Helminth living in tissue

(Morphology)

- Rahmat Azimi (C011181311)

- Andi Muhammad Mario Riwawo (C011181312)
- Syeila Marsela (C011181313)
- Fadillah Amalia Darma ( C011181314)
- Sakkti ( C011181315)
- Andi Bunga Aqila ( C011181316)
- Afifah Nabila Ismail ( C011181317)
- Achmad Razak Nirhamzah ( C011181318)
- Shahnaz Azis Alamri (C011181319)
08/17/2021 - Intan Wirastuti Masri ( C011181320) 1
22:00
 Parasite in lymphatic
system
• Nematode species
• Wuchereria
bancrofty
• Brugia malayi
• Brugia timory

08/17/2021 Tissue Helminth/ 2

22:00 SWahyuni
Adult filarial worm

• Head: Slightly swollen and bears two

circles of papillae
•Mouth: Small, buccal capsule is
lacking Female
• 6-10 cm (Brugia 8-10 cm)
• Vulva near to oesophagus
•Produce
microfilaria Males
• 4-5 cm (Brugia 1.5-2 cm)
• Tail like finger (Brugia: curved ventrally)
• No nuclei in the end of tail (Brugia: nuclei in
the end of tail)
Aranae et.,al.2020
3
Microfilari
a

Arina, et ., al .2021
Microfilaria

Roy
et.,al.2019
Microscopic detection

• To detect microfilaria
• Sample: Finger prick or
venous blood filtration
• Methods: Thick blood smear
stain with Giemsa 3%

6
 Helminth
7
in
Vena Mesenterica and V. Vesicalis

• Blood trematode species:

• Schistosoma mansoni
• Schistosoma japonicum
• Schistosoma haematobium
• Schistosoma mekongi
• Schistosoma intercalatum
 Host intermediate 8

• Biomphalaria • Bulinus sp. • Oncomelania

sp. Host • Host perantara sp. Host
perantara dari perantara dari
S. mansoni S.haematobium S. japonicum Aes., et
and al. 2020
S.intercalatum
Infective stage 9

Cercaria penetrate
skin
Adult worm 10

• Have oral sucker

• Female:
• 1-2 cm long thinner &
longer than male
• Stay in a groove on ventral
side (gynaaecophoric
canal) of male
• Feed on host erythrocytes and
body solutes
• Life span of 5-10 years
• 4-7 weeks post infection the
mated adult female starts to
produce eggs (3000 eggs/day)
08/17/2021 Helminth in Tissue/
22:00 SWahyuni
worm 11

08/17/2021 Helminth in Tissue/

22:00 SWahyuni
Morphology
Schistosome Eggs 12

S. S. S. haematobium S. intercalatum S
Japonicum mekongi haematobium
08/17/2021 Helminth in Tissue/
22:00 SWahyuni
diagnosis 13

Parasite detection
• Stool examination (S. mansoni
or S. japonicum)
• Simple smear (1 to 2 mg of fecal
material)
• Concentration procedures (formalin-
ethyl acetate technique)
• Kato-Katz technique
• Urine examination (S. haematobium)
• Collection time 12-15 PM
• Enhanced by centrifugation &
examination of the sediment
• Quantification by using filtration
through a Nucleopore® membrane of
a standard volume
08/17/2021 Helminth in Tissue/
22:00 SWahyuni
 Helminth the Lung 14

• Trematoda: Paragonimus sp
• Intermediate: Snail and water crab/
shrimp

Freshwater snails:
a. Triculinae sp. (from Yen Bai
b. Triculinae sp. 2 from Quang Tri.
c. Sulcospira quangtriensis from
Quang Tri

08/17/2021 Helminth in Tissue/

22:00 SWahyuni
 Morphology adult paragonimus westermani
• Adults of Paragonimus spp.
• 7.5 to 12 mm by 4 to 6 mm.
• Large, robust, ovoid flukes.
• Hermaphroditic, a lobed ovary
located anterior to two
branching testes.
• Possess oral and ventral
suckers.

