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Faculty of Health Sciences: Department
Faculty of Health Sciences: Department
Department
of
Medical laboratory sciences
Course: MEDICAL PARASITOLOGY II
Lecture (5)
Prepared and presented by:
CHAPTER TWO
INTESTINAL NEMATODES
Learning Objectives
After completion of this chapter, the student will be able to
Discuss Life cycle of Hook worm .
Explain the Pathogenicity and Laboratory diagnosis
of Hook worm.
Describe the characteristics of Necator Americanus .
Life cycle
Man is the only host . No intermediate host is required.
Adult worms in inhabit the small intestine of man attaching
Themselves to the mucous membrane
by means of their mouth parts.
The eggs containing segmented ova are passed out in
the faeces of infected person.
Life cycle
In the warm and moist soil rhabditioform larvae hatch
out from the egg in 24-48 hours.
They measure 250µm in length and are 17µm
in maximum diameter.
These feed on bacteria and organic debris and the third
and fifth day and develop into filariform larvae,
Life cycle
These measure 500-700µm in length and are
the infective stage of the parasite.
Depending on the temperature and moisture
content of the soil, filariform larvae can remain
infective for up to 6 weeks.
Life cycle
When a person walks barefoot on soil containing
The filariform larvae they penetrate the skin,
particularly the skin between the toes, the
dorsum of the foot .
and the In farm workers the larvae may penetrate
the skin of the hands.
Cont….
On reaching the subcutaneous tissue
Through lymph-vascular system
they enter into venous circulation and
are carried via the right heart into the pulmonary
capillaries.
Cont….
Here they break through the capillary walls
and enter into the alveolar spaces. From
alveoli, the larvae migrate up the bronchi,
trachea and larynx, to the pharynx
and are swallowed.
Cont….
During migration or on reaching oesophagus
There after they reach small intestine, undergo
and develop into adult worms.
They attach themselves to the mucous
membrane of small intestine by means of their mouth
parts.
Cont….
In about six weeks, from the time of infection,
adult worms become sexually mature.
Male fertilizes female and the latter lays eggs which are pa
ssed in faeces
and the cycle is repeated.
Cont….
Larvae A. duodenale may pass from the mother
to foetus in utero.
In addition, infection by A. duodenale may
properly also occur by the oral
and transmammary route.
Pathogenicity
Clinical disease in A. duodenale infection
may be caused by the migrating larvae
or adult worms. The Migrating larva of A.duodenale
may cause two types of lesion ancylostoma
dermatitis and pulmonary lesions.
Pathogenicity
The ancylestoma dermatitis, is a condition occurs
when filariformlarva enter skin they may lead to dermatitis.
The causes intense itching and oedema of the area
which soon develop
This condition is more common with N. americanus
than with A. duodenale infection. It disappears in
1-2 weeks.
Pathogenicity
Pulmonary lesions, is a condition occurs when
The filariform larvae break through
The pulmonary capillaries and enter the alveoli
They may be lead to bronchitis and bronchopneumonia.
A marked eosinophilia occurs at this stage.
The disease caused by adult worms is responsible for
the syndrome commonly referred to as hook diseases.
Pathogenicity
The maturing and adult worms attach themselves to
The mucosa of small intestine by means of their mouth parts
Hookworm ingests blood. One adult worm of A. duodenale
and N. americanus sucks 0.2ml and 0.03ml of blood daily,
respectively.In addition, the worm frequently
leaves one site and attaches themselves to another site.
Pathogenicity
As secretions of the worms contain anticoagulant activity,
The bleeding form abandoned site may continue
for some time.
These two facts are responsible for microcytic hypochromic
Type of iron deficiency anaemia.
The degree of anaemia depends on the number of worms,
body irons store and dietary iron.
Pathogenicity
Patient develops , vomiting and diarrhea,
the stool being reddish
Also Symptoms –Abdominal pain ,diarrhea,
loss of appetite Weight loss , Fatigue and anemia.
Laboratory diagnosis
Diagnosis of hookworm infection
can be established by following methods
Laboratory diagnosis
a) Direct methods
Demonstration of characteristics eggs in the faeces
by direct microscopy or by concentration methods.
In heavy infection, a substantial
amount of blood can be lost, and severe iron deficiency a
naemia may develop in a short time.
Adult female hookworm
produce about 2,500 to 5,000 eggs per day, thus
the faecal egg count may reflect
the number of adult hookworms and, in turn, indicate
the severity of infection.
Indirect methods
Blood examination may reveal microcytic
hypochromic anaemia and eosinophilia.
In many cases of hookworm disease stool examination
may show occult blood and crystals.
2) Necator Americanus
Necator americanus adult worm are slight smaller
and thinner than those of A. duodenale.
Differences between the adult worms of
these two human hookworms are given in the .
The eggs of N. americanus
are indistinguishable from those A. duodenale and
life cycle, pathogenicity
and diagnosis of the former is also similar to that of
latter.
SELF-ASSESSMENT QUESTIONS