Nematodes
 Free living, invertebrate
 Millimeter-meter in size
 Phylum Aschelminthes
 Round or cylindrical in shape
 Presence of pseudocoel with chitinous
like cuticle
 Male- curved pposterior end with
copulatory spicules; smaller than the
female
 No circulatory sytem
 Dioecoius
 Stage – adult-larva(l1-l4)-egg/ovum(one
female can produce 200000 eggs/day)
 Definitive host: human
o Rhabditiform larva-excreted
o Filariform larva- infective
 Intermediate host: antropods
 Treatment(oral)
o Albendazole(400mg/day)
o Mebendazole (100mg twice daily
for 3 days)
Digestive system:
 Mouth, buccal cavity(hooks, teeth or
cutting plates, esophagus(muscular),
intenstines, rectum, anus
Reproductive system
 Male: spicules, copulatory bursa
 Female: uterus; vagina
 Maybe oviparous, larviparous or
viviparous
Chemoreceptors: Amphids and Phasmids
 Phasmid worm
 Aphasmid worm
o Trichuris, Trichinella, Capillaria
Ascaris lumbricoides
 Giant intenstinal roundworm
 Most common in the world(2nd in US)
 Rural>urban, children>adults
 Female(20-35cm)-vulvar waist; Male(12-
30cm): coiled end
 Habitat: lumen of small intenstine
 FINAL HOST: Man
 Infective Stage: EMBRYONATED
EGG(highly resistant)
o Unfertilized- narrower, elongated
with thinner shells filled with
globular protoplasm
 Undergoes Heart Lung Migration
 MOT: Ingestion of Embryonated Eggs
 PATHOLOGY attributed to:
o Host Immune Response
o Effects of Larval Migration
o Mechanical Effect of Adult Worms
o Nutritional Deficiencies
 Luminal Parasite
 Patients may suffer no signs or symptoms
 Abdominal Pain, Vomiting, Growth
Stunting
 Intestinal Obstruction that may lead to
Intestinal Perforation
 Erratic Worms may wander into other
parts of the body
 Larval stage:
o may cause Eosinophilic
Pneumonitis (Loeffler’s
Syndrome), Eosinophilia
o Presence of Charcot Leyden
Crystals
 Diagnosis:
o DFS, Kato-Katz, Concentration
Techniques
o Examination of Sputum (Larval
Stages)
o Macroscopic ID of adult on stool or
through mouth or nose
 Treatment: Mebendazole or Albendazole
Enterobius vermicularis(pinworm)
 Highly communicable Seat,society worm
causing door yard infection
 Cosmopolitan(more common among
females)
 Most common in US
 No free living stage
 Perianal skin: where gravid female
migrates to deposit embryonated eggs
 Egg- Lipoidal membrane surrounded by
thich transparent hyaline albuminous
shell
 Greater prevalence in temperatue
climates and in children
 Female(0.8-1.3cm)- spindle shaped
body(filled with eggs in uterus) with a
long thin sharply tail, cervical/cephalic
alae at head
 FINAL HOST: HUMANS
  INFECTIVE STAGE: Embryonated Egg(D  Female(35-50mm): anterior 2/3 is
shaped) after 4-6hrs threadlike expanding to broader
 Habitat: : Large Intestine posterior
 MOT: Oral, Air-borne, Retroinfection,  Male: similar to female but exhibiting a
Autoinfection strong curvature of tall
Pathology  Eggs – Barrel Shaped/Lemon
 Enterobiasis Shaped/Foot Ball Shaped,
 Patients experience Nocturnal Pruritus Japanese Lanternz
Ani, Insomnia, Pathology
 Secondary Bacterial Infection, Loss of  Adults attach to the lining of the colon
Appetite, (PIN FASHION
 Abdominal Pain, Vulvovaginitis may also MANNER)
occur  Usually asymptomatic, but infections can
 Familial Disease, Spreads Easily, cause:
Everyone in the Family o Diarrhea, Blood in Stool, IDA,
 Must Be Treated Rectal Prolapse,
 Treatment: Mebendazole, Albendazole,  Weight Loss
Pyrantel  Treatment: Albendazole (Drug of Choice),
 Pamoate Mebendazole
Diagnosis: Diagnosis
 Scotch Tape Swab; Swellengrebel;  DFS, Kato-Katz, Concentration
Graham’s technique; Petrolatum Techniques
o Recovery and identification of eggs
Trichuris trichuria(whipworm) in feces
 egg only free living state
o must stay on soil for 10 days- HOOKWORMS
3weeks for development of  Kingdom: Animalia
pathogenesis  Phylum: Nematoda
o glycogen containing lypoidal  Class: secerentea
membrane surrounded with  Order: Strongiloidae
albuminoid membrane with mucus  Family: Ancylostomatidiae
plug  Genus: Ancylostoma/Necator
 no intermediate host  Species: A. duodenale/N. americanus
 commonly seen with Ascaris(similar  No intermediate host
mode of infection), 3rd most common on
US
 STH
  N. americanus A. duodenale
Common New world hookworm Old world hookworm
Name
  American hookworm Asia Hookworm
Habitat Upper level of the small small intestines
intestines
Buccal cavity Dorsal and ventral cutting 2 ventral plates and two large
plates teeth(6 teeth)
Buccal capsule 2 crescent-shaped cutting with symmetric pair of sharp
set plates on ventral side teeth on ventral slide
ingests 30 ul blood/day ingests 260 ul blood/day
Curvature S shaped C shaped
Life span 4-20 yrs 5-7 yrs
size of female 9-11 mm 10-13mm
size of male 7-9mm 8-11mm
Position of mid body 1/3 from posterior
vulva
egg production 9000/day 25000/day
egg survival 3-5 yrs 1 yr
penetration Yes Yes
through skin
Longevity 15 years 5 years

