongyloidiasis, Strongyloidosis posterior end is sharply pointed; vulva
found in the middle third; paired genital
Pathology and Symptoms: organs
1. Skin: allergic, raised red blotches at the site
of larval penetration
2. Migration of larvae: bronchial verminous
pneumonia
3. Intestine: abdominal pain, diarrhea and
constipation, vomiting, weight loss, variable
Mode of Transmission ✓ Toxocara infections can cause OLM, an eye
disease that can cause blindness.
 By anus to mouth via contaminated fingers
and fomites 2) Visceral larva migrans (VLM):
 Through contaminated food and drinks
 Heavier, or repeated Toxocara infections,
especially if the food handler is the carrier
while rare, can cause VLM, a disease that
 Via inhalation- viable ova can float in the air
causes swelling of the body's organs or
 Retro infection: gravid female after laying
central nervous system.
their eggs in the perianal area goes back
 Liver lesions: gray, elevated, circumscribed,
through the anus to the large intestine. The
diameter: 4 mm
larvae upon hatching migrate back to the
 granulomatous lesions: eosinophils,
large intestine
lymphocytes, epitheloid cells and giant cells
Pathology & Symptomatology: of foreign body type
 Larvae:to the liver, brain, eye, spinal cord,
 Some are asymptomatic; rarely causes
lungs, cardiac muscle, kidney and lymph
serious lesion
nodes
 Other symptoms
- Nocturnal perianal itching Symptoms: due to the inflammatory reaction at
- Vulva irritation; vulvovaginitis, salpingitis the site of infection Benign: 20-80% eosinophilia
- Cardinal feature: hypersensitivity and hepatomegaly
- Mild nausea or vomiting
 Severe: Intermittent(consistent) pain,
- Loss of sleep, irritability
dermatitis and neurologic disturbances,
- Slight irritation to intestinal mucosa
Pneumonitis. Liver and spleen
Control & Prevention: extremely difficult once enlargement, Skin rashes on the lower
infection sets in the household extremities
 Larvae: liver, brain, eye (blindness-most
 Home and community sanitation
serious), spinal cord, lungs, cardiac
 Better personal hygiene; fingernails should
muscle, kidney and lymph nodes
be cut short
 Use showers rather than bath tubs Treatment:
 Infected persons should sleep alone
 Mebendazole to eliminate the worm:
Diagnosis  Prednisone for inflammatory symptoms

a) Graham Scotch Tape Technique/Cellulose Prevention: avoidance of infected dogs and cats
Acetate Technique
Diagnosis
b) NIH Swab Technique
c) Schuffner and Swelling Rebel Method  Clinical s/s: triad of marked
TOXOCARA SPECIES  eosinophilia (increase of eosinophils),
hepatomegaly (enlargement of liver) &
hyperglobulinemia (excess globulin)
 History of exposure to dogs, cats and dirt
Disease There are two major forms of
eating
toxocariasis:
 ELISA; EIA (enzyme immunoassay)
1) Ocular larva migrans (OLM):
GNATHOSTOMA SPECIE
  1st Intermediate Host: copepods - Choko-Fushu Tua chid or chokofishi
 2nd Intermediate Host: fish and (Japan),
amphibians - consular disease (Nanjing).
- Shanghai rheumatism,
Diagnosis: migratory lesions, eating raw fish
- Tau-cheed (Thailand),
LENGTH: 2 to 3 centimeters long and are rust- - Woodbury bug (Australia),
colored - Yangtze River edema

LARVA Mode of transmission

 four rows of hooklets extruding from the - eating undercooked or raw freshwater fish,
surface of the cephallic bulb eels, frogs, birds, and reptiles
 Tiny, cuticular spines run along the length - contaminated water
of their bodies - In rare instances, larvae can directly
penetrate the skin of individuals who are
exposed to contaminated food sources or
 Two types of papillae extend from the freshwater.
worm-a cervical papilla off the main body SIGNS & SYMPTOMS-migratory swellings under
and two labial papillae on the cephalic bulb the skin increased levels of eosinophils in the
 Four sac-like openings in the cephalic bulb blood
EGGS/OVA - Rarely, the parasite can enter other tissues
 ovular with a mucus plug at one end such as the liver, and the eye, vision loss or
 approximately 40 micrometers to 70 blindriess
micrometers - It can also affect the nerves, spinal cord, or
 may cause a VLM like syndrome (Southeast brain, resulting in nerve pain, paralysis,
Asia) The larvae may migrate through coma and death
subcutaneous tissues, causing transient TRICHOSTRONGYLUS SPP
swelling, and to deeper tissues, eventually
invading the CNS Zoonotic infection (herbivores)

 Human infection: T colubriformis, T.

orientalis, T. axei, T. brevi
 Trichostrongylus tenuis: Infects poultry and
other birds worldwide
 Trichostrongylus axel: The stomach
hairworm. Infects cattle, sheep, goats, pigs
and horses and many wild mammals

Gnathostomiasis (Gnathostoma spinigerum) Found worldwide Trichostrongylus

colubriformis. Bankrupt worms, black scours
 food-borne worms: Infects cattle, sheep, goats, pigs and
parasitic infection that results from the horses and many wild mammals. Found
human ingestion of the third stage larvae worldwide Other less frequent species are
 OTHER TERMS: Trichostrongylus probolurus and
Trichostrongylus vitrinu
Habitat: small intestines eggs-larvae-ingestion the L1-larvae that complete development to
by DF infective L3-larvae in about 5 days by
suitable weather (hot and humid),
Disease. light & asymptomatic; heavy infection
significantly longer by cold weather. These
may produce abdominal pain and diarrhea,
infective larvae can survive in the
usually with eosinophilia
environment and remain infective for up to
6 months.

