Introduction to Nematodes

Nematodes Nematodes on the Basis of the Habitat of Adult Worms

Intestinal Human Somatic Human
-means ‘thread-like’; ‘nema’ meaning ‘thread’
Nematodes Nematodes
-most worm-like of all helminths
Small intestine Lymphatics
- elongated, cylindrical, unsegmented worms with tapering -Ascaris lumbricoides -Wuchereria bancrofti
ends (Giant Intestinal Worm) -Brugia malayi
-Ancylostoma duodenale -Brugia timori
General Characteristics (Old World Hookworm)
- Necator americanus Skin/subcutaneous tissue
1. They are cylindrical in shape, bilaterally symmetrical with
(American or New World -Loa loa
a secondary triradiate symmetry at the anterior end. Hookworm) -Onchocera volvulus
2. Adult worms vary greatly in size. Male is generally smaller -Strongyloides stercoralis -Dracunculus medinensis
than female and its posterior end is curved or coiled -Trichinella spiralis (Guinea worm)
-Capillaria philippinensis
ventrally.

3. Anterior end may be equipped with hooks, teeth, plates Large intestine Mysentery
and papillae for purpose of abrasion, attachment, and -Trichuris trichuria (Whip -Mansonella ozzardi
sensory response. worm) -Mansonella perstans
-Enterobius vermicularis Conjuctiva
4. Their body is covered with an elastic cuticle, consists of (Thread or pin worm) -Loa loa
four basic layers: epicuticle, exocuticle, mesocuticle and
endocuticle. The middle layer is hypodermis and the inner
layer is the somatic muscular layer. They move by sinuous
Ascaris lumbricoides
flexion of the body.
(Giant Intestinal Roundworm/Common Round Worm)
5. The nematodes are diecious (sexes are separate). Vectors: Flies and Cockroach

From a latin word “Lumbricus”meaning earthworm

Types of Female Nematodes: Member of unholy three:

1. Oviparous – laying eggs
2. Viviparous – producing larvae
3. Ovoviviparous – laying eggs containing fully formed
larvae, which hatch out immediately
Modes of Infection
By ingestion of:
1. Eggs: Ascaris, Enterobius. Trichuris
2. Larvae within intermediate host: Dracunculus
3. Encysted larvae in muscle: Trichinella
By penetration of skin: Ancylostoma, Necator, Strongyloides Morphology
By blood-sucking insects: Filariae
By inhalation of dust containing eggs: Ascaris, Enterobius.
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H: Hookworm
A: Ascaris lumbricoides
T: Trichuris trichuria
Habitat: Small intestines
Final Host: Man
Diagnostic Stage: Ova found in stool (fertilized/unfertilized)
Infective Stage: Embryonated eggs
Mode of transmission: Ingestion of embryonated eggs
Disease: Ascariasis
Treatment: Albendazole and Mebendazole
Adult Worm: white cream or pinkish yellow when fresh
-head is provided 3 lips and a triangular buccal
cavity/trilobite lip.
- 1 dorsal and 2 ventrolateral
Male worm: smaller than female, its posterior end is curved
ventrally to form a hook and carries 2 copulatory spicules
Female worm: larger than male, posterior extremity is
straight and conical
Introduction to Nematodes

Features of Round Worm Egg

Unfertilized egg
- 85-95 µm by 38-45 µm; size variations possible
- Elliptical in shape
- Narrower and longer
- Has a thinner shell with an irregular coating of
albumin
- Contain a small atrophied ovum with a mass of
disorganized highly refractile granules of various size
- Does not float in salt solution

Fertilized Egg
- 40-75 µm by 30-50 µm
- Round or oval in shape
- Always bile-stained
- Golden brown in color
- Surrounded by thick smooth translucent shell
- With an outer coarsely mamillated albuminous coat,
A. Adult female and male worms a thick transparent middle layer and the inner
B. Anterior end of a worm, head-on view, showing 1 dorsal and lipoidal vitelline membrane
2 ventral lips with papillae - Some eggs are found in feces without the outer
C. Posterior end of female, showing anal opening, a little above mamillated coat (decorticated eggs)
the conical tip - In the middle of the egg is a large unsegmented
D. Posterior end of male, showing 2 protruding copulatory ovum, containing a mass of coarse lecithin granules.
spicules It nearly fills the eggs, except for a clear crescentic
area at either pole
- Floats in saturated solution of common salt

Laboratory Diagnosis
Specimen of Choice: STOOL
Wet Preparation or Direct Fecal Smear

