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I Got Worms…ADAM C. HUNT, DO, MHS

COVENANT EMERGENCY CARE CENTER, SAGINAW, MI

Disclosures

This is gonna make you cringe…

No financial disclosures

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Tapeworm (Cestoda) Taenia sp (Saginata, Solium)

Beef and Pork

Diphyllobothrium latum

Bear/Fish Tapeworm

Cysticercosis v. Adult Tapeworm

https://www.cdc.gov/parasites/taeniasis/biology.html

Tapeworm

Presentation:

Dizziness, Abd Pain, diarrhea, headache, localized pain

Treatment

Praziquantel & albendazole

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Sushi worm Anisakis simplex (Anisakiasis)

Preparation/Cooking/Freezing

Japan (2K-3K), ↑ in US

Treatment

EGD & Albendazole

https://www.cdc.gov/parasites/anisakiasis/biology.html

Hookwork

Ancylostoma duodenale & Necator americanus

Barefoot (skin) contact with larvae hatched from human

feces

Anemia from blood loss in GI tract

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Hookworm

Life Cycle

Phases

Cutaneous, Pulmonary, Intestinal

Symptoms

Cutaneous Larval Migrans

Cough, hemoptysis

Abd Pain, Diarrhea, Anemia

Treatment

Albendazole, Mebendazole

Schistosomiasis

Schistosoma mansoni, haematobium,

japonicum

CDC: “In terms of impact this disease is

second only to malaria as the most

devastating parasitic disease.

Schistosomiasis is considered one of

the neglected tropical diseases

(NTDs).”

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Schistosomiasis

Life Cycle

Migratory, Acute and Chronic Phases

Treatment

Praziquantel

Long term effects

Bladder CA

Ascites

Adults live in vascular system and soft tissue

Prevention

Roundworm

Ascaris lumbricoides (Human Roundworm)

Soil transmitted helminths (STH) along with hookworm

and whipworm

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Roundworm

Fecal-Oral

Ingest eggs from contaminated soil or

vegetables

Symptoms

Very mild, abdominal discomfort, cough,

progresses to bowel obstruction

Treatment

Albendazole and Mebendazole

Filarial Worm

Wuchereria bancrofti, Brugia malayi and Brugia timori

Lymphatic filiariasis, Lymphedema, Elephantiasis

Arthropod Born Disease (Anopheles, Aedes, Culex

quinquefasciatus, Mansoni)

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Filarial Worm

No animal intermediate host

Adult worms live in lymphatic vessels

Treatment

Diethylcarbamazine (DEC)… funny story

Ivermectin, if co-infected with Onchocerciasis or

Loa Loa

Doxycycline???

Whipworm

Trichuriasis (Trichuris trichiura)

Fecal-Oral (Contaminated soil or veggies)

Symptoms

Depends on worm burden, can be painful stools

with mucus, water and blood

Children can have anemia, growth retardation,

impaired cognitive development

Rectal Prolapse

Treatment

Albendazole or Mebendazole

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Pinworm

Enterobiasis (Enterobius vermicularis)

Most common worm infection in the US

Mostly affects children, people who are

institutionalized and those who care for

these populations

Gravid females migrate to perianal

region and lay eggs at night

Scotch tape test

Treatment

Mebendazole, pyrantel pamoate, or

albendazole

Fun Book

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Resources

Atlas of Tropical Medicine. 6th Ed. Wallace Peters & Geoffrey Pasvol.

2008.

Foundations of Parasitology. 6th Ed. Gerald Schmidt, Larry Roberts &

John Janovy. McGraw-Hill. 2000.

CDC website

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