Petrache, Joseph Dacanay, Gilian Medina, Julius Co, Kenneth Jr. Corcelles, Kevin

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Commonly known as Roundworms unsegmented terrestrial, freshwater, or marine worms almost worldwide in distribution abundant in the surface layers of soils (geohelminths) cylindrical, tapering animals with simple bodies

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They consist an interior gut and a muscular outer wall, separated by a fluid-filled cavity called a pseudocoel The outer wall secretes an elastic cuticle that is molted four times during the animal's lifetime Species range in size from microscopic to about 10 cm (about 4 in) long Most species have separate sexes (dioecious), but a few are hermaphroditic

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Classification NematodesA. Based on the presence of absence of caudal receptor.

Class Enoplea- with caudal receptor and with caudal glands. Class Rhabditea- with caudal receptor but without caudal glands

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Classification NematodesB. Based on Habitat Intestinal Nematodes Small intestine Large intestine Extra intestinal Nematodes Muscle Lymphatic tissue Brain

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ASCARIS LUMBRICOIDESy Common name: Giant intestinal roundworm y Disease: Human Ascariasis & Ascaris Pneumonitis y Infective stage: Larval Stage y Habitat: Small intestine

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y Adult

- largest and most common - 15-30 cm by 3 mm male - 20-40 cm by 5 mm female - cylindrical, elongated, tapering in the end - containing lateral lines seen as whitish streak along the entire length of the body - terminal mouth with trilobate lips with a small triangular buccal cavity7

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Ovay Fertilized ova y Broadly ovoid, golden brown in color y 45-75 by 35-45 micron with 3 thick transparent layersy y y

Vitelline membrane- inner non permeable Glycogen membrane- thick transparent middle layer Albuminous/ mammilary coat- outermost layer

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y Fertilized ova

y Decorticated fertilized

ova

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y Unfertilized ova y Larger, longer, elongated or sometimes irregular in shape y 88-94 microns y Two layersy y y

Glycogen membrane Albuminous layer * vitelline layer is absent

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y Unfertilzed Ova

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Life cycley Adult in small intestine y Eggs passes out in the feces y Embryonation in 1-2 weeks y Fully embryonayed eggs ingested by man y In the small intestine, larva penetrate the mucosa

and enters the blood circulation y Heart and lung migration, molt twice y Larvae ascend respiratory tree and swallowed, descend to the small intestine to mature

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Transmissiony ingestion of mature embryonated eggs

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Pathologyy Abdominal Pain y Diarrhea y Nausea y Loss of Appetite y Due to eratic migration might lead to regurgitation

and escape through the nostril y Vomited ascaris may pass the larynx and might lead to suffocation or reach the lung producing gangrene16

y Might enter the eustachian tube and provole otitis

media y May invade bile duct, gall bladder, appendix y May cause hemorrhagic pancreatitis y Migration to the peritoneal cavity leads to peritonitis y May rarely produced toxic manifestation such as edema and urticaria accompanied by loss of appetite and weight17

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Diagnosisy Direct fecal smear y Kato-thick y Kato- katz y Concentration technique

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Treatmenty Piperazine citrate y Pyrantel pamoate y Mebendazole y Albendazoley *piperazine and pyrantel pamoate with

neuromuscular blocking effect that paralyses the parasites.

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Prevention and controly Treatment of infected individual y Sanitary waste disposal y Hand washing before meals y Proper personal hygiene y Thorough washing and cooking of food y Avoid using human excreta as fertilizer

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TRICHURIS TRICHURAy Common name: Whipworm y Disease: Trichuriasis y Infective Stage: Embryonated Stage y Habitat: Large Intestine y Adults y Attached to the wall of the caecum y Whiplike and posterior end is more robust y Female- 3.5- 5 cm y Male- 3-4.5 cm and coiled posterior end23

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Ovay Unsegmented, barrel shaped, lemon, football shaped

ova or japanese lantern egg y Bi-polar plugs y With 3 layers y Embryonation takes place in the soil where the first stage larvae is formed within 3 weeks

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Life cycley Adult worms attached to the wall of the caecum y Eggs passes out of the feces y Embryonate in 2-3 weeks y Embryonated eggs ingested by man y Larvae hatch in the intestine

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Transmissiony ingestion of mature embryonated eggs

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Pathologyy Small streaked diarrheic stool y Abdominal pain and tenderness y Nausea and vomiting y Hypochromic anemia y Weight loss y Rectal prolapse

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Diagnosisy Direct fecal smear analysis y Kato-thick or kato Katz y Concentration technique

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Treatmenty Albendazole y Mebendazole y Pyrantel pamoate

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Prevention and controly Treatment of infected individual y Sanitary waste disposal y Hand washing before meals y Proper personal hygiene y Thorough washing and cooking of food y Avoid using human excreta as fertilizer

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Hookwormsy Necator americanus- New World Hookworm y Ancylostoma duodenale- old world hookworm y Ancylostoma braziliense- cat hookworm y Ancylostoma caninum- dog hookworm

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Necator americanusy S-shaped y Buccal capsule is provided with semilunar cutting

plate y With amphidial gland that secretes anticoagulant y No teeth

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Necator americanus

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Ancylostoma duodenaley Stout, body contour into letter c y 2 pairs of ventral teeth y With copulatory bursa characterized as bristle like

with tridigitate dorsal ray

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Ancylostoma duodenale

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Ancylostoma brazilienzey With a pair of teeth and a pair o f inconspicuous

median teeth in the buccal capsule y Broad and long copulatory bursa with short lateral rays

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Ancylostoma caninumy With 3 pair of ventral teeth y Secretes anticoagulant that delays the coagulation of

blood.

