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Chapter 11 : Tissue Nematodes

Editor: Lynne S. Garcia1
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Affiliations: 1: LSG & Associates, Santa Monica, California
Content Type: Reference
Publication Year: 2007

Category: Clinical Microbiology

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Abstract:

This chapter begins with a discussion on spp. Studies of isolates of spp. from Arctic, temperate, and tropical areas have confirmed that there are major differences related to their genetic structure and overall biology. The chapter next focuses on . There is no effective cure for infection; treatment is symptomatic and involves systemic corticosteroids and anthelmintic agents. An excellent review of the diagnostic morphology of four larval ascaridoid nematodes that may cause visceral larva migrans (VLM) include identification keys for , , , and . VLM symptoms caused by spp. must be differentiated from those caused by other tissue-migrating helminths (ascarids, hookworm, filariae, spp., and spp.), as well as other hypereosinophilic syndromes. Diethylcarbamazine, thiabendazole, ivermectin, and albendazole are effective in some cases but not in others. Corticosteroids may also be given to patients with VLM or ocular larva migrans (OLM). Various reports were published during the late 1800s; however, it was not until 1926 that the most common etiologic agent of cutaneous larva migrans (CLM) in the southern United States was found to be , a very common hookworm of dogs and cats. , the common hookworm of dogs, has been implicated in cases of CLM. Other species are also capable of producing CLM, although they are less common than . The chapter also focuses on , , and spp.

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11

Key Concept Ranking

Parasitic Diseases
0.4716145
Enzyme-Linked Immunosorbent Assay
0.46179307
Meat and Meat Products
0.45319062
Infectious Diseases
0.42555907
Adult Worm
0.42084616
Type III Hypersensitivity
0.41004747
0.4716145
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Tissue Nematodes
Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
/content/10.1128/9781555816018.ch11.ch11fig01
Figure 11.1
Life cycle of spp. A number of infected meat sources other than pork are relevant for the various species of
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Figure 11.1

Life cycle of spp. A number of infected meat sources other than pork are relevant for the various species of

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.2
spp., encysted larva in muscle. (Illustration by Sharon Belkin.)
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Image of Figure 11.2
Figure 11.2

spp., encysted larva in muscle. (Illustration by Sharon Belkin.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.3
(A) , encysted larva in muscle (×85). Adjacent muscle has been replaced by fibrous tissue and is infiltrated with chronic inflammatory cells. (Armed Forces Institute of Pathology photograph.) (B) Coiled larva of in a teased muscle preparation (wet mount, ×193). (Armed Forces Institute of Pathology photograph.)
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Figure 11.3

(A) , encysted larva in muscle (×85). Adjacent muscle has been replaced by fibrous tissue and is infiltrated with chronic inflammatory cells. (Armed Forces Institute of Pathology photograph.) (B) Coiled larva of in a teased muscle preparation (wet mount, ×193). (Armed Forces Institute of Pathology photograph.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.4
Unencapsulated (Image courtesy of the Centers for Disease Control and Prevention, Atlanta, Ga.)
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Figure 11.4

Unencapsulated (Image courtesy of the Centers for Disease Control and Prevention, Atlanta, Ga.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Algorithm 11.1
Diagnosis of trichinosis.
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Image of Algorithm 11.1
Algorithm 11.1

Diagnosis of trichinosis.

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.5
Life cycle of Accidental infection in the human leads to visceral larva migrans (VLM), ocular larva migrans (OLM), and/or neural larva migrans (NLM), which are very serious diseases that can cause death. Infections are seen primarily in very young children.
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Figure 11.5

Life cycle of Accidental infection in the human leads to visceral larva migrans (VLM), ocular larva migrans (OLM), and/or neural larva migrans (NLM), which are very serious diseases that can cause death. Infections are seen primarily in very young children.

