Liver Flukes: Clonorchis sinensis Flashcards
Common name of Chlonorchis sinensis
- Chinese Liver Fluke
1st IH of C. sinensis
- Bulinus spp.
- Parafossarulus manchouricus
- Parafossarulus anomalospiralis
- Parafossarulus stratulus
- Alocinma longicornis
- Thiara granifera
- Melanoides tuberculatus
- Semisulcospira
For the 1st IH, what are the species under Parafossarulus? There are 3.
- P. manchouricus
- P. anomalospiralis
- P. stratulus
For the 1st IH, what are the species under Bulinus? There is only 1.
- B. striatulus
For the 1st IH, what are the species under Alocinma? There is only 1
- A. longicornis
For the 1st IH, what are the species under Thiara? There is only 1
- T. granifera
For the 1st IH, what are the species under Melanoides ? There is only 1
- M. tuberculatus
2nd IH of Clonorchis sinensis. There are 2.
- Freshwater fish (Cyprinidae)
- Freshwater shrimp (but not all the time)
Final host/Definitive Host of C. sinensis.
Human
Habitat of the adult C. sinensis in Man.
- Bile ducts
- Bile passages
- Gallbladder
Diagnostic Stage of C. sinensis
Recovery of eggs/ovaries in stool
embryonated eggs
Drug of choice for C. sinensis
Praziquantel
Alternative Drug of choice for C. sinensis
Albandazole
What is the appearance of the oral sucker of C. sinensis and where is it located?
- Located on the anterior which is tapering
Which sucker is bigger than the other C. sinensis
Oral > Ventral
What is the appearance of C. sinensis’s testis?
A. Branched
B. Unbranched
C. Highly Branched
D. Coiled
C. Highly branched
What is the arrangement of C. sinensis Testis?
A. In tandem
B. Simple
C. Oblique
A. In tandem
What trematode is highly associated with cancer/malignancy?
Clonorchis sinensis
What trematode can also be attributed to the ff. diseases?
- cholangiocarinoma
- gallbladder carcinoma
- liver carcinoma`
Chlonorchis sinensis
Why does cancer/malignacy happens to a human when infected with C. sinensis?
The presence of the parasite in the liver, the liver adjusts. They are secreting substances which triggers inflammation or tissue damage in liver/gallbladder.
When the egg of C. sinensis is laid, is it embryonated or unembryonated?
Embryonated
The abopercular end of C. sinensis has what distinct appearnce?
- Has small tail or comma-like projection
What is the appearance of C. sinensis embryonated egg? In terms of its shape, color, operculum, and shoulders.
(same with Opisthorchis)
- Shape: Ovoid
- Color: Yellowish brown
- Operculum: Convex
- Shoulders: Thickened rim
+ well-developed miracidium that has assymetrical feature inside the eggs
In C. sinensis eggs are stained using what stain?
Potassium permanganate
Adult c. sinensis are stained with what stain?
India Ink
Diagnosis of C. sinensis
- Detection of egg in stool (DFS, FECT, Kato-Katz)
- Liver biopsy
- Cholangiography -> CT Scan, X-ray
- ELISA
- EIA (Enzyme immunoassay, RTPCR),
- Coproovosccopy
- PCR
What trematode is associated in these pathology?
- Clonorchiasis
- Cholangiocarcinoma
Clonorchis sinensis
T/F:
Clonorchis egg is leaf-like structure
True
It is the most important Liverpool Fuke of man
a. Clonorchis
b. Opisthorchis
a. Clonorchis
Reservoir hosts of C. sinensis
- Cats
- Dogs
- Pigs
- Other mammals
C. sinensis Life Cycle
not yet
Clonorchis sinensis: Adult Morphology
- mas manipis yung upper part, mas makapal/rounded yung lower part
- Flat
- transparent
- attenuated anteriorly
- rounded posteriorly
Clonorchis sinensis: Adult Morphology
- Ovaries: _______
- Testes: ______
- Intestinal Ceca: ______
- Looks like ______
- Oral Sucker is ______ (size)
- Ovaries: Lobed
- Testes: Deeply branched, in tandem
- Intestinal Ceca: Simple; Not branching
- Looks like Spatula
- Oral Sucker is very large
C. sinensis/Opisthorchis eggs - Yes/No:
Presence of abopercular protrude
Yes
C. sinensis/Opisthorchis eggs
Immature/Mature when passed?
Mature when passed
Clonorchis and Opisthorchis: Eggs
In the opposite side of operculum, there is a hook-like structure called ________ ________.
abopercular protruberance
Clonorchis and Opisthorchis: Disease Manifestations
What happens in Acute infection?
- Fever and chills
- fatigue
- weakness
- weight loss
- liver enlargement
- eosinophilia
Clonorchis and Opisthorchis: Disease Manifestations
What happens in Chronic infection?
- Periductal fibrosis
- Cirrhosis and portal hypertension
- Perforation of gallbladder
- Chronically infected persons may develop
- Cholangiocarcinoma (Bile duct Carcinoma)
Clonorchis and Opisthorchis: Diagnosis
For Stool
- FECT, KATO-KATZ, STOLL’S DILUTION
- Duodenal Aspirates, Entero-test
Clonorchis and Opisthorchis: Diagnosis
For Serology
- ELISA (Detect secretory antigens)
Clonorchis and Opisthorchis: Diagnosis
For Molecular
- PCR
Pathology of C. sinensis
● Bile duct obstruction
● Cholangio carcinoma
● Liver carcinoma
● Gallbladder carcinoma
