Helminths

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Group Species Common Name Exposure Treatment
Platyhelminths: trematodes (flukes)
lung flukes Paragonimus lung fluke seafood, especially crayfish or crab in Southeast Asia praziquantel
liver flukes Fasciola hepatica common or sheep liver fluke underwater vegetation, especially watercress, near sheep-rearing in South America, Europe, and Middle East triclabendazole
Opisthorchis viverrini Southeast Asian liver fluke freshwater fish in Southeast Asia praziquantel or albendazole
Clonorchis sinensis Chinese liver fluke fish in Southeast Asia and eastern Russia praziquantel or albendazole
intestinal flukes Fasciolopsis buskii water vegetables, especially watercress, bamboo, and water chestnuts in China, India, Thailand, and Bangladesh; pig reservoir praziquantel
Metagonimus fish in Middle and Far East praziquantel
Heterophyes heterophyes eating undercooked fresh/brackish water fish in Egypt and Middle and Far East praziquantel
blood flukes Schistosoma haematobium blood fluke freshwater in Africa and the Middle East praziquantel
Schistosoma mansoni blood fluke freshwater in Africa, the Middle East, and South America praziquantel
Platyhelminths: cestodes (tapeworms)
pseudophyllideans Diphyllobothrium latum fish tapeworm undercooked/smoked/pickled fish in Scandinavia, Siberia, Russia, Japan, Chile, and Uganda praziquantel
intestinal cyclophyllideans Taenia solium pork tapeworm eating undercooked pork
Taenia saginata beef tapeworm eating undercooked beef
Hymenolepis nana dwarf tapeworm praziquantel
tissue cyclophyllideans Echinococcus granulosus hydatid worm albendazole
Echinococcus multilocularis alveolar hydatid disease albendazole
Taenia solium cysticercosis eating soil contaminated with pig or human feces albendazole or praziquantel
Nematodes (roundworms)
filarial roundworms Onchocerca volvulus river blindness ivermectin
Loa loa eye worm diethylcarbamazine
Wuchereria bancrofti lymphatic filariasis diethylcarbamazine
Brugia malayi lymphatic filariasis diethylcarbamazine
Brugia timori lymphatic filariasis diethylcarbamazine
Mansonella perstans maybe doxycycline
Mansonella streptocerca maybe doxycycline
Mansonella ozzardi maybe doxycycline
intestinal roundworms Ascaris lumbricoides great roundworm albendazole or mebendazole or ivermectin
Necator americanus New World hookworm albendazole or mebendazole or pyrantel pamoate
Ancylostoma duodenale Old World hookworm albendazole or mebendazole or pyrantel pamoate
Strongyloides stercoralis threadworm immunosuppression in a person who has ever spent time on a tropical beach ivermectin ± albendazole
Trichuris trichiura whipworm albendazole
Enterobius vermicularis pinworm albendazole or mebendazole or pyrantel pamoate
Capillaria mebendazole
Trichostrongylus pyrantel pamoate
Anisakis anisakidosis endoscopic removal
Gongylonema gullet worm ingestion of food or water contaminated by sheep or pig feves surgical removal or albendazole
tissue-invasive roundworms Trichinella spiralis pork worm eating undercooked pig, boar, or bear meat albendazole plus steroids
Anyclostoma braziliense cutaneous larva migrans albendazole or ivermectin
Ancylostoma caninum eosinophilic enterocolitis albendazole or mebendazole or endoscopic removal
Dracunculus medinensis Guinea worm none
Toxocara visceral larva migrans albendazole or mebendazole
Angiostrongylus cantonensis rat lungworm controversial
Gnathostoma albendazole or ivermectin ± surgical removal
Baylisascaris procyonis raccoon roundworm albendazole + steroids

Investigations

  • Eosinophilia seen in tissue-invasive worms, not in those that live in the gut or in cystic structures