(F) Trematodes: Monoecious (lecture-based) Flashcards
Enumerate the liver flukes
Fasciola hepatica
Clonorchis sinensis
Opisthorchis felineus
Disease produced: Sheep liver rot Fascioliasis hepatica
Geographical distribution: Cosmopolitan, prevalent in most sheep-raising countries
F. hepatica
F. hepatica
- Common name:
- Habitat
- Sheep liver fluke
- Proximal biliary passages, gallbladder
F. hepatica
1st intermediate:
2nd inter:
- Lymnaea truncatula (SRRC)
- Aquatic vegetation watercress
Pathology
A 45-year-old farmer from a rural area presents to the clinic with complaints of intermittent fever, abdominal pain, and fatigue. Laboratory tests reveal elevated liver enzymes and eosinophilia. Imaging studies show dilated bile ducts with areas of fibrosis. Upon further history-taking, the patient reports frequent consumption of raw watercress from nearby streams.
During examination, you notice symptoms indicative of biliary inflammation. A biopsy of the liver reveals necrotic lesions and fibrosis around the bile ducts. Pathology findings also suggest the presence of migrating larvae causing abscesses in ectopic foci.
Anong trematode
F. hepatica
Chat-GPT generated yung situational pero nasa ppt yan ni sir
- Mechanica/ & Toxic effect
- Traumatic & necrotic lesions
- Migrating larvae may be lodge in ectopic foci, abscesses or fibrosis may develop
- Adult provoke inflammation & adenomatous changes on biliary epithelium with fibrosis of the ducts
A 52-year-old woman presents to the emergency department with complaints of severe right upper quadrant pain, fever, and chills. She describes episodic colic pain and persistent nausea over the past two weeks. Physical examination reveals hepatomegaly and tenderness in the right upper quadrant.
Laboratory tests show elevated bilirubin, alkaline phosphatase, and white blood cell count, consistent with biliary obstruction and inflammation. Imaging studies reveal dilated bile ducts and evidence of cholelithiasis. Further questioning reveals the patient recently traveled to a rural area and consumed undercooked freshwater fish.
F. hepatica
- Signs & symptoms of biliary obstruction & cholangitis
- Chills, fever, right upper quadrant pain, hepatomegaly
- Colic pain & obstructive jaundice, epigastric pain & abdominal tenderness
- Cholelithiasis is relative common complication
- Halzoun (Suffocation) temporary lodgment of adult on pharyngeal mucosa, causing congestion of soft palate, pharynx, larynx & eustachian tube
- Dyspnea, dysphagia or deafness
- False fascioliasis: Ingestion of infected liver
pagod na ako magpagawa ng situational
F. hepatica
F. hepatica
Diagnosis:
Drug used:
Control & prevention (at least 1):
Diagnosis: Stool examination
Drug used: Praziquantel
C&P:
* Personal hygiene & environmental sanitation
* Eradication of worms from reservoir host
* Killing molluscan host & public education
Disease Produced: Clonorchiasis
Geographica/ Distribution: Far East, China, Japan, Korea Taiwan, Vietnam
Clonorchis sinensis
Clonorchis sinensis
Common N:
Habitat:
Common Name: Chinese liver fluke, Oriental liver fluke
Habitat: Distal biliary passages, Pancreatic duct, gallbladder
Clonorchis sinensis
1st inter:
2nd:
- Bulimus, Alocinma (SRC)
- Fresh water fishes Cyprinoid fish
Pathology
* Proliferative & inflammatory reaction in biliary epithelium
* May cause biliary obstruction, block common bile
* Trauma & toxic irritation
* Cholecystitis & cholelithiasis
* Has been linked with neoplasm of bile duct
C. sinensis
Symptomatology:
* Mild, essentially symptomless
* Hepatomegaly, tender liver, intermittent jaundice, right upper quadrant pain, fever
* Abdominal fullness, irregular appetite, diarrhea
* Symptoms of cholecystitis & hepatitis
C. sinensis
C. sinensis
Diagnosis:
Drug used:
Control
DIAGNOSIS: Stool Examination
DRUG USED: Praziquantel
CONTROL and PREVENTION
* Thorough cooking of fresh water fishes
* Personal hygiene & environmental sanitation
Public education
Disease Produced: Opisthorchiasis
Geographical Distribution: Southern, central & eastern Europe and Asia
Opisthorchis felineus
Opisthorchis felineus
