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TREMATODES

TREMATODES. Dr. Sudheer Kher. Trematodes. M ulticellular eukaryotic helminths U nsegmented leaf-shaped worms MONECIOUS except for schistosomes (DIECIOUS). TREMATODES. B lood flukes Schistosoma mansoni S. japonicum S. hematobium . Intestinal fluke Fasciolopsis buski

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TREMATODES

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  1. TREMATODES Dr. SudheerKher

  2. Trematodes • Multicellular eukaryotic helminths • Unsegmented leaf-shaped worms • MONECIOUS except for schistosomes (DIECIOUS)

  3. TREMATODES • Blood flukes Schistosomamansoni S. japonicum S. hematobium. • Intestinal fluke Fasciolopsisbuski • Liver fluke Clonorchissinensis • Lung fluke Paragonimuswestermani.

  4. Trematodes • MOT: 1. Cercariae - FREE SWIMMING LARVAE - Given off by infected snail - Penetrate the skin of the human definitive host 2. Metacercariae - Encysted form of the cercariae - Edible plants or animals water plants fishes crustaceans

  5. Praziquantel -Paralysis of musculature -Attachment of phagocytes to parasite and death.

  6. Schistosomiasis (Bilharziasis) • S. hematobium: Africa • S. mansoni : Africa and America • S. japonicum: Far East. • 250 million people are infected

  7. Morphology • Adult worms are 10 to 20 mm long • Male: lamelliform shape with marginal folds

  8. “The sweetest parasites on earth”

  9. SCHISTOSOMESMOT: skin penetration by cercariae

  10. FAVORITE SITES • S. japonicum :Veins of GIT • S. mansoni : Veins of GIT • S. haematobium : Veins of Bladder

  11. Schistosomiasis • Type I and type IV hypersensitivity • Collagenase: damage to the vascular endothelium.

  12. Three major disease syndromes occur in schistosomiasis 1. schistosome dermatitis 2. acute schistosomias (Katayama fever) 3. chronic schistosomiasis.

  13. Dermatitis (swimmers' itch): penetration of cercariae

  14. Acute schistosomiasis(Katayama fever) -4 to 8 weeks after primary exposure -Cough, hepatosplenomegaly -Lymphadenopathy and eosinophilia

  15. Chronic disease • May appear many years later • Japonica and mansoni • hepatomegaly • splenomegaly • portal hypertension • esophageal varices

  16. Schistosomahaematobium • inflammation and fibrosis • obstruction • hydronephrosis • uremia

  17. Schistosoma eggs in the intestinal mucosa

  18. S. haematobiumand bladder cancer

  19. Schistosomiasis

  20. Characteristic eggs: diagnosis Apical spine: S. haematobium Lateral spine: S. mansoni Vestigial spine (Knob): S. japonicum

  21. Treatment and control • Praziquantel is effective against all species. • Contaminated water should be avoided. • Control measures include sanitary disposal of sewage and destruction of snails. • No vaccine is available.

  22. Fasciolopsis buski (Giant intestinal fluke) • central and southeast Asia. • elongate oval fluke • 2 to 7 cm long • small intestine

  23. Fasciolopsisbuski:MOT: INGESTION OF CYSTS

  24. Pathology • attaches itself to the intestinal mucosa • inflammation, ulceration, abscesses

  25. WATERCRESS

  26. Fasciolopsiasis • DiagnosisEggs in feces • Treatment and controlPraziquantel • Water chestnuts • Sewage treatment

  27. Clonorchis sinensis(Chinese Liver Fluke) • Parasite of man, dogs and cats in the southeast of Asia • Extraordinarily common: China, Korea and Japan

  28. Clonorchiasis • Morphology • Spindloid flukes

  29. MOT: INGESTION OF METACERCARIAE

  30. Clonorchis adult worms in the liver

  31. CLONORCHIASIS • irritation of the bile ducts  dilated • Liver: enlarged necrotic tender elevated liver enzymes

  32. CLONORCHIASIS • Diagnosiseggs in the feces or bile • Treatment and controlPraziquantel • Fish should be cooked well before consumption. • Sewage must be treated before disposal.

  33. Paragonimus westermani (Lung Fluke) • most commonly encountered in parts of Asia, Africa and South America. • plump reddish brown oval worm • 10 by 4 mm

  34. MOT: INGESTION OF METACERCARIAE

  35. Paragonoimus • Migrate by penetrating through the intestinal wall  peritoneal cavity abdominal wall  diaphragm  lungs. • Immature worms settle close to the bronchi  grow  sexually mature hermaphrodite worms  eggs

  36. Paragonimuswestermani: lung tissue

  37. Paragonimus • Dry cough • Blood stained rusty brown sputum • Pulmonary pain and pleurisy • Brain: granulomatous abscess  Epilepsy

  38. Paragonimus • Diagnosis Eggs are found in rust colored sputum • Treatment and controlPraziquantel • Adequate cooking of crustaceans • Improved sanitary conditions

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