[6] Trematodes Flashcards
1
Q
trematodes class
A
Trematoda
2
Q
trematodes phylum
A
Platyhelminthes
3
Q
trematodes common name
A
Flukes
4
Q
types of flukes (4)
A
intestinal
liver
kung
blood flukes
5
Q
covered by cuticle (spiny or smooth)
A
- Trematode Body
6
Q
presence of 2 oral suckers for attachment:
○ anterior oral sucker
○ ventral sucker (posterior acetabulum)
A
- Trematode Body
7
Q
has excretory, neuromuscular, digestive, reproductive system
A
Trematode Body
8
Q
lacks circulatory and respiratory system
A
Trematode Body
9
Q
Reproductive organs and their associated structures occupy most
of the parasite’s body
A
Trematode Body
10
Q
possess single ovaries and two testes
A
Trematode Body
11
Q
uterus (houses eggs) is the largest organ of most trematodes
A
Trematode Body
12
Q
Covered with a smooth, transparent, yellow-brown to
brown-colored hard shell.
A
13
Q
Their miracidium, except that of ? , emerges through an
opening or cap, called operculum, located at one end of the egg.
A
schistosomes
14
Q
Meanwhile, ? is released as the egg ruptures
in water.
A
schistosome miracidium
15
Q
Many genera and species of intestinal, lung, and liver trematodes
are pathogenic for humans.
A
yes
16
Q
Severity of the disease depends on the original infective dose of the
?
A
metacercariae.
17
Q
Some cases may even be asymptomatic/symptomatic
A
asymptomatic
18
Q
All or not all schistosomes are definitely pathogenic for humans.
A
all
19
Q
The loading dose of ? present from infected water sources
predicts the severity of the infection.
A
cercaria
20
Q
FASCIOLOPSIS BUSKI; Commonly known
A
Large Intestinal Fluke
21
Q
FASCIOLOPSIS BUSKI; Mode of Transmission
A
ingestion of infected aquatic plants
22
Q
FASCIOLOPSIS BUSKI; Diagnostic stage:
A
unembryonated eggs
23
Q
FASCIOLOPSIS BUSKI;Intermediate host:
A
nail
24
Q
FASCIOLOPSIS BUSKI; Definitive host:
A
man and pigs
25
FASCIOLOPSIS BUSKI; Habitat of adults in man:
maill inestine
26
FASCIOLOPSIS BUSKI; Infective stage:
metacercariae
27
MORPHOLOGY: FASCIOLOPSIS BUSKI;Yellowish brown
EGG
28
MORPHOLOGY: FASCIOLOPSIS BUSKI; has a clear, thin shell with a small operculum but
no opercular shoulders
EGG
29
MORPHOLOGY: FASCIOLOPSIS BUSKI; the less mature the egg, the more difficult it is to
see the operculum “breaks” in the shell outline
EGG
30
MORPHOLOGY: FASCIOLOPSIS BUSKI;Fleshy, dark red, and elongate-ovoid
ADULT
31
MORPHOLOGY: FASCIOLOPSIS BUSKI;have no cephalic cone structures
ADULT
32
adults inhabit the duodenum and jejunum; fasciolapsis
light infections
33
adults found in the stomach and most of the
intestinal tract; fasciolapsis
heavy infections
34
Attachment of worms to the mucosal wall (5)
● local inflammation
● hypersecretion of mucus
● hemorrhage
● ulceration
● possible abscess formation
35
- Heavy infections (8)
● bowel obstruction,
● edema and ascites
● impaired vitamin B12 absorption
● marked eosinophilia and leukocytosis
● profuse and yellow-green stool
● malabsorption
● symptoms may be confused with giardiasis or peptic ulcer or with
other causes of bowel obstruction
● depending on the worm burden - severe cachexia, prostration,
and even death
36
Fasciolopsiasis; Laboratory diagnosis
1. Eggs are found in the stool; rarely, adult worms are found during
heavy infections
2. Eggs when passed do not contain mature larvae but
undifferentiated embryos
3. Formalin-ethyl acetate sedimentation concentration is
recommended for egg recovery
4. The less mature the egg, the more difficult it may be to see the
actual operculum
5. Egg has no opercular shoulders
37
Fasciolopsiasis; treatment
drug of choice – praziquantel
● alternative drug – niclosamide
38
Fasciolopsiasis; Prevention and Control:
● Cook all aquatic plants well before eating them (in boiling
water).
● 2. In endemic areas, prevent fecal contamination (from
● humans or pigs) of water where aquatic plants are
● grown. Do not feed raw aquatic plants to pigs.
