Enterobius

vermicularis
(pinworm)

Who

Morpholog
y

S/Sx

Dx

Tx

Life cycle

Preventio
n

Most
common
helminth;
daycares

Eggs
flattened on
one side

Perianal itching

Scotch tape
test for
adults or
eggs
Eggs in
feces

Pyrental
palmoate,
mebendazole,
or albendazole
Mebendazole,
albendazole

Humans
definitive host,
fecal-oral
transmission
Humans
definitive host;
eggs must
embryonate in soil
before being
infectious
Eggs hatch in
environment,
enters thru skin;
can migrate from
skin to blood,
heart, lungs and
other organs;
cough them up
and swallow them
Eggs need to
embryonate to be
infectious; worms
can transit from
blood to lung to
intestinal tract,
can cause
Loefflers

Hygiene

Trichuriasis
(whipworm)

Nonspecific, diarrhea, blood

loss, anemia

Hookworm

Adults have
teeth, eggs
have clear
outer shell,
produces
anticoagulant

Teeth attach to intestinal

villi and produce
anticoagulant, can cause
microcytic anemia; larva
can migrate and cause
inflammation and
eosinophilia (Loefflers =
eosinophilic pneumonitis)

Eggs in
feces

Mebendazole,
albendazole,
maybe iron if
anemic

Ascariasis

Eggs have
irregular
outer coating

Severity related to worm

burden; can cause
pneumonitis (Loefflers),
intestinal obstruction, bowel
perforation

Eggs in
feces

Mebendazole,
albendazole,
ivermectin

Toxocara
canis and T.
cati

Strongyloide

Dogs, cats,
people

Visceral larva migrans

larva penetrate mucosa and
go to liver, lungs, eyes,
cause inflammation;
cutaneous larva migrans
larva penetrate skin and
cause inflammation; most
commonly massive
asymptomatic eosinophilia
Most commonly

Humans
accidental host;
dogs and cats
cause visceral
form, hookworm of
other species
cause cutaneous
form
Larva in

Ivermectin,

Autoinfection

Shoes

Proper
sewage
disposal,
wash food,
sanitize,
dont spray
poop on
fruits and
veggies
Wear shoes
to prevent
cutaneous
larva
migrans

s stercoralis

Trichinella
spiralis

Pork,
undercooke
d meat,
bear meat

Adult in
intestine,
larva in
tissue

Wuchereria
bancrofti

Tropical
areas,
mosquito
vector

Adults in
lymphatics,
microfilaria in
bloodstream

Taenia
saginata, T.
solium
(tapeworm)

Developing
world

Scolex
head,
proglottid
make eggs,
hermaphrodit
ic and no
digestive
tract
Smallest of
all
tapeworms,
scolex, 1
immature, 1
mature, 1
gravid
proglottid
Mansoni
side spine,
hematobium
terminal
spine,

Echinococcu
s granulosus
(hydatid cyst
disease)

Schistosomia
sis

Depends on
region

asymptomatic with
eosinophilia, can invade skin
(purpuric papules), lung
(Loefflers), intestines (GI
symptoms); hyperinfection
in immunocompromised (no
eosinophilia)
Depends on worm burden,
can cause gastroenteritis,
fever, muscle pain,
periorbital edema,
weakness, elevated WBC
and eosinophilia
Inflammation and
obstruction of lymphatic
channels (lymphatic
filariasis, elephantiasis),
adults die and calcify and
cause occlusion
T. solium (pork) more
infectious, can cause
cysticercosis involving brain
(cerebral), eyes, liver, lung,
or muscles, leading to
seizures; eggs cause
neurocysticercosis, cysts
cause gut cysticercosis
Forms cysts in various
tissues that grow slowly
over time, can present like a
slow growing tumor; liver
cyst (obstructive jaundice),
brain cyst (ICP and
seizures), ruptured cyst
(anaphylaxis)
Mansoni and japonicum GI
(periportal fibrosis, portal
HTN, hepatosplenomegaly),
hematobium GU (bladder
granuloma, hematuria,

stool or
sputum,
serology

albendazole

(chronic infection
for decades),
rhabditiform larva
can be shed or
autoinfect the host

History,
eosinophilia
, serology,
larva in
muscle

Supportive tx;
mebendazole
or albendazole
kills adults but
not larva

Humans dead
end host; larva
become encysted
in muscle of
animal hosts and
eaten

Microfilaria
in blood at
night

Diethylcarbama
zine kills
microfilaria,
doxycycline
kills adults,
steroids
Praziquantel,
niclosamide

Eggs or
proglottids
in stool,
serology or
imaging for
extraintesti
nal disease
History
(sheep
herding),
serology,
space
occupying
lesion with
eosinophilia
History;
eggs in
urine
(hematobiu
m) or stool

Properly
clean and
cook meat

Treat to
prevent
transmissio
n

Humans
definitive host,
cysts can also be
caused by
ingesting eggs
from human fecal
matter

Properly
cook beef
and pork to
kill
cysticerci,
hygiene

Surgery for
cyst,
albendazole or
mebendazole,
PAIR

Definitive dog;
intermediate
goat and sheep;
accidental
human

Hygiene,
avoid dog
feces

Praziquantel

Humans
intermediate host

Snail
control,
proper
sewage
disposal

Entamoeba
histolytica

1-3% of US
population

Naegleria
fowleri
(brain eating
amoeba)

