NEMATODES
GENERAL FEATURES
1. They are
elongated,cylindrical,unsegmented worms
with seperates sexes [ diecious]
2. Males are smaller than females and their
posterior end is curved ventrally
3. Size varies from 5mm to 1m
4. They possess a tough,acellular, hyaline
cuticle
5. They have body cavity with various organs
6. Digestive system is complete and consists
of mouth,oesophagus, intestine, anus.
7. Females are either
viviparous = produce larvae
oviparous = lay eggs
ovoviviparous = lay eggs,which
hatch immediately producing larvae.
8. Moulting [ shedding old cuticle ] is
another feature.
CLASSIFICATION
Based on habitat of adult worms 2 types;
1. Intestinal nematodes
2. Tissue nematodes
Intestinal nematode
They inhabits in intestine of definitive
host
Man is optimum host
Only one host required
3 morphological forms
a) ADULT FORM =found in intestine of man
b) EGGS = passed in stool
c) LARVAE = develop from egg
Tissue nematodes
Nematodes invading tissue and organs
Requires 2 hosts for completion of their
lifecycle
Intermediate host = for larval
development
2 morphological forms
a) Adult worm = in defenitive host
b) Larval stage = in insect vector/
cyclopes
EG: FILARIASIS
Intestinal nematodes
SMALL INTESTINE
Ascaris lumbricoides
Ancylostoma duodenale
Necator americanus
Strongyloides stercoralis
Trichinella spiralis
Large intestine
Enterobius vermicularis
Trichuris trichiura
ASCARIS
LUMBRICOIDES
Ascaris lumbricoides
Common name = Round worm [giant
round worm ]
Habitat = lumen of small intestine
[jejunum] of humans
morphology
1. ADULT
Shape = cylindrical, with tapering ends
Size = upto 40cm, largest intestinal
nematodes
Anterior end = thin ,shows a mouth with
3 finely toothed lips
Freshly passed worms are = pink in
color
Body cavity present, with a toxic fluid
known as ascaron
Life span = 2 yrs
MALE WORMS
FEMALE WORMS
Stouter than males
Curved
Straight and
posteriorly
Tail end with 2
conical posterior
end
curved Vulva is present at
copulatory junction of
spicules anterior 1/3rd of
15-25 cm length
body this part is
called vulvar waist
It is oviparous =
liberates 2,00,000
eggs daily
EGGS
3 TYPES
FERTILIZED – Corticated
Decorticated
UNFERTILIZED- Corticated
Decorticated
FERTILISED EMBRYONATED
FERTILIZED
Shape = round/oval
Color= yellow –brown bile stained
Egg shell = thick,smooth,transluscent
= albuminous coat may or
maynot be present
If present = corticated
IfAbsent = decorticated
Unfertiliszed egg
Shape = narrow,longer
Colour = brownish- bile stained
Egg shell – thinner, irregular
Albuminous cot may /may not be present
If Present =corticated
If Absent = decorticated
Life cycle
Definitive host = human
Infective form = embryonated egg
Sources = contaminated food , drink, or
raw vegetables
Mode of infection = ingestion /
inhalation of polluted dust particles
containing embryonated eggs
pathogenicity
Disease = ASCARIASIS
Symptoms are produced by both larvae
and adult worms
Symptoms due to larvae
Ascaria pneumonia [ loefflers
syndrome]
Characterised by;
Fever
Non productive cough
dyspnoea
Symptoms due to adult
worms
Incubation period = 60-75 days
The adult worms produces pathogenic
effects in the following ways
1. Spoliative action
When present in large numbers especially
in children, they interfere with digestion
and absorption of food and cause protein
energy malnutrition and vitamin A
deficiency [ night blindness]
2. Toxic action
The body fluid of adult worms, if absorbed,
produces toxic effects such as typhoid- like
fever and hypersensitivity reaction such as
Fever
Urticaria
Oedema of face
Conjunctivitis
Irritation of upper respiratory tract.
