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Case Study in Parasitology

Case Study in Parasitology. 温锦娣 0456208 3 November 2006. Case 4: geohelminths. 36-year old woman History of travel to Puerto Rico Submitted routine stool specimen. Wet Mount Examination of the Concentrate from the Stool Specimen. Fertile (infective) Ascaris eggs bile stained

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Case Study in Parasitology

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  1. Case Study in Parasitology 温锦娣 0456208 3 November 2006

  2. Case 4: geohelminths • 36-year old woman • History of travel to Puerto Rico • Submitted routine stool specimen

  3. Wet Mount Examination of the Concentrate from the Stool Specimen • Fertile (infective) Ascaris eggs • bile stained • thick, warty, albuminous coat • thick transparent inner shell • Crescent-shaped spaces • 45~75 x 35~50 mm in length • Resistant: chemicals, temperature, pH, irradiation

  4. Infertile egg • elongated and larger than fertile egg • thin shelled • shell ranges from irregular mammillations to smooth • internal contents: a mass of disorganized, highly refractive granules • 85-95 mm x 43-47 mm

  5. Diagnosis Disease Ascariasis Transmission fecal-oral route (soil, water, foodborne) Occurrence 1.5 billion (25%) infections worldwide Detection direct microscopic observation

  6. Symptoms • Vague intestinal pain, nausea, diarrhea, malnutrition • Intestinal obstruction • Larva migrans: allergic hypersensitivity reactions such as asthmatic attacks, pulmonary infiltration and urticaria and oedema of the lips

  7. Wet Mount Examination of the Concentrate from the Stool Specimen • Trichuris trichiura (Whipworm) • characteristic opercular plugs at each end of the egg • Barrel-shaped • yellow-brown, thick smooth shell • 50-55 mm x 22-24 mm

  8. Diagnosis Disease Trichuriasis Transmission fecal-oral route (soil-borne, contaminated vegetables) Diagnosis direct microscopic observation of the egg from stool specimen: smear, sedimentation

  9. Symptoms • Chronic dysentery, bloody stools • Iron-deficiency anemia • Rectal prolapse

  10. Wet Mount Examination of the Concentrate from the Stool Specimen • Enterobius vermicularis (Pinworm) • elongated and flattened on one side • thick colorless shell • 50-60 mm x 20-30 mm • Found in feces: unembryonated • Cellulose tape preparation: embryonated (infective)

  11. Diagnosis Disease Enterobiasis Transmission anal-oral route, airborne Detection cellophane tape

  12. Symptoms • majority of infections are asymptomatic • irritation of the perianal region • Appendicitis • Pelvic inflammation

  13. Treatment • administration of an anti-helminthic drug • Mebendazole • Albendazole

  14. Association between Multiple Geohelminth Species Infection • Infection intensities of different species were positively correlated • Individuals with single-species infections had generally lower species-specific egg counts than individuals with multiple-species infections.

  15. Association between Multiple Geohelminth Species Infection • individuals with multiple species infections are likely to be at highest risk of geohelminth-related morbidity • number of infections they harbour • carry heavier infections of each species

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