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Ancylostoma caninum

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Life cycley Adults in the small intestine y Ova in feces y Rhabditiform larvae 1-2 days y Filariform 5-8 days y Filariform penetrate the skin y Enters the circulation y Lungs y Trachea y Swallowed y Esophagus43

Transmissiony Direct contact with the soil y Walking barefoot on your lawn

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Pathologyy Ground itch- pruritus, secondary bacterial

infection y Pulmonary lesion- Wakana disease y Creeping eruption- dermatitis characterized by intracutaneous lesion y Hookwrom anemia- microcytic hypochronic y Hypoalbuminemia- low level of albumin due to combined loss of blood, lymph and protein45

Diagnosisy Direct fecal smear y Harada-mori

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Treatmenty Mebendazole y Albendazole y Thiabendazole

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Enterobius vermicularisy y y y y

Common name: Pinworm or seatworm Disease: Enterobiasis or oxyuriasis Infective stage: Embryonated stage Habitat: Large intestine Adultsy Small whitish or brown in color y Male- 2-5 mm coiled tail end y Female- 8-13mm pointed tail end y Diagnostic in the presence of cephalic alae and distinct

or prominent esophageal bulb.48

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Ovay Elongated y 50-80 by 20-30 microns y Flattened lateral side, lopsided D y Two egg-shell layery Albuminous layer- outer y Embryonic or lipoidal membrane- inner y Embryonated when laid y Resistant to disinfectant y Under favorable condition, it remains viable for 13 days52

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Life cycley Adults in the caecum y Gravid females migrate to the perianal area to

deposit embryonayed egg y Ova are infective to man 6hrs after deposition y Ova are ingest of inhaled by man y Larvae hatch in the duodenum y Migrate to its final habitat in the large intestine

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Transmissiony ingestion of infectious eggs y direct anus-to-mouth transfer by fingers y touching contaminated surfaces such as clothing, bed

linen, and bathroom fixtures followed by ingestion y even through inhalation

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Pathologyy Poor appetite y Insomia y Weight loss y Irritability y Grinding of teeth y Nausea y Vomiting y Pruritus ani

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Transmissiony Hand to mouth y Inhalation y autoinfection

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Diagnosisy Scotch tape swab

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Treatmenty Albendazole y Mebendazole y Pyrantel pamoate

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Trichinella spiralisy y y y y

Common name: Trichina worm Disease: Trichinosis Infective Stage: Larvae Stage Habitat: Muscle Tissue Adulty y y y

Minute Male-1.5 by 0.04 mm with single testis near the posterior end Female- 3.6 by 0.06 mm with single ovary The female is viviparous or larviparous capable of producing 1,500 larvae60

y Larvae y 80-120 micron by 5.6 microns at birth y 900-1300 micron by 35-40 microns y Spear like burrowing anterior

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Life cycley Encysted larvae in pig muscle y Ingestion of improperly cooked pork y Infected flesh is digested by gastric juice y Adults in the duodenum y Larviparous female burrows into mucosa and deposit larvae y Larvae enters the circulation y Encyst in striated muscle y Dead end cycle

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Transmissiony Eating improper cooked meats products

that contain infective juvenile

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Pathologyy Incubation and intestinal invasion

abdominal cramps, nausea y Larval migration muscle invasion y Fever, facial edema, urticaria, pain and swelling weakness y Splenomegaly, gastric and intestinal hemorrhages y Encysment and encapsulation y Fever, weak, pain64

y Includes diarrhrea, constipation, vomiting

Diagnosisy Muscle biopsy y Serological- ELISA

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Treatmenty Thiabendazole during the first week y Mebedazole larvicidal

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Prevention and controly Cook meat 77 C 177 F y Freezing- - 15C for 20 days or -30 C for 6 days y Smoking, salting, or drying is not effective

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Strongyloides stercoralisy Common name: Threadworm y Disease: Cochin-china diarrhea y Infective stage: Filariform y Habitat: Small intestine y Capable of both free living and parasitic y 2-7 mm and 30-40um in width y Colorless, semitransparent nematode

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Larvaey Rhabditiform- short buccal cavity, elongated

esophagus with pyriform posterior bulb and conspicuous genital primodium y Filariform- long delicate larvae with long esophagus and forked or notched tail

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Life cycley y y y y y y y y y

Small intestine Ova in feces Rhabditiform Filariform ---- host Skin Circulation Heart Lungs Trachea esophagus72

