Vet Guide 2025: Tongue Worm (Pentastome) Infections in Reptiles & Amphibians 🐍🦎 by Dr Duncan Houston 🩺

Hello! I’m Dr Duncan Houston, BVSc and founder of Ask A Vet. Tongue worms—parasites in the subclass Pentastomida—infect reptiles, amphibians, birds, mammals and pose both animal health and zoonotic risks. In 2025, we’re better able to spot, treat, and reduce transmission through precise diagnosis and ivermectin-based therapy. This guide unpacks their biology, clinical signs, diagnostics, medical and surgical treatment, zoonotic safety, and prevention strategies to keep your exotic pets safe and healthy.

1. What Are Tongue Worms?

Tongue worms (pentastomes) such as Raillietiella and Armillifer are not true worms—they’re parasitic crustaceans that live in the respiratory tracts of reptiles and carnivores :contentReference[oaicite:2]{index=2}. Adult pentastomes can grow a few centimeters long and attach via hook-bearing appendages in the throat, lungs, or nasal passages of their hosts.

2. How Do Infections Develop?

Pentastomes use an indirect life cycle. Intermediate hosts—typically small mammals or amphibians—ingest larvae that encyst. When these intermediate hosts are preyed upon, the larvae mature within the respiratory tract of the definitive reptilian host :contentReference[oaicite:3]{index=3}.

3. What Species Are Affected?

• Snakes—including pythons and boas—harbor Armillifer species.
• Lizards, such as geckos, may host Raillietiella :contentReference[oaicite:4]{index=4}.
• Amphibians and even captive mammals can become involved as carriers or accidental hosts.

4. Clinical Signs to Watch

• Respiratory issues like coughing or wheezing.
• Nasofacial swelling, mucus, or sneezing.
• Weight loss, anorexia, or lethargy in chronically infected reptiles.
• Pneumonia is a common sequela in heavy infections :contentReference[oaicite:5]{index=5}.

5. Zoonotic Risk

Pentastome larvae can infect humans, causing visceral pentastomiasis—though rare, human disease is documented in regions exposed to contaminated reptiles or undercooked hosts :contentReference[oaicite:6]{index=6}. Basic hygiene and handling precautions are vital.

6. Diagnosing Tongue Worms

• Fecal egg detection: ova passed from respiratory tract may appear in feces; microscopic screening is key :contentReference[oaicite:7]{index=7}.
• Endoscopy or imaging: larval worms may be visualized or inferred via lung/nasal swells.
• Post-mortem inspection: adult worms often seen in lungs or nasal cavities on necropsy.

7. Treatment Protocols

7.1 Medical Management

• Ivermectin: In a 2022 case study, two reptiles were cleared of tongue worm infections using 200 µg/kg orally once weekly, with no adverse reactions :contentReference[oaicite:8]{index=8}.
• Follow-up fecal exams are critical to confirm elimination.

7.2 Surgical Intervention

If imaging reveals accessible worms—e.g., in nasal cavities or lung airways—endoscopic removal may be required after initial ivermectin therapy :contentReference[oaicite:9]{index=9}.

8. Prognosis

When diagnosed and treated early, prognosis is generally good. Chronic heavy burdens or internal tissue damage may require supportive care and longer-term recovery, but ivermectin shows encouraging efficacy :contentReference[oaicite:10]{index=10}.

9. Prevention & Husbandry

• Quarantine new or imported reptiles for 60–90 days and screen for pentastome eggs.
• Avoid feeding live feeder species sourced from areas with pentastome prevalence.
• Maintain strict hygiene and personal protective measures when cleaning tanks.
• Perform annual fecal checks, especially in collections with multiple reptile species.

10. Ask A Vet Support 🩺

If your reptile shows respiratory signs, weight loss, or you detect respiratory parasites, upload fecal images, endoscopy visuals, and case history via the Ask A Vet app. Our vet team will provide dosage guidance (including ivermectin), removal strategies, and zoonotic protection protocols. Visit AskAVet.com 📱

11. Final Thoughts

Tongue worms can silently gravely affect reptile lung health—and pose rare risks to handlers. In 2025, with improved fecal diagnostics, ivermectin therapy, and hygienic protocols, these infections can be managed effectively. Early detection and supportive care ensure the best outcomes, and Ask A Vet is always available to guide you through identification, treatment, and prevention. 🩺🌿

— Dr Duncan Houston, BVSc