1. Mollusks/snail 2. Plants, insects, animals, water plants, fish, crustaceans (except Schistosoma)

- sheep, cattle, and other herbivores - humans infected occasionally

PR TRM GENERALITIES, LIVER & PANCREATIC FLUKES Flashcards by EJ E

body with holes

Trematodes

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Trematodes are also called as

flatworms / flukes

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IH of trematodes

has 2 intermediate hosts except Schistosoma

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T/F All appear flat and leaf-like

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T/F All are bilaterally symmetrical and segmented

F; unsegmented

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T/F All are monoecious

F; Schistosoma species are dioecious

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Term used if both testes and ovary is present in one parasite

hermaphrodites

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T/F All have well developed organs

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T/F All eggs are operculated

F; Schistosomes do not have an operculum

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T/F All require 2 IH except Schistosomes

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T/F All possess two suckers

F; Heterophyes heterophyes has 3 suckers

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Systems present

Digestive System - incomplete alimentary canal
Reproductive System - well-developed
Nervous System - basic

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Liver Flukes

Fasciola hepatica
Fasciola gigantica
Clonorchis and Opisthorchis
Dicrocoelium dendriticum

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Intestinal Flukes

Fasciola buski
Echinostoma ilocanum

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Lung Fluke

Paragonimus westermani

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Blood Fluke

Schistosoma spp.

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Other term for ventral sucker

acetabulum

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Pancreatic Fluke

Eurytrema pancreaticum

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3 types of suckers and its function present in trematodes

Oral sucker - for nutrition
Ventral sucker - for attachment
Genital sucker - for reproduction

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Intermediate hosts

Mollusks/snail
Plants, insects, animals, water plants, fish, crustaceans (except Schistosoma)

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Other term for genital sucker

gonotyl

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Life Cycle of Trematodes

Embryonated egg (freshwater)
Miracidium
1st IH
Sporocyst
Redia
Cercaria
2nd IH
Metacercaria
Humans
Adult worms (depends on habitat)

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Fasciola spp.

sheep, cattle, and other herbivores
humans infected occasionally

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DS of trematodes

Embryonated egg except Schistosoma

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MOT of trematodes

- Ingestion - Schistosoma : skin penetration

IS of trematodes

- Metacercaria - Schistosoma : fork-tailed cercaria

Shape of trematodes

- flat, leaf-like - Schistosoma : cylindrical

branching structures on lateral portion for egg-shell production

Vitellaria

T/F Trematodes has no circulatory, skeletal, and respiratory system

T; only reproductive and nervous system

Fasciola hepatica FH

Sheep

Fasciola gigantica FH

Cattles

Fasciola spp. Habitat

biliary passages of liver

Fasciola spp. 1st IH

Snails - Lymnaea philippinensis - Planorbidae spp.

Fasciola spp. 2nd IH

Aquatic plants - Ipomea obscura (kangkong, swamp cabbage) - Nasturtium officinale (water cress)

Fasciola spp. MOT

ingestion of undercooked or raw aquatic plants containing the metacercaria

Fasciola spp. How eggs are reported

Fasciola eggs

Fasciola hepatica Common name

Sheep Liver Fluke, Temperate Liver Fluke

Fasciola hepatica Adult Worms (Shape, cephalic cone and shoulders)

- Large broad, flat body - Shorter cephalic cone and prominent shoulders

Fasciola hepatica Intestinal ceca

highly branched

Fasciola hepatica Testes

highly branched, in tandem

Fasciola hepatica Ovary and uterus

- Ovary : dendritic - Uterus : coiled and short

Fasciola gigantica Adult Worms (Shape, cephalic cone and shoulders)

- Longer but narrower (slender) - present cephalic cone and less developed shoulders

Fasciola gigantica Testes

branching, in tandem

Fasciola spp. eggs Appearance

- hen's egg appearance - similar to Fasciolopsis and echinostomes

Fasciola spp. eggs Operculum & Maturity

operculated, unembryonated

Fasciola spp. Three important manifestations

Triad of high fever, hepatomegaly and marked eosinophilia

Fasciola spp. Disease Manifestation

- Fascioliasis - Halzoun/Marrara - Pseudofascioliasis - Sheep Liver Rot - Cirrhosis, Liver Atrophy, Liver Cancer

Fasciola spp. Diagnosis

- Fecalysis : FECT, Kato-Katz - Duodenal or Bile Aspirate - Serology - Laparotomy : Surgical - Diet History

