Trematodes Flashcards
Blood Flukes
Trematodes
NO PSEUDOCOELE, NO EXCRETORY PORE
Trematodes/Flukes
Flat and leaflike - unsegmented
Trematodes/Flukes
2 suckers of Flukes
Oral and Ventral suckers
complicated life cycle
Trematodes/Flukes
Snails are always the 1st Intermediate host
Trematodes/Flukes
All are hermaphrodites (both male and female sex organs) except?
Schistosoma
With operculated eggs except for?
Schistosoma
Requires two intermediate host
Trematodes/Flukes
Mode of transmission of Trematodes/Flukes (except for Schistosoma)
Ingestion
Mode of transmission of Schistosoma spp.
Skin penetration
Schistosoma spp. are example of what Fluke?
Blood Fluke
Paragonimus westermani is example of what Fluke?
Lung Fluke
Fasciola hepatica, Clonorchis sinensis, and Opisthorchis felineus are example of what Fluke?
Liver and Bile Fluke
Fasciolopsis buski, Echinostoma ilocanum, and Heterophyids are example of what Fluke?
Intestinal Fluke
immature eggs (P-F-E-F)
Paragonimus westermani, Fasciolopsis buski, Echinostoma ilocanum, Fasciola hepatica
mature eggs (S-C-O-H)
Schistosoma spp., Clonorchis sinensis, Opistorchis felineus, Heterophyids
Fasciola hepatica common name
Sheep Liver Fluke
Sheep liver fluke scientific name
Fasciola hepatica
Fasciola gigantica common name
Giant liver fluke
Giant liver fluke scientific name
Fasciola gigantica
Has a cephalic cone
Fasciola hepatica
Highly branched intestinal ceca
Fasciola hepatica
Dendritic testes in tandem and single dendritic ovary
Fasciola hepatica
Hen’s egg
Fasciola hepatica
1st Intermediate host of Fasciola hepatica (Snails)
Lymnea philippinensis
2nd Intermediate host of Fasciola hepatica
Ipomoea aquatica (Kangkong/Swamp Cabbage)
Reservoir host of Fasciola hepatica
Sheep/Cattle
Final host of Fasciola hepatica
Man
Disease of Fasciola hepatica
Laryngopharyngitis
Diagnosis of Fasciola hepatica
Direct Fecal Smear
Fasciolopsis buski common name
Giant Intestinal Fluke
Giant Intestinal Fluke scientific name
Fasciolopsis buski
Egg: Ellipsoidal, Rounded at both ends
Fasciolopsis buski
1st Intermediate host of Fasciolopsis buski (Snails)
Segmentina, Hippeutis
2nd Intermediate host of Fasciolopsis buski
Trapa bicornis (water caltrop), Nymphaea lotus (lotus)
Final host of Fasciolopsis buski
Man and Pigs
Disease: Inflammation, Ulceration, EDEMA
Fasciolopsis buski
Diagnosis of Fasciolopsis buski
Direct Fecal Smear
Clonorchis sinensis common name
Chinese/Oriental Liver Fluke
Chinese/Oriental Liver Fluke scientific name
Clonorchis sinensis
Ventral sucker is smaller than oral sucker
Clonorchis sinensis
Deeply branched testes in tandem and Single ovary is small and lobed
Clonorchis sinensis
Egg: “Old-fashioned electric bulb” shape
Clonorchis sinensis
1st Intermediate host of Clonorchis sinensis (Snails)
Bulimus, Melanoides
2nd Intermediate host of Clonorchis sinensis
Carps and minnows
Reservoir host of Clonorchis sinensis
Cat, Pigs, Dogs
Final host of Clonorchis sinensis
Man
Disease: May cause gallstones, Periductal fibrosis, Eosinophilia
Clonorchis sinensis
Diagnosis of Clonorchis sinensis
Direct Fecal Smear
Opisthorchis felineus common name
Cat liver fluke
Cat liver fluke scientific name
Opisthorchis felineus
Oral sucker is smaller than ventral sucker
Opisthorchis felineus
Lobate testes and lobed ovary
Opisthorchis felineus
Lancet-shaped and Reddish yellow
Opisthorchis felineus
Egg: “Old-fashioned electric bulb” shape but SMALLER
Opisthorchis felineus
1st Intermediate host of Opisthorchis felineus (Snails)
Bithynia leachi
2nd Intermediate host of Opisthorchis felineus
Carps and minnows
Reservoir host of Opisthorchis felineus
Cat, Pigs, Dogs
Final host of Opisthorchis felineus
Man
Disease: Autonomic dysregulation of the cardiovascular system
Opisthorchis felineus
Diagnosis of Opisthorchis felineus
Recovery of diagnostic ova
Echinostoma ilocanum common name
Garrison’s Fluke
Garrison’s Fluke scientific name
Echinostoma ilocanum
Covered with plaque-like scale
Echinostoma ilocanum
Dumbbell shaped
Echinostoma ilocanum
Oral sucker: equipped with circumoral disc
Echinostoma ilocanum
How many is the collar of spines of Echinostoma ilocanum?