Rare, netipots

Trichomonas
vaginalis

STD

Giardia
intestinalis

Common,
esp.
daycares,
increased
in immunocompromis
ed
Gambiense
in W Africa,
rhodesiens
e in E
Africa;
tsetse fly
vector
Central and
S America;
reduviid
bug vector

African
trypanosomi
asis (T.
brucei,
sleeping
sickness)
American
trypanosomi
asis (T. cruzi,
Chagas
disease)

japonicum
no spine
Trophozoite
active form,
single
nucleus with
ingested
RBC; flaskshaped
ulcers
Portal of
entry nose,
craws up
cribriform
plate
Flagellated,
single
nucleus,
undulating
membrane

bladder cancer),
hypersensitivity to eggs
Acute dysentery with
abdominal pain, chronic
recurrent episodes with
blood and mucus in feces,
can disseminate to form
abscesses in liver (anchovy
paste), lung, brain

(mansoni,
japonicum)
Cysts in
stool,
serology,
amoeba
antigen,
PCR and
DNA tests

Causes amebic
meningoencephalitis

Trophozoite
s in CSF and
tissue

Amphotericin B

Frothy vaginal discharge,

strawberry cervix

Trophozoite
s in
discharge,
PCR

Metronidazole,
tinidazole

Flagellated, 2
nuclei and
bilateral
symmetry,
suction disks

Uncontrollable flatulence,
abdominal distension, foulsmelling diarrhea,
malabsorption (trophozoites
cover and flatten intestinal
epithelium)

Cysts and
trophozoite
s in stool

Metronidazole,
tinidazole,
nitazoxanide

Trypomastigo
te with
kinetoplast
and
undulating
membrane

Bite rxn (chancre),

parasitemia, fever, CNS
(coma and death); E African
form more rapidly
progressive

Parasites in
blood or
lymph
nodes; Card
agglutinatio
n test

Blood
pentamidine,
suramin; CNS
melarsoprol,
nifurtimox,
eflornithine

Immune evasion
via antigenic
variation (VSG,
variable surface
glycoproteins)

Mosquito
nets, avoid
tsetse flies,
protective
clothing

Trypomastigo
te in blood,
amastigote in
tissue

Primary lesion (chagoma)

usually at bite, periorbital
swelling (Romana sign),
nonspecific symptoms,
parasitemia and
lymphocytosis; chronic

Bloor
smear,
tissue
histology

Complex;
benznidazole,
nifurtimox

Reduviid bug lays

feces near bite and
gets rubbed into
eye, wound, or
mouth; become
amastigotes once

Can kill with

gentian
violet plus
heat

Metronidazole
or tinidazole for
symptomatic,
iodoquinol or
paromyomycin
for
asymptomatic

Transmitted by
free-living amoeba
in the water

Multiplies by
binary fission,
sexually
transmitted, no
cysts, no
reservoirs
Have cysts, cysts
are ingested, can
have animal
reservoirs

Dont drink
or eat
fecally
contaminat
ed things

Dont swim
in
freshwater,
dont use
neti pots
Safe sex

Not killed
by chlorine;
kill by
heating and
desiccation

Leishmaniasi
s

Depends on
species and
immune
status;
sandfly
vector

Promastigote
taken up by
macrophages
and become
amastigote

Toxoplasma
gondii

Congenital,
direct
contact
with cat
feces, blood
transfusion,
undercooke
d meat

Pseudocysts

Cryptosporid
i hominis or
parvum

Outbreaks
via
contaminat
ed water,
water
parks, pools
Different by
region;
anopheles
mosquito
vector

Oocysts,
sporozoites,
merozoites

Malaria
(plasmodium
)

Ring-form
trophozoites
in blood
smear,
hypnozoites
are dormant
and cause
relapsing
disease

cardiomyopathy,
megaesophagus, megacolon
Cutaneous (ulcers, boils and
sores), mucocutaneous
(face, nose deformities),
visceral (hepatomegaly,
splenomegaly), damage
mainly due to immunologic
response
Rarely symptomatic in
immunocompetent people,
can cause congenital
infections and serious illness
via reactivation in
immunocompromised
people, extra caution for
pregnant and HIV/AIDS
patients
Diarrhea (dose-dependent),
can disseminate and cause
severe disease in
immunocompromised,
dehydration from diarrhea
RBC rupture, cyclic
symptoms, headache, n/v,
anemia, seizures,
pulmonary symptoms,
ARDS, hypoglycemia, lactic
acidosis; P. falciparum is
deadliest

inside cells
Blood or
tissue
exam,
serology,
clinical hx

Sodium
stibogluconate,
miltefosine,
amphotericin B

Obligate
intracellular
organism

Control
sandflies,
sleep
higher,
permethrin
bed sheets

Special
antibodies

Pyrimethamine
and
sulfadiazine, or
TMP-SMX

Cat definitive
host, forms
pseudocysts in
intermediate
hosts, can infect
placenta and
vertical
transmission

Avoid cat
litter, cook
meat, TMPSMX
prophylaxis
in HIV/AIDS
patients

Antigen
testing,
stool
microscopy

Nitazoxanide

Ingest oocysts,
release
sporozoites,
differentiate into
merozoites

UV and
filters, boil
water,
resistant to
chlorine

Giemsa
stain blood
smear,
rapid
antigen test

Variable
resistance,
primaquine to
kill hypnozoites
(P. vivax and P.
ovale)

DEET, bed
nets, avoid
mosquito
bites,
mefloquine
prophylaxis
in kids

Schistosoma

Leischmaniasis

Malaria