Helmentic infections can be caused by roundworms, tapeworms, and flukes. Roundworm infections include enterobius vermicularis (pinworm), ascariasis (roundworm), trichuriasis (whipworm), and hookworm. Tapeworm infections include taeniasis caused by Taenia saginata and Taenia solium. Fluke infections include schistosomiasis caused by several Schistosoma species. Symptoms vary depending on the parasite but can include abdominal pain, diarrhea, blood in urine or stool, and malnutrition. Diagnosis involves examining stool or biopsy samples microscopically for parasite eggs. Treatment involves antiparasitic medications.

1. Helmentic infections: Dr.Mohamad Shaikhani.

6. Roundworms(Nematodes). Round worms(asaris lumbricoides)

12. Treatment for common intestinal nematodes. Asaris Hook E.V Trichuris Strongyloides Piperazine +++ + +++ - - Pyrantel +++ ++ +++ - - Oxantel - - - +++ - Mebendazole ++ ++ +++ ++ + Albendazole ++ ++ + + ++ Thiabendazole ++ ++ ++ + +++ Levamisole +++ + + - - Pyrvinium + - +++ - -

18. Humans Accidental Intermediate Host

22. Cestodes(Tape worms). Echinococcus granulosus & multilocularis(hydatid cysts):

23. Cestodes(Tape worms). Echinococcus granulosus & multilocularis(hydatid cysts): Scolex Adult worm Taenia saginata Infected beef

30. Trematodes(Fluke). Shistosomiasis (Bilharziasis):

32. Trematodes(Fluke). Shistosomiasis (Bilharziasis): pathogenesis & clinical features. Stage Time S.Hematobium Other types. Cercarial penitration Days Papular dermatitis. Swimmers itch Same Larval migration& maturation. Weeks Pneumonitis,myositis,hepatitis,fever,eosinophilia,seroconversion. Same. Early egg deposition. Months. Cystitis, hematuria Immune complex glomerulonephritis. Colitis,hepatitis, Portal HT Same.

33. Trematodes(Fluke). Shistosomiasis (Bilharziasis): pathogenesis & clinical features. Stage Time S.Hematobium Other types. Late egg deposition. Years. UB, ureters fibrosis calcification,Ca Infection,stones,hydronephrosis. Pulmonary granulomas & pulmonary hypertension. Colonic polyposis & strictures,periportal firosis, portal hypertension. Same.

35. Trematodes(Fluke). Shistosomiasis (Bilharziasis): Treatment. Type Praziquantel Oxamniquine Metrifonate Mansoni 40mg/kg once 15mg/kg*2*2 days Not useful Japonicum 40mg/kg*2 in one day Not useful Not useful Hematobium 40mg/kg once Not useful 7.5mg/kg every 2 weeks * 3

37. A: Acute liver granuloma around S mansoni egg in liver. B: Chronic liver granuloma around the remains of a schistosome egg in liver, with dominant fibrous tissue.

38. C: Macrohaematuria due to ulceration of the bladder wall in urinary schistosomiasis. D: Ultrasonography of irregular bladder wall and polyp; E: IVP showing bilateral hydroureter and hydronephrosis.

39. F: Severe bloody diarrhoea due to S mansoni . G: 6-year-old boy with gross hepatosplenomegaly. H: 19-year-old man with symptoms of chronic fibrotic liver schistosomiasis—splenomegaly, external varices, ascites, growth retardation. I: ultrasonography of advanced periportal fibrosis &portal venodilatation;