34: Go, Maria Danielle Nicolette O.

Ascaris lumbricoides
2 BMT  CN: giant intestinal roundworm
 STH: soil transmitted helminths- soil plays a major
NEMATODES role in the development and transmission of the
parasite. (polymyarian)
 Helminths- worms  Most common intestinal nematode of man
 Kingdom Anemalia  Most frequent in tropics
 Phylum Nemathelminthes/Aschelminthes  FH: man
 SHAPE: elongated and cylindrical  IS: embryonated egg
 Bilaterally symmetrical  MOT: ingestion
 Non-segmented  Habitat: lumen of small intestine
 Complete DIGESTIVE system (mouth-anus) o Larva: heart-lung migration
 Complete NERVOUS system (receptors) o Back to small int. to be an adult worm and
o Amphids- anterior portion reproduce
o Phasmids- posterior portion o Egg: released in stool
Not all have phasmids (APHASMIDS)  hepato-tracheal migration phase takes about 14
o Trichuris days, while the development of egg-laying adult
o Capillaria worms takes about 9 to 11 weeks after egg
o Trichinella ingestion. The life span of an adult worm is about 1
 Tegument- protective covering (chitinous) year.
 Pseudocoel- body cavity containing the organs  have a terminal mouth with trilobate lips and
 Life cycle sensory papillae
o Adult- mature form
o Larva- immature form
o Egg/Ovum  Produces pepsin inhibitor 3 (PI-3)- protects worms
 Dioecious- separate sexes (male and female) from digestion and phosphorylcholine that
o Male: suppresses lymphocyte proliferation.
 Smaller  Adult morphology:
 Posterior portion is coiled/curved
 Copulatory structures: 2 spicule &
copulatory bursa

 Larval morphology: similar to the adult

 Egg morphology:
o Unfertilized (female worms only)
 Corticated- w/ mammillary coat
o Female:  Decorticated- w/o mammillary coat
 Larger  Thin shell
 Posterior portion is pointed
 Paired reproductive organs
There are 4 kinds of female nematodes
1) Oviparous- produce unembryonated eggs o Fertilized (both male and female)
2) Ovoviviparous- produce embryonated eggs  Corticated- w/ coarse mammillary coat
3) Larviparous- larva  Decorticated- w/o mammillary coat
4) Parthenogenetic- female can self fertilize  thick, transparent, hyaline shell

Infective stage: Embryonated egg

(A T E)
 Ascaris lumbricoides
 Trichuris trichiura
 Enterobius vermicularis
 o Embryonated (soil)  Larvae are not usually described because soon after
the embryonated eggs are ingested, the larvae
escape and penetrate intestinal villi where they
 female Ascaris produces about 200,000 eggs per day remain for 3 to 10 days
 2 to 3 weeks for eggs to embryonate in the soil o TT47- pore-forming protein that allows them
 larvae undergo two molts to reach their 3rd stage to imbed their entire whip-like portion into
within the egg the intestinal wall.
Pathogenesis and Clinical Manifestations  Egg morphology
 Asymptomatic o Shape: football, barrel, Japanese lantern
 During lung migration- the larvae may cause allergic
manifestations such as lung infiltration, asthmatic
attacks, and edema of the lips.
 Diseases:
o Ascariasis: erratic worms, high eosinophil
o Loeffler’s syndrome:in heavy infections,
pneumonitis  eggs develop and become embryonated in the soil
Diagnosis within 2 to 3 weeks
 Clinical diagnosis- rather inaccurate, signs and  12 weeks- four larval stages to become adult worms
symptoms are vague Pathogenesis and Clinical Manifestations
 should be confirmed or established by microscopic  Petechial hemorrhages- caused by the embedded
examination of a stool sample anterior portions in the mucosa. May predispose to
o DFS- least sensitive amebic dysentery
o Kato thick smear  Enterorrhagia or intestinal bleeding is common
o Kato-Katz- provides quantitative diagnosis  consequent irritation and inflammation may lead to
(eggs per gram of stool) appendicitis or granuloma formation
o FECT  over 5,000 T. trichiura eggs per gram of feces are
Treatment usually symptomatic
 broad-spectrum anthelminthics such as  Heavy infection:
o albendazole, mebendazole, and pyrantel o Trichuris dysentery syndrome manifested by
pamoate. chronic dysentery and rectal prolapse
 bind to the parasites’ b-tubulin resulting o Anemia is strongly correlated
in the disruption of parasite microtubule  Very good prognosis
polymerization Diagnosis
 Clinical diagnosis is possible only in very heavy
Trichuris trichiura chronic Trichuris infection
 CN: whipworm o patient suffers from frequent blood-streaked
 STH: soil transmitted helminths diarrhea, abdominal pain and tenderness, and
 Holomyarian rectal prolapse
 FH: man  Laboratory diagnosis:
 IS: embryonated egg o DFS
 MOT: ingestion o Kato thick- diagnosis of trichuriasis
 Habitat: colon o Kato-Katz- quantitative method to determine
o Pin fashion attachment (anterior part) the intensity of infection
 Adult morphology: o FECT
Treatment
 Albendazole, mebendazole
 Deworming

