Helminthology

Nematode
Cestode
Trematode
MG Isworo Rukmi
A. NEMATHELMINTHES
Roundworms, cylindrical, B. PLATYHELMINTHES
hollow, sex entity separate. flatworms, the bodies was not
hollow, hermaphrodite
- Intestinal Nematodes
- Trematoda : leaf worm
- Tissue Nematodes
• leaves shape
• don't have digestive organs
• segmented body

- Cestoda : tapeworms
• the tape shaped
• segmented body
• has no digestive organs

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 Nematodes
• It is the largest of the living worm specis
• parasites in Human
• Body is cylindrical, hollow basking in the cuticle
• the eggs are removed from the body of hospes (20-
200,000) with or without intermediary
• the sexes separate
• Infective stage can entry into the human body actively,
ingested or vector

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 Intestinal Nematodes
• Habitat - the digestive
tract of humans &
animals
• Soil-borne worm :
Ascaris lumbricoides, Non-soilborne worms:
Necator americanus, - Oxyuris vermicularis
Ancylostoma duodenale, - Trichinella spiralis
Trichuris trichiura,
Strongyloides
stercoralis dan
beberapa species
Trichostrongilus sp
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 Ascaris lumbricoides

• Cosmopolit, especially in tropical areas (hygiene and sanitation)

• often found in children age 3 -10 years, caused askariasis
• In Indonesia, frequency is 20-90%
• Defenitive host only human (obligate host).
• Live in the human intestine cavity, often called the worm's belly.
• The female worms 20-30 cm 15-31 cm in males, worm
• Eggs are removed along with the feces
• Infection: swallowing infective eggs
• Diagnosis: the presence of eggs in the feces or larvae in sputum
• In severe infection vomiting worms, or out with feces

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 Ancylostoma duodenale (cacing tambang)
• found in mining areas.
• In Indonesia is still high-frequency 60-70%
• live as parasites: sucking blood and bodily fluids
in the human intestine.
• Females (10-13 x 0.6) mm, jatan (8-11 x 0.5)
mm.
• Shape like the letter C On the anterior end.
There are 1-4 pairs of hooks or teeth on chitin
ventral side, serves to attach to the host
intestine.
• Larval Stadium:-skin disorders – ground itch
-mild lung disorder
• adult Stage, depending on the species and
number of worm & general conditions
• heavy infection sufferer and chronic anemia

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 Diagnosis:
found eggs in fresh feces,
or larvae in ‘old’ feces.

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Oxyuris vermicularis (pinworms)

• Cosmopolite, high fruequency in

Indonesia  children
• Female 8-13 mm, male 2-5 mm
• Definitive hospes : human  oxyuriasis
• Habitat adult worm: caecum
• Pinworms infection doesnot need
intermediaries.
• The eggs of worms can be ingested
through worm eggs contaminated food.
• This worms lays eggs on the anus and
cause sufferers itching.
• Diagnosis by anal swab

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Trichinella spiralis – muscle worm
• Definitive hospes : human, pig, rat,
cat, dog, boar.
• Inhabiting the intestinal mucosa
(doudenum to the cecum)
• Female 3-4 mm, male 1.5 mm.
• enter into human muscle cause
muscle damage or trichinosis.
• Infection due to eat meat that isn't
cooked properly.
• Adult female worms hollow out
delicate intestinal wall, the living
descendants carried away by blood
flow leading to skeletal muscle then
becomes a cyst

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 Trichinella spiralis

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 Tissue Nematodes
• Periodicity – the period when microfilaria
(larvae) are on blood vessels. :
-nocturna
-diurna
• Wucheria brancofti – Filaria
• Brugia malayi
• Brugia timori
• Loa-loa *
*not found in Indonesia
•Brugia malayi

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 Wuchecheria bancrofti (cacing rambut)
• Spreading in tropical and subtropical
region: India, southern China, Japan, etc.
• Endemic areas are found in Indonesia.
• Adult worms live in the the lymph vessels
and nodes.
• Females (0.25 x 65-100) mm, males (40 x
0.1) mm
• Causing elephant foot disease
(elephantiasis),.
• Vektor Culex mosquito - in the tropics.

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Wuchereria bancrofti (cacing rambut)

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• To prevent filariasis or
commonly called the
elephant foot disease.
• Filariasis prevention with
Diethyl Carbamazine
dispensing Citrate (DEC)
combined with Albenzol
should be done once a
year for the next 5 to 10
years as immunization

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 Loa loa
• Penyebaran terutama di Afrika Barat dan
Afrika Tengah
• Cacing dewasa hidup di jaringan subkutan
manusia dan sering ditemukan di jaringan
subkonjunktiva mata.
• Betina (6.0 x 0.5) cm, jantan (3.0 x 0.35) mm
• Hospes perantara : lalat Crysops silaceae dan
C. dimidiata
• Daya hidup: 4-17 tahun
• Distribusi: terbatas pada hutan dan tepi hutan
di daerah katulistiwa Afrika yang sering hujan
• Cacing betina mengeluarkan mikrofilaria
yang beredar dalam darah pada siang hari
(diurna).
• Pada malam hari mikrofilaria berada dalam
pembuluh darah paru-paru.

