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Chapter 13 : Intestinal Nematodes

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Abstract:

    • Hookworms (, , and )
    • spp.
    • spp.

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Figures

Image of Figure 13.1
Figure 13.1

Adult : (left) male; (middle) female; (right) three lips on anterior end. (Courtesy of CDC Public Health Image Library.) doi:10.1128/9781555819002.ch13.f1

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.2
Figure 13.2

life cycle. doi:10.1128/9781555819002.ch13.f2

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.3
Figure 13.3

unfertilized eggs. (Left) bumpy shell; (right) decorticate (loss of the bumpy coat); this can also be seen in the fertilized egg in Fig. 13.4 . doi:10.1128/9781555819002.ch13.f3

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.4
Figure 13.4

(Upper left) fertilized egg; (right) fertilized egg containing larva. (Lower left) fertilized egg containing larva; (right) decorticate fertilized egg. doi:10.1128/9781555819002.ch13.f4

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.5
Figure 13.5

larvae in lung tissue. (From , a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch13.f5

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.6
Figure 13.6

Two spot films from an upper gastrointestinal barium study show that white barium in the small bowel outlines an adult worm that has displaced the barium and appears dark. (From , a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch13.f6

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.7
Figure 13.7

Small bowel barium study shows adult worms that present as longitudinal dark lines against the white barium in the small bowel. The worms have ingested the barium, and their guts appear as white lines between the dark body outlines. (From , a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch13.f7

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.8
Figure 13.8

, paired worms in the gut (X ray). (From , a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch13.f8

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.9
Figure 13.9

, adult worms in the gut. (From , a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch13.f9

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.10
Figure 13.10

(Upper) esophageal obstruction (courtesy of George Healy, CDC); (lower) adult coming out of the nose and mouth. (From , a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch13.f10

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.11
Figure 13.11

, adult female pinworms. Note pointed tail (arrows). doi:10.1128/9781555819002.ch13.f11

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.12
Figure 13.12

life cycle. doi:10.1128/9781555819002.ch13.f12

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.13
Figure 13.13

. (Upper) Eggs on a Scotch tape preparation. (Lower left) Enlarged egg containing larva; (right) adult worm seen on perianal skin. doi:10.1128/9781555819002.ch13.f13

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.14
Figure 13.14

cross section of adult worm in appendix. Note the pointed lateral alae (arrows). doi:10.1128/9781555819002.ch13.f14

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.15
Figure 13.15

adult worm. (From , a cooperative collection prepared and/or edited by H. Zaiman.) Note: the small end is the head end; thicker portion of worm is the “handle.” doi:10.1128/9781555819002.ch13.f15

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Algorithm 13.1
Algorithm 13.1

Ascariasis. doi:10.1128/9781555819002.ch13.Alg13.1

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.16
Figure 13.16

life cycle. doi:10.1128/9781555819002.ch13.f16

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.17
Figure 13.17

eggs. (Illustration by Sharon Belkin.) doi:10.1128/9781555819002.ch13.f17

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.18
Figure 13.18

eggs; note the two polar plugs, one at each end of the egg. (Lower right) Egg stained with Wheatley's trichrome (routine ova and parasite stain). doi:10.1128/9781555819002.ch13.f18

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.19
Figure 13.19

, rectal prolapse. (From , a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch13.f19

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.20
Figure 13.20

Numerous adult worms attached to the colonic mucosa of a patient who died of trichuriasis. (From , a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch13.f20

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.21
Figure 13.21

(Upper) eggs. (Lower) Adult worm (courtesy of CDC Public Health Image Library). doi:10.1128/9781555819002.ch13.f21

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.22
Figure 13.22

(A) mouth parts (teeth); (B) mouth parts (cutting plates). (Illustration by Sharon Belkin; adapted as a composite from a number of photographs, including those in Markell EK et al., , 7th ed, The WB Saunders Co, Philadelphia, PA, 1992.) doi:10.1128/9781555819002.ch13.f22

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.23
Figure 13.23

Hookworm life cycle. doi:10.1128/9781555819002.ch13.f23

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Algorithm 13.2
Algorithm 13.2

