PREPARED BY: MARIA CARMEN SHIELER-DIZON, RMT, BSN, MAT, MSMT, PHD(C)

NEMATODES Ancyclostoma Hookworm of cats

GENERAL CHARACTERISTICS braziliensi
➔ Basically, named as roundworms Dirofilaria immitis Dog Heart Worm
➔ Elongated, cylindrical unsegmented worms Angiostrongylus Rat lung worm
with tapering ends cantonensis
➔ Cuticula – thick hyaline protective coating
➔ Male is generally smaller than female with MODES OF INFECTION AND INFECTIVE STAGE:
posterior end which is either curved or coiled. Ascaris lumbricoides Ingestion of
➔ Dioecious: male and female reproductive Trichuris trichiura EMBRYONATED EGG
organs Enterobius
➔ Complete with mouth, nervous system and vermicularis
digestive system Dracunculus Ingestion of LARVAE
➔ Homoxenous: requires only one host in the medinensis within INTERMEDIATE
life cycle Capillaria philippinesis HOST
➔ Heteroxenous: more than one life cycle Trichinella spiralis Ingestion of ENCYSTED
➔ All are equipped with amphid – LARVAE in MUSCLE of
chemoreceptors located in shallow, anterior DEFINITIVE HOST
depressions or pits at the same level of the Hookworms Skin penetration of
body as the cephalic papillae Strongyloides FILARIFORM LARVA
➔ Some are equipped with phasmid – stercoralis
chemoreceptors located posteriorly Filarial worms Skin inoculation of
 Aphasmid (TTC): Trichuris, THIRD STAGE LARVA
Trichinella and Capillaria Ascaris lumbricoides Inhalation of DUST
 Phasmidea (SAHE) – Enterobius CONTAINING
Strongyloides, Hookworm, vermicularis EMBRYONATED OVA
Enterobious (rare)

SPECIES COMMON NAMES NOTE:

INTESTINAL NEMATODES ➔ Undergo Heart to Lung Migration –
Capillaria phillipinensis Pudoc worm Hookworms & Ascaris & Strongyloides
Ascaris lumbricoides Giant intestinal (HAS) (LARVA)
roundworm/Eel worm/ ➔ Larva Migrans – do not develop into adult
Roundworm of man worms but only elicit swelling, inflammation
Strongyloides Threadworm
stercoralis TYPES OF FEMALE NEMATODES
Necator americanus New world hookworm Oviparous Ascaris lumbricoides
Ancylostoma Old world hookworm Eggs without fully Trichuris trichiura
duodenale developed larva Hookworm
Trichuris trichiura Whip worm Viviparous/Larviparous Trichinella spiralis
Enterobius Pinworm/ Seatworm Fully developed larva Dracunculus medinensis
vermicularis with eggs Filarial Worms
INTESTINAL – EXTRA INTESTINAL NEMATODES Ovoviparous Enterobius vermicularis
Trichinella spiralis Trichina worm or muscle Eggs with fully developed Strongyloides stercoralis
Roundworm larva
Dracunculus Guinea worm, Dragon
medinensis worm, Serpent worm NOTE:
BLOOD AND TISSUE NEMATODES ➔ Capillaria philippinesis: typical: peanut
LYMPHATIC SYSTEM shaped appearance of ova; atypical: - ova
Wuchereria bancrofti Bancroft filarial without no flattened bipolar
Brugia malayi Malayan filarial
LARVA MIGRANTS
SUBCUTANEOUS TISSUE
Loa loa Eye worm Visceral Larva Cutaneous
Migrans Larva Migrans
Onchocerca volvulus Convoluted filarial
(Creeping
Mansonella
Eruption)
streptocerca
“Sandworm
SEROUS CAVITIES disease”
Mansonella ozzardi Ozzard filarial Eosinophilia Usually seen Rarely seen
Mansonella perstans Persistent filarial Transmission Migrate through Migrate through
various internal the skin of the
PRIMARILY ZOONOTIC NEMATODES organs hosts
Toxocara canis Ascaris of dogs Serological Well developed Not well
Toxocara cati Ascaris of cats Test developed
Ancylostoma caninum Hookworm of dogs Toxocara canis Ancyclostoma
Toxocara cati caninum

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PREPARED BY: MARIA CARMEN SHIELER-DIZON, RMT, BSN, MAT, MSMT, PHD(C)
Baylisascaris Ancyclostoma
procyonis braziliense

