Diagnosing the Intestinal Nematodes

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The page below is a sample from the LabCE course Intestinal Worms. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Diagnosing the Intestinal Nematodes

Table 7 is a reference for identifying the diagnostic stage of the common intestinal nematodes. The geographic location and means of infection are also listed.
Table 7. Nematodes Living in the Intestinal Tract.
Species and DescriptionImage of Diagnostic StageGeographic LocationMeans of Infection
Ascaris lumbricoides
egg ~45-75 µm long
a. Fertilized corticated egg (bumpy coat surrounding the egg)
b. Fertilized decorticated egg (no bumpy coat)
a.

(36)
b.

(37)
Throughout tropical and subtropical regions, especially where sanitation is poor. Occasionally pig farms.Consuming something that has soil contaminated with eggs on it.
Enterobius vermicularis
a. egg 50-60x20-50 µm
seen in tape prep
b. adult 2.5 mm x 0.2mm
(adults are seen in perianal folds and occ. in stool specimen
a.

(38)
b.

(39)
Worldwide, even where sanitation is good Consumed from contaminated hands or can be breathed in and swallowed.
Hookworm: Necator americanus and Ancylostoma duodenale
60-75 x 35-40 µm

(40)
Worldwide, especially in warmer climates where larvae in the soil can survive; certain species predominate in certain areas Penetration of human skin by infective larvae living in the soil.
Strongyloides spp. primarily larvae are seen in the feces
180-380 µm long
Arrow shows typical rhabditiform larva in stool specimen

(41)
Tropical and subtropical areas throughout the worldDirect penetration by infective filariform larvae from the soil.
Trichuris trichiura
50-55 x 20-25 µm
note characteristic polar plugs.

(42)
Worldwide, especially in tropical areas and where there is poor sanitation. Consuming substances contaminated with eggs.
36. DPDx. "Ascariasis - Figure D: Fertilized egg of A. lumbricoides in an unstained wet mount of stool."CDC.gov, 19 Jul 2019, https://www.cdc.gov/dpdx/ascariasis/index.html
37. DPDx. "Ascariasis - Figure A: A. lumbricoides decorticated, fertile egg in wet mounts, 200x magnification." CDC.gov, 19 Jul 2019, https://www.cdc.gov/dpdx/ascariasis/index.html
38. DPDx. "Enterobiasis - Figure B: Eggs of E. vermicularis in a wet mount." CDC.gov, 5 Aug 2019, https://www.cdc.gov/dpdx/enterobiasis/index.html
39. DPDx. "Enterobiasis - Figure A: Adult male of E. vermicularis from a formalin-ethyl acetate (FEA) concentrated stool smear. The worm measured 1.4 mm in length. Image contributed by the Centre for Tropical Medicine and Imported Infectious Diseases, Bergen, Norway." CDC.gov, 5 Aug 2019, https://www.cdc.gov/dpdx/enterobiasis/index.html
40. DPDx. "Hookworm (Intestinal) - Figure B: Hookworm egg in an unstained wet mount, taken at 400x magnification." CDC.gov, 17 Sep 2019, https://www.cdc.gov/dpdx/hookworm/index.html
41. DPDx. "Strongyloidiasis - Figure D: Rhabditiform larva of S. stercoralis in an unstained wet mount of stool. Note the short buccal canal and the genital primordium (red arrow)." CDC.gov, 30 Jul 2019, https://www.cdc.gov/dpdx/strongyloidiasis/index.html
42. DPDx. "Trichuriasis - Figure B: Egg of T. trichiura in an unstained wet mount." CDC.gov, 19 Dec 2017, https://www.cdc.gov/dpdx/trichuriasis/index.html