Escolar Documentos
Profissional Documentos
Cultura Documentos
Nematodes
• Nonsegmented
• Cylindrical
• Tapered at both ends
• Complete digestive tract
• Separate sexes
• Females are usually larger
• Males are usually curved at
the posterior and have special
copulatory organs
INTESTINAL NEMATODES
Ascaris lumbricoides
• Life Cycle
Ascaris lumbricoides
• Morphology
Adult :
- male : 10 – 31 cm
- female : 22 – 35 cm
Ascaris lumbricoides
• Morphology
Ova:
Ascaris lumbricoides
• Clinical Manifestations
- allergic reactions to larval migration
- pneumonitis
- abdominal pain
- lactose intolerance
- bowel obstruction
Ascaris lumbricoides
• Diagnosis
- detection of eggs in stool
Ascaris lumbricoides
• Review
• parasite of pigs
• Some studies suggest that it may be the same species as
Ascaris lumbricoides
Hookworms
• 5 species
- Necator americanus
- Ancylostoma duodenale
- Ancylostoma ceylanicum*
- Ancylostoma braziliense
- Ancylostoma caninum
Hookworms
• Soil transmitted
• Blood-sucking nematodes
Hookworms
• Life Cycle
Hookworms
• Necator americanus
- infects only through skin penetration
• Ancylostoma duodenale
- skin penetration, ingestion, transmammary,
and probably transplacental
Hookworms
• Morphology
Adult:
Hookworms
• Morphology
Ova
Hookworms
• Morphology
Rhabditiform larvae
Hookworms
• Morphology
Filariform larvae
Hookworms
• Clinical Manifestations
• Clinical Manifestations
• Diagnosis
• Review
• Whipworm
• Soil transmitted
• Frequently observed with Ascaris
Trichuris trichiura
• Life Cycle
Trichuris trichiura
• Morphology
Adult:
Trichuris trichiura
• Morphology
Ova:
Trichuris trichiura
• Clinical Manifestations:
• Diagnosis
• Review
• Threadworm
• Facultative parasite / zoonotic
Strongyloides stercoralis
• Life Cycle
Strongyloides stercoralis
• Morphology
Adult:
Strongyloides stercoralis
• Morphology
Rhabditiform:
Strongyloides stercoralis
• Morphology
Filariform:
Strongyloides stercoralis
• Morphology
Ova:
Strongyloides stercoralis
• Clinical Manifestastions
• Diagnosis
- demonstration of larvae in stool
- Harada-Mori, Baermann funnel
- duodenal sampling
• Review
• Strongyloides fulleborni
- parasite of monkeys
- eggs are passed in stool
- larvae has been found in breast milk
• Pinworm
• Seatworm
• *threadworm*
• Etiologic agent of oxyuriasis / enterobiasis
Enterobius vermicularis
• Life Cycle
Enterobius vermicularis
• Morphology
Adult
Enterobius vermicularis
• Morphology
Ova
Enterobius vermicularis
• Clinical Manifestations:
- pruritus ani
- mild intestinal inflammation
• Diagnosis
- ova or adult in perianal swab
- rarely in stool
- cellophane tape swab*
Enterobius vermicularis
Enterobius vermicularis
• Review
• Life Cycle
Capillaria philippinensis
• Morphology
Adult
Capillaria philippinensis
• Morphology
Ova
Capillaria philippinensis
• Clinical Manifestations:
• Diagnosis
- demonstration of ova in stool
- coproantigen detection
- Ab detection
(crossreactive with Trichinella spiralis antigen)
Capillaria philippinensis
• Review
• Trichostrongylus orientalis
• parasites of herbivores
• Humans are accidental hosts
• Related to the hookworms
Trichostrongylus spp.
• Life Cycle
Trichostrongylus spp.
• Morphology
Trichostrongylus spp.
• Clinical Manifestations:
• Diagnosis
- ova in stool
Trichostrongylus spp.
• Review
• Life Cycle
Anisakis, Pseudoterranova, & Contracaecum
• Clinical Manifestations:
(Anisakiasis / Anisakidosis)
- inflammation of the intestinal wall
- partial ileus(intestinal obstruction) of the small
intestines
- abdominal pain, nausea, vomiting, diarrhea
Anisakis, Pseudoterranova, & Contracaecum
• Diagnosis
- history of eating raw fish
- demonstration of worms from gastroscopy,
surgery, or due to being vomited by the patient
• Review
• Concentration Methods:
a. floatation methods
(zinc sulfate, sheather’s sugar flotation,
FLOTAC)
b. sedimentation methods
(FECT, KOH)
Lab Exam of Stool Samples
• Zoonotic
• Disease of carnivores and omnivores
- T. spiralis
- T. britovi
- T. nativa
- T. nelsoni
- T. murrelli
- T. papuae
- T. pseudospiralis
Trichinella spiralis
• Life Cycle
Trichinella spiralis
• Morphology
Trichinella spiralis
• Clinical Manifestations:
- diarrhea or constipation, vomiting, abdominal
cramps, malaise, nausea
- myalgia, periorbital edema, eosinophilia
- remittent fever, dyspnea, dysphagia, paralysis
• Diagnosis
- Beck’s Xenodiagnosis
(+) result: presence of adult female in the
duodenum and/or larvae in the muscle after 14
days
Trichinella spiralis
• Review
• Rat Lungworm
• Zoonotic
Parastrongylus cantonensis
• Life Cycle
Parastrongylus cantonensis
• Morphology
Parastrongylus cantonensis
• Clinical Manifestations:
eosinophilic meningoencephalitis
- intermittent occipital or bitemporal headache
- stiff neck, weakness of the extremities, paralysis,
paresthesia, eosinophilia, confusion, incoherence,
disorientation, memory lapses, coma
Parastrongylus cantonensis
• Diagnosis
- history of exposure
- spinal fluid eosinophilia (>10%)
- mildly elevated CSF protein
- larvae or young adults may be found in CSF
- CT scans
- Serology
Parastrongylus cantonensis
• Review
• Wuchereria bancrofti
• Brugia malayi
• Filarial worms
• Vector-borne
Lymphatic Filaria
• Life Cycle
Lymphatic Filaria
• Life Cycle
Lymphatic Filaria
• Vectors:
Aedes Mansonia
Anopheles
Culex
Lymphatic Filaria
• Morphology
(table 3.2, p.150)
Wuchereria bancrofti
Brugia malayi
Lymphatic Filaria
• Morphology
(table 3.2, p.150)
Wuchereria bancrofti
Brugia malayi
Lymphatic Filaria
Lymphatic Filaria
• Diagnosis
Mazzoti test
- administration of DEC provokes intense
pruritus w/in a few hours
Mansonella spp.
• M. ozzardi
• M. streptocerca
• M. perstans
- generally asymptomatic
- adenopathy, pruritic maculopapular lesions,
arthritis, fever
Mansonella ozzardi unsheathed nuclei does not extend nonperiodic blood, skin
to tip
Mansonella streptocerca unsheathed curved tail / nonperiodic skin, blood
shepherd’s crook
• Diagnosis:
- demonstration of adults in biopsy of tumors
Dracunculus medinensis
• Guinea worm
- found in the middle east
Manifestations:
- urticaria
- skin ulcers
- ankylosis
Which is it?
• “fiery serpents”
• medicine
Visceral Larva Migrans
• Lab Methods
Cestodes