CLINICAL PARASITOLOGY (LECTURE)

1: INTRODUCTION TO MEDICAL PARASITOLOGY

INSTRUCTOR: MR. EUGENE DAYAG
TRANS BY: SUNGA, AUDREY JANELLE J.
DATE: JANUARY 23, 2024

- Association that is beneficial to one partner

OUTLINE and at least not disadvantageous to the
other
I. DEFINE PARASITOLOGY - A relation between two kinds of organisms
II. EXPLAIN THE HOST-PARASITE RELATIONSHIP in which one obtains food or other benefits
III. DISCUSS THE DIFF. TYPES OF ASSOCIATION AND from the other without damaging it
RELATIONSHIP - Ex. Entamoeba coli
3. Parasitism
- A form of symbiosis in which one
organism benefits at the expense of other
INTRODUCTION
organism (parasiye) usually of different
PARASITOLOGY species (host).
- May also lead to the injury of the host.
- Branch of biology concerned with the
- The parasite cannot live an independent life
phenomenon of dependence of one living
- Feeding/fattening
organism on another
- Ex. Entamoeba histolytica
- Study of parasites, their hosts and the relationship
between them
- The study of HOST-PARASITE relationship PARASITE
→ Parasite – an organism that lives in another - Any organism that lives in or on the body of
organism, called host, and often harms it another organism in order to survive
uses the host to gain strength, and the host - An organism that has sustained contact with
loses some strength as a result another organism to the detriment to the host
→ Host – an animal or plant on or in which a organism
parasite or commensal organism lives
HOST
- Any organism that harbors a parasite
- The organism from which a parasite obtains its
nutrition and shelter

HOST CLASSIFICATION
1. DEFINITIVE/FINAL HOST
- Adult form of the parasite, sexually mature form
- The parasite attains sexual maturity
RELATIONSHIP/ASSOCIATION
- The host in which the parasite goes through its
SYMBIOSIS – ASSOCIATION OF LIVING ORGANISM sexual cycle (i.e. Fertilization and meiosis
- Ex: mosquitoes serve as definitive hosts of the
1. Mutualism
malaria parasite (Plasmodium spp)
- An association between organisms of two
- Snakes (30 species) serve as definitive hosts of
different species in which each is
Sarcocystis singaporensis, a disease of mammals
benefited
- The definitive host may be a human or any other
- “work together” each benefiting from the
living being. However, in majority of human
relationship
parasitic infections, man is the definitive host (e.g.
- Ex. Termites and the flagellates inside
filaria, roundworm, hookworm).
their digestive system
2. Commensalism
- An association between individuals of two 2. INTERMEDIATE HOST
species in which one species obtains food - Harbors the asexual or larval form of the parasite
or benefited from the other without either - Is used normally by a parasite in the course of its life
harming or benefiting the latter cycle and which it may multiply asexually but not
- Means eating at the same table sexually

