Helminth living in tissue

(Morphology)

- Rahmat Azimi (C011181311)

- Andi Muhammad Mario Riwawo (C011181312)
- Syeila Marsela (C011181313)
- Fadillah Amalia Darma ( C011181314)
- Sakkti ( C011181315)
- Andi Bunga Aqila ( C011181316)
- Afifah Nabila Ismail ( C011181317)
- Achmad Razak Nirhamzah ( C011181318)
- Shahnaz Azis Alamri (C011181319)
08/17/2021 22:00 - Intan Wirastuti Masri ( C011181320) 1
 Parasite in lymphatic
system
• Nematode species
• Wuchereria bancrofty
• Brugia malayi
• Brugia timory

08/17/2021 22:00 Tissue Helminth/ SWahyuni 2

Adult filarial worm

• Head: Slightly swollen and bears two circles of

papillae
•Mouth: Small, buccal capsule is lacking
Female
• 6-10 cm (Brugia 8-10 cm)
• Vulva near to oesophagus
•Produce microfilaria
Males
• 4-5 cm (Brugia 1.5-2
cm)
• Tail like finger
(Brugia: curved
ventrally) Aranae et.,al.2020
3
• No nuclei in the end of tail (Brugia: nuclei in the
Microfilaria

Arina, et ., al .2021
Microfilaria

Roy et.,al.2019
Microscopic detection

• To detect microfilaria
• Sample: Finger prick or venous
blood filtration
• Methods: Thick blood smear stain
with Giemsa 3%

6
 Helminth
7 in
Vena Mesenterica and V. Vesicalis

• Blood trematode species:

• Schistosoma mansoni
• Schistosoma japonicum
• Schistosoma
haematobium
• Schistosoma mekongi
• Schistosoma intercalatum
 Host intermediate 8

• Biomphalaria sp. • Bulinus sp. • Oncomelania sp.

Host perantara • Host perantara dari Host perantara
S. mansoni S.haematobium dari
and S.intercalatum S. japonicum Aes., et
al. 2020
Infective stage 9

Cercaria penetrate skin

Adult worm 10

• Have oral sucker

• Female:
• 1-2 cm long thinner & longer
than male
• Stay in a groove on ventral side
(gynaaecophoric canal) of male
• Feed on host erythrocytes and body
solutes
• Life span of 5-10 years
• 4-7 weeks post infection the
mated adult female starts to
produce eggs (3000 eggs/day)

08/17/2021 22:00 Helminth in Tissue/ SWahyuni

worm 11

08/17/2021 22:00 Helminth in Tissue/ SWahyuni

Morphology Schistosome
Eggs 12

S. Japonicum S. mekongi S. haematobium S. intercalatum S haematobium

08/17/2021 22:00 Helminth in Tissue/ SWahyuni

Microscopic
diagnosis 13

Parasite detection
• Stool examination (S. mansoni or S.
japonicum)
• Simple smear (1 to 2 mg of fecal
material)
• Concentration procedures (formalin- ethyl
acetate technique)
• Kato-Katz technique
• Urine examination (S. haematobium)
• Collection time 12-15 PM
• Enhanced by centrifugation & examination
of the sediment
• Quantification by using filtration through a
Nucleopore® membrane of a standard
volume
08/17/2021 22:00 Helminth in Tissue/ SWahyuni
 Helminth the
Lung 14

• Trematoda: Paragonimus sp
• Intermediate: Snail and water crab/ shrimp

Freshwater snails:
a. Triculinae sp. (from Yen Bai
b. Triculinae sp. 2 from Quang Tri.
c. Sulcospira quangtriensis from Quang Tri

08/17/2021 22:00 Helminth in Tissue/ SWahyuni

 Morphology adult paragonimus westermani
• Adults of Paragonimus spp.
• 7.5 to 12 mm by 4 to 6 mm.
• Large, robust, ovoid flukes.
• Hermaphroditic, a lobed ovary
located anterior to two branching
testes.
• Possess oral and ventral suckers.

http://www.drchurchbiology.com/BIO3270/Images/Worms/paragonimus.htm
 Morphology 16

Egg Paragonimus
• Size 80-120 x 45-70,
• Yellow-brown, ovoid or elongate, with a thick
shell, and often asymmetrical with one end
slightly flattened.
• At the large end, the operculum is clearly
visible and the opposite (abopercular) end is
thickened.
• Un-embryonated when passed in sputum or
feces.

ps://mcdinternational.org/trainings/malaria/english/dpdx5/html/Frames/M-R/Paragonimiasis/body_Paragonimiasis_mic1

08/17/2021 22:00 Helminth in Tissue/ SWahyuni

Microscopic detection 17

• Specimen: Fecal sample or sputum

• Methods: Wet mount
• Egg present 2 to 3 months after infection.
• Concentration techniques may be necessary in light infections.

08/17/2021 22:00 Helminth in Tissue/ SWahyuni

 18

Animal ring worm

• Nematoda:
• Toxocara cati (cat roundworm)
• Toxocara canis (dog roundworm)

8/17/2021 S. Wahyuni, Parasitology Dept, Medical Faculty, Unhas

 Adult toxocara

The anterior end,

showing the three lips Posterior end
characteristic of ascarid of Toxocara sp.
worms. (New Jersey State Public
(New Jersey State Public Health Laboratories).
Health Laboratory.
https://commons.wikimedia.org/wiki/File:Toxocara-canis-adults.jpg
https://mcdinternational.org/trainin
gs/malaria/english/dpdx5/html/Ima
geLibrary/S-
Z/Toxocariasis/body_Toxocariasis_i
https://www.dreamstime.com/photos-images/adult- l3
toxocara.html
 Toxocara
Toxocara
eggs eggs

• Golden in color
• Spherical to slightly pear shaped, thick-shelled,
and have
 a pitted surface.