49-51
Egg: Inconspicuous operculum with germ ball
Echinostoma ilocanum
1st Intermediate host of Echinostoma ilocanum (Snails)
Hippeutis umbilicus
2nd Intermediate host of Echinostoma ilocanum
Kuhol or Pila conica
Final host of Echinostoma ilocanum
Man, cats, pigs, rats, dogs
Disease: Ulceration and Diarrhea (sometimes bloody)
Echinostoma ilocanum
Diagnosis of Echinostoma ilocanum
Recovery of Egg
Heterophyes heterophyes common name
Heterophyd worm
Two equal sized testes
Heterophyes heterophyes
Two unequal testes
Metagonimus yokagawai
Heterophyd worm scientific name
Heterophyes heterophyes
Smallest yet deadliest trematode
Heterophyes heterophyes
With 3rd genital sucker (gonotyl)
Heterophyes heterophyes
Egg: Smallest eggs, Embryonated Golden brown
Heterophyes heterophyes
Egg: Thickened abopercular portion
Heterophyes heterophyes
1st Intermediate host of Heterophyes heterophyes (Snails)
Melanoides juncea
2nd Intermediate host of Heterophyes heterophyes
Chanos chanos (Milkfish/Bangus)
Final host of Heterophyes heterophyes
Man, cats, dogs
Disease: Peptic ulcer disease, Acid peptic disease, Gurgling abdomen
Heterophyes heterophyes
Diagnosis of Heterophyes heterophyes
Recovery of diagnostic ova
Paragonimus westermani common name
Oriental lung fluke
Oriental lung fluke scientific name
Paragonimus westermani
Coffee bean shaped
Paragonimus westermani
Posterior ovary to ventral sucker with 6 long unbranched lobes
Paragonimus westermani
Unembryonated/immature egg with germ cells not miracidium
Paragonimus westermani
1st Intermediate host of Paragonimus westermani (Snails)
Antemelania asperata
2nd Intermediate host of Paragonimus westermani
Sundathelpusa philippina (Talangka)
Disease: Paraganomiasis with HEMOPTYSIS Chest pain, dyspnea, hemoptysis (couging of blood)
Paragonimus westermani
Diagnosis: Sputum exam, X-ray, Serology, Intradermal tests
Paragonimus westermani
Have separate sexes
Schistosoma
Eggs are NOT operculated
Schistosoma
Portal of Entry: Skin penetration
Schistosoma
Have No metacercaria stage
Schistosoma
Has only 1 intermediate host
Schistosoma
Identification of species is mainly by egg appearance
Schistosoma
Schistosoma: Egg with knob-like protuberance
Schistosoma japonicum
Schistosoma: Egg with lateral spine (“rose’s thorn”)
Schistosoma mansoni
Schistosoma: Egg with terminal spine
Schistosoma haematobium
Less common Schistosoma species (2)
Schistosoma intercalatum and Schistosoma mekongi
Terminal bent spine
Schistosoma intercalatum
Lateral spine
Schistosoma mekongi
Schistosoma japonicum common name
Oriental blood fluke
Oriental blood fluke scientific name
Schistosoma japonicum
Schistosoma Distribution: Pacific region
Schistosoma japonicum
Schistosoma mansoni common name
Intestinal blood fluke
Intestinal blood fluke scientific name
Schistosoma mansoni
Schistosoma Distribution: Africa and Latin America
Schistosoma mansoni
Schistosoma haematobium common name
Vesical Blood Fluke
Vesical Blood Fluke scientific name
Schistosoma haematobium
Schistosoma Distribution: Africa and Middle East
Schistosoma haematobium
Schistosoma Distribution: Laos and Cambodia
