Basic mechanisms of parasite infections

General concept of Helminth infections

Sitti Wahyuni, MD, PhD
Parasitology Department Faculty of Medicine
Hasanuddin University

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 Introduction to parasitology

Upon completion of this part, the learner is expected to

• Understand general morphology of helminth
• Understand general life-cycle of parasite
• Understand basic mechanisms of helminth infection

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 THE MORPHOLOGY AND LIFE-CYCLE
OF HELMINTH
Sitti Wahyuni, MD., PhD.
Department of Parasitology
Medical Faculty, Hasanuddin University

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 Introduction

• Helminth is a general term meaning worm.

• Invertebrates characterized by elongated, flat or round bodies.
• The clinically relevant groups are separated according to their
general external shape and the host organ they inhabit.
• Hermaphroditic and bisexual species.
• Classification is based on the external and internal morphology
of egg, larval, and adult stages

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 Cestoda
Nematoda

Trematoda
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 Classification based on morphology
• Nematodes (Roundworms): • Cestodes (Tapeworms):
• Adult: Cylindrical worm, symmetries bilateral • Adult: elongated, segmented, hermaphroditic,
• Bisexual inhabit the intestinal lumen. Larval : cystic or
• Inhabit intestinal and extra intestinal sites solid
(tissue helminth) • Intra intestinal and extra-intestinal tissues
• Tissue helminth include arthropods and pig in • Life cycle includes cow, pig, dog and cat
life cycle

• Trematodes (Flukes):
• Adult: leaf-shaped flatworms.
• Prominent oral and ventral suckers help
maintain position in situ.
• Hermaphroditic except for blood flukes
• life-cycle includes a snail intermediate host.

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 Nematods Trematods Cestodes

Ascaris lumbrocoides Paragonimus westermani Diphyllobothrium latum

Toxocara spp. (Diphyllobothrium mansoni)
Necator americanus Fasciola hepatica
Ancylostoma spp. Fasciola gigantica Taenia saginata
Enterobius vermicularis Ophistorcis felineus Taenia solium
Trichuris trichuria Ophistorcis viverini Echinococcus granulosus
Strongiloides stercoralis Clonorchis sinensis Echinococcus alveolaris
Trichostrongilus spp. Dicrocoelium dendriticum Multiceps multiceps

Gnathostoma spinigerum Faciolopsis buski Bertiella studeri

Trichinella spiralis Echinostoma ilocanum
Wuchereria bancrofti Heteropyes heteropyes Diphyllidium caninum
Brugia malayi Metagonimus yokogawai
Loa loa Gastrodiscoides hominis Hymenolepis nana
Onchocerca volvulus Hymenolepis diminuta
Manzonella ozardi Schistosoma hematobium
A. perstans Schistosoma mansoni
Dracunculus medinensis Schistozoma japonicum
Capilaria hepatica
A. cantonensis
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 Life cycle stage
• Knowledge of the different stages in relation to their growth and
development is the basis for understanding the epidemiology and
pathogenesis of helminth diseases
• Stages of helminths commonly responsible for
pathologic changes in humans
Helminths Egg Larva Adult
Trematodes + +a +
Cestodes - + +
Nematodes - + +

aMigrating and developing larva forms may cause transient pathologic

responses in host
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 Larvae of helminths
Trematodes Cestodes Nematodes

Miracidiuma Cysticercosusb,c,d Rabditiformd

Sporocystaa Cysticercoidb Filariformb
Rediaa Coenurusb,d Microfilariaa,d
Cercariaa,b,c Coracidiuma
Metacercariab Procercoida,b
Pleurocercoida,b,c,d (sparganum)
Hydatida,c,d
a) Infective to or develops within intermediate host or vectors
b) Infective stages for human
c) Cause of pathogenic changes in humans
d) Can be isolated from human host and, therefore, is important in definitive diagnosis

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 Trematodes morphology

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 Trematodes life cycle

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 Cestodes (morphology)

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 Cestoda (life cycle)

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 Nematodes (morphology)

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 Life cycle of intestinal nematoda

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 Life cycle of tissue nematodes

Include insect in life cycle:

Include pig in life cycle:
- Trichinella spiralis
-Wuchereria bancrofti (mosq)
-Brugia malayi/ timori (mosq)
-Loa-loa (Chrysop fly)
-Dracunculus medinensis (Cyclops)
-Onchocerca volvulus (Black fly /Simulium)
-Manzonella spp (horse fly /Tabanus)

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 Helminth entry and localization in human body

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 Basic Mechanism of
Helminth infection
• Irritation/ physical trauma
– Skin-> Dermatitis→ ground itch,
swimmer itch, creeping eruption
– Eyes
• Hyper lacrimation
• Conjunctivitis
• Vision impairment
– Intestinal mucosa
• Diarrhea osmotic
• Bleeding→ anemia
• Neoplasm growth
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• Obstruction
• Ileus
• Appendicitis
• Jaundice
• Host immune response
– Granuloma formation
• Hepatic granuloma→ portal hypertension→ ascites
• Lymph nodus obstruction→
lymphatic vessel enlargement

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• Hypersensitive
• Tropical pulmonary eosinophilia
• Loeffler syndrome
• Anaphylactic shock
• Calabar swelling
• Entry of other microbes
• Neurologic problem
– Meningitis
– Cyst formation

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• Inflammation systemic → fever, malaise, nausea, vomiting
• Nutritional problem
– Anemia
• Blood loose
• Hemolysis
• Erythrocite formation disruption
– Lost of food→ Malnutrition

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