Ascaris lumbricoides
➔ Giant intestinal roundworm/eel worm
➔ Most common parasite on children in the Decorticated (Fertilized)
Philippines ➔ Round; w/ embryo
➔ RECALL: Oviparous/ Embryonated egg on ➔ 2 layers: w/o outer albuminous coat
soil / Heart and Lung Migration
PATHOGENICITY
A. Intestinal Ascariasis
B. Ascaris Pneumonia or Loeffler Syndrome
C. Spoliative or Nutrition Deficiency
D. Ectopic Ascariasis (Wanderlust)
LABORATORY DIAGNOSIS
A. Stool (Qualitative or Quantitative)
B. Sputum
C. ELISA
DISTINGUISHING FEATURES OF Ascaris Trichuris trichiura
lumbricoides ➔ RECALL: Oviparous/ Embryonated egg on
➔ Superficially resembles roundworm soil
➔ With trilobate lips ➔ Life Cycle of Trichuris trichiura
➔ Ingestion of embryonated ova initiates the
infection. The larvae emerge from the eggs in
the small intestine. The larvae proceed to the
cecum, where they become adult. Eggs are
passed in the stool by the adult worm. Soil
molting happens
PATHOGENICITY
➔ Trichuriasis/ Whipworm
infection/Trichocephaliasis
LIFE CYCLE ➔ Rectal Prolapse
Infection begins following the ingestion of
embryonated eggs/ova→ in the small intestine,
larvae will emerge from the egg → the larva will
undergo hepatic and lung migration for further
development then return to the small intestine where it
will become adult → the female adult will lay egg
which will be passed on the stool → where it needs soil
to be embryonated and taken up by man to repeat the
cycle
LABORATORY DIAGNOSIS
ASCARIS LUMBRICOIDES OVA ➔ Stool (Qualitative or Quantitative)
Unfertilized ➔ Sigmoidoscopy – diagnostic test used to
➔ Disorganized germ cell; w/o embryo check sigmoid colon/lower part of the colon
➔ Amorphous mass of cytoplasm (large intestine)
ADULT
➔ Whiplike structure
➔ Prominent/Thickened Posterior
➔ Male prominent coiled tail

Corticated (Fertilized)
➔ Mamillated
➔ Organized germ cell/finely granular; w/
embryo OVA
➔ 3 layers: outer albuminous, middle ➔ Barrel of Football shape
transparent, inner lipoidal ➔ w/ Embryo
➔ w/ prominent bipolar plugs
➔ “ Japanese Lantern Ova”

Enterobius vermicularis
➔ Most common parasite in the world;

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PREPARED BY: MARIA CARMEN SHIELER-DIZON, RMT, BSN, MAT, MSMT, PHD(C)
➔ Most common helminths of infection
➔ RECALL: Ovoviparous/ Embryonated egg
LIFE CYCLE
➔ It is initiated by in the ingestion of
embryonated ova. Eggs hatch in the small
intestine to become larvae. It matures into
an adult worm in the large intestine. After
copulation, the nocturnal gravid female worm
migrates to the perianal region
PATHOGENICITY
➔ Enterobiasis/ Oxyuriasis / Pinworm Infection
➔ Pruritis ani – intense itchiness of anus
➔ Retroinfection – migrates back into the hosts
body developed and reproduced
➔ Autoinfection – if the infected egg is ingested
via and to mouth
LABORATORY DIAGNOSIS
➔ Perianal swab or Scotch Tape Swab
➔ B. Fingernail Scrappings
Enterobius vermicularis MALE AND FEMALE
DISTINGUISHING FEATURES
➔ Cervical alae
➔ Prominent double esophageal bulb
➔ Complete Blood Count -RBC, MCV and
MCHC with eosinophilia
LIFE CYCLE
➔ The third stage filariform larva will
penetrate the skin. It will migrate to the
lympathics and blood system. It will
undergo lung migration and it will mature
as adult in the small intestine. Eggs will be
passed on the stool and upon contact to the
soil will become first stage rhabditiform larvae
afterwards and eventually becoming filariform
larva repeating the life cycle
HOOKWORMS OVA DISTINGUISHING FEATURES
➔ Clear thin shell w/ blastomeres that resemble
morula balls (4-8)
HOOKWORMS

Enterobius vermicularis OVA

➔ Lopsided or D-shape
➔ With larva inside ova (embryonated)
➔ Outer thick-walled shell

