PRELIM
INTRODUCTION TO PARASITOLOGY
////lHN Parasitology
● Study of paL.rasites
● is the area of biology concerned with the
phenomenon of dependence of one living
organism on another.
Medical Parasitology
● is concerned with the animal parasites of
humans and their medical significance, as
well as their importance in human
communities.
Tropical Medicine
● is a branch of medicine which deals with
tropical diseases and other special medical
problems of tropical regions.
• A tropical disease
● is an illness, which is indigenous to or
endemic in a tropical area. Many tropical
diseases are parasitic diseases.
Biological Relationships (Between
Species)
❖ SYMBIOSIS
● living together of unlike organisms
● It may also involve protection or other
advantages to one or both organisms.
● may be distinguished on the basis of
whether or not the association is
detrimental/beneficial to one of the two
organisms.
3 types of Symbiosis:
❖ Mutualism
● two organisms mutually benefit from
each other
● Ex.
- termites and the flagellates in their
digestive system, which synthesize
cellulase to aid in the breakdown of
ingested wood.
- Bees & flower: bees collect nectar
from flowers for food, while
inadvertently transferring pollen
between flowers, aiding in
pollination.
- Cleaner fish and larger fish:
Cleaner fish remove parasites and
dead skin from larger fish, benefiting
from a source of food, while the
larger fish benefit from being
cleaned.
❖ Commensalism
● symbiotic relationship in which two
species live together and one
species benefits from the
relationship without harming or
benefiting the other.
● Ex. Entamoeba coli in the intestinal
lumen are supplied with nourishment
and are protected from harm, while it
does not cause any damage to the
tissues of its host.
● Remora fish and sharks: Remora
fish attach themselves to sharks
using a suction cup-like structure,
benefiting from the protection and
access to leftover food scraps, while
the shark is unaffected.
● Parasitism
● one organism, the parasite, lives in
or on another, depending on the
latter for its survival and usually at
the expense of the host.
Ex. Entamoeba histolytica, which derives
nutrition from the human host and causes
amebic dysentery.
o Fleas and dogs: Fleas feed on the
blood of dogs, causing discomfort
and potential health issues for the
dog.
o Tapeworms and humans:
Tapeworms live in the intestines
of humans, absorbing nutrients
from the host and potentially
causing health problems.
PARASITISM
Parasite - organisms which lives in or on the body
of another organism for growth and survival.
Host – human being, plant or an animal that
harbors the parasite and is usually larger than the
parasite.
PARASITES
● Parasites are often described according to:
⮚ According to its habitat
⮚ According to its relationship with the
host
● ACCORDING TO ITS HABITAT:
● Ectoparasite - lives on the outside
of the host (hair, skin)
o (infestation) - the presence of
an ectoparasite on a host
caused by arthropods.
(Lice, mites, ticks)
● Endoparasite - lives within the body
of the host (organs, intestines)
o (infection) - the presence of
an endoparasite in a host.
● ACCORDING TO ITS RELATIONSHIP
WITH THE HOST:
● Obligate (dapat naa sila sa Host)
▪ when they take up a
permanent residence in and
are completely dependent
upon the host.
▪ They can’t complete their life-
cycle w/out suitable host.
▪ Ex.
(Ascaris lumbricoides)
- Giant Intestinal roundworm.
- through SOIL fecal-oral
transmission.
● Facultative
▪ they are capable of leading
both a free and a parasitic
existence even if they are
outside the body of the host.
▪ They don’t need to rely on
host to complete their life-
cycle
Ex. (S. stercoralis) or
Strongyloides stercoralis
● Intermittent
▪ visit the host only during
feeding time
▪ Ex. Mosquito (Aedes
Aegypti)
● Incidental
▪ establishes itself in a host in
which it does not ordinarily
live
▪ Ex. Hymenolepis diminuta
(rat tapeworm)
▪ Toxocara canis, -
roundworm typically found in
dogs, and as a result, they
may not be able to complete
their life cycle.
● Permanent
▪ remains on or in the body of
the host from early life until
maturity, sometimes for its
entire life cycle.
▪ Ex.
(Ascaris lumbricoides)
- Giant Intestinal roundworm.
- through SOIL fecal-oral
transmission.
● Pseudoparasite
▪ artifacts mistaken as
parasites (pollen, hairs)
▪ misidentified as parasites
due to their appearance or
presence in a host organism,
but they don't cause harm or
benefit from the host in the
way a true parasite does.
LIFE-CYCLE
1. Egg stage: The life cycle begins with the
parasite laying eggs.
2. Larval stage: The eggs hatch, and the larvae
emerge.
3. Development and growth: The larvae undergo
development and growth as they feed on nutrients
from the host or the environment.
4. Adult stage: After reaching a certain size and
maturity, the larvae develop into adults worm.
5. Reproduction: The adult parasites mate and
produce eggs or offspring within the host's body.
Classification of Hosts
(based on the roles of Hosts in the Parasite)
● DEFINITIVE HOST (final host)
● harbors the sexual or adult
stages/terminal/final stages of the
parasite(humans)
● Ex. Taenia spp to HUMANS
● Taenia saginata (beef tapeworm),
● T. solium (pork tapeworm), and
● T. asiatica (Asian tapeworm).
- These tapeworms have a complex
life cycle involving both animals and
humans.
● INTERMEDIATE HOST
● harbors the asexual stages or larval
stages of the parasite
● Ex.
▪ SNAILS (Schistosoma
japonicum) A.k.a “Flukes”
▪ PIGS (taenia solium)
● PARATENIC HOST
● a host which act as a transporting
agent for the parasite and in which
the parasite does not undergo any
development (prawns)
● Ex. Paragonimus metacercaria.
in raw WILD BOAR MEAT
● RESERVOIR
● a host in which the parasite is
maintained and act as a source of
infection for new cases
● They allow the parasite’s life cycle to
continue and become additional
sources of human infection.
● Ex.
 ● PIGS(Balantidium coli, taenia
solium),
● FIELD RATS of Paragonimus
westermani,
● CATS of Brugia malayi
● BATS of Ebola Virus
● cattle, rodents
● INCIDENTAL HOST: (Accidental)
● refers to a situation in which the
infected individual is not necessary
for the parasite survival or
development
● Ex. HUMANS
● (trichinosis) Trichinella spiralis by
consuming undercooked meat,
particularly pork, that contains the
larvae of the parasite.
● (Toxocariasis)Toxocara canis, -
roundworm typically found in dogs
HOSTS
- Classified according to the International
Code of Zoological Nomenclature
- Each parasite belongs to a
• Phylum
• Class
• Order
• Family
• Genus, and
• Species
- For SCIENTIFIC NAME (Genus &
Species)
● Nomenclature
⮚ At times, the further divisions of
Suborder, Superfamily, Subfamily, and
Subspecies are employed
● Family Name - "-idae"
● Superfamily - “-oidea"
● Subfamily - "-inae"
⮚ Names are BINOMIAL FOR SPECIES
(Genus, species) and
⮚ TRINOMIAL for subspecies (Genus,
species, subspecies)
Modes of Transmission
1. SOIL-TRANSMITTED
● undergo development in the soil to
reach the infective stage
ex.
● Ascaris lumbricoides
(GIANT INTESTINAL
ROUNDWORM)
● Trichuris trichiura
(WHIPWORM)
2. SNAIL-TRANSMITTED
● undergo further development in the
snail to reach their infective stage
ex:
Schistosoma japonicum
(BLOOD FLUKES)
3. ARTHROPOD TRANSMITTED
● undergo further development in insect
vectors to reach their infective stage
(stage of parasite that causes
disease/infection)
Ex: (mites, ticks, flies)
● Malaria – Anopheles mosquito
● Filariasis - mosquito
● Leishmaniasis - sandfly
● Trypanosomiasis
A. American - reduviid bug
B. African - tse-tse flies
4. FOOD-ANIMAL TRANSMITTED
● undergo further development in animals to
reach their infective stage.
ex.
● Taenia solium - pork tapeworm
● Taenia saginata – beef tapeworm
5. CONTACT TRANSMITTED
● parasite is really infective
● parasite does not have to go further
development
Ex:
● Trichomonas vaginalis
- through sex
● Enterobius vermicularis
-(a.k.a Seatworm/Pinworm or Kigwa)
-type of familial disease
6. ANIMAL-BORNE
● animal to human
● Zooanthroponosis - diseases that can be
transmitted from animals to humans
and then potentially spread between
humans.
7. AIRBORNE
Ex: Enterobius vermicularis
(Kigwa)
Ascaris lumbricoides
(Giant Intestinal
roundworm)
8. AUTOINFECTION
● infecting one's self
● process of infecting oneself with a
parasite or pathogen. This can happen
when the infectious agent completes its
life cycle within the same host, leading to
reinfection
● Ex.
1. Strongyloides stercoralis
2. Enterobius vermicularis
3. Taenia solium
Portals of Entry
1. Mouth (Oral Cavity)
A) Ingestion of:
● EMBRYONATED EGGS
- Ex: Ascaris lumbricoides
● CYSTS
- Ex: Entamoeba histolytica
B) Intimate Oral Contact:
● Trichomonas Tenax (oral sex)
● Entamoeba gingivalis (oral
contact)
2. Skin
 A) Active Skin Penetration (Wala ga slipper)
● filariform larvae - Ex: hookworm
● cercariae - Ex:
Schistosomes(parasitic flatworm)
The cercariae stage of the
schistosome lifecycle is
responsible for active skin
penetration.
3. Others
A) Sexual Contact
● Trichomonas vaginalis
B) Transplacental
● Toxoplasma gondii (host-CAT)
That’s why kung mahimo maglikay muna sa
cats while naga buntis ang mother.
C) Transmammary (mammary gland)
● Strongyloides stercoralis
● is the study of patterns, distribution, and
occurrence of a disease.
Epidemiologic Measures
1. INCIDENCE - is the number of new cases
of infection appearing in a population in a
given period of time.
2. PREVALENCE - is the number (usually
expressed in percentage) of individuals in a
population estimated to be infected with a
particular parasite species at a given time.
(total number of cases in a population at
a given time)
3. CUMULATIVE PREVALENCE - is the
percentage of individuals in a population
infected with at least one parasite.