Common name:
Habitat:
Common Name: Cat liver fluke
Habitat: Distal biliary passages, Pancreatic duct, gallbladder
Opisthorchis felineus
1st:
2nd:
First Intermediate Hosts: Bulimus (S-S- R- C)
Second Intermediate Host: Fresh water fishes Cyprinus
- Inflammatory and proliferative changes in biliary epithelium
- Fibrosis of biliary vessel
- Pathologic process may extend to proximal bile duct and gallbladder & may result in peri-portal fibrosis
Opisthorchis felineus
SYMPTOMATOLOGY:
* May cause moderate painful enlargement of the liver & passive congestion of spleen
* Bile stones may form around the egg
* Cholecystitis with colic pain
* Loss of appetite
Opisthorchis felineus
Opisthorchis felineus
Diagnosis:
Drug used:
Control and prevention:
DIAGNOSIS: Stool examination
DRUG USED: Praziquantel
CONTROL and PREVENTION
* Abstinence from eating raw or inadequately cooked fish and proper cooking of fish
* Sanitary excreta disposal
Life cycle of liver fluke
- Ingestion of (stage) from raw or improperly cooked 2nd intermediate host
- The stage will excyst in (duodenum/jejunum/ileum)
- Metacercaria
- Duodenum
Life cycle of liver fluke
2nd intermediate host
1. F. hepatica
2. C. sinensis
3. O. felineus
options: fish, aquatic vegetation, watercress
repeat options in answers
- aquatic vegetation, watercress
- Fish
- Fish
Life cycle of liver fluke
Metacercariae excyst in the duodenum
3: migrating larvae migrate through intestinal wall, to body cavity, Glisson’s capsule, liver, to the Proximal biliary passages, the habitat
4: migrating larvae usually enter the common bile duct, through the ampulla of Vater, to the Distal biliary passages, the habitat
option: 3 liver flukes
- F. hepatica
- C. sinensis and O. felineus
Life cycle of liver fluke
Adult produces eggs & discharged in the bile duct and evacuated with stool in a body of water
1. Immature eggs develop in the water & hatch, miracidium escape from the egg
2. Eggs hatch only after ingestion by first intermediate host
- Miracidium developed in the 1st IH (snail) until they become cercariae
- Cercariae escape from the 1st IH and swim in the water until they come in contact with the 2nd IH
- Cercariae encyst in the 2nd IH and become metacercariae, the infective stage
option: 3 liver flukes
- F. hepatica
- C. sinenesis and O. felineus
Enumerate Lung Flukes
Paragonimus westermani
Paragonimus westermani
1st and 2nd intermediate host
First Intermediate Hosts: Antemelania asperata (S- R- C)
Second Intermediate Host: Sundathelphusa philippina
Life cycle: Paragonimus westermani
please read the life cycle
page 8
PATHOLOGY
* Provoke inflammatory reaction and granulomatous reaction in the lungs with fibrotic encapsulation
* Provoke leukocytic infiltration with layer of fibrous tissues, prodcuing cystic encapsulation of parasites
* Around the worm, accumulation of blood-tinged, thick, purulent fluid with flecks (eggs) of rusty materials
* Generalized or localized diffuse fibrosis, cystic dilatation of bronchi
* Persistent pneumonia and tubercle-like abscess
* Worm may reach and develop in ectopic foci because of devious migration from intestine to lungs
PARAGONIMUS WESTERMANI
SYMPTOMATOLOGY
* Chills, fever, headache
* Persistent cough, hemoptysis, distressing chest pain
* Viscous sputum, flecked with dark golden-brown particles (eggs)
* Closely resemble that of pulmonary TB
* Physical signs may suggest bronchopneumonia or bronchiectasis with pleural effusion
* Abdominal type, dull abdminal pain and diarrhea
* Cerebral type: Jacksonian type of epilepsy, hemiplegia, visual disturbances
* Worms in subcutaneous tissues may cause creeping tumors
PARAGONIMUS WESTERMANI
PARAGONIMUS WESTERMANI
Diagnosis (3):
Drug:
Control and Prevention:
- Diagnosis:
Demonstration of eggs from sputum, aspirated pleural effusion, stool
Chest film may show patchy infiltrate with nodular cystic shadow
Complement fixation test - Drug: Praziquantel
- Control and Prevention
Abstain from eating raw, improperly cooked crabs or crayfish
Proper washing of hands to prevent contamination with metacercariae while preparing infected crabs or crayfish.
