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DPDx

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Oesophagostomiasis

[Oesophagostomum spp.]

Cross-section of an adult of Oesophagostomum sp. in a colon biopsy specimen from a patient from Africa, stained with H&E. Image taken at 200x magnification.

Cross-section of an adult of Oesophagostomum sp. in a colon biopsy specimen from a patient from Africa, stained with H&E. Image taken at 200x magnification.


Eggs of Oesophagostomum sp. in an unstained wet mount of stool.

Egg of Oesophagostomum sp. in an unstained wet mount of stool.

Causal Agents

Bursate nematodes in the genus, Oesophagostomum. Oesophagostomum bifurcum is the most-common species infecting humans in Africa.


Life Cycle

Life cycle of Oesophagostomiasis

Common livestock such as sheep, goats, and swine, as well as non-human primates, are the usual definitive hosts for Oesophagostomum spp., but other animals, including humans and cattle, may also serve as definitive hosts. Eggs are shed in the feces of the definitive hostThe number 1, and may be indistinguishable from the eggs of Necator and Ancylostoma. Eggs hatch into rhabditiform (L1) larvae in the environmentThe number 2, given appropriate temperature and level of humidity. In the environment, the larvae will undergo two molts and become infective filariform (L3) larvaeThe number 3. Worms can go from eggs to L3 larvae in a matter of a few days, given appropriate environmental conditions. Definitive hosts become infected after ingesting infective L3 larvaeThe number 4. After ingestion, L3 larvae burrow into the submucosa of the large or small intestine and induce cysts. Within these cysts, the larvae molt and become L4 larvae. These L4 larvae migrate back to the lumen of the large intestine, where they molt into adultsThe number 2, . Eggs appear in the feces of the definitive host about a month after ingestion of infective L3 larvae.

Geographic Distribution

Oesophagostomum spp. are widely distributed wherever livestock is raised, but more common in the tropics and subtropics. The highest incidence in humans is in the northern regions of Togo and Ghana, where O. bifurcum (primarily a monkey parasite) appears to cycle naturally in the human populations. Sporadic cases in humans have also been recorded in Brazil, Malaysia, Indonesia, French Guiana, and West Africa

Clinical Presentation

Acute abdomen is the most-common manifestation in humans, mimicking an appendicitis. A low-grade fever and tenderness in the lower-right quadrant are the most-common symptoms; vomiting, anorexia, and diarrhea are less-common. Intestinal obstruction may also occur, mimicking a hernia. Patients may also present with large, painless cutaneous masses in the lower abdominal region. In rare instances, Oesophagostomum spp. will perforate the bowel wall, causing purulent peritonitis or migrate to the skin, producing cutaneous nodules.

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  • Page last reviewed November 29, 2013
  • Page last updated November 29, 2013
  • Content source: Global Health - Division of Parasitic Diseases and Malaria
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