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

 - Host in which the parasite replicates but does not parasite, usually having acquired the parasite by
go through its sexual cycle ingestion of the original host
- In some parasites, two different intermediate hosts - One in which the parasite does not develop further
may be required to complete different larval stages. to later stages
These are known as first and second intermediate - Parasite remains alive and is able to infect another
hosts, respectively host
- Ex: mammals, including humans, serve as - Gives infection to definite host
intermediate hosts of the malaria parasite - A host, in which larval stage of the parasite remains
(Plasmodium spp) viable without further development is referred as a
- Mammals (30 species including humans) serve as paratenic host. Such host transmits the infection to
intermediate hosts of Sarcocystis singaporensis another host
✓ Sarcocystis singaporensis – has been - Ex. Fish for plerocercoid larva of Diphyllobothrium
proposed as biological control of rodents latum
pests apparently it can selectively kill
them NOTE
- Parasites with man as intermediate or secondary
host: ✓ Senistosoma – blood
✓ Plasmodium spp. → Reservoir
✓ Babesia spp. → Intermediate host -snail
✓ Toxoplasma gondii → Infection to man
✓ Echinococcus granulosus
✓ Echinococcus multilocularis PARASITE CLASSIFICATION
✓ Taenia solium
✓ Spirometra spp. HABITAT
1. Ectoparasite
3. RESERVOIR HOST - A parasite living outside the body of a host
- Organism in which the parasite is harbored until - “Infestation”
transmitted to the main or primary host, - Ectoparasites inhabit only the body surface
- Alternate host or passive carrier of a pathogenic of the host without penetrating the tissue.
organism of the original host. Lice, ticks and mites are examples of
- Allows the parasite’s life cycle to continue and ectoparasites. The Parasitology term
become additional sources of infection infestation is often employed for
parasitization with ectoparasites.
- Is an organism in which a parasite that is
2. Endoparasite
pathogenic for some other species lives and
multiplies usually without damaging its host. - A parasite living inside the body of a host
- Is the population in which a parasite resides when - A parasite, which lives within the body of
it isn’t affecting a population that we care more the host and is said to cause an infection is
about called an endoparasite. Most of the
protozoan and helminthic parasites causing
- Ex .The rabies virus normally is passed back and
human disease are endoparasites
forth among wild mammals (these serve as the
reservoir hosts – the populations that we don’t - “Infection”
much care about)
- Rabies can infect pets, and thereby us AREA/LOCATION
- To prevent the latter, we vaccine pets, avoid 1. Capnophilic
handling wild animals, and otherwise attempt to - Can live and multiply in the moist
reduced the incidence of rabies in reservoir pops - Ex: Protozoans
2. Hematozoic
4. ACCIDENTAL HOST - Live in RBC or also known as erythrocyte
- Infection with parasite not normally found on the 3. Cytozoic
host - Live inside the cell / tissues Isospora
- Not occur from the host hominis
- Ex. Man is an accidental host for Cystic 4. Coelozoic
echinococcosis - Live in body cavities – Mansonella
perstans
5. Enterozoic
5. PARATENIC HOST - Lives inside the lumen of intestines
- Animal acting as a substitute intermediate host of a 6. Permanent parasite

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

 - Forever parasite; lives in a single host 1. Mechanical vector – cockroach with
- Remains on or in the body of the host for ascaris
its entire life 2. Biological vectror - bitten
7. Periodic 3. Food – borne
- Larval stage is different from adult stage - Taenia species
8. Erratic - Trichenella spiralis
- Fix in an unsual habitat - Toxoplasma gondii
- Capillaria philippinensis
RELATIONSHIP BETWEEN HOST-PARASITE - Heterophyds
- Paragonimus westermanii
1. Obligate - Fasciolid
- Needs host to complete their 4. Water – Borne
development; cannot survive without its - Amoeba
own host - Giardia lamblia
- Ex: Ascaris lumbricoides - Blastocystis hominis
2. Facultative - Cryptosporidum species
- With or without host they can live; free - Cyclospora cayetanensis
living 5. Direct contact
- May become parasitic when the need - Trichomonas vaginalis
arises - Enterobius vermicularis
- Ex: thread worm
3. Intermittent
- Visit host during feeding time only SOURCES OF INFECTION
(mosquito) 1. Air
4. Opportunistic ✓ Inhalation
- Infects individual with underlying 2. Animal
diseases ✓ Direct contact
5. Spurious ✓ Zoonosis
- Under came a transient stay in the host - Disease of animals
(napadaan lang) - Disease of animals that are
- Free-living organism transmissible to man
- Passes through the digestive tract without - Trichinellosis - Humans get infected
infecting the host after ingestion of raw or insufficiently
6. Accidental/ incidental cooked meat from infected animals.
- Establishes itself on a host in which it The infection is usually maintained in
does not normally lives a pig-to-pig or pig-to-rat-to-pig cycle.
- Ex. Echinococcus granulosus 3. One’s self
✓ Auto-infection
4. Inanimate objects
EFFECT OF PARASITE ON THE HOST
1. Pathogenic
PORTAL OF ENTRY
2. Non Pathogenic (commensals)
MOUTH
TRANSMISSION - Ingestion
1. Soil Transmitted - Intimate oral contact
- Ascaris lumbricoides - Taenia solium, Taenia saginata, and
- Trichuris trichura Diphyllobothrium latum from eating food harboring
- Hookworm the infective larval stages
- Strongyloides stercoralis - Entamoeba histolytica and Giardia lamblia from
- Requires a period of development in the drinking water contaminated with cysts
soil - Clonorchis, Opistorchis, and Haplorchis through
2. Arthropod/ Vector transmitted ingesting raw or improperly cooked freshwater fish
- Leishmania containing infective larvae
- Trypanosomes
- Babesia
SKIN
- Schistosoma species
- Types of vectors - Active larval penetration → Filariform
- Introduction of the vector

