Cestodes (tapeworms/segmented) Helminthes- Hooman Golfeiz

Diphyllobothrium Dipylidium Egg/larvae T Echinococcus

T saginata Adult T solium
Cestodes latum caninum solium granulosus

English name Fish tapeworm Beef tapeworm Pork tapeworm Cysticercosis

Mode of Eating improperly Ingesting larval
Ingesting fleas Ingesting larval Ingesting egg
transmission to cooked form in Ingesting eggs ONLY
infected with form in ONLY from
human and fish/crustaceans undercooked from (canid) dog feces
larvae undercooked beef human feces
infective form containing larvae pork
Larvae grow to
Migration within
mature tapeworm in Grows in small Grows in small Grows in small Penetrates Penetrates GIhydatid
human
small intestine in 3 intestine intestine intestine GIany organ cyst in lungs, liver, etc.
mo. Can be 10 meters
-appendicitis or
Production of -abdominal -appendicitis or cystercosisskin, -hepatic/pulmonary
-megaloblastic cholangitis
pathology discomfort, cholangitis (from skeletal muscle, involvement
anemia, caused by ↓ (from passage
pruritic and passage of eggs brain (10% of ER -rupture of cyst
B12 of eggs through
diarrhea through GI) seizures) uticaria, eosinophilia
GI)
Eggs/proglottids Eggs or
Eggs/proglottids Eggs or “gravid” Ab detection,
Diagnosis in feces “gravid” Ab detection, IgE,
(operculated with proglottids in ultrasonography to look
(colorless egg proglottids in eosinophilia
knob at bottom) feces for hydatid cyst
packets) feces
Definitive host
Humans, carnivores Humans, dog Humans Humans Humans Dogs

Intermediate host
Water flea and fish Fleas Ox, cattle Humans & pigs Humans & pigs Humans and livestock

Form transmitted
from human Fecal eggs Fecal eggs Fecal eggs Fecal eggs

Geographic foci Most frequent in sheep

Worldwide worldwide worldwide worldwide worldwide
raising countries
Surgery to remove Surgery to remove cyst,
Treatment cysterci, anti- danger if cyst
prazyquantel prazyquantel prazyquantel prazyquantel
seizure rupturesIgE/eosinophi
medications lia
 Trematodes (flukes/nonsegmented)

S.mansoni & Cercarial

Trematodes S. haematobium Paragonimus westermani Faciola hepatica
S.japonicum dermatitis
Wander
English name Lung fluke Liver fluke
Schistosoma
Mode of
By contact through the skin By contact through the skin Ingestion of raw Ingestion of
transmission to By contact with
by cercariae by cercariae crustaceans containing metacercariae on
human and cercariae
(from fresh water) (from fresh water) metacercariae water plants
infective form
Penetrate skin (via
Penetrate skin (via HLA) Penetrate intestinal Penetrate
HLA)lose tail to form Penetrate
lose tail to form wallmigrate to lungs skinfail to
Migration within schistosomulaeget in walladults in
schistosomulaeget in blood and lay form functional
human bloodlay eggs in hepatic biliary
lay eggs in liverintestinal eggssputumcan be schistosomulum
liverintestinal ducts
lumen/bladder swallowed & enter feces and die
lumen/bladder
-pathology caused by -acute (invasion and -acute: diarrhea,
inflammatory response to Hematuria in early disease, migration): diarrhea, enalrged liver
Inflammatory
Production of dead eggs fibrosis of bladder and cough, IgE, eosinophilia -chronic:
reaction in skin
pathology -portal hypertension, ascites, obstructive uropathy, renal -chronic (Pulmonary): intermittent
(small red spots)
esophageal varices, liver failure, hydronephrosis discoloration of sputum block of biliary
fibrosis from eggs duct
-Eggs in stool/sputum
Diagnosis Eggs in feces Eggs in urine -Immunodiagnosis Eggs in stool
possible DD from TB
Humans, sheep,
Definitive host Humans Humans Humans Birds
cattle
Intermediate host Snails Snails Snails Snails
Eggs Eggs (50% of eggs die within
Form transmitted
(eggs produce proteases host tissue causing most of Eggs Eggs
from human
allowing tissue migration) the pathology)
Sheep, cattle,
Geographic foci Southeast Asia and Japan consumption of Pond swimmers
raw watercress
Anti-
Treatment prazyquantel prazyquantel prazyquantel Triclabendazole inflammatory
drugs
 Nematodes (roundworms/nonsegmented)

