NEMATODES  STH: soil transmitted helminths- soil plays a major

role in the development and transmission of the

 Helminths- worms
 Kingdom Anemalia
 Phylum Nemathelminthes/Aschelminthes
 SHAPE: elongated and cylindrical
 Bilaterally symmetrical
 Non-segmented
 Complete DIGESTIVE system (mouth-anus)
 Complete NERVOUS system (receptors)
o Amphids- anterior portion
o Phasmids- posterior portion
Not all have phasmids (APHASMIDS)
o Trichuris
o Capillaria
o Trichinella
 Tegument- protective covering (chitinous)
 Pseudocoel- body cavity containing the organs
 Life cycle
o Adult- mature form
o Larva- immature form
o Egg/Ovum
 Dioecious- separate sexes (male and female)
o Male:
 Smaller
 Posterior portion is coiled/curved
 Copulatory structures: 2 spicule &
copulatory bursa
parasite. (polymyarian)
 Most common intestinal nematode of man
 Most frequent in tropics
 FH: man
 IS: embryonated egg
 MOT: ingestion
 Habitat: lumen of small intestine
o Larva: heart-lung migration
o Back to small int. to be an adult worm and
reproduce
o Egg: released in stool
 hepato-tracheal migration phase takes about 14
days, while the development of egg-laying adult
worms takes about 9 to 11 weeks after egg
ingestion. The life span of an adult worm is about 1
year.
 have a terminal mouth with trilobate lips and
sensory papillae
 Produces pepsin inhibitor 3 (PI-3)- protects worms
from digestion and phosphorylcholine that
suppresses lymphocyte proliferation.
 Adult morphology:

 Larval morphology: similar to the adult

 Egg morphology:
o Unfertilized (female worms only)
o Female:  Corticated- w/ mammillary coat
 Larger  Decorticated- w/o mammillary coat
 Posterior portion is pointed  Thin shell
 Paired reproductive organs
There are 4 kinds of female nematodes
1) Oviparous- produce unembryonated eggs
2) Ovoviviparous- produce embryonated eggs o Fertilized (both male and female)
3) Larviparous- larva  Corticated- w/ coarse mammillary coat
4) Parthenogenetic- female can self fertilize  Decorticated- w/o mammillary coat
 thick, transparent, hyaline shell
Infective stage: Embryonated egg
(A T E)
 Ascaris lumbricoides
 Trichuris trichiura
 Enterobius vermicularis
Ascaris lumbricoides
 CN: giant intestinal roundworm o Embryonated (soil)
 escape and penetrate intestinal villi where they
 female Ascaris produces about 200,000 eggs per day remain for 3 to 10 days
 2 to 3 weeks for eggs to embryonate in the soil o TT47- pore-forming protein that allows them
 larvae undergo two molts to reach their 3rd stage to imbed their entire whip-like portion into
within the egg the intestinal wall.
Pathogenesis and Clinical Manifestations  Egg morphology
 Asymptomatic o Shape: football, barrel, Japanese lantern
 During lung migration- the larvae may cause allergic
manifestations such as lung infiltration, asthmatic
attacks, and edema of the lips.
