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    General Characters of Nematodes: Cylindrical Cuticle. Separate

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    Ayop Kh
    A young man presented with abdominal pain and constipation. He was diagnosed with intestinal obstruction. 1. Helminths that can cause this include Ascaris lumbricoides, Taenia saginata, and Taenia solium. 2. If he reported eating contaminated green salad, Ascaris lumbricoides is the likely parasite. 3. The infective stage is the embryonated Ascaris egg.

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    General Characters of Nematodes: Cylindrical Cuticle. Separate

    Uploaded by

    Ayop Kh
    34 views18 pages
    A young man presented with abdominal pain and constipation. He was diagnosed with intestinal obstruction. 1. Helminths that can cause this include Ascaris lumbricoides, Taenia saginata, and Taenia solium. 2. If he reported eating contaminated green salad, Ascaris lumbricoides is the likely parasite. 3. The infective stage is the embryonated Ascaris egg.

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    011-Introduction & Ascaris

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    A young man presented with abdominal pain and constipation. He was diagnosed with intestinal obstruction. 1. Helminths that can cause this include Ascaris lumbricoides, Taenia saginata, and Taenia solium. 2. If he reported eating contaminated green salad, Ascaris lumbricoides is the likely parasite. 3. The infective stage is the embryonated Ascaris egg.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    34 views18 pages

    General Characters of Nematodes: Cylindrical Cuticle. Separate

    Uploaded by

    Ayop Kh
    A young man presented with abdominal pain and constipation. He was diagnosed with intestinal obstruction. 1. Helminths that can cause this include Ascaris lumbricoides, Taenia saginata, and Taenia solium. 2. If he reported eating contaminated green salad, Ascaris lumbricoides is the likely parasite. 3. The infective stage is the embryonated Ascaris egg.

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    General Characters of Nematodes

    Body of the worm is cylindrical (rounded in cross section)


    and covered with cuticle.
    Sexes are separate. ♀
    ♂
    Male has: - alimentary canal.
    - one set of male genital organs.
    - curved posterior end with male organ.
    Female has: - alimentary canal.
    - two sets of female genital organs.
    (except two nematodes)
    - straight posterior end.
    Females lay either eggs (called oviparous)
    OR larvae (called larviparous)
    Embryo that develops inside Helminth’s egg
    mouth

    Hexa: 6 Rhabditiform
    oesophagus
    Miracidium canth: hook
    oncho: solid Rhabditiform
    sphere: ball larva
    Develops Develops Develops
    inside inside inside
    Trematode Cestode Nematode
    egg egg egg
    Ascaris lumbricoides Ascariasis
    Ascaris: worm
    lumbricoides:
    earthworm-like
    Geographical Distribution:
    cosmopolitan Green salad
    25 ♀ 20 contaminated with
    cm cm embryonated Ascaris
    ♂ eggs
    migration

    Adult Ascaris worm


    Definitive host:
    Man
    Habitat:
    lumen of small Ascaris eggs in stool
    intestine Diagnostic stage
    Diagnostic Stage Infective Stage
    Ascaris egg in stool Embryonated egg

    X
    Fertilized Decorticated Egg contains 2nd
    Unfertilized egg egg
    egg stage rhabditiform
    As fertilized egg
    larva
    S 90X40µ 60X45µ but lacking
    long, narrow, oval, thick mamillations
    S ill-defined smooth layer Rhabditiform Larva develops in
    Covered by the egg on the ground
    mamillations mamillations
    1st moult
    C brownish
    ‫األرض‬
    C immature Geohelminthic infection
    Development of Ascaris inside body of infected human
    Larva is swallowed Embryonated egg
    Migration stage is swallowed

    2nd
    moult

    Rhabditiform
    larva Venous circulation
    Adult Ascaris in
    small intestine
    Intestinal stage
    3rd & 4th moults
    Pathogenesis and Clinical Picture
    During larval migration:
    Intense‫ديد‬GG‫ ش‬local inflammatory reaction around the larvae leading to pneumonitis.
    Eosinophilia