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.6
eggs; note the larvae within the egg shells. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
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Figure 11.6

eggs; note the larvae within the egg shells. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.7
, CNS atrophy, sclerosis, and larval granuloma in the brain in a 2-year-old boy who died following 14 months of CNS problems. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman. Photograph courtesy of K. R. Kazacos.)
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Image of Figure 11.7
Figure 11.7

, CNS atrophy, sclerosis, and larval granuloma in the brain in a 2-year-old boy who died following 14 months of CNS problems. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman. Photograph courtesy of K. R. Kazacos.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.8
(A) , larva in the brain of an 18-month-old boy who died after a 3-week bout of CNS disease. (B) Mesenteric granuloma from the same patient. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman. Photograph courtesy of K. R. Kazacos.)
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Image of Figure 11.8
Figure 11.8

(A) , larva in the brain of an 18-month-old boy who died after a 3-week bout of CNS disease. (B) Mesenteric granuloma from the same patient. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman. Photograph courtesy of K. R. Kazacos.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.9
egg; note the pits in the egg shell (somewhat similar to eggs). (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
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Image of Figure 11.9
Figure 11.9

egg; note the pits in the egg shell (somewhat similar to eggs). (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.10
Life cycle of spp., the cause of visceral larva migrans (VLM) and ocular larva migrans (OLM).
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Image of Figure 11.10
Figure 11.10

Life cycle of spp., the cause of visceral larva migrans (VLM) and ocular larva migrans (OLM).

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.11
: (A) immature egg; (B) mature egg containing larva; (C) adult worms. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
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Figure 11.11

: (A) immature egg; (B) mature egg containing larva; (C) adult worms. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Algorithm 11.2
Diagnosis of toxocariasis.
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Image of Algorithm 11.2
Algorithm 11.2

Diagnosis of toxocariasis.

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.12
Life cycle of spp., the cause of cutaneous larva migrans (CLM).
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Image of Figure 11.12
Figure 11.12

Life cycle of spp., the cause of cutaneous larva migrans (CLM).

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.13
Linear tracks caused by migration of spp. (cutaneous larva migrans [CLM]). (From a Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
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Image of Figure 11.13
Figure 11.13

Linear tracks caused by migration of spp. (cutaneous larva migrans [CLM]). (From a Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.14
, blister on leg (contains female worm); note removal of the adult worm. (Illustration by Sharon Belkin.)
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Image of Figure 11.14
Figure 11.14

, blister on leg (contains female worm); note removal of the adult worm. (Illustration by Sharon Belkin.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.15
Life cycle of the cause of guinea worm disease.
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Image of Figure 11.15
Figure 11.15

Life cycle of the cause of guinea worm disease.

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.16
, adult worm in subcutaneous tissues below the breast. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman. Photograph courtesy of J. Donges.)
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Image of Figure 11.16
Figure 11.16

, adult worm in subcutaneous tissues below the breast. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman. Photograph courtesy of J. Donges.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.17
, abscess caused by developing worm. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
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Image of Figure 11.17
Figure 11.17

, abscess caused by developing worm. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.18
infection. Blisters develop in the skin, usually on the lower extremities, when the gravid female worm approaches the surface of the skin. (Armed Forces Institute of Pathology photograph.)
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Image of Figure 11.18
Figure 11.18

infection. Blisters develop in the skin, usually on the lower extremities, when the gravid female worm approaches the surface of the skin. (Armed Forces Institute of Pathology photograph.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.19
Female worm being removed by winding on a stick. (Armed Forces Institute of Pathology photograph; contributed by Everett L. Schiller, Johns Hopkins University School of Public Health, Baltimore, Md.)
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Image of Figure 11.19
Figure 11.19

Female worm being removed by winding on a stick. (Armed Forces Institute of Pathology photograph; contributed by Everett L. Schiller, Johns Hopkins University School of Public Health, Baltimore, Md.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.20
Extraction of The stick has been removed, and larvae have been squeezed from the flattened exterior portion of the worm. (Armed Forces Institute of Pathology photograph; contributed by Everett L. Schiller, Johns Hopkins University School of Public Health, Baltimore, Md.)
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Image of Figure 11.20
Figure 11.20

Extraction of The stick has been removed, and larvae have been squeezed from the flattened exterior portion of the worm. (Armed Forces Institute of Pathology photograph; contributed by Everett L. Schiller, Johns Hopkins University School of Public Health, Baltimore, Md.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.21
Life cycle of spp. [see (1) in figure]. Humans present with encephalitis when worms die in the brain tissue.
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Image of Figure 11.21
Figure 11.21

Life cycle of spp. [see (1) in figure]. Humans present with encephalitis when worms die in the brain tissue.

