INTRODUCTION TO NEMATODES TAXONOMY

Phylum: Nematoda
NEMATODES - Unsegmented, bilaterally Class: Aphasmidia
symmetrical, elongated cylindrical worms, with Family: Trichinellidae
distinct longitudinal axis, complete digestive tract, Trichinella spiralis
body cavity not lined with mesothelium. Sexes are Capillaria philippinensis
Trichuris trichiura
usually separate
Class: Phasmidia
Order: Rhabditida (mouth surrounded by 3
MORPHOLOGY
or 6 lips, esophagus muscular, with posterior
bulb)
Family: Strongyloididae
Strongyloides stercoralis
Family: Ancylostomatidae
Ancylostoma duodenale
Ancylostoma braziliense
Necator americanus
Family: Metastrongylidae
Angiostrongylus cantonensis
• May have a tough, elastic, or sometimes
Family: Oxyuridae
delicate integument or cuticle that is
Enterobius vermicularis
resistant to digestion while the organism is
Family: Ascarididae
alive. Ascaris lumbricoides
• Most organ systems are greatly reduced due Toxocara cati
to parasitism. Toxocara canis
• The reproductive system however is greatly
elaborated. APHASMIDS
• Elongate and cylindrical in shape ----------------------------------------------------------------------
• Adult stages vary in size from barely visible 1. Capillaria philippinensis
to large
• Integument – secreted from the underlying
epithelium
• Epithelial layer – under the integument.
Appears as a syncytium of intermingled
nuclei and fibers.
• Dermomuscular layer – below the
epithelium. Contains important somatic
musculature.
• Sensory papillae or chemo-receptors
• Pseudocele –It contains the digestive
system, reproductive system, excretory • Paracapillaria philippinensis
system, and the nervous system • Common names: Pudoc worm
• Nematodes lack a circulatory system • Mystery worm
• Mouth - useful for attachment or for • Disease: Human Intestinal Capillariasis
penetrating tissues.
• Esophagus • Disease was first discovered in 1962, in the
• Midgut – absorbs digested food stuffs province of Ilocos Sur and caused an
• Rectum-situated behind the midgut epidemic in 1967-1970
• All nematodes are diecious • There were 1877 cases and 115 deaths
• Caused an outbreak in 1998 in an endemic
area Compostela Valley Province
• Zamboanga del Norte is also an endemic
area
• Also seen in Thailand, Taiwan, Japan,
Korea, Egypt, Iran, Colombia