HOOKWORMS
➔ Two Species: Necator americanus and A. duodenale N. americanus
Ancylostoma duodenale – Hookworms of Size Large and Small and
man thicker slender
➔ RECALL: Oviparous/ Shape “C” “S”
➔ Mode of transmission: Skin penetration of Teeth 4 ventral teeth Semilunar
filariform larva cutting plate
PATHOGENICITY Copulatory Two separate Two spicules
➔ Ancyclostomiasis/Uncinariasis – allergic bursa spicules with fused at the tip,
reaction in skin ground or coolie itch or dew - Umbrella like dorsal ray dorsal ray split;
itch. structure single; Bidigitate
➔ Microcytic hypochromic anemia – due to Tridigitate
ingestion of blood in the small intestine Rate of Faster Slower
➔ Pneumonitis or Eosinophilia during larval Development
migration in the lungs Pathogenicity More Less
LABORATORY DIAGNOSIS
➔ Ova – Direct fecal smear and concentration
technique OTHERS:
➔ Species identification – culture method is ➔ Ancyclostoma braziliense – 1 pair of
preferred (Harada mori) buccal teeth
➔ Reverse Enzyme Immunoassay for ➔ Ancyclostoma caninum – 3 pairs of buccal
specific IgE – alternative method teeth

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PREPARED BY: MARIA CARMEN SHIELER-DIZON, RMT, BSN, MAT, MSMT, PHD(C)
1

Strongyloides stercoralis
➔ Smallest nematode to infect human;
➔ Also known as threadworm
➔ Female is classified as parthenogenic:
natural form of asexual reproduction
➔ RECALL: Ovoviparous, Skin penetration of Filariform Hookworm Strongyloides
filariform larva Larva stercoralis
PATHOGENICITY Esophagus Shorter Longer
➔ Strongyloidosis or Vietnam Diarrhea or Tail Pointed tail end Notched tail
Cochin China Diarrhea end
➔ Racing larva or Larva currens – after skin Sheath With sheath Without sheath
penetration of larva migration
➔ Autoinfection Trichinella spiralis
➔ Bronchopneumonia - larva of S. stercoralis ➔ Also known as pork muscle round
may be seen worm/trichina worm
LABORATORY DIAGNOSIS ➔ Adult: found in small intestine
➔ Qualitative and Quantitative Stool or ➔ Encysted Larva: seen in the striated
Duodenal Aspirates muscles/tissues
➔ Concentration Method – Zinc Sulfate ➔ Human becomes the terminal host
Flotation Method ➔ RECALL: Viviparous, Ingestion of
➔ Stool Culture – Harada Mori; Baermann inadequately cooked pork within a definitive
Technique host
➔ ELISA PATHOGENICITY
➔ CBC ➔ Trichinosis
➔ Beale String Test  STAGE 1: Intestinal Invasion:
DIRECT presence of diarrhea and GIT
➔ Same with hookworm disturbances
➔ But survive in soil for week and may  STAGE 2: Muscle Invasion:
penetrate in the skin encysted larva (highest eosinophilia
➔ May hatch in the stool because it is seen)
occasionally found in stool specimen  STAGE 3: Encystment: Symptoms
INDIRECT/FREE LIVING subside
➔ Filariform larva in the soil can become free LABORATORY DIAGNOSIS
living male and female and proceed to ➔ Muscle biopsy
hatching ➔ Bachman Intradermal Test
AUTOINFECTION ➔ X-ray – presence of calcified cyst
➔ Rhabditiform larva may transform to filariform ➔ Serological Test – Bentonite flocculation test
larva and penetrate the perianal region or and ELISA
undergoes heart to lung migration ➔ Elevation of muscular enzymes
DISTINGUISHING FEATURES Trichinella spiralis ENCYSTED LARVA
➔ Smaller than hookworms DISTINGUISHING FEATURES
➔ Well developed larva ➔ Coiled larva encysted in the nurse cell of
➔ Rarely seen in stool striated muscle
➔ Chinese lantern ova

