NAME: AWURUMIBE DANIELLA CHIAMAKA

MATRIC NUMBER: AUL/NSC/22/108

COURSE CODE: MCB 225
COURSE TITLE: MEDICAL MICROBIOLOGY AND PARASITOLOGY II
LECTURER: MR AZEEZ IBRAHIM
Explain the characteristics, life cycles and pathologies of the following parasites
1. Paragonimus
2. Echinococcus
3. Hymenolepis

ANSWER

1.

General Characteristics:

 Phylum: Platyhelminthes (flatworms)

 Class: Trematoda (flukes)
 Habitat: Parasites in the lungs of various mammals, including humans.
 Life Cycle: Complex, involving multiple hosts (snails, crustaceans, mammals).

Adult Paragonimus:

 Size: 7.5-12 mm long, 4-6 mm wide, resembling a coffee bean when alive.
 Color: Reddish-brown.
 Body: Flat, oval-shaped, covered with scale-like spines.
 Suckers: Possesses two muscular suckers - an oral sucker for attachment and a
ventral sucker for feeding.
 Hermaphroditic: Each adult worm has both male and female reproductive organs,
allowing self-fertilization.

Eggs:

 Size: 80-120 μm long, 45-70 μm wide.

 Shape: Yellow-brown, ovoid or elongate, with a thick shell and often asymmetrical.
 Operculum: Large opening at one end (operculum) for releasing miracidia
(embryonic stage).
 Unembryonated: Eggs are not infectious when passed in feces or sputum.

Life Cycle of Paragonimus westermani

1. Eggs are excreted in sputum or stool of infected people.

2–3. In the environment, the eggs develop, hatch into an immature form (called
miracidia), and are ingested by snails.

4. Inside the snail, the miracidia go through several stages to develop into a form
that can swim (cercariae).

5.The cercariae infect crabs or crayfish and form cysts (called metacercariae).
NAME: AWURUMIBE DANIELLA CHIAMAKA
MATRIC NUMBER: AUL/NSC/22/108
COURSE CODE: MCB 225
COURSE TITLE: MEDICAL MICROBIOLOGY AND PARASITOLOGY II
LECTURER: MR AZEEZ IBRAHIM
6. People are infected when they swallow cysts in raw, undercooked, or pickled
freshwater crabs or crayfish.

7. In the intestine, the larvae leave the cyst.

8. The larvae penetrate the wall of the intestine, pass through the diaphragm, and
invade the lungs. There, they develop into adults and produce eggs, which are
passed in sputum that is coughed up and spit out or swallowed and passed in stool.

Pathogenesis: Although the pathogenesis of human infection of P. westermani is not fully

elucidated, experimental infections of cats or dogs could explain the early phase of
paragonimiasis. As the larvae of P. westermani penetrate the intestinal wall and localize in the
peritoneal cavity there appears to be a considerable migration inside the abdominal cavity
before they direct toward the chest cavity through the diaphragm. Approximately 20 days
following experimental infection with metacercariae by oral route first pathological changes
can be detected in the pleural cavity with turbid or haemorrhagic exudation containing also
numerous pus cells. Also juvenile parasites are often found in the pleural cavity. The
diaphragm is another organ that is heavily affected by penetrating larvae and by surrounding
intense inflammatory reactions that develop about 25 days after infection. The worms finally
get into the lung parenchyma and induce acute exudative pneumonitis and haemorrhage. They
gradually mature and are encysted, thereby producing zones of active inflammation with
exudate and of collagenous fibrous tissue. The worms are found usually in pairs. When grown
up, these worms are often found inside the bronchial lumen lined with bronchial epithelia of
squamous metaplastic character. The cysts consist of the parasite and of dense collagenous
connective tissue including various inflammatory cells and eosinophils.

Clinical features: The most remarkable clinical feature is cough and blood-tinged sputum. In
1907 paragonimiasis was classified into 4 types: chest paragonimiasis, cerebral
paragonimiasis, abdominal paragonimiasis and generalized paragonimiasis. The clinical
symptoms of chest paragonimiasis are haemoptysis in some cases, and quite a few patients
complain of difficulty in breathing

Diagnosis:

 Microscopic examination: Identification of Paragonimus eggs in sputum or feces.