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Siklus hidup Loa loa

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 Cestode – tapeworm
• Echinococcus granulosus
• Echinococcus multilocularis
• Multiceps spp.
• Taenia saginata
• Taenia soleum

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Cestode – tapeworm
• Head: scolex has hooks and
suckers to attached to the
host’s intestinal walls.
• The body called strobila,
segmented into proglotid,
contained a complete set of
genital organs, and other
structures.

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Taenia soleum – pig tapeworm
• Kosmopolit, also in Indonesia
• Definitive hospes human, habitat
intestine, causing taneasis solium
• Adult worm 2-4 meter, sometimes
up to 8 meter
• Scolex – head with 4 sucker
mouths
• There are 25-30 hooks in rostelum
• Active proglotide produce 30-50
thousands eggs.
• Larva in intermediate hospes
growth in muscle, tongue,
abdominal muscle, etc.
• Infection by ingestion meat
containing cellulose cysticercus.
• Eggs or proglotides infection
causing cystercercosis.
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Taenia soleum

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 Echinococcus
granulosus
• Almost all over the
world (the ox/goat
cattle)
• Hospes definitive: dogs,
wolves, rarely in cats.
• Habitat in the human
intestine, in the form of
hydathyda in different
parts of the body,
• Small liver tapeworm :
2.5-9.0 mm
• only had 3 progrotid

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Trematode – leafworm
• Known as a suction worm
because it has suction tools
(sucker) in the mouth in the
anterior portion to stick and suck
the food network or form its
host Body Fluids
• not segmented
• Hermaphrodit

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 Trematodes – leafworm
• Lever (liver flukes) • Lung ( LUNG FLUKES)
Fasciola hepatica Paragonius westermani

• Intestine (intestinal • Blood

flukes) Schistosoma japonicum
Fasciola buski

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 Fasciola hepatica - liverfluke
• Known as leverfluke worm, parasitic
leafworm in the sheep liver/ cow
• Infected mammalian liver including
human. causes fasciolosis
• Distribution throughout the world,
causing huge losses on farms sheep and
cows.
• Size 2.5-3 cm length and 1-1.5 cm
width.
• adult worms lay eggs in the bile duct
and gallbladder of cows or sheep

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• Infeksi cacing hati - fascioliasis:
anemia, kehilangan berat badan
dan pembengkakan pada sub-
mandibular.
• Kadang terjadi diare.
• Diagnosis ditegakkan dengan
ditemukannya telur berwarna
coklat kekuningan pada feces.

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• Life cycle :
1. Sexual stage: definitive host (adult
worm)
2. Asexual stage: intermediate host
(snail) :
The larvae are changed 3 times in
the body of the Lymnea snail.
the order of liverflukes life cycle are:

T-M-S-R - C- MC ( Tumisir Calon MC )

Telur - Mirasidium - Sporosis - Redia
- Cercaria – MetaCercaria

The tailed Metacercaria swim to

plants grown in the water
surrounding ,which is eaten by
definitive host., and become adult
worm.

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Perbandingan ukuran F. hepatica dan F. buski
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Paragonius westermani - lung
• Eggs : Paragonimus westermani 80 - 120 µm
long and 45 - 70 µm wide. Yellowis brown ,
round or oval with thick walled.
• unembryonated egg can be liberate through
soutun or stool.
• Adult worm: reddish brown, oval, 7 - 16 mm
long & 4 - 8 mm with, similar to the size and
the color of coffee beans.
• Hemaphrodhite,
• Have oral and ventral suckers, like other
Trematode.
• Eggs in the sputum, will be found after 2-3
months infection.
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• Diagnosis enforced by microscopic
examination : the presence of eggs in the
phlegm, recently discovered after 2-3
months after infection.
• The infection can be acute or chronic,
with symptoms in lung or outside the
lung.
• Acute symptoms: acute phase (invasion
and migration) is characterized by
diarrhea, abdominal pain, fever, cough,
urticaria, hepatosplenomegaly,
pulmonary disorders, and eosinofilia
• Chronic symptoms: coughing, brownish
phlegm, abnormalities in thoracic
photos and hemoptysis.

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Schistosoma japonicum – blood
• Live in the blood vessel of human
digestive tract,
• Definitive host - human, can infected
can infect mice, dogs, pigs, and cows.
• Intermediate hospes is amphibious
snail Oncomelania hupensis.
• The cause of the schistosomiasis with
the sign (acute) fever, anaemia,
dysentery, weight loss, and the liver
swelling.

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• A separate sex : males and females.
• The female worms stacking/storing eggs in blood vessels around the gut
of the host.
• Eggs migrate to the intestines and then liberate through stool.
• The eggs hatch into larvae in the water and swim looking for water snail.
• Larvae reproduce asexually and finally leave the snail.
• When the larvae penetrate human skin,and will be ripe in the liver and
then penetrate the intestinal blood vessels.

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• This man has advanced schistosomiasis.
Note the distension of the collateral
veins due to portal hypertension

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 Penderita schistomiasis berat

• Kronis
– Urinary schistosomiasis (S. haematobium)
– Intestinal schistosomiasis
– Hepatic schistosomiasis and hepatosplenic schistosomiasis (S. mansoni, S.

japonicum)
– Ectopic ("displaced") schistosomiasis
• Genital schistosomiasis (S. mansoni, S. haematobium)
• Pulmonary schistosomiasis (S. mansoni)
• Neuroschistosomiasis (S. japonicum, S. haematobium)
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• cacing kremi
• cacing gelang
• cacing tambang
• cacing
Trichostrongylus
colubriformis

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