Classification Based on Host Dependence

Type of Parasite Definition Example Parasite

A parasite that must live inside a host to survive and Wuchereria bancrofti (filarial
Obligate Parasite
complete its life cycle. worm)

A parasite that can live both freely in the environment and Naegleria fowleri (brain-eating
Facultative Parasite
inside a host. amoeba)

Accidental (Incidental) Anisakis spp. (infects humans but

A parasite that infects a host it does not normally infect.
Parasite cannot complete its cycle)

A parasite that only visits the host for a short period to feed Mosquitoes (suck blood but do
Temporary Parasite
before leaving. not live inside the host)

Permanent Parasite A parasite that lives inside the host for its entire life cycle. Taenia solium (tapeworm)
Classification Based on Location in the Host
Type of Parasite Definition Example Parasite

Ectoparasite A parasite that lives on the surface of the host’s body. Lice, Fleas, Ticks

Ascaris lumbricoides (intestinal

Endoparasite A parasite that lives inside the host’s body.
nematode)
Plasmodium spp. (malaria
Intracellular Parasite A parasite that lives inside host cells.
parasite)
A parasite that lives in tissues or body fluids, but not inside Trypanosoma spp. (causes
Extracellular Parasite
cells. sleeping sickness)
Classification Based on Life Cycle
Monoxenous (Direct) A parasite that requires only one host to complete its life
Enterobius vermicularis (pinworm)
Parasite cycle.
Heteroxenous (Indirect) A parasite that requires multiple hosts to complete its life
Taenia solium (humans and pigs)
Parasite cycle.
Zoonotic Parasite A parasite that can infect both animals and humans. Toxocara canis (dog roundworm)
 Nematodes
Common Mode of Special
Scientific Name Symptoms Treatment Diagnosis Morphology
Name Transmission Characteristics
Produces a
Abdominal pain, Large, pinkish-white
Ascaris Giant Albendazole, Stool exam Ingestion of eggs protease inhibitor
malnutrition, cough worms; eggs have
lumbricoides roundworm Mebendazole (ova in feces) (fecal-oral) that helps evade
(Löffler's syndrome) thick shell
host immunity
Stool exam
Thin anterior, thick Contains TT47, an
Trichuris Diarrhea, rectal Albendazole, (barrel-shaped Ingestion of eggs
Whipworm posterior; eggs have immunodominant
trichiura prolapse, anemia Mebendazole eggs with (fecal-oral)
bipolar plugs protein
bipolar plugs)
Hookworms
Curved anterior end,
(Ancylostoma Iron-deficiency Stool exam Anticoagulants in
Albendazole, Skin penetration buccal capsule with
duodenale, Hookworms anemia, ground itch, (oval, thin- saliva prevent
Mebendazole by larvae cutting plates or
Necator respiratory symptoms shelled eggs) blood clotting
teeth
americanus)

Diarrhea, abdominal Stool exam Can cause

Skin penetration Short buccal cavity,
Strongyloides pain, skin rashes, Ivermectin, (rhabditiform autoinfection,
Threadworm by larvae, prominent genital
stercoralis hyperinfection in Albendazole larvae), leading to lifelong
autoinfection primordium
immunocompromised serology infection

Scotch tape Ingestion or Small white worms; Females migrate to

Enterobius Perianal itching Albendazole,
Pinworm test (eggs inhalation of eggs eggs are flattened on perianal region to
vermicularis (especially at night) Mebendazole
around anus) (fecal-oral) one side lay eggs at night
Ingestion of Can undergo
Chronic diarrhea, Stool exam Thin, filamentous
Capillaria Intestinal Albendazole, raw/undercooked autoinfection,
protein loss, weight (eggs, larvae, adult worms; peanut-
philippinensis capillariasis Mebendazole fish containing leading to severe
loss or adult worms) shaped eggs
larvae malnutrition
 Nematodes

Scientific Common Mode of Special

Symptoms Treatment Diagnosis Morphology
Name Name Transmission Characteristics

Albendazole,
Myalgia, fever, Ingestion of
Trichinella Mebendazole, Muscle biopsy, Encysted larvae in Larvae encyst in
Trichina worm periorbital undercooked meat
spiralis steroids for severe serology striated muscles skeletal muscles
edema (larvae in muscle)
cases

Eosinophilic CSF Ingestion of infected Most common

Supportive care (no
Parastrongylus meningitis, eosinophilia, snails, slugs, or Slender worms with cause of
Rat lungworm specific
cantonensis headache, history of contaminated pointed tails eosinophilic
anthelmintic)
nausea exposure vegetables meningitis

