Ascaris lumbricoides. Гельминтозы

1. Ascaris lumbricoides

240,000 eggs per day
10 to 14 days
1 to 2 years
18 days to several weeks

2. Unfertilized eggs

3. Fertilized eggs

4. Egg containing a larva

5. Larva hatching from an egg

6. Ascaris lumbricoides adult male and female

7.   Ascaris lumbricoides larva in section of lung

Ascaris lumbricoides larva in
section of lung
250 x 15 µm

8. Distended abdomen is characteristic of a child with severe ascariasis. (Reprinted from Despommier D et al. Parasitic Diseases.

2001)

9.

• Ascaris
(roundworm)
collection following
anthelmintic therapy
in a child. (Reprinted
from Despommier D
et al. Parasitic
Diseases. 2001)

10. Treatment

• Mebendazole, 200 mg, for adults and 100
mg for children, for 3 days is effective.

11. Toxocara canis

12. Eggs of Toxocara canis

These eggs are passed in dog feces, especially puppies'
feces. Human infections with Toxocara do not produce or
excrete eggs, and therefore eggs are not a diagnostic
finding in human toxocariasis.

13. Treatment

• Albendazole 400 mg bid x 5d
• Mebendazole 100-200 mg bid x 5d

14. Trichuris trichiura

The life span of the adults is about 1 year
4 cm in length
cecum and ascending
colon
3,000 to 20,000 eggs
per day
15 to 30 days

15. Trichuris trichiura adult male and female 

Trichuris trichiura adult male and
female

16.   Trichuris trichiura eggs

Trichuris trichiura eggs

17.

18. Treatment

• Mebendazole, 200 mg, for adults and 100
mg for children, for 3 days is effective.

19. Enterobius vermicularis

The life span of the adults is about two months

20. Three eggs of Enterobius vermicularis

60 µm x 27 µm

21.   Enterobius vermicularis adult male and female 

Enterobius vermicularis adult male
and female
8 mm x 0.5

22. Enterobius vermicularis adults in section of appendix

23. Treatment

• Two doses (10 mg/kg; maximum of 1g
each) of Pyrental Pamoate two weeks apart
gives a very high cure rate. Mebendazole is
an alternative. The whole family should be
treated, to avoid reinfection.

24. Necator americanes and Ancyclostoma duodenale

1 to 2 years
1 to 2 days
5 to 10 days

25. Ancylostoma duodenale adult male and female

11 mm x 50 µm

26. Hookworm eggs examined on wet mount

27.

Clinical features of hookworm disease
Site
Symptoms
Dermal
Local erythema, macules,
papules (ground itch)
Pulmonary
Bronchitis, pneumonitis and,
sometimes, eosinophilia
Gastrointestinal
Anorexia, epigastric pain and
gastro-intestinal hemorrhage
Hematologic
Iron deficiency, anemia,
hypoproteinemia, edema,
cardiac failure
Pathogenesis
Cutaneous invasion
and subcutaneous
migration of larva
Migration of larvae
through lung, bronchi,
and trachea
Attachment of adult
worms and injury to
upper intestinal
mucosa
Intestinal blood loss

28. Treatment

• Albendazole 400 mg once
• Mebendazole 100 mg bid x 3d or 500
mg once
• Pyrantel pamoate 11 mg/kg (max. 1g) x
3d

29. Strongyloides stercoralis

2.2 mm x 45 µm
1 mm x 60 µm

30.

31. Treatment

• Ivermectin 200 μg/kg/d x 1-2d
• Thiabendazole 50 mg/kg/d in 2
doses(max. 3 grams/d) x 2d

32. Cutaneous Larva Migrans

33.

34.

35.

36.

37.

38.

39. TREATMENT

• Drug of choice: Albendazole 400 mg
daily x 3d
• OR Ivermectin 200 g/kg daily x 1-2d
• OR Thiabendazole Topically

40. Clonorchis

16x4 mm.

41. Clonorchis sinensis adult

42. Clonorchis sinensis egg

43.

44. Treatment

• Praziquantel 75 mg/kg/d in 3 doses x 1d
• OR Albendazole 10 mg/kg x 7d

45. Paragonimus westermani

10 x 4 mm

46. Paragonimus westermani adult

47. Paragonimus westermani egg

48. Paragonimus westermani adult in section of lung

49. Treatment

• Praziquantel taken orally is quite effective
75 mg/kg/d in 3 doses x 2d
• Bithionol* 30-50 mg/kg on alternate
days x 10-15 doses
*Availability problems

50. Fasciola hepatica (sheep liver fluke)

51. Fasciola hepatica eggs

52. Treatment

• Triclabendazole* 10 mg/kg once
• Bithionol* 30-50 mg/kg on alternate
days x 10-15 doses
*Availability problems

53. Fasciolopsis buski

2-7 cm

54. Fasciolopsis buski adult

20 to 75 mm by 8 to 20 mm

55. Fasciolopsis buski egg 

Fasciolopsis buski egg

56. Treatment

• Praziquantel 75 mg/kg/d in 3 doses x
1d

57. Tenia solium

58.

59. Scolex of Taenia solium

60.

61.

62.

63. Taenia sp. egg 

Taenia sp. egg

64. Цистицеркоз

• Миграция и инцистация личинок
занимает 60 – 70 дней
• Мышцы, подкожная клетчатка
• ЦНС!
• Гибель через 5 – 6 лет и кальцификация

65. Диагностика

• Эозинофилия во время диссеминации, но
не всегда после кальцификации!
• КТ и МРТ головного, спинного мозга
• ELISA с низкой чувствительностью,
поэтому отрицательный результат не
исключает цистицеркоз!

66. Лечение

• Празиквантель 50-100 mg/kg/d in 3
doses x 30d
• Альбендазол 400 mg bid x 8-30d; can be
repeated as necessary

67. Taenia soliumcysticercus, whole and in section of muscle

68. Cysticercosis: Antibody Detection

CDC immunoblot for cysticercosis

69.

70.

71.

72. T. saginata

73. Gravid proglottids

74.

75.

76.

77. Histopathology of Taenia saginata in appendix.

78. Diphyllobothrium latum

79. Diphyllobothrium latum scolex and gravid proglottids  

Diphyllobothrium latum scolex and
gravid proglottids

80. Proglottids of Diphyllobothrium latum

81. Eggs of Diphyllobothrium latum

58 to 76 µm by 40 to 51 µm

82. Echinococcosis

83. Echinococcus granulosus adult

3 to 6 mm long

84. Echinococcus granulosus egg 

Echinococcus granulosus egg

85. Echinococcus granulosus hydatid cysts in section of lung

86.

87. Fluid aspirated from a hydatid cyst will shows multiple protoscolices (size approximately 100 µm),

88. Hydatid cysts

89. Hydatid cysts

90.

91.

92. Type I and II hydatid cysts demonstrated on non-contrast CT. The type II cysts appear septated because the walls of multiple

daughter cysts abutt
one another (white arrows). Some hydatids show edema (black arrows)
surrounding the cysts after albendazole treatment. (Courtesy of Dr. von
Sinner and Eur J Rad, 1991).

93. Univesicular uncomplicated type I cyst in a 54-year-old man from Tunisia

94. Multivesicular type II hydatid with multiple daughter cysts giving a septated appearance to the cyst in a 21-year-old woman

95.

96. CT scan of the brain showing a large hydatid cyst in the left parieto-temporal region

97.

98. TREATMENT

• Albendazole 15 mg/kg/d
(max. 800 mg) x 1-6 months