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Capillaria philippinensis

disease
• Intestinal capillariasis
• Pudoc worm,Ilocos region
• Was first recognized as a new species of
human parasite in the early 1960s in a patient
who died after a long illness characterized by
intractable diarrhea and cachexia
• Male and female worms measures 2-5mm in
length
• Eggs and larvae found in the submucosa of
both the small and large intestines
Life cycle and epidemiology
• Adult worms are embedded in the mucosa of
the upper small intestine
• They can produce eggs or larvae,so fecal
specimens of infected hosts may contain all
forms of the parasite,eggs,larvae,or adults
• Eggs are peanut-shaped,with flattened bipolar
plugs,20x40 u in size
• When eggs reach fresh or brackish water,they
embryonate,are ingested by fish,hatch in the fish
intestine,and then develop into infective larval
stages
• If the infected fish is eaten raw by a suitable
vertebrate,including humans and birds,the larvae
develop into adult worms and start producing
larvae in about two weeks
• This first generation larvae remain within the
hosts’s intestine and develop into egg-laying
adults.
• Some female worms continue to produce
autoinfective larvae,an important component of
the life cycle
• Human infections are believed to be acquired
by eating small,uncooked fish whole
Clinical features
• Abdominal pain,diarrhea,borborygmi are the
main features of the disease
• As the infection continues,a protein-losing
enteropathy ensues,with severe metabolic
and nutritional imbalance that can be fatal
diagnosis
• Eggs,larvae,or adult worms in the stool
treatment
• Mebendazole 200mg BID x 20days
• Albendazole 400mg OD x 10 days
Capillaria hepatica
• Cosmopolitan parasite primarily of the rat,
rarely humans
• Adult worms resemble Trichuris trichiura
• Eggs are lemon-shaped and have outer shells
that are pitted like a golf-ball
• The adult female worm deposits eggs in the
liver(hepar) where they remain undeveloped
• When the infected liver of a rat is eaten
through cannibalism by another rat,the eggs
escape in the feces to become embryonated
in the soil from which infective eggs are
ingested
pathology
• The accumulation of eggs cause an
inflammatory reaction in the liver,with the
production of fibrous connective tissue and
inheavy infections,extensive tissue destruction
and hepatic cirrhosis
Clinical features
• Enlarged liver
• Eosinophilia
• Ascites
• anemia
diagnosis
• Liver biopsy
• Eggs in stool
Dioctophyma renale
• Kideny worm
• Europe,North and South America,China
• Female-20 to 100cm x 5-12 mm
• Large,reddish nematode
• Brownish yellow,barrel-shaped eggs have thick
pitted shells
• Found in dog and mink
Life cycle
• Eggs passed in urine are ingested by annelids
parasitic on freshwater crayfish
• Oligochetes with encapsulated embryos are
eaten by fish the larvae pass through a 3rd and
4th stage in their mesentery
• Mammals acquire the adult by consuming
infected fish
• Usually found on right kidney
• Destroys the kidney substance leaving an
enlarged cystic shell containing the coiled
worm and purulent material
diagnosis
• Eggs in urine
treatment
• Removal of infected kidney