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Parasitic Worm Infection

more about Parasitic Worm Infection

Nematode infection or Helminthic Infection

  • Parasites are creatures that invade a host, attach themselves externally and internally (to tissues and organs), and rob the host of nutrients.  Some parasites, such as certain worms, eventually weaken and cause disease in their gracious hosts.
  • Parasitic worms are common in Africa, Asia, Central and South America, and are rare in countries where sanitation is practiced.
  • Worms (nematodes) are long, naked, and boneless creatures that pass their young from eggs or cyst to larval (newly hatched worms) stage, maturing into worms in the tissues they infect, such as skin, muscle, lungs, or intestine (gut or digestive tract).

  • No symptoms or very few
  • Symptoms may occur immediately or take more than 20 years.
  • At times worms can be passed whole or in segments in the stool.
  • Digestive tract (stomach, intestine, liver, colon, and rectum) with intestinal worms:
    Abdominal pain or Bloating, weakness, Diarrhea, loss of appetite, weight loss, vomiting, anemia, Malnutrition with deficiencies of vitamins (B 12) minerals (iron), fats, and protein.  Itching around anus and vagina, inability to sleep, urinating in bed, and abdominal pain seen in pinworm infections.
  • Skin (Tr, To, CE, Ac, and Gn):
    1. Eruptions
    2. Fluid-filled sacs called vesicles or bullae. 
    3. Intense facial swelling, especially around the eyes.
  • Allergic reactions:
    1. Skin rash
    2. Skin itchiness and itchiness around the anus (Pw).
  • Lungs (Tw and fluke):
    1. Cough
    2. Coughing blood
    3. Difficulty breathing.
  • Liver flukes:
    1. Enlarged tender liver
    2. Fever
    3. Abdominal pain
    4. Diarrhea
    5. Yellowish skin
  • Brain (Cy):
    1. Headache
    2. Seizures
    3. Vomiting
    4. Visual changes
    5. Dizziness.
  • Bones (Ec):

- Fractures.

  • Heart:

- Irregular heart rate

  • Bladder:
    1. Blood in the Urine
    2. Pain below the belly button
    3. Pain upon urination.
  • Lymphatic involvement:

- Swollen elephant-like legs or testicles

  • Tissue Nematodes or roundworms:
    1. Trichinella Spiralis -- the cysts of this worm can live in pork and other meats (dog, horse, bear, walrus) that when eaten, can cause serious disease in the host.  The disease is called Trichinosis (Tr.).
    2. Toxocara Canis -- causes a syndrome called visceral and ocular larva migrans or Toxocariasis (To.).  The eggs are found in dog feces.  Often presented in kids eating dirt.  Cat and raccoon feces may carry similar worms.
    3. Ancyclostoma brazilien -- eggs of this worm pass from cat or dog feces and drop in the soil, where it can then enter humans through a cut in the skin, causing a condition known as cutaneous larva migrans (Creeping Eruptions or CE).
    4. Angiostrongylus cantonenis (AC) or rat lungworm -- rat droppings contain the eggs picked up by snails and slugs.  Humans eat vegetables contaminated by snail slime, raw clams, snail, freshwater shrimp, crab, and fish that may have eaten or been exposed to this parasite.  The disease is known as Angiostrongyliasis.
    5. Gnathostomiasis (Gn) is acquired by eating undercooked or raw fish (sashimi) or poultry.  The eggs of the Gnathestoma spinigerum are found in dog or cat feces eaten by chicken, fish, or other animals.
  • Intestinal Nematodes:
    1. Ascariasis (round worm Rw) -- the eggs are found in the feces of the worm ascaris and humans accidentally ingest them from contaminated soil, such as from fertilizer on vegetables.  The worms can grow in the intestine and migrate through the blood to other sites, such as the lungs.  They can grow up to 40cm.
    2. Necator americanus and Ancylostoma duodenale (hookworm or Hw) -- worms deposit eggs through their feces in soil and the larvae enter a skin cut and invade the lungs of the host-in this case man.
    3. Strongyloidiasis (threadworm or Tw) -- worm feces containing the eggs hatch into larvae (in the soil) and enter a cut in the skin of its human host, to travel to the lungs where they grow and cause problems.
    4. Trichuriasis (whipworm or Ww) -- transmitted via larvae in the soil and accidentally ingested to grow in the small and large intestine.
    5. Entrobiasis (pinworm, Pw or seatworm) -- about 40 million Americans are infected.  The adult worm lives in the intestines and comes down to the rectum and anus, lays eggs so that when the human host scratches its anus area, eggs get under the nails and infect others.
  • Trematodes or flukes:
    1. Schistosomiasis (Sh) -- after the adult worm lays eggs, they hatch into Cercariae, infecting brain and muscle.  They come from eating raw or undercooked fish or meat from tiny fluke that live off snails, fish, Crabs, and vegetation in fresh water rivers and ponds.  The Cercariae penetrate through a cut in human skin and migrate to different parts of the body (intestine, liver, lungs, bladder, etc.) and cause various illnesses.  Eating undercooked crab, crayfish, or smoked and pickled fish are also ways of infection.
    2. Paragonimiasis (oriental lung fluke), Clonorchiasis (oriental liver fluke) -- are examples of many different types of fluke, with variety of conditions associated with them.
  • Cestodes or tapeworms:
  • These worms have many segments. They often invade the digestive tract, where they get their nutrition from their host.
    1. Diphyllobothriasis or fish tapeworm infection (intestine), Taeniasis Saginata or beef tapeworm infection (intestine), Cysticercosis (Cy) or pork tapeworm all come from animals that have eaten the eggs of these worms.
    2. Echinococcosis (Ec) or hydatid diseases are caused by variety of worms infecting animals that ingest the eggs, such as rodents, dogs, sheep, cattle, and humans.  They can invade and grow in many organs, such as liver, bone, heart, and brain.
    3. Hymenolepiasis Nana and Diminuta larval stage occurs inside insects and fleas (rats and mice) and if these insects are eaten, as in uncooked cereals, they can grow in the intestine and cause problems.

