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What are trematodes?
- Platyhelminthes - hermaphroditic parasites of vertebrates
- aka Flukes
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What intermediate host do trematodes require?
A mollusk (snail or clam)
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Fasciolopsis buski - Where?
India, China, SE Asia
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Fasciolopsis buski - How do you get it?
Ingestion of metacercariae on vegetation contaminated by infected mollusk
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Fasciolopsis buski - Life cycle?
- Eggs passed in feces
- Matures to miracidium - infects mollusk
- Leaves mollusk as Cercaria
- Metacercariae ingested
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Fasciolopsis buski - Presentation?
- Attachment of large worms to bowel mucosa
- Inflammation, ulceration
- Diarrhea, malabsorption
- Pernicious anemia (B12 def.)
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Fasciolopsis buski - Diagnosis?
O&P in stool
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Fasciolopsis buski - Treatment?
Praziquantel (Biltricide) - a platyhelminthicide
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Clonorchis sinensis - Where?
East Asia
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Clonorchis sinensis - How do you get it?
Ingestion of metacercaria (usually in infected fresh water fish)
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Clonorchis sinensis - Presentation?
- Worms live in bile ducts
- Usually asymptomatic
- Fever, diarrhea, pain, anorexia, hepatomegaly, jaundice
- Biliary obstruction
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Clonorchis sinensis - Diagnosis?
- O&P in feces
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Clonorchis sinensis - Treatment?
Praziquantel or albendazole
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Opisthorchis felineus - Where?
Central and Eastern Europe, Siberia
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Opisthorchis felineus - Describe
- Very similar to clonorchis sinensis
- From consumption of uncooked fresh water fish
- Also inhabits the bile ducts
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Opisthorchis felineus - Treatment?
Praziquantel
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Opisthorchis viverrini - Where?
Thailand, Laos
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Opisthorchis viverrini - How do you get it?
Consumption of uncooked fresh water fish
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Opisthorchis viverrini
- Another liver platyhelminth
- Inhabit bile ducts
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Opisthorchis viverrini - Treatment?
Praziquantel
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Fasciola hepatica - Where?
South America
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Fasciola hepatica - How do you get it?
Ingestion of encysted metacercariae on aquatic vegetation
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Fasciola hepatica - Presentation?
- Worms in gallbladder and bile ducts
- May be found ectopically
- Fever, chills, RUQ pain
- Hepatomegaly
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Fasciola hepatica - Diagnosis?
- O&P of stool
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Fasciola hepatica - Treatment?
Bithionol
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Paragonimus spp.
- Lung fluke
- Usually P. westermani
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Paragonimus spp. - Where?
East Asia, Africa, Americas
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Paragonimus spp. - How do you get it?
Ingestion of raw crayfish or fresh water crabs with encysted metacercaria
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Paragonimus spp. - Presentation?
- Metacercariae excyst in the small intestine, penetrate to lungs
- Inflammatory reaction, cough, bloody sputum
- Dangerous if becomes cerebral paragonimiasis
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Paragonimus spp. - Diagnosis?
ID of dark golden-brown eggs in sputum or feces
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Paragonimus spp. - Treatment?
Praziquantel or bithionol
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