PARASITOLOGI

dr. Adi Arianto, M. Biomed

HELMINTHOLOGY

1. Nematodes
 Nematodes
(roundworms)

General Morphology & Classification

Morphology
Cylindrical, elongated
Unsegmented
No appendages
Taper at both ends
Bilaterally symmetrical
Various size
Body covered with
cuticle
Pronounced sexual
dimorphisms

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Classification
Due to:
 Host preferences

 Habitat in host (human)

 Mode of infection
 Egg or larval production

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Classification
Host preferences
 Human nematodes: infect human in
adult form

 Zoonotic nematodes: final host is

animals, but can infect human in larval
form:
 Toxocara sp.
 Zoonotic hookworms
 Gnathostoma spinigerum
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 Classification
Habitat in host (human)

Somatic
Intestine

Subcutaneous
Lymphatic
Loa loa
Small Large
O.volvulus
intestine intestine W. bancrofti D. medinensis
B. malayi
A. lumbricoides E. vermicularis B. timori
Hookworms Trichuris trichiura
S. stercoralis conjunctiva body cavity
T. spiralis
Loa loa
Capillaria sp.
Mansonella sp.
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Classification
Route of infection
 Ingestion:
 Soil transmitted helminths: A. lumbricoides, Toxocara sp.,

Trichuris trichiura, A. duodenale

 Enterobius vermicularis

 With intermediate host: Trichinella spiralis, Gnathostoma

spinigerum
 Skin penetration:
 STH: Ancylostomatidae, S. stercoralis

 Arthropod-borne:
 Filaria

 Dracunculus medinensis

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Soil Transmitted Helminths

Ascaris lumbricoides
Toxocara sp. (zoonotic)
Ancylostomatidae (hookworm)
Strongyloides stercoralis
Trichuris trichiura
Ascaris lumbricoides
Roundworm

Life cycle

 Infective stage:
embryonated eggs
 Route of infection:
ingestion
 Diagnostic stage: eggs
in feces

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Ascaris lumbricoides
Adults

 Habitat: human’s small

intestine
 Female: 20-30 cm, linear tail
end
 Male 15-25cm, hooked tail
end (consists of spicule
protrudes out of cloaca)
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Ascaris lumbricoides
Adults

 Mouth consists of three lips:

 2 ventrolateral lips
 2 dorsolateral lips

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Ascaris lumbricoides
Eggs

 Measurements: 60-80 x 40-50 μm, ovoid shape

 Found in human feces or contaminated soil
 Mature in soil → embryonated
 Egg types, based on:
1. The presence of albumin layer (corticated/decorticated)
2. Contents:
a. Granules (unfertilized), usually more elongated shape egg
b. Egg cells (fertilized)

c. Larva (embryonated/infective stage)

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Ascaris lumbricoides
Eggs

Corticated fertilized egg:

1. Albumin layer
present
2. Contains egg cells

Decorticated fertilized
egg:
1. Albumin layer
absent
2. Contains egg cells

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Ascaris lumbricoides
Eggs

Corticated unfertilized
egg:
1. Albumin layer
present
2. Contains granules

Decorticated unfertilized
egg:
1. Albumin layer
absent
2. Contains granules

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Ascaris lumbricoides
Eggs

Corticated embryonated
egg:
1. Albumin layer
present
2. Contains larva

Corticated embryonated
egg:
1. Albumin layer
present
2. Contains larva

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Ascaris lumbricoides
Infection

 Called ascariasis
 Diagnosis is based on stool
examination:
 Eggs found microscopically
 Adults from stool
 Microscopic examination
method:
 Kato method
 Lugol
 Eosin
 NaCl

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Toxocara sp.
Dog & cat roundworms

Life cycle

 Infective stage:
embryonated eggs
 Route of infection:
ingestion

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Toxocara sp.
Adults
 Habitat: pet’s small intestine:
 T. canis: dog
 T. cati: cat
 Resembles A. lumbricoides,
only smaller
 Cervical alae; T. cati’s is
broader
 Female: 8-13 cm, linear tail
end
 Male 5-8cm, hooked tail end
(consists of spicule protrudes
out of cloaca)