Schistosoma mekongi
Schistosoma Distribution: Rainforest belt of Africa
Schistosoma intercalatum
Schistosoma Habitat: Superior mesenteric veins
Schistosoma japonicum
Schistosoma Habitat: inferior mesenteric veins
Schistosoma mansoni
Schistosoma Habitat: urinary/vesical plexuses
Schistosoma haematobium
Used in copulation
Gynecophoral canal
They are shorter and stouter
Schistosoma adult male
Average lifespan: 3-10 years
Schistosoma adult male and female
Intermediate host: Snails which includes Oncomelania
Schistosoma japonicum
Intermediate host: Snails which includes Biomphalaria
Schistosoma mansoni
Intermediate host: Snails which includes Bulinus
Schistosoma haematobium and Schistosoma intercalatum
Intermediate host: Snails which includes Tricula
Schistosoma mekongi
Final/Definitive host of Schistosoma spp.
Man
Infective stage of Schistosoma spp
Cercaria - bifurcated (fork-tailed)
Cercaria - bifurcated (fork-tailed)
Infective stage of Schistosoma spp
Diagnostic stage of Schistosoma spp
Egg/Ova in stools/urine
Immediate itching and urticaria
Schistosome dermatitis
Penetration of non-human schistosome cercaria
Swimmer’s Itch
Acute onset of infection, fever, myalgia, headache, nausea, diarrhea, etc.
Katayama fever
Observed in eggs trapped in tissues
Egg Granuloma
The enlargement of both the liver and the spleen
Hepatosplenomegaly
Hematuria, scarring and calcification, occasional embolic egg granulomas in brain or spinal cord, bladder cancer
Disease of Schistosoma haematobium
Intermittent and Bloody diarrhea, colonic polyps and inflammatory pseudopolyps, colon cancer in chronic infection
Disease of Schistosoma mansoni, japonicum, mekongi
Hepatosplenic Schistosomiasis
Disease of Schistosoma japonicum and mekongi
Diagnosis of Schistosoma spp
Direct Fecal Smear, Urinalysis, FECT, MICT, Faust Malloney Egg Hatching Technique, Biopsy, Ultrasound, Serodiagnosis
Urinalysis (Ovum) diagnosis of Schistosoma spp
Schistosoma hematuria and haematobium
MICT
Merthiolate Iodine Concentration Technique
Advantages of MICT
Eggs will sediment, Fecal debris can be removed, Procedure can be interrupted anytime
Stool is diluted with water
Faust Malloney Egg Hatching Technique
Biopsy diagnosis of Schistosoma spp
Rectal biopsy, Open Wedge biopsy (Liver)
A specific precipitation technique which uses lyophilized Schistosoma egg (antigen) as reagent
Circumoval Precipitin Test (Serodiagnosis)
Treatment of Schistosoma spp
Praziquantel, Oxamniquine (Vasnil), Metrifonate (Bilarcil)
Praziquantel - total dose of __mg/Kg body wt. for all species.
60mg/Kg body wt.
Oxamniquine (Vasnil) - single dose of __mg/Kg body wt.
15mg/Kg body wt.
Oxamniquine (Vasnil) is a treatment for what Schistosoma spp?
Schistosoma mansoni
Metrifonate (Bilarcil) - single dose of __mg/Kg body
10mg/Kg body
Metrifonate (Bilarcil) is a treatment for what Schistosoma spp?
Schistosoma haematobium
Prevention of Schistosoma spp
Education, Vaccination, Topical Prophylaxis, Snail Eradication
Snail eradication is a removal through what?
Mechanical removal
What is a topical prophylaxis?
To prevent penetration of cercariae
