Helminthology

Lab Course
 LEARNING OBJECTIVES
• Understand medically important helminthes including
their life cycles, modes of transmissions, clinical features,
diagnosis, and prevention.
 INTRODUCTION
Medical helminthology is the
study of parasitic worms

Helminthes are metazoa (multi-

cellular organisms)

Cause of high mortality of

people worldwide

Cause anemia and malnutrition

Cause economic loss as a result

of infections of domestic animals
Helminthes classification
1. Trematodes (Flukes)

Faciola
hepatica

2. Cestodes (Tape worms)

3. Nematodes (Round worms)

Phylum: Platyhelminthes
‫شعبه الديدان المسطحه‬
 General characteristic
• Dorso-ventrally flattened worms
• Bilaterally symmetrical
• Possess an incomplete digestive tract
• Lack body cavity (Acoelomate)
• Without special skeletal, circulatory or respiratory
systems.
• The excretory system is based on the flame cells.
• They are mostly hermophroditic (Both sexes are
contains in one individual) with few exceptions.
 Flat worms divided into three
chief classes
• Class : Turbellaria

• Class: Trematoda

• Class: Cestoidea
Class: Trematoda
‫صنف المخرمات‬
Order: Digenea
 General Characteristic

All are parasitic

Adults usually parasitize vertebrates
Body flat; oval to elongate in shape
Range in size from <1 mm to ~60 mm
Efficient at absorbing nutrients
Have two suckers: oral sucker and acetabulum
Anterior mouth
Digestive system divides into two blind pouches
called cecae
 Order: Digenea
Divided into four groups according to the site where worm
presence:
1- Liver Fluke
2- Intestinal Fluke
3- Lung Fluke
4- Blood Fluke
Life Cycles
Liver Flukes
 Fasciola hepatica
Scientific name :Fasciola hepatica
Common name: Sheep liver fluke
Disease: Liver rot

Infective stage: Metacercaria

1st intermediate host: Lymnea

2nd intermediate host: aquatic vegetation (water cress)

Diagnosis: ova are found in faeces

Presence in the host: The adults live in the Bile ducts of sheep, goats,
caws, and sometimes could infect human
Fasciola hepatica ‫ ملم‬30 ‫يصل طولها الى‬
Fasciola hepatica life cycle
 Fasciola hepatica
Unembryonated ova
Fasciola hepatica
miracedium
Cross Section in Snail Tissue showing
Sporocyst of Fasciola hepatica
 Fasciola hepatica
Mother Redia

Fasciola hepatic
Daughter Redia

Fasciola hepatica
cercaria
 Clonorchis sinensis
Scientific name: Clonorchis sinensis
Common name: Chinese or Oriental Liver Fluke
Disease: Clonorchiasis
Infective stage: Metacercaria

1st intermediate host: Thiara or Bithynia

2nd intermediate host: Fresh water fish (Cyprinoid fishes)

Diagnosis: Ova are found in faeces

Presence in the host: Adults lives in bile ducts of human and

mammals eat fish (Cats, Dogs)
Ova of Clonorchis sinensis
Clonorchis sinensis life cycle
 Dicrocoelium dendriticum
Scientific name : Dicrocoelium dendriticum
Common name: Lancet liver fluke
Infective stage: Metacercaria

1st intermediate host: Cionella lubrica

2nd intermediate host: Formica fusca

Diagnose: Ova in faeces

Presence in the host: Adults lives in bile ducts of sheep, goats,

pigs. deer, rabbits
Dicrocoelium dendriticum
Oral sucker

Testes
testes

ovary

V.gland

Uterus
Dicrocoelium dendriticum life cycle
Helminthology
Intestinal flukes
 Fasciolopsis buski
Common name/ location: Giant intestinal fluke/
human small intestine, found in pigs as well

Length: 25-75 mm

Disease: Fasiciolopsiasis

Infective stage: Metacercaria

Intermediate host: 1- Snail Segmentina

2- Water chestnut

Diagnosis: Ova in feces (unemberyonated ova)

Fasciolopsis buski
Oral sucker

Ventral sucker

cecum

Uterus

ovary

Vitelline gland
Testes
Fasciola hepatica up to 30 mm Fasciolopsis buski 25-75 mm
Fasciolopsis buski life cycle
 Heterophyes heterophyes
Common name/ location : Small intestine fluke/ live
in small intestine between the villi of human/ other
mammals that eating fish

