(M) Nematoda: Secernentea: Ascaradida (lecture-based) Flashcards by ASHLEY JARED DEFENSOR

Order of subclass

Enumerate all under this subclass: secernentea (5)

Ascaradida
Strongylida
Rhabditida
Oxyurida
Spiruruda

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Superfamily of the order Ascaradida

Ascaridoidea

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Species of the super family Ascaridoidea

Ascaris lumbricoides
Toxocara canis
Toxocara cati
Anisakis spp.

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It has a worldwide distribution, (WHO Classification of Helminthes), and is soil transmitted.
Incidence of infection among children is greater than adult individuals.
Most common helminth infection of man

A. lumbricoides

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ASCARIS LUMBRICOIDES AKA

Giant intestinal roundworm

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LIFE CYCLE: ASCARIS LUMBRICOIDES

MOT

ingestion of viable, embryonated eggs present in foods and/or drinks

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LIFE CYCLE: ASCARIS LUMBRICOIDES

Give the excystation after the egg hatches the small intestine

ano nangyare after

larva penetrates the intestinal wall, enters
venous circulation, passes through the liver, and enter the right side of the heart.

intestinal wall -> circulation -> liver -> right side of the heart

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LIFE CYCLE: ASCARIS LUMBRICOIDES

It is carried by blood to the lungs and develops into the?

anong stage

4th larval stage

blood-lung phase cycle.

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LIFE CYCLE: ASCARIS LUMBRICOIDES

The larva breaks through pulmonary capillaries, goes into the air sacs, to the bronchioles, bronchi, trachea, epiglottis, and then?

swallowed

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LIFE CYCLE: ASCARIS LUMBRICOIDES

Where does the larva in the stomach goes to? to become adult worms

small intestine (final habitat)

mainly lumen of the ileum

Mating takes place and females lay eggs, which are discharged into the feces of human host

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PATHOLOGY: ASCARIS LUMBRICOIDES

pathogenic to man

larva and adults

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PATHOLOGY: ASCARIS LUMBRICOIDES

where the passage of larvae through liver & lungs provokes no remarkable pathologic symptoms unless the number of larvae is immense.
Eosinophilic infiltration & granuloma formation around the path of migrating larvae
Fibrosis of the periportal & interlobular spaces

larval migration

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PATHOLOGY: ASCARIS LUMBRICOIDES

o Migratory larvae in the lungs cause tiny
hemorrhages in the alveoli, which incite cellular
infiltration and consolidation.
o Fever, cough, eosinophilia, dyspnea, and rales may
be present.

Ascaris pneumonitis

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PATHOLOGY: ASCARIS LUMBRICOIDES

Severe pulmonary symptoms
Dyspnea, dry productive cough
X-ray: scattered, shifting mottled lung infiltration
Spontaneously clearing associated w/ marked peripheral eosinophilia: Loffler’s syndrome

reffered to as

LOEFFLER’S PNEUMONITIS

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PATHOLOGY: ASCARIS LUMBRICOIDES

Adult worms in the small intestine, mainly in the
ileum tend to be well tolerated unless infection is
heavy and/or the patient’s nutrient intake is
inadequate.

INTESTINAL ASCARIASIS

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PATHOLOGY: ASCARIS LUMBRICOIDES

Children may have intermittent colicky abdominal
cramps, loss of appetite, and protruding abdomen (pot-belly appearance).

INTESTINAL ASCARIASIS

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PATHOLOGY: ASCARIS LUMBRICOIDES

TOF. Single worm can cause serious disease

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PATHOLOGY: ASCARIS LUMBRICOIDES

Worms may be entangled to each other resulting to a?

ball of worms or Ascaris bolus

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PATHOLOGY: ASCARIS LUMBRICOIDES

Ascaris bolus may lead to?

intestinal obstruction

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PATHOLOGY: ASCARIS LUMBRICOIDES

The worm is also able to perforate intestinal wall that
will result to

peritonitis

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PATHOLOGY: ASCARIS LUMBRICOIDES

The worm in the peritoneum can enter the liver to produce

Ascaris liver abscess

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PATHOLOGY: ASCARIS LUMBRICOIDES