Enterobius vermicularis
 CN: pinworm, seatworm, society worm, tiwa
 FH: man
 Habitat: colon
 MOT:
o Ingestion
o Inhalation
o Autoinfection
o Retroinfection
 Infection is characterized by perianal
itching/pruritus ani
 Not a usual cause of significant morbidity or
mortality
 Most common helminth parasite in temperate
regions
 Meromyarian (arrangement of somatic muscles)- 2-5
cells per dorsal or ventral half
 Adult morphology:
 Males are rarely seen- usually die after copulation
 Gravid Females- migrate down the intestinal tract
and exit through the anus to deposit eggs (oviposit)
on the perianal skin, usually in the evening hours.
o Female: average of 11,000 eggs/day
o After egg deposition, the female usually dies
 Rhabditiform larva: w/ esophageal bulb, w/o
cuticular expansion on the anterior end
 Egg morphology:
o Asymmetrical (one side flattened, other side
convex)
o D-shaped/ lopsided
o becomes fully mature outside the host within
4 to 6 hours
o Eggs are resistant to disinfectants
o Succumb to dehydration in dry air within a day
o Mist condition- viable for up to 13 days
o viable longest under conditions of fairly high
humidity and moderate temperature
Pathogenesis and Clinical Manifestations
 relatively innocuous parasite and rarely produces
any serious lesions
 Mild catarrhal inflammation of the intestinal
mucosa: from the attachment of the worms
 secondary bacterial infection: Intense itching leads
to scratching due to the migration of egg-laying
females
 Other signs of infection are poor appetite, weight
loss, irritability, grinding of teeth, and abdominal
pain
 Complications such as appendicitis, vaginitis,
endometritis, salpingitis, and peritonitis: due to
aberrant adult worm migration
 prognosis of enterobiasis or oxyuriasis is good
 This parasitic disease is extremely contagious and
can easily spread among members of a family or in
institutions
 described as a familial or a group disease.
Diagnosis
 suspected in children and adults who show perianal
itching
o relieved only by vigorous scratching
 confirmed by finding adult worms or eggs on
microscopic examinations
o Stool sample- only 5% of infected persons
o Graham’s scotch adhesive tape swab (perianal
cellulose tape swab)- gives the highest
percentage of positive results, and the
greatest number of eggs seen. This low-cost
diagnostic method is easy to perform and is
very sensitive and specific.
Treatment
 Albendazole and mebendazole
 Treatment of the entire household is recommended
 Considered cure after 7 negative perianal smears on
consecutive days
Epidemiology
 only intestinal nematode infection that cannot be
controlled through sanitary disposal of human feces,
because the eggs are deposited in the perianal
region instead of the intestinal lumen
 Risk factors: overcrowding, thumb-sucking, nail-
biting, and lack of parental knowledge on pinworms
Prevention and Control
 Personal cleanliness and personal hygiene
 Fingernails should be cut short
 Hand washing should be done
Infective stage: larva
Hookworms
 Soil transmitted helminth
 Blood sucking- attaches to the mucosa of the small
intestine
 Meromyarian- 2-5 cells arranged per dorsal or
ventral half
 IS: filariform larva (L3) [fenetrates the skin]
 Egg Ancylostoma braziliense Ancylostoma caninum
o Thin shell
o Starts w/ a single embryo then divide divide
o All looks similar, undistinguishable
o Oviparous- unembryonated
 Causes microcytic hypochronic anemia = pain, lazy
 Lab diagnosis
o DFS
o Kato-katz
 Larva o Kato thick
o L1: rhabditiform o Harada Mori culture technique
 Diagnostic stage Pathogenesis and Clinical Manifestation
 Feeding form- open mouth  Penetration of filariform causes
o Maculopapular lesions
o Localized erythema
o Severe itching- ground itch, dew itch
o L2  Lung migration
o L3: filariform o Bronchitis
 Infective stage (skin penetration) o Pneumonitis
 Ecdysis- shedding = sheath  Adult worm in the small intestine
 Appears fiat (thin) o Abdominal pain
 Dies in alcohol o Steatorrhea
o Diarrhea with blood and mucus
o Eosinophilia
 heavy hookworm infection results in a progressive,
 After skin penetration it will circulate in the body secondary, microcytic, hypochromic anemia of the
o Results in elevated eosinophil iron-deficient type, due primarily to continuous loss
 Heart-lung migration of blood
o Wakana disease (lungs)  Hypoalbuminemia- due to combined lost of blood,
 It will travel to the pharynx where it will be lymph and protein
swallowed back to the small intestine  Good prognosis
 Small intestine- where it will become an adult Treatment
 Human hookworms  Albendazole
o Necator americanus- CN: new world hw.  Mebendazole
o Ancylostoma duodenale- CN: old world hw.
 Animal hookworms- can still infect humans Strongyloides stercoralis
(cutaneous larva migrant “creeping eruption”)  CN: threadworm
o Ancylostoma braziliense- CN: cat hw.  Cochin-china diarrhea or vietnam diarrhea
o Ancylostoma caninum- CN: dog hw.  Facultative (free-living)
 Buccal cavity- differentiation of human and animal  Parthenogenetic
hookworm  Ovoviviparous- embryonated
Necator americanus Ancylostoma duodenale  Honey-comb appearance in intestinal mucosa
 Filariform female- larger than free-living male and
free-living female