http://www.drchurchbiology.com/BIO3270/Images/Worms/paragonimus.htm
 Morphology 16

Egg Paragonimus
• Size 80-120 x 45-70,
• Yellow-brown, ovoid or elongate, with a
thick shell, and often asymmetrical with
one end slightly flattened.
• At the large end, the operculum is clearly
visible and the opposite (abopercular)
end is thickened.
• Un-embryonated when passed in
sputum or feces.

https://mcdinternational.org/trainings/malaria/english/dpdx5/html/Frames/M-
R/Paragonimiasis/body_Paragonimiasis_mic1

08/17/2021 Helminth in Tissue/

22:00 SWahyuni
Microscopic detection 17

• Specimen: Fecal sample or sputum

• Methods: Wet mount
• Egg present 2 to 3 months after infection.
• Concentration techniques may be necessary in light
infections.

08/17/2021 Helminth in Tissue/

22:00 SWahyuni
 18

Animal ring worm

• Nematoda:
• Toxocara cati (cat roundworm)
• Toxocara canis (dog roundworm)

8/17/202 S. Wahyuni, Parasitology Dept, Medical Faculty,

1 Unhas
 Adult toxocara
The anterior end,
showing the three lips
characteristic of ascarid
worms.
(New Jersey State Public
Health Laboratory.
https://commons.wikimedia.org/wiki/File:Toxocara-canis-adults.jpg
https://www.dreamstime.com/photos-
images/adult-toxocara.html
Posterior end
of Toxocara sp.
(New Jersey State Public
Health Laboratories).
https://mcdinternational.org/t
rainings/malaria/english/dpdx
5/html/ImageLibrary/S-
Z/Toxocariasis/body_Toxocari
asis_il3
 Toxocara
Toxocara
eggs eggs

• Golden in color
• Spherical to slightly pear shaped, thick-
shelled, and have
 a pitted surface.

• Size
• T. canis is slightly larger (80—85 µm)
• T. cati (65—75 µm).
• Eggs embryonate in 1 to 4 weeks in the
environment and
 become infective, containing third-
stage (L3) larvae
https://www.researchgate.net/figure/Eggs-of-Toxocara-canis-and-Toxascaris-
leonina-A-T-canis-bar-80-m-B-T-leonina_fig1_7790389 • Can persist in the environment for
 Helminth in Muscle: Trichinella spiralis
Speciment: Muscle
biopsy

https://www.britannica.com/animal/trichina

Larvae of Trichinella, freed from their cysts, typically coiled;

length: 0.8 to 1 mm

https://www.researchgate.net/figure/Figura-2-Larva-de-T-spiralis-
viable-Puede-visualizarse-su-forma-espiralada-y-
su_fig1_44853276/amp

8/17/202 S. Wahyuni, Parasitology Dept, Medical Faculty, 21

1 Unhas
 hepar
• Trematode Parasite (flukes)
• Fasciola h e p a t i c a Fascioliosis
• Fasciola g i g a n t i c a Fasciolopsiasis
• Parasite of herbivores that can infect
humans accidentally
• Size F hepatica : up to 30 x 13 mm
• Reside in the large biliary ducts of the
Gilles et al. 2017
mammalian host. Host intermediate:
Galba truncatula,
• Worldwide distribution the main intermediate host in
Europe and western Asia.
Conchology, Inc, Mactan
Island, Philippines.

