Trematodes Flashcards
(85 cards)
1
Q
The infective stage is_____
EXCEPT Schistosomes
A
metacercariae
2
Q
Classification of Medically Important Trematodes
A
Phylum Platyhelminthes
Class Trematoda
Subclass Digenea
3
Q
Classification of Ova
• Mature
A
Clonorchis
Heterophyids
Opisthorchis
4
Q
Classification of Ova
Immature
A
• Fasciola
• Fasciolopsis
• Echinostoma
• Paragonimus
• Schistosoma
5
Q
General Life Cycle of Trematodes
Larvae
A
MS. RC Muñoz
Miracidium
Sporocyst
Redia
Cercaria
Metacercaria
6
Q
Classification Based on
Location in Man
A
(Blood Flukes)
(Intestinal Fluke)
(Liver Flukes)
(Lung Flukes)
7
Q
Blood Flukes
A
Schistosoma japonicum
Schistosoma mansoni
Schistosoma haematobium
8
Q
- Skin penetration of cercaria
- Schistosomiasis japonicum or
Oriental schistosomiasis
A
Schistosoma japonicum
9
Q
Intestinal Flukes (FEAH)
A
- Fasciolopsis buski (Giant Intestinal Fluke)
- Echinostoma ilocanum
- Artyfechinostomum malayanum
- Heterophyid Group
10
Q
- ingestion of metacercaria on waterplants
A
Fasciolopsis buski (Giant Intestinal Fluke)
(Fasciolopsiasis)
Fasciola hepatica (Sheep Liver Fluke)
11
Q
- ingestion of metacercaria from snails
A
Echinostoma ilocanum
(Echinostomiasis)
12
Q
- ingestion of snail with infective stage (snail: Bullastra cumingtiana)
A
Artyfechinostomum malayanum
13
Q
- ingestion of metacercaria from fishes
A
Heterophyid Group
(Heterophyidiasis)
14
Q
Heterophyid Group
A
• H. heterophyes
• M. yokogawai
• H. taichui
• H. yokogawai
15
Q
Liver Flukes (FCO)
A
- Fasciola hepatica (Sheep Liver Fluke)
- Clonorchis sinensis (Chinese Liver Fluke)
- Opisthorchis felineus (Cat Liver Fluke)
16
Q
- ingestion of metacercaria in fish
A
Clonorchis sinensis (Chinese Liver Fluke)
(Clonorchiasis)
17
Q
- ingestion of metacercaria in fish
A
Opisthorchis felineus (Cat Liver Fluke)
(Opisthorchiasis)
18
Q
Lung Flukes
- ingestion of metacercaria from crabs
A
- Paragonimus westermani (Oriental Lung Fluke)
(Paragonimiasis)
19
Q
BLOOD FLUKES
Schistosome species
A
Schistosoma japonicum : Oriental blood fluke
Schistosoma haematobium: Visceral blood fluke
Schistosoma mansoni: Manson’s blood fluke
20
Q
Parasitizes portal vein and its branches
Each female fluke deposits 500-2000 immature eggs/day
A
Schistosoma japonicum
21
Q
Schistosoma japonicum in eternal copula
• Males have a _______ which receives the female during copulation
A
gynecophoral canal
22
Q
S japonicum ova
A
• Ovoidal, rounded or pear-shaped
• Thin shell
• Pale yellow
• Curved hook / spine or lateral knob
• Laid in the multicellular stage and embryonate within 10-12 days
23
Q
Schistosome Miracidium
• Hatches from the egg in slightly
alkaline clean water with a temp.
