1. Helminthes (worms)

2. Helminthes sub kingdom metazoa Phylum Nemathelminthes (round worms)
(intestinal round worm)
Nematodae
class
(tissue round worm)
Filariea
(flat-worms)
Platyhelminthes
Phylum
(tape worm)
Cestodea
(Flukes)
Trematodea

3. Nematodes (round worm)

4. General characteristics
-bilaterally symmetrical, unsegmented and elongated,
-The body is covered with a non cellular cuticle.
-The sex is separated ( bisexual the )female is longer than the male.
-Size varies from less than one mm to several centimeters.
-Digestive system is complete with mouth, gut & anus.
-Nervous system is very simple.
-Reproductive system is well developed.
The fundamental stages in are the egg , larva & the adult..

5. Enterobius vermicularis
Threadworm,
Pinworm,
Seatworm, or
Oxyuris vermicularis.
(entero = intestine, bius = live) ,
(oxy = sharp, uris = tail).

6. Epidemiology -It is cosmopolitan.
-It is more common in cold, temperate than in tropical and subtropical climates.
(decrease bathing and less change of the (underwear, so more chance to infection.

7. Morphology

10. Mode of transmission 1-Anus to mouth by:
a-contaminated finger: (reinfection).
b-contaminated night clothes, bed linen, etc.
2-Airborne.
3-Retroinfection.
4-People sleeping in the same bed or bedroom,
also contaminated toilet seat and wears.

11. Pathology and clinical manifestations
Majority of infections are asymptomatic.
-Pruritis ani is main clinical manifestation, which results from:
1-tickiling sensation from the emergence of the adult female worm.
2-biproduct of adult worms.
3-sticky albumin material coated the eggs.
-Perianal excoriation, abdominal pain, appendicitis and eosinophilia are other manifestations.

12. Behavioral changes -nail biting, -nose picking,
-grinding of teeth during night,
-inattention and poor cooperation
nervousness, night mare, insomnia, anorexia, loss of weight, tiredness and dark shadow under the eye.

13. Ectopic enteropiasis -Ectopic migration of worms may cause -vaginitis,
-omentiti,
-cervisitis,
-peritonitis and
-recurrent UTI.

14. Diagnosis 1-History and clinical finding:
2-Specific diagnosis by detection of:
-Adult worms in a-stool (on the surface).
b-peri-anal area
-Eggs: by
a-Scotch tape slide method:
95% of infected cases.
b-Stool examination:
5% of infected cases

15. Treatment
-Mebendazole (vermox) repeated after 7-10 days. -All family must be treated. -All bed lines & towels washed in hot water & the home must be cleaned.

16. Trichuris trichiura (Whipworm)
-It occurs worldwide.
-most common in warm moist climates and areas where sanitation is poor.

17. Trichiuris trichiura: adult worms (female and male)

18. Egg of Trichiuris trichiura

20. Pathogenesis and clinical features
-Abdominal pain, weight loss, or epigastric pain.
-Rectal prolapsed (probably due to toxic irritation of nerve endings).
-Anaemia due to heavy worm load.
-Malnutrition.
-Bloody diarrhea.
-Acute appendicitis due to mechanical blockage.
-Eosinophilia

21. Diagnosis 1-Stool examination a-typical barrel shaped eggs.
b-occasionally an adult worm may appear in stool.
2-Sigmoidoscopy
In heavy infection, sigmoidoscopy may show the white bodies of the worm hanging from the inflamed mucosa- the so called coconut cake rectum.