 Diseases:
o Ascariasis: erratic worms, high eosinophil
o Loeffler’s syndrome:in heavy infections,
pneumonitis  eggs develop and become embryonated in the soil
Diagnosis within 2 to 3 weeks
 Clinical diagnosis- rather inaccurate, signs and  12 weeks- four larval stages to become adult worms
symptoms are vague Pathogenesis and Clinical Manifestations
 should be confirmed or established by microscopic  Petechial hemorrhages- caused by the embedded
examination of a stool sample anterior portions in the mucosa. May predispose to
o DFS- least sensitive amebic dysentery
o Kato thick smear  Enterorrhagia or intestinal bleeding is common
o Kato-Katz- provides quantitative diagnosis  consequent irritation and inflammation may lead to
(eggs per gram of stool) appendicitis or granuloma formation
o FECT  over 5,000 T. trichiura eggs per gram of feces are
Treatment usually symptomatic
 broad-spectrum anthelminthics such as  Heavy infection:
o albendazole, mebendazole, and pyrantel o Trichuris dysentery syndrome manifested by
pamoate. chronic dysentery and rectal prolapse
 bind to the parasites’ b-tubulin resulting o Anemia is strongly correlated
in the disruption of parasite microtubule  Very good prognosis
polymerization Diagnosis
 Clinical diagnosis is possible only in very heavy
Trichuris trichiura chronic Trichuris infection
 CN: whipworm o patient suffers from frequent blood-streaked
 STH: soil transmitted helminths diarrhea, abdominal pain and tenderness, and
 Holomyarian rectal prolapse
 FH: man  Laboratory diagnosis:
 IS: embryonated egg o DFS
 MOT: ingestion o Kato thick- diagnosis of trichuriasis
 Habitat: colon o Kato-Katz- quantitative method to determine
o Pin fashion attachment (anterior part) the intensity of infection
 Adult morphology: o FECT
Treatment
 Albendazole, mebendazole
 Deworming

Enterobius vermicularis
 CN: pinworm, seatworm, society worm, tiwa
 FH: man
 Larvae are not usually described because soon after  Habitat: colon
the embryonated eggs are ingested, the larvae  MOT:
o Ingestion
 o Inhalation
o Autoinfection
o Retroinfection
 Infection is characterized by perianal
itching/pruritus ani
 Not a usual cause of significant morbidity or
mortality
 Most common helminth parasite in temperate
regions
 Meromyarian (arrangement of somatic muscles)- 2-5
cells per dorsal or ventral half
 Adult morphology:
 Males are rarely seen- usually die after copulation
 Gravid Females- migrate down the intestinal tract
and exit through the anus to deposit eggs (oviposit)
on the perianal skin, usually in the evening hours.
o Female: average of 11,000 eggs/day
o After egg deposition, the female usually dies
 Rhabditiform larva: w/ esophageal bulb, w/o
cuticular expansion on the anterior end
 Egg morphology:
o Asymmetrical (one side flattened, other side
convex)
o D-shaped/ lopsided
o becomes fully mature outside the host within
4 to 6 hours
o Eggs are resistant to disinfectants
o Succumb to dehydration in dry air within a day
o Mist condition- viable for up to 13 days
o viable longest under conditions of fairly high
humidity and moderate temperature
Pathogenesis and Clinical Manifestations
 relatively innocuous parasite and rarely produces
any serious lesions
 Mild catarrhal inflammation of the intestinal
mucosa: from the attachment of the worms
 secondary bacterial infection: Intense itching leads
to scratching due to the migration of egg-laying
females
 Other signs of infection are poor appetite, weight
loss, irritability, grinding of teeth, and abdominal
pain
 Complications such as appendicitis, vaginitis,
endometritis, salpingitis, and peritonitis: due to
aberrant adult worm migration
 prognosis of enterobiasis or oxyuriasis is good
 This parasitic disease is extremely contagious and
can easily spread among members of a family or in
institutions
 described as a familial or a group disease.
Diagnosis
 suspected in children and adults who show perianal
itching
o relieved only by vigorous scratching
 confirmed by finding adult worms or eggs on
microscopic examinations
o Stool sample- only 5% of infected persons
o Graham’s scotch adhesive tape swab (perianal
cellulose tape swab)- gives the highest
percentage of positive results, and the
greatest number of eggs seen. This low-cost
diagnostic method is easy to perform and is
very sensitive and specific.