Preventiony Proper waste disposal y Personal hygiene y Avoid being barefooted on suspected infected area y medication

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Treatmenty Mebendazole y Albendazole y thiabendazole

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Precautiony Administration of ORS to prevent dehydration and

loss of electrolytes

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Capillaria Philippinensis Common name: Pudoc worm Disease: Capillariasis, and Borborygamy Infectve Stage: Larvae Stage Habitat: Small Intestine Intermediate host : Hipon or bagsang Endemic in Pudoc. Tagudin, Ilocos Sur, Bangar, La

Union

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Capillaria Philippinensis

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Pathology Borborygmy abdominal pain Diarrhea Anorexia nausea and vomiting Hypotension Cachexia death due to cardiac failure78

Diagnosis Stool exam (ova)

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Treatmenty Mebendazole

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Filarial wormsy Arthropod transmitted y Invades circulatory system, muscle, serous cavities,

lymphatic system y 2-50cm with inconspicuous buccal cavity y Males with two copulatory spicule y Viviparous females gives birth to prelarval microfilaria y Microfilaria is motile , snakelike with dark staining nuclei occupying most of the entire body y Sheathed ( with embryonic sheath ) y Unsheated ( with no embryonic sheath )

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Periodicityy Nocturnal y Diurnal y Subperiodic y Subperiodic diurnal y Subperiodic nocturnal

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Wuchereria Bancroftiy Common name: Bancroft s filarial worm y Disease: elephantiasis y Habitat: Lower lymphatics y Males- 2-4 cm y Females- 8-10 cm y Microfilaria is nocturnal with curvatures and

graceful appearance, tapering tail with no terminal nuclei83

Microfilaria ( wuchereria bancrofti )

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Pathologyy Tropical pumonary eosinophilia y Granuloma of the spleen y In the lymph nodes they promote pseudotubercular

granulomatous reactions, leads to edema, vascular and lymphatic hyperplasia, fibrosis and caesation y Elephantiasis- scrotum, vulva, enlargement of the genitals and lower lymphatics

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Diagnosis and treatmenty Blood smear ( check periodicity ) y Treatmenty DEC- Diethylcarbamazine

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Vectorsy Aedes Poecilius

y Anophelles Minimus

Flavirostris

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Brugia malayiy Common name: Malayan filarial worm y Disease: Malayan filariasis y Habitat: Upper Lymphatics y Male- 13-23 mm y Female- 43-55 mm y With two distinct or discrete nuclei at the tip of the

tail

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VectorMansonia Uniformis

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Treatmenty DEC

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Loa Loay Common name: African Eye worm y Disease: Calabar swelling y Habitat: Subcutaneous tissue y Sheathed microfilaria y Subcutaneous tissue ( Habitat )

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VectorChrysops

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Diseasey Calabar swelling y Conjunctiva granuloma y Bug eye- painless edema of the eyelids y Protopsis- bug eye

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Calabar swelling

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Treatment and controly Protection from the bite of the vectors y Control of the vector y Chemotherapy with diethylcarbamazine

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Onchocerca volvulusy Common name: Convoluted filaria y Disease: River blindness y Habitat: Subcutaneous tissue y Nodules in the subcutaneous tissue y Males- 19-42 mm y Females- 33.5-50mm y Vector: simulium

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Pathologyy Fever y Eosinophilia y Urticaria y Blindness y Pruritus y Hyperkeratosis y Hanging groin

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Diagnosis and treatmenty Skin snip of the subcutaneous nodules y Not found on the blood but can be found on the urine y Surgical removal of the nodule y DEC followed by suramin y Mebendazole as an alternate drug of choice

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Toxocara canis and Catiy Dog and cat ascaris y Normal habitat- cats and dogs, human accidental host y Visceral larval migrans y Life cycle- same as humans

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Toxocara cati

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Pathologyy Visceral larval migration y Hemorrhage y Necrosis and granuloma y Eosinophilia y Liver damage y Pulmonary inflammation y Ocular problems

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Diagnosis and Treatmenty Marked eosinophilia y Hepatomegaly y Hyperglobulinemia y Direct fecal smear y Txy Thiabendazole

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Prevention and controly Avoid contact with infected animals y Animal under 6 mos. Should be dewormed with

piperazine y Proper waste disposal of animal droppings

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Other nematodesy Angiostrongylus cantonensis y Common name: Rat lungworm y Pila, planaria, fresh water prawns are intermediate host y Infection to rats involves lungs for development y In humans stays in the brain

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Pila Africana

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Planaria

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Dracunculus medinensisy Guinea worm, dragon worm, fiery serpent worm of the

israelites y Inhabits the tissue y Female 70-120cm

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Life cycley Adults in the cutaneous tissue y Larva escapes from skin blister 1st stage y Free swimming ( rhabditiform ) y Ingested by cyclops, copepods y Body cavity of cyclops or copepods y Infective stage ( filariform ) y Ingested by man y Adults in the tissue

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Diagnosisy includes flooding of the ulceration on the skin

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Treatmenty Niridazole y Metronidazole y Thiabendazole

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