between______-_____
• Free swimming ciliated embryo liberated from the egg
• Phototactic
• Infect snails
A
25 oC to 31oC
24
Q
Schistosome
Emerges from daughter sporocysts
Escapes from the snail
Has a body and a forked tail
Infects man by skin penetration
A
Cercaria
25
Schistosome
• Mother ______ develop from miracidium within the snail
Daughter sporocyst develops
from mother sporocyst
________ develop from daughter sporocyst
Sporocysts and Cercaria
26
Develops from cercaria after skin penetration
Adapted to survive in serum or physiologic saline at 37 °C
• Enter the pleural cavity---diaphragm--- peritoneal space---penetrate the liver to reach the intrahepatic portions of the portal vein
Schistosomule
27
Schistosoma manson
Ova
With Lateral spine
28
Schistosoma haematobium
Ova
• Note the terminal spine
• Eliminated with urine
29
Blood Flukes: Diagnosis Schistosomiasis
Rectal biopsy
Stool Examination Techniques
• Merthiolate-lodine Formalin
Concentration Technique (MIFC)
• Kato Katz Technique
Immunodiagnosis
30
Sensitive for moderate and heavy infections
Not adequate for light infections (less than 10 eggs/gram of stool)
Merthiolate-lodine Formalin
Concentration Technique (MIFC)
31
For enumeration of eggs
Most commonly used for evaluating epidemiology, effect of control measures, drug trials
Kato Katz Technique
32
LIVER FLUKES
Fasciola species
***Fasciola hepatica***
Sheep Liver Fluke
Temperate Liver fluke
***Fasciola gigantica***
Giant Liver Fluke
Tropical Liver Fluke
***Clonorchis sinensis***
(Chinese Liver Fluke)
***Opisthorchis felineus*** (Cat Liver fluke)
***Opisthorchis viverrini*** (South East Asian Liver Fluke)
33
Adult
Large, flat, brownish 3 x 1.5 cm o With OS and VS
Integument covered with scales; posterior end surface smooth
Alimentary system inverted Y-branched ceca with lateral branches
Fasciola hepatica / Fasciola gigantica
34
OVA
Operculated 140-150 × 65-90 micra (hepatica) 160-190 x 70-90 micra (gigantica)
Light yellow: bile stained
Transparent with thin double walls
Contain lecithin granules (immature)
Fasciola hepatica / Fasciola gigantica
35
Fasciola spp
1st IH
1st Intermediate Host
Lymnaea philippinensis
Lymnaea swinhoei
36
Fasciola spp
2nd IH
Ipomoea obscura (Kangkong)
Nasturtium officinale (water cress)
37
Fasciola species: Laboratory Diagnosis
Microscopy
Serologic tests
(RFLP) Restriction Fragment Length Polymorphism
PCR
38
Adult
size 11-20 um x 3- 4.5um
***Lanceolate***
Translucent and brownish in color
Clonorchis sinensis
(Chinese Liver Fluke)
39
Egg
Bile stained with a smooth outer coat and is ***flask-shape***
There are fully developed with miracidia and possess.
Prominent opercular shoulders
Measures 29 um x 16 um
Clonorchis sinensis
(Chinese Liver Fluke)
40
Clonorchis sinensis
1st Intermediate Host
• Bulimus
• Parafossarulus
• Semiculcoapira
• Alosinma
• Melanoides
41
Clonorchis sinensis
2nd Intermediate Host
2nd Intermediate Host
• Fish of the Family
Cyprinidae
42
Clonorchis sinensis : Diagnosis
Detection of parasite egg in stool
Clonorchis, Opistorchis and Hetrophyid ova may not be differentiated under ordinary light microscope
ELISA with crude Clonorchis sinensis antigen
Enzyme immunoassay (EIA)
Polymerase Chain Reactions
43
ADULT
• 7-12 um length
• They have two testes lying one behind the other in the posterior portion of the body
• The ovary is anterior to the testes and a uterus is coiled between ventral sucker
Opisthorchis felineus (Cat Liver fluke)
Opisthorchis viverrini (South East Asian Liver Fluke)
44
EGG
The egg measure 19-29 um long x
12-17 um wide
They have knob at the abopercular end that may be prominent, inconspicuous, or absent
Opisthorchis felineus (Cat Liver fluke)
Opisthorchis viverrini (South East Asian Liver Fluke)
45
Opisthorchis felineus (Cat Liver fluke)
Opisthorchis viverrini (South East Asian Liver Fluke)
1st Intermediate Host
• Bithynia
46
Opisthorchis felineus (Cat Liver fluke)
Opisthorchis viverrini (South East Asian Liver Fluke)
2nd Intermediate Host
Fish majority belonging to the Family Cyprinidae
47
INTESTINAL FLUKES
Fasciolopsis buski
Heterophyid group
Echinostoma ilocanum
48
Giant Intestinal Fluke of man
Parasite of the intestines of humans and pigs
The viable metacercariae excyst in the duodenum and become mature in about three months
Fasciolopsis buski
49
MOT of Fasciolopsis buski
Mode of transmission is by ingestion of encysted metacercariae on aquatic plants
50
ADULT
• Elongated
• Oval
• 20-75mm in length and 8-20 mm in width
• Covered with spines
• No cephalic cone
• Unbranched intestinal caeca which reach up to the posterior end
Fasciolopsis buski
51
OVA
• Yellowish brown
• Ellipsoidal
• 130-140 x 80-85 micra
• With clear thick shell
• Operculated
• Unembryonated when laid
Fasciolopsis buski
52
Fasciolopsiasis: Diagnosis
• Detection of parasite eggs in stool
• Resemble Fasciola eggs
• Provided with an operculum
53
Enumerate the 4 Heterophyids
• Many species live in the intestine of fish-eating hosts:
• Heterophyes heterophyes
• Metagonimus yokogawai
• Haplorchis taichui
• Haplorchis yokogawai
54
ADULT
• Elongate, pyriform and grayish
• 1-1.7 x .3 - 4 mm
• Cuticle covered with scale like spines
• OS small, VS thick walled and muscular
• Genital sucker at left posterior border
• With 2 ovoid testes posterior 5th of body
• ***Subglobose*** ovary anterior of testis
• Vitellaria with large polygonal follicles in lateral posterior end
Heterophyid group
55
OVA
• Light brown in color
• Ovoid in shape
• Operculated
• A fully developed symmetrical miracidium is already present
• Operculum fits into the egg smoothly
• No abopercular protuberance like that of Clonochis sinensis ovum
Heterophyid group
56
MOT of Heterophyids
• Mode of transmission is by ingestion of
***metacercariae encysted in fish***
• Metacercariae in the abdomen excysts, liberating a larva that attaches to the intestinal wall
57
Clonorchis sinensis
1st IH
1st Intermediate Host
• Melania juncea
• Thiara riquetti (snails in the brackish water)
58
Clonorchis sinensis
2nd IH
2nd Intermediate Host
Chanos chanos(bangus)
Clarias batracus(hito)
Ophiacephalusstriatus (dalag)
Sigamus canalicatus (danggit)
Tilapia nilotica (tilapia)
And many other fishes that live in fresh water, brackish water.
