Metazoa (Helmithes) : multicellular eukaryotic organisms Name Paragonimus westermanii Clonorchis sinensis Fasciola hepatica Heterophyes heterophyes Trematodes

(flukes) Fasciolopsis buski Schistosoma mansoni S. japonicum Giant intestinal fluke Intestinal schistosomiasis Common name Lung fluke Chinese liver fluke Sheep liver fluke Transmission Reservoir Cycle Hermaphroditic leaf shaped worms that are flat and fleshy 1st intermediate: Snails 2nd intermediate: Fish, crustacean Definitive host: Mammals Eggs with lateral spine in feces Diagnosis Operculated eggs present in feces (lid covered eggs) Pathology Disease Mimics pulmonary TB in lungs Infects bile duct causing Clonorchiasis > Cholangiocarcinoma, jaundice Liver: anemia, weight loss, submandibular edema Pain and diarrhea, extra intestinal: heart, brain Pigs, dogs, rabbits, humans Cats, dogs, cattle Asymptomatic, abdominal pain, chronic diarrhea, anemia, allergic sensitization Skin penetration > acute schistosomiasis (Katayama fever) itching, hivers, fever, cough > chronic > blood vessels of the intestine/ liver portal veins > granulomas around eggs > portal hypertension Urinary Skin penetration > acute itching > mature in bladder veins > calcification of bladder walls > bladder carcinoma (high in Egypt and Africa) Itchy papules/ dermatitis on skin at site of entry Small intestine Proglottid segments of worm containing eggs in feces Can grow very large Take in Vitamin B12 megaloblastic anemia Intestinal disease Eggs cause tissue disease Praziquantel Treatment Praziquantel

Ingestion of raw crab, crayfish Cat, dogs, pigs, humans Raw fish Aquatic plants: watercress Raw fish Aquatic plants: water chestnuts Direct penetration of skin via cercaeria life form Swimming/ playing in infected water Dogs, cats, humans Sheep, cattle, humans

Platyhelminthes (flatworms)

Schistosoma hematobium

Vesicular schistosomiasis

Primates

Eggs present in urine with terminal spine

Praciquantel

Non-human schistosomes Diphyllobothrium latum Cestodes (tapeworms)

Swimmers itch Broad/fish tapeworm Beef tapeworm Pork tapeworm Ingestion of contaminated/raw fish Ingestion of infected / uncooked meat Ingestion of parasite eggs in feces (contaminated food/water) Ingestion of parasite eggs in feces (contaminated food/water) Ingestion of eggs via contaminated food/water Skin penetration by larvae, commonly at feet Ingestion of eggs found in perianal region (scratching fecal-oral) Skin penetration by larvae, commonly at feet Ingestion of improperly cooked meat (larvae ingested)

Birds, Great Lakes US

Trimeprazine lotion

Taenia saginata Taenia solium

Intestine/ muscle / brain Biopsy of tissue in / liver tissue tissue disease, eggs/proglottid in feces in intestinal disease Liver (75% of cases), lung (10-20%) Intestine Imaging (ultrasound) of infected organ Larvae in feces Larvae in feces Scotch tape test to locate eggs in perianal region Eggs in feces Muscle tissue (cyst form), intestine (adult form) Cysts in muscle biopsy penetrate

Echinococcus granulosus E. multilocularis Ascaris lumbricoides

Dog tapeworm

Causes hyatid disease (cyst)

Roundworm Threadworm Pinworm

Most common human worm world wide Causes ground itch Common in US children Common sign: scratching around anus

Nematodes (roundworms)

Strongyloides stercoralis Enterobius vermicularis

Intestinal

Ancylostoma duodenale Trichinella spiralis

Hookworm Porkworm

No external phase and no eggs Dead end: transmission by carnivorism

Blood & Tissue

Wucheria bancrofti Brugia malayi Brugia timori Onchocerca volvulus

Filaria

Vector transmission via mosquito (Anopheles, Culex, Aedes) Vector transmission via simlium black fly

Lymph, blood

Microfilaria in blood

Tissue Nematodes

Elephantitis

No eggs (produces microfilaria instead) Definitive host: humans

Subcutaneous tissue

Larvae/microfilaria in subcutaneous tissue (skin nip) Larvae/microfilaria in blood smear Larvae/microfilaria from blister formed by worm

Filaria

River blindness/ onchocerciasis (patients can see worm crossing eye)

Loa loa

Eyeworm

Vector transmission via deer fly Vector transmission via water flea (ingestion of water containing flea)

Subcutaneous tissue (adults), blood, CSF, lungs (microfilaria) Subcutaneous tissue, connective tissue

Dracunculus medinensis

Guinea worm