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Sunday, August 10, 2025

Worms in humans


Overview
Worms (helminths) are multicellular parasites that live inside the human body and can cause a wide range of health problems. They are mainly classified into three groups: roundworms (nematodes), tapeworms (cestodes), and flukes (trematodes). Infections occur through ingestion of contaminated food or water, skin penetration by larvae, or via insect vectors.

1. Major Types and Examples

A. Nematodes (Roundworms)

  • Ascaris lumbricoides – large intestinal roundworm

  • Enterobius vermicularis – pinworm

  • Trichuris trichiura – whipworm

  • Hookworms (Ancylostoma duodenale, Necator americanus)

  • Strongyloides stercoralis – threadworm

  • Wuchereria bancrofti, Brugia malayi – lymphatic filariasis

B. Cestodes (Tapeworms)

  • Taenia saginata – beef tapeworm

  • Taenia solium – pork tapeworm (can cause cysticercosis)

  • Diphyllobothrium latum – fish tapeworm

  • Echinococcus granulosus – hydatid disease

C. Trematodes (Flukes)

  • Blood flukes (Schistosoma species)

  • Liver flukes (Fasciola hepatica, Clonorchis sinensis)

  • Lung fluke (Paragonimus westermani)

2. Common Symptoms

  • Abdominal pain, diarrhea, nausea, bloating

  • Weight loss, malnutrition, anemia

  • Skin rash or itching (larval entry sites)

  • Respiratory symptoms (cough, wheezing) in migrating larvae

  • Neurological symptoms in CNS involvement (e.g., seizures in neurocysticercosis)

3. Diagnosis

  • Stool examination for eggs, larvae, or worm segments

  • Anal tape test for pinworms

  • Blood tests for eosinophilia or specific antibodies

  • Imaging (ultrasound, CT, MRI) for tissue-invasive infections

4. Treatment and Typical Adult Doses

Infection / WormFirst-line DrugUsual Adult Dose*
Ascariasis (Ascaris lumbricoides)Albendazole400 mg single dose orally
Pinworm (Enterobius vermicularis)Mebendazole100 mg single dose; repeat after 2 weeks
Whipworm (Trichuris trichiura)Albendazole400 mg once daily for 3 days
Hookworm (Ancylostoma, Necator)Albendazole400 mg single dose
Strongyloidiasis (Strongyloides stercoralis)Ivermectin200 µg/kg orally once daily for 1–2 days
Lymphatic filariasis (W. bancrofti, B. malayi)Diethylcarbamazine6 mg/kg/day orally in 3 divided doses for 12 days
Beef / Pork tapeworm (T. saginata, T. solium)Praziquantel5–10 mg/kg single dose
Neurocysticercosis (T. solium larvae)Albendazole15 mg/kg/day orally in 2 doses for 8–30 days (with corticosteroids)
Fish tapeworm (D. latum)Praziquantel5–10 mg/kg single dose
Hydatid disease (E. granulosus)Albendazole10–15 mg/kg/day in 2 doses for ≥28 days; repeated cycles with breaks
Schistosomiasis (Schistosoma spp.)Praziquantel40 mg/kg single dose (some species require divided doses)
Liver fluke (Fasciola hepatica)Triclabendazole10 mg/kg single dose; repeat after 12–24 hours
Lung fluke (Paragonimus westermani)Praziquantel25 mg/kg three times daily for 2–3 days



*Doses are for typical adults with normal liver and kidney function; adjustments may be needed for children, pregnancy, or comorbidities.

5. Prevention

  • Wash hands before eating and after toilet use

  • Drink safe water and eat thoroughly cooked food

  • Wash raw vegetables and fruits

  • Wear footwear in endemic areas to prevent hookworm

  • Avoid swimming or bathing in contaminated freshwater (for schistosomiasis)

  • Community-wide deworming in high-risk areas




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