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Chapter 145 : Less Common Helminths

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Abstract:

This chapter covers the less common causes of helminthic parasitic infections, particularly those caused by the less common nematodes and cestodes. It includes some of the most interesting and challenging of parasitic diseases. The collection, transport, and storage of specimens are similar regardless of the helminth present, so these guidelines are consolidated in this chapter to reduce duplication. The chapter presents additional information about serologic tests for the diagnosis of parasites. The diseases caused by less commonly encountered helminthic parasites are interesting and demonstrate their highly evolved life cycles and the complex interactions with their hosts. Dietary customs are also important in the prevalence of human disease, as many of these are associated with the ingestion of raw animal products. The treatment of these parasites varies depending on the infectious agent, but common preventive measures may significantly diminish the transmission of many of these parasitic diseases. These measures include the zoonotic control of parasitic disease in animal hosts and the vectors of transmission, washing of fruits and vegetables, access to clean drinking water, and thorough cooking of meats before consumption.

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145

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Parasitic Diseases
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Meat and Meat Products
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Adult Worm
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Figures

Image of FIGURE 1
FIGURE 1

(top row, left) This species (arrows) has penetrated into the deep tissues of the abdomen. Multiple cross sections of the worm, which is 300 μm in diameter, are seen in the omentum. Movat stain; original magnification, ×2.5 (AFIP negative no. 96-5760).

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145
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Image of FIGURE 2
FIGURE 2

(top row, right) This coiled first-stage larva is in a “nurse cell.” Note the hyaline, amorphous appearance of the external aspect of the nurse cell and the surrounding chronic inflammatory infiltrate. The worm diameter is 35 μm. Hematoxylin and eosin stain; original magnification, ×30 (AFIP negative no. 70-6004).

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145
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Image of FIGURE 3
FIGURE 3

(middle row, left) The minute lateral alae are useful in the identification of species. The worm diameter is 18 μm. Hematoxylin and eosin stain; original magnification, ×500 (AFIP negative no. 69-4372).

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145
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Image of FIGURE 4
FIGURE 4

(middle row, right) The serpiginous tract of a female worm is demonstrated in the scrotum of this patient (AFIP negative no. 74-9011).

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145
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Image of FIGURE 5
FIGURE 5

(bottom row, left) Rhabditiform larvae (short arrow) fill the body cavity of this gravid worm. Also note the presence of the two prominent bands of somatic muscle (long arrow). The worm diameter is 1.1 mm. Movat stain; original magnification, ×25 (AFIP negative no. 92-8429).

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145
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Image of FIGURE 6
FIGURE 6

(bottom row, right) The bipolar plugs (arrows), pitted egg shell, and rectangular shape are characteristic of species. This photomicrograph is from a human small intestine and demonstrates an egg that is 40 μm long. Hematoxylin and eosin stain; original magnification, ×490 (AFIP negative no. 69-1287).

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145
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Image of FIGURE 7
FIGURE 7

(row 1, left) The immature worm (arrows) in the meninges of this patient is eliciting a marked eosinophilic response. The worm is 200 μm in diameter. Hematoxylin and eosin stain; original magnification, ×50 (AFIP negative no. 73-6862).

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145
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Image of FIGURE 8
FIGURE 8

(row 1, right) The coiled remnants of an immature male worm are present in this branch of the pulmonary artery. The maximum worm diameter is 250 μm. Movat stain; original magnification, ×15 (AFIP negative no. 71-11563).

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145
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Image of FIGURE 9
FIGURE 9

(row 2, left) The two uteri (arrows), muscle, and trilaminar (arrowhead), smooth cuticle are characteristic of an immature female worm. The worm diameter is 250 μm. Movat stain; original magnification, ×80 (AFIP negative no. 72-2732).

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145
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Image of FIGURE 10
FIGURE 10

(row 2, right) The species other than have external longitudinal cuticular ridges, whereas the cuticle of is smooth. is pictured here, in cross section; it is 270 μm in diameter and has obvious cuticular ridges (arrows). species other than are often found in a subcutaneous location rather than in the pulmonary arterial vasculature. Movat stain; original magnification, ×80 (AFIP negative no. 94-5122).

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145
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Image of FIGURE 11
FIGURE 11

(row 3, left) An egg packet of , obtained from a crushed gravid proglottid, is 150 μm in diameter. The eggs within the packet are 40 μm in diameter. Unstained (AFIP negative no. 86-7369).

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145
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Image of FIGURE 12
FIGURE 12

(row 3, right) The thick inner membrane of the egg of is surrounded by a gelatinous matrix and then by an outer striated shell. The eggs of are spherical, whereas those of are ovoid. The egg pictured here is 80 μm in diameter. Unstained; original magnification, ×250 (AFIP negative no. 96-5119). See chapter 143 for more detailed coverage of spp.

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145
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Image of FIGURE 13
FIGURE 13

(row 4, left) A sparganum superficially resembles an adult tapeworm. Close inspection, however, clarifies its immature form, with a head with only a ventral groove or bothrium (arrow) and a lack of proglottids. The maximum width is 6 mm. Unstained; original magnification, ×0.5 (AFIP negative no. 70-15303)

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145
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Tables

Generic image for table
TABLE 1

Other less common nematodes

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145
Generic image for table
TABLE 2

Other less common cestodes

Praziquantel is the treatment of choice for infections with adult tapeworms; it is also effective for treatment of coenurosis. Effective preventive measures center around controlling disease in the zoonotic host (e.g., cats or dogs) or controlling the zoonotic hosts themselves (e.g., rats). Controlling intermediate hosts is also effective but may prove more difficult.

This parasite is covered in detail in chapter 143 in this

Citation: Procop G, Neafie R. 2011. Less Common Helminths, p 2243-2254. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch145

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