D) Intranasal (enters the nose and can go 4. INTENSITY OF INFECTION

to the brain)
● Naegleria fowleri (free-living
amoeba commonly found in warm
freshwater environments such as
lakes, hot springs, and poorly
maintained swimming pools)
● Acanthamoeba culbertsoni
(known to enter the body through
the eyes, particularly in cases
where contact lenses are not
properly cleaned or disinfected.)
Portals of Exit
1. STOOL
● recovery of ova/Adult worm
● number of worms per infected
person
● this may be measured directly or
indirectly and is also called as the
worm burden.
5. MORBIDITY - clinical consequences of
infections or diseases that affect an
individual's well-being.
- state of being diseased or
experiencing illness or
injury.
6. MORTALITY - incidence of death in a given
population because of parasitic infection.

2. URINE Parasitic Infection and Disease

● Trichomonas vaginalis, (T. vaginalis)
● Scistosoma haematobium
(S. Haematobium) EPIDEMIOLOGIC TRIAD
The transmission of parasites involved 3
3. SPUTUM factors:
● Paragonimus westermani a) source of infection - AGENT
(LUNG FLUKE)
(parasites)
4. BLOOD b) mode of transmission -
● Microfilaria (microfilariae) ENVIRONMENT
● Gametocytes c) presence of susceptible host – HOST
5. TISSUE BIOPSY

A) Muscle

● Trichinella spiralis
(ENCYSTED LARVA)
Taenia solium – pork tapeworm
(CYSTICERCUS CELLULOSAE)
Diphyllobothrium latum
- fish Tapeworm (SPARGANUM)

B) Rectal Biopsy
● Amoebiasis (Entamoeba
histolytica)
● secondary Schistosoma infection
(Schistosoma spp.)

EPIDEMIOLOGY
A human being, when infected by a
parasite may serve as:
a) its ONLY HOST
- In some cases, humans can be the
only host for a particular parasite.
This means that the parasite
completes its entire life cycle
exclusively within the human body.
- An example of a parasite that may
have humans as its only host is the
human-specific tapeworm Taenia
solium, which can cause infections
when humans consume
undercooked pork contaminated with
its larvae.

b) its PRINCIPAL HOST with other:

● animals also infected
- An example of this is the malaria
parasite Plasmodium, where
humans are the principal host, but
mosquitoes serve as vectors,
transmitting the parasite between
humans.

c) its INCIDENTAL HOST with 1 or other:

● animals as principal host
o Toxocara canis, a roundworm
typically found in dogs. While dogs
are the principal host for Toxocara
canis, humans can become
incidental hosts if they accidentally
ingest the parasite's eggs through
contact with contaminated soil or
objects.

● Nematoda – Roundworm (like spaghetti)

● Cestoda – Tapeworm (tape-like/long)
● Trematoda – Flukes (leaf-like)

