SECTION 2A Flashcards
Trichinella spiralis
Trichinella spiralis
Trichocephalus trichiurus
Trichuris trichiura
Trichocephalus dispar
Trichuris trichiura
Eustrongylus gigas
Dioctophyma renale
Trichina worm, Muscle worm
Trichinella spiralis
Pudoc worm
Capillaria philippinensis
Capillary liver worm
Capillaria hepatica
Whipworm
Trichuris trichiura
Giant Kidney Worm
Dioctophyma renale
Encysted larva
Trichinella spiralis
3rd stage larva
Capillaria philippinensis
Dioctophyma renale
embryonated ova
Capillaria hepatica
Trichuris trichiura
Small intestine, skeletal muscles (larva)
Trichinella spiralis
Small intestine, large intestine
Capillaria philippinensis
liver of the host
Capillaria hepatica
cecum & appendix
Trichuris trichiura
Kidney (typically the right kidney)
Dioctophyma renale
4-16 weeks
Trichinella spiralis
5-10 years
Trichuris trichiura
5 years
Dioctophyma renale
ingested of encysted larva
(improperly cooked meat)
Trichinella spiralis
eating infected fish
Capillaria philippinensis
Distribution:
Philippines & Thailand
Capillaria philippinensis
✓ Eating of dog’s meat
Capillaria hepatica
✓ Ingestion of contaminated food and drinks (embryonated ova)
Capillaria hepatica
Intermediate hosts:
Same animal as the final host
Trichinella spiralis
Final hosts:
Hogs, rats, man
Trichinella spiralis
Accidental:
Humans
Trichinella spiralis
Intermediate hosts:
glassfish, “bagsit”, “bagsang”, “ipon”
Capillaria philippinensis
Definitive hosts:
Man and birds
Capillaria philippinensis
Hosts:
rats, dogs, cats, monkeys and rarely in human
Capillaria hepatica
Principal host:
man, but has been found in hogs, monkeys, cattle, dogs, mice
Trichuris trichiura
Intermediate hosts:
Oligochaete annelids
Dioctophyma renale
Definitive hosts:
Mink, dogs, foxes, and other carnivores; fish eating mammals
Dioctophyma renale
Paratenic hosts:
Fish and frogs
Dioctophyma renale
Larva: at birth
Trichinella spiralis
Larva 80-120 μm & highlycoiled
Trichinella spiralis
Larva has spear-like burrowing tip at its tapering anterior end
Trichinella spiralis
Larva grows rapidly about 1 mm
Trichinella spiralis
Adult: rarely seen in stool or any material
Trichinella spiralis
Females 3.5 mm x 0.06 mm
Trichinella spiralis
Females Posterior end: bluntly rounded
Trichinella spiralis
Females Anterior fifth: with single vulva
Trichinella spiralis
Females LARVIPAROUS
Trichinella spiralis
Capillaria philippinensis
✓ Males:
1.5 mm x 0.04 mm
Trichinella spiralis
Males Cloaca: internal cavity; last part of the rectum
Trichinella spiralis
Ova ✓ Color: Pale yellow
Capillaria philippinensis
Ova ✓ Size: 42x20 μ
Capillaria philippinensis
Ova ✓ similar to that of T. trichiura
Capillaria philippinensis
Ova ✓ smaller & more striated shells
Capillaria philippinensis
Ova ✓ Flattened plugs
Capillaria philippinensis
Ova ✓ Peanut shape
Capillaria philippinensis
Females size: 2.4 – 4.3 mm
Capillaria philippinensis
Females Anterior: esophagus and esophageal
glands
Capillaria philippinensis
Females Posterior: intestine and reproductive organs
Capillaria philippinensis
- uterus lined with 2-3 rows of eggs
Capillaria philippinensis ❖ Atypical female
Capillaria philippinensis ❖ Atypical female -
Larviparous
- causes internal auto-reinfection
Capillaria philippinensis ❖ Atypical female
- uterus lined with 1 row of egg
Capillaria philippinensis ❖ Typical female
Capillaria philippinensis ❖ Typical female -
oviparous
Males size: 2.3 – 3.17mm
Capillaria philippinensis
Males caudal alae; long, non-spiny sheath
Capillaria philippinensis
Ova “lemon – shaped” eggs
Capillaria hepatica
