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Paper II — 2015 September (Supplementary) (2010 Scheme) — Q7

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Paper II
2015 September (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Eggs of nematodes

Q72 marksShort Notes

Answer

Eggs of medically important intestinal nematodes — key features distinguishing the common species on stool microscopy:

  • Ascaris lumbricoides — large, oval, thick-shelled eggs; fertilized eggs have a characteristic mammillated (bumpy) outer coating (composed of albumin, often bile-stained brown/golden); unfertilized eggs are more elongated, thinner-shelled, and lack this mammillation.
  • Trichuris trichiura (whipworm) — a distinctive barrel-shaped (football-shaped) egg with a prominent transparent plug (mucoid polar plug) at each pole, bile-stained brown.
  • Ancylostoma duodenale / Necator americanus (hookworm) — thin-shelled, oval eggs, colourless/transparent, typically containing a developing 4–8-cell-stage embryo when passed in fresh stool (early cleavage stages visible, distinguishing from other species’ eggs which are usually more developed or unsegmented at excretion).
  • Enterobius vermicularis (pinworm) — asymmetrically oval, flattened on one side (“D-shaped”), thin-shelled, typically containing a fully developed larva; classically NOT found in routine stool samples (the female worm migrates out of the anus at night to lay eggs perianally), requiring the perianal (Scotch/cellophane tape) swab technique for diagnosis rather than stool examination.
  • Strongyloides stercoralis — eggs are rarely seen in stool since they hatch rapidly within the intestine; instead, characteristic rhabditiform larvae (rather than eggs) are the typical diagnostic form found in stool.

General diagnostic principle: stool microscopy (direct wet mount, and concentration techniques such as formalin-ether sedimentation for improved sensitivity with low egg counts) remains the mainstay for diagnosing intestinal nematode infections, with the characteristic size, shape, shell structure, and internal contents of the egg allowing species-level identification.

  1. 1General Parasitology

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