59
Clonorchis sinensis
Laboratory Diagnosis
Detection of eggs in the stool using ***Kato Katz method***
Care must be taken to distinguish them from Clonorchis and Opistorchis ova
60
ADULT
Reddish gray
Horseshoe-shape collar of spines (circum oral disk) around the oral suckers
49-51 collar spines
Integument is covered by plaque like scales
Simple intestinal caeca
Echinostoma ilocanum
61
Color of Echinostoma ilocanum
Reddish gray
62
OVA
Straw-colored
Operculated
Ovoid
Similar to Fasciola and
Fasciolopsis buski ova
Echinostoma ilocanum
63
Echinostoma ilocanum ova is same with
Similar to Fasciola and
Fasciolopsis buski ova
64
Echinostoma ilocanum
1st IH
1st Intermediate Host
• Gyraulus convexiusculus
• Hippeutis umbilicalis
65
Echinostoma ilocanum
2nd IH
2nd Intermediate Host
• Pila luzonica (kuhol)
• Vivipara angularis (susong pampang)
66
Echinostoma ilocanum
Laboratory Diagnosis
Detection of characteristic eggs in the stool
67
LUNG FLUKES
Paragonimus westermani
68
ADULT
• Hermaphroditic
• Body covered with spines
• Reddish brown
• Measures 4-6 mm in width and
3.5-5 mm in thickness
• Resembles a coffee bean
• Adult worms are found in pairs or in threes in fibrotic capsules or cysts in the lungs
Paragonimus westermani
69
Paragonimus westermani resembles a
Coffee bean
70
OVA
Yellowish brown
Thick-shelled
Operculated with thickened abopercular end
May be seen in the sputum or in feces if the sputum is swallowed
Paragonimus westermani
71
MOT of Paragonimus westermani
Metacercariae
• Man gets infected after ingestion of raw or insufficiently cooked crabs harboring the metacercariae
72
Paragonimus westermani
1st IH
1st Intermediate Host
• Brotia asperata (snail)
Where miracidium develops into 1 sporocyst and 2 redial stages of development
73
Paragonimus westermani
2nd IH
2nd Intermediate Host
• ***Sundathelphusa philippina*** or
Parathelphusa grapsoides (former name)
Harbors the metacercaria that is infective to man
74
Paragonimus westermani is misdiagnoed with
TB
75
Diagnosis of Paragonimiasis
Radiographs aid in diagnosis
Definitive diagnosis is based on the finding of ova in the sputum, stool or less frequently in aspirated material from abscesses or pleural effusions
Multi-dot ELISA
76
PANCREATIC FLUKES
Eurytrema pancreaticum
77
Pancreatic fluke
Stout worm with ruffled margins
Oral sucker is larger than the ventral sucker
Eurytrema pancreaticum
78
OVA
Operculated
Thick shelled
Dark brown in color
Embryonated when laid
Eurytrema pancreaticum
79
Eurytrema pancreaticum
1st Intermediate Host
• Macrochlamys indica (snail)
80
Eurytrema pancreaticum
2nd Intermediate Host
Technomyrmex deterquens(ant)
81
S .japonicum
Habitat
Superior mesenteric vein
(and tributaries)
82
S. mansoni
Habitat
Inferior mesenteric vein (and tributaries)
83
S. Haematobium
Habitat
- vesical venous plexus
84
Purpose of knob
Attachment and penetration
85
How to see miracodium in kato katz?
Add 1% eosin dye
