NEMATODES

NEMATODES
- Commonly known as roundworms
or intestinal roundworms.
- Can’t appreciate this without the
use of high-power microscope. E.g.,
electron
General Characteristics: - Move like an earthworm.
- For MOT they can be transmitted by
1. General morphology: Unsegmented,
ingestion of the eggs or larva, skin
elongated and cylindrical in shape. The
penetration or through arthropods.
body is covered by a non-nucleated cuticle
2. The sexes are separate, and the females are
which may be smooth striated, bossed or
larger than the males; male posterior end is
ornamented with spines.
usually curved
- With bilateral symmetric cover with 3. Reproductive system
rutilant.
- They have complete digestive tract • Male: testes, vas deferens, seminal
and muscular triglycepharynx or vesicle, ejaculatory duct, cloaca
their attachment. a) accessory copulatory apparatus

 Pseudocoele - body cavity which contains b) gubernaculum (wing- like appendage)

all of the viscera (digestive, excretory,
c) telamon
reproductive and nervous system.
d) copulatory spicule
 Anterior end-mouth/buccal cavity which
e) copulatory bursa (umbrella like ex:
may be provided with spines, hooks, cutting
Hookworms)
plates, stylets, or other structures for
attachment or penetration 4. Digestive System: with complete alimentary
tract
 Length - a few mm to a meter in length  Esophagus: filariform, rhabditiform,
-general rule, female is larger spiruroid, strongyliform or
than male stichosoma. (Disregard this part as
stated)
 Movement-by sinuous changes of their
5. Nervous System: with chemoreceptors
bodies
-move by sinuous Acetyl choline- executory
neurotransmitter(radar)
 Mode of transmission – ingestion of
 Gamma-amino butyric acid (GABA)-
egg and larva, skin penetration, or
inhibitory neurotransmitter
through arthropods
 AMPHIDS: pair of laterally placed
minute receptor organs in the cephalic
or cervical region of all nematodes.
- aka as Adenophora
 NEMATODES

caudal glands common in Adenophorean  Oral attachment to the mucosa

nematodes.
-Acylostoma or hookworms
caudal glands secrete adhesive materials
by which the nematodes can attach to a  Penetration of the tissues
sub strain. -Strongyloides

 Retention in the folds of the mucosa

 PHASMIDS: pair of minute lateral post-anal
organs in species w/o caudal glands -Ascaris lumbricoides

-aka as Phasmedia 12. Modes of nourishment- need to deworm

once a year
caudal glands are present in amphids and  By sucking with ingestion of blood
absent in phasmids.  By ingestion of lyzed tissues and
blood by embedded worms
6. Excretory System: with collecting tubules or
 By feeding with intestinal contents
collecting canal & an excretory pore
 By deriving from body fluids
7. No circulatory system
13. Life span o Trichinella spiralis: 4 - 16 weeks
• Enterobius vermicularis: 1-2 months
• Ascaris lumbricoides: 12-17 months
• Hookworms: at least 14 years
- once infected you are infected, can
cause Vit B 12 deficiency/ Iron
deficiency.

8. No respiratory system •Filarial worms: up to 25 years

9. Developmental stages • Trichuris trichiura: 5-10 years
- eggs stage • Strongyloides stercoralis: 20 - 30 years
- larva stage 14. Life Cycle
- adult stage • Egg – have three layers
10. Reproduction: The adult female may be • Four larval stages
• Oviparous- female can lay eggs with • Adult stage
hard shells to produce they young once
o E.G Ascaris lumbricoides
• Viviparous- they produce egg and keep
it to them, inside the mother’s body
until the parasites fully developed
(ex. Trichinella spiralis)
o other term for oviparous
• Parthenogenetic- can produce eggs
without male (ex. Strongyloides)
11. Modes of attachment
 Anchorage with attenuated ends
-Trichuris trichiura
 NEMATODES