 Free-living female- found in the soil

o Lay eggs that develop into rhabditiform in a
few hours
o Muscular double-bulbed esophagus
o Straight cylindrical intestine
 Free-living male  Harada-Mori
o Ventrally curved tail
o 2 copulatory spicule
o Gubernaculum (testis)
o No caudal alae
 Uteri contain a single file of 8-12 thin-shelled ova
 Parasitic male- not been reliably identified o One of the most successful method
 Rhabditiform larva  Beale’s string test
o Elongated esophagus w/ pyriform posterior  Duodenal aspiration
bulb  Small bowel biopsy
o slightly smaller and less attenuated posteriorly Treatment
than hookworm  Albendazole
 Thiabendazole
 Ivermectin
 Contraindicated in pregnant women- albendazole
 Heterogonic life cycle- freeliving, facultative and thiabendazole
(indirect)
 Egg reduction rate cannot be determined because
 Homogonic life cycle- not conducive environment eggs are not passed out in the feces
(direct)
 Copulate outside the host Capillaria philippinensis
 Autoinfection- rhabditiform larvae pass down the  one of four Capillaria species that are known to
large intestine and develop into filariform larvae. infect humans
may invade the mucosa and enter the circulation to  Mystery disease- curse from God
start another parasitic cycle without leaving the body o 1963 Bacarra Ilocos Norte
of the host o 1967 Tugudin Ilocos Sur
 Eggs hatch inside the host  associated with protein- losing enteropathy,
 Hyperinfection is a syndrome of accelerated electrolyte imbalance, and intestinal malabsorption
autoinfection  Severe disease can result in death
Pathogenesis and Clinical Manifestation
 nematode from the superfamily Trichinelloidea, to
 larval invasion of the skin which Trichuris and Trichinella belong
o Erythema
 characteristically have a thin filamentous anterior
o pruritic elevated hemorrhagic papules
end and a slightly thicker and shorter posterior end
 Larval migration phase
 IS: L2 larva
o lungs are destroyed causing lobar pneumonia
 DS: unembryonated egg
with hemorrhage
 IH: freshwater fishes
o Cough and tracheal irritation mimics
 FH: man
bronchitis
 Fish-eating birds are believed to be the natural hosts
 Good prognosis in light infections
of C. philippinensis, and humans are considered
 Moderate and heavy infections have high mortality
incidental hosts.
rates
 Adult
Diagnosis
o Esophagus- rows of secretory cells called
 Unexplained eosinophilia
stichocytes. The entire esophageal structure is
 Baermann funnel gauze method- research puroses
called stichosome.
o Male
 Smaller than the female
 Spicule has an unspined sheath
o Female
 Vulva- located at the junction of
anterior and middle thirds
 Ovoviviparous (cause autoinfection)-
40-45 embryonated eggs
  Oviparous- eggs are in a single row (8-10 o T. britovi- most widely distributed species
eggs) among wild animals, 2nd most common
 Larva Trichinella affecting humans
o Development from L1-L2 happen inside the o T. nativa- wild carnivores
fish o T. murrelli, T. nelsoni, T. papuae, T.
 Egg pseudospiralis
o Peanut or guitar shaped  Adult
o Smaller that Trichuris trichiura o Male
o “Sexy pero flat”  Single testicle located near the posterior
end of the body, and is joined in the
mid-body by the genital tube which, in
turn, extends back to the cloaca
 Cloaca- outlet into which the intestinal,
urinary, and genital tracts open. Has a
pair of caudal appendages and two pairs
o Passed in the feces of humans and of papillae
embryonate in the soil or water where fishes o Female
can ingest them.  Single ovary situated in the posterior
o Eggs hatch in the intestines of the fish and part
grow into the infective larvae.  has an oviduct, a seminal receptacle, a
Pathogenesis and Clinical Manifestation coiled uterus, a vagina, and a vulva