Fasciola spp. Reservoir hosts

hares and rabbits

Fasciola spp. DOC

Bithionol Triclabendazole

Clonorchis sinensis Habitat

Liver, Gallbladder

Clonorchis and Opisthorchis Habitat

Liver - biliary passages, bile duct

Clonorchis and Opisthorchis MOT

ingestion of raw or undercooked fish containing metacercaria

Clonorchis FH

humans

Clonorchis and Opisthorchis Reservoir hosts

cats, dogs, pigs, other mammals

Clonorchis and Opisthorchis where adult worms feed on

tissue fluids, red blood cells, and mucus

most important liver fluke of man

Clonorchis sinensis

Clonorchis sinensis 1st IH

Snails - Parafossarulus - Bulinus

Clonorchis sinensis 2nd IH

Freshwater fish (Cyprinidae) Freshwater Shrimp

Clonorchis Common name

C. sinensis: Chinese/Oriental Liver Fluke

Clonorchis Adult Worms

- Flat, transparent, elongated, rounded posteriorly - Attenuated anteriorly - Lance-shaped - Spatulate

Clonorchis Intestinal ceca

simple and unbranched

Clonorchis Testes

Deeply branched, arranged in tandem

Clonorchis Suckers

Oral sucker bigger than ventral sucker (biggest OS)

Opisthorchis spp. Common name

O. felineus: Cat liver fluke, Siberian Liver Fluke O. viverrini: Southeast Asian Fluke

Opisthorchis spp. Appearance

- Leaf-like - Elongated and spatulate

Opisthorchis Intestinal Ceca

simple, branched

Opisthorchis spp. Suckers

VS > OS

Opisthorchis spp. Testes

lobate and oblique

Clonorchis and Opisthorchis Eggs Appearance

Old fashioned bulb or pitcher shape Well defined operculated shoulders

Clonorchis and Opisthorchis Eggs Operculum, Maturity

Operculated, Embryonated

Clonorchis and Opisthorchis Eggs Distinction from other eggs

Has convex operculum and abopercular protuberance

Clonorchis or Opisthorchis Abopercular protuberance of egg is thick

Opisthorchis

Clonorchis and Opisthorchis Abopercular protuberance of egg is comma shaped

Clonorchis

Clonorchis and Opisthorchis Eggs are similar to

H. heterophyes (no abopercular protuberance)

Clonorchis sinensis Disease Manifestation

Cancer Cholangiocarcinma Clonorchiasis

Opistorchis spp. Disease Manifestation

Opistorchiasis Hepatomegaly Cholangiocarcinoma

Clonorchis and Opisthorchis Diagnosis

- Fecalysis (FECT, Kato-Katz) - Duodenal aspirates, entero-test - Stoll's Dilution - Serology - Cholangiography

Clonorchis and Opisthorchis Stain used for eggs

Potassium permanganate

Clonorchis and Opisthorchis DOC

Praziquantel

Dicrocoelium dendriticum Common name

Lanceolate Fluke or Lancet Fluke

Dicrocoelium dendriticum Other names

Fasciola dendriticum or Fasciola lanceolata

Dicrocoelium dendriticum FH

herbivores (ruminents), cows, sheep, and cattle

Dicrocoelium dendriticum Habitat

Bile Duct, Liver

Dicrocoelium dendriticum 1st IH

Snail - Cionella lubrica

Dicrocoelium dendriticum 2nd IH

Ants - Formica fusa

Dicrocoelium dendriticum MOT

ingestion of ants containing metacercaria

Dicrocoelium dendriticum Groups of cercaria

Germ ball / Slime ball formation

Dicrocoelium dendriticum Appearance

Lancet shaped - Blade like, lancet like

Dicrocoelium dendriticum Testes

Branching, tandem, located in anterior 1/3

Dicrocoelium dendriticum Eggs

Dark brown, thick shelled, large operculum

Dicrocoelium dendriticum Operculum, Maturity

Operculated, Embryonated

Dicrocoelium dendriticum Diagnosis

Stool exam

Dicrocoelium dendriticum Disease manifestation

Asymptomatic Hyperplasia of epithelium

Dicrocoelium dendriticum Disease Manifestation : Heavy Infections

enlargement of bile ducts and hyperplasia of epithelium, may lead to cirrhosis

Dicrocoelium dendriticum DOC

Praziquantel

Eurytrema pancreaticum Type of Fluke

Pancreatic Fluke

Eurytrema pancreaticum FH

hogs, sheep, goat, cattle

Eurytrema pancreaticum AH

human

Eurytrema pancreaticum Habitat

Pancreas, Liver

Eurytrema pancreaticum 1st IH

Snail - Macrochlamys indica

Eurytrema pancreaticum 2nd IH

Technomyrmex deterquens (ant), Grasshoppers, Mantis, Crickets

Eurytrema pancreaticum Adult Worms

Ruffled border or body margin

Eurytrema pancreaticum Testis and Ovary

Testis : 2 notched Ovary : 1 notched

Eurytrema pancreaticum Eggs

Similar to lancet fluke, operculated

Eurytrema pancreaticum Operculum, Maturity

Operculated, Embryonated

Eurytrema pancreaticum Disease Manifestation

- Eurytremiasis : Type 1 Diabetes Mellitus-like symptoms - Pancreatitis

Eurytrema pancreaticum Diagnosis

Stool exam

Eurytrema pancreaticum DOC

Praziquantel