Treatment
 Albendazole and mebendazole
 Treatment of the entire household is recommended
 Considered cure after 7 negative perianal smears on
consecutive days
Epidemiology
 only intestinal nematode infection that cannot be
controlled through sanitary disposal of human feces,
because the eggs are deposited in the perianal
region instead of the intestinal lumen
 Risk factors: overcrowding, thumb-sucking, nail-
biting, and lack of parental knowledge on pinworms
Prevention and Control
 Personal cleanliness and personal hygiene
 Fingernails should be cut short
 Hand washing should be done
Infective stage: larva
Hookworms
 Soil transmitted helminth
 Blood sucking- attaches to the mucosa of the small
intestine
 Meromyarian- 2-5 cells arranged per dorsal or
ventral half
 IS: filariform larva (L3) [fenetrates the skin]
 Egg
o Thin shell
o Starts w/ a single embryo then divide divide
 o All looks similar, undistinguishable
o Oviparous- unembryonated

 Causes microcytic hypochronic anemia = pain, lazy

 Lab diagnosis
o DFS
 Larva o Kato-katz
o L1: rhabditiform o Kato thick
 Diagnostic stage o Harada Mori culture technique
 Feeding form- open mouth Pathogenesis and Clinical Manifestation
 Penetration of filariform causes
o Maculopapular lesions
o Localized erythema
o L2 o Severe itching- ground itch, dew itch
o L3: filariform  Lung migration
 Infective stage (skin penetration) o Bronchitis
 Ecdysis- shedding = sheath o Pneumonitis
 Appears fiat (thin)  Adult worm in the small intestine
 Dies in alcohol o Abdominal pain
o Steatorrhea
o Diarrhea with blood and mucus
o Eosinophilia
 After skin penetration it will circulate in the body  heavy hookworm infection results in a progressive,
o Results in elevated eosinophil secondary, microcytic, hypochromic anemia of the
 Heart-lung migration iron-deficient type, due primarily to continuous loss
o Wakana disease (lungs) of blood
 It will travel to the pharynx where it will be  Hypoalbuminemia- due to combined lost of blood,
swallowed back to the small intestine lymph and protein
 Small intestine- where it will become an adult  Good prognosis
 Human hookworms Treatment
o Necator americanus- CN: new world hw.  Albendazole
o Ancylostoma duodenale- CN: old world hw.  Mebendazole
 Animal hookworms- can still infect humans
(cutaneous larva migrant “creeping eruption”) Strongyloides stercoralis
o Ancylostoma braziliense- CN: cat hw.  CN: threadworm
o Ancylostoma caninum- CN: dog hw.  Cochin-china diarrhea or vietnam diarrhea
 Buccal cavity- differentiation of human and animal  Facultative (free-living)
hookworm  Parthenogenetic
Necator americanus Ancylostoma duodenale  Ovoviviparous- embryonated
 Honey-comb appearance in intestinal mucosa
 Filariform female- larger than free-living male and
free-living female

 Free-living female- found in the soil

o Lay eggs that develop into rhabditiform in a
few hours
Ancylostoma braziliense Ancylostoma caninum o Muscular double-bulbed esophagus
o Straight cylindrical intestine
 Free-living male
 o Ventrally curved tail o One of the most successful method
o 2 copulatory spicule
o Gubernaculum (testis)
o No caudal alae
 Uteri contain a single file of 8-12 thin-shelled ova
 Parasitic male- not been reliably identified
 Rhabditiform larva  Beale’s string test
o Elongated esophagus w/ pyriform posterior  Duodenal aspiration
bulb  Small bowel biopsy
o slightly smaller and less attenuated posteriorly Treatment
than hookworm  Albendazole
 Thiabendazole
 Ivermectin
 Contraindicated in pregnant women- albendazole
 Heterogonic life cycle- freeliving, facultative
and thiabendazole
(indirect)
 Egg reduction rate cannot be determined because
 Homogonic life cycle- not conducive environment
eggs are not passed out in the feces
(direct)
 Copulate outside the host Capillaria philippinensis
 Autoinfection- rhabditiform larvae pass down the  one of four Capillaria species that are known to
large intestine and develop into filariform larvae. infect humans
may invade the mucosa and enter the circulation to
 Mystery disease- curse from God
start another parasitic cycle without leaving the body
o 1963 Bacarra Ilocos Norte
of the host
o 1967 Tugudin Ilocos Sur
 Eggs hatch inside the host
 associated with protein- losing enteropathy,
 Hyperinfection is a syndrome of accelerated electrolyte imbalance, and intestinal malabsorption
autoinfection
 Severe disease can result in death
Pathogenesis and Clinical Manifestation
 nematode from the superfamily Trichinelloidea, to
 larval invasion of the skin
which Trichuris and Trichinella belong
o Erythema
 characteristically have a thin filamentous anterior
o pruritic elevated hemorrhagic papules
end and a slightly thicker and shorter posterior end
 Larval migration phase
 IS: L2 larva
o lungs are destroyed causing lobar pneumonia
 DS: unembryonated egg
with hemorrhage
 IH: freshwater fishes
o Cough and tracheal irritation mimics
bronchitis  FH: man
 Good prognosis in light infections  Fish-eating birds are believed to be the natural hosts
of C. philippinensis, and humans are considered
 Moderate and heavy infections have high mortality
incidental hosts.
rates
Diagnosis  Adult
o Esophagus- rows of secretory cells called
 Unexplained eosinophilia
stichocytes. The entire esophageal structure is
 Baermann funnel gauze method- research puroses
called stichosome.