CHAIN OF INFECTION
1. Pathogen
2. Reservoir
3. Portal of exit
4. Transmission
5. Portal of entry
6. Establishment of infection in new host
Specimen Collection, Handling
and Transport
For suspected samples w/ parasite.
Patients w/ parasitic infections have signs and
symptoms that tend to overlap w/ the sign and
symptoms of those w/ infections caused by
bacteria, viruses and fungi.
Confirmed using accurate laboratory examinations.
SPECIMENS FOR PARASITIC EXAMINATIONS
• Stool (most commonly used sample)
o Eggs, Larvae, adult worm,
tropozoites, cysts.
• Other specimens/samples:
o Urine – schistosomes, Trichomonas
vaginalis
o Blood – Blood flukes, Plasmodium
falciparum, Plasmodium malariae,
etc.
o Sputum – Paragonimus westermani
o Cerebrospinal fluid – Naegleria
fowleri
o Tissue aspirate
o Tissue biopsies – Trichinella
spiralis, Taenia spp.
o Orifice swabs -
STOOL SAMPLE
Stool Collection
o stool may be passed directly into
clean dry paper carton, or a portion
may be transferred to a container
after px squats over a wax paper.
o Patients w/ diarrhea may also be
collected in clean bed pans.
• Clean, wide-mouthed containers
• Plastic
• With a tight-fitting lid – to ensure retention
of moisture, and avoid accidental spillage
when transporting the sample.
o Container should be placed in plastic
bag before transporting to lab.
Information Required (passed together w/
sample)
• Patient's name
• Age
• Sex
• Date/time of collection
• Requesting physician
• Requested procedure
• Presumptive diagnosis
• Prior infections Travel history
Important Factors to Consider
• INTAKE OF DRUGS/MEDICINAL
SUBSTANCES
o May leave crystalline
residues/medicinal
substances that may
interfere w/ identification.
o antacids, antidiarrheals,
barium, bismuth, laxatives,
etc. (THE SAMPLE
SHOULD BE TAKEN A
WEEK AFTER THE LAST
INTAKE)
• INTAKE OF ANTIBIOTICS
o Can kill microorganisms,
decrease protozoan or cysts.
o Should be taken after sample
is collected.
• AMOUNT OF STOOL:
o Routine stool exam:
▪ Thumb-sized/specimen of
formed stool or 2mg or about
5-6 tablespoons of watery
stool.
• Fecal specimens Should Not be collected
from the toilet bowl.
• No contamination of toilet water, urine or
soil, mineral or any castor oil, etc
• Age of stool sample:
o 30 minutes- 1 hour (ex.9am-10am)
o All fresh specimens of patients w/
diarrhea should be examined w/in
1 hour of passage as much as
possible.
o For LIQUID SPECIMEN (w/in 30
minutes) if not, we can use
preservatives to maintain the best
yield of parasites.
Storage of Stool Samples
• Preservations if there is delay
• Storage: Temporary (3-5 degrees
Celsius/Ref) – prolonged refrigeration can
cause dissication or tropozoites are
killed.
• NEVER FREEZE STOOL SAMPLES
• NEVER KEEP THEM IN INCUBATORS
STOOL PRESERVATIVES o Color (may indicates presence of
parasites)
o Preserve the morphology
o Dark-colored blood:
of parasites, and possible
suggests bleeding in the
destruction of eggs and
upper GIT
larvae.
o Bright-red blood: suggests
• FORMALIN – AP fixative (reco. 5% for
bleeding in the lower GIT
cysts, 10% for helminth eggs and larvae,
o Ex. Intake of Iron may
can also be used w/ sodium sulphate to
cause red or black colored
preserve morphology.
stools.
• SCHAUDÍNN’S SOLUTION – for fresh stool
that will be stained.
• Microscopic Examination
• POLYVINYL ALCOHOL (PVA) – plastic
resin, adheres stool sample to glass slide, Elements that can be found:
can preserve protozoan cysts for permanent
o WBC – PMNS (neutrophil means
staining however, may also have mercuric
inflammation, eosinophil-parasitic
chloride.
infection)
• MERTHIOLATE-IODINE-FORMALIN (MIF)
o RBC – Bleeding/Ulcers
- for fixation of intestinal protozoans,
o Macrophage – bacterial/parasitic
helminth eggs & larvae
infections
- M is a.k.a Thimerosal
o Charcot-Layden Crystals – released
- M&I acts fro staining
when eosinophil in disintegrated,
- F serves as preservative
means hypersensitivity/Parasitic
• SODIUM ACETATE-ACETIC ACID infection.
FORMALIN (SAF) o Epithelial cells – linings of GIT
o Liquid fixative w/ long shelf life unlike o Helminth eggs, ova, cysts,
Schauddin’s, PVA, & MIF, it doesn’t trophozoites
contain any mercuric chloride, o Fungal spores
however its not good for staining. o Pseudoparasites – hairs, bubbles,
contaminants.

• Techniques
o Direct Fecal Smear (most common)
o Kato Thick Smear
o Concentration Techniques
o Stool Culture
o Staining
o Immunoassay methods

❖ Direct Fecal Smear (most common)

(Routine method; direct Wet mounts)
• Stool sample: 2 mg/thum-size
• Applicator stick
• 0.85% NSS (parasites are pale/and
transparent)
• Cover slip and Glass slide
• Lugol's iodine (drop, 1:5 solution
or if not available – D’ Antoni)
o Cytoplasm: gold yellow
o Nucleus: pale and refractile
METHOD OF EXAMINATION
o Glycogen: deep brown
• Macroscopic/Gross Examination
o Consistency (indicates the specific
stages present in our sample)
o Formed, semi-formed, soft,
loose, or watery
o Trophozoites: soft, loose
and watery stool.
o Cysts: formed, semi-formed,
and soft stool
o Eggs and larvae: any type
of consistency
❖ Kato Thick Smear
1. Stool sample: 50-60 mg/ 2 mung
beans size
2. Uses Glycerine(clearing solution)
and Malachite Green solution +
plastic (stain) – gives color to the
ggs & mins. Brightness of
microscopic field.
3. Good in detecting eggs with thick
shells (clean) such as Ascaris and
Trichuris spp.
❖ Concentration Techniques
(Separates cysts and eggs based on
Specific gravity.)
• Stool sample: 1g
• Used in cases of light infection or if
there is a need to recover more
Parasites
• 2 Types:
o Sedimentation
o Acid Ether Concentration
Technique (AECT)
- 40% HCl and Ether
- HCl dissolve
albuminous material
- Ether dissolve
neutral fat in stool
o Formalin-Ether/Ethyl Acetate
Concentration Technique
(FECT)
- 10% Formalin and
Ether
- Formalin (fixative)
- Ether - dissolve
neutral fat in stool
o Flotation
o Zinc Sulfate Flotation
- 33% zinc sulfate
solution ZnS04
(1.18-1.20 S.grav.)
o Brine Flotation
- Saturated table salt
(morphology of
eggs may be
affected if used)
o Sheather's Sugar Flotation
- Boiled sugar
solution (Best for
the recovery of
coccidian oocysts,
Cryptosporidium,
Cyclospora, and
Cystoisospora.
❖ Stool Culture
o Less frequent as we don’t
usually do it.
o For research/ other parasites
not usually seen in the PH.
• Copro Culture
o Moistened soil or granulated
charcoal
o Pinapatubo ang
microorganism(parasite)
o Harvest using Baermann
procedure
• Harada-Mori or the Test Tube Culture
Method
o Use of Test tubes, filter
paper strips, and 7mL boiled
or distilled water
3 other stool culture methods
❖ Staining
• Iron-Hematoxylin
• Wheatley's Trichome
• Periodic Acid Schiff (PAS)
• Chlorazol Black E
• Modified Acid-Fast Stains
• Modified Kinyoun method, modified
acid-fast dimethyl sulfoxide, or
auramine-O
❖ Immunoassay method
o Use of species specific
antibody reagents to detect
antigens of specific parasite.
NOTES!!!
Sedimentation:
• Process: Denser particles sink to the
bottom due to gravity.
• Applicability: Useful for parasites with
a higher specific gravity (denser) than
the surrounding liquid.
• Advantages:
o Simple and inexpensive
technique.
o Easy to detect parasites, eggs,
and other stages due to clean
separation.
Flotation:
• Process: Lighter particles float to the
surface of a solution with a higher
specific gravity than the particle itself.
• Applicability: Useful for parasites with
cysts or eggs that are less dense than
the surrounding liquid.
In a nutshell:
• Imagine a parasite-laden sample in a
container. During sedimentation, denser
parasites sink (like a stone) and are
recovered from the bottom. Flotation, on
the other hand, utilizes a special
solution that makes the parasites
buoyant, allowing them to float to the top
for collection.
Additional points:
• Both techniques can be enhanced by
using centrifugation, which increases
the force acting on the particles,
speeding up the separation process.
• Sedimentation is generally considered a
more straightforward method for
parasite detection.