Diethylcarbamazine
Lymphedema, Blood smear Nocturnal
Wuchereria Bancroftian (DEC), Mosquito bite (Culex, Long, thread-like
elephantiasis, (microfilariae at periodicity of
bancrofti filariasis Albendazole, Anopheles, Aedes) filarial worms
hydrocele night), serology microfilariae
Ivermectin
Blood smear
Diethylcarbamazine Smaller than W. Similar to W.
Lymphedema (microfilariae Mosquito bite
Malayan (DEC), bancrofti, bancrofti, but
Brugia malayi (commonly in with terminal (Mansonia,
filariasis Albendazole, microfilariae with two restricted to
lower limbs) nuclei), Anopheles)
Ivermectin terminal nuclei Southeast Asia
serology
Severe Endoscopic Ingestion of Causes gastric
Endoscopy,
abdominal pain, removal, raw/undercooked Spiral-shaped larvae or intestinal
Anisakis spp. Anisakiasis histological
nausea, symptomatic seafood (larvae in in marine fish inflammation
examination
vomiting treatment tissue) after ingestion
Visceral larva
Albendazole, Causes larva
migrans (VLM), Serology Ingestion of eggs Large ascarid-like
Dog Mebendazole, migrans
Toxocara canis ocular larva (ELISA), clinical from contaminated worms; eggs have
roundworm corticosteroids for syndromes in
migrans (OLM), presentation soil or dog feces thick shell
severe cases humans
eosinophilia
 Hosts (Nematodes)

Scientific Name Definitive Host Intermediate Host

Ascaris lumbricoides Humans None (direct life cycle)

Trichuris trichiura Humans None (direct life cycle)

Hookworms (Ancylostoma
Humans None (direct life cycle)
duodenale, Necator americanus)
Strongyloides stercoralis Humans None (direct life cycle)

Enterobius vermicularis Humans None (direct life cycle)

Capillaria philippinensis Humans Fish (paratenic host)

Humans, Pigs, Bears, None (larvae encyst in muscle

Trichinella spiralis
Other carnivores tissue of the same host)
Parastrongylus cantonensis Rats Snails, Slugs
Mosquito (Culex, Anopheles,
Wuchereria bancrofti Humans
Aedes)
Mosquito (Mansonia,
Brugia malayi Humans, Cats
Anopheles)
Marine Mammals (e.g.,
Anisakis spp. Crustaceans → Fish/Squid
Whales, Dolphins)
None (humans are accidental
Toxocara canis Dogs
hosts)
 Stages (Nematodes)

Parasite Infective Stage Diagnostic Stage

Ascaris lumbricoides Embryonated egg (ingested) Fertilized/unfertilized egg in stool

Trichuris trichiura Embryonated egg (ingested) Unembryonated egg in stool

Hookworms (Ancylostoma
duodenale, Necator Filariform larvae (skin penetration) Eggs in stool
americanus)
1. Filariform larvae (skin penetration)
Strongyloides stercoralis Rhabditiform larvae in stool
2. Autoinfection via rhabditiform larvae
developing inside the host
Eggs in perianal region (Scotch tape
Enterobius vermicularis Embryonated egg (ingested)
test)
1. Infective larvae in freshwater fish
(ingested)
Capillaria philippinensis Peanut-shaped egg in stool
2. Autoinfection by larvae inside the host
Encysted larvae in muscle (ingested from
Trichinella spiralis Encysted larvae in muscle biopsy
undercooked meat)
Third-stage larvae (L3) in snails/slugs
Parastrongylus cantonensis Larvae in cerebrospinal fluid (CSF)
(ingested)
Microfilariae in blood (nighttime
Wuchereria bancrofti Third-stage larvae (L3) from mosquito bite
collection)
Microfilariae in blood (nighttime
Brugia malayi Third-stage larvae (L3) from mosquito bite
collection)
Anisakis spp. Third-stage larvae (L3) in raw fish (ingested) Larvae in gastric mucosa (endoscopy)
Toxocara canis Embryonated egg (ingested) Larvae in tissues (biopsy), serology
Strongyloides has an autoinfection cycle, allowing it to persist in the host for years. The rhabditiform larvae can mature inside the
intestine and reinfect the host.
C. philippinensis can cause autoinfection, where larvae hatch within the intestine and cause severe reinfection cycles, leading to
chronic diarrhea and wasting.
 Site of Infection

Site of Infection Scientific Name

Ascaris lumbricoides, Hookworms, Strongyloides stercoralis,
Small Intestine
Capillaria philippinensis
Large Intestine
(Cecum, Colon, Trichuris trichiura, Enterobius vermicularis
Rectum)
Lymphatic System Wuchereria bancrofti, Brugia malayi
Skeletal Muscle Trichinella spiralis
Brain & Meninges Parastrongylus cantonensis
Lungs (During Larval
Ascaris lumbricoides, Hookworms, Strongyloides stercoralis
Migration)
Stomach &
Anisakis spp.
Intestinal Wall
Various Tissues
(Liver, Lungs, Eyes, Toxocara canis (Visceral/Ocular Larva Migrans)
Brain)
Blood (Microfilariae
Wuchereria bancrofti, Brugia malayi
Circulation)
Perianal Region Enterobius vermicularis (Egg-laying site)