 Borborygmus and abdominal pain  vulva is situated in the anterior 5th on
 Weight lost, vomiting, edema the ventral side of the body
 Intermittent diarrhea (8-10 per day)  Lives for 30 days and can produce more
 Severe protein lost and hypoalbuminemia than 1,500 larvae in its lifetime.
 High levels of IgE  Larva
 parasites do not invade intestinal tissue, but they are o Speak-like, burrowing anterior tip
responsible for micro-ulcers in the epithelium o digestive tract of a mature larva encysted in a
Diagnosis muscle fiber resembles adult worm
 DFS o reproductive organs, at this stage, are not yet
 FECT, AECT fully developed
 Duodenal aspiration  Habitat:
 Jejunal biopsy o Adults- small intestine
Treatment o Larva- skeletal muscle
 Electrolyte replacement and high protein diet  FH: man
 Mebendazole  DS: larva
 Albendazole  IS: encysted larvae (found in meat)
 MOT: ingestion of raw or insufficiently cooked meat
Trichinella spiralis  Female are larviparous (no egg)
 CN: muscle worm or trichina worm  Not found in stool
 1st described by Tiedemann in 1822  Enteric phase
 In 1835, James Paget and Richard Owen o Intestinal phase
demonstrated Trichinelle in human cadavers in o Incubation
London o Female froduce larvae
 German investigators- prove that raw or  Invasion phase
insufficiently cooked meat was responsible for o Larval migration
Trichinellosis in humans. o Muscle invasion
 8 species  Convalescent phase
o T. spiralis- most important, most adapted to o Encystment
domestic and wild pigs o Encapsulation
o Symptoms subside
o Trichinosis- self-limiting (mamamatay din dahil
wala naman canibalism)
 Lab diagnosis (4 B’s)
o Biopsy
o Bentonite
o Bachman
o Beck’s xenodiagnosis- animal inoculation test

 Prevention  Has a GRACEFUL curve (“nakaka WoW”)

o Heat meat: 77 C  1: as long as wide
o Freeze meat: -15 C/ 20 days or -30 C/6 days  2: regularly spaced and organized
 Treatment  3: no nuclei at the end (terminal nuclei)
o Mebendazole  4: remains unstained (maganda na siya, no need for
o Albendazole makeup)

Filarial worms
(Wuchy and Brugy)
 Vector transmitted: mosquito
 Does not lay eggs
 Lymphatic worm- one of the most debilitating
diseases
 Treated with diethylcarbamazine
Wuchereria bancrofti
 CN: Bancroft’s filarial worm
 Transmitted by mosquito bites at night
o Anopheles- slow flowing, clear, shaded
o Aedes- from abaca and banana leaves
o Culex
 DS: microfilaria (can be observed in a wet smear)
 IS: filiform (thread-like)
 The parasite is nocturnal (10 pm-2 am/ 8 pm-4 am)
 Specimen for diagnosis: blood collected at night
 Causes Bancroftian filariasis
Brugia malayi
 CN: Malayan filarial worm
 Transmitted by mosquito bites at night
o Mansonia- fresh water or rice fields
 DS: microfilaria
 IS: filiform (thread-like)
 The parasite is nocturnal (10 pm-2 am/ 8 pm-4 am)
 Specimen for diagnosis: blood collected at night
 Causes Malayan filariasis
 Kinky curves (bruha)
 1: longer than wide
 2: overlapping, disorganized
 3: 2 terminal nuclei
 4: stains pink in Giemsa stain
Pathogenesis and Clinical Manifestation
 Lymphatic filariasis- caused by the adult worm
 Weingartner’s syndrome- tropical pulmonary
eosinophilia
 Mayer’s-Kouwenaar syndrome- massive eosinophilia
 Expatriate syndrome- people who get infected after
migration to the endemic regions (di taga doon)
 Lymphangiectasia- Filarial adult worms cause
parasite-induced lymphatic dilatation.
 Chyluria- milky urine
 The most common chronic manifestation of LF is
lymphedema, which on progression leads to
elephantiasis
o The lower limbs are commonly affected, but
upper limb and male genitalia may be
involved.
o In females, breasts and genitalia may be
affected, but this is relatively uncommon
Diagnosis and Treatment
 Knott’s concentration technique- recovery of
microfilaria