 Anterior end: Buccal capsule

 Posterior end: copulatory bursa
o A. duodenale: pinkish/creamy gray(living worms), umbrella or bell shaped bursa
o N. americanus: grayish yellow at times with reddish undertone, fan-like bursa, bipartite
dorsal ray and spicule is barbed
 A. duodenale: secretes neutrophil inhibition factor
 N. americanus: acetyl cholinesterase(inhabits gut peristalsis)
 Eggs: ovoid, thin colorless, 4-8 cells in feces
o Hatches after 24-48 hrs to be a rhabditiform larvae and after 5-8 days, will form filariform
larvae(infective stage)
 Skin- lungs-trachea-esophagus-stomach-intenstine
 FINAL HOST: Man
 Infective Stage: Filariform (L3) Stage
 Habitat: Small Intestine
 MOT: Skin Penetration
 Undergoes heart Lung Migration
 Identification of Species: Dental Pattern/Buccal Cavity
 Eggs are indistinguishable
Pathology
 Cutaneous Phase: Ground Itch (Allergic Reaction)
 Pulmonary Phase: Wakana’s Disease
 (Pneumonitis)
 Intestinal Phase: Blood Loss (IDA), Abdominal
 Pain, Diarrhea, Eosinophilia
 Treatment: Albendazole, Mebendazole, Pyrantel Pamoate
o Not given to pregnant women
Diagnosis
 Microscopy-direct wet mount
 Concentration-formalin ether, salt floatation and kato katz method
 Culture: Harada Mori
Technique(filter paper)
 Recovery of eggs in feces
A. braziliense A. caninum
Common cat hookworm; creeping eruption hookwom dog hookworm
name

habitat duodenum duodenum

male size 7.75-8.85 x 0.35 mm 10 mm x 0.4 mm
 female 9-10.5 mm x 0.375 mm 14mm x 0.6 mm
size
Buccal pair of small very insconspicuous median teeth wide to
capsule and a pair of larger outer teeth aside form 2 accommodate the 3
pairs of ventral teeth pairs of ventral
teeth
 Imaging method: x-ray

\
Strongyloides stercoralis
 Thread Worm
 Smallest Nematode of Man
 Soil Transmitted Helminth
 Facultative Parasite
 Definitive host: Human, dogs, cats
 Habitat: Small Intestine(duodenum and jejunum)
 Infective Stage: Filariform Larva(3rd larval stage)
 Diagnostic stage: First stage larvae(Rhabditiform)4weeks on infection in feces
 MOT: Larval Penetration
 Heart Lung Migration
 Forms: Parasitic, Free-living
 Eggs are rarely seen
 Parasitic Males have not yet identified
 Parasitic Females: Parthenogenetic
Morphology
 Parasitic or free living Male: 0.7mm, rhabditiform esophagus, posteriot and curved ventrally with
spicules
 Parasitic Female: 2.2 mm in length, cylindrical esophagus (1/3 body length)
Posterior and straight
 Free living female: 1mm in length, rhabditiform esophagus, posterior and straight
 Egg(laid in mucosa): 55x30um, oval clear, thin shelled similar to hookworm but s,aller
Diagnosis
 Recovery and identification of larvae and egg in feces or duodenal drainage
 Direct stool smear(larvae)
 Cultivation of stool (Damp charcoal or Hara-mon mediums)
 Examination of duodenal or jejunal biopsy obtained by endoscopy(adult worms) in mucosa
 Eosinophilia-present in uncomplicated strongyloidiasis but lost in hyperinfection
 ELISA for IgG anti-strongyloides antibodies-for population screening in endemic areas