Dracunculus medinensis
➔ Guinea worm/Medina worm/Serpent
worm/Dragon worm

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PREPARED BY: MARIA CARMEN SHIELER-DIZON, RMT, BSN, MAT, MSMT, PHD(C)
➔ RECALL: Viviparous, Ingestion of larvae
within intermediate host
➔ DEFINITIVE HOST: man
➔ INTERMEDIATE HOST: copepods/cyclopes
➔ Secretes a toxin that causes blister formation
discharging a milky fluid with numerous larva
➔ Released worm after bathing the ulcer with
water (Detection) – winding of larva
Capillaria philippinensis
➔ RECALL: Oviparous and Ovoviparous /
Ingestion of larvae within intermediate host
➔ DEFINITIVE HOST: man
➔ Piscivorous birds – reservoir for pudoc worm
– herons, egrets and bitterns
➔ INTERMEDIATE HOST: fish (Hypselotris
bipartita) / Brackish Water Fishes
➔ Causative agent of Mystery disease or
Borborygmus (Gurgling stomach) – Chronic
diarrhea; Autoinfection may occur in man
OVA (EMBRYONATED IN THE WATER)
 Diurnal Periodic (10:15AM-
2:15PM) - largest number of
microfilariae at day
 Non-periodic - constant levels day
and night
 Sub-periodic or nocturnal sub-
periodic - Can be detected at day
but high numbers in late afternoon
or night
LABORATORY DIAGNOSIS
➔ Blood – Giemsa Stained or filtering of
heparinized blood using nucleopore filter
(Stage: chronic infection)
➔ Scraping from infected nodule and skin snip
➔ Concentration technique – Knott (for small
amount of microfilaria) or 1mL blood
immersed in 10mL 2% formalin solution to
lyse red cells.
➔ Serological Test
➔ Opthalmologic examination using slit
lamp – filarial worms residing in eyes
➔ Ultrasonography – presence of filarial
dance sign

SUMMARY OF MICROFILARIA (PATHOGENICITY)

➔ Elephantiasis – tissue
swelling due to obstruction of
W. bancrofti lymph glands
➔ Malabar leg
➔ Hydrocoele
Typical Ova Atypical Ova ➔ Fugitive swelling or Calabar
Peanut shape Not peanut shape Loa loa swelling or transient
Flattened bipolar plugs No flattened polar plug subcutaneous swelling
Striated shell ➔ River blindness – second
causing preventable
Angiostrongylus cantonensis blindness in the world
➔ Rat lung worm ➔ Onchocercomata – painless
Onchocerva
➔ Definitive Host: Rat nodules
volvulus
➔ Intermediate hosts: molluscs, slugs and ➔ Sowdah/Onchodermatitis
snails (Human as terminal host) ➔ Nodding syndrome –
➔ Man acquired it through ingestion of believed to be associated
with this parasite
FILARIAL WORMS
➔ RECALL: Viviparous/ Skin inoculation of SHEATHED
vector with L3 larva
➔ Definitive Host: man/vertebrate animal Wuchereria
➔ Intermediate Host: invertebrate/arthropods bancrofti
LIFE CYCLE
➔ L3 Larva will be introduced by the vector
through skin inoculation. Inside the body,
larva migrates to the tissue and becomes Brugia malayi
adult. The adult worms may reside in the
lymphatic, subcutaneous tissue or internal
body cavities. Adult female worms lay alive
microfilariae in which it may be released in
the body via blood meal by the arthropod Loa loa
vector. L1 transforms until L3 in body of the
blood sucking insects and repeat life cycle
SPECIMEN REQUIREMENTS
➔ MICROFILARIA AS NON-SHEATHED
 Nocturnal Periodic (9PM – 4AM) -
largest number of microfilariae at
night Onchocerca
volvulus

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 PREPARED BY: MARIA CARMEN SHIELER-DIZON, RMT, BSN, MAT, MSMT, PHD(C)
Mansonella
ozzardi

Mansonella
perstans

W. bancrofti BLOOD
B. malayi
L. loa
M. perstans
M. ozzardi
O. volvulus Skin snips

Periodi Vector Location

city
W. bancrofti Culex; aedes;
anopheles
B. malayi Aedes,
anopheles,
mansonia
Loa loa D Chrysops; Subcutaneous
deer fly; tissue
mango fly conjunctiva
O. volvulus NP Simulium; Subcutaneous
black fly nodule
M. NP Culicoides Subcutaneous
streptocerca
M. ozzardi NP Culicoides; Serous cavity
simulum
M. perstans NP Culicoides Serous cavity

Dirofilaria immitis
➔ Definitive Host: Dog
➔ Intermediate Host: Aedes, Culex,
Anopheles and Mansonia
➔ Partial nocturnal, Unsheathed and Arthropod
borne infection
➔ In human heart, dead worm becomes
embolus producing pulmonary infarct
➔ Dead worm in hearts – coin lesion on x-ray

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