Gi System- Parasitic Worms By Jackson

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GI System- Parasitic Worms by Jackson

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GI System- Parasitic Worms by Jackson

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when do you most likely see eosinophilia?

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accompanies worm infections.

especially worm infections where there's a migrating phase that goes through the tissues. if a worm is ingested and it stays in the lumen of the intestines, you won't see much eosinophils.

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With trematodes, where do you find the diseases?

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Diseases of the lungs, liver, intestines, blood.

History of travel not in the US.

Eosinophilia

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Schistosoma are trematodes. they are not WHAT. what is the life cycle? what is the infective stage called? Schistosomiasis presents with what?

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Schistosomiasis is known worldwide. The only trematodes that are not hermaphrodites.

Schistosoma life cycle: Eggs excreted in stools -> larva enters snail -> cercariae larvae enter human through skin -> migrate through heart and lungs -> mature in veins, mate and produce eggs

Infective stage is cercariae

Schistosomiasis - Fever, diarrhea, abdominal pain, weight loss, hepatosplenomegaly

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Cestodes (Tapeworms)

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Cestodes are flat ribbon-like parasitic worms that lack complete digestive tracts, blood vessels, and body cavities. Tapeworms are hermaphrodites. They have three distinct body parts:

A. Head (scolex): with attachment organs
B. Neck: where body parts are generated
C. Body segments (proglottids)

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Taenia: T. saginata and T. Solium

how do humans get these?

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ingesting beef and/or pork that is improperly cooked.

if you ingest a few, that's not a problem...usually just see vague GI problems and aches. the exception to that is instead of that, you present with a person from an undeveloped country, you see neurological problems, seizures, and headaches. will see unsanitary conditions. **Neurocysticercosis**

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Characteristics of Cysticercosis

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-Cysticerci develop from ingested eggs (fecal-oral)
-Cysticerci lodge in organs and tissues
-Cysticerci remain viable up to 5 years
-Most prevalent parasitic infection of the CNS
-Hydrocephalus, seizures, meningitis, visual defects

this is different from ingesting improperly cooked pork, giving you an intestinal infection because of ingesting a larval form which can then develop in a human. instead, here you're ingesting eggs accidentally which grows into a larval form that migrates around and symptoms depend on what tissue it gets lodged in. a lot of the problems are due to inflamm reactions. the problems are worse when they go in the CNS.

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Patient shows signs of anemia. The history includes eating raw fish.

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Fish Tapeworm -> Diphyllobothrium latum

Infection associated with eating raw fish, B12 deficiency, anemia

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History of contact with sheep dogs.

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Small tapeworms (5 mm long) with only 3 proglottids. Canines are definitive host. Associated with hydatid cyst disease.

Echinococcus spp.!!

once the eggs are ingested, the larval form of the egg will hatch, they begin to migrate to certain tissues and organs. once they inhabit the tissues, they form a Hydatid cyst. it's a bladder that fills with fluid, also with material to reproduce. and depending where it is, it can cause various clinical signs. but it can be very serious depending on location and size.

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patient from rural Georgia presents with abdominal pain, +/- bloody diarrhea.

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Trichuris trichiura (The Whipworm):
-Human infections from ingesting eggs
-Disease of poor sanitation
-Found worldwide and in S.E. U.S.A.
-Eggs must mature in soil before infectious
-Rectal prolapse

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patient from rural Alabama presents with abdominal pain, +/- diarrhea, and asthma-like symptoms.

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Ascaris lumbricoides:
-Largest intestinal nematode...looks like an earthworm
-Human infection from ingesting eggs
-Eggs must mature in soil 2 - 3 weeks
-Larvae migrate through lungs
-Disease of warm climate and poor sanitation
-Females can produce > 200K eggs/day
-can go from systemic to right side of heart, to lungs, then coughed up then go into the GI tract
-S&S range from none -> fever -> abdominal pain and/or obstruction -> liver damage -> pneumonitis

*in general, the amount of worms you ingest the amount that you have. normally the number does not multiply within the human host. the organisms cn make eggs in the body, but the eggs have to pass out the feces and into the soil and be re-ingested

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patient from rural *Georgia presents with abdominal pain, +/- *bloody diarrhea. Stool cultures were negative for bacterial pathogens. Hematological studies were remarkable for *eosinophilia, *elevated IgE and *anemia. There may be a history of *ground itch.

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Ancylostoma and Necator (Hookworms):
-Infective filariform larvae penetrate skin (’Ground itch’)
-Larvae through lungs-> intestines
-Adult worms in gut attach and suck blood (may see anemia)
-seen with kids playing in the dirt

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Strongyloides stercoralis

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Found in S.E. U.S.A and tropics
Infective filariform larva penetrates skin
Eggs hatch in the intestines -> larvae passed
Cause pneumonitis, epigastric pain, vomiting, diarrhea
will see eosinophilia

*exception of where you see eggs hatched in the human host and get re-infected (autoinfection)...and hyperinfection

seen more in the immunocompromised

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itchy butt

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Enterobius vermicularis (The Pinworm):
-Infection from ingesting eggs
-G.I. infections; Peri-anal itch
-**Scotch tape prep
-Most common worm infection in N. America

at night, these things deposit their eggs on the peri-anal skin.

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Visceral larva migrans is caused by what species. and where do they come from?

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-Caused by Toxocara spp.
-Intestinal nematode of cats and dogs
-Human accidentally ingest eggs
-Symptoms depend on migration and number of larvae

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-Caused by dog and cat hookworms
-Infective larvae penetrate skin
-from poop on the beach

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Cutaneous larva migrans

but since humans are the natural host, they migrate out to the skin. see raised skin lesions.

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Trichinella spiralis

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-Trichinosis from eating undercooked pork
-Worms produce live offspring
-Larvae encyst in muscles
-S&S periorbital edema, G.I. distress, eosinophilia, muscle pain or weakness


present with muscle pain, discomfort. tongue, diaphragm, etc
significant eosinophilia

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-Infective larvae injected by mosquito
-Tropical and subtropical regions
-Can lead to “elephantiasis”

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Lymphatic Filaria Worms (Wuchereria and Brugia species)

casual travelers dont have to worry. needs repeated infections.

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Balantidium coli
Taenia solium
Trichinella spiralis
Toxoplasma gondii


all connected by what?

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something about pigs/pork