Enterobiasis. doi:10.1128/9781555819002.ch13.Alg13.2

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.24
Figure 13.24

(A) Hookworm egg; (B) egg. (Illustration by Sharon Belkin.) doi:10.1128/9781555819002.ch13.f24

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.25
Figure 13.25

(Left) Immature hookworm egg; (right) embryonated hookworm egg. doi:10.1128/9781555819002.ch13.f25

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.26
Figure 13.26

(Left) , immature egg; (right) hookworm, immature egg. doi:10.1128/9781555819002.ch13.f26

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.27
Figure 13.27

Hookworm, section of a worm attached to the mucosa. (From , a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch13.f27

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.28
Figure 13.28

(Left) Worms seen at colonoscopy (arrow); (middle) worm with head buried in mucosa and engulfing blood (arrow); (right) hookworm mouth parts. (Courtesy of Hsu YC, Lin JT, e20, 2012.) doi:10.1128/9781555819002.ch13.f28

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.29
Figure 13.29

Rhabditiform larvae. (A) ; (B) hookworm; (C) sp. Abbreviations: bc, buccal cavity; es, esophagus; gp, genital primordium; cb, beadlike swelling of caudal tip. (Illustration by Nobuko Kitamura; from Garcia LS, Finegold SM, Baron EJ, , 7th ed, The CV Mosby Co, St. Louis, MO, 1986.) doi:10.1128/9781555819002.ch13.f29

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.30
Figure 13.30

life cycle. doi:10.1128/9781555819002.ch13.f30

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.31
Figure 13.31

Buccal cavity (rhabditiform larvae). (Left) ; (right) hookworm. doi:10.1128/9781555819002.ch13.f31

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.32
Figure 13.32

(Upper) rhabditiform larva; note the packet of genital primordial cells toward the right side of the image. (Lower) rhabditiform larva; note the packet of genital primordial cells in the middle of the field (enlarged) (circle). doi:10.1128/9781555819002.ch13.f32

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.33
Figure 13.33

larva currens. (Courtesy of CDC Public Health Image Library.) doi:10.1128/9781555819002.ch13.f33

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Algorithm 13.3
Algorithm 13.3

Trichuriasis. doi:10.1128/9781555819002.ch13.Alg13.3

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.34
Figure 13.34

(Upper left) larvae in lung tissue (routine hematoxylin and eosin stain); (right) larvae in direct wet mount of stool (heavy infection). (Lower left) larva in stool (Wheatley's trichrome, routine ova and parasite stain); (lower right) larva in Gram stain. doi:10.1128/9781555819002.ch13.f34

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.35
Figure 13.35

, ulcerations seen in the stomach mucosa. (From , a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch13.f35

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.36
Figure 13.36

, hyperinfection in the colon of an immunosuppressed patient. (From , a cooperative collection prepared and/or edited by H. Zaiman.) doi:10.1128/9781555819002.ch13.f36

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.37
Figure 13.37

Tail (filariform larvae). (A) ; (B) hookworm. doi:10.1128/9781555819002.ch13.f37

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Algorithm 13.4
Algorithm 13.4

Hookworm. doi:10.1128/9781555819002.ch13.Alg13.4

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Algorithm 13.5
Algorithm 13.5

Strongyloidiasis. doi:10.1128/9781555819002.ch13.Alg13.5

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Image of Figure 13.38
Figure 13.38

eggs. They measure within the same range as ; differentiation between the two species is very difficult. However, the patient's clinical history should be helpful. doi:10.1128/9781555819002.ch13.f38

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
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Tables

Generic image for table
TABLE 13.1

Normal life spans of the most common intestinal nematodes

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
Generic image for table
TABLE 13.2

The most common intestinal nematodes

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
Generic image for table
TABLE 13.3

Factors related to continuing infections in urban communities in developing countries and DALYs lost to a range of causes, including ascariasis

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
Generic image for table
TABLE 13.4

Strongyloidiasis hyperinfection syndrome

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
Generic image for table
TABLE 13.5

Strongyloidiasis: associated conditions related to immunosuppression

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13
Generic image for table
TABLE 13.6

Diagnostic methods for strongyloidiasis

Citation: Garcia L. 2016. Intestinal Nematodes, p 299-335. In Diagnostic Medical Parasitology, Sixth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555819002.ch13

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