8/17/202 S. Wahyuni/lecture/tissue 22
1 helminth
Fasciola
hepatica

https://edubiologi.co
m/daur-hidup-
fasciola-hepatica/
Fasciola hepatica
eggs
• Yellow-brown,
large, ovoid,
operculated, bile-
stained
• Size: 140 μm by 80 μm.
• The eggshell is smooth
and fined with a double
line.
• Eggs contain an
immature
larva, the miracidium.
• It unembryonated
when freshly passed.
https://www.researchgate.net/figure/Fasciola-hepatica- • F. hepatica and
sample-No-48-flotation-Operculum-on-the-left-pole-inside-
remains_fig7_235923475
Fasciolopsis buski eggs
cannot be differentiated.
 Fasciolopsis buski 25

8/17/202 S. Wahyuni, Parasitology Dept, Medical Faculty,

1 Unhas
 Fasciolopsis buski eggs 26

8/17/202 S. Wahyuni, Parasitology Dept, Medical Faculty,

1 Unhas
 Microscopic
diagnostic 27

• Specimen: Fecal, duodenal or biliary fluids

• Methods: Wet mount
• False fascioliasis (pseudofascioliasis): The presence of eggs in the stool
resulting not from an actual infection but from recent ingestion of
infected livers containing eggs:  can be avoided by having the
patient follow a liver-free dietseveral days before a repeat stool
examination.

8/17/202 S. Wahyuni, Parasitology Dept, Medical Faculty,

1 Unhas
Animal hookworm 28

• Species
• Ankylostom
a caninum
Ankylostom
a
braziliennsi
• Difficult to differentiate A. A.
s)
from other
Ankylostoma
caninum
eggs braziliensis
hookworms.
• Males are smaller
than females
• Have three pairs
teeth

08/17/2021 Tissue Helminth/

22:00 SWahyuni
volvulus 29

• Specimen: Nodulus subcutaneous biopsy

• White or cream transparent &
transverse striation in the cuticle
• Male: 19 to 42 mm by 130 to 210 µm
• Female: 33 to 50 mm in length and
270 to 400 µm in diameter, produce
1000-3000 mf/day for 9 years
• Tightly coiled in couples in
subcutaneous tissues and in
nodules
• Longevity of 10-15 years

Taken from a skin nodule of a patient

08/17/2021
22:00
Tissue helminth/
SWahyuni
stained with H&E.1000x oil
 Microfilaria Onchocerca 30

volvulus
• 220 to 360 µm by 5 to 9 µm
• Unsheathed The tail tapers to a point
and is often sharply bent
• Life span that may reach 2 years.
• live 7-10 days in flies

08/17/2021 Tissue helminth/

22:00 SWahyuni
 Laboratory
diagnosis
31

• Specimen for adult: Biopsy skin nodules or

remove the nodule
Skin
• Microfilariae: Skin snips snips
• Should be thin enough, include the outer part of the
dermal palpillae but not so thick as to produce
bleeding.
• Should be placed immediately in normal saline or
distilled water, just enough to cover the specimen.
• Microfilariae tend to emerge more rapidly in
saline, however in either medium the
microfilariae typically emerge in 30-60 min and
can be seen in wet mount preparations.
• For a definitive diagnosis, allow the wet mount to
dry, fix in methanol, and stain with Giemsa or
hematoxylin-and- eosin.
08/17/2021
22:00
Tissue helminth/
SWahyuni
 Helminth in the Eyes: Loa
32
loa

Adult morphology
• Visible with naked eye
• White or cream transparent
• Male: 30 to 34 mm in length and
0.35 to 0.43 mm in diameter
• Female: 40 to 70 mm in length and
0.5 mm
• The female produce microfilaria

08/17/2021 Tissue helminth/

22:00 SWahyuni
 Microfila
ria 33

• 250 to 300 µm by 6 to 8 μm
• Sheathed and have diurnal periodicity.
• Can be found from spinal fluids, urine,
and sputum.
• During the day they are found
in peripheral blood
• During the noncirculation phase, they are
found in the lungs .
Microfilaria of L. loa a thick blood
smear from a patient from
Cameroon, stained with Giemsa.
Note the nuclei extending
to the tip of the tail to the left of
the image.
08/17/2021 Tissue helminth/
22:00 SWahyuni