Mammomonogamus - Pathogenesis

Pathogenesis

Little is known about how M. laryngeus causes disease. Symptoms do not arise until the worms have reached the adult stage and obstruct the bronchial airways leading to asthma-like symptoms and coughing. Similar symptoms are seen in humans as well as the domestic ungulates and ruminant hosts. Bronchial inflammation or hemotypsis may occur due to the worms attaching to the mucosal walls and ingesting red blood cells.

The incubation period is usually 6–11 days after infection. This supports the second hypothesis of a possible pulmonary cycle that explains the one to two week delay in the presentation of symptoms.

Eosinophilia count is not a reliable measure of extent of infection because it varies from individual to individual. Some cases with multiple pairs of worms have reported low eosinophils levels while other cases with a single pair had very high eosinophil count. Such variation may be due to the lack of host tissue invasion by the parasite, since M. laryngeus attaches to the mucosal epithelium in the tracheolaryngeal region. A singular case even found worms within a cyst.

Past cases have demonstrated that simple removal of the worms from upper-respiratory area led to a cessation of symptoms and was a sufficient cure with or without anti-helmintics. No lasting pathological tissue damage was reported.

Thus far, there has been no mention of a re-infection mechanism for M. laryngeus, so all adult worms found inside a human must be the result of an ingested embryonated egg, larvae, or adult worm. Most of the time, only one pair of worms is found, but occasionally, the patient may have multiple pairs that must all be removed.