Table 217-1 Major Human Intestinal Parasitic Nematodes

Parasitic Nematode
Feature

Ascaris
Necator
Strongyloides
lumbricoides americanus, stercoralis
(Roundworm) Ancylostoma
duodenale
(Hookworm)

Trichuris
trichiura
(Whipworm)

Enterobius
vermicularis
(Pinworm)

Global
prevalence in
humans
(millions)

807

576

100

604

209

Endemic areas

Worldwide

Hot, humid
regions

Hot, humid
regions

Worldwide

Worldwide

Infective stage

Egg

Filariform
larva

Filariform
larva

Egg

Egg

Route of
infection

Oral

Percutaneous Percutaneous
or
autoinfection

Oral

Oral

Gastrointestinal Jejunal lumen

location of
worms

Jejunal
mucosa

Small-bowel
mucosa

Cecum, colonic Cecum,

mucosa
appendix

Adult worm size 1540 cm

712 mm

2 mm

3050 mm

813 mm
(female)

Pulmonary
passage of
larvae

Yes

Yes

Yes

No

No

Incubation
perioda (days)

6075

40100

1728

7090

3545

Longevity

1y

Decades
(owing to
autoinfection)

5y

2 months

500010,000

30007000

2000

N.
americanus:
25 y
A. duodenale:
68 y
Fecundity
240,000
(eggs/day/worm
)

N.
americanus:

Parasitic Nematode
Feature

Ascaris
Necator
Strongyloides
lumbricoides americanus, stercoralis
(Roundworm) Ancylostoma
duodenale
(Hookworm)

Trichuris
trichiura
(Whipworm)

Enterobius
vermicularis
(Pinworm)

400010,000
A. duodenale:
10,000
25,000
Principal
symptoms

Rarely
gastrointestinal
or biliary
obstruction

Diagnostic stage Eggs in stool

Irondeficiency
anemia in
heavy
infection

Gastrointestina Gastrointestina Perianal

l symptoms;
l symptoms,
pruritus
malabsorption anemia
or sepsis in
hyperinfection

Eggs in fresh Larvae in stool Eggs in stool

stool, larvae or duodenal
in old stool
aspirate;
sputum in
hyperinfection

Eggs from
perianal skin
on cellulose
acetate tape

Mebendazole

Mebendazole 1. Ivermectin

Mebendazole

Albendazole

Pyrantel
pamoate

Treatment

Pyrantel
pamoate

2. Albendazole Albendazole

Pyrantel
pamoate

Ivermectin
Albendazole

Ivermectin
Nitazoxanide

Mebendazole

Time from infection to egg production by mature female worm.

Albendazole