 Imaging: X-rays or CT scans may reveal lung lesions.
 Antibody tests: Detect the presence of antibodies against Paragonimus.

Treatment:

 Antiparasitic medications like praziquantel are used to kill adult worms.

 Supportive care may be needed to manage symptoms like coughing and chest pain.
NAME: AWURUMIBE DANIELLA CHIAMAKA
MATRIC NUMBER: AUL/NSC/22/108
COURSE CODE: MCB 225
COURSE TITLE: MEDICAL MICROBIOLOGY AND PARASITOLOGY II
LECTURER: MR AZEEZ IBRAHIM

2.

ECHINOCOCCUS: A CESTODE PARASITE

Echinococcus is a genus of tapeworms belonging to the cestode class within the

Platyhelminthes phylum (flatworms). These parasitic worms are known for causing a serious
disease called hydatid disease or echinococcosis in humans and various mammals. Here's a
detailed look at their characteristics, life cycle, and the pathologies they cause:

CHARACTERISTICS:

 Size: Adult Echinococcus species are very small, typically ranging from 2-9 mm in
length.
 Habitat: Adult Echinococcus live in the small intestine of definitive hosts, which are
usually carnivores like dogs, foxes, and wolves.
 Body Structure: They have a simple body structure with a scolex (head) equipped with
hooks and suckers for attachment to the intestinal wall, a neck, and a segmented strobila
containing reproductive organs.

LIFE CYCLE
The adult Echinococcus granulosus (sensu lato) (2—7 mm long) resides in the small
intestine of the definitive host. Gravid proglottids release eggs that are passed in the
NAME: AWURUMIBE DANIELLA CHIAMAKA
MATRIC NUMBER: AUL/NSC/22/108
COURSE CODE: MCB 225
COURSE TITLE: MEDICAL MICROBIOLOGY AND PARASITOLOGY II
LECTURER: MR AZEEZ IBRAHIM
feces, and are immediately infectious. After ingestion by a suitable intermediate host, eggs
hatch in the small intestine and release six-hooked oncospheres that penetrate the
intestinal wall and migrate through the circulatory system into various organs, especially the
liver and lungs. In these organs, the oncosphere develops into a thick-walled hydatid cyst
that enlarges gradually, producing protoscolices and daughter cysts that fill the cyst interior.
The definitive host becomes infected by ingesting the cyst-containing organs of the infected
intermediate host. After ingestion, the protoscolices evaginate, attach to the intestinal
mucosa , and develop into adult stages in 32 to 80 days.

Humans are aberrant intermediate hosts, and become infected by ingesting eggs .
Oncospheres are released in the intestine , and hydatid cysts develop in a variety of
organs . If cysts rupture, the liberated protoscolices may create secondary cysts in other
sites within the body (secondary echinococcosis).

Pathologies (Hydatid Disease):

 Cyst Growth: Hydatid cysts in the liver, lungs, or other organs can grow large over
time, causing pressure, pain, and organ dysfunction.
 Rupture: Cyst rupture can release protoscolices and cyst fluid into the body cavity,
triggering an allergic reaction (anaphylaxis) and potentially seeding new cysts in other
organs.
NAME: AWURUMIBE DANIELLA CHIAMAKA
MATRIC NUMBER: AUL/NSC/22/108
COURSE CODE: MCB 225
COURSE TITLE: MEDICAL MICROBIOLOGY AND PARASITOLOGY II
LECTURER: MR AZEEZ IBRAHIM
 Secondary Infections: Ruptured cysts can also become infected with bacteria, leading to
complications.

Diagnosis:

 Imaging: Ultrasound, X-ray, CT scan, or MRI scans can detect hydatid cysts.
 Serological Tests: Blood tests can detect antibodies against Echinococcus.

Treatment:

 Surgery: Surgical removal of the cyst is the preferred treatment when possible.
 Albendazole or Mebendazole: These medications may be used to kill protoscolices and
reduce cyst size before or after surgery.
 Puncture and Aspiration: In some cases, the cyst may be punctured with a needle to
remove fluid and inject medication.

Prevention:

 Proper Hygiene: Proper sanitation and hygiene practices can help prevent accidental
ingestion of eggs.
 Deworming Pets: Regular deworming of dogs and other carnivores can help control the
parasite population in definitive hosts.
 Meat Inspection: Thorough inspection of livestock meat can help identify and remove
infected organs before consumption.