FECT VS. ZINC SULPHATE

The FECT (Formalin-Ethyl Acetate Concentration
Technique) is a biphasic sedimentation technique
that is more efficient in recovering most protozoan
cysts and helminth eggs and larvae. It helps
preserve the integrity and undistorted appearance
of the cysts when compared to the zinc sulfate
solution.
PHYLUM NEMATODA
❖ GENERAL CHARACTERISTICS
• Females larger than males and have
a straight tail
• Most nematodes are dioecious
• Males have curved tail with spicules
for copulation
• Unsegmented
• Some are hermaphroditic
• May be oviparous or ovoviviparous
• Round elongated worms measuring
from a few mm to a meter in length
• Complete digestive tract (mouth to
anus)
• No circulatory system
• Found in the intestine, blood, and
tissue
• World-wide distribution

❖ SENSORY ORGANS OF THE WORM:

• Anterior – Amphids
• Posterior – Phasmids

▪ Aphasmids
o Trichinella spiralis
o Trichuris trichiura
o Capillaria philippinensis

▪ Phasmids
o Ascaris lumbricoides
o Strongyloides stercoralis
o Hookworms
o Enterobius vermicularis
o Filarial worms
❖ HABITAT
• Small Intestine:
o Ascaris lumbricoides
o Strongyloides stercoralis
o Hookworms
o Capillaria philippinensis
o Trichinella spiralis
• Large intestine:
o Trichuris trichiura
o Enterobius vermicularis
• Tissue Nematodes:
o Trichinella spiralis
o Wuchereria bancrofti
o Brugia malayi
o Onchocerca volvulus
o Loa loa
o Dirofilaria immitis
Trichinella spiralis
• Also known as:
"Trichina Worm"
"Pork Worm"
• Diseases:
o Trichinosis
o Trichiniasis
o Trichinellosis
• SCIENTIFIC CLASSIFICATION
Kingdom: Animalia
Phylum: Nematoda
Class: Adenophorea
Order: Trichurida
Family: Trichinellidae
Genus: Trichinella
Species: T. spiralis
Binomial name: Trichinella spiralis

• Larva Migrans in Man

o Dracunculus medinensis
o Angiostrongylus cantonensis
o Ancylostoma caninun
o Ancylostoma braziliense
❖ MORPHOLOGY of Trichinella • LIFE CYCLE
spiralis - Infective Stage
- encysted larva
• Male Worm - Definitive Host
o Measures 1.4-1.6 mm in length - swines
- Man (accidental host)
by 40-60 micra in transverse - Diagnostic Stage
diameter. - Encysted larva
o Cloaca is found at the caudal end
which is evertible during coitus.
o It is guarded by 2 conspicuous
conical papillae which clasp the
female during copulation.
o SPICULE is absent.
o Posterior end of the worm is
curved ventrad.

• Female Worm
o About 3-4 mm long and
60-80 micra in width.
o Vulva opens at the anterior
fifth of the body.
o Has a single uterus which
contains larvae.

❖ MORPHOLOGY: ENCYSTED LARVA

o measures 100 by 6 micra when
extruded by the female worm
o provided with a spear-like
burrowing tip at its tapering • DIAGNOSIS
- Muscle Biopsy
anterior end. - Bentonite
o in the striated muscles, the larva Flocculation Test

grows to about 0.8-1mm and

becomes encrusted along the • CLINICAL
DISEASE
axis of the muscle fibers.
1. Destruction of the muscle fiber
2. Eosinophilia
3. May have myocardial involvement

• PREVENTION AND CONTROL

1. Sterilizing garbage containing
raw meat scraps.
2. Cook meat properly (770C or
1700F)
3. Storage at -150C for 20 days or -
300C for 6 days.
4. Screening of pigs
5. Public education

• TREATMENT:
1.Thiabendazole
2. Mebendazole
Trichuris trichiura Trichuris trichiuria – OVA
o Also known as the “Whipworm” • Characteristics:
o Diseases: o With mucoid, bipolar plug
- Trichuriasis o Foot ball - shaped
- Whipworm Infection o Lemon-shaped
o Barrel-shaped
❖ MORPHOLOGY: o Diagnostic stage
• Male Worm • LIFE CYCLE
o Infective Stage
▪ Measures 3 -3.5 cm
o embryonated egg
▪ A single lanceolate spicule protrudes o Definitive Host
through a refractile penial sheath
o humans
which has a bulbous termination
covered with small recurved spines. o Diagnostic Stage
▪ Distinguished from the female by its o egg (unsegmented)
coiled caudal extremity about 360 o No heart and lung phase
degrees or more. o Resides in the large intestine
• Female Worm o No intermediate host needed
▪Measures 3.5 - 5.5 cm in length.
▪Vulva opens at the anterior end, the
fleshy portion of the body.
▪ Has a single uterus and ovary
▪ Bluntly rounded at the posterior end.
• ADULT MORPHOLOGY
o Flesh colored or pinkish slender
worm
o Anterior 2/3 of the worm is
o attenuated and thin in contrast to the
remaining posterior 1/3 which is
fleshy and robust
o "Whip like appearance"

• PATHOLOGY:
1. Mild ulceration
2. Abdominal pain
3. Diarrhea
4. "rectal prolapse"

• DIAGNOSIS:
1. Direct Fecal Smear
❖ MORPHOLOGY: OVA 2. Kato-Katz Technique
• characteristically barrel-shaped with
3. Concentration Technique
bipolar unstained intralaminar
prominences which have the (Recovery of eggs in the stool
appearance of mucoid plugs. specimen)
• SIZE: 50-54 micra by 22-23 micra
1. PREVENTION AND CONTROL
• in addition to a vitelline membrane,
it has a triple shell consisting of: 1. Proper disposal of feces
o chorionic layer 2. Hand washing
o albuminous layer 3. AVOID using human fecal matter
o bile-stained layer as fertilizer "night soil"
4. Community education

2. TREATMENT:
1. Piperazine citrate
2. Mebendazole
3. Pyrantel Pamoate
Capillaria philippinensis
• DISEASE:
- Intestinal Capillariasis
- Capillariasis

• HISTORY:
o was 1st recognized in the Philippines
in 1963 at PGH
o Bacarra, llocos Norte
o 1967, epidemic in Capillariasis in ❖ MORPHOLOGY: EGGS
Pudoc, West Tagudin, llocos ❖ similar to that of the whipworm but are
smaller about 42 by 20 micra usually in
Sur(approximately 1,300 persons
became ill and 90 persons died of the single or 2-segmented stage of
development more oval in shape
the infection)
❖ bipolar mucous plugs that are not
❖ MORPHOLOGY: protruberant
❖ shell is thick and pitted which appear
• Male Worm: as striations hence peanut-shaped
o Small, measuring 1.5 to 3.9
mm in length.
o Characterized by caudal alae
and long, non-spiny sheaths
(male spicule)

• Female Worm:
-Measures 2.3 to 5.3 mm in length.
-Body is divided into 2 almost equal parts
▪ Anterior:
o esophagus
o esophageal glands
▪ Posterior:
o intestine
o reproductive system with
slightly prominent vulva

❖ MORPHOLOGY:
❖ Types of Female Worm:
1. Atypical Female
- larviparous (responsible for
population build-up)
2. Typical Female ❖ LIFE CYCLE:
- oviparous ❖ Infective Stage:
o 3rd stage larva
NB: Both have an esophagus with secretory ❖ Intermediate host:
cells called STICHOCYTES and the o fishes
esophageal structure is called STICHOSOME. ❖ Definitive host
o humans
❖ Diagnostic Stage
o egg, larva, adult in the fecal
sample
❖ DIAGNOSIS:
1. Demonstration of
characteristic eggs in the feces:
o Direct Fecal Smear (DFS)
or Wet Mount
o Stool Concentration
methods
o Duodenal aspiration
2. Larva and adult stages may
also be seen.

❖ PREVENTION AND CONTROL:

1. Proper disposal of feces
2. Proper cooking of fishes
3. Freezing of fishes
Enterobius vermicularis Female Worm
• Measures 8 to 13 mm by 0.4 mm.
❖ Common Name:
• It has a long pointed tail hence the name,
1. Pinworm
pinworm.
2. Threadworm
3. Seatworm • Uteri of the gravid female are distended
4. Oxyuris with eggs.
5. Society worm • Capable of laying as much as
6. Familial worm 4, 672 to 16, 888 eggs/day.