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Toxocara sp.
Eggs

 Found in host’s stool or

contaminated soil
 Resembles eggs of A.
lumbricoides, only more
spherical (rounded)
 Albumin coat is better Decorticated
arranged (chain-like) embryonated egg:
1. Albumin layer absent
2. Contains larva

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Ancylostomatidae
Hookworm
Life cycle

 Infective stage:
filariform larvae
 Route of infection:
skin penetration
 Diagnostic stage: eggs
in feces

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Life cycle of
hookworms

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Ancylostomatidae
Ancylostoma duodenale

 Adult: C-like
appearance in alcohol
70%
 Female: 10-13 mm,
tappered end
 Male: 8-11 mm,
copulatory bursa at
tail end
 Mouth: 2 pairs of
tooth

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Ancylostomatidae
Necator americanus

 Adult: S-like
appearance in alcohol
70%
 Female: 10-13 mm,
tappered end
 Male: 8-11 mm,
copulatory bursa at
tail end
 Mouth: 1 pairs of
cutting plates (chitin)

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Ancylostomatidae
Eggs
 Found in stool
 60 x 40 μm
 Transparent and
thin shelled
 Content:
developed egg
cells

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Ancylostomatidae
Larvae

Filariform larva:
• Found in
contaminated soil
• Sheathed
• Longer and
slender, 0.7 mm
long
• Tappered end
• N. americanus: oral
cavity seen as
mouth spear
• A. duodenale:
mouth spear
absent

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Ancylostomatidae
Infection

 Called ancylostomiasis
 Diagnosis is based on stool
examination:
 Eggs found microscopically
 Culture to get filariform
larvae
 Culture method:
 Harada-Mori
(modification)
 Sand and charcoal

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Ancylostomatidae
Zoonotic hookworms

 Other species of hookworm:

 Ancylostoma caninum
 Ancylostoma braziliense
 Ancylostoma ceylanicum
 Different in number and measure
of teeth
 Habitat: small intestine of dog
and cat
 In human: only larva migrates
cutaneosly (cutaneous larva 3 pairs of tooth of Ancylostoma
migrans) caninum

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Trichuris trichiura
Whipworm

Life cycle

 Infective stage:
embryonated eggs
 Route of infection:
ingestion
 Diagnostic stage: eggs
in feces

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Trichuris trichiura
Adults

Adult: whip-like
appearance, thin
anterior, thick
posterior
Female: 4-5 cm,
linear tail end
Male: 3-4 cm,
curled tail end

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Trichuris trichiura
Adults

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Trichuris trichiura
Eggs

 50 x 20-30 μm
 Barrel shaped egg, pores at
both ends
 Content: developed egg cells
or larva (infective stage)

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Other intestinal nematodes

Enterobius vermicularis
Trichinella spiralis
Enterobius vermicularis
Pinworm

Life cycle

 Infective stage:
embryonated eggs
 Route of infection:
ingestion
 Diagnostic stage: eggs
and females in
perianal (anal swab)

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Enterobius vermicularis
Adults

Cephalic alae1
Female: 8-13 mm,
pointed tail end2,
abdomen is occupied
by uterus filled with
eggs
Male: 2-5 mm, curled
2
tail end

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Enterobius vermicularis
Adults
1

Cephalic alae1
Bulb oesophagus2

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Enterobius vermicularis
Eggs

 Asymmetrical, 50 x 20 μm
 Transparent eggshell
 Content: larva
 Obtained from anal swab, along
with the female worms

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Trichinella spiralis

Life cycle

 Infective stage:
encysted larvae in the
meat (usually pork)
 Route of infection:
ingestion
 Diagnostic stage:
encysted lavae in
muscle

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Trichinella spiralis
Larvae

 Encapsulated within striated

muscle
 Obtained from muscle biopsy

Hemma Yulfi 40
TERIMA KASIH

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