Ova resembles that of Trichuris trichiura
Capillaria hepatica
Ova outer shell: pitted like golf ball
Capillaria hepatica
Adult males are half as long as the female with slightly chitinized spicule
Capillaria hepatica
Ova
Barrel/football-shaped
Japanese lantern
Trichuris trichiura
Ova 50 μmX25μm in size
Trichuris trichiura
Ova
3 layers:
- undeveloped, unicellular embryo
- outermost layer: smooth, bile-stained
- Hyaline/Mucus plug
Trichuris trichiura
Adults Flesh: colored
Trichuris trichiura
Adults anterior three-fifths is attenuated (whiplike)
Trichuris trichiura
Adults stichosoma type of esophagus
Trichuris trichiura
Females 35-50 mm
Trichuris trichiura
Females bluntly rounded posterior end
Trichinella spiralis
Trichuris trichiura
Females 3,000-10,000 eggs per day
Trichuris trichiura
Males 30-45 mm
Trichuris trichiura
Males posterior portion: coiled ( 360o)
Trichuris trichiura
Males lanceolate spicule protruding through a refractile pineal sheath
Trichuris trichiura
Ova ellipsoidal and brownish-yellow
Dioctophyma renale
Ova deeply sculptured depressions
Dioctophyma renale
Adults blood red in color
Dioctophyma renale
Adults attenuated (slightly) on both ends
Dioctophyma renale
✓ Females:
vulva: midventral near anterior
Dioctophyma renale
Males Size: 14-20 cm x 4-6 mm
Dioctophyma renale
Males Bell-shaped copulatory bursa
Dioctophyma renale
Males not supported by rays; covering of papillae
Dioctophyma renale
Trichinosis
Trichiniasis
Trichinelliasis
Trichinella spiralis
Disease caused: Capillariasis or Mystery disease and Malabsorption Syndrome (flattening of the villi)
Capillaria philippinensis
-Predominant Symptoms
✓ borborygmi
✓ abdominal pain
✓ Diarrhea (chronic)
Capillaria philipinensis
✓ Death: 2 – 8 weeks after these are seen
Capillaria philippinensis
Trichuriasis (Heavy infection)
Trichuris trichiura
Trichucephaliasis
Trichuris trichiura
Whipworm infection
Trichuris trichiura
Trichuris trichiura
- Slight infection:
asymptomatic
- Heavy infection:
Trichuris trichiura surface of colon matted with worms (rectal prolapse)
✓ Asymptomatic for light infections
Trichuris trichiura
✓ Heavy infection: surface colon is matted with worms
Trichuris trichiura
- Bloody or mucoid diarrhea
Trichuris trichiura
- Weight loss and weakness
Trichuris trichiura
- Abdominal pain and tenderness
Trichuris trichiura
- Increased peristalsis and rectal prolapse
Trichuris trichiura
- Obstruction and inflammation of the appendix (appendicitis)
Trichuris trichiura
- Hypoalbuminemia and IDA
Trichuris trichiura
- Extreme cachexia
Trichuris trichiura
✓ gastrocnemius and biceps
Muscle Biopsy
✓ digest with pepsin-hydrochloride
Muscle Biopsy
✓ 3rd or 4th week of infection
Muscle Biopsy
✓ use antigen preparation of Trichinella larva
Bachman Intradermal Test
✓ Observe after 30 minutes
Bachman Intradermal Test
✓ (+) result: large elevated swelling at the site of injection (intradermal)
Bachman Intradermal Test
- Muscle Biopsy
Trichinella spiralis
- Bachman Intradermal Test
Trichinella spiralis
- Beck’s Xenodiagnosis (albino rats)
Trichinella spiralis
- Serodiagnosis
Trichinella spiralis
- Bentonite Flocculation
Trichinella spiralis
- Blood Count
Trichinella spiralis
Laboratory Diagnosis: DFS & Concentration technique
Capillaria philippinensis
Liver biopsy (revealing characterist ic egg and parasite)
Capillaria hepatica
DFS, KTS, Concentration techniques
Trichuris trichiura
eggs in urine (Urine sedimentation)
Dioctophyma renale
Elimination of encysted larva in hogs through freezing at -30oC for 24 hours
Trichinella spiralis