Key Insights:
• Intestinal Nematodes → Ascaris, Hookworms, Trichuris, Strongyloides, Enterobius, Capillaria.
• Lymphatic Filarial Worms → Wuchereria, Brugia.
• Tissue-Dwelling Parasites → Trichinella (muscle), Toxocara (various organs), Parastrongylus (brain), Anisakis (stomach wall).
• Migratory Larvae → Ascaris, Hookworms, Strongyloides (lung migration), Toxocara (visceral migration).
 Cestodes

Common Mode of
Scientific Name Symptoms Treatment Diagnosis Morphology Special Characteristics
Name Transmission
Ingestion of Scolex: No hooks, 4
Stool exam
Beef Mild GI discomfort, Praziquantel, undercooked suckers; Proglottids: Causes taeniasis, no
Taenia saginata (proglottids,
Tapeworm weight loss Niclosamide beef containing Motile, longer than cysticercosis
eggs)
cysticerci wide
Praziquantel Ingestion of
Mild GI symptoms Stool exam Scolex: Hooks + 4
(taeniasis), undercooked Neurocysticercosis
Pork (taeniasis); (taeniasis), suckers; Proglottids:
Taenia solium Albendazole + pork (taeniasis); when larvae infect the
Tapeworm Neurocysticercosis: CT/MRI Less motile, shorter
Steroids ingestion of eggs brain
seizures, headaches (cysticercosis) than T. saginata
(neurocysticercosis) (cysticercosis)
Abdominal pain, Direct ingestion Only tapeworm with a
Small, thin-walled
Hymenolepis Dwarf diarrhea, weight Praziquantel, Stool exam of eggs direct life cycle (no
eggs with polar
nana Tapeworm loss (especially in Niclosamide (eggs) (autoinfection intermediate host
filaments
children) possible) needed)
Mostly Humans infected
Hymenolepis Stool exam Ingestion of Large eggs, no polar
Rat Tapeworm asymptomatic, mild Praziquantel accidentally by eating
diminuta (eggs) infected insects filaments
diarrhea contaminated insects
Stool exam
Asymptomatic, Ingestion of Scolex: 4 suckers;
Dipylidium Dog Praziquantel, (proglottids, Eggs in packets, often
perianal itching, infected flea Proglottids: Pumpkin
caninum Tapeworm Niclosamide eggs in seen in pet feces
mild GI symptoms larvae seed-shaped, motile
packets)
Vitamin B12 Stool exam Ingestion of
Scolex: Bothria Largest human
Diphyllobothrium Broad Fish deficiency → Praziquantel, (operculated undercooked
(grooves), no tapeworm (up to 10m);
latum Tapeworm megaloblastic Niclosamide eggs, freshwater fish
suckers/hooks causes B12 deficiency
anemia proglottids) with larvae
 Cestodes

Common Mode of
Scientific Name Symptoms Treatment Diagnosis Morphology Special Characteristics
Name Transmission
Hydatid cysts in
liver, lungs → Albendazole, Imaging (US, Small tapeworm (3 Hydatid cysts contain
Echinococcus Hydatid Ingestion of eggs
pressure effects, Surgical removal CT, MRI), proglottids); Eggs protoscolices (hydatid
granulosus Tapeworm from dog feces
anaphylaxis if (PAIR technique) Serology resemble Taenia sand)
ruptured

Alveolar Invasive tumor-like Albendazole, Imaging (US, Ingestion of eggs Small tapeworm Alveolar cysts grow
Echinococcus
Hydatid cysts (liver, lungs, Surgery (if CT, MRI), from carnivore (similar to E. aggressively, mimicking
multilocularis
Tapeworm brain) possible) Serology feces granulosus) cancer

Subcutaneous
Imaging (if Ingestion of
nodules, eye Scolex: Bothria Humans act as
Sparganosis Surgical removal, larva in infected water
Spirometra spp. inflammation, CNS (grooves), no accidental second
Tapeworm Albendazole tissues), (copepods) or raw
symptoms (if brain suckers/hooks intermediate host
Serology amphibians/reptiles
affected)