❖ Final Host: Humans

❖ Habitat: Large Intestine
❖ Diagnostic Stage: Ova
❖ Infective Stage: Embryonated Ova
❖ Sources of Infection: Contact borne
❖ Mode of transmission: Ingestion,
Inhalation
❖ Diseases:
1. Enterobiasis
2. Oxyuriasis

Scientific Classifications
Kingdom: Animalia:
Phylum: Nematoda
Class: Secernentia Adult Male: This image shows a
Subclass: Spiruria close up of the male.
Order: Oxyurida Note the esophageal bulb, characteristic of
the species, in the anterior end (black
Family: Oxyuridae
arrow) and the curled posterior tail with a
Genus: Enterobius
spicule, characteristic of the male (red arrow).
Enterobius vermicularis (Linnaeus,
1758)
Enterobius anthropopitheci
Species:
(Gedoelst,
Enterobius gregorii
(Hugot, 1983)

❖ Morphology:
MALE WORM
• Measures 2 to 5 mm by 0.1 to 0.2 mm.
• It has a characteristic curved tail with a
single spicule and cephalic alae
• Relatively smaller that the female worm.
Egg:
• They are rarely seen because they die
o approximately 25 x 60 um in
after copulation.
size.
• type of - MEROMYARIAN
o Has thin shell and one of the
MUSCULATURE
sides is flattened.
o collected by swabbing the
➢ NEMATODE SOMATIC MUSCULATURE
perianal area during the early
• Meromyarian musculature:
morning with an adhesive tape
o 2-6 rows of muscle cells present
and then examining the tape with
per quadrant
a microscope.
• Polymyarian musculature:
o more than 6 rows of muscle cells per
quadrant
❖ MORPHOLOGY: OVA
▪ are asymmetrical
▪ measures 50 to 60 micra by 20
to 30 micra (ave. 55 by 36
micra)
▪ the translucent shell:
• outer, triple
albuminous covering
• inner lipoidal
membrane
▪ outside the host, eggs become
infective in four to six hours
❖ Life Cycle:
• Infective Stage
▪ embryonated egg
• Definitive Host
▪ humans
• No (intermediate Host) IH needed
• Autoinfection is very possible
❖ Pathology:
1. Perianal itching or pruritus ani
2. Autoinfection
3. Familial disease
❖ Route of infection:
1. Mouth
2. Respiratory system
3. Anus
❖ Diagnosis:
1. Scotch tape technique (cellulose tape)
- eggs and larvae stick to the tape.
- since migration of female occurs at
night, the method is performed before
the patient's bowel movement or
before the patient has taken a bath.
 ❖ Prevention and Control: Female Worm
1. Proper hygiene • Measures 22 to 35 cm with
2. Public Education smooth striated cuticles.
3. Familial treatment • They have a terminal mouth with
three lips with a sensory papillae.
❖ Treatment: • They have, paired reproductive
1. Pyrantel pamoate organs in the posterior 2/3.
2. Albendazole • Posterior end is blunt.
3. Mebendazole • Productive capacity of 26 million
eggs or 200, 000 eggs per day.
* Negative Scotch Tape Swab test:
7perianal smears

Ascaris lumbricoides
• Common Name:
- Pink Worm
- Giant Intestinal Roundworm
• Disease of poverty:
- Ascariasis
- Ascaris infection
- Roundworm infection
• POLYMYARIAN MUSCULATURE

❖ MORPHOLOGY

MALE WORMS
• Measures 10 to 31 cm with
smooth striated cuticles.
• They have a terminal mouth with
three lips with a sensory papillae.
• They have a ventrally curved
posterior end with two spicules.
MORPHOLOGY: EGG (3 TYPES) ❖ Life Cycle:
1. Fertilized Egg 1. Infective Stage
- measures 45 - 70 micra by - embryonated egg
35 - 50 micra, shorter than the 2. Definitive Host
infertile eggs. - humans
- there is an outer coarsely 3. Diagnostic Stage
mammilated albuminous - fertilized or unfertilized eggs
covering in the feces.
- compact yolk granules

2. Unfertilized Egg
- measures 88 - 94 micra by
39 - 44 micra, longer and
narrower than fertilized eggs
- it is thin-shelled with an irregular
mammilated coating filled
refractile granules
- they are difficult to identify and CLINICAL DISEASE:
Are found only in the absence of 1. Worm Ball
Males. – blockage in the Intestine

2. Ascaris pneumonitis
– due to larvae migration in the lungs

3.Decorticated Egg
-Absence of albuminous coating
DIAGNOSIS: Strongyloides stercoralis
1. Demonstration of characteristic
eggs COMMON NAME:
in feces
• Threadworm
a. DFS
b. Kato-thick DISEASE:
c. Kato-Katz
• Strongyloidiasis
2. Recovery of adult worms from • Cochin-China Diarrhea
anus, nasal passage, or even
sputum. MORPHOLOGY:

❖ PARASITIC OR FILARIFORM
PREVENTION AND CONTROL:
1. Proper disposal of feces
2. Cooking well of vegetables
3. Avoid using human feces as
fertilizer
4. Proper hygiene
TREATMENT:
1. Albendazole
2. Pipperazine citrate
3. Mebendazole or pyrantel pamoate
FEMALE:
• SMALLEST NEMATODES
measuring 2.2 x 0.04 mm
• it has a slender tapering anterior
end and a short conical pointed
tail.
• SHORT BUCCAL CAVITY
- 4 indistinct lips
- vulva is located 1/3 the
length of the body from the
posterior end.
• Uteri contain a single file of 8 to
12 thinshelled, transparent,
segmented ova
• PARTHENOGENETIC OR
• PARTHENOGENIC
❖ FREE-LIVING FEMALE:
• Measures 1 mm by 0.06 mm and
is smaller than the parasitic female
• It has a muscular double-bulbed
esophagus:
• Intestine is a straight cylindrical
tube
❖ FREE-LIVING MALE;
• measures 0.7 mm by 0.04 mm
and is smaller than the female
• it has a ventrally curved tail, two
copulatory spicules,
• Has a GUBERNACULUM but
no caudal alae.
❖ RHABDITIFORM LARVA: - --
• measures 225 micra by 16 micra
• has an elongated esophagus
with a pyriform posterior bulb.
• Differs from hookworm in being
slightly smaller and less
attenuated posteriorly.
• also has a shorter buccal
capsule and a larger genital
primordium
• Feeding stage
❖ FILARIFORM LARVA:
❖ is the non-feeding stage
❖ SLENDER measuring about 550
micra
❖ it is similar to the hookworm
filariform larva but usually is
smaller, with a distinct cleft
(notched) at the tip of the tail.
 ❖ EGG
• rarely seen in the stool specimen
• it has a clear, thin shell and are
similar to those of hookworms except
that they measure about 50-58
micra by 30 - 34 micra
C.) Autoinfection
- some of the rhabditiform larva develop
into filariform larva in the bowel and
reinfect the host
- internal autoinfection
- external autoinfection

❖ CLINICAL DISEASES:
A.) Three Stages based on Life Cycle
1. Cutaneous
-initial skin penetration ❖ DIAGNOSIS:
2. Pulmonary • Demonstration of rhabditiform larvae and/or
- larval migration in the lungs filariform larvae in the feces using:
3. Intestinal
-symptoms depend on worm load a) DFS
- immunocompromised patients may b) Concentration technique
exhibit LEUKOCYTOSIS and c) Baermann technique
EOSINOPHILIA.