THE LABORATORY DIAGNOSIS OF

NEMATODES

- recovery of eggs or larvae and

occasionally adult worms
• cellophane tape preparations
available on selected nematodes
e.g Enterebius vermicularis
• Stool samples
Ex. A. lumbricoides, hookworms
• tissue biopsies
ex. T. spiralis PATHOGENESIS AND CLINICAL
SYMPTOMS
• infected skin ulcers
method of lab diagnosis 1. Factors Contributing to Nematode Infection
• serologic test
Severity:
method of lab diagnosis. Available
for selected nematodes only. • Number of worms present
• Duration of infection
• Overall host health

2. Infection Duration:

Nematode infections can last:

• Up to 12 months or longer
• Some may persist for 10 to 15 years or
more
• Occurrence of reinfections and
autoinfection can extend duration
• Some infections persist indefinitely

Symptom Severity:

• Small worm burden in a healthy

individual:
- May remain asymptomatic or
cause minimal discomfort
• Heavy worm burden, especially with
other health problems:
- Likely to experience severe
symptoms and complications

Common Infection Symptoms:

• Typically involve the intestinal tract

• Symptoms may include:
 Abdominal pain
 NEMATODES

 Diarrhea 1. Wuchereria bancrofti

 Nausea 2. Brugia malayi
 Vomiting 3. Loa loa
 Fever 4. Dracunculus medinensis
 Eosinophilia
D. Species which causes larva migrants in man
-if high eosinophilia, either infected
in parasite or allergic reaction 1. Ancylostoma braziliense
(basophil & eosinophil) 2. Ancylostoma caninum
3. Toxocara spp.
Additional Symptoms:
- Soil transmitted helminths
• Skin irritation • Hookworm
• Formation of skin blisters • Ascaris lumbricoides
• Muscle involvement may also occur • Trichuris trichiura
- Heart to lung migration
CLASSIFICATION OF MEDICALLY • Ascaris lumbricoides
IMPORTANT GROUPS AND SPECIES • Strongyloides stercoralis
OF NEMATODES • Hookworms
1. Class: Aphasmidia (lack "Phasmids" or - Causes Autoinfection
without caudal chemoreceptors) • Enterobius vermicularis
• Strongyloides stercoralis
A. Species which parasitize the small intestine

1. Trichinella spiralis
2. Capillaria philippinensis

Morphology, Pathophysiology, Life

cycle,
B. Species which parasitize the large intestine Specimens used for Identification,
Diagnostic Features, Prevention &
1. Trichuris trichiura
Control of Aphasmid Nematodes
(Adenophorea):
mainly free living in soil and water
2. Class: Phasmidia (with "Phasmids")
➢ Trichinella spiralis
A. Species which parasitize the small intestine
➢ Capillaria philippinensis
1. Ascaris limbricoides ➢ Capillaria hepatica
2. Necator americanus ➢ Trichuris trichiura
3. Ancylostoma duodenale
➢ Dioctophyma renale
4. Ancylostoma ceylanicum
5. Strongyloides stercoralis

B. Specie which parasitizes the large intestine

1. Trichinella spiralis
1. Enterobius vermicularis

C. Species which parasitize the tissues

 NEMATODES

Tiedemann was the 1st to describe the - T. spiralis can only be detected by its
Trichinella spiralis adult/larva stage only. Trichina worm
James Paget and Richard Owen demonstrate T.
is an accidental human infection. It is
spiralis only for animals only.
- Zoonosis – a disease which can be
• Synonym: Trichinella spiralis transmitted to humans from animals.
• Common name: Trichina worm
• Infective stage: Encysted larva
• Main Habitat: small intestine (egg stage),
skeletal muscles (larva)
• Final Hosts: hogs, rats, man
• Intermediate hosts: same animal as the final
host (dead end development of parasite, no
further development)

Developmental stages:

1. Larva: at birth: 80-120 µm & highly coiled

• has spear-like burrowing tip at its

tapering anterior end
• grows rapidly about 1 mm

2. Adults: rarely seen in stool or any material Stages of pathologic changes:

✓ Females: 3.5 mm x 0.06 mm 1. Intestinal: inflammation of duodenal &

jejunal mucosa, malaise, nausea, diarrhea
• Posterior end: bluntly rounded; anterior and abdominal cramps
fifth: with single vulva LARVIPAROUS 2. Muscle invasion: fever(40’C), facial edema
(particularly in the eyes, blurry vision), pain,
✓ Males: 1.5 mm x 0.04 mm
swelling & weakness of the involved muscle,
• posterior end: ventrally curved with two eosinophilia
lobular caudal appendages 3. Convalescence: begins at about the end of
the 3rd week; s/s subside; cyst wall then the
➤ Life span: 4-16 weeks
larva itself CALCIFY
Intestinal invasion → larval migration →  3 clinical phases
muscle • Intestinal Phase
• Eggs: small intestines • Migration Phase- it is possible to
• Larva: muscles have high fever up to 40° and would
- Gold Standard Method for the cause convulsion.
Recovery of this parasite is: MUSCLE • Muscular Phase - it’s possible to
BIOPSY. Though this method is have a blurry vision and eventually
invasive and unable to detect the early cause edema. – 4 to 8 weeks
invasion if not treated would cause
stage of infection.
death.
 NEMATODES

Diagnosis - 1st reported in 1963 in Bacarra Ilocos Norte

Province
1. Muscle Biopsy:
• Causes Capillariasis
 gastrocnemius and biceps digest with • Infective stage: 3rd stage larva
pepsin-hydrochloride 3rd or 4th week • Intermediate host: glassfish, "bagsit",
of infection "bagsang", "ipon"
 GOLD STANDARD method/procedure • Direct Host: Man, and birds
for the recovery of Trichinella spiralis • Main Habitat: Large intestin & S.I.
 accidental human infection, it is for • Distribution: Philippines & Thailand and
animals only other neighboring country
• Developmental stages: OVA
Disadvantage: • Color: Pale yellow
 This method is invasive, it invades • Size: 42x20 μ
your muscle • similar to that of T. trichiura
 Cannot detect early stage of • smaller & more striated shells Flattened
infection bipolar plugs Peanut shape
 only detect in adult form 2. FEMALE
- for CC elevated serum muscle enzyme
level such as: LDH, Aldolase and size: 2.4-4.3 mm✓ Divisions:
Creatinine Phosphokinase are increase ✓ Anterior - esophagus and esophageal glands
during the infection of T. spiralis.
- Eosinophil and Leukocytes as a whole ✓ Posterior - intestine and reproductive organs
corelated in Hema.  Atypical female (viviparous)
2. Bachman Intradermal Test
uterus lined with 2-3 rows of eggs
• use antigen preparation of Trichinella
larva Viviparous/Larviparous causes internal auto-
• Observe after 30 minutes reinfection
• (+) result: large elevated swelling at the  Typical female(oviparous)
site of injection
1. Beck's Xenodiagnosis uterus lined with 1 row of egg oviparous
2. Serodiagnosis
3. MALE
3. Bentonite Flocculation
4. 6 Blood Count: Eosinophilia  size: 2.3-3.17mm
 caudal alae; long, non-spiny
Prevention:
Disease caused: Capillariasis or Mystery disease
Thorough cooking of pork killed by cooking
meat at 77 deg C or by freezing meat at -15 deg Predominant Symptoms
C for 20 days or -30 deg C for 6 days
 borborygmus (rumbling or noise made
by fluid)
2. Capillaria philippinensis  abdominal pain
• Common name: Pudoc  Diarrhea (chronic)
worm
Untreated:
 NEMATODES

 weight loss; malaise  resembles that of Trichuris trichiura

 vomiting; dehydration  outer shell: pitted like golf ball
 anorexia (eat disorder and note gaining
2. Adults
weight)
 pneumonia, heart failure and cerebral  males are half as long as the female
edema with slightly chitinized spicule.
 Death: 2-8 weeks after these are seen

Treatment

1. Albendazole
 best drug of choice
 400 mg/day for 10 day
 desstroys larvae readily
2. Mebendazole
 200mg twice a day for 20 days or 400
mg/day for 20 days
3. Electrolyte replacement therapy and high
protein diet

