WEEK 3 (LEC-LAB) MLS 306** CLINICAL PARASITOLOGY
◼ With the aid of a pipette, mix the sediment &
CAPILLARIA PHILIPPINENSIS
- PUDOC worm (barangay in municipality of L.U)
- Originated in the Philippines, Endemic in Thailand
- Tiny nemathode
MORPHOLOGY
- Female : 2.3-5.3 mm in length
◼ 2 types of female
- typical female – eggs in utero number from 8-
10 arranged in a single row
- atypical female - eggs in utero are from 40-45
arranged in 2-3 rows
- Male : shorter; 1.5-3.9 mm in length; chitinized
spicule and a long spicule sheath extending beyond
the length of the worm; stichocytes (excretory
cells) & stichosomes (entire esophageal)
EGGS
- Typical egg is pale yellow
- Trichuris like ova
- With moderately thick striated shell
- Flattened bipolar plugs
- Peanut-shaped
- 42 by 20 microns
- Atypical egg is thin shelled without polar plugs
◼ 2 types of eggs
-Embryonated – lacking of shell; will not directly
infect human (directly sa fish) ; infective
-Unembryonated – pass out in feces; embryonation
sa water
PATHOLOGY
- Malabsorption syndrome
- Constipation alternating with LBM (characterized
by peculiar abdominal sound “ BORBORYGMI”
Responsible for PUDOC disease (mystery disease)
- Abdominal pain
- Diarrhea
- Weight loss
- Dehydration
- Malaise
- Anorexia
- Vomiting
- Anasarca
- Cachexia
- Micro ulcers in the epithelium
- Malabsorption of fats & sugars
- Protein-losing enteropathy
- Low plasma levels of K, Ca, carotene, and total
protein; high levels of IgE
- Severe metabolic & nutritional imbalance
- If there is electrolyte loss – heart failure or
septicemia - death
DIAGNOSIS
- Direct fecal smear
- Acid ether concentration technique
◼ In 5 cc of 40% HCl, emulsify 1 gram of stool
◼ Strain thru one layer of wet gauze & receive in
centrifuge tube
◼ Add 5 cc of ether, stopper, and shake for one
minute. Then centrifuge at 1, 500 rpm for 2 mins
◼ The interspace film at the acid ether junction is
loosened by an applicator stick & the acid ether
layers are rapidly poured off
◼ With a piece of cotton at the tip of an applicator
stick, wipe off all remaining interspace film
LPU-BATANGAS TAMAYO, H.B.A
BSMLS 3A
transfer to a glass slide & put a cover slip.
Examine
- Can use duodenal aspirates
- ELISA
EPIDEMIOLOGY
- Endemic provinces (Zambales, Southern Leyte,
Agusan del Sur, Zamboanga del Norte, Zamboanga
del Sur, Compostela Valley, Misamis Occidental)
- Japan, Iran, Thailand, Egypt, South Korea, India,
Taiwan, Italy, Spain, Indonesia, UAW, Lao
People’s Democratic Republic
TREATMENT, PREVENTION & CONTROL
- Changing of eating habits
- Educational program
- Improved sanitation
- Capacity building for health personnel
- Patient w/ electrolyte & protein loss are given
electrolyte replacement & high protein diet
- Mebendazole / albendazole (400 mg for 10 days;
200 mg – 2x a day for 20 days
ENTEROBIUS VERMICULARIS
- Pinworm; seat worm; society worm
- Most common helminth infection in the world
- Meromyarian
MORPHOLOGY
- Adult
- Small, whitish, brownish in color
- Anterior end has a pair of lateral wings / cephalic
alae
- Male : 2-5 mm in length by 0.1-0.2 mm; tail
strongly curved (caudal alae); single spicule; die
after copulation
- Female : 8-13 mm by 0.4 mm ; long, sharply
pointed tail; uteri are distended with eggs; 4,672-
16,888 eggs/day (mean of 11,105)
EGGS
- D-shaped ova
- 50-60 by 20-30 microns
- Elongated, ovoidal, flattened on the ventral side
- 2 layers of the egg shell : outer thick hyaline
albuminous shell (mechanical protection) ; inner
embryonic, lipoidal membrane (chemical
protection)
- The eggs become fully embryonated & mature
within few hours after oviposition
- Resistant to disinfectant; remain viable/alive up to
13 days
- Tadpole – line embryo (4-6 hours)
LIFE CYCLE
- Adults are residing in the large intestine
- Gravid female migrated to the perianal region to
deposit eggs
- Egg is ingested; tach in small intestine releasing
larva & develop into adult worms in the large
intestine
PATHOLOGY
- Never fatal
- Minute ulceration / abscess
- Mechanical irritation & secondary bacterial
invasion may lead to inflammation of the intestine
- Intense itching or pruritus in the perianal region
- Insomnia
RMT 2023
WEEK 3 (LEC-LAB) MLS 306** CLINICAL PARASITOLOGY BSMLS 3A
- Extra-intestinal Enterobiasis (2 weeks-2 months)
; may oviposit in the genital organs; may enter the
appendix, may enter the reproductive tract up to the
fallopian tube; endometritis; peritonitis (reported in
liver & lungs)
- Other signs of infection : poor appetite, weight
loss, irritability, grinding of teeth, abdominal pain
- Possibility of AUTOINFECTION &
RETROINFECTION
EPIDEMIOLOGY
- 29% among private school children; 56% in public
- More prevalent in females (!6%) than males (9%)
- Found in temperate & tropical areas
- There are around 208.8 million infected with 18
million in Canada & US
DIAGNOSIS
- Graham’s scotch adhesive tape, cellulose tape /
scotch tape method (PERIANAL SWAB)
- Modes of transmission : direct hand to mouth;
soiled night clothes; sleeping in bed with carriers
(Familial tendency – society worm); contaminated
table tops, door knobs, other objects; inhalation of
airborne eggs dislodged from bed linens
TREATMENT, PREVENTION & CONTROL
- Personal cleanliness & hygiene
- Fingernails should be cut short
- Underwear, night clothes, blankets & bed sheet
should be handled with care, boiled & laundered
- Chemotherapy of the entire family

LPU-BATANGAS TAMAYO, H.B.A RMT 2023