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

 - Hookworms and Strongyloides stercoralis
- enter via exposure of skin to soil, while PARASITIC DAMAGE TO HOST
Schistosoma species enter skin via water
1. Trauma
- Damage to tissues, intestine, liver, eyes,
INTRANASAL etc.
- Compromise the host when has low
immune system
2. Tissue response
- Localized inflammation, eosinophilia
- Reaction to infection
TRANSMAMMARY
- Check the CBC
- With Ancylostoma and Strongyloides, the parasites 3. Blood loss
may be transmitted through mother’s milk - Anemia (heavy Hookworm infection)
- Occurs when previously non-infected hosts become - Hookworms are the bloodsuckers
infected during pregnancy 4. Secondary Infection
- Weakened host susceptible to bacterial
TRANSPLACENTAL infection
- Microbial infection from the bacteria
- Toxoplasma gondii trophozoites can cross the
placental barrier during pregnancy
EPIDEMIOLOGY
SEXUAL - Occurrence & prevalence of disease
- Study the manner of spread of contagious disease
- Trichomonas vaginalis - Study of patterns, distribution and occurrence of
disease
PORTAL OF EXIT
- Determines the specimen to be collected for 1. EPIDEMIC
diagnosis - Sudden increase of infection
a. Stool
b. Urine
c. Sputum 2. ENDEMIC
- Paragonimus westerwani - Certain infection is present in low number but
- Hemoptysis is the blood in sputum constantly present in the area
d. Blood
3. PANDEMIC
TISSUE ASPIRATES - Disease which spreads to several countries and
✓ Liver - amoeba affects a large number of people.
✓ Duodenal - strongy/giardia
✓ Lymph nodes – leishmania, american PARASITIC CONTROL AND PREVENTION
trypanosomes
✓ CSF – african trypanosmes - Drug treatment / Therapeutic measures
✓ Hydrocoele - microfilaria of bancrofti - Sanitary control
→ Water, food, proper waste disposal
- Insecticide spraying
TISSUE BIOPSY
- Meat Inspection
✓ Muscle –Trichenella spiralis is the cause of the - Public education & awareness
pork → Personal prophylaxis
✓ Rectal - Schistosomes
✓ Lymph node – Adult filarial worm
✓ Skin - Cutaneous leishmaniasis STAGES IN LIFE CYCLE
1. Ovum
ORIFICE SWAB 2. Egg
- ova
✓ Vagina 3. Embryo
✓ Peri anal swab - Development of the egg
- Also known as Scotch Tape Method 4. Larva
- Enterobius vermicularis 5. Trophozoite

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

 - Identified in protozoa
6. Cyst
- Identified in protozoa

OTHER TERMINOLOGIES
1. Zoonosis
a) Enzoonotic
- a low level of disease that is
constantly present in a population
b) Epizoonotic
- outbreak of disease in which
there is an unusually large
number of cases
2. Monoxenous Life Cycle
- Direct/simple life cycle
- Parasite lives in the host body for a longer
period of time
3. Heteroxenous Life Cycle
- Indirect life cycle
4. Oviparous
- No embryonic development
5. Ovoviviparous
- Development within the mother’s body
6. Viviparous
- No eggs
- Larva stage

