Parasitology

Nahda University, Faculty of Pharmacy

Microbiology & Immunology Department

Lecture 6 Class: Nematoda

 General Characteristics of
Nematodes
Nematodes are elongated, cylindrical, unsegmented worms that
range in size from less than 1 mm (male Strongyloides stercoralis;
thread worm) to about a meter (female Dracunculus medinensis).

They are unisexual; males are usually smaller than females.

Body has rounded anterior end and tapered to a pointed

posterior end, which is straight in female and curved ventrally
in male, pointed or expanded in the form of a bursa.

They don’t need IH.

They posses a body cavity (pseudocoelom) within which
complete digestive system (mouth, oesophagus, midgut, and
rectum or anus) and reproductive organs float in the body fluid
(haemolymph).

The oral opening is surrounded by lips, papilla or may be

provided with teeth or cutting plates.

Oesophagus may be muscular (Club-shaped, double bulbed,

rhabditidform, cylindrical) or cellular.
 Life Cycle:

It may be completed in one host (direct) or in more than one

host (indirect).
The egg, larva and adult worms are the important morphological
forms seen during development. There are 4 larval stages; the 1st
and the 2nd have rhabditiform oesophagus i.e. rhabditiform larvae,
the 3rd and the 4th have filariform oesophagus i.e. filariform larvae.

According to the final habitat of the adult worm, Nematodes are

classified into Intestinal and Tissue nematodes:
 I. Intestinal Nematodes II. Tissue Nematodes
most adult worms live in the •inhabit either lymph vessels; or
intestinal tract and their diseases skin and subcutaneous tissues.
are diagnosed by identifying their
•diseases are diagnosed by
characteristic eggs in stool
demonstrating microfilariae in
Parasite Habitat
(intestine) blood, tissue or tissue fluids
Ascaris lumbricoides Small Adult in Larva in tissues
Ancylostoma duodenale Small
tissues
• Filaria. •Visceral larva migrans.
Necator americanus Small
• Dracanculus •Cutaneous larva migrans.
Trichinella spiralis Small
medinensis. •Trichinella larva in
Enetrobius vermicularis Large
muscles.
Trichocephalus trichiurus Large
 I. Intestinal Nematodes
1. Ascaris lumbricoides (Giant intestinal roundworm)
Distribution: Worldwide, where human feces are used as
fertilizer.

DH: Man.

Habitat: Small intestine free in the lumen, may be found in lung.

Morphology: Cylindrical, pinkish with small mouth surrounded

by three lips. The oesophagus is muscular and club shaped.

– Male: 15-25 cm, Female: 20-35 cm, (lays around 200000

egg/day).
 Life cycle

Infective stage: Embryonated egg with 2nd larva (rhabditiform).

Mode of infection: Ingestion of infective egg.
 Pathogenesis and Clinical Manifestations (Ascariasis):
1. Migratory (pulmonary): due to migration of the larvae in the
lung with release of antigens leading to allergic manifestations
(urticarial and itching), 4-16 days post infection. Fever, cough
(hemoptysis), dyspnea, and asthma symptoms and eosinophilia.

2. Intestinal (heavy infection): Colic (small number), Allergic

manifestation (irritation and toxic secretion of adult worm),
diarrhea, loss of weight, hunger and epigastric pain.
3. Complication: Larval ascariasis, due to migration of larvae to
the left side of the circulation, Obstructive jaundice, Intestinal
obstruction, Liver abscess, Pancreatitis, Appendicitis,
Peritonitis.

Treatment:
Anthelminthic medications such as Albendazole, Mebendazole and
Pyrantel pamoate.
 2. Enterobius vermicularis
(Pinworm, Oxyuris, Seat worm)
Distribution: Worldwide, commonest nematode affecting man.

Habitat: Large intestine caecum, appendix, adjacent part of

ileum and ascending colon. Free in the lumen or loosely
attached to the mucosa.

DH: Man especially children.

Morphology:
–Male: 2-5 mm, Female: 8-13 mm, posterior 1/3 tapering with
pointed tail hence the name pinworm.
Life cycle
 Infective stage: Embryonated egg.

Mode of infection:

1. Ingestion of eggs lodged on contaminated fingers scratching

the perianus, of the infected persons (autoinfection).

2. Ingestion of eggs with contaminated foods or drinks.

3. Inhalation of eggs liberated into the air from contaminated

sheets, clothing, etc.

4. Re-entrance of larvae that sometimes hatch from eggs on the

perianal skin to the large intestine (retro-infection).
 Pathogenesis and Clinical
Manifestations: Enterobiasis (oxyuriasis)

Perianal itching, especially at night, may cause nervous

irritability, insomnia, restlessness, appendicitis (if worms
present in appendix) and abdominal pain.

In female patients the worms may reach:

• invasion of girls’ genital tract cause vaginitis with mucoid

discharge and night enuresis.

• The bladder causing urethritis and cystitis.

• The Fallopian tube causing salpingitis.

 Treatment:
Mebendazole, Pyrantel pamoate, White mercury ointment should
be applied around anus at night to kill the ovi-positing females
and relief itching. This should be given to all members of the
family of infected patient.
 Enterobius vermicularis Ascaris lumbricoides
Name Pinworm, seat worm Ascariasis, round worm

Size Female 8-13 , male 2-5 mm Female 20-35, male 15-25 cm

Disease Enterobiasis (oxyuriasis) Ascariasis
Geo. Distr. Worldwide Worldwide
Inf. stage Embryonated egg Embryonated egg
Mode of Ingestion; or autoinfection via Ingestion of eggs in food
infection nails scratching the perianus contaminated with human feces
Infection site Large intestine Small intestine, lung
Symptoms Perianal Pruritis, especially at Migrating worms cause occlusion of
night, appendicitis, abdominal biliary tract or oral expulsion in lung
pain, *invasion of girls’ genital it causes inflammation with
tract cause vaginitis, pelvic or pulmonary symptoms, e.g. cough,
peritoneal granulomas hemoptysis
Identification Characteristic eggs collected Characteristic eggs in feces, larvae
mornings from perianal area identified in sputum or gastric
aspirate adult may pass in stool.
Treatment Mebendazole, Pyrantel pamoate Albendazole, Mebendazole, Pyrantel
pamoate