o Male
 Smaller than the female
 Spicule has an unspined sheath
o Female
 Vulva- located at the junction of
anterior and middle thirds
 Ovoviviparous (cause autoinfection)-
40-45 embryonated eggs
 Oviparous- eggs are in a single row (8-10
 Harada-Mori eggs)
 Larva o T. murrelli, T. nelsoni, T. papuae, T.
o Development from L1-L2 happen inside the pseudospiralis
fish  Adult
 Egg o Male
o Peanut or guitar shaped  Single testicle located near the posterior
o Smaller that Trichuris trichiura end of the body, and is joined in the
o “Sexy pero flat” mid-body by the genital tube which, in
turn, extends back to the cloaca
 Cloaca- outlet into which the intestinal,
urinary, and genital tracts open. Has a
pair of caudal appendages and two pairs
of papillae
o Female
o Passed in the feces of humans and  Single ovary situated in the posterior
embryonate in the soil or water where fishes part
can ingest them.  has an oviduct, a seminal receptacle, a
o Eggs hatch in the intestines of the fish and coiled uterus, a vagina, and a vulva
grow into the infective larvae.  vulva is situated in the anterior 5th on
Pathogenesis and Clinical Manifestation the ventral side of the body
 Borborygmus and abdominal pain  Lives for 30 days and can produce more
 Weight lost, vomiting, edema than 1,500 larvae in its lifetime.
 Intermittent diarrhea (8-10 per day)  Larva
 Severe protein lost and hypoalbuminemia o Speak-like, burrowing anterior tip
 High levels of IgE o digestive tract of a mature larva encysted in a
 parasites do not invade intestinal tissue, but they are muscle fiber resembles adult worm
responsible for micro-ulcers in the epithelium o reproductive organs, at this stage, are not yet
Diagnosis fully developed
 DFS  Habitat:
 FECT, AECT o Adults- small intestine
 Duodenal aspiration o Larva- skeletal muscle
 Jejunal biopsy  FH: man
Treatment  DS: larva
 Electrolyte replacement and high protein diet  IS: encysted larvae (found in meat)
 Mebendazole  MOT: ingestion of raw or insufficiently cooked meat
 Albendazole  Female are larviparous (no egg)
 Not found in stool
Trichinella spiralis  Enteric phase
 CN: muscle worm or trichina worm o Intestinal phase
 1st described by Tiedemann in 1822 o Incubation
 In 1835, James Paget and Richard Owen o Female froduce larvae
demonstrated Trichinelle in human cadavers in  Invasion phase
London o Larval migration
 German investigators- prove that raw or o Muscle invasion
insufficiently cooked meat was responsible for  Convalescent phase
Trichinellosis in humans. o Encystment
 8 species o Encapsulation
o T. spiralis- most important, most adapted to o Symptoms subside
domestic and wild pigs o Trichinosis- self-limiting (mamamatay din dahil
o T. britovi- most widely distributed species wala naman canibalism)
among wild animals, 2nd most common  Lab diagnosis (4 B’s)
Trichinella affecting humans o Biopsy
o T. nativa- wild carnivores o Bentonite
o Bachman
 o Beck’s xenodiagnosis- animal inoculation test
 Prevention
o Heat meat: 77 C
o Freeze meat: -15 C/ 20 days or -30 C/6 days
 Treatment
o Mebendazole
o Albendazole
Filarial worms
(Wuchy and Brugy)
 Vector transmitted: mosquito
 Does not lay eggs
 Lymphatic worm- one of the most debilitating
diseases
 Treated with diethylcarbamazine
Wuchereria bancrofti
 CN: Bancroft’s filarial worm
 Transmitted by mosquito bites at night
o Anopheles- slow flowing, clear, shaded
o Aedes- from abaca and banana leaves
o Culex
 DS: microfilaria (can be observed in a wet smear)
 IS: filiform (thread-like)
 The parasite is nocturnal (10 pm-2 am/ 8 pm-4 am)
 Specimen for diagnosis: blood collected at night
 Causes Bancroftian filariasis
Brugia malayi
 CN: Malayan filarial worm
 Transmitted by mosquito bites at night
o Mansonia- fresh water or rice fields
 DS: microfilaria
 IS: filiform (thread-like)
 The parasite is nocturnal (10 pm-2 am/ 8 pm-4 am)
 Specimen for diagnosis: blood collected at night
 Causes Malayan filariasis
 Adult females of B. malayi and W. bancrofti are
indistinguishable.
