Professional Documents
Culture Documents
Extraintestinal Nematodes
Extraintestinal Nematodes
Extraintestinal Nematodes
spiralis
EXTRAINTESTINAL NEMATODES Treatment
Blood and Tissue Nematodes
Mebendazole–drug of choice
- 5mg/kg body wtdaily
Trichinella spiralis Albendazole
“Muscle worm” - 15mg/kg body wtper day in two
divided doses, for 10
Trichinella species: - 15 days
o Children >2 yrs old : 10 mg/kg body wt
1. Trichinella spiralis
most important cause of trichinellosisin humans A treatment cycle may be repeated 5 days after the
the species that is most adapted to domestic and initial cycle in cases of severe infection
wild pigs
Prevention and Control
2. Trichinella britovi o Health education
2nd most common species affecting humans o Meat cooked in at least 77OC
most widely distributed species among wild o Freezing to kill the larvae
animals in Asia, Europe, Northern Africa, o Storage of meat at –15OCfor 20 days or
Western Africa –30OCfor six days
o Meat inspection
3. Trichinella native o Keeping pigs in rat-free pens
infects primarily wild carnivores in the frigid zone o Proper disposal of suspected carcasses
of Asia, North America and North Eastern Europe
4. T. murrelli The Filariae
5. T. nelsoni
Filarial Nematodes
6. T. papuae
1. Subcutaneous
7. T. pseudospiralis
o Loa loa(African eye worm)
o Onchocerca volvulus
Trichinella spiralis: o Mansonella streptocerca
ADULT 2. Serous cavity
o Mansonella–serous cavity in abdomen
3. Lymphatic Filariasis
Males : 0.62 –1.58 mm x 0.025 –0.033 mm o Wuchereria bancrofti
•Single testis near the posterior end o Brugia malayi
o Brugia timori
Females: 1.26 –3.35 mm x 0.029 –0.038 mm
•Has a single ovary, oviduct, seminal receptacle, Filarial Parasites
coiled uterus, vagina, and vulva 1. Wuchereria bancrofti
creamy white, long, and filiform in shape
LARVA male: 20 –40 mm length
At birth : 80 –120 um x 5.6 um
After it enters the muscle fibers: 0.65 –1.45 mm x 0.026 – female: 80 –100 mm
0.040 mm 2. Brugia malayi
•Has a spear-like, burrowing anterior tip male: 13 –23 mm length
•The digestive tract of the a mature larvae encysted female: 43 –55 mm
in muscle fiber resembles that of the adult worm 1. Wuchereria bancrofti
•Reproductive organs are not yet developbut it is 270 –290 um
already possible to identify the sex of the parasite Sheathed (hyaline sheath is longer than
microfilaria itself)
Diagnosis:
Stained blood smear: the central axis
Muscle biopsy – definitive diagnosis shows dark-staining nuclei (important
Digestion of muscle with pepsin and HCl to identifying feature). The column of nuclei
determine the number of larvae per gram of is arranged in 2 or 3 rows and distinctly
muscle** conspicuous
Creatinine phosphokinase, LDH, myokinase Have several curvatures and a graceful
appearance
•Total IgE Minute snake-like organisms constantly
ELISA –recommended for diagnosis moving along the RBCs is a fresh blood
specimen
Latex agglutination –may be utilized for rapid (<1 hr) Filarial Parasites
confirmation 111 –230 um
Immunologic tests
Bentonite flocculation test (T. spiralis, E. granulosus) Stained blood smear: Sheathed
Intradermal test: Bachmann -have angular curvatures with secondary kinks
Xenodiagnosis tests - 2 nuclei at the tip of the tail (indistinct and
Uses lab animal (T. spiralis, T. cruzi) confluent), composed of 2 rows
OTHER SPECIES Stage 5
1. Dipetalomena perstans Swelling not reversible at night
•“Acanthocheilonemaperstans” Skin folds-Deep
•Habitat: body cavities Skin: Smooth or Irregular
•Vector: Culicoidesspp
Stage 6
•Specimen: blood
Swelling not reversible at night
•Microfilariae: Mossy lesions
•Unsheathed
Wart-like lesions on foot or top of the toes
•Nuclei up to the tip of the tail
•Non periodic Stage 7
Swelling not reversible at night
2. Mansonella ozzardi Skin folds-Deep
•Habitat: body cavities needs help for daily activities like walking,
•Vector: Culicoidesspp. bathing, using bathrooms, dependent on
•Specimen: blood family or health care systems
•Microfilaria:
•Unsheathed HYDROCELE OR CHYLOCELE FILARIA
Diagnosis:
•Tail is free of nuclei
- Wet smears or thick blood smears
•Non periodic taken between 8pm –4am
- Quantitative Buffy Coat
Filaria Pathogenesis - DEC provocative test (3 mg/kg DEC single
Lymphedema and elephantiasis dose)
most common chronic manifestation - Immunochromatographic Card Tests –
lower limbs commonly affected detects CFA
upper limbs and genitalia may be involved - Sensitive and specific
females: breast and genitalia - Molecular xenomonitoring of parasites in
pools of mosquitoes
Prevention
Stages of Chronic Lymphedema •Use of mosquito nets
•Insecticidal residual spraying
Stage 1 –swelling increases during the day but is •Development of Bacillus sphaericus sprays
reversible once the patient lies flat in bed and n-polysterene beads to seal latrines to
Stage 2 –swelling is no longer reversible overnight, eliminate or reduce Culex vectors
and the patient may experience acute attacks •Health education