1 / 17

Clonorchiasis Sinensis

Clonorchiasis Sinensis. Dept. Of Infectious Disease Shengjing Hospital. Intruduction. The disease is a kind of chronic parasitosis caused by clonorchis sinensis , which inhabit human intrahepatic ducts Clinical Manifestation: hepatomegaly, vague pain of upper abdomen, lassitude and tiredness

roanna-cox
Download Presentation

Clonorchiasis Sinensis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Clonorchiasis Sinensis Dept. Of Infectious Disease Shengjing Hospital

  2. Intruduction • The disease is a kind of chronic parasitosis caused by clonorchis sinensis, which inhabit human intrahepatic ducts • Clinical Manifestation: hepatomegaly, vague pain of upper abdomen, lassitude and tiredness • The infection is acquired by ingestion of raw or inadequately cooked freshwater fish or shrimp

  3. Etiology • Morphology • Adult worm Flat, elongated worm, with the size 10-15×3-5 mm They are monocious, with two suckers The most characteristic feature is branched testis in the posterior third of the body, and relative small ovary before them • Eggs The smallest one of the eggs of human parasites. The sizes are 27.3-35.1×11.7-12.9m Yellow brown operculated eggs,with a fully embryonated miracidia in it

  4. Life Cycle adult worm in human and mammal eaten 1 month eggs into water metacercariae first intermediate host Secocond intermediate host (special snail) (Freshwater fish and shrimp) swallow eggs invade miracidia enter water 2 months cercaria

  5. Epidemiology • Source of infection: patients, infected reservior hosts:cats, dogs, mice, pigs • Route of transmission: the infection is acquired by eating raw or inadequately cooked freshwater fish or shrimp, which are previously infected • Susceptibility: human is generally susceptive, related with the dietary habits

  6. Pathogenesis • Worms mechanical stimulation proliferate inflammatory reaction in the biliary epithelium • The wall of the bile ducts thickened ,fibrous tissue around the bile duct, and worm obstruction cause cholestasis • When bacteria infection occur, cause cholecystitis, cholangeitis, sometimes cholelithiasis happens

  7. Pathology • Intrahepatic bile ducts expansion, hepatomegaly, necrosis of liver tissue • Continuous severe infection may cause liver cirrhosis • Persistent Cholestasis cause biliary liver cirrhosis • Associate with cholangiocarcinoma and hepatic carcinoma

  8. Clinical Manifestation • Incubation period: 1-2 months • Most person with mild clonorchis sinensis infections are asymptomatic, only eggs can be found in the feces • Severe infections: onset is insidious, with intestinal manifestations like viral hepatitis, hepatomegaly, neurasthenia, person with heavy worm loads may suffer from biliary angina and obstructive icteric

  9. Clinical Manifestation • Acute symptoms appear when the primary infection is heavy: sudden onset, chill, high fever, slight jaundice, hepatomegaly, eosinophilia, a few patients have splenomegaly, and weeks later, enter chronic stage • Continuous reinfection: cirrhosis and portal hypertension. In children may cause malnutrition growth development disturbance, even dwarf

  10. Complications • Acute or chronic cholecystitis, cholangeitis and cholelithiasis are the most common complications • Portal liver cirrhosis: portal hepertension result in upper gastrointestinal bleeding • Cholestatic cirrhosis • Pancreatitis • Primary carcinoma of the liver and cholangiocarcinoma

  11. Laboratory Findings • Blood routine test: eosinophilia, anemia in severe infection • Eggs examination: simple smear feces to find eggs Stool concentration technique may increase the positive rate Duodenal aspiration: raise the chance of finding eggs

  12. Laboratory Findings • Immunological Test • Skin test: positive rate 97.9%, 99.5% coincide with the result of the feces • PHA: positive rate 53.7%, 80% coincide with the result of the feces • ELISA: positive rate 98.3%, 93.5% coincide with the result of the feces

  13. Diagnosis • Epidemiologic date: living in or come from the endemic area The history of eating raw or inadequately cooked freshwater fish and shrimp • Clinical date: gastrointestinal symptoms, hepatomegaly, neurasthenia, cholangoitis, cholecystitis, etc. • Laboratory findings: Discovery ofcharacteristic eggs in feces or by duodenal aspiration come to accurate diagnosis Eosinophilia and positive immunologic test support the diagnosis

  14. Differential Diagnosis • Viral hepatitis • Liver cirrhosis of other origins • Primary carcinoma of the liver • Fasciolopsiasis • Other specie of flukes infection

  15. Prognosis • Good of the mild infection • Co-infection with viral hepatitis may make the disease severe

  16. Treatment • Pathogenic Treatment • Praziquantel is the best choice of drug for the therapy • Dose: 15-25mg/kg, three times a day, for 2 days, the total dose is 90-150mg/kg • Another choice of drug is Albendazole • Heteropathy Treatment

  17. Prevention • Control of the source of infection: Treat the patients and domestic animal(cats and dogs, etc.) at the same time. • Cut off the route of transmission: Avoid of eating inadequately cooked freshwater fish and shrimp Sanitary disposal of the excreta Avoid of drinking raw water

More Related