39
FASCIOLA HEPATICA; common name
Liver fluke or sheep liver fluke
40
FASCIOLA HEPATICA;Mode of Transmission:
Ingestion of infected aquatic plants
41
FASCIOLA HEPATICA;Infective stage:
metacercariae
42
FASCIOLA HEPATICA;- Diagnostic stage:
Unembryonated eggs
43
FASCIOLA HEPATICA;Intermediate host:
Snail
44
FASCIOLA HEPATICA;Definitive host:
Man and sheep
45
FASCIOLA HEPATICA; Habitat of adults in man:
Small intestines
46
MORPHOLOGY: FASCIOLA HEPATICA; Identical to the eggs of F. buski in all respects.
egg
47
MORPHOLOGY: FASCIOLA HEPATICA;both consist of an oblong undeveloped
miracidium equipped with a distinct operculum
egg
48
MORPHOLOGY: FASCIOLA HEPATICA;comparable in size to F. buski
adult
49
MORPHOLOGY: FASCIOLA HEPATICA; unlike F. buski, F. hepatica is equipped with
so-called “shoulders”
adult
50
FASCIOLA HEPATICA; Laboratory dioagnosis
1. specimen of choice – stool
2. patient symptoms and travel history
3. speciation - recovery of the adult worm
4. other methodologies
○ Enterotest
○ ELISA
○ Gel diffusion
51
Sheep Liver Rot
Fascioliasis:
52
Experience symptoms caused by the presence and attachment of
the adult worm to the biliary tract
Fascioliasis:
53
Fascioliasis; symptoms
● Headache, fever, and chills, and pains in the liver area
● Eosinophilia
● Jaundice and liver tenderness
● Anemia
● Diarrhea
● Digestive discomfort
● biliary obstruction
54
Fascioliasis; treatment
dichlorophenol (bithionol)
55
Fascioliasis; prevention
● Exercise proper human fecal disposal and sanitation practices,
particularly in areas in which animal reservoir hosts reside
● Control the snail population
● Avoid the human consumption of raw water plants or
contaminated water
56
PARAGONIMUS WESTERMANI; Commonly known
Oriental lung fluke
57
PARAGONIMUS WESTERMANI; Mode of Transmission:
Ingestion of infected crustaceans
58
PARAGONIMUS WESTERMANI; Infective stage:
Metacercariae
59
PARAGONIMUS WESTERMANI; Diagnostic stage:
Unembryonated eggs
60
PARAGONIMUS WESTERMANI; Intermediate host:
1st - snail
● 2nd - crustaceans
61
PARAGONIMUS WESTERMANI; Definitive host:
Man
62
PARAGONIMUS WESTERMANI; Habitat of adults in man:
Cystic cavities in lungs
63
MORPHOLOGY: PARAGONIMUS WESTERMANI; 80-120 μm long by 45-70 μm wide
EGG
64
MORPHOLOGY: PARAGONIMUS WESTERMANI; Yellow-brown, ovoid or elongate, with a thick
shell
EGG
65
MORPHOLOGY: PARAGONIMUS WESTERMANI Often asymmetrical with one end slightly
flattened.
EGG
66
MORPHOLOGY: PARAGONIMUS WESTERMANI; At the large end, the operculum is clearly visible.
EGG
67
MORPHOLOGY: PARAGONIMUS WESTERMANI; Opposite (abopercular) end is thickened
EGG
68
MORPHOLOGY: PARAGONIMUS WESTERMANI; Large, robust, ovoid flukes
EGG
69
MORPHOLOGY: PARAGONIMUS WESTERMANI; Hermaphroditic
ADULT
70
MORPHOLOGY: PARAGONIMUS WESTERMANI; Possess oral and ventral suckers
ADULT
71
MORPHOLOGY: PARAGONIMUS WESTERMANI; Cuticle possesses spines, similar to the other
adult trematodes
ADULT
72
PARAGONIMUS WESTERMANI; laboratory diagnosis -demonstration of eggs; but these are not
present until 2 to 3 months after infection.
Stool examination
73
PARAGONIMUS WESTERMANI; laboratory diagnosis - eggs may also be encountered.
Effusion fluid or biopsy material
74
PARAGONIMUS WESTERMANI; laboratory diagnosis - adult or developing fluke may be recovered; diagnostic
confirmation and species identification
Biopsy
75
PARAGONIMUS WESTERMANI; laboratory diagnosis - antibody detection
Serologic tests
76
PARAGONIMUS WESTERMANI; laboratory diagnosis - concentration
Concentration techniques
77
PARAGONIMUS WESTERMANI; prevalent in Asia, Africa, and Central and South America.
Paragonimiasis
78
PARAGONIMUS WESTERMANI; should be differentiated from pulmonary tuberculosis, especially
when it presents with hemoptysis.
Paragonimiasis
79
PARAGONIMUS WESTERMANI; corresponds to invasion and migration of young flukes
Acute stage
80
PARAGONIMUS WESTERMANI; corresponds to the adult flukes residing in a cyst in the lung
parenchyma
Chronic stage
81
PARAGONIMUS WESTERMANI; chronic cough with gelatinous, tenacious
Chronic stage
82
PARAGONIMUS WESTERMANI;rusty-brown sputum
Chronic stage
83
PARAGONIMUS WESTERMANI; most important form of extrapulmonary paragonimiasis
Cerebral involvement
84
Paragonimiasis treatment
● Praziquantel is the medication of choice
● alternative drug - bithionol.