TOF. Allergic manifestations may appear such as asthma-like symptoms and urticaria

o Bronchospasm & pulmonary infiltrates
o Pronounced during pulmonary migration
o Asthma & urticaria may continue during intestinal
phase

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PATHOLOGY: ASCARIS LUMBRICOIDES

Heavy worm burden may cause

protein-calorie malnutrition or impairment of growth

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PATHOLOGY: ASCARIS LUMBRICOIDES

Worms that become erratic or restless cause them to enter structures resulting to?

familiarize mo nalang

appendicitis, biliary duct, to cause biliary obstruction, or pancreatic duct, causing acute pancreatitis.

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# PATHOLOGY: ASCARIS LUMBRICOIDES Erratic worms may go to the epiglottis to cause edema that may lead to airway obstruction and therefore?

asphyxia

# DIAGNOSIS: A. LUMBRICOIDES ENUMARATE

* Sputum * gastric washings * DFS * Abdominal X-ray * Barium Swallow

# DIAGNOSIS: A. LUMBRICOIDES o To confirm Ascaris Loeffler’s pneumonitis o Demonstration of larvae

Sputum

# DIAGNOSIS: A. LUMBRICOIDES o To confirm Ascaris Loeffler’s pneumonitis o Demonstration of eosinophils and Charcot-Leyden crystals

Gastric washings

# DIAGNOSIS: A. LUMBRICOIDES o To confirm intestinal ascariasis o Highly effective o Demonstration of eggs (unfertilized or fertilized – not embryonated in fecal smears)

Direct Fecal Smears

# DIAGNOSIS: A. LUMBRICOIDES o X-ray of abdomen may show the so-called “tramway sign (railroad track-like)”.

Abdominal X-ray

# DIAGNOSIS: A. LUMBRICOIDES o Can also be requested and may show the string sign, wherein the adult worms ingest the contrast material. o Adult worms that passed out in the anus or in the mouth can be a sign of erraticism.

Barium swallow

# TREATMENT: A. LUMBRICOIDES DOG drug of choice

Albendazole and mebendazole ## Footnote 100 mg BID for 1-3 days

# TREATMENT: A. LUMBRICOIDES OTHER drugs

* PIPERAZINE CITRATE (75 mg) per kg OD for 2 days * PYRANTEL PAMOATE (11 mg) per kg in single dose

# TREATMENT: A. LUMBRICOIDES For heavy infestation

surgery may be required to remove worms, such as Ascaris bolus and repair damage they've caused like intestinal perforations, bile duct blockage, and appendicitis.

# TREATMENT: A. LUMBRICOIDES Drainage may also be done for?

Liver abscess

# Prevention: A. LUMBRICOIDES ANU

* Proper and hygienic methods of human waste disposal * Prohibit use of human feces (night soil) as fertilizer in vegetable gardens * Care for foods and water from contamination with fecal material * Control of insects that may serve as mechanical transmitters, such as flies and cockroaches * Provision of safe drinking water

# SECERNENTEA: UN-ADAPTED WORMS Identify

1. TOXOCARA CANIS AND CATI 2. ANISAKIS SPECIES

consist of species that are UNABLE TO REACH ADULTHOOD IN THE HUMAN HOST BUT, can cause disease in man.

Un-adapted worms

# SECERNENTEA: UN-ADAPTED WORMS Disease among humans is labeled as

visceral larva migrans ## Footnote owing to the ability of the larval stages to cause significant and potentially serious pathology in various internal organs

# SECERNENTEA: UN-ADAPTED WORMS It is the presence of migrating larval stages of a particular worm in the visceral organs of the body.

