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Helminth Infections

Helminth Infections. Dr Seid Mahmoud Eshagh Hoseini Associated Professor of Tehran University of Medical Sciences . Nematodes Ascariasis Trematodes Facioliasis Cestodes Echinoccosis. Ascariasis. The most common helmintic infection

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Helminth Infections

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  1. Helminth Infections Dr SeidMahmoudEshaghHoseini Associated Professor of Tehran University of Medical Sciences

  2. Nematodes Ascariasis • Trematodes Facioliasis • Cestodes Echinoccosis

  3. Ascariasis • The most common helmintic infection • Round,15 to 35 cm length, inhabit jejunum and middle ileum • Infection occurs at all ages ,most common in preschool and school children • Transmission :hand to mouth

  4. Clinical Syndromes • Most frequently is asymptomatic • Pulmonary and nutritional disorders • Intestinal or biliary tract obstruction

  5. Pulmonary Manifestations • During the stage of larval migration through the lungs(Loffler syn.) • Transient respiratory symptoms associated with pulmonary infiltration and eosinophilia in a few of cases

  6. Nutritional Disorders • In moderately heavy infection • Impairment of digestion or absorption of dietary proteins

  7. Intestinal obstruction • In children with heavy infection • Vomiting,abdominal distention and cramps • Patients may pass worms in vomitusor in stool

  8. Biliary Tract Invasion • Most common feature is abdominal pain (98%) • Less common feature include : cholangitis,pancreatitis, obstructive jaundice

  9. Diagnosis • Direct smear examination of stools • Abdominal X-Ray ,US ,ERCP

  10. Management • Mebendazol 100 mg BD for 3 days • Intestinal or biliary obstruction :piperazine citrate 150 mg/kg initially,followed by 65 mg/kg q12 h for 6 doses

  11. Fasciola hepatica • Zoonosis,2.5 cm length,leaf shaped • Natural hosts :sheep,cattle • Final habitat of mature worms is the biliary system • Intermediate host is snail

  12. Life Cycle • Mature worm – Oviposition – miracidia – multiply in snail – Cercaria – encystment on waterplants – metacercaria – larve inintestine –invasion liver capsule • From infection to oviposition : 12 ws

  13. Clinical Syndromes Two clinical phases : • Hepatic migratory phase : fever,RUQpain,hepatomegaly • Presence of the worms in the bile ducts :obstruction,biliary cirrhosis

  14. Diagnosis • Eosinophilia • Serologic test • Imaging : CT scan ,MRI (small nodules or tortuous linear tracks) • Detection ova in feces or bile with formol ether method

  15. Treatment • Bithionol :30-50 mg/kg on alternate days for 10 to 15 doses • Triclobendazole

  16. Hydatid Disease • Main host : canines • Intermediate host : sheep,goat,horse • Infection in human: liver 50-70 %, lung 20-30 % , brain,heart,bones10 %

  17. Clinical Manifestations • Usually Asymptomatic • Incidentally by imaging is detected • Symptoms due to mass effects • Complications :less than 10 %

  18. Complications • Rupture in biliary tree or bronchus :obstruction orpostobstructivebacerial infection • Pyogenic abscess • Cyst leakage : Allergic reaction • Rupture:seedingdaughter cyst

  19. Diagnosis • Imaging study : US ,CT scan ,MRI,X-Ray • Serologic tests :ELISA

  20. Treatment • Surgical resection • Preoperative medical therapy • PAIR • Medical therapy(Albendazole)

  21. Thank you

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