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

CLINICAL PARASITOLOGY (LECTURE)
2: NEMATODES
INSTRUCTOR: MR. EUGENE DAYAG
TRANS BY: SUNGA, AUDREY JANELLE J.
DATE: JANUARY 30, 2024

OUTLINE the body openings

I. Intestinal Nematodes
• Other Specialized techniques
- Serology
II. Tissue Nematodes
- Sputum microscopy
III. Filarial worms • Stool examination
- DFS
→ 2mg of stool
- Concentration techniques
GENERAL CHARACTERISTICS → kato katz/kato thick - formed stool
only (40-50mg stool)
- Unsegmented bodies covered with cuticle
→ FECT
- Cylindrical tapered at both ends
NOTE:
- Have complete digestive tract
- All unfertilized ova – all female
- Color: Light cream – white
- Infection with no ova – all male infection
- Separate sexes
→ Female larger than males (straight tail) Adult Ascaris lumbricoides
→ Male have curved tail w/ spicule Male Female
(copulation) 150 – 200 mm or 200 – 300 mm or 20
- Distribution: Worldwide > 30 cm long – 35 cm long
- Stages in life cycle:
→ Egg, larvae & adults

INTESTINAL NEMATODES
ASCARIS LUMBRICOIDES
- CN: Giant Intestinal Roundworm
- Disease: Anterior Tri lips
→ Ascariasis
- Ascaris Pneumonitis – larvae - A female may produce approximately 200,000
migration in lungs eggs per day
- “worm ball” – blockage in - Fertile eggs embryonate and become infective
intestine after 18 days to several weeks
- Disease of poverty: - After infective eggs are swallowed , the larvae
→ Loaffler’s Syndrome hatch , invade the intestinal mucosa, and are
- Habitat: Small intestine carried via the portal circulation, then systemic
- MOT: ingestion of embryonated eggs (fecal-oral) circulation to the lungs .
- Infective Stage: embryonated ova - Adult worms can live 1 to 2 years
- DX: ova / adult in stool, x-ray
- Tx: Albendazole, Mebendazole, Pyrantel pamoate Fertilized Ova – Ascaris
- Control: Educational awareness & drug therapy lumbricoides
- Broadly oval
Laboratory Diagnosis - 45 - 75 µm x 35 – 50
• Gross Examination of the adult stage coming out of µm

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

 - Outer covering:
albuminoid coat
- Presence of
mammilation
- Stained as “golden
brown” in fresh stool

3 Layers of egg shell

1) Inner non permeable vitelline membrane Example of Ascaris lumbricoides:
2) Thick transparent middle layer glycogen
membrane
3) Outer coat albuminoid layer

Life Cycle of Ascaris lumbricoides

Unfertilized Ova
- Longer and narrower
- 90 x 40 µm
- Thin inner shell & albuminous coat

TRICHURIS TRICHIURA
- CN: Whipworm
- Rectal prolapse, bloody diarrhea, anemia
- Habitat: large intestine (ileo-cecal region)
✓ Which cause the irritation in the intestine
and has no testinall
- MOT: ingestion of embryonated eggs
- Infective stage: embryonated ova
- DX: Ova in stool
- TX:

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

 → Albendazole, Mebendazole Rectal prolapsed
- Control:
→ Educational awareness, Drug therapy

Laboratory Diagnosis
• Stool examination
- DFS
- Concentration techniques
→ kato katz/kato thick – formed stool only
(40-50mg stool) Example of Trichuris trichiuria:
→ Formalin-ether Concentration Technique
(FECT)