❖ PREVENTION AND CONTROL:

1. Proper sewage disposal
2. Avoid walking barefooted
• CONTROL:
1. Ivermectin
2. Thiabendazole

B.) Hyperinfection Syndrome

- may lead to death due to tissue
damage
- occurs in immunosuppressed
patients (AIDS, drugs)
- can be transferred through
organ transplantation
-TRANSMAMMARY
HOOKWORMS • MORPHOLOGY:

• SPECIES FILARIFORM LARVA

o Necator americanus(New-World o Infective, non-feeding stage
Hookworm)
o 700 um long
o Ancylostoma duodenale(Old-World
Hookworm) o Straight esophagus (1/4 of the length
o Ancylostoma braziliense of the body)
o Ancylostoma caninum o Curved tail
o Ancylostoma ceylanicum
• EGG (characteristics)
• DISEASE: o Ovoidal
- Ancylostomiasis o Thin shelled
- Necatoriasis
o Colorless
- Uncinariasis
- Hookworm Disease o - "Morula bal!"

• MORPHOLOGY: MALE WORM

o 8-11 mm long
o Posses a bursa (bursa copulatrix)
which aids in the speciation of
hookworms
o Exhibits dental pattern

Ancylostoma Necator
Duodenale Americanus
Common Old world New world
Name Hookworm hookworm
Body "C" shaped “S” shaped
Curvature:
Dental 2 pairs of teeth Semi lunar
pattern: cutting plate
• MORPHOLOGY:FEMALE WORM Bursa: Dorsal ray, Dorsal ray
o 10-13 mm long tridigitate or bidigitate or bifid
tripartite
o Pointed Tail
Spicule: Plain, bristle-like Barbed, fused
o Adults may live 2-14 years
Habitat: Small intestine Small intestine
o Rarely seen in the stool since it’s
Diagnostic Ova Ova
firmly attached to the mucosa (small stage:
intestine) Infective La (FILARIFORM) La (FILARIFORM)
stage:
MOT Skin penetration, Purely
transmammary percutaneous

• MORPHOLOGY:
RHABDITIFORM LARVA:
o Non-infective, Feeding Stage
o Bulbuous esophagus
o Long buccal cavity(approximately
as Ìong as the width of the body)
o Inconspicuous genital primordium
 ❖ CLINICAL DISEASE:
1. Pneumonitis
2. Allergic Reactions
3. Anemia (each adult worm consumes
0.2 ml of blood/day)
4. Cutaneous Larva Migrans
(due to migration of dog/cat hookworms)
• A. braziliense & A. caninum through
the subcutaneous tissue causing
itching and the formation of
HOOKW L1 STRONGYLOIDES SERPIGINOUS TUNNEL
ORM
Long BUCCAL Short ❖ DIAGNOSIS:
CAPSULE
1. Demonstration of characteristic
egg in the feces (2-8 cell stages)
Small GENITAL Prominent
PRIMORDIUM 2. Larva is not seen in feces
L3
(unless the specimen is left for 24
Shorter ESOPHAGUS Longer
Pointed TAIL END Notched/ hours)
(Both sheathed) Cleft
R-E-M-E-M-B-E-R

If a stool specimen is left at room temp. The

larva may continue to develop and must be
differentiated with Strongyloides.

Should you recover the adult hookworm, easier

differentiation is done by observing the buccal
capsule.
• Necator americanus - semilunar cutting
plates
• Ancylostoma caninum - 3 pairs of ventral
teeth
• Ancylostoma duodenale - 2 pair of ventral
teeth
• Ancylostoma braziliense - a pair of big
teeth
• Ancylostoma ceylanicum - 2 pair of
ventral teeth with outer bigger than the inner
pair

❖ PREVENTION AND CONTROL

1. Proper disposal of feces
2. Avoid walking barefooted
3. Health education on personal, family,
and community hygiene
4. Treatment of infected individuals
5. Mass chemotherapy when prevalence is
greater than 50%
6. Protection of susceptible individuals

❖ TREATMENT
1. ALBENDAZOLE
2. MEBENDAZOLE
❖ LIFE CYCLE 3. PYRANTEL PAMOATE
• Infective Stage
- Filariform Larva
• Definitive Host
- Human
• Diagnostic Stage
- Eggs/ova
BLOOD AND TISSUE
NEMATODES
- can cause infection in the tissues and blood or
lymphatic
- the “Microfilariae Group’’

GENERAL CHARACTERISTICS
• Require an arthropod as an intermediate
host.
• Diagnosis is made by examining Giemsa
stained thick and thin blood smears ( except
Onchocerca volvulus- skin scraping from
nodules ) Giemsa means differential stain
• They exhibit periodicity.

BLOOD AND TISSUE NEMATODES

1. Wuchereria bancrofti Brugia malayi
- also known as bancrofts filarial worm,
inhabit the lymphatic system
2. Brugia malayi ❖ DISEASE :
- inhabit the lymphatic system • Malayan filariasis
3. Loa loa
- inhabit subcutaneous tissue so meaning • HIGH TITERS OF FILARIAL ANTIBODY (
beneath the skin IgE)
4. Onchocerca volvulus
- inhabit subcutaneous tissue , skin
scraping • VECTORS :
• Mansonia mosquito
o Infective stage of mosq. 2 weeks

Wuchereria bancrofti • Formation Of Hydrocoele Or Chylocele

❖ DISEASE: ❖ CHARACTERISTICS OF B. malayi

• Bancroftian filariasis
• Wuchereriasis
• Elephantiasis MICROMICROFILARIAE :
• Sheathed
• Nuclei stops then there is a clear space
• MOSQUITO VECTORS : with 2 distinct nuclei at the tip of the tail.
• Culex Mosquito
• Aedes mosquito ELEPHANTIASIS :
• Anopheles mosquito • Restricted to the upper extremities.
TRANSMISSION : BLOOD MEAL
DIAGNOSIS :
• Demonstrate in blood smears ( thick and
• CHARACTERISTICS OF W. bancrofti
thin ) sheathed microfilariae with 2
Microfilaria : terminal nuclei in tail
• Sheathed • Generally found in the far east
• No nuclei at the tip of the tail
• Nocturnal periodicity
( 9pm - 2am is it’s greatest
concentration in the blood )
best time to collect blood
• Elephantiasis : disease in humans
• Permanent blockage of the lymphatic
system
• can occur in Lower Extremities or
upper extremities.

• DIAGNOSIS :
• Demonstrate in blood smears ( thick and
thin )
• sheathed microfilariae with NO NUCLEI AT
THE TIP OF THE TAIL.
Loa loa Onchocerca volvulus
• Also known as the “ EYE WORM “ • Also known as the “ BLINDING
WORM “
CHARACTERISTICS
MICROFILARIAE
• Sheathed DISEASE:
• Nuclei up to the tip of the tail • ONCHOCERCIASIS
( from anterior to posterior tip ) • ONCHOCERCOSIS
• Exhibits DIURNAL PERIODICITY ( • RIVER BLINDNESS
microfilaria is shed in peripheral blood
constantly during the day rarely at night )
MICROFILARIAE
• Only pathogenic tissue nematode
Loiasis : Disease which is not sheathed
• Causes CALABAR SWELLINGS • Continuous nuclei at the tip of the
• Allergic reaction due to worm tail
migration in tissue and death in • Found in nodules under skin, not in
capillaries peripheral blood- slightly elevated
lesions on the skin.
• Redness in the eye, conjunctiva,
swelling, photophobia
CLINICAL SIGNIFICANCE/ DISEASE:
What you can feel when you have Loa loa: • Severe dermatitis
• Microfilaria in ocular structures may
• Itchy , burning , prickling result in blindness
sensation in the eyes. • Leading cause of blindness in africa
- AFRICAN RIVER BLINDNESS