    Inflammatory cells
    Fever, cough, dyspnea (‫لنفس‬GG‫يقا‬GG‫ ) ض‬and asthmatic
    attacks ( ‫ ) أزماتربو‬and oedema of lips
    Pathogenesis and Clinical Picture
    Adult worms in the intestine:
    1- Digestive disturbances:
    Abdominal pain, colic, nausea,
    vomiting.
    Distension (‫نتفاخ‬G‫ )ا‬or

    Dyspepsia
    Due (G‫)عسر هضم‬
    to production of lytic enzymes
    that interfere with protein digestion.
    Malnutrition and underdevelopment
    Adult in the
    of children. intestine
    2- Changes of the bowel movements:
    Diarrhoea or Constipation.
    How can adult Ascaris worm protect itself from
    digestive juices?
    1- Ascaris worm causes 2- Worm cuticle & lytic
    retention of folds of mucosa enzymes resist the action
    and press on it of digestive juices

    Folds of intestinal
    mucosa
    Complications ‫مضاعفات‬
    Traumatic effects: due to worm irritation by fever, drugs
    or anaesthesia
    Liver abscess

    Perforation,
    peritonitis
    Obstructive
    jaundice

    Appendicitis Intestinal obstruction


    Intussusception
    Volvulus a portion of the
    a portion of the intestine intestine enters into
    twists around itself another portion
    Ascaris worms
    enter the
    stomach to be
    vomited and may
    Ascaris worms
    come out of
    coming out of
    external nares
    the anus
    Complications
    II-Toxic effects:
    caused by toxins of living or dead worms.
    Oedema of face, urticaria ‫ى‬( ‫ ) طفح جلد‬, asthma (‫) ربو‬,
    insomnia (‫) أرق‬, nervous irritability and convulsions

    Urticaria Oedema of
    Asthma face
    Complications
    III- Larvae in ectopic Larvae go to
    sites: patient’s viscera

    Venous
    blood
    Larvae penetrated intestinal
    Visceral larva migrans wall to blood stream
    Diagnosis
    Clinically:
    Transient cough, dyspnea (1-2 weeks).
    Vague ‫ضحة‬G‫غير وا‬abdominal manifestations.
    Laboratory:
    Sputum examination: streaks of blood, eosinophils
    and larvae.
    Eosinophilia (20% - 7%)
    Eggs in stool.
    Adult in vomits, faeces.
    Radiologically:
    Plain X-ray of the lungs and Barium meal.
    Plain X-ray of the lungs

    Normal lung Lung shows


    scattered mottling
    ‫ مبعثرة‬G‫قع‬GGG‫ب‬
    Loeffler’s syndrome
    Barium meal
    Treatment
    Albendazole OR Mebendazole

    In mixed infections: treat Ascaris


    infection first to prevent stimulating
    the worms to unwanted activity
    ‫ مرغوب فيها‬G‫تذهب الى أماكن غير‬

    Surgical treatment of complications.


    Epidemiology and Control
    Ascariasis is prevalent (‫ ) منتشر‬at all
    ages, most common in preschool
    children.
    (Play and defaecate in soil)

    Sanitary disposal of human faeces.


    Nightsoil (human faeces & urine) should
    not be used as fertilizer for food crops.
    Proper washing of vegetables eaten raw.
    Washing of hands before meals.
    Mass treatment.
    Case
    A young youth suddenly complained of abdominal pain
    accompanied by constipation. He was admitted to the
    Emergency Department of Kasr El Aini Hospital. He was
    diagnosed as a case of intestinal obstuction.
    a- Enumerate helminths that may cause such condition.
    T.solium T.saginata D.Latum ??? A.lumbricoides
    b- If the patient gave a history of eating Grilled
    Grilled
    Greenbeef,
    pork
    salad
    what is the possible parasite causing this condition?
    A.lumbricoides
    T.saginata
    T.solium
    c- Name the infective stage in this condition.
    Embryonated
    Cysticercus S: 60X40µ C:Scolex
    brownish
    Scolex with
    Cysticercus bovisS: Bladder-like
    thick-shelled with
    cellulosae
    egg 10X5 mm
    & mamillated
    C:
    noLarva
    hooks
    hooks

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