Prevention: Thorough cooking of fish

Diagnosis: LIVER BIOPSY (revealing
Laboratory Diagnosis: DFS (direct fecal smear) characteristic egg and parasite)
& Concentration technique
Transmission:
Mode of Transmission: eating infected fish
 Eating of dog's meat
 Ingestion of contaminated food and
drinks (embryonated ova)
3.Capillaria hepatica
Common name: Capillary liver
worm

Infective stage: embryonated

ova

Hosts: rats, dogs, cats, monkeys and rarely in

human

Habitat: liver of the host

Diagnostic stage: liver biopsy

Developmental stages

1. Ova:
4. Trichuris trichiura

 "Lemon - shaped" eggs

 NEMATODES

 posterior portion: coiled (3600)

 lanceolate spicule protruding through a
refractile pineal sheath

b) female

 35-50 mm
Syno  bluntly rounded posterior end
nyms: Trichocephalus trichiurus, Trichocephalus  3,000-10,000 eggs per day
dispar

Common name: whipworm

Disease:
Infective stage: embryonated ova
 Trichuriasis
Principal host: man, but has been found in hogs,
 Trichucephaliasis
monkeys, cattle, dogs, mice
 Whipworm infection
Main habitat: cecum & appendix - Slight infection - asymptomatic
- Heavy infection - surface of colon
Life span: 5-10 years matted with worms
this parasite can possibly co-infect with A. possibly can cause bloody or mucoid
lumbricoides. diarrhea, weight loss, weakness,
abdominal pain, increase in peristalsis (the
Developmental stages increase movement of intestine), rectal
prolapse (large intestine slips out of the
1. Ova: anus and would cause obstruction and
 Barrel/football-shaped, Japanese lantern inflammation on the appendix),
 50 µmX25µm in size hypoalbuminemia and iron deficiency
anemia.
can result to extreme cachexia (heavy or
sudden weight loss of the patient). This
cause to muscle wasting.
✔ 3 layers:
Pathology & Symptomatology
✓ undeveloped, unicellular embryo
 Asymptomatic for light infections
✓ outermost layer-smooth, bile-stained
 Heavy infection: surface colon is matted
✓ Hyaline/Mucus plug
with worms
2. Adult - Bloody diarrhea
- Weight loss
 flesh-colored
- Abdominal paint
 anterior three-fifths are attenuated
- hypermotility or hyperperistalsis
(whiplike)
(increase movement of intestines)
 stichosoma type of esophagus
- Rectal prolix
a) male - Hypoabluminia (decrease of albumin)

 30-45 mm
 NEMATODES

- Extreme cachexia (heavy weight loss/ Ova: ellipsoidal and brownish-yellow, deeply
sudden weight loss) sculptured depressions

Diagnosis: DFS, KTS, Concentration techniques Adults:

Treatment: Mebendazole (500mg), Albendazole blood red in color attenuated (slightly) on both
(400 mg) & Oxantel-pyrantel ends

Prevention Males:

- Sanitary disposal of feces Size: 14-20 cm x 4-6 mm

- Thorough washing of hands
Bell-shaped copulatory bursa not supported by
- Thorough washing and cooking of food
rays; covering of papillae
- Avoid using human feces as fertilizer
- Females
Dioctophyma renale Sy
- vulva: midventral near anterior
nonym: Eustrongylus gigas
- Common name; Giant Kidney Worm
- Infective stage: 3rd stage larva
- Habitat: Kidney
 typical in the right kidney.
 appearance of the ova is like a
pitted golf ball. –humans here
are just an incidental host.
- It is common to dog, accidental in human

Host:

 Definitive - Mink, dogs, foxes, and other

carnivores; fish eating mammals
 Intermediate - Oligochaete
annelids (earth worm)
 Incidental host: man
 Paratenic - Fish and frogs.

Life span: 4-5 years

Diagnosis: eggs in urine (Urine sedimentation

technique)

Treatment: surgical excision

Developmental stages