DIAGNOSIS: VECTOR: SIMULIUM BLACKFLY

• Demonstrate in blood smear ( thick
and thin ) sheathed microfilariae with
continuous nuclei to the tip of the DIAGNOSIS :
tail. • Demonstrate from skin snips/tissue
scrapings unsheathed microfilariae
VECTOR: with no nuclei in tail.
• FLY ( GENUS CHRYSOPS)
Tissue Nematodes Dracunculus medinensis
- LARVA MIGRAN AND ALSO KNOWN AS
“ LITTLE DRAGON FROM MEDINA “
PATHOLOGY:
• TPE or Tropical Pulmonary
Eosinophilia is associated with the COMMON NAME :
microfilariae of these nematodes • Guinea worm
• Fiery serpent
• Medina worm
Philippines: adults> children : male >
female ( infection )
DISEASE:
• DRACUNCULIASIS

Dracunculus medinensis - Parasite is

frequently found in the subcutaneous tissues
and muscles of humans, dogs, and sometimes
cattle and horses.
• The disease causes cutaneous nodules
and subsequent ulcers

LIFE CYCLE OF TISSUE NEMATODES :
1. Ingestion of the microfilariae from the
blood or tissues by a blood-sucking
insect.
2. The metamorphosis of the
microfilaria in the arthropod vector
1st into rhabditiform larva and then
into an infectious filariform larva.
3. The transfer of the infective larva to
the skin of a new host by the
proboscis of the biting insect.
4. The development of the larva after
entry to the bite wound into a mature
worm at its selective site.
TREATMENT/ PREVENTION / CONTROL
1. Control on mosquitoes and human
sources of infection
2. Spraying of houses with residual
insecticides
3. Diethylcarbamazine citrate ( DEC )
4. Ivermectin
MORPHOLOGY:
• Males are small 1.2 to 2.9 cm long
• Females measures 60 cm in length
• The larvae, which measure between
500 and 700 micrometers, can live
for 6 days in clean water and 2 to 3
weeks in muddy water.
LIFE CYCLE:
• INFECTIVE STAGE- 3rd stage larva
• DEFINITIVE HOST - humans, dogs,
horses
• INTERMEDIATE HOST - cyclops/
copepods
TREATMENT :
• REMOVAL OF WORM
• FILTERING WATER SOURCES
• AVOID CONTACT WITH
CONTAMINATED WATER

For acute attacks: relieve the pain by

cooling the affected area
Management of lymphatic filariasis:
• Frequent washing ( at least
twice daily )
• Affected area should be
elevated at night and regularly
exercised
Angiostrongylus cantonensis
COMMON NAME:
• RAT LUNGWORM
• Was described by Chen in
1935 from domestic rats in
Canton,China
• The lungworm normally lives
in the lungs of rats but can
cause eosinophilic
meningoencephalitis in man
DISEASE:
• Angiostrongyliasis
• Eosinophilic meningoencephalitis
PREVENTION / CONTROL
MORPHOLOGY : MALE
• Pale and filiform
• 16 to 19 mm x 0.26 mm in diameter
• They have a well- developed caudal
bursa ( kidney- shaped & single-
lobed)
TREATMENT:
• No antihelminthic treatment is
recommended
• Usually self-limiting ; administration of
antihelminths not necessary
• Killing worms found in the brain would
cause greater inflammatory reaction
• Management
• Symptomatic treatment with
analgesics
• Frequent removal of about 10 ml
spinal fluid at intervals relieves
headaches (invasive)
• Thiabendazole, Mebendazole,
Albendazole, Ivermectin (effective in
experimental animals )
• Proper eating habits
• Safe food preparation
• Elimination of intermediate host
• Washing of leafy vegetables

MORPHOLOGY : FEMALE
• Pale and filiform
• 21 to 25 mm x 0.30 - 0.36 mm in
diameter
• Has uterine tubules which are round
spirally around the intestine
• ( barber’s pole pattern )
• Lays 15,000 eggs
EGGS
• Have delicate hyaline shells
• Measures 46-48 micra x 68
micra
• Unembryonated when oviposited

LIFE CYCLE :
• INFECTIVE STAGE - 3rd stage larva
• DEFINITIVE HOST - rats
• INCIDENTAL HOST - humans
• INTERMEDIATE HOST - snails (
Achantina fulica )

DIAGNOSIS :
• Relatively difficult
• Presumptive diagnosis is made by travel
history and exposure
• CSF ( 10% eosinophilia in proportion to
the WBC )
• CT scan
• ELISA
PHYLUM PLATYHELMINTHES ORDER ORDER
PSEUDOPHYL CYCLOPHYLLI
–Collectively called the FLATWORMS LIDEA DE
–Dorsoventrally flattened, bilaterally SCOLEX spatulate scolex globular scolex
symmetrical (both sides) w/ sucking with 4 muscular
–They are covered by a membrane called grooves (bothria) suckers.
PORES genital + uterine genital pores
tegument from latin “tegumentum” means to
pores
cover. EGGS operculated (w/ non-operculated
• For secretion & absorption lid - operculum) (no lid) and readily
–They are hermaphrodite except for and immature, passed out
Schistosoma species. require aquatic containing the
development of hexacanth embryo
embryo
CESTODES TREMATODES
IH require 2 ihs require only 1 ih
COMMON NAME TAPEWORMS FLUKES MOT CONSUMPTION CONSUMPTION
OF INFECTED OF IH; ALSO
MORPHOLOGY SEGMENTED; UNSEGMENTED;
RIBBON LIKE LEAF LIKE IH INFECTION VIA
APPEARANCE APPEARANCE LARVAL &
DIGESTIVE NONE INCOMPLETE CYSTIC STAGE
TRACT