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.22
in the central canal of the spinal cord. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
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Image of Figure 11.22
Figure 11.22

in the central canal of the spinal cord. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.23
adult male worm in the eye. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)
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Image of Figure 11.23
Figure 11.23

adult male worm in the eye. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.24
Life cycle of
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Image of Figure 11.24
Figure 11.24

Life cycle of

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.25
, adult worm. [Illustration by Sharon Belkin; adapted from reference ; originally adapted from I. Miyazaki, Studies on occurring in Japan (Nematoda: Gnathostomidae). II. Life history of and morphological comparison of its larval forms, 123–140, 1954.]
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Image of Figure 11.25
Figure 11.25

, adult worm. [Illustration by Sharon Belkin; adapted from reference ; originally adapted from I. Miyazaki, Studies on occurring in Japan (Nematoda: Gnathostomidae). II. Life history of and morphological comparison of its larval forms, 123–140, 1954.]

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.26
Head of adult gnathostoma. (Armed Forces Institute of Pathology photograph.)
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Image of Figure 11.26
Figure 11.26

Head of adult gnathostoma. (Armed Forces Institute of Pathology photograph.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.27
Life cycle of , and spp. (larval nematodes acquired from saltwater fish).
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Image of Figure 11.27
Figure 11.27

Life cycle of , and spp. (larval nematodes acquired from saltwater fish).

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.28
Scanning electron micrograph of an larva penetrating human stomach tissue in vitro. Note the tunnel created in the mucosa and the burrow in the submucosa. (Reprinted with permission from J. A. Sakanari and J. H. McKerrow, Identification of the secreted neutral proteases from . 625–630, 1990.)
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Image of Figure 11.28
Figure 11.28

Scanning electron micrograph of an larva penetrating human stomach tissue in vitro. Note the tunnel created in the mucosa and the burrow in the submucosa. (Reprinted with permission from J. A. Sakanari and J. H. McKerrow, Identification of the secreted neutral proteases from . 625–630, 1990.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.29
(A) in fish flesh. (B) Larval nematodes in fish viscera. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman. Photograph courtesy of L. A. Jensen.)
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Image of Figure 11.29
Figure 11.29

(A) in fish flesh. (B) Larval nematodes in fish viscera. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman. Photograph courtesy of L. A. Jensen.)

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Figure 11.30
eggs in liver. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.) For information on intestinal capillariasis with , see chapter 10.
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Image of Figure 11.30
Figure 11.30

eggs in liver. (From A Pictorial Presentation of Parasites: A cooperative collection prepared and/or edited by H. Zaiman.) For information on intestinal capillariasis with , see chapter 10.

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
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Tables

Tissue Nematodes
Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
/content/10.1128/9781555816018.ch11.ch11tab01
Table 11.1
Characteristics of species
Generic image for table
Table 11.1

Characteristics of species

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
/content/10.1128/9781555816018.ch11.ch11tab02
Table 11.2
spp.: encapsulated and nonencapsulated species
Generic image for table
Table 11.2

spp.: encapsulated and nonencapsulated species

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
/content/10.1128/9781555816018.ch11.ch11tab03
Table 11.3
Tissue nematodes
Generic image for table
Table 11.3

Tissue nematodes

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
/content/10.1128/9781555816018.ch11.ch11tab04
Table 11.4
: life cycle stages and clinical conditions
Generic image for table
Table 11.4

: life cycle stages and clinical conditions

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
/content/10.1128/9781555816018.ch11.ch11tab05
Table 11.5
Trichinosis: incubation period, larval numbers, and degree of illness
Generic image for table
Table 11.5

Trichinosis: incubation period, larval numbers, and degree of illness

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
/content/10.1128/9781555816018.ch11.ch11tab06
Table 11.6
Outbreaks due to consumption of spp. in horse meat
Generic image for table
Table 11.6

Outbreaks due to consumption of spp. in horse meat

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
/content/10.1128/9781555816018.ch11.ch11tab07
Table 11.7
Trichinellosis: prevention and control measures
Generic image for table
Table 11.7

Trichinellosis: prevention and control measures

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11
/content/10.1128/9781555816018.ch11.ch11tab08
Table 11.8
Differential diagnosis of infection
Generic image for table
Table 11.8

Differential diagnosis of infection

Citation: Garcia L. 2007. Tissue Nematodes, p 283-318. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch11

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