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HELMINTH PART II

HELMINTH PART II. DR SAMUEL AGUAZIM. CESTODE. TAPE WORM TAENIA SAGINATA INTERMEDIATE HOST : CATTLE DEFINITIVE HOST : HUMANS FORMS/TRANSMISSION - Rare beef containing cysticerci is ingested Interstinal tapeworm( affects small intestine) Asymptomatic to vague abdominal pain

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HELMINTH PART II

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  1. HELMINTH PART II DR SAMUEL AGUAZIM

  2. CESTODE • TAPE WORM • TAENIA SAGINATA • INTERMEDIATE HOST: CATTLE • DEFINITIVE HOST: HUMANS • FORMS/TRANSMISSION • - Rare beef containing cysticerci is ingested • Interstinal tapeworm( affects small intestine) • Asymptomatic to vague abdominal pain • Chronic indigestion • Diagnosis: eggs or proglottids in feces • Treatment: praziquantel

  3. TAENIA SOLIUM • INTERMEDIATE HOST: SWINE • DEFINITIVE HOST: HUMANS • Humans can be both intermediate and definitive host. • Forms/transmission • Intestinal tape worm • Raw pork containing the cysticerci ingested by humans

  4. CYSTICERCOSIS(INTERMEDIATE HOST): Humans ingest eggs directly. • Water and food contaminated with eggs auto inoculation. • disease/organ involvement/symptoms • -intestinal tapeworm( same as taeniasaginata) • Larvae penetrate intestinal wall and migrate via the blood to brain, heart, lungs and eye • Diagnosis: eggs or proglottids in feces • Treatment: praziquantel…

  5. T. SOLIUM T. SAGINATA

  6. MOT: INGESTION OF CYSTICERCUS (larval worm) IN PORK/BEEF PRODUCTS

  7. CT Scan of Cysticercosis

  8. DIPHYLLBOTHRIUM LATUM • INTERMEDIATE HOST: CRUSTACEANS • DEFINITIVE HOST: HUMANS, MAMMALS • HUMANS can be both IH & DH • Forms/transmission • SPARGANUM • Drinking pond water with copepods crustaceans carrying the larval forms • Intestinal tape worm • Rare, eating raw prickled fish containing sparganum

  9. FISH TAPEWORMDiphyllobothriumlatum longest tapeworm found in man 3-10 meters with more than 3000 proglottids.

  10. Fish tapeworm: Scolex has two elongated sucking grooves; no circular suckers or hooks

  11. Fish tapeworm: Oval eggs have an operculum (lidlike opening) at one end

  12. MOT: INGESTION OF PLEROCERCOID LARVAE/SPARGANUM IN INFECTED FISH

  13. Copepod

  14. Disease/organ involvement/symptoms • Sparganosis: larvae penetrate intestinal wall and encyst • Interstinal tape worm in the small intestine that absorb vitamin B12 leading to PERNICIOUS ANEMIA • DIAGNOSIS: Eggs or proglottids in feces • Biopsy for sparganosis • Treatment: praziquantel

  15. Echinococcusgranulosus( dog tape worm) • INTERMEDIATE HOST: HERBIVORES • DEFINITIVE HOST: Carnivores in sheep- raising area • Humans are intermediate hosts • Forms/ transmission • Ingestion of eggs • Larvae can migrate to anywhere( liver is the most common place)

  16. Dog tapeworm. Scolex has four suckers and a double circle of hooks.

  17. Disease:HYDATID CYST DISEASE • Liver and lungs where cyst containing brood capsules develop • Eggs are ingested by sheep (and humans) and hatch larvae in the gut that migrate in the blood to various organs, especially the liver and brain. • Larvae form one large, unilocularhydatid cyst containing many minor pathogen and daughter cysts. • Diagnosis-imaging and serology • Treatment: surgery and albendazole

  18. Echinococcusmultilocularis • IH: RODENTS • DH: CANINES & CATS • HUMANS are intermediate hosts • Forms/transmission • Ingestion of eggs • Larvae can migrate to anywhere( liver is the most common place)

  19. Disease: ALVEOLAR HYDATID CYST DISEASE • Much more serious than echinococcusgranulosus : cyst metastasis: exogenous budding cyst • Diagnosis: difficult: MRI OR CT • TREATMENT: SURGICAL RESECTION

  20. E. Multilocularismultilocular, liver

  21. Hymenolepis nana (dwarf tapeworm) • most frequently diagnosed cestode infection in theUS • small tapeworm • infects children • Reservoirs: Rodents • vague abdominal pain  enteritis • Diagnosis :eggs • DOC: Nicolsamide

  22. MOT: INGESTION OF EGGS/ CYSTICERCOID IN INSECTS

  23. Spirometra • sparganosis • MOT: ingest polluted water raw or inadequately cooked flesh of snakes or frogs • southeastern region of the United States • east Asia (China, Japan, and Korea) • southeast Asia (Malaysia, India, and the Philippines)

  24. Sparganosis • subcutaneous edema • Muscles • Eyes • urogenital system • abdominal viscera • central nervous system

  25. Sparganosis • Treatment Surgical removal of sparganum larvae Praziquantel no available treatment for proliferative sparganosis

  26. Trichuristrichiura Disease:Whipworminfection Characteristics:Intestinal nematode. The characteristic of“whiplike”apperance of the adult worm. Life cycle: • Humans ingesteggs,which develop into adults in gut. • Eggs are passedin feces into soil, where they embryonate, ie, become infectious.