Adult - Trichuris trichiura

Male Female
30-45 mm 35-50 mm
Coiled tail - 360º Straight posterior end

HOOKWORK
- Male: 8-11 mm
- Female: 10-13 mm

- Causes bloody stool

Ova - Trichuris trichiura

Barrel / football-shaped
w/ refractile “bi-polar plugs” /
prominences
Lemon – shaped
Chinese lantern -shaped
50 – 54 µm

Laboratory Diagnosis
• Stool examination
- DFS
- Concentration techniques
→ kato katz/kato thick – formed
Life Cycle of Trichuris trichiura: stool only (40-50mg stool)
→ FECT
- Stool Culture
→ Harada-Mori culture

Harada-Mori cultures of specimens 1 – 5

hookworm – after 10days

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

 ✓ Harada Mori Stool Culture worm), itchy rash “cutaneous larva
- It allows hatching of larva from migrans”
eggs on strip of filter paper with - MOT: skin penetration of filariform larvae
one end immersed in water. - TX: Thiabendazole
- Longest life span

NOTE:
✓ 3 pairs of ventral teeth
✓ eosinophilic enteritis

Adult Ancylostoma caninum

1) Ancylostoma duodenale
- CN: Old World Hookworm
- Disease: same as Necator (human)
- Habitat: Small intestine
- MOT: skin penetration of filariform
larvae/ingestion of contaminated food
- Infective stage: filariform larvae
- DX: Ova in stool
3) Ancylostoma braziliense
- TX: Albendazole, Mebendazole,
- CN: Cat hookworm
Pyrantel Pamoate and iron supplements
(anemia) - Commonly infects cats
- Control: Educational awareness, Drug - Disease: Cutaneous Larva Migrans
therapy ✓ inflammation
- Blood loss – 0.03 ml/day (A.duodenale - MOT: skin penetration of filariform larvae
– 0.15 – 0.25 ml/day) - Larva migrate from skin to subcutaneous
- C – shaped tissue; do not mature but “creep” in
subcutaneous tissue
- Life span: 1 year
- TX: Thiabendazole
- Shortest life span

NOTE:
✓ 3 pairs of teeth
✓ can infect humans causing “creeping
eruption” also known as cutaneous larva
migrans (CLM)

Adult Ancylostoma braziliense

Adult Ancylostoma duodenale

4) Necator americanus
- CN: New World Hookworm
2) Ancylostoma caninum
- Disease: Ground itch, diarrhea, vomiting,
- CN: Dog Hookworm
abdominal pain, iron deficiency anemia,
- Commonly infects dogs
mazza mora (human)
- Disease: Eosinophilic enteritis (adult

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

 - Life cycle phase: Blood-Lung phase host
- Habitat: Small intestine
- MOT: skin penetration of filariform larvae NOTE
✓ Blood suckers because of the 2
Life Cycle of Hookworms
cutting plate
- Infective stage: filariform larvae
- DX: Ova in stool
- TX: Albendazole, Mebendazole, Pyrantel
Pamoate and iron supplements (anemia)
- Control: Educational awareness, Drug
therapy
- Dew itch
- Wakana
- Miner’s disease (hookworm disease)
- Blood loss – 0.03 ml/day
- Microcytic hypochromic anemia

Ova of Hookworm
- Colorless, smooth, thin shell
- 30 – 50 µm
- 6-8 cell stages

Adult Necator americanus

Curvature: S-shaped
Life span: 14 years

Hookworm Rhabditiform larvae

- Feeding stage
- 250 µm
- Bulbous esophagus
- Long buccal cavity

Life Cycle of Necator americanus

- Released of rhabditiform larvae
- grow in the feces and/on the soil
- become filariform (third-stage) that are
infective
- Infective larvae penetrate the skin
- carried through:
→ the veins to
→ the heart to
→ the lungs
- Adult worms live in the lumen of the small
intestine wall with resultant blood loss by the