Visceral Larva Migrans (VLM)

# SECERNENTEA: UN-ADAPTED WORMS most common

Toxocara canis

# TOXOCARA CANIS AND CATI Dog ascarid

T. canis

# TOXOCARA CANIS AND CATI cat ascarid

TOXOCARA CATI

# TOXOCARA CANIS AND CATI adult worms inhabit the intestines of?

dogs or cats

# TOXOCARA CANIS AND CATI TOF. Humans are accidental hosts.

# LIFE CYCLE: TOXOCARA CANIS AND CATI Definitive host

animals

# LIFE CYCLE: TOXOCARA CANIS AND CATI What is shed out of the feces?

unembryonated eggs

# LIFE CYCLE: TOXOCARA CANIS AND CATI Where does the eggs will embryonate and become infective?

environment

# LIFE CYCLE: TOXOCARA CANIS AND CATI TOF. The adult worm will be developed and oviposit in the small intestine.

# LIFE CYCLE: TOXOCARA CANIS AND CATI MOT

fecal-oral route

# LIFE CYCLE: TOXOCARA CANIS AND CATI Infective stage

Embryonated egg

# LIFE CYCLE: TOXOCARA CANIS AND CATI egg hatches in the small intestine and the larva that escapes from the egg penetrates the intestinal walls to go into the?

MESENTERIC VENULES

# LIFE CYCLE: TOXOCARA CANIS AND CATI larval form reaches different sites through the

blood circulation

# LIFE CYCLE: TOXOCARA CANIS AND CATI Organs invaded

liver (most common), lungs, brain, and eyes

# LIFE CYCLE: TOXOCARA CANIS AND CATI TOF. The larva does not develop into the adult stage in the human body.

T ## Footnote They will become adults in the small intestine of dogs/cats

# LIFE CYCLE: TOXOCARA CANIS AND CATI If the larva goes into the eyes, the condition is referred to as

ocular larva migrans

# LIFE CYCLE: TOXOCARA CANIS AND CATI TOF. Ocular larva migrans typically occurs only in **one eye** and can cause irreversible vision loss

# LIFE CYCLE: TOXOCARA CANIS AND CATI present in the liver

hepatitis

# LIFE CYCLE: TOXOCARA CANIS AND CATI Main manifestations of toxocariasis

VLM and OLM

# LIFE CYCLE: TOXOCARA CANIS AND CATI present in the lungs

pneumonia

# PATHOLOGY AND CLINICAL MANIFESTATIONS: T. cati and canis Migration of larvae causes eosinophilic inflammation that result to

granuloma formation ## Footnote severity of which depends on the number of larvae, the type of tissue invaded, and the duration of the infection

# PATHOLOGY AND CLINICAL MANIFESTATIONS: T. cati and canis TOF. most striking clinical feature of human toxocariasis (or VLM) is high, sustained increase of eosinophils (eosinophilia)

# PATHOLOGY AND CLINICAL MANIFESTATIONS: T. cati and canis CHARACTERISTIC TRIAD OF THE INFECTION

o Marked eosinophilia o Hepatomegaly o Hyperglobulinemia

# DIAGNOSIS: T. cati and canis enumerate

Microprecipitation test ELISA (confirmatory) Tissue biopsy (if present in diff parts of the body)

# Treatment: T. cati and canis ENUMERATE

* Drugs used for treatment include thiabendazole and corticosteroids. * Albendzole * The infection may be prevented through protecting children from contact with infected dogs, these animals should be de-wormed regularly, and do not allow domestic pets to defecate promiscuously.

Anisakis species causes?

Anisakiasis or Herring Worm Disease

# Anisakis sp. MOT

Ingestion of 3rd stage larva (L3) in undercooked fish

# Anisakis sp. Clinical manifestation

instestinal obstructuon

# Anisakis sp. Infective stage to definitive host

L3 larvae

# Anisakis sp. Diagnostic stage

Anisakiasis (larva)

# Anisakis sp. Adult worm inhibits

Stomach of marine mammals

# Anisakis sp. Where do they embryonate

body of water ## Footnote the larva stage is developed there

# Anisakis sp. When it dies, where does it go?

muscle tissues

# Anisakis sp. Incidental host

Humans

# Anisakis sp. Laboratory diagnosis

* serologic * gastroscopy (larva) * surgery (biopsy)

# Anisakis spp Treatment

Albendazole and/or surgery

(M) Nematoda: Secernentea: Ascaradida (lecture-based) Flashcards

A. lumbricoides (lesson 1), T. canis, T. cati, Anisakis spp. (lesson 2)