Trem-Ing pptII
Trem-Ing pptII
Trem-Ing pptII
TREMATODA
TREMATODA
Morphology:
- Leaf-shaped, flat worm
- unsegmented
- Size:Mm to cm
- Sucker (+)
- medium Trematoda
- small Trematoda
Classification based on habitat:
1. Intestinal Trematoda : - Fasciolopsis buski
- Heteropyes heteropyes
- Metagonimus yokogawai
- Echinostoma ilocanum
2. Hepatic Trematoda : - Fasciola spp.
- Eurytrema pancreaticum
- Dicroecoelium dendriticum
- Clonorchis sinensis
- Opisthorchis spp.
3. Pulmonary Trematoda : - Paragonimus spp.
4. Blood Trematoda : - Schistosoma spp.
IINTESTINAL TREMATODA
- Fasciolopsis buski
- Heteropyes heteropyes
- Metagonimus yokogawai
- Echinostoma ilocanum
Causal Agent:
Fasciolopsis buski, Largest trematoda that infected human being.
Life Cycle:
Immature eggs+ faeces (1) water hatched (2).
miracidium(3) snail (IH. I) (4). sporocyst (4a),
redia (4b) dan cercaria (4c). Escape from snail (5)
encyst/metacercaria on water plant (6).
Mammalia eat waterplant that contain metacercaria.
duodenum metacercaria excyst (7) adult flukes
( 20 – 75 mm x 8 – 20 mm) (8).
Geographic Distribution:
Asia: China, Thailand, Malaysia,
Clinical Sign:
ussually mild.
severe infection : diarhhoe, abdominal
discomfort, fever, ascites, oedema anasarca
and obstruction.
Laboratory Diagnosis:
Eggs in faeces or vomit.
egg is similar to Fasciola hepatica’s
Treatment:
Praziquantel*(drug of choice).
A: Fasciolopsis buski’s egg, B: adult Fasciolopsis buski :
Similar to Fasciola hepatica’s. 20 - 75 mm x 8 - 20 mm.
oval shaped,
thin wall, and operculated
(operculum is open).
Heterophyes heterophyes
Egg: Oval
thin-shelled
Operculum +
Unembryonated
Life Cycle:
IH I: Water snail
IH II: Water snail, fish, waterplants
depend on spesies.
Infective form: metacercaria
Pathogenesis, symptom, diagnosis are similar
to the other Intestinal Trematoda.
Therapy: Tetrachlorethylene
Praziquantel
HEPATIC TREMATODA
- Fasciola spp.
- Eurytrema pancreaticum
- Dicroecoelium dendriticum
- Clonorchis sinensis
- Opisthorchis spp.
Causal Agents: Fasciola hepatica ANDFasciola gigantica parasit from herbivora.
Life Cycle:
Life Cycle:
Eggs immature in bile duct faeces (1).
water (2) miracidium (3), snail (IH. I / genus
Lymnea)(4). sporocysts (4a), rediae(4b),
cercariae (4c) watercress
encyst/metacercaria (5) Mamalia consume
water plant + metacercaria (6). excyst in
duodenum (7) penetrate intestinal wall
cavum peritonium and hepatic parenchym, to
bile duct adult (8).
Geographic Distribution:
Cosmopolitan,
Fasciola hepatica infect herbivora
Size:
Fasciola hepatica 30 mm x 13 mm
Fasciola gigantica 75 mm.
Adult Worm:
cephalic cone
VS > OS
Lateral compound
branch Ceca
Dendritic Testis in
tandem formation
Clinical sign:
Acute phase: young flukes migration
parenchym hepar, symptom: abdominal pain,
fever, vomit, diarrhoea, urticaria.
Chronic phase : adult flukes in bile duct
intermitten sign of bile duct obstruction,.
Ectopic infection: e.g. in intestinal wall, lung,
subcutan tissue of mucosa pharynx.
Laboratory Diagnosis:
Eggs : - in faeces
- duodenal/biliary fluid.
Egg of Fasciola hepatica is similar to Fasciolopsis buski’s.
False Fascioliasis (pseudo fascioliasis): finding Fasciola’s
egg in faeces as the result of eating liver (that contains
faciola’s egg) repeated exam and prohibition to eat liver
for days.
Immunologis/serologis examination is important esp. in
invasif stadium or in ectopic fascioliasis.
A, B, C: egg of Fasciola hepatica. Operculum (+) at one pole. New
egg still Unembryonated. ( 120 – 150 x 63 – 90 μ)
Treatment:
Clinical Sign:
Manifestation of inflammation reaction and
diarrhea
Chronic Infection : cholangitis, cholelithiasis,
Laboratory Diagnosis:
Egg in faeces or duodenal fluid.
Treatment:
Praziquantel or albendazole.
Morphology differences between Clonorchis
sinensis, Opisthorchis felineus and Opisthorchis
viverini
Causal Agent:
more than 30 species of Paragonimus, usually Paragonimus westermani, infect animal and human.
Life Cycle:
Unembryonated egg in sputum/faeces (1).
escape embryonated (2) hatch miracidium
snail (IH. I)(3) sporocyst (4a), redia (4b),
and cercaria (4c), escape from snail. crustacea
(IH. II) (crab/crayfish) metacercaria (5)
ingested (6) Excyst in duodenum (7), penetrate
intestinal wall peritoneum diaphragma lung
adult worm(8). (7,5 – 12 mm x 4 – 6 mm).
Clinical Sign:
Pulmonary and extra-pulmonary
paragonimiasis
Pulmonary paragonimiasis : Chronic cough,
lika pulmonary TBC
extra-pulmonary paragonimiasis : enter any
organ of the body, such as liver, intestine,
peritoneum.
Laboratory Diagnosis:
Egg in sputum or faeces,
2 – 3 months post infection
Treatment:
- Praziquantel (drug of choice).
- Bithionol
A: egg of Paragonimus westermani. (85 µm x 53 µm). Brown-
yellow color , oval . Operculum at wide pole, thickened wall at
another pole. Unembryonated.
Causal Agents:
Schistosoma haematobium, S. japonicum, and S. mansoni. Rare : S. mekongi and S.
intercalatum.
Life Cycle:
Egg + faeces/urine (1) hatch
miracidium(2), penetrate snail (IH.)(3)
sporocyst(4) cercaria(5) penetrate
human skin (6) shistosomulae (7) hepar
migration (8,9) plexus venosus
(species) adult(10).
Habitat:
(A) Schistosoma japonicum at Plexus mesentericus
superior,
(B) (B)Schistosoma mansoni at plexus venosus inferior
(C) (C) Schistosoma hematobium at plexus venosus
vesicalis.
Treatment:
Praziquantel (drug of choice)
Schistosoma mansoni