3.

Hymenolepis nana (Dwarf Tapeworm)

Hymenolepis nana is a small intestinal cestode (tapeworm) parasite commonly infecting

humans, particularly children. Here's a detailed breakdown of its characteristics, life cycle,
and pathologies:

Characteristics:

 Phylum: Platyhelminthes (flatworms)

 Class: Cestoda (tapeworms)
 Habitat: Small intestine of humans (definitive host).
 Size: Adults are tiny, typically 1.5-4 cm long and 0.5 mm wide.
 Scolex (Head): Possesses four suckers (bothria) for attachment to the intestinal wall
and no hooks (unlike some other tapeworms).
 Neck: Short and slender.
 Proglottids (Segments): Body composed of numerous proglottids, increasing in size
and maturity towards the posterior end.
 Hermaphroditic: Each mature proglottid has both male and female reproductive
organs.
 H. nana is more frequent in populations, particularly children, living in conditions of
poverty and poor hygiene, particularly when fleas are present.
 H. nana has 3 modes of infection:
 Indirect 2-host cycle: Rodents are the primary definitive hosts, and grain beetles,
fleas, or other insects feed on contaminated rodent droppings as intermediate hosts;
humans can become infected by ingesting parasitized insects.
NAME: AWURUMIBE DANIELLA CHIAMAKA
MATRIC NUMBER: AUL/NSC/22/108
COURSE CODE: MCB 225
COURSE TITLE: MEDICAL MICROBIOLOGY AND PARASITOLOGY II
LECTURER: MR AZEEZ IBRAHIM
 Human-to-human oral-anal cycle: Eggs are passed from one human to another or
recycle externally in a single host.
 Internal autoinfection: Eggs hatch within the gut and initiate a second generation
without ever exiting the host. Autoinfection can result in large numbers of worms and
symptoms.

Pathology:

 Light infections may be asymptomatic.

 Moderate to heavy infections can cause:

 Diarrhea
 Abdominal pain
 Nausea and vomiting
 Anal itching
 Loss of appetite and weight loss (in severe cases)
 Nutritional deficiencies (due to impaired nutrient absorption)

Symptoms and Signs of Hymenolepis nana Infection

Infections are often asymptomatic, but heavy infections may cause crampy abdominal pain,
diarrhea, anorexia, pruritis ani, and nonspecific systemic symptoms. On occasion H. nana is
misdiagnosed as pinworm infection.

Diagnosis of Hymenolepis nana Infection

 Microscopic examination of stool for ova and proglottids

 Diagnosis is made by finding eggs in stool samples.

Treatment of Hymenolepis nana Infection

Praziquantel
Alternatively, nitazoxanide or, outside the United States, niclosamide

The treatment of choice for H. nana infection is Praziquantel 25 mg/kg orally once

Alternatives include nitazoxanide and niclosamide (not available in the United States).
For nitazoxanide, dosage is

For patients > 11 years: 500 mg orally 2 times a day for 3 days

For children aged 4 to 11 years: 200 mg orally 2 times a day for 3 days

For children aged 1 to 4 years: 100 mg orally 2 times a day for 3 days

For niclosamide, dosage is

For adults: 2 g orally once/day for 7 days

For children > 34 kg: 1.5 g in a single dose on day 1, then 1 g once/day for 6 days
NAME: AWURUMIBE DANIELLA CHIAMAKA
MATRIC NUMBER: AUL/NSC/22/108
COURSE CODE: MCB 225
COURSE TITLE: MEDICAL MICROBIOLOGY AND PARASITOLOGY II
LECTURER: MR AZEEZ IBRAHIM

For children 11 to 34 kg: 1 g in a single dose on day 1, then 500 mg once/day for 6 days

A stool sample should be repeated one month after therapy is completed to verify cure.

Prevention:

 Good hygiene practices, especially handwashing after using the toilet and before
eating.
 Proper sanitation measures to prevent fecal contamination of food and water.
 Short fingernails in children to minimize fecal-oral transmission.
 Treatment of infected individuals to prevent further transmission.