3. mechanical effect
Presence of large no.of entangled worms
may cause intestinal obstruction
It may also cause
Appendicitis
Obstructive jaundice
Acute haemorrhagicpancreatitis
asphyxia
Lab diagnosis
1. Demonstration of characteristic eggs in
feces by saline and iodine
preparation
2. Demonstration of eggs in concentrated
faeces, if routine examination is
negative
3. Demonstration of adult worms passed
in feaces,vomiting or through nose
4. Demonstration of larvae in sputum/
gastric aspirate in ascaris pneumonia
5. X- ray and ultrasound = demonstration of
worms in intestine
prophylaxis
Proper sanitation
Proper sanitary disposal
Avoid consumption of raw vegetables and
fruits in soil contaminated with human
faeces
Personnel hygiene
treatment
Piperazine salts
Mebendazole and albendazole
ANCYLOSTOMA
DUODENALE
Common name = hook worm
Habitat = small intestine particularly jejunum
Morphology
1. ADULT
Shape = small, greyish white and cylindrical
Anterior end = bent dorsally , hence called
HOOKWORM
Freshly passed worm = reddish brown in
color
mouth – has 6 teeth
4 hooklike on ventral surface
2 knob like on dorsal surface
MALE
FEMALES
Its posterior end is
Smaller
Posterior end tapered
No bursa present
has umbrella like
It is oviparous
copulatory bursa
Lays 10000-25000
with 2
copulatoryspicul eggs daily
es
Bursa have 3 lobes
EGG
Shape = oval/ elliptical
Color = colourless – non bile stained
Ovum = segmented, with 4 blastomers
Floats in saturated solution of common salts
Life cycle
Definitive host – human beings
Infective form – filariform larvae
Sources = contaminated soil
Mode of infection = penetration of skin
Pathogenicity and clinical
features
Disease = ancylostomiasis [ hook worm
disease]
Symptoms are produced by both adult and
larvae
Symptoms due to larvae
1. Ground itch/ dermatitis
Characterised by pruritic maculopapular
dermatitis at the site of entrance of larvae
2. Creeping erruption [ cutaneous larval
migrans ]
Reddish itchy papule along the path
traversed by larvae
Symptoms produced by adult
worms
Epigastritis pain
Vomiting
Diarrhoea
Anaemia due to
Because of sucking of blood by adult
worms through wound produces in
intestinal mucosa
Continuous bleeding from punctured
site
Nutritional defect
Leading to iron deficiency anaemia
labdiagnosis
1. Demonstration of eggs in faeces by saline
and iodine preparation
2. Demonstration of adults worms passed in
faeces
3. Duodenal contents may be studied
under microscope for presence of
eggs and worms
4. Stool examination for occult blood
and charcot leyden crystals
prophylaxis
Effective waste desposal
Disinfection of faeces or soil
Personnel protection – wearing boots/
gloves
treatment
Mebendazole = twice a day for 3 days
albendazole
Enterobius vermicularis
Enterobius vermicularis
Common name = pin worm/thread
worm / seat worm
Morphology
1. ADULT WORM
Shape = small,white,spindled shape
resembles a piece of thread
Anterior end = wing like expansion
FEMALE
MALE Posterior 1/3rd of
Posterior end –
body is long
curved Tail = tapered
Have single spicule
Oviparous
It dies after
Lays eggs
fertilization of Dies 2/3 week after
females
after oviposition.
EGG
Shape = planoconvex
Ventral side = flattened
Dorsal side = convex
Color = colorless
Egg shell = transparent
Larva= tadpole like inside egg
Life cycle
Definitive host = human beings
Infective form = mature eggs
Sources = contaminated hands , food, and
water
Mode of infection = ingestion and
inhalation
PATHOGENICITY
Disease = ENTEROBIASIS
Common in children
Infection occurs by ingestion of eggs.The
eggs deposited on perianl skin contaminate
night clothes and bed linen of infected
persons.
Infection can be transmitted by handling
such night clothes and bed linen
Infection also can occur by inhalation of
eggs that become air borne during bed
making.
Reinfection of same host [ autoinfection ]
is also possible . It happens by 2 ways
1. By hand to mouth
2. Retrograde infection= egg hatches on
perianal skin out into larvae which
migrate back into anus upto colon
and develops into adult worms.
Clinical features
Perianal pruritis
Eczematous condition around anus
Nocturnal enuresis
Inflammation of vermiform appendix.
Lab diagnosis
1. Demonstration of the adult worms in
faeces after a purge or anemia.
2. Demonstration of characteristic egg
in perianal area.= NIH swab /
cellophane tape method
prophylaxis
Personnel and community hygiene
Treatment of all infected persons
treatment
Mebendazole
Pyrantel pamoate.