Extermination of rats and mice around farms
Trichinella spiralis
Thorough cooking of pork
Trichinella spiralis
✓ drug of choice
Albendazole
✓ 400 mg/day for 10 days
Albendazole
✓ destroys larvae readily
Albendazole
✓ 200mg twice a day for 20 days or 400 mg/day for 20 days
Mebendazole
Albendazole
Capillaria philippinensis
Mebendazole
Capillaria philippinensis
Electrolyte replacement therapy and high protein diet
Capillaria philippinensis
Thorough cooking of fish (Kilawi)n
Capillaria philippinensis
Sanitary disposal of feces
Trichuris trichiura
Thorough washing of hands
Trichuris trichiura
Thorough washing and cooking of food
Trichuris trichiura
Avoid using human feces as fertilizer
Trichuris trichiura
- Mebendazole (500mg)
Trichuris trichiura
- Albendazole (400 mg)
Trichuris trichiura
- Oxantel-pyrantel
Trichuris trichiura
Surgical excision
Dioctophyma renale
- requires 2 hosts in order to complete the life cycle
BLIND ALLEY CYCLE
- Human infection is a dead-end infection
BLIND ALLEY CYCLE
: inflammation of duodenal & jejunal mucosa, malaise, nausea, diarrhea and abdominal cramps
Intestinal
: fever, facial edema (particularly in the eyes), pain, swelling & weakness of the involved muscle, eosinophilia
Muscle invasion
: begins at about the end of the 3rd week; s/s subside; cyst wall then the larva itself CALCIFY
Convalescence
✓ first week
Intestinal Phase
✓ small intestinal edema and inflammation
Intestinal Phase
✓ nausea, vomiting, abdominal pain, diarrhea, headache and fever, myalgia
Intestinal Phase
✓ up to 6th week:
- high fever (40oC)
- blurred vision
- edema of the face and eyes
- cough, pleural pains
- eosinophilia (15-40% for 1 month)
Migration Phase
✓ 4th to 8th week: death
Migration Phase
✓ acute local inflammation
Muscular Phase
✓ edema and pain of the musculature
Muscular Phase
✓ Larval encystation
Muscular Phase
✓ muscle fibers
Muscular Phase
- 3-4 days after larval invasion
muscle fibers
- Edematous
muscle fibers
- spindle shape
muscle fibers
- lose their cross striations
muscle fibers
- undergo basophilic degeneration
muscle fibers
: size and number migrate to the anterior of the muscle cell
- Nuclei
Predominating symptoms
✓ Eosinophilia
✓ orbital edema
✓ muscular pain and tenderness
✓ shallow, painful breathing
✓ general weakness
Muscular Phase
✓ fever, weakness, pain and other symptoms start to abate
Encystment/Encapsulation Phase
The (?) seems to be the most primitive group of nematodes.
Adenophorea (also called the Aphasmidia)
Mainly, they are free-living in soil and water; however, there are a few parasitic forms
Adenophorea (also called the Aphasmidia)
As the alternate name implies, they do not have phasmids, and the amphids are located posteriorly on the head region.
Adenophorea (also called the Aphasmidia)
In fact, they have no sensory bristles or papillae on the head and body.
Adenophorea (also called the Aphasmidia)
They are simple, spindle-shaped worms with simple excretory organs (single-celled).
Adenophorea (also called the Aphasmidia)
Aphasmids are nematodes which lack phasmids or it lacks caudal chemoreceptors. The nematodes in this classification are:
✓ Trichinella spiralis
✓ Capillaria philippinensis
✓ Capillaria hepatica
✓ Trichuris trichiura
✓ Dioctophyma renale
✓ Males:
Posterior end: ventrally curved with two lobular caudal appendages
Trichinella spiralis
✓ Untreated:
✓ weight loss; malaise
✓ vomiting; dehydration
✓ anorexia
✓ pneumonia, heart failure and cerebral edema
Capillaria philipinensis
✓ 400 mg/day for 10 days
Albendazole
✓ destroys larvae readily
Albendazole
