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Intestinal Helminths

Intestinal Helminths. Nematodes: Location in the human body. Intestinal nematodes Tissue nematodes. Elongated worm, cylindrical, unsegmented and tapering at both ends. Variable in size, measure <1 cm to about 100cm. Sex separate and male is smaller than female.

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Intestinal Helminths

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  1. Intestinal Helminths

  2. Nematodes: Location in the human body • Intestinal nematodes • Tissue nematodes

  3. Elongated worm, cylindrical, unsegmented and tapering at both ends. Variable in size, measure <1 cm to about 100cm. Sex separate and male is smaller than female Nematodes :General features

  4. Common intestinal nematode infections: Enterobius (Oxyuris) vermicularis(Pinworm,seatworm,threadworm) Trichuristrichiura(whipworm) Ascarislumbricoides(roundworm) Ancylostomaduodenale & Necatoramericanus(hookworms) Strongyloidesstercoralis : Nematodes: common intestinal infections

  5. (Common names :Pin worm, seat worm, thread worm( Found all over the world. adult in lumen of cecum and appendix from which adult female migrate to rectum. It can be seen by naked eye as white thread ± 1cm. Male is smaller than female ± 0.5cm, with coiled end. Enterobiusvermicularis (Oxyuris)

  6. Enterobiusvermicularis (Oxyuris) LIFE CYCLE

  7. Pathology Majority of infections are asymptomatic. Main clinical presentation pruritusani perianal excoriation Ectopic enterobiasis occurs in female when invade vulva and vagina result in valvovagintis Usually accompanied by insomnia, anorexia, loss of weight and concentration (Side effect) Enterobiusvermicularis (Oxyuris)

  8. Enterobiusvermicularis (Oxyuris)

  9. Treatment ِِAlbandazole , Mebendazole for whole family Enterobiusvermicularis (Oxyuris)

  10. Ascarislumbricoides (roundworm)

  11. The commonest human helminthes infection. Found in jejunumand upper part of ileum. Female ± 20 cm longer than male ± 10 cm Feed on semi digested food. Ascarislumbricoides (roundworm)

  12. Ascarislumbricoides (roundworm) LIFE CYCLE

  13. Ascaris eggs Ascaris larva emerging from egg Ascaris egg (embryonated)

  14. Pathology: 1-Adult worm: Light infection : asymptomatic. Heavy infection : intestinal obstruction Migrating adult : to bile duct -jaundice 2-Larvae: Loeffler`ssyndrome Pneumonia, cough with bloody sputum Eosinophilia, urticaria Ascarislumbricoides (roundworm)

  15. Ascarislumbricoides (roundworm) Loeffler`s syndrome:Larvae in lung pnumonia,cough ,bloody sputum

  16. Ascarislumbricoides (roundworm) Ascaris larva in lung

  17. Diagnosis: -eggs in stool. -larvae in sputum. -adult may pass with stool. Ascarislumbricoides (roundworm) Treatment: Albendazole , Mebendazole

  18. Trichuris trichiura (Whipworm)

  19. Trichuris trichiura (Whipworm) LIFE CYCLE

  20. World wide ,common in poor sanitation. It coexists with Ascaris because of similar requirement. Adult live in large intestine especially caecum and appendix–inheavy infection the whole length of large intestine affected. Male and female worm have narrowanterior portion penetrate the intestinal mucosa Trichuristrichiura(whipworm)

  21. Pathology light infection : asymptomatic heavy infection :abdominal pain ,bloody diarrhea. Rectal prolapse in children is a common complication. - Trichuristrichiura(Whipworm)

  22. -Diagnosis: egg in stool characterized by its barrel shape with mucoid plugs at each pole . Treatment :Albendazole. Trichuristrichiura(Whipworm)

  23. Hook worms Ancylostomadudenale &Necatoramericanus

  24. Hook worms Buccal cavity attached to intestinal mucosa

  25. Hook worms Ancylostomadudenale &Necatoramericanus LIFE CYCLE

  26. A common cause of anemia. Found in small intestine mainly jejunum. Its buccal capsule (mouth) lined with hard hooks, triangular cutting plates and anticoagulant glands. Hook worms Ancylostomadudenale &Necatoramericanus

  27. Hook worms Pathology& clinical picture: • - larvae: • At the site of entry of larvae (ground itch). • Migration phase: • cough with bloody sputum • pneumonia, eosinophilia,urticaria. • - adult worm: • low worm burden: no symptoms. • Moderate to heavy burden: • Epigastric pain, vomiting , hemorrhagic enteritis. • Protein loss: hypoproteinaemia edema. • Anemia: due to withdrawal of blood by parasites and hemorrhage from punctured sites lead to sever anemia = microcytichypochromic .

  28. Diagnosis: -Eggs in stools.; -occult blood (+) Hook worms Diagnosis and treatment Treatment: Albendazol, Mebendazole

  29. Strongyloidesstercoralis Widely distributed in tropical region worldwide. fetal opportunistic in immuno-compromised host. It is smallest pathogenic nematodes ± 2.5mm. adult live in mucous membrane of duodenum jejunum rarely m.m.of bronchus.

  30. Strongyloides stercoralis LIFE CYCLE

  31. Cuteneouslittle reaction on penetration. sever dermatitis at perianal region in case of external autoinfection. Migration :same as hook worms . Intestinal: inflammation of upper intestinal mucosa, diarrhea, upper abdominal pain clocky in nature. Disseminated strongyloidiasis : in patient with immunodeficiency ,uncontrolled diarrhea –granulomatus changes –necrosis--perforation--peritonitis--death. Strongyloidesstercoralis: Pathology and clinical picture:

  32. Diagnosis: rhabditiform larvae diagnostic stage in: -Stool examination -Duodenal aspirate Treatment:Albandazole, Mebendazole Strongyloidesstercoralis

  33. DISEASE TRANSMISSION OF INFECTION LOCATION OF ADULT IN HUMANS LOCATION OF LARVA IN HUMANS CLINICALPICTURE Common Tapeworm Infections Taenia saginata taeniasis ingestion of larva in undercooked beef Small Intestine not present vague digestive disturbances eggs or proglottids in stools taeniasis ingestion of larva in undercooked pork Small Intestine not present vague digestive disturbances eggs or proglottids in stools Taenia solium- LARVA (cysticercus cellulosae) Cysticercosis ingestion of egg not present (except in autoinfection: ,small intestine) sub-cutaneous muscles brain,eyes depending on locality: from none to epilepsy X -ray,CT,MRI Serology Hymenolepis nana hymenolepiais ingestion of egg Small Intestine Intestinal Villi Enteritis diarrhoea eggs in stools Echinochoccus granulosus hydatid disease ingestion of egg not present Liver, lungs, Bones etc depending on locality X-ray,CT,US Serology Hydatid sand LAB. DIAGNOSIS Taenia solium- ADULT TAPEWORM

  34. Taenia saginata

  35. Life cycle of Taenia saginata

  36. Life cycle of Taenia solium

  37. Taenia solium

  38. Hymenolepis nana

  39. Life cycle of Echinococcus granulosus

  40. Location of hydatid cyst Echinococcus granulosus

  41. Adult Echinococcus granulosus

  42. Hydatid cyst

  43. Hydatid cyst

  44. Hydatid cyst

  45. Treatment of Tapeworms • Intestinal stages: Praziquantel • Tissue stages ( Hydatid , cysticersosis): • Depends on clinical condition : Surgical and/or Albendazole

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