Enterovious Trichuris Dracunculus

Nematodes Ascaris lumbricoides Trichinella spiralis Necator/ancylostoma
Vermicularis trichiura medinensis
English name Pinworm Whipworm Largest worm Trichinosis Guinea worm Hookworm
Ingestion of
Mode of Ingestion of embryonated Ingestion of Ingestion of
transmission to embryonated eggs eggs embryonated eggs Ingestion of larvae unfiltered water Flariform larvae
human and (eggs take ~6 hrs to (eggs take 3-4 (eggs take 2-4 wks to in pork meat containing L3 penetrate skin
infective form become mature) days to become become mature) larvae
mature)
Intestinemigrate Intestinestay in Intestinelung/liver -small intestine -skinmigrate via lung
Migration
to perianal regions to cecum and lay tracheaepiglottis mucosastriated -penetrate epiglottisswallowed
within human
lay eggs eggs there swallowedintestine muscle (tissue) GIfertilized ~Ascaris & westermani
- often female migrates -cutaneous-ground itch
-predilection for to surface of
-often asymptomatic, -large numbers can -pulmonary phase- local
striated muscle, skinblister
Production of asymptomatic, anemia, bloody cause pneumonitis and hemorrhage,
myocarditis and discharges
pathology perianal pruritis diarrhea, mucous liver enlargement eosinophilia
potentially fatal, larvae
specially at night with heavy -IgE, eosinophilia -intestinal phase-iron
eosinophilia
infections deficiency, anemia, pica
-Eggs (purple) on -eggs in feces (thick -Eggs (ovoid with
-presence of eggs -based on clinical -painful blister,
anal skin (scotch- shell with transparent shell) in
(football) in Sx (myositis) and with worm
Diagnosis tape test) mammillated layer) stool
feces, NOT in IgE, eosinophilia emerging as a
-Sometimes also in -occasionally whole -eosinophilia in
perianal region -EIA, biopsy whitish filament
feces worms expelled migratory phase
-Humans, pork,
Definitive host
mice
Intermediate
Direct life cycle Direct life cycle Direct life cycle
host
Form from Eggs, Largest Larvae from
Eggs Eggs Eggs
human nematode blister
The most common Most common
Home-raised pork, Narrow belt of
helminthic infection -tropical climate, helminthic infection
Geographic foci wild boar, polar African Moist climates
in the U.S. southern U.S. worldwide
bear, fox countries
-temperate climate -tropical climate
Pyrantel pamoate, -No drug once Steroids, Albendazole,
Mechanically
Treatment Mebendazole, Mebendazole migrated, Mebendazole, Mebendazole, Pyrantel
extract of worm
Albendazole Mebendazole Albendazole pamoate
 Nematodes Strongyloides Wuchereria Onchocerca Anisakiasis Toxocara A. braziliense/A.
stercoralis bancrofti volvulus cani/cati caninum
English name Wander
Threadworm Elephantiasis River blindness Wander worm Wander worm
hookworm
Mode of
Transmission of Transmission of Ingestion of
transmission to Flariform larvae By ingestion of By contact
larvae by mosquito larvae by blackfly infection fish
human and penetrate skin larvae (dog/cat)
bite bite with larvae
infective form
Migration within BitesubQ
Bitelymph Larvae
human - skinmigrate via lung nodules
Produce penetrates gastric
epiglottisswallowed Produce Tissue infection
microfilariaeblood and intestinal
-similar to hookworm microfilariaeskin
and lymph mucosa
except: eggs hatch in and lymphs
Production of intestine before they are -Visceral larva
Hydrocelechyluria Abdominal pain,
pathology passed to feces, larvae migrans (fever, -cutaneous larva
Elephantiasis, Punctuate keratitis, severe
can mature into wheezing, migrans (
tropical pulmonary blindness, subQ eosinophilia
flariforms in hepatomegaly intensely
eosinophilia nodules, Resembles
intestineautoinfection eosinophilia) pruritic)
Crohn’s disease
Diagnosis Microfilariae in -Microfilariae in skin
Gastroscopic asymptomatic
Rhabtidiform larvae in peripheral blood by snip biopsy, Ag/Ab
examination and -Eosinophilia
feces (NO eggs) Kit, marked -DEC patch test-
biopsy and + serology
eosinophilia in CBC Mazzotti rxn
Definitive host
Monkeys, dogs

Intermediate host

Form transmitted Rhabtidiform larvae in

from human feces
Geographic foci
Tropical, southern U.S.
Treatment Ivermectin,
doxycycline, surgery Ivermectin,
Ivermectin Surgical removal Albendazole Self-limiting
of hydrocele, nodulectomy
elephantiasis