 Has a GRACEFUL curve (“nakaka WoW”)
 1: as long as wide
 2: regularly spaced and organized
 3: no nuclei at the end (terminal nuclei)
 4: remains unstained (maganda na siya, no need for
makeup)
 Kinky curves (bruha)
 1: longer than wide
 2: overlapping, disorganized
 3: 2 terminal nuclei
 4: stains pink in Giemsa stain
Pathogenesis and Clinical Manifestation
 Lymphatic filariasis- caused by the adult worm
 Weingartner’s syndrome- tropical pulmonary
eosinophilia
 Mayer’s-Kouwenaar syndrome- massive eosinophilia
 Expatriate syndrome- people who get infected after
migration to the endemic regions (di taga doon)
 Lymphangiectasia- Filarial adult worms cause
parasite-induced lymphatic dilatation.
 Chyluria- milky urine
 The most common chronic manifestation of LF is
lymphedema, which on progression leads to
elephantiasis
o The lower limbs are commonly affected, but
upper limb and male genitalia may be
involved.
o In females, breasts and genitalia may be
affected, but this is relatively uncommon
Diagnosis and Treatment
 Knott’s concentration technique- recovery of
microfilaria
Miscellaneous Nematodes
Parastrongylus cantonensis
 CN: rat lungworm
 Formerly classified under genus Angiostrongylus  After 6 days, eggs hatch to release the
 First described by Chen in 1935 from domestic rats in L1
Canton, China o Eventually expelled in feces, 6-8 weeks after
 Known to cause eosinophilic meningoencephalitis infection
 Adult: (pale and filiform)  IS: L3
o Male Pathogenesis and Clinical Manifestation
 Well-developed caudal bursa- kidney-  chief complaint- acute, severe, intermittent occipital
shaped and single-lobed or bitemporal headache
o Female  Other common symptoms- stiffness of the neck,
 Uterine tubules- wound spirally around paresthesia, vomiting, fever, nausea, blurred vision
the intestines, barber’s pole appearance or diplopia, body or muscle pain, and fatigue
 Associated complications- Intraocular hemorrhage
and retinal detachment
 Postmortem examination may show leptomeningitis,
 Posterior end- blunt shaped encephalomalacia and moderate ventricular dilation
 Lay up to 15,000 eggs daily  Worms- also seen in cerebrum and cerebellum
 Egg  Eosinophils, monocytes, and foreign body giant cells
o elongated ovoidal in the spinal cord or in the cerebrospinal fluid (CSF)
o w/ delicate hyaline shells are usually associated with the infection
o Unembryonated o 100 to 1,000 leukocytes per μL
 Larva  Adult worms are also recovered from the eyes
o 1st stage  Good prognosis
 Lungs of the rodent host  Infection is self-limited
 Has a distinct small knob near the tip of  Symptoms gradually disappear
the tail Diagnosis
o 3rd stage  Relatively difficult dahil nasa brain
 2 well-developed chitinous rods below  Presumptive diagnosis- based on travel and exposure
its buccal cavity history, correlated with clinical symptoms, medical
 DH: rats history, laboratory findings, brain imaging results,
 IH: slugs and snails and serological tests
o Achatina fulica or giant African snail  Examination of blood- high proportion of
o Hemiplecta sagittifera eosinophils, comprising 7 to 36% of the WBC count.
o Helicostyla macrostoma  Examination of CSF
o Vaginilus plebeius o CSF eosinophilia- greater than 10% in
o Veronicella altae. proportion to WBC
 MOT: ingestion of L3 o CSF protein level- mildly elevated
 Life cycle: o CSF glucose is normal
o Penetrates the stomach wall  CT scan and MRI
o Travel in the bloodstream to the central Treatment
nervous system  No anthelminthic treatment is recommended at
o Undergo 2 molts, takes about 2 weeks to present
reach maturity  mebendazole and albendazole have been
o After the final molt in rats, the young adults demonstrated to effectively treat parastrongyliasis in
migrate to the pulmonary arteries China, Taiwan, and Thailand
o After 2 weeks adult females start laying eggs  Anthelminthic therapy- relieve symptoms and
 Early development occur in the brain reduce the duration of the disease.