85
Paragonimiasis prevention
● avoiding human ingestion of undercooked crayfish and crabs
● exercising proper disposal of human waste products.
86
SCHISTOSOMA SP.; Commonly known
Bilharzia
87
SCHISTOSOMA SP.; Mode of Transmission:
skin penetration
88
SCHISTOSOMA SP.;Infective stage:
cercariae
89
SCHISTOSOMA SP.; Diagnostic stage:
eggs
90
SCHISTOSOMA SP.; Intermediate host:
snail
91
SCHISTOSOMA SP.; Definitive host:
man
92
ADULT MORPHOLOGY; the only trematodes that have separate sexes (dioecious)
SCHISTOSOMA SP.
93
ADULT MORPHOLOGY; rounder in appearance
SCHISTOSOMA SP.
94
ADULT MORPHOLOGY; ● Female: 2 cm long
SCHISTOSOMA SP.
95
ADULT MORPHOLOGY; Male: 1.5 cm long
SCHISTOSOMA SP.
96
SCHISTOSOMA SP.; Laboratory Diagnosis - - detect antibodies and/or antigens in blood or urine samples
Serologic tests
97
SCHISTOSOMA SP.; Laboratory Diagnosis -● filtration technique using nylon, paper, or
● polycarbonate filters
● microscopic blood in urine
Urogenital schistosomiasis
98
SCHISTOSOMA SP.; Laboratory Diagnosis - methylene bluestained cellophane
soaked in glycerin or glass slides
Kato-Katz technique - for Intestinal schistosomiasis
99
SCHISTOSOMA SP.; Laboratory Diagnosis - CCA (Circulating Cathodic Antigen) test
S. mansonitransmission areas
100
SCHISTOSOMA SP.; Laboratory Diagnosis -serological and immunological tests
Non-endemic or low-transmission areas
101
Schistosome eggs, and not adult worms, induce the morbidity
caused by schistosome infections.
Schistosomiasis
102
Eggs not excreted become permanently lodged in the intestines
or liver (for S. mansoni and S. japonicum) or in the bladder and
urogenital system (for S haematobium) → granuloma formation
→ chronic inflammation
Schistosomiasis
103
Acute schistosomiasis
Katayama syndrome
104
● Sudden onset of fever, malaise, myalgia, headache, eosinophilia,
fatigue, and abdominal pain lasting 2– 10 weeks
Katayama syndrome
105
Non-specific intermittent abdominal pain, diarrhea, and rectal
bleeding
Chronic intestinal form
106
Some people develop extensive fibrosis and hepatosplenic
disease with periportal fibrosis
Chronic intestinal form
107
Upper abdominal discomfort with palpable nodular and hard
hepatomegaly, often with splenomegaly
Chronic intestinal form
108
Pulmonary hypertension caused by granulomatous pulmonary
arteritis can also occur in patients with advanced hepatic fibrosis
disease
Chronic intestinal form
109
● Hematuria
Urogenital schistosomiasis
110
urinary frequency, burning micturition, and suprapubic
discomfort
Urogenital schistosomiasis
111
squamous-cell carcinoma of the bladder
Urogenital schistosomiasis
112
● S. haematobium eggsin the vesical plexus migrate to the genital
tract causing inflammatory lesions in the ovaries, fallopian tubes,
cervix, vagina, and vulva.
Female genital schistosomiasis
113
● pain, stress incontinence, infertility, and increased risk of
abortion
Female genital schistosomiasis
114
● lesions can increase transmission of HIV
Female genital schistosomiasis
115
hematospermia, orchitis, prostatitis, dyspareunia, and
oligospermia
Male urogenital schistosomiasis
116
resolve more readily after anti-schistosomal treatment than
female genital schistosomiasis
Male urogenital schistosomiasis
117
most common with S. japonicum
Cerebral schistosomiasis
118
includes symptoms of meningoencephalitis with pyrexia,
headache, vomiting, blurred vision, and altered sensorium or
Jacksonian epilepsy
Cerebral schistosomiasis
119
spinal cord involvement can present as acute transverse myelitis
or subacute myeloradiculopathy → paralysis or lumbar and leg pain, with muscle weakness, sensory loss, and bladder
incontinence.
Cerebral schistosomiasis
120
Cerebral schistosomiasis; treatment
○ drug of choice
○ acts against adult schistosome worms
○ has poor activity against immature schistosome larvae
Praziquantel
121
Cerebral schistosomiasis; treatment
○ antimalarial drugs
○ kill immature larval forms of developing schistosomes.
○ in areas of continuous transmission, artemisinin derivatives
could be used in conjunction with praziquantel to improve
overall cure rates and infection control
Artemisinin derivatives
122
Cerebral schistosomiasis; prevention
- Widespread elimination will almost certainly need integrated use
of many or all the methods that can be applied
● preventive chemotherapy
● snail control
● behavioral modification
● water and sanitation improvements
● (eventually) a prophylactic or transmission-blocking vaccine