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

Hookworm Filariform larvae intestinal mucosa
- Infective stage - Life cycle phase: Blood-lung phase
- 700 µm - Habitat: small intestine
- Straight esophagus - Infective stage: filariform larvae
- Pointed tail - MOT:
- Long buccal cavity - Skin penetration of filariform larvae
- Autoinfection
- DX: Rhabditiform / Filariform in feces
- TX: Thiabendazole
- Opportunistic: for Immunocompromised
- Lifecycle
→ parthenogenetic – able to produce
offspring without fertilization with males
- Female worms:
→ ovo-viviparous – they lay eggs containing
larvae that hatches out immediatetly

Hookworm Filariform Skin Infection

1) Cutaneous Larva migrans
Laboratory Diagnosis
- Stool examination
→ DFS
→ Concentration techniques
→ Other Specialized Technique
✓ Stool culture (Harada-Mori:
strongy-after 5 days)
✓ Examination of sputum

Ova – Strongyloides stercoralis

2) A. braziliense - Similar to hookworm
- 50 – 58 µm x 30 - 34 µm

Strongyloides stercoralis Rhabditiform

larvae
- 250 µm
STRONGYLOIDES STERCORALIS - Short buccal cavity
- CN: Threadworm - Prominent primordial genetalia
- Disease: - Club-shaped esophagus w/
→ skin pruritus; diarrhea with posterior bulb
malabsorption, Cutaneous, Pulmonary &
Intestinal disease,
→ Cochin diarrhea; Vietnam diarhea,
honey combed appearance of

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

 - TX: Albendazole & Pyrantel pamoate
- Control: Educational awareness, drug therapy

Strongyloides stercoralis Filariform

larvae
- 600 µm
- Lacks bulb on the esophagus
- Short buccal cavity Laboratory Diagnosis
- Notch tail - Microscopic Examination
→ Anal swab or Scotch tape swab for eggs
(90%)
Collection is ideally done in the
morning, before defecation and washing
→ DFS (5-10%)
NOTE:
- Declare negative for 7 consecutive days
- Toluene – used as a clearing agent
- Iodine or xylol – makes the ova more visible

Adult – Enterobius vermicularis

Male Female
2 - 5 mm long 8 – 13 mm long

0.2 mm wide 0.5 mm wide

Long thin pointed tail

ENTEROBIUS VERMICULARIS
- CN: Pinworm, Seat Worm
- Perianal itching, “pruritus ani”
- Habitat: Large intestine
- Infective stage: embryonated egg
- MOT:
- ingestion of embryonated egg
- Inhalation of Infective stage
- Autoinfection, retroinfection
- Dx: Scotch-Tape technique/Cellulose tape

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

Ova - Enterobius vermicularis - Control: Educational awareness, Drug therapy
- Translucent shell , moderate thickness - Discovered by: Nelia P. Salazar
- 50 – 60 µm in length; 20 – 32 µm in width - 1963: first reported case with stichocyte (Pudoc,
- “D” – shaped; flattened on one side Ilocos) admitted at Philippine General Hospital
- DH: Man, Fish-eating birds
- IH: Fresh water fishes (IPON, BIROT, Bagsung)
- Clinical symptom: “Borborygmus” – gurgling
stomach

Life Cycle of Enterobius vermicularis

Adult - Capillaria philippinensis

Male Female
2.3 – 3.17 mm 2.5 – 4.3 mm
With spicule sheath With spicule sheath

- Gravid females migrate nocturnally outside the

anus
- Deposited eggs on perianal folds .
- Following:
→ ingestion of infective eggs, ✓ Spicule sheat – covers adult parasite
→ airborne and inhaled
→ retro infection Ova - Capillaria philippinensis
→ migration of newly hatched larvae from - Flat bi-polar end
the anal skin back into the rectum - Striated ova
- The larvae hatch in the small intestine and the - Peanut shaped
adults establish themselves in the colon

CAPILLARIA PHILIPPINENSIS
- CN: Pudoc’s worm
- Disease: Capillariasis, diarrhea
- Habitat: small intestine
- MOT: ingestion of contaminated fish
- DX: Ova in stool
- TX: Albendazole, Mebendazole