• Size
• T. canis is slightly larger (80—85 µm)
• T. cati (65—75 µm).
• Eggs embryonate in 1 to 4 weeks in the
environment and
 become infective, containing third-stage (L3)
larvae
https://www.researchgate.net/figure/Eggs-of-Toxocara-canis-and-Toxascaris-leonina-A-T-
canis-bar-80-m-B-T-leonina_fig1_7790389
• Can persist in the environment for years.
 Helminth in Muscle: Trichinella spiralis
Speciment: Muscle biopsy

https://www.britannica.com/animal/trichina

Larvae of Trichinella, freed from their cysts, typically coiled;

length: 0.8 to 1 mm

https://www.researchgate.net/figure/Figura-2-Larva-de-T-spiralis-viable-
Puede-visualizarse-su-forma-espiralada-y-su_fig1_44853276/amp

8/17/2021 S. Wahyuni, Parasitology Dept, Medical Faculty, Unhas 21

 Helminth in hepar
• Trematode Parasite (flukes)
• Fasciola h e p a ti c a → Fascioliosis
• Fasciola g i g a n ti c a → Fasciolopsiasis
• Parasite of herbivores that can infect humans
accidentally
• Size F hepatica : up to 30 x 13 mm
• Reside in the large biliary ducts of the mammalian
Gilles et al. 2017
host. Host intermediate:
Galba truncatula,
• Worldwide distribution the main intermediate host
in Europe and western Asia.
Conchology, Inc, Mactan
Island, Philippines.

8/17/2021 S. Wahyuni/lecture/tissue helminth 22

Fasciola hepatica

https://edubiologi.com/daur
-hidup-fasciola-hepatica/
Fasciola hepatica eggs
• Yellow-brown,
large, ovoid, operculated,
bile-stained
• Size: 140 μm by 80 μm.
• The eggshell is smooth and
fined with a double line.
• Eggs contain an immature
larva, the miracidium.
• It unembryonated when
freshly passed.
• F. hepatica and Fasciolopsis
buski eggs cannot be
differentiated.
https://www.researchgate.net/figure/Fasciola-hepatica-sample-No-48-
flotation-Operculum-on-the-left-pole-inside-remains_fig7_235923475
 Fasciolopsis buski 25

8/17/2021 S. Wahyuni, Parasitology Dept, Medical Faculty, Unhas

 Fasciolopsis buski eggs 26

8/17/2021 S. Wahyuni, Parasitology Dept, Medical Faculty, Unhas

 Microscopic
diagnostic 27

• Specimen: Fecal, duodenal or biliary fluids

• Methods: Wet mount
• False fascioliasis (pseudofascioliasis): The presence of eggs in the stool resulting
not from an actual infection but from recent ingestion of infected livers
containing eggs: → can be avoided by having the patient follow a liver-free
deit several days before a repeat stool examination.

8/17/2021 S. Wahyuni, Parasitology Dept, Medical Faculty, Unhas

Animal hookworm 28

• Species
• Ankylostoma
caninum
Ankylostoma

braziliennsis)
• Difficult to differentiate
Ankylostoma eggs A. caninum A. braziliensis
from other hookworms.
• Males are smaller than
females
• Have three pairs teeth

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volvulus 29

• Specimen: Nodulus subcutaneous biopsy

• White or cream transparent & transverse
striation in the cuticle
• Male: 19 to 42 mm by 130 to 210 µm
• Female: 33 to 50 mm in length and 270 to
400 µm in diameter, produce 1000-3000
mf/day for 9 years
• Tightly coiled in couples in subcutaneous
tissues and in nodules
• Longevity of 10-15 years

T
a
08/17/2021 22:00 k
Tissue helminth/ SWahyuni
 Microfilaria Onchocerca 30

volvulus
• 220 to 360 µm by 5 to 9 µm
• Unsheathed The tail tapers to a point and
is often sharply bent
• Life span that may reach 2 years.
• live 7-10 days in flies

08/17/2021 22:00 Tissue helminth/ SWahyuni

 Laboratory
diagnosis
31

• Specimen for adult: Biopsy skin nodules or remove the

nodule
• Microfilariae: Skin snips Skin snips

• Should be thin enough, include the outer part of the

dermal palpillae but not so thick as to produce bleeding.
• Should be placed immediately in normal saline or distilled
water, just enough to cover the specimen.
• Microfilariae tend to emerge more rapidly in saline,
however in either medium the microfilariae typically
emerge in 30-60 min and can be seen in wet mount
preparations.
• For a definitive diagnosis, allow the wet mount to dry, fix
in methanol, and stain with Giemsa or hematoxylin-and-
eosin.
08/17/2021 22:00 Tissue helminth/ SWahyuni
 32
Helminth in the Eyes: Loa loa

Adult morphology
• Visible with naked eye
• White or cream transparent
• Male: 30 to 34 mm in length and 0.35
to 0.43 mm in diameter
• Female: 40 to 70 mm in length and 0.5
mm
• The female produce microfilaria

08/17/2021 22:00 Tissue helminth/ SWahyuni

 Microfilar
ia
33

• 250 to 300 µm by 6 to 8 μm
• Sheathed and have diurnal periodicity.
• Can be found from spinal fluids, urine,
and sputum.
• During the day they are found in
peripheral blood
• During the noncirculation phase,
they are
found in the lungs .
Microfilaria of L. loa a thick blood smear
from a patient from Cameroon, stained
with Giemsa. Note the nuclei extending
to the tip of the tail to the left of the
08/17/2021 22:00 Tissue helminth/ SWahyuni
image.