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Case Study in Parasitology. 温锦娣 0456208 3 November 2006. Case 4: geohelminths. 36-year old woman History of travel to Puerto Rico Submitted routine stool specimen. Wet Mount Examination of the Concentrate from the Stool Specimen. Fertile (infective) Ascaris eggs bile stained

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Case study in parasitology l.jpg

Case Study in Parasitology

温锦娣 0456208

3 November 2006


Case 4 geohelminths l.jpg
Case 4: geohelminths

  • 36-year old woman

  • History of travel to Puerto Rico

  • Submitted routine stool specimen


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Wet Mount Examination of the Concentrate from the Stool Specimen

  • Fertile (infective) Ascaris eggs

    • bile stained

    • thick, warty, albuminous coat

    • thick transparent inner shell

    • Crescent-shaped spaces

    • 45~75 x 35~50 mm in length

  • Resistant: chemicals, temperature, pH, irradiation


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  • Infertile egg Specimen

    • elongated and larger than fertile egg

    • thin shelled

    • shell ranges from irregular mammillations to smooth

    • internal contents: a mass of disorganized, highly refractive granules

    • 85-95 mm x 43-47 mm


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Diagnosis Specimen

Disease Ascariasis

Transmission fecal-oral route (soil, water, foodborne)

Occurrence 1.5 billion (25%) infections worldwide

Detection direct microscopic observation


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Symptoms Specimen

  • Vague intestinal pain, nausea, diarrhea, malnutrition

  • Intestinal obstruction

  • Larva migrans: allergic hypersensitivity reactions such as asthmatic attacks, pulmonary infiltration and urticaria and oedema of the lips


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Wet Mount Examination of the Concentrate from the Stool Specimen

  • Trichuris trichiura (Whipworm)

    • characteristic opercular plugs at each end of the egg

    • Barrel-shaped

    • yellow-brown, thick smooth shell

    • 50-55 mm x 22-24 mm


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Diagnosis Specimen

Disease Trichuriasis

Transmission fecal-oral route (soil-borne, contaminated vegetables)

Diagnosis direct microscopic observation of the egg from stool specimen: smear, sedimentation


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Symptoms Specimen

  • Chronic dysentery, bloody stools

  • Iron-deficiency anemia

  • Rectal prolapse


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Wet Mount Examination of the Concentrate from the Stool Specimen

  • Enterobius vermicularis (Pinworm)

    • elongated and flattened on one side

    • thick colorless shell

    • 50-60 mm x 20-30 mm

  • Found in feces: unembryonated

  • Cellulose tape preparation: embryonated (infective)


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Diagnosis Specimen

Disease Enterobiasis

Transmission anal-oral route, airborne

Detection cellophane tape


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Symptoms Specimen

  • majority of infections are asymptomatic

  • irritation of the perianal region

  • Appendicitis

  • Pelvic inflammation


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Treatment Specimen

  • administration of an anti-helminthic drug

    • Mebendazole

    • Albendazole


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Association between Multiple Geohelminth Species Infection Specimen

  • Infection intensities of different species were positively correlated

  • Individuals with single-species infections had generally lower species-specific egg counts than individuals with multiple-species infections.


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Association between Multiple Geohelminth Species Infection Specimen

  • individuals with multiple species infections are likely to be at highest risk of geohelminth-related morbidity

    • number of infections they harbour

    • carry heavier infections of each species


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