  27. Trichuristrichiura Transmission: • More than 500 million infected. • Transmitted byfood or watercontaminated with soil containing eggs. • Humans are the only hosts. Occurs worldwide, especially in the tropics. Pathogenesis: • Worm in gut usually causeslittle damage. • The whipworm infects about 2 million children in the U.S. • Causesrectal pruritis and tenesmus, which often results inrectal prolapse.

  28. Infectious DiseasesWhipworm – Rectal Prolapse

  29. Infectious DiseasesWhipworm – Rectal Prolapse

  30. Laboratory Diagnosis: • Eggs visible in feces. • The egg isbarrel-shape with a plug at each end, in the stool. Treatment:Mebendazole. Prevention:Proper disposal of human waste

  31. FOOTBALL SHAPE EGG Trichuristrichiura eggs, a typical barrel shape two polar plugs, that are unstained 

  32. LOA LOA Disease:Loiasis. Characteristics:Tissue nematode.

  33. Transmission:Transmitted by deer flies. Humans are the only definitive hosts. No animal reservoir. Endemic in central and west Africa. Pathogenesis: Hypersensitivity to adult worms causes “swelling” in skin. Adult worm seencrawling across conjunctivas Laboratory Diagnosis: • Microfilariae visible on blood smear. Treatment:Diethylcarbamazine. Prevention:Deer fly control.

  34. Onchocerca Disease: Onchocerciasis(river blindness). Characteristics:Tissue nematodes.

  35. Onchocerca Transmission: Transmitted by female black flies. Humans are the only definitive hosts. No animal reservoir. Endemic along rivers of tropical Africa and Central America. Pathogenesis:Microfilariae in eyeultimately can causeblindness. Adults induce inflammatory nodules in skin. Laboratory Diagnosis:Microfilariae visible in skin biopsy, not in blood. Treatment:Ivermectinaffects microfilariae, not adult worms. Suramin for adult worms. Prevention:Black fly control and ivermectin

  36. RIVER BLINDNESS/SOWDA trapped microfilaria in the cornea, choroid, iris and anterior chambers, leading to photophobia, lacrimation and blindness

  37. Toxocaracanis Disease:Visceral larva migrans. Characteristics: Nematode larvae cause disease.

  38. Life cycle: • Toxocaraeggs are passed in dog feces • Ingested by humans. • Hatch into larvae in small intestine • Larvae enter the blood and migrate to organs, especiallyliver, brain, and eyes, where they are trapped and die. Transmission: • ingestion of eggs in food or water contaminated withdog feces. • Dogs are definitive hosts. Humans are dead end hosts. Pathogenesis:Granulomas form around dead larvae.Granulomas in the retina can cause blindness

  39. Laboratory Diagnosis:Larvae visible in tissue. Serologic tests useful. Treatment:Diethylcarbamazine Prevention:Dogs should be dewormed

  40. Tissue nematodeDracunculus Disease:Dracunculiasis. Characteristics:Tissue nematode.

  41. Dracunculiasis

  42. Transmission: • copepods in drinking water. • Humans are definitive hosts. • Many domestic animals are reservoir hosts. • Endemic intropical Africa, Middle East, and India Pathogenesis: • Adult worms in skin cause inflammation and ulceration. Treatment: • Niridazole. • Extraction of worm from skin ulcer. Prevention: • Purification of drinking water

  43. Dracula ate an infected crustacean and got an ulcer with protruding worm. He removed the worm by winding it around a stick.

  44. Strongyloides Disease:Strongyloidiasis Characteristics:Intestinal nematode. • NOTE:the only helminth to secrete larvae (and not eggs) in feces

  45. Transmission:Filariform larvae in soil penetrate skin. Endemic in the tropics. Pathogenesis: • Little effect in immunocompetent persons. • In immunocompromised persons, massive superinfectioncan occur accompanied by secondary bacterial infections. Laboratory Diagnosis: Larvae visible in stool. Eosinophilia occurs. Treatment:Thiabendazole. Prevention:Proper disposal of human waste. Use of footwear

  46. Memory Tool • The strongman (Strongyloides) is brought down by a larvae penetrating his skin causing pulmonary distress and superinfection. Poor strongman!

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