 Adult worm  Ocular parastrongyliasis- require surgical removal of
o Live in the 2 main branches of the pulmonary worms from the eyes.
arteries of the rat  Symptomatic treatment- use of analgesics and
o Bloodstream- gravid females lay eggs, lumbar puncture can relieve the headaches
transported into the smaller vessels of the experienced by the patient with eosinophilic
lungs meningitis
  If the penetration is deep, a tumor-like granuloma
Anisakis species surrounded by inflammatory cells and eosinophils
 Anisakids- nematode parasites of whales, dolphins, will develop
porpoises, walruses, seals, sea lions, and other deep  Gastric anisakidosis less avute and less exudative
marine mammals than the intestinal form
 Elongated vermiform bodies without segmentation Diagnosis
 Comlete digestive tract  should be highly suspected if there is a recent history
 Dioecious of eating raw or improperly cooked fish or squid
 can cause gastrointestinal infections and allergic  gastroscopic/endoscopic examination- the larvae
reactions in humans can be visualized and removed for identification
 Adult  Intestinal anisakidosis- may be diagnoses only after
o Embedded in the gastric wall of marine surgery
mammal host Treatment
o Discharge unembryonated egg into the sea  Removing the larva using endoscopic forceps
 Larvae  Corticosteroids- used in allergic anisakidosis but
o 1st stage clinical trials have not been performed
 develop inside the egg into 2nd stage  Albendazole
nd
o 2 stage
 hatch out of the egg Toxocara
 Free swimming  Toxocariasis- zoonotic disease
 Ingested by micro-crustaceans  When ingested by humans, larvae are released and
rd
o 3 stage penetrate the intestinal wall then migrate via the
 Develop inside the micro-crustaceans veins into the liver and the rest of the body, where
 Transported to various paratenic hosts they remain as larvae
(squid and several species of fish)  Toxocara spp. belong to the Family Toxocaridae and
 More concentrated in fish viscera but Order Ascaridida
may occasionally be found in the fish Toxocara canis Toxocara cati
muscles Intermediate h. Dog Cat
 Anisakis simplex- milky white in color,, Paratenic H. Vertebrates and Vertebrates and
long stomach, and a blunt tail with some some
mucron, and are referred to as Type I invertebrates invertebrates
larvae Final h. Dogs and other Cat
 Pseudoterranova- yellowish brown in canids Humans
color Human (accidental h)
 Other species of Anisakis- shorter (accidental h)
stomachs and blunt tails, and are called Infective stage Embryonated Embryonated
Type II larvae egg egg
 Molt twice and develop into adult MOT Ingestion Ingestion
worms
Egg (DS) Brownish color Brownish in
Pathogenesis and Clinical Manifestation
Superficial pits color
 3rd stage larvae (sticky) Pitted
o Ingested by humans through raw or Unembryonated Unembryonated
improperly cooked infected fish when laid when laid
o Do not develop into the adult inside the 2-4 years in cool
human moist condition
 Anisakiasis or anisakidosis- larval infection
 May result in gastric and intestinal pathology  Female can lay up to 200,000 eggs per day
 Allergic reaction- due to the chemicals secreted by o Infective after 2 weeks
the worms Pathogenesis and Clinical Manifestations
 Hemorrhage and inflammation- Ingested larvae  Visceral larva migrants (VLM)
invade the submucosa of the stomach or intestines o Due to the migration and subsequent death of
the larvae
 o Produces and intense inflammatory response
manifested as eosinophilic granulomas
o Most sensitive- liver, lungs, central nervous sys
and eyes
o Wheezing common sign of VLM
o Associated with liver enlargement and
necrosis
 Ocular larva migrants (OLM)
o Sign and symptoms manifested in the eyes
o Children 5-10 y/o
o most serious consequence is the invasion of
the retina
o Blindness is common
 Covert toxocariasis (CoTOX)
o used to identify a less specific syndrome
o coughing, wheezing, chronic or recurrent
abdominal pain, hepatomegaly, sleep
disturbances, headache, malaise, and anorexia
 Neurological toxocariasis
o Encephalitis
o Larvae migrate to the brain
o Solitary mass lesions- causing seizures, static
encephalopathy, arachnoiditis, spinal cord
lesions, optic neuritis, and eosinophilic
meningitis, a form of aseptic meningitis in
which the WBCs in the CSF mainly consist of
eosinophils
Diagnosis
 In humans- difficult to diagnose
 Symptoms are similar to other infections
 No to fecalysis- eggs are not produced or excreted
 Definitive diagnosis- biopsy tissues (time consuming
and difficult)
Treatment
 Albendazol or Mebendazole
 Anti-inflammatory medications
 Most patients recover without therapy
 Anthelminthic treatment is mandatory for
neurological toxocariasis or lung or cardiac
complications