Updated: 9/10/2019

Helminths

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  • Snapshot
    • A 20-year-old college student returns home from a camping trip with her friends. They were camping by a freshwater lake, where they fished and canoed. Since then, she reports feeling tired and fatigued. On physical exam, she appears pale. Basic laboratory evaluation is sent, including a complete blood count. This reveals a megaloblastic anemia. Subsequent labs reveal vitamin B12 deficiency. She is started on praziquantel for suspected helminth infection for ingesting fish from the freshwater lake. (Diphyllobothrium latum infection)
  • Introduction
    • Helminths are macroscopic parasitic worms that are classified into three clinically relevant groups:
      • cestodes (tapeworms)
      • trematodes (flukes)
      • nematodes (roundworms)
    • General features of helminths
      • macroscopic (though the parasite‚Äôs eggs are usually microscopic)
      • multicellular
      • have 3 main life-cycle stages
        • eggs
        • larvae
        • adults
  • Helminths
      • Tapeworms (Cestodes
      • Helminths
      • Transmission
      • Disease
      • Treatment
      • Taenia solium (pork)
      • Ingestion of larvae in undercooked pork
      • Ingestion of eggs in food contaminated with human feces
      • Intestinal tapeworm (ingestion of larvae)
      • Neurocysticercosis (ingestion of eggs)
      •  Praziquantel
      • Albendazole (for neurocysticercosis)
      • Taenia saginata (beef)
      • Ingestion of larvae in undercooked beef
      • Intestinal tapeworm
      •  Praziquantel
      • Diphyllobothrium latum (fish)
      • Ingestion of larvae in raw freshwater fish
      • Megaloblastic anemia due to vitamin B12 deficiency
      •  Praziquantel
      • Echinococcus granulosus/multilocularis
      •  Ingestion of eggs in food contaminated with dog feces
      • Hydatid cyst disease (liver cysts)
      •  Albendazole
      • Flukes (Trematodes
      • Helminths
      • Transmission
      • Disease
      • Treatment
      • Schistosoma
      • Penetration of skin by cercariae, usually in contaminated fresh water (snails are intermediate host)
      • Hepatosplenomegaly
      • Portal hypertension
      • Squamous cell carcinoma of the bladder (chronic infection with S. haematobium)
      • Praziquantel
      • Clonorchis sinensis (Chinese liver fluke)
      • Ingestion of undercooked fish
      • Clonorchiasis (biliary tract inflammation)
      •  Cholangiosarcoma
      • Praziquantel
      • Paragoniums westermani (lung fluke)
      • Ingestion of undercooked crab or crayfish
      • Mimics pulmonary TB (hemoptysis)
      • Praziquantel
  • Roundworms (Nematodes)
      • Transmitted by the Ingestion of Eggs ("EATT")
      • Helminths
      • Transmission
      • Disease
      • Treatment
      • Enterobius vermicularis (pinworm)
      • Fecal-oral
      • Anal pruritis
      •  Albendazole
      • Pyrantel pamoate
      • Ascaris lumbricoides (giant roundworm)
      • Fecal-oral
      • Colonic obstruction
      • Biliary obstruction
      • Intestinal perforation
      •  Albendazole
      • Trichuris trichiura (whipworm)
      • Fecal-oral
      • Diarrhea
      • Rectal prolapse (with heavy infection
      •  Albendazole
      • Toxocara canis
      • Fecal-oral
      •  Visceral larva migrans
      •  Albendazole
      • Transmitted by the Invasion of Larvae through Skin ("SANd")
      • Helminths
      • Transmission
      • Disease
      • Treatment
      • Strongyloides stercoralis (threadworm)
      • Penetration of the skin by larvae
      • Gastrointestinal upset
      • Albendazole
      • Ivermectin
      • Ancylostoma braziliense
      • Necator americanus (hookworm)
      • Penetration of the skin by larvae
      • Microcytic anemia
      • Albendazole
      • Pyrantel pamoate
      • Transmitted by the Ingestion of Larvae
      • Helminths
      • Transmission
      • Disease
      • Treatment
      • Trichinella spiralis
      • Ingestion of larvae in undercooked pork
      •  Myalgia
      •  Albendazole
      • Transmitted by Arthropods
      • Helminths
      • Transmission
      • Disease
      • Treatment
      • Wucheria bancrofti
      •  Arthropod vector (mosquito)
      • Lymphatic filariasis
      • Diethylcarbamazine
      • Loa loa (African eye worm)
      • Arthropod vector (Deer, horse, or mango fly)
      • Skin swelling
      • Worm in conjunctiva
      •  Diethylcarbamazine
      • Onchocerca volvulus
      • Arthropod vector (blackfly)
      •  River blindness
      •  Ivermectin
      • Dracunculus medinensis (Guinea worm)
      • Ingested copepod in contaminated freshwater
      • Skin inflammation and ulceration
      • Worm eruption from skin
      •  Niridazole

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