NEMATODES

Ann Fatima Quindao

A. General Characteristics
• Nematodes (roundworms) are a class of helminths.
• Adult nematodes have a tapered, cylindric body with an esophagus
and longitudinal muscles.
• Diagnosis is based on adult, larvae, or egg morphology.
• Nematode life cycles vary as to species and can be quite complex.
a. Most species require an intermediate host to develop into an
infective form.
b. Some nematodes are transmitted through the ingestion of eggs.
c. Other nematode infections are transmitted by larvae, which must
gain entry through the skin on their way to the intestines.
• Nematodes cause diseases associated with the intestines and the skin,
including diarrhea, vomiting, and skin lesions.
Life Cycle Developmental stages
Infective stage: Egg
• Four larval stages (wormlike)
• Sexually mature adult

• Direct Lifestyle: No intermediate host

• Indirect Lifestyle: Needed the intermediate host

• Development may occur in the area of its final location or may occur after
extensive migration through the body of the definitive host

Diagnostic stages
• Most found in feces, blood, sputum, or urine
• Some in lungs, kidney, urinary bladder, or heart
Nematodes are placed into one of two groups: the intestinal nematodes and
the intestinal-tissue nematodes.

A. Intestinal nematodes
1) Enterobius vermicularis
2) Trichuris trichiura
3) Ascaris lumbricoides
4) Strongyloides stercoralis
5) Necator americanus
6) Ancylostoma duodenale

B. Intestinal-tissue nematodes
1) Trichinella spiralis
2) Dracunculus medinenis
Enterobius vermicularis
• Pinworm, causes infections (enterobiasis) that are usually self-limiting and
characterized by itching and inflammation of the anus. Enterobiasis can be
asymptomatic.
• Pinworm infections are common in school-age children.
• Life cycle
a. Infective eggs are ingested, and larvae are released in the small intestines.
b. Larvae develop into adult worms in the colon.
c. Gravid females migrate to the perianal region, where eggs are laid.
d. The eggs are infective following a 6-hour incubation period.
e. Itching results from the irritation caused by the deposition of eggs. Eggs are
spread from the perianal region by scratching.
f. The eggs will be infective for several weeks and can be found in dust, clothing, etc.
• Infective stage: EGG
Trichuris trichiura
• T. trichiura (whipworm) causes infection that in children, presents as colitis and
dysentery. In adults symptoms include abdominal pain and bloody diarrhea.
• Infective stage: EGGS from (human feces). After ingestion of the ova, the larvae
develop into adults in the intestines.
• Diagnosis: Detection of eggs in stool samples
Egg morphology
• The eggs range in size from 50 to 60 um in length and 25 um in width and are football
shaped with clear plugs at each end.
• The shell is smooth and yellow to brown.
• The egg contains a developing embryo.
Adult morphology
• The female adult measures 35-50 mm long, and the male is 30-45 mm long. Adults are
rarely found in the stool.
• The anterior end resembles a whip handle.
• The posterior end resembles a whip and is gray in color.
Ascaris lumbricoides
• A. lumbricoides is known as the giant intestinal roundworm and causes ascariasis,
resulting in intestinal tissue destruction and bowel obstruction that can be fatal. The
worms can also migrate to the lungs, where they cause pulmonary disorders, and to
other body sites.
• Worldwide, A. lumbricoides affects over 1 billion people per year; however, infection is
rare in the U.S.
• Infective stage (passed in human feces): EGG
• Diagnosis: Examination of stool for eggs and adult forms
• Size Range: 85-95 ^m by 38-45 urn Ascaris lumbricoides infertile egg
Egg morphology
• Infertile ova are oval and measure up to 90 jam in length.
• Fertile eggs are round and range in size up to 75 um in length and 50 um in width. The
shell is thick and contains a developing embryo.
Adult morphology
a. Females are 20-30 cm long.
b. Males are 15-31 cm long with a curved posterior end.
Necator americanus and
Ancylostoma duodenale
• N. americanus (New World hookworm) and A. duodenale (Old World hookworm) cause
human hookworm infections. Depending on the infected body site, symptoms can include
coughing (lung infection) and headaches.
• Hookworms are common worldwide, including in North America.
• Humans acquire the filariform larvae through skin penetration. The larvae migrate to the lungs
and then to the intestines.
• Diagnosis: Identification of larvae in sputum or ova from stool specimens
• Egg morphology
a. Eggs of the two species are identical.
b. The eggs are oval and measure 56-75 urn long by 36-40 jam wide.
c. Eggs are thin shelled, and a developing embryo can sometimes be seen inside.
• Morphology of adult worms
a. Adult worms firmly attach to the intestinal mucosa and are rarely seen.
b. Adults range in size from 7 to 11 mm in length; Anclyostoma worms tend to be slightly
larger than Necator worms.
c. The buccal cavity of N. americanus contains a pair of cutting plates, whereas A.
duodenale has teeth.
Strongyloides stercoralis
• Causes threadworm infections, characterized by diarrhea and
abdominal pain
• Most infections occur in the tropics.
• Skin contact with contaminated soil (filariform larvae) is the transmission
route for humans. After penetration, larvae migrate through the skin,
and repeated exposure to larvae can produce an allergic reaction
commonly referred to as larva migrans.
• Diagnosis: Stool examination for rhabditiform larvae
• Morphology of rhabditiform larvae
• Larvae range in size up to 700 jam in length.
• The tail is notched.
Trichinella spiralis
• Causes trichinosis with symptoms including diarrhea, blurred vision, muscle
edema (mostly striated muscle), and coughing. Infections can be fatal.
• The parasite is found worldwide; pigs are important reservoirs.
• Humans acquire the infection by eating contaminated undercooked pork.
• Diagnosis can be made by examining muscle tissue for encysted larvae.

• Laboratory tests reveal eosinophilia, leukocytosis, and increased creatine

kinase and lactate dehydrogenase.

Morphology
• Larvae range in size up to 125 jam in length and 7 um in width. Many
encysted forms are found in striated muscle tissue.
• Adults range up to 1 mm in length and reside in the intestinal tract..
Dracunculus medinensis
• Causes guinea worm infection; symptoms include allergic reactions
and painful ulcers
• Most infections occur in Africa, India, and Asia.
• Humans acquire the infection by the ingestion of infected copepods
(water fleas) carrying the larvae.
• Diagnosis: Observing worms emerging from ulcerated areas of the
body
• Morphology of adults
a. Adult females range in size up to 1 m in length and 2 mm in width.
b. Males are about 2 cm in length.
NEMATODES