Length: 0.1 – 1.7 mm

Disease: Heterophyiasis

Infective stage: Metacercaria

Intermediate host: 1- Pirenella conica

2- Mugil
Diagnosis: ova in feces (Emberyonated )
Heterophyes heterophyes life cycle
Intestinal flukes of animals
 Paramphistomum cervi
Common name/ location : Ruminal flukes, found in
the Rumen of ruminants cattles

Length: 5-13 mm

Disease: Amphistomiasis

Infective stage: Metacercaria

Intermediate host: 1-Fresh water snail Bulinus

2-Aquatic plant

Diagnosis: Ova in feces

Paramphistomum cervi
Paramphistomum cervi life cycle
 Echinostoma revolutum
Echinostoma ilocanum
Common name/location: Trematode flukes/ found usually in
the ileum of ducks/geese/ pigeons/ chicken/ rarely humans

Length: 8.8 – 9.5 mm

Infective stage: Metacercaria

Intermediate host: Snail (Physa)

Snail or Frogs

Diagnosis: Ova in feces

Echinostoma revolutum, oral sucker surrounded
by circumoral disk with three rows of spines (37
spines in E.r.)
Echinostoma revolutum Oral sucker

Ventral sucker

uterus

Ovary

Mehlis’ gland
V.Gland

testes
Echinostoma revolutum life cycle
Lung flukes
 Paragonimus westermani
Common name/ Location: Oriental lung fluke , found in
lungs of human
Length: 7.5 – 12 mm

Body: covered with scal-like spines

Disease: Paragonimiasis or pulmonary distomiasis

Infective stage: Metacercaria

Intermediate host: 1- Fresh water snail Thiara

2- crayfish

Diagnosis: Ova in sputum (sometimes in feces)

Paragonimus westermani

Oral sucker

Cecum

Ventral sucker
Uterus

Ootype
Ovary
Yolk gland
Testes
Paragonimus westermani Life cycle
 Class: Trematoda
Blood Flukes
Schistosomiasis
)‫المثقوبات الدموية (المنشقات‬
the first described the adult Schistosoma worm
in Egypt
 Blood flukes
• S. haematobium - Africa and middle east

• S. mansoni - Africa and Latin America

• S. japonicum – Pacific region

• Dioecious (male and female)

 Blood flukes
Oral sucker: includes mouth
Ventral sucker: usually bigger than oral sucker and
located near genital pore Oral sucker
Ventral
sucker

Female Male
The body has a groove along match of its length
and, it was this groove that inspired the name
Schistosoma or split body

The female lies within this groove, which is

called gynaecophoric groove
 Anatomy of Blood flukes
•There is no muscular
pharynx , and the
intestinal ceca unite
posteriorly to form
single ceca

•4-8 testes are found

in males (depending
on species)

•Only single ovary in

females
• Cercaria of schistosoma spp is forked tailed
cercaria
• No redia in their life cycle stages
 Site of infection
S. haematobium urinary ‫األورده البولٌه‬
‫ واألورده المثانٌه‬veins
‫ و الضفائر‬vesicle veins
Pelvic plexus ‫الحوضٌه‬

S. mansoni ‫األورده المسارٌقٌه السفلى‬

inferior mesenteric
‫ وفً الضفائر‬vein
hemorrhoidal ‫الباسورٌه‬
plexus
S. japonicum ‫األورده المسارٌقٌه العلٌا‬
superior mesenteric
‫ قد توجد فً األورده‬vein
gastric ‫المعدٌه المسارٌقٌه‬
mesenteric veins
 Disease
Schistosoma Urinary bilharziasis
haematobium ‫بلهارزٌا المجاري البولٌه‬

Schistosoma mansoni Intestinal Schistosomiasis

‫داء المنشقات المعوي‬

Schistosoma Oriantal Schistosomiasis

japonicum ‫داء المنشقات الٌابانٌه او داء المنشقات‬
ً‫الشرق‬
 Intermediate hosts
S. haematobium Bulinus

S. mansoni Biomphalaria

S. japonicum
Oncomelania
 Blood flukes eggs (ova)

S. haematobium egg S. mansoni egg S. japonicum egg

big, with terminal spine, Bigger, with lateral spine, small, with reduces
Secreted with urine Secreted with stool lateral spine (knob)
Secreted with stool
 Male cuticula type and length

S. haematobium S. mansoni S. japonicum

Cuticula with fine Cuticula with coarse
Smooth cuticula
tegument tegument
10-15 mm 6.5-9.9 mm 12-20 mm
Schistosoma spp. Life cycle