 Adult females of B. malayi and W. bancrofti are

indistinguishable.
 Miscellaneous Nematodes o Bloodstream- gravid females lay eggs,
transported into the smaller vessels of the
Parastrongylus cantonensis lungs
 CN: rat lungworm  After 6 days, eggs hatch to release the
 Formerly classified under genus Angiostrongylus L1
 First described by Chen in 1935 from domestic rats in o Eventually expelled in feces, 6-8 weeks after
Canton, China infection
 Known to cause eosinophilic meningoencephalitis  IS: L3
 Adult: (pale and filiform) Pathogenesis and Clinical Manifestation
o Male  chief complaint- acute, severe, intermittent occipital
 Well-developed caudal bursa- kidney- or bitemporal headache
shaped and single-lobed  Other common symptoms- stiffness of the neck,
o Female paresthesia, vomiting, fever, nausea, blurred vision
 Uterine tubules- wound spirally around or diplopia, body or muscle pain, and fatigue
the intestines, barber’s pole appearance  Associated complications- Intraocular hemorrhage
and retinal detachment
 Postmortem examination may show leptomeningitis,
encephalomalacia and moderate ventricular dilation
 Posterior end- blunt shaped  Worms- also seen in cerebrum and cerebellum
 Lay up to 15,000 eggs daily  Eosinophils, monocytes, and foreign body giant cells
 Egg in the spinal cord or in the cerebrospinal fluid (CSF)
o elongated ovoidal are usually associated with the infection
o w/ delicate hyaline shells o 100 to 1,000 leukocytes per μL
o Unembryonated  Adult worms are also recovered from the eyes
 Larva  Good prognosis
o 1st stage  Infection is self-limited
 Lungs of the rodent host  Symptoms gradually disappear
 Has a distinct small knob near the tip of Diagnosis
the tail  Relatively difficult dahil nasa brain
o 3rd stage  Presumptive diagnosis- based on travel and exposure
 2 well-developed chitinous rods below history, correlated with clinical symptoms, medical
its buccal cavity history, laboratory findings, brain imaging results,
 DH: rats and serological tests
 IH: slugs and snails  Examination of blood- high proportion of
o Achatina fulica or giant African snail eosinophils, comprising 7 to 36% of the WBC count.
o Hemiplecta sagittifera  Examination of CSF
o Helicostyla macrostoma o CSF eosinophilia- greater than 10% in
o Vaginilus plebeius proportion to WBC
o Veronicella altae. o CSF protein level- mildly elevated
 MOT: ingestion of L3 o CSF glucose is normal
 Life cycle:  CT scan and MRI
o Penetrates the stomach wall Treatment
o Travel in the bloodstream to the central  No anthelminthic treatment is recommended at
nervous system present
o Undergo 2 molts, takes about 2 weeks to  mebendazole and albendazole have been
reach maturity demonstrated to effectively treat parastrongyliasis in
o After the final molt in rats, the young adults China, Taiwan, and Thailand
migrate to the pulmonary arteries  Anthelminthic therapy- relieve symptoms and
o After 2 weeks adult females start laying eggs reduce the duration of the disease.
 Early development occur in the brain  Ocular parastrongyliasis- require surgical removal of
 Adult worm worms from the eyes.
o Live in the 2 main branches of the pulmonary
arteries of the rat
 Symptomatic treatment- use of analgesics and  Hemorrhage and inflammation- Ingested larvae
lumbar puncture can relieve the headaches invade the submucosa of the stomach or intestines
experienced by the patient with eosinophilic  If the penetration is deep, a tumor-like granuloma
meningitis surrounded by inflammatory cells and eosinophils
will develop
Anisakis species  Gastric anisakidosis less avute and less exudative
 Anisakids- nematode parasites of whales, dolphins, than the intestinal form
porpoises, walruses, seals, sea lions, and other deep Diagnosis
marine mammals  should be highly suspected if there is a recent history