Enumerate Intestinal flukes
- FASCIOLOPSIS BUSKI
- ECHINOSTOMA ILOCANUM
- HETEROPHYES HETEROPHYES
- METAGONIMUS YOKOGAWAI
DISEASE: Fasciolopsiasis
Geographical Distribution: Central & South China, Vietnam and Thailand
Fasciolopsis buski
Fasciolopsis buski
First and 2nd intermediate host
First Intermediate Hosts:
* Segmentina hemisphaerula (S- R-R- C)
Second Intermediate Host:
* Aquatic vegetation
* Water bamboo, Water caltrop Water chestnut, Roots of lotus
PATHOLOGY:
* Damage - Traumatic, Obstructive or Toxic
* Inflammation & ulceration of mucosa
* Abscess and hemorrhages
* Acute ileus, partial obstruction of the bowel
* Profound intoxication & sensitization
Fasciolopsis buski
SYMPTOMATOLOGY
* Toxic diarrhea with hunger pain
* Ascites, edema of face; abdominal wall and lower limbs
* Nausea, vomiting, abdominal pain & diarrhea
* Dry skin with extreme prostration ath due to profound intoxication
Fasciolopsis buski
Fasciolopsis buski
Diagnosis:
Drugs:
Control and prevention:
DIAGNOSIS: Stool Examination
DRUG USED: Praziquantel
CONTROL and PREVENTION:
* Proper cleaning of aquatic vegetation before eating
* Public Education
* Prohibition of use of night soil as fertilizer in aquatic vegetation
Disease Produced: Echinostomiasis
Geographical Distribution: Philippines, Thailand
Echinostoma ilocanum
Echinostoma ilocanum
Common Name:
Habitat:
Common Name: Garrison’s fluke
Habitat: Attached to the wall of the small intestine
Echinostoma ilocanum
1st & 2nd intermediate host
First Intermediate Hosts: Gyraulus convexiusculus (R-R- C)
Second Intermediate Host: Pila luzonica
Pila conica
PATHOLOGY;
* Inflammation & ulceration at site of attachment
* Generalized toxic process
SYMPTOMATOLOGY
› There is intestinal colic and diarrhea
› Eosinophilia
E. ilocanum
E. ilocanum
DIAGNOSIS:
DRUG USED:
CONTROL and PREVENTION:
DIAGNOSIS: Stool Examination
DRUG USED: Praziquantel
CONTROL and PREVENTION:
* Destruction of molluscan vector
› Avoid eating raw or improperly cooked snails in endemic areas
Disease: heterophyiasis
Geographical Distribution: Egypt, Nile Delta, Turkey and the Far East
Habitat: Attached to the wall of small intestine
Heterophyes heterophyes
Heterophyes heterophyes
Habitat
Attached to the wall of small intestine
Heterophyes heterophyes
First Intermediate Hosts:
Second Intermediate Host:
First Intermediate Hosts: Pironella conica
(S - R- C)
Second Intermediate Host: Tilapia nilotica
PATHOLOGY:
* Inflammation & irritation
* Eggs may be filter through the intestinal wall, mesenteri venules, filtered in cardiac valves & myocardium, causing myocarditis
SYMPTOMATOLOGY:
* Colicky pains, abdominal discomfort & tenderness
* Chronic intermittent mucus diarrhea
Heterophyes heterophyes
Heterophyes heterophyes
DIAGNOSIS:
DRUG USED:
CONTROL and PREVENTION:
DIAGNOSIS: Stool Examination
DRUG USED: Praziquantel
CONTROL and PREVENTION:
› Destruction of molluscan vector
› Curtail practice of eating raw, improperly cooked or salted fishes
Disease Produced: Metagonimiasis
Geographical Distribution: Far East
Metagonimus yokogawai
Metagonium yokogawai
Common Name:
Habitat:
- Yokogawai’s fluke
- Attached to the wall of upper and middle jejunum
Metagonimus yokogawai
First Intermediate Hosts:
Second Intermediate Host:
First Intermediate Hosts: Semisulcospira libertine (S - R-R- C)
Second Intermediate Host: fish
PATHOLOGY
* * Inflammation
* Eggs may enter lymphatic or mesenteric venules causing granulomatous lesions in the myocardium, brain, spinal cord and other tissues
* May cause myocarditis
SYMPTOMATOLOGY:
* Depends on the number of worms and the organs
involved
Metagonimus yokogawai
Metagonimus yokogawai
DIAGNOSIS:
DIAGNOSIS:
CONTROL and PREVENTION:
DIAGNOSIS: Stool Examination
DRUG USED: Praziquantel
CONTROL and PREVENTION:
› Destroy molluscan vector & eat properly cooked fish
Intestinal fluke life cycle
1: Ingestion of metacercaria from raw or improperly cooked second intermediate host
* F. buski
* E. ilocanum
* H. heterophyes
* M. yokogawai
Options (Aquatic vegetations, Fish, Snail
- F. buski - Aquatic vegetations
- E. ilocanum - Snail
- H. heterophyes - Fish
- M. yokogawai - Fish
Intestinal fluke life cycle
2: Metacercariae eXcyst in the small intestine, and attached to the wall becomes adult
3: Adult produces eggs & evacuated with stool in a body of water & Immature when laid, mature in the water, then hatch, miracidium
* ??
* ??
what flukes
H. heterophyes
M. yokogawai
Intestinal fluke life cycle
- Adult produces eggs & evacuated with stool in a body of water
Mature when laid, hatches after ingested by appropriate snail, miracidium
- ???
- ???
- H. heterophyes
- M. yokogawai
5: Miracidium develop in first intermediate host (snail) into cercariae
* F. buski - (?-?-?-?)
* E. ilocanum - (?-?-?)
* H. heterophyes- (?-?-?)
* M. yokogawai - (?-?-?-?)
6: Cercariae escape from snail into second intermediate host, becomes metacercariae, the infective stage
F. buski - (S-R-R-C)
E. ilocanum - (R-R-C)
H. heterophyes- (S-R-C)
M. yokogawai - (S-R-R-C)