Key Takeaways:
• Intestinal Tapeworms → Taenia spp., Hymenolepis spp., Dipylidium caninum, Diphyllobothrium latum
• Tissue-Infecting Tapeworms (Larval Stage in Humans) → Echinococcus spp. (hydatid cysts), Spirometra spp. (sparganosis), Taenia solium
(neurocysticercosis)
• Special Cases:
o Hymenolepis nana is the only tapeworm with a direct life cycle (no intermediate host needed).
o Diphyllobothrium latum is the largest human tapeworm and causes B12 deficiency.
o Echinococcus spp. and Spirometra spp. do not mature in humans, but their larvae cause severe disease.
o Dipylidium caninum eggs are found in packets, and infection is commonly seen in children who accidentally ingest fleas.
 Hosts (Cestodes)
Scientific Name Definitive Host(s) Intermediate Host(s)
Taenia saginata (Beef
Humans Cattle
Tapeworm)

Taenia solium (Pork Pigs, Humans (accidental for

Humans
Tapeworm) cysticercosis)

Hymenolepis nana (Dwarf None (direct cycle), but insects can

Humans, Rodents
Tapeworm) serve as optional intermediate hosts

Hymenolepis diminuta (Rat

Humans, Rodents Insects (beetles, fleas)
Tapeworm)
Dipylidium caninum (Dog
Dogs, Cats, Humans (accidental) Fleas (Ctenocephalides spp.)
Tapeworm)

Diphyllobothrium latum Humans, Fish-eating Mammals 1st: Copepods (Cyclops); 2nd:

(Broad Fish Tapeworm) (Bears, Seals, Cats, Dogs) Freshwater Fish

Echinococcus granulosus
Dogs, Canids Sheep, Cattle, Humans (accidental)
(Hydatid Tapeworm)

Echinococcus multilocularis
Foxes, Dogs Rodents, Humans (accidental)
(Alveolar Hydatid Tapeworm)

1st: Copepods (Cyclops); 2nd:

Spirometra spp. (Sparganosis
Cats, Dogs, Wild Carnivores Amphibians, Reptiles, Humans
Tapeworm)
(accidental)
Key Takeaways:
• Humans as Definitive Hosts: Taenia spp., Hymenolepis spp., Dipylidium caninum, Diphyllobothrium latum (adults in the intestine).
• Humans as Accidental Intermediate Hosts: Taenia solium (cysticercosis), Echinococcus spp. (hydatid disease), Spirometra spp. (sparganosis).
• Tapeworms Requiring Two Intermediate Hosts: Diphyllobothrium latum and Spirometra spp. (copepod + fish/amphibian).
 Site of infection (cestodes)

Site of Infection Scientific Name

Taenia spp. (Taenia solium, Taenia saginata), Hymenolepis nana,

Small Intestine
Hymenolepis diminuta, Dipylidium caninum, Diphyllobothrium latum

Various Organs (Liver, Lungs, Echinococcus spp. (Echinococcus granulosus, Echinococcus multilocularis)
Brain, etc.) (Hydatid cysts)
Subcutaneous Tissue, Eyes, CNS Spirometra spp. (Sparganosis)

Key Insights:
• Intestinal Tapeworms → Taenia spp., Hymenolepis spp., Dipylidium caninum, Diphyllobothrium latum (adults remain in the small
intestine).
• Tissue-Dwelling Tapeworms (Larval Stage) → Echinococcus spp. (hydatid cysts in various organs), Spirometra spp. (sparganosis
in subcutaneous tissues, eyes, or CNS).
 Stages (Cestodes)

Parasite Infective Stage Diagnostic Stage

1. Cysticercus larva (ingestion from
undercooked pork → causes Taeniasis)
Taenia solium Eggs or proglottids in stool
2. Eggs (Embryonated eggs) (ingestion via
fecal-oral route → causes Cysticercosis)

Cysticercus larva in undercooked beef

Taenia saginatta Eggs or proglottids in stool
(ingested)

1. Embryonated egg (direct ingestion)

Hymenolepis nana Embryonated egg in stool
2. Cysticercoid larva (ingestion from infected
arthropods)

Cysticercoid larva in infected arthropod

Hymenolepis diminuta Egg in stool
(ingested)

Dipylidium caninum Cysticercoid larva in flea (ingested) Egg packet or proglottids in stool

Plerocercoid larva in freshwater fish

Diphyllobothrium latum Operculated egg in stool
(ingested)

Echinococcus spp. Embryonated egg (ingested from dog feces) Hydatid cysts in organs (imaging)

Plerocercoid larva (sparganum) in raw

Spirometra spp. Sparganum larva in tissues (biopsy)
amphibians or reptiles (ingested)

Hymenolepis nana - H. nana is unique among tapeworms because it can complete its life cycle without an intermediate host (direct
ingestion of eggs), but it can also infect through arthropods as an intermediate host.
Taenia solium - If a human ingests cysticerci from undercooked pork, they develop intestinal tapeworm infection (taeniasis). If a
human ingests the eggs (via contaminated food or water), the larva can migrate to tissues, causing cysticercosis.