- A varied group of worms that invade the skin (subcutaneous tissues) and lymphatic tissue (series of pea-sized nodes and canals that collect white blood cells and return them to the blood stream).  In some cases, the eyes may also be involved.  These worms are very small, and their offspring, called microfilariae, are no bigger than 250 micrometers.  Examples are those carried by mosquitoes, such as Wuchereria bancrofti, Brugia malayi, and timori, and those carried by black flies, deer flies, and midges.

  • History of events, symptoms, travel, foods, occupation, habits, illnesses, medications, and surgeries
  • Medical exam
  • Blood samples may show anemia or large number of eosinophils (type of white blood cells) or elevation of a protein called IgE.
  • Blood and other body fluids may show microfilariae.
  • Stool is collected and sent to a laboratory for the presence of eggs, cysts, or larvae (Ova and parasites).
  • In case of pinworm, direct examination of the anus can be done using a flashlight or doctor's index finger.
  • In pinworm infection, a transparent tape can be applied to the anus and repeated for three nights.  When the worms come down to lay their eggs (ova) the tape collects them and the doctor can examine the scotch tape and eggs under a microscope.
  • X-Rays may show cavities in the lungs.
  • CAT scan may show Calcium deposits in the muscles (Tr) or guide a needle into a hydatid cyst and drain it.
  • MRI may be needed to provide a detailed picture of the Brain (Tr).
  • Ultrasound uses sound to show cavities in the liver.
  • A sample or a biopsy of muscle or skin may be removed and studied under a microscope.
  • Colonoscopy (via the rectum) or endoscopy (via the mouth) may be performed by inserting a flexible long tube like camera into the rectum or mouth so that the intestine and colon can be viewed.

  • Hunting and wild game
  • Warm climates
  • Rare in the United States and the west
  • Asia, Central and South America, and Africa
  • Migrants
  • Fecal contamination of water
  • Unsanitary conditions
  • Eating raw or undercooked meats or fish
  • Keeping animals in close unsanitary conditions
  • Rat or insect infestations
  • Institutionalized individuals, as in orphanages, prisons, and mental hospitals
  • Malnourished or diseased persons
  • Heavy mosquito or fly infestations
  • Playgrounds where children can eat or come in contact with soil
  • Fertilized areas

  • Fluids
  • Rest
  • All family members should be tested and treated
  • Underwear, clothes, and bed sheets should be washed in hot water till treatment completed
  • Wash hands often
  • If in a foreign country -- wash hands, avoid undercooked or raw foods, wash vegetables and fruits, avoid ice and water (use bottled drinks and water), and boil water before drinking.
  • Have your pets checked and de-wormed regularly.
  • Medications such as DEC, Mebendazole (Vermox), piperazine citrate, and others.
  • Surgery and other procedures may be necessary.

  • Contact your physician.  Wash everything before eating it.  Cook everything completely.  Consult with your doctor before traveling abroad.  Avoid contact with blood, urine, or feces of infected animals or humans.  Boil all suspect water before using.  On camping trips, avoid swimming in fresh water areas unless they have been inspected and cleared by authorities.

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