CAUSAL AGENTS
Hymenolepiasis is caused by two cestodes (tapeworm) species, Hymenolepis nana (the dwarf
tapeworm, adults measuring 15 to 40 mm in length) and Hymenolepis diminuta (rat
tapeworm, adults measuring 20 to 60 cm in length). Hymenolepis diminuta is a cestode of
rodents infrequently seen in humans and frequently found in rodents.

LIFE CYCLES

Hymenolepis nana

Eggs of Hymenolepis nana are immediately infective when passed with the stool and cannot
survive more than 10 days in the external environment . When eggs are ingested by an
arthropod intermediate host (various species of beetles and fleas may serve as intermediate
hosts), they develop into cysticercoids, which can infect humans or rodents upon ingestion
and develop into adults in the small intestine. A morphologically identical variant, H.
nana var. fraterna, infects rodents and uses arthropods as intermediate hosts. When eggs are
ingested (in contaminated food or water or from hands contaminated with feces), the
oncospheres contained in the eggs are released. The oncospheres (hexacanth larvae) penetrate
the intestinal villus and develop into cysticercoid larvae . Upon rupture of the villus, the
cysticercoids return to the intestinal lumen, evaginate their scoleces , attach to the intestinal
mucosa and develop into adults that reside in the ileal portion of the small intestine producing
gravid proglottids . Eggs are passed in the stool when released from proglottids through its
genital atrium or when proglottids disintegrate in the small intestine . An alternate mode of
infection consists of internal autoinfection, where the eggs release their hexacanth embryo,
which penetrates the villus continuing the infective cycle without passage through the
external environment . The life span of adult worms is 4 to 6 weeks, but internal
autoinfection allows the infection to persist for years.

Hymenolepis diminuta
NAME: AWURUMIBE DANIELLA CHIAMAKA
MATRIC NUMBER: AUL/NSC/22/108
COURSE CODE: MCB 225
COURSE TITLE: MEDICAL MICROBIOLOGY AND PARASITOLOGY II
LECTURER: MR AZEEZ IBRAHIM

Eggs of Hymenolepis diminuta are passed out in the feces of the infected definitive host
(rodents, man) . The mature eggs are ingested by an intermediate host (various arthropod
adults or larvae) , and oncospheres are released from the eggs and penetrate the intestinal
wall of the host , which develop into cysticercoid larvae. Species from the
genus Tribolium are common intermediate hosts for H. diminuta. The cysticercoid larvae
persist through the arthropod’s morphogenesis to adulthood. H. diminuta infection is acquired
by the mammalian host after ingestion of an intermediate host carrying the cysticercoid
larvae . Humans can be accidentally infected through the ingestion of insects in precooked
cereals, or other food items, and directly from the environment (e.g., oral exploration of the
environment by children). After ingestion, the tissue of the infected arthropod is digested
releasing the cysticercoid larvae in the stomach and small intestine. Eversion of the
scoleces occurs shortly after the cysticercoid larvae are released. Using the four suckers on
the scolex, the parasite attaches to the small intestine wall. Maturation of the parasites occurs
within 20 days and the adult worms can reach an average of 30 cm in length . Eggs are
released in the small intestine from gravid proglottids that disintegrate after breaking off
from the adult worms. The eggs are expelled to the environment in the mammalian host’s
feces .

REFERENCE

https://www.msdmanuals.com/professional/infectious-diseases/cestodes-tapeworms/
hymenolepis-nana-dwarf-tapeworm-infection#Treatment_v1015286

https://www.msdmanuals.com/home/searchresults?query=echinococcus
NAME: AWURUMIBE DANIELLA CHIAMAKA
MATRIC NUMBER: AUL/NSC/22/108
COURSE CODE: MCB 225
COURSE TITLE: MEDICAL MICROBIOLOGY AND PARASITOLOGY II
LECTURER: MR AZEEZ IBRAHIM
https://www.msdmanuals.com/home/searchresults?query=echinococcus

https://www.cdc.gov/dpdx/echinococcosis/index.html#:~:text=Echinococcus
%20multilocularis%20affects%20the%20liver,%2C%20spleen%2C%20and%20brain
%20occur.

https://pubmed.ncbi.nlm.nih.gov/6542390/

Centers for Disease Control and Prevention (CDC). (2021, August 09).
Paragonimiasis (Paragonimus flukes). Centers for Disease Control and
Prevention. https://www.cdc.gov/dpdx/paragonimiasis/index.html