MORPHOLOGY

• Adult worms are slender and are present in

enormous numbers
LIFE CYCLE OF NEMATODES • Overwhelming infections result in
EggàL1àL2àL3àL4àsexually mature adult worm autoinfection
• Habitat: jejunum
 • Size of adults: 4-5 mm long
• Male spicule has an unspined sheath
• The esophagus has a row of secretory cells
called stichocytes
• Entire esophagus is called stichosome
• Has a subterminal anus
• Vulva of females is located at the junction of
anterior and middle thirds of the adult worm
nd
• Adult females are oviparous (2 generation
st
females) and larviparous (1 generation
females)
• Size of eggs: 45 X 21 µm
• Egg described as peanut-shaped with a
striated shell with flattened bipolar plugs
• Definitive host: humans
• Intermediate host: fish
• Reservoir host: fish-eating birds
• Eggs are ingested by fresh water and
brackish-water fish thereby causing a
zoonotic infection
• Mode of transmission: eating of raw fresh
water fish with larvae
• Larval stages can be found in intestines of
fish
LIFE CYCLE
Humans acquire the infection via ingestion
of raw or undercooked fish with the infective stage
larve. Larvae matures in the small intestine and
develop into adults. Adult male and female worms
st
copulate. The 1 generation adult female oviposits
larvae in the small intestine, which may cause
autoinfection. The larvae will moult and further
develop until it reaches sexually maturity. After
nd
fertilization by the adult male worm, the 2
generation adult female oviposits unembryonated
eggs which may embryonate inside the host and
cause autoinfections. But usually, unembryonated
eggs pass out of the host thru the feces. When feces
reaches water, the eggs embryonate and small fish
ingest the eggs. The eggs hatch in the intestine of
the fish releasing the larvae. It invades the
mesenteric tissue of the fish and after a few weeks
of development the larvae becomes infective.
Humans become infected by eating raw or
undercooked fish with the infective stage larvae.
• Infective stage to fish: embryonated egg
• Infective stage to man: L3 larvae
DIAGNOSIS
• Identification of adults, eggs, or larvae in
feces or by intestinal biopsy, duodenal
aspiration
SYMPTOMS
Characteristic Clinical picture of Human Intestinal
Capillariasis:
• Abdominal pain, borborygmus (gurgling
stomach), diarrhea, anorexia, nausea,
vomiting, hypotension, hypoproteinemia,
hypokalemia
• Visible peristaltic waves may be seen over
the distended abdomen
• Death may occur as a result of heart failure,
low electrolytes, or secondary bacterial
infections.
TREATMENT
• Mebendazole – drug of choice
• Fluid and electrolyte replacement, high-
protein diet
OTHER SPECIES:
• Capillaria hepatica – hepatic capillariasis
• Capillaria aerophilia – pulmonary
capillariasis
----------------------------------------------------------------------
2. Trichuris trichiura
• Common name: Whipworm
• Worldwide in distribution but more common
in the tropics where sanitation is poor
MORPHOLOGY
• Adult has a thick posterior part and long thin
anterior portion resembling a whip
• Adult worms are 3-5 cm long, females are
larger than males.
• The thin anterior portion is 3/5 of the body
and it contains the esophagus, the
expanded posterior contains the intestine
and reproductive organs
• Mode of transmission: ingestion of fully
embryonated eggs from contaminated food
and water
• Eggs are passed unsegmented. It requires
10 days or more to reach the infective stage
(fully embryonated egg). The shell is
digested in the small intestine where the
larvae lodge temporarily. After a period of
growth, larvae pass to the cecal area where
they attach permanently to the mucosa with
their anterior ends
• Egg: barrel-shaped
ü 50-54 µm in length
ü With “bipolar plugs” or refractile
prominences at both ends
• Female worm produces 3000-7000 eggs
daily
LIFE CYCLE
• Ingestion of embryonated egg à egg
hatches in the small intestine and burrows
into the villi for a few daysà goes to its final
habitat in the cecum and develops to
maturityà adults reproduce and females
oviposit eggs in the cecumà
unembryonated eggs are passed out in the
feces à eggs embryonate in the soil under
favorable conditions which takes place in
about 2-3 wks à fully embryonated egg is
ingested by humans
DIAGNOSIS 3 PHASES OF TRICHINOSIS:
• Demonstration of eggs in the feces via DFS, 1. Enteric phase- incubation and intestinal
Kato Techniques, and concentration invasion
techniques 2. Invasion phase – larval migration and
muscle invasion
• Use concentration technique like Zinc
3. Convalescent phase – encystment and
Sulfate Flotation Method encapsulation

SYMPTOMS CLINICAL MANIFESTATION

• Abdominal pain, distention, bloody or • During muscular invasion, there is fever,
mucoid diarrhea, anemia, tenesmus, weight eosinophilia, increased IgE. Myositis,
loss, weakness circumorbital edema, photophobia, muscle
pain, splinter hemorrhages due to vasculitis
• Rectal prolapse is seen in heavy infections
• CNS involvement: acute psychosis.
• Worms may be seen in the prolapsed, Meningoencephalitits
edematous rectum
• Trichuriasis mimics inflammatory bowel DIAGNOSIS
disease • Biopsy of skeletal muscle reveals encysted
larvae
TREATMENT • Serology: Polymerase Chain Reaction,
Indirect Immunofluorescence, Western blot
• Albendazole, Mebendazole, Loperamide
assay
hydrochloride helps by increasing contact
• Elevated enzymes: CK-MM, aldolase, LDH,
time between the drug and the parasite AST
----------------------------------------------------------------------
3. Trichinella spiralis TREATMENT
• Mebendazole, Albendazole
• A parasite of carnivorous & omnivorous
mammals PREVENTION
• Common in rats and swine eating uncooked • Pork must be heated to 58.3 ᵒC (some
pork books 70ᵒC)
• Disease: Trichinellosis/Trichinosis • Freezing pork for at least 20 days at -5ᵒC
• Stages: adults with well-developed kills the larvae
reproductive organs • Microwave cooking doesn’t kill the encysted
• Larvae don’t have fully developed larvae
reproductive organs
• Larvae encystment in muscles is prolonged
and produces serious symptoms
• Larvae are coiled spirally in the muscles and
can live for many years in an encapsulated,
calcified cyst
• Trichinella destroys striated muscles in
which it encysts

LIFE CYCLE
• Infection is acquired by eating raw or
undercooked pork with encysted larvaeà
larvae excysts after the cysts are digested
and penetrate into the intestinal mucosa à
develop into adults within 30-40 hours à
male and female worms mate à female
produce eggs in its uterusàa larvae grows
in the uterus within 3 days after fertilization
à female gives birth to larvae (viviparous)
and deposits larvae in the mucosa of the
intestine à larvae enter the lymphatic
vessels and bloodstream à larvae enter
striated muscles where they
encystàencysted larvae remains viable for
many years until they are ingested by
carnivores