Intestinal Worms

Intestinal Worms Intestinal worms include the following: 1. 2. 3. 4. 5. Enterobius Vermicularius Ancylostoma Duodenale and Necator Americanus Ascaris Lumbricoides Strongyloides Stercoralis Trichinella Spiralis En Entero tero terobius bius Ver Vermicul micul micularis aris aris:: 1. Also called pinworm 2. Causes itching of anus Diagnosis: 1. Scotch tape test a. Scotch tape is pressed on anus at night and eggs by the worm during night can be visualized under microscope in the morning Treatment: 2. Pyrantel Pamoate 3. Albendazole a. Microtubule inhibitor i. Makes worms immobile b. Contraindicated in pregnancy Life Cycle: (5) Anus is scratched (1) Eggs are ingested (4) Female worms migrates down to anus at night to lay their eggs (2) Larvae hatch in the intestine (3) Mature into adults in cecum Anc Ancylos ylos ylostoma toma Duo Duoden den denal al ale e&N Nec ec ecato ato atorr Ame Amerric icanus: anus: 1. Found in Southern USA 2. Hookwarm a. Attach to gut wall b. Feed from capillaries of intestinal villi i. Leads to iron deficiency anemia which is: 1. Microcytic anemia 2. Hypochromic anemia Transmission: 1. Walking barefoot a. Larvae penetrate sole of feet Diagnosis: 1. Eggs in stool 2. Eosinophilia Prevention: Use shoes Treatment: 1. Albendazole 2. Pyrantel Pamoate Life Cycle: (9) Eggs hatch into larvae (1) Larvae enter sole of feet (8) Lay eggs which are passed out into stools (2) Migrate into bloodstream (7) Mature into Small intestine (3) Lungs (6) Swallowed (4) Trachea (5) Pharynx As Ascar aarri ris iis Lum umb mb mbri ric ico coi oid ides es: s: 1. Giant roundworm 2. Causes: a. Malnutrition b. Respiratory symptoms i. Ascaris is the most likely worm to cause respiratory symptoms c. Intestinal obstruction i. Specifically, obstruction at ileocecal valve Transmission: Ingesting eggs in contaminated food or water Diagnosis: 1. Eggs in stool 2. Eosinophilia Treatment: 1. Albendazole a. May induce intestinal obstruction Life Cycle: (1)Eggs ingested in contaminated food or water (9) Eggs are passed out into the stools (8) Larvae mature in small intestine and lay eggs (2) Eggs hatch into larvae in the small intestine (3) Larvae invade mucose and go into the bloodstream (7) Swallowed (6) Pharynx (4) Lungs (5) Trachea Stro Strongy ngy ngyloides loides Ste Stercor rcor rcoralis: alis: 1. Life cycle similar to Ancylostoma Duodenale, except for the fact that: a. Mature adult worms are formed in soil, instead of in human body b. Can cause auto-infection i. Larvae re-penetrate the intestinal mucose ii. This can be serious in immunocompromised patients, in which auto-infection leads to: 1. Hyper-infection 2. Dissemination of worms Diagnosis: 1. Larvae in stool a. Eggs not found because they are layed into the intestinal wall 2. Eosinophilia Treatment: 1. Albendazole 2. Ivermectin Life Cycle: (10) Eggs hatch into larvae (1) Larvae penetrate sole of feet (9) Larvae mature into adults and produce e (2) Bloodstream (8) Larvae passed out into the stools (3) Lungs (7) Larvae small intestine (4) Trachea (6) Swallowed (5) Pharynx Tric Trichinel hinel hinella la Sp Spirali irali iralis: s: 1. Found in undercooked meat, like pork or bear 2. Causes: a. Fever b. Vomiting c. Periorbital edema d. Muscle inflammation i. Leads to severe myalgia ii. Occurs due to the cyst in striated muscle cells Lab Diagnosis: Eosinophilia Treatment: Albendazole Larvae move into circulation Female worm lays eggs from which larvae are produced Larvae are released in small intestine which mature into adult worms Undercooked meat contaminated with encysted larvae is eaten Encysted larvae settle in striated muscle cells