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

Life Cycle of Capillaria philippinensis - TX: Mebendazole

- Unembryonated eggs are passed in the human stool

- become embryonated (external environment)
- Infects fresh water fish
- Ingestion of raw or undercooked fish results in Laboratory Diagnosis
infection of the human host - Muscle Biopsy
- Females deposit unembryonated eggs - Bachman Intradermal test – serological test
- Can cause autoinfection - Beck’s test– xenodiganosis; uses albino rats
✓ Human intestinal capillariasis - Blood tests - eosinophilia
- considered a parasite of fish-eating
birds, which seem to be the natural
definitive host

NOTE
Differences between Capillaria. philippinensis and
Trichuris trichiura
Capillaria ova Trichuris ova

Trichinella spiralis
Male Female
1.5 mm 1.5 mm
NO Copulatory spicule Viviparous

TISSUE NEMATODES
TRICHINELLA SPIRALIS
- CN: Trichina worm
- Disease: Muscle pains
- Habitat: muscle
- MOT: ingestion of encysted larvae in undercooked
pork
- DX: muscle biopsy

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

Life Cycle of Trichinella spiralis Clinical Disease
- As the worm moves downwards, usually to the lower
leg, through the subcutaneous tissues it leads to
intense pain localized to its path of travel. The
painful, burning sensation experienced by infected
people has led to the disease being called "the fiery
serpent".
- Fever, nausea, eosinophilia, diarrhea, asthma and
fainting.
- It could also cause putrefaction or petrification if the
worm is damaged or broken during worm removal.
→ Putrefaction leads to the skin sloughing off
around the worm.
→ Petrification is a problem if the worm is in
a joint or wrapped around a vein or other
- Accidentally ingestion of infected improperly important area.
processed meat
- After exposure to gastric acid and pepsin; Laboratory Diagnosis
→ larvae are released from the cysts - direct observation of the worms emerging from the
lesions
→ invade the small bowel mucosa and
- microscopic examinations of the larvae
develop into adult worms.
- X-ray examinations may reveal calcified worms
- After 1 week
→ females release larvae
→ Larvae migrate to the striated muscles
where they encyst

DRACUNCULUS MEDINENSIS
- Common Name:
→ Guinea Worm, Worm of Medina, Dragon
Worm, Fiery Serpent

Dracunculus medinensis Life Cycle of Dracunculus medinensis

Male Female Larvae
- 12 to 29 - 500 to 1,200 - 500 to 700 m
mm by 0.4 mm by 0.9 to long (long
mm 1.7 mm pointed tail)
- mouth
surrounded by a
cuticular plate,
- flattened
intestine (whole
body cavity is
taken up by the
uterus)

NOTES
- Adults are usually found in subcutaneous tissues
- Non-filarial parasite as it only has one uterus
- Longest nematode infecting humans causing “
Dracunculiasis”
- Mature female worms migrate along subcutaneous
Cause: tissues to reach the skin below the knee, forming a
→ Guinea worm disease is caused by drinking water painful ulcerating blister. They can also emerge
contaminated by water fleas (copepods). from other parts of the body like the head, torso,

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

 upper extremities, buttocks, and genitalia.

ANGIOSTRONGYLUS CANTONENSIS
- Rat Lungworm
- Disease: Eosinophilic Meningoencephalitis
- Intermediate Hosts
→ Slugs and snails
→ Achatina fulica
- Natural Host: Rattus rattus/ Rattus norvegicus
Mode of transmission
1. Ingestion of mollusks infected with 3rd stage
infective larvae
2. Ingestion of leafy vegetables contaminated with
mollusk mucus carrying the infective stage
3. Ingestion of infected paratenic hosts such as
freshwater prawns and crabs
4. Drinking of contaminated water