CIRCULATORY NONE NONE

SYSTEM

REPRODUCTION MOSTLY HERMAPHRODITIC

HERMAPHRODITIC

LOCATION IN THE MOSTLY FOUND IN FOUND IN

DEFINITE HOST THE INTESTINES BLOOD,LIVER, LUNG,
INTESTINES

INTERMEDIATE SOME REQUIRE 2 REQUIRES 2 IHs TO

HOST IHs TO COMPLETE COMPLETE ITS LIFE
ITS LIFE CYCLE CYCLE

CHARACTERISTICS OF
CLASS CESTODA
• Taenia species (Taenia solium, saginate,
etc.)
PARTS
• A adult worms are seen in the intestines
• Proglottids contain male and female parts Scolex – anterior structure, main organ of
• Eggs have 6 hooked embryos attachment, head and has the rostellum.
• World wide distribution Rostellum – at the top, small beak,
• nO respiratory,circulatory or digestive retractable, comb-like, muscular
system.
• Ribbon like body, flat structure. Sometimes w/ or w/out hooks and
• Middle host (intermediate host is required) attaches to the intestines.
Copod, crustaceans, etc. Hooks – for attachment, to keep when
digestion & bowel movement happens & will
CLASS CESTODA – the ff. Below are Cestoda not be flushed by feces.
that are of medical importance:
Suckers – absorbs nutrients once the
A. Pseudophyllidea tapeworm is already attached.
- Diphyllobothrium latum (FISH TAPEWORM) Neck – region of growth, start of segmentation
- Spirometra spp.: (strobilization)
• S. erinacei Strobila – segments or proglottid
• S. mansoni
• S. ranarum
3 TYPES OF PROGLOTTID :
B. Cyclophyllidea 1. Immature - undeveloped sexual organ,
nearest to the neck (as well as scolex)
- Taenia solium and Taenia saginata
2. Mature - fully mature sexual organ
- Hymenolepis nana (drawf tapeworm)and
3. Gravid- contains fertilized egg,
Hymenolepis diminuta (rat tapeworm)
undergoes apolysis, ready to be
- Raillietina garrisoni
released.
- Echinococcus granulosus
- Dipylidium caninum ( DOG TAPEWORM )
APOLYSIS - Separation of gravid segment
from the main body and the eggs are release in
the intestine)
SPECIES OF CLASS CESTODA
➢ SPECIES w/c REQUIRE A VERTEBRATE
INTERMEDIATE HOST
• Taenia solium ( pork tapeworm )
• Taenia saginata ( beef tapeworm )
• Echinococcus granulosus ( dogs,
carnivores )
➢ SPECIES w/c REQUIRE AN
INVERTEBRATE INTERMEDIATE HOST
• Dipylidium caninum ( dog tapeworm,
double pored tapeworm )
• Hymenolepis diminuta (rat tapeworm )
• Raillietina garrisoni(tribolium
confusum) – tapeworm in rats,
usually beetles
➢ SPECIES w/c MAY OR MAY NOT
REQUIRE INTERMEDIATE HOST
• Hymenolepis nana (dwarf tapeworm) -
autoinfecting parasite
➢ SPECIES w/c INFECT MAN IN THEIR
LARVAL STAGES
• Echinococcus granulosus
(hydatid worm )
• Echinococcus multilocularis
• Taenia solium
• Diphyllobothrium latum
1. Diphyllobothrium latum
(Pseudophyllidean)
COMMON NAME:
• FISH TAPEWORM
• BROAD TAPEWORM
MORPHOLOGY :
• Adult worm is yellowish grayOOVA:in color
• Dark central markings in the strobila
(body)are due to the egg-filled uterus
• Measures 3 to 10 meters in length
• Life- span is for a period of 5 to 15
years
• Scolex is spoon-shaped or spatulate
• Scolex bears 2 slit like grooves called
bothria
• (1 on the dorsal (back portion)
surface and 1 on the ventral
(abdominal part) surface )
• Scolex has no rostellum and no
hooklets
• Neck is thin and unsegmented and is
much longer than the head
MORPHOLOGY :
• 3,000 TO 4,000 Proglottids are present
• A mature segment is filled with male
and female reproductive organs
• Terminal segments shrink and becomes
empty as eggs are constantly
discharged
• Dried up segments break off from the
body in chains (apolysis)and are passed
out in the host’s feces
• Uterus at the center of the segment
appears in the form of a
rosette.(Round,flower-designed)
NOTE:
• Proglottids disintegrate only when the
segment completed its reproductive
function
OVA:
• 66 x 44 um w/ 58-76 um (L) X 40-51 (W)
• Oval
• Bile stained (because of its lipid content)
• Contains abundant granules and
unsegmented ovum
• Inconspicuous operculum at one end and a
small knob at the other end
• Does not float in saturated solutions of
common salt (ONLY FERTILIZED)
• A single egg gives rise to single larvae
• Not infective to man
• About 1 million released everyday
• No striations and it has abundant granules
inside
• Single egg gives rise to single larva
• Not infective to man
• About 1 million released everyday
• NONE-BILE STAINED EGGS:
➢ Ancylostoma
duodenae
➢ Hymenolepis nana
➢ E. vermicularis
➢ Necator americanus
EGGS THAT FLOAT IN SATURATED
SOLUTION:
✓ T – Trichuris trichiura
✓ H – Hymenolepis nana
✓ E – Enterobius vermicularis
✓ A – Ancylostoma duodenale
INFECTIVE STAGE:
• PLEROCERCOID LARVA
DIAGNOSIS / DIAGNOSTIC STAGE:
• Microscopic examination of feces for the
characteristics OPERCULATED
EGGS

LARVA: TREATMENT/ PREVENTION / CONTROL:

• Passed first in water and then in the
• Praziquantel 5-10 mg/kg single dose
respective intermediate hosts
• 3 STAGES • Recovery of scolex (successful)
• First stage larva • Repeat stool exam after 3 months
✓ CORACIDIUM • All freshwater fishes should be cook
✓ Ciliated oncosphere that properly
develops from egg in WATER • Freezing for 24-48 hours at -18c
(kill plerocercoid )
• Second stage of larva
• Proper disposal of sewage and
✓ PROCERCOID
✓ Spindle like solid body with marketing of fish
cephalic invagination
✓ Found inside the
CYCLOPS/COPODS/CRUSTAC
EANS
o (the first IH )

• Third stage of larva / INFECTIVE

STAGE
✓ PLEROCERCOID
✓ Head is invaginated in the neck
✓ Found in the FRESHWATER
FISH, (the second IH )

DEFINITIVE HOST:
• Man, Dog, cat
• Small intestine

1ST INTERMEDIATE HOST:

• Cyclops or Diaptomus

2ND INTERMEDIATE HOST:

• Freshwater fish, pike, trout, salmon,
perch

MODE OF INFECTION:
• Ingestion of imperfectly cooked infected
fish or roe containing plerocercoid
larvae
INFECTION (DISEASE)
• Diphyllobothriasis
• G.I disturbances
• Hyperchromic (elevated hemoglobin) &
megaloblastic anemia(big rbc’s) with
thrombocytopenia (low platelets)
and leukopenia (low WBS’s)
• Mistaken for Pernicious anemia
(vit. B12 deficiency)
 REPORTED CASES IN THE PHILIPPINES
2.Spirometra species
o 1935 - sparganum recovered form the
-EXTRA INTESTINAL CESTODES- occur outside
the intestine
abdominal wall of seminarian from
Pulilan, Bulacan
• Spirometer mansoni
• Spirometra erinacei o 1950 - fisherman from Libon, Albay with
• Spirometra ranarum 4 cm chest lump

• Echinococcus granulosus o 1953 - 50 y.o nun, from Pulilan, Bulacan

• Echinococcus multilocularis ( missionary in mindanao )
erythematous, slightly painful, pruritic
mass in the inner aspect of the thigh

o 1962 - 46 y.o female, with slightly

painful , subcutaneous nodule at the
base of the neck

o Late 70’s and Early 80’s ( At U.P

Public Health Department ) - human
sparganosis were reported a typical
solid body with worm like appearance

POSSIBLE TRANSMISSION
• Drinking water with cyclops containing
procercoids (2nd stage larva)

DIAGNOSIS
• Finding of white larvae in the lesion
• Computed tomography (CT scan ) an
area of low density distinct from other
brain lesions
• Multi-Dot ELISA - positive with
Spirometra antigen

PREVENTION
• Drinking filtered or boiled water
• Cooking the intermediate hosts
thoroughly
• Avoid applying flesh of frogs to inflamed
areas ( as poultice )
 Taenia solium Taenia saginata

COMMON NAME PORK TAPEWORM BEEF TAPEWORM

LENGTH Whitish , creamy white, 3-5 meters White and semi-transparent;

5-10 meters

# OF SEGMENTS 800 - 1000 1000- 2000

SCOLEX Globular in shape w/ 4 cuplikes Globular with 4 cuplikes

suckers, has a rostellum armed suckers, w/out of rostellum
with double rows of 25-30 large and hooklets
and small alternating hooklets (
shaped like daggers)

PROGLOTTIDS 8- 12 Lateral 15- 30 lateral

(GRAVID) branches branches

APOLYSIS In chains Singly/ in singles

# OF EGGS/ GRAVID 30,000 TO 50,000 EGGS 80,000 EGGS

PROGLOTTID

EGGS 31- 56 Micra in diameter with 31- 56 Micra in diameter with

oncosphere embryo, radially oncosphere embryo, radially
striated striated
-With striations and hooks -With striations and hooks

INTERMEDIATE PIG COW

HOST

INFECTIVE STAGE Cysticercus cellulosae Cysticercus bovis

Taeniasis solium Taeniasis saginata

PATHOLOGY Cysticercosis No larval stage
• Deprivation of nutrition
• Dysfunction of the intestine:
vomiting or diarrhea
• Allergic reactions
• Appendicitis
• Obstructions of the intestine