Life Cycle

Egg
Either fertile or unfertilized
lecithin granules → is present in unfertilized eggs
(3) layers:
1. Inner Vitel/ Lipoidal/ Lecithin layer → not found in
unfertilized eggs.
2. Middle glycogen layer
3. Outermost Mammillation/ Corticated layer →
albumin coat for protection (both fertilized and
unfertilized egg can be corticated or decorticated).
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Introduction to Nematodes

Clinical Features:
1. Spoliative action – protein and Vitamin A deficiency.
2. Toxic action – urticaria and angioneurotic edema
3. Mechanical action- intestinal obstruction, intussusception,
volvulus, intestinal perforation.
4. In Lungs – Ascaris can cause pneumonia (Loeffler’s
syndrome)
5. Asymptomatic infection
Additional Notes:
Toxocara cati → Ascarid of cats
Toxocara canis → Ascarid of dogs
Can be ingested by man and cause Visceral Larva Migrans
Visceral Larva Migrans: Larva will hatch but will not mature
into adult worms.
Enterobius vermicularis
-formerly called Oxyuris vermicularis
Common name: Pinworm, social worm, Society worm,
Thread worm
From Greek word, Enteron- intestine, bios- life, and
vermiculus- small worm
Oxyuris means ‘Sharp tail’, feature of the female worm, from Male Worm
which name “pin worm” is also derived
Habitat: Large Intestine
Final Host: Man
Infective Stage: Embryonated Egg
Mode of Transmission: Inhalation, Ingestion, Autoinfection, Egg
Retro infection
Diagnostic Stage: Embryonated Egg
Enterobius vermicularis Morphology
Adult worm
The adults are short, white, fusiform worms with
point ends, looking like bits of white thread.
The mouth is surrounded by 3 wing-like cuticular
expansions (cervical alae), which are transversely
striated.
The esophagus has a double-bulb structure, a feature
unique to this worm.
Female Worm
-The female is 7–14 mm long and 0.3–0.5 mm thick.
Its posterior third is drawn into a thin pointed pin-like tail.
- The vulva is located just in front of the middle third of the
body and opens into the single vagina, which leads to the
paired uteri, oviducts, and ovaries. In the gravid female,
virtually the whole body is filled by the distended uteri
carrying thousands of eggs.
-The worm is oviparous.
-Females survive for 5–12 weeks.
-The male worm is 2–4 mm long and 0.1–0.2 mm thick.
-Its posterior end is tightly curved ventrally, sharply truncated
and carries a prominent copulatory spicule.
- Males live for about 7-8 weeks.
The egg is colorless and not bile-stained
-It floats in saturated salt solution.

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Introduction to Nematodes
-It has a characteristic shape, being elongated ovoid, Life Cycle
flattened on one side, and convex on the other side E. vermicularis is monoxenous, passing its entire life
(planoconvex), measuring 48-60 µm long, 20-35 µm wide. cycle in the human host. It has no intermediate host and does
-The egg shell is double layered and relatively thick, though not undergo any systemic migration.
transparent. The outer albuminous layer makes the egg stick
to each other and to clothing and other objects.
-The egg contains a tadpole-shaped coiled embryo, which is
fully formed, but becomes infectious only 6 hours after being
deposited on the skin. Under cool moist conditions, the egg
remains viable for about 2 weeks.
-A single female worm lays 5,000 – 17,000 eggs.

Clinical features:
Pruritis ani
Nocturnal enuresis

Laboratory Assessment:
5% survival in stool
Scotch Tape Swab (Graham’s Scotch Adhesive Tape Swab)
Specimen of choice: Cellophane tape preparation
collected from the perianal region of suspected person

Treatment:
Mebendazole and Albendazole

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 Introduction to Nematodes
Trichuris trichuria Symptoms and Pathology
Common name: Whipworm Disease: Trichuriasis, trichoencephaliasis, whipworm
From Greek word ‘Trichuris’ means a “hair-like tail” infection
Trichos -hair 1. Bloody or mucoid diarrhea
Oura – tail 2. Weight loss, abdominal pain
3. **Rectal prolapse: Heavy infection
Habitat: Large intestine/ colon
Final Host: Man
Diagnostic Stage: Ova found in stool
Infective Stage: Embryonated egg
Mode of Transmission: Ingestion

Morphology
Adult Worm
-flesh colored or pinkish gray worms, slender or attenuated in
Treatment:
the anterior.
Albendazole
-anterior is attenuated and slender resembling a whip
Mebendazole
-the posterior end of male is coiled ventrally, while the hind
end of the female is straight, blunt and rounded.
Life Cycle
-worm has a lifespan of 5 – 10 years

Egg
- “Barrel-shaped” with bipolar plugs at each pole containing
an unsegment ovum. The plugs are colorless.
- Foot-ball shaped
- Resembling as Japanese lantern
- brown in color being bile-stained
-Eggs floats in saturated salt solution

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