Life Cycle of Angiostrongylus cantonensis

- first described by Chen in 1935 from domestic

rats in Canton, China
- Man served as accidental host

FILARIAL WORMS
- Blood nematodes

Laboratory Diagnosis
- CSF Lumbar Examination (eosinophils)
- CT Scan
- ELISA
- Post Mortem exam

Angiostrongylus cantonensis
Male Female
Pale and filiform Pale and filiform
16 to 19 mm in length by 21 to 25 mm in length by
0.26 mm in diameter 0.30 to 0.36 mm in
diameter
Has a well developed Has a uterine tubule that
caudal bursa, which is spirally surrounds the
kidney shape and single- intestines (“barber’s pole”
lobed pattern)

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

 Periodicity WUCHERERIA BANCROFTI
- (Peripheral blood smear)
- Rhytmical appearance of microfilaria in the PBS - no reservoir host
- Could be: - Disease: Filariasis
→ Periodic - nocturnal or diurnal - Mosquito vector
→ Sub periodic - sudden increase at night → Anopheles flavirostris
time → Aedes poecillus
→ Non periodic - the number of parasite in → Mansoni spp.
day and night is constant - Cause: Economic and social burden

Filarial worms Common in the Philippines

Wuchereria Brugia malayi

bancrofti
Common Bancrofti filarian Malayan worm
name worm
Periodicity nocturnal Sub P
Cephalic As long as wide Longer than broad
space
Terminal none 2 distinct
nuclei
Somatic Discrete/ separate Overlapping
cells
General graceful kinky Life Cycle of Wuchereria bancrofti
appearance

Laboratory Diagmosis
- Microscopic examination -Thick smear
- Lymph node biopsy
- Serological test
- Knott’ concentration technique

NOTES
- Adult – lives in the lymphatics, subcutaneous tissue
- Giemsa: Thick blood smear - Microfilaria – lives in tissue
→ 1ml of blood + formalin and centrifgue - The filaria in lymphatic system can lead into:
(examine sediment) → Lymphedema
- Knotts techniques - An abnormal accumulation of
→ 1ml of Blood + 10ml 2%formalin = lymph in tissues (swelling of
centrifuge legs, arms, breasts, or genitals)
→ Aka: Membrane filtration technique

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

 → Elephantiasis NOTES
- Disabling and disfiguring
Lymphedema of the Limbs, Brugia malayi & Wuchereria bancrofti
Breasts, genitals, accompanied
by marked thickening of the Brugia malayi Wuchereria bancrofti
skin

Kinky curve
→ Hydrocele
- Fluid – filled ballon – like
enlargement of the sacs around Graceful curve
the testes
✓ Unilateral lang lumalaki
ONCHOCERCA VOLVULUS
(one side)
- Disease: River blindness
- MOT: Larvae-infected black fly bite
- DX: Microfilaria in blood films
- TX: Surgical removal and ivermectin

→ Kidney Damage
- Leading to blood and protein
loss in urine

BRUGIA MALAYI
- reservoir host monkeys
- Disease: Filariasis
- Mosquito vector
→ Mansoni spp.
- Cause: Economic and social burden - In subcutaneous tissues the larvae develop into
adult filariae, which commonly reside in nodules
in subcutaneous connective tissues .
- They are occasionally found in peripheral blood,
urine, and sputum but are typically found in the
skin and in the lymphatics of connective tissues

SECOND SEM | SECOND YEAR (A.Y 2023-2024)

 Life Cycle of Onchocerca volvulus Life Cycle of Loa loa

LOA LOA
- CN: African eye worm
- Disease: Filariasis, Calabar swellings
- MOT: Infective larvae in Chrysops (mango fly)
bite
- TX: Diethylcarbamazine

- The vector for Loa loa filariasis are flies from

two species of:
- Genus Chrysops:
- C. silacea
- C. dimidiata.
- The larvae develop into adults that commonly
reside in subcutaneous tissue .

SECOND SEM | SECOND YEAR (A.Y 2023-2024)