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Location of Trematodes Adults in Human Hosts:
Fasciolopsis buski
Metagonimus yokogawai
Heterophyes heterophyes
Intestin
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Location of Trematodes Adults in Human Hosts:
Fasciola hepatica
Clonorschis sinensis
Dicrocoelium dendriticum
Liver Flukes
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Location of Trematodes Adults in Human Hosts:
Paragonimus westermani
Lung flukes
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Location of Trematodes Adults in Human Hosts:
Schistosoma haematobium
S. j aponicum
S. mansoni
Blood flukes
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How are circulatory Schistosoma spp. acquired?
Cercariae directly penetrate the skin of humans
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How are all trematodes/flukes acquired (except circulatory)?
Eating metacercariae
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Trematode Adults:
Dorsoventrally flattened (except schistosomes which are round)
Hermaphroditic (except schistosomes)
Self-fertilizing (except schistosomes)
Two suckers
Blind cecae (intestinal sacs)
- Trematode Eggs:
- Pass in feces/secretions of definitive hosts
- Thick walled
- Oval to round
- Operculate or capped
- +/_ embryonated (hatch or develop in water, miracidium often swims free)
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What type of cecae do flukes have?
Blind
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Fasciolopsis buski
Giant Intestinal Fluke
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Diarrhea, toxemia from parasite metabolites, peripheral eosinophilia (rare in protozoa).
Tx?
- Fasciolopsis buski
- Praziquantel (Biltricide)
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Diagnostic stage of Fasciolopsis buski?
Metacercariae
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Heterophyes heterophyes transmission?
Ingestion of encysted metacercariae in raw, pickled, or poorly cooked fish
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Metacercariae excyst attaches to mucosa of small intestine (btw villi) and mature into adults
Heterophyes heterophyes
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Diagnosis of Heterophyes heterophyes?
Tx?
- Demonstrate characteristic eggs in stool
- Praziquantel
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Protozoa w/ ventral sucker on side, spread by metacercariae in fish muscle (fish raised w/ feces).
Tx?
- Metagonimus yokogawai
- Praziquantel
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Transmission of Fasciola hepatica?
Ingestion of encysted metacercariae on raw, aquatic vegetation (water cress salad)
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Where is Fasciola hepatica most prevalent?
Bolivia and Peru (Andes)
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Which adult fluke is large and fleshy with branched testes?
Fasciola hepatica
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Sheep Liver Fluke
Fasciola hepatica
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Peruvian sheep herder w/ liver damage (RUQ pain, biliary colic, jaundice)
Fasciola hepatica
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Eating raw sheep liver with flukes causes a tickle in the throat and flukes/eggs in stool
Halzoun; Fasciola hepatica
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Which fluke can NOT be treated w/ Praziquantel?
What do you use to treat it?
- Fasciola hepatica
- Triclabendazole, Nitazoxanide
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Clonorchis sinensis
Chinese liver fluke
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Chinese man eats raw fish, which came from a farm using human feces as fertilizer. Protozoa found in his gall bladder.
Clorochis sinensis (Chinese Liver Fluke)
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Metacercariae exist in small intestin and migrate up to bile duct to develop to adults. Adults are lancet shaped w/ branched testes.
Clonorchis sinensis
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Clonorchis sinensis (Chinese Liver Fluke)
Praziquantel (Biltricide)
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Reddish-brown, lancet-shaped flukes that penetrate the duodenal wall into the peritoneal cavity and migrate to lungs
Paragonimus westermani
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Which fluke gives you rust-colored sputum and hemoptysis?
Paragonimus westermani
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Adult worms of Paragonimus westermani are located?
Cystic spaces in the lungs
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Paragonimus westermani tx?
Praziquantel (Biltricide)
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Schistosome Life Cycle
- Eggs (S. mansoni, S. japonicum, and S. haernatobium) hatch releasing miracidia
- Miracidial penetrate snail tissue
- Sporocytes produced in snails
- Cercariae released by snail into water and free-swimming
- Penetrate skin
- Cercariae lose tails during penetration and become schistosomutae
- Circulation
- Migrate to portal blood in liver and mature into adults
- Paired adult worms migrate to mesenteric venules of bowle/rectum (lay eggs that shed in stool) and venous plexus of bladder
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Diagnostic stage of Schistosome life cycle
Eggs in feces (S. mansoni, S. japonicum) or in urine (S. haemotobium)
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Infective stage of Schistosome
Cercariae released by snail into water penetrates the skin
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Forms of schistosome eggs shed in feces
S. mansoni, S. japonicum
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Forms of Schistosome egg released in urine?
S. haematobium
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Name the 3 species of Shistosoma (blood flukes) and where they are found.
- S. masoni- colonic mesenteric veins
- S. japonicum- small intestinal mesenteric veins
- S. haematobium- vesicle, prostatic and urinary plexus
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Which flukes have diecious (separate sexes/not hermaphroditic) adults?
Schistosomes
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Which Schistosome gives abdominal pain, hepatosplenomegaly, granuloma formation, dysentery, anemia, + serology
Schistosoma mansoni
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Which fluke can give you pipestem fibrosis or portal hypertension?
Schistosoma mansoni
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Schistoma mansoni
Praziquantel (Biltricide)
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Which blood fluke give eosinophhia Yangtze River Fever, brain edema, urticaria, etc?
Schistosoma japonicum (Oriental blood fluke)
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Which blood fluke causes pipestem fibrosis, cor pulmonale, heart failure, hepatomegaly, portal cirrhosis, etc?
Schistosoma japonicum
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Diagnosis and tx of Schistosoma japonicum?
- Eggs in stool
- Praziquantel
- Repair of damaged organs is not possible
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Which fluke gives HEMATURIA?
Schistoma haematobium
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Secondary calcification and bladder fibrosis is a result of?
Scistosoma haematobium
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Diagnosis of Schistosoma haematobium?
Tx?
- Eggs in urine or bladder wall(eggs have a terminal spine)
- Praziquantel
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Swimmer's itch is caused by?
Penetration of humans by bird schistosomes, adults do NOT mature in abnormal host
- 1st Exposure results in mild prickling of skin/macules
- 2nd Exposure results in erythema, vesicle formation
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