ANGIOSTRONGYLUS CANTONENSIS

Synonym: Pulmonema cantonensis

Common name: rat/rodent lungworm

Definitive host: rats Main habitat: lungs

Trichostrongylosis or Trichostrongyliasis Disease:

- worms damage the lining of the small Human Angiostrongylosis

intestine or the stomach-enteritis, gastritis,
Mode of transmission:
and sometimes anemia
- Typical signs are diarrhea (mucous and/or ingestion of larvae in raw or undercooked snails
hemorrhagic) or constipation - general or other vectors, or contaminated water and
weakness and wasting vegetables
- loss of appetite
Infective stage: 3dr stage larva
- reduced weight gains or even weight loss,
etc.
- Acute severe infections in young animals
may be fata

Eggs resemble those of hookworms (78-98 µm

by 40-50 µm)- slightly tapered at one end

Diagnosis:

 detection of characteristic eggs in the feces. Prevention & Control

 determination of the species requires post
mortem examination of adult worms after  Thorough cooking of prawns and crabs
necrops  Thorough washing of leafy vegetables
 Avoidance of ingestion of raw Achatina 1
Life cycle  Elimination of the snail and eradication of
 Direct life cycle rodents
 Adult females lay eggs in the large intestine
of the host that are shed with the feces.
Once in the environment the eggs release
Developmental stages  Ingestion of raw leafy vegetables
contaminated with mucus secretions of
1. Ova
the mollusks containing the 3rd stage
 Elongatit, ovoidal with a delicate hyaline
larva
shell: 46-48 to 74 microns
 Drinking water contaminated with the
2. fat stage larva
infected larva
 Has a distinct dorsal minute notch near
 Ingestion of paratenic hosts such as fresh
water prawns and crabs containing the
ANISAKIS SPECIES
infective larva
the slip of the tall  nematode of planctonic crustacean, sea fish
3. 3rd stage tarva and sea mammals
 With 2 weil developed chitinous rods  Common gastrointestinal parasites of
with expanded knob-like tips at the marine mammals
anterior end
Disease: Anisakis: Anisakiasis or Herring Disease
4. Adult worms
 Fidorm worms with a length of 17-25
mm
 Anisakis spp appear to be more prone to
a) FEMALE the milky white uterine
produce invasive disease
tubutes are spirally wound around the
 Pseudoterranova spp tend to be coughed
blood-filled intestine and can be seen
up or vomited intact
through transparent cuticle as a
 Eustrongyloides spp have been reported in
barbiers pole pattem
individuals who had eaten live minnows or
b) MALE: has a well-developed caudal
home prepared sushi. These parasites
bursa which is kidney-shaped and
usually infect fish-eating birds, but in
single lobed
humans the bright red larvae invade the
Pathology & Symptomatology abdominal cavity, requiring surgical
removal.
 Confusion, incoherence, disorientation
and impairment of memory of profound
coma

Diagnosis

 Brain dyscrasia- moderate to high

eosinophilic counts in the spinal fluid
 History of the patient as to ingestion of Mode of Transmission:
snails, crabs or leafy vegetables
 Autopsy to make thorough gross and ingestion of 3rd stage larva in the flesh of raw
microscopic examination of the brain fish
and spinal cord Anisakis Diagnosis: confirmed by the recovery
Transmission of an intact worm at endoscopy or by the
presence of an eosinophilic granuloma
 Ingestion of raw mollusks containing the containing an identifiable nematode in a
3rd stage larva surgical specimen
Prevention  Mesenteric tissues- it causes
pseudoperitoneal syndromes and allergic
 Freezing the fish -20oC for 24 hours
manifestations.
 Fishermen are required to eviscerate the
 Superficial tissues- the worm liberates a
fish soon after the catch
toxic substance that produces local
Treatment: inflammatory reactions; blisters appear at
any location and rupture of blister favors
 Depending on the severity of the infection, the escape of larva.
it might require medical attention.  Contamination of ruptured blister causes
 The larva(e) can be removed surgically or secondary bacterial infection such as
during endoscopic examination. abscesses, cellulitis, extensive ulceration
Albendazole and necrosis

DRACUNCULUS MEDINENSIS Diagnosis

 Visual observation of painful skin blister-

Common name: Guinea worm, fiery serpent of
outline of worm under the skin is revealed
the Israelites; Medina worm, serpent worm or
by reflected light; emerging worm
dragon worm
 Larvae release may be induced when cold
Disease: water is applied
 Calcified worm may be located by x-ray
Dracunculiasis/Dracontiasis/Dracunculosis

Habitat: cutaneous and subcutaneous tissue

Life span: 12-18 months

Morphology:

- female measures 50-120 cm long by 0.7-1.7

mm in diameter
- Male measures 12-29 by 0.4 m Treatment

 Mebendazole, niridazole, thiabendazole

 Surgical removal of the worm or slow
withdrawal from blister by gentle
traction and rolling the protruded
portion on a stick (few cm per day)
 Aspirin for pain and prevent secondary
infection

Prevention & Control

Pathogenesis & Symptomatology
 Infected individuals must not be
 If worms fail to reach the skin, it dies and allowed to bathe or wade in water used
either disintegrates or calcifies for drinking purposes
 Refrain from drinking from suspected
water source
 Boiling of water. Provision of piped
water or well