 Elongated vermiform bodies without segmentation of eating raw or improperly cooked fish or squid
 Comlete digestive tract  gastroscopic/endoscopic examination- the larvae
 Dioecious can be visualized and removed for identification
 can cause gastrointestinal infections and allergic  Intestinal anisakidosis- may be diagnoses only after
reactions in humans surgery
 Adult Treatment
o Embedded in the gastric wall of marine  Removing the larva using endoscopic forceps
mammal host  Corticosteroids- used in allergic anisakidosis but
o Discharge unembryonated egg into the sea clinical trials have not been performed
 Larvae  Albendazole
o 1st stage
 develop inside the egg into 2nd stage Toxocara
o 2nd stage  Toxocariasis- zoonotic disease
 hatch out of the egg  When ingested by humans, larvae are released and
 Free swimming penetrate the intestinal wall then migrate via the
 Ingested by micro-crustaceans veins into the liver and the rest of the body, where
o 3rd stage they remain as larvae
 Develop inside the micro-crustaceans  Toxocara spp. belong to the Family Toxocaridae and
 Transported to various paratenic hosts Order Ascaridida
(squid and several species of fish) Toxocara canis Toxocara cati
 More concentrated in fish viscera but Intermediate h. Dog Cat
may occasionally be found in the fish Paratenic H. Vertebrates and Vertebrates and
muscles some some
 Anisakis simplex- milky white in color,, invertebrates invertebrates
long stomach, and a blunt tail with Final h. Dogs and other Cat
mucron, and are referred to as Type I canids Humans
larvae Human (accidental h)
 Pseudoterranova- yellowish brown in (accidental h)
color Infective stage Embryonated Embryonated
 Other species of Anisakis- shorter egg egg
stomachs and blunt tails, and are called MOT Ingestion Ingestion
Type II larvae
Egg (DS) Brownish color Brownish in
 Molt twice and develop into adult
Superficial pits color
worms
(sticky) Pitted
Pathogenesis and Clinical Manifestation
Unembryonated Unembryonated
 3rd stage larvae when laid when laid
o Ingested by humans through raw or 2-4 years in cool
improperly cooked infected fish moist condition
o Do not develop into the adult inside the
human
 Female can lay up to 200,000 eggs per day
 Anisakiasis or anisakidosis- larval infection
o Infective after 2 weeks
 May result in gastric and intestinal pathology Pathogenesis and Clinical Manifestations
 Allergic reaction- due to the chemicals secreted by  Visceral larva migrants (VLM)
the worms
 o Due to the migration and subsequent death of
the larvae
o Produces and intense inflammatory response
manifested as eosinophilic granulomas
o Most sensitive- liver, lungs, central nervous sys
and eyes
o Wheezing common sign of VLM
o Associated with liver enlargement and
necrosis
 Ocular larva migrants (OLM)
o Sign and symptoms manifested in the eyes
o Children 5-10 y/o
o most serious consequence is the invasion of
the retina
o Blindness is common
 Covert toxocariasis (CoTOX)
o used to identify a less specific syndrome
o coughing, wheezing, chronic or recurrent
abdominal pain, hepatomegaly, sleep
disturbances, headache, malaise, and anorexia
 Neurological toxocariasis
o Encephalitis
o Larvae migrate to the brain
o Solitary mass lesions- causing seizures, static
encephalopathy, arachnoiditis, spinal cord
lesions, optic neuritis, and eosinophilic
meningitis, a form of aseptic meningitis in
which the WBCs in the CSF mainly consist of
eosinophils
Diagnosis
 In humans- difficult to diagnose
 Symptoms are similar to other infections
 No to fecalysis- eggs are not produced or excreted
 Definitive diagnosis- biopsy tissues (time consuming
and difficult)
Treatment
 Albendazol or Mebendazole
 Anti-inflammatory medications
 Most patients recover without therapy
 Anthelminthic treatment is mandatory for
neurological toxocariasis or lung or cardiac
complications