Helminthes (Nematodes)

Introduction
General
characteristics
Cylindrical with
Complete digestive tract which started with mouth, esophagus, intestine
& end in sub terminal anus. They have no circulatory system & nutrients
are transported through body via fluid in body cavity (pseudocelom).The
nematode has no respiratory system. They are varying in size, separated
sexes (diecious), female are longer than male.

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Helminthes (Nematodes): intestinal nematodes

Ascaris lumbricoides

Ascariasis (giant roundworm)

Ascaris lumbricoides is the most prevalent of all human roundworms and occurs
endemically in all parts of the world except in cold, dry climates.
(fecal_ soil_ oral transmission)
Morphology
.
The mature male worm measures 12-31 cm in length.
Its posterior end is curved ventrally.
The female measures 20-35cm in length but in certain cases, up to 45 cm may be
observed.

Egg morphology (Fig 1 &Fig 2)

(Figure 1) at the time of oviposition is spherical, and consists of
The following:
1) a coarsely granular , spherical ovum that usually doesn’t completely fill the shell
2) An outermost, coarsely mammillated, albuminoid layer laid down in utero serving
as a protective membrane.

Figure 1 fertilized egg Figure 2 unfertilized egg

Disorganized granules and globules that completely fill the shell (Figure 2).
Fertile eggs are passed in one cell stage. At 22 – 33C˚, development to the
infective stage larva usually occur s in 3-4 weeks. Eggs remain viable in soil for
more than a year. 2
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Life cycle (Figure 3)

Ingestion of emryonated eggs (stage larva) in food or water contaminated

With human feces, eggs hatch in the small intestine, larva migrate through

The gut wall into the blood stream and then to the lungs. On about the 9 th

Day of infection, they, pass up the bronchi and trachea and are swallowed.

Within small intestine, they become adults. They live in the lumen don’t

Attach to the wall, and derive their substance from ingested food.

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Pathogenesis and clinical features:

In the stage of larval migration, passage through the liver and lungs in the

initial infection provokes no remarkable pathologic changes unless

hundreds of larvae are migrating simultaneously.

1. Pneumonia associated with migration of larvae in the lungs (first stage at

time of infection).
2. Obstruction of the intestinal.
3.Migrating larvae may also be seen in the sputum. Pulmonary Ascariasis
appears to be most common and severe in endemic area and sometime
fatal, even in adults.

4. When adult worms present in the small intestine in small No., usually
cause no symptoms.
5. Intermittent colic, loss of appetite.

NOTE:

1- The survival time of mature A.lumbricoides in human intestine is short

and not exceeds a year.

2- Ascariasis is frequently associated with whipworm (Trichuris trichiura)

3- Infection as well as diseases due to other causes.

Diagnosis:

Once the worm in the intestine and eggs are passed by the mature worms,

1-the diagnosis can be made with ease by detecting eggs in the stool.

Sometime the patient sees adult worms in the stool.

2-Infective stages eggs remain viable for weeks, months, or even years.
3-Dirt eating is responsible for heavy infection in small children.
4- Hogs infected with Ascaris suum probably an occasional source of

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 intestinal Ascariasis in man and the larva make lung migration and
sometimes develop to adult stage in man.

5- Ascaris of human origin may develop to adult stage in pigs.

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