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Trematodes
Trematodes
(Flukes)
General Charac.:
All flukes:
- leaf-like in appearance - Except Schistosomes
- generally Hermaphroditic (posses both male and female
genitalia) - Except Schistosomes
cross-fertilization and self-insemination are method of
reproduction
- provided with oral and ventral suckers -
Except Schistosomes ; some flukes have genital sucker
(Gonotyl)
MOT
oral ingestion of the infective stage: encysted
metacercaria, Except - Schistosomes
requires 2 I.H. - Except Schistosomes
egg operculated - Except Schistosomes
terribly difficult to get rid of once infected, may
accumulate for 10-20 years
Disease: Fasciolopsiasis
Geographical Distribution:
Central and South China, Taiwan, Vietnam, Thailand,
Indonesia and other parts of Orient
Morphology:
Adult worm: Diagnosis: Demonstration of egg in stool
live attached to the bowel wall primarily in the duodenum
and jejunum Treatment: Hexylresorcinol/Tetrachlor Ethylene/Praziquantel
elongate, broadly ovoidal, large and fleshy 30mg/kg body weight
anterior end narrower than posterior end
Echinostoma ilocanum (Garrisons fluke)
integument spinose
absence cephalic cone or shoulder
Geog. Distribution:
ventral sucker larger than oral sucker located close to it Confirmed to be endemic in the Philippines
dendritic testes at the posterior half of the body in Prevalent in Northern Luzon, Leyte, Samar and Mindanao
tanderm
also found in Indonesia, India, China, Thailand, Japan,
ovary branched and lies midline anterior to the testes
Malaysia and Sumatra
vitelaria extensive at the lateral site to the caudal end
Disease: Echinostomiasis
Ova
hens egg shape (identical to that of F. hepatica) Morphology:
thin-shell with small operculum at one end Adult worm:
unembryonated when laid elongated, bluntly rounded
integument covered with plaque-like scales
anterior end rounded and provided with circumoral disc
oral sucker lies in the center of circumoral disc
surrounded with collarette of spines (distinguishing
characteristic)
ventral sucker in the anterior fifth of the body
2 deeply lobed dumbell-shaped testes arranged in
tandem at the posterior half of the body
vitellaria at the lateral side of the body
Ova
ovoidal and operculated
immature when passed in feces
Treatment: Tetrachlorethylene/Praziquantel/Hexylresorcinol
Echinostoma malayanum
Geographical distribution:
= Malay Peninsula, India, China, Sumatra
Morphology: Adult
ovoid and bluntly rounded
oral suckers surrounded with spines
testes deeply indented at tandem
excretory system Y- shape appearance and pouch-like
excretory bladder
Morphology:
Adult worm:
oval or pyriform-shaped, pointed anteriorly, rounded post.
integument covered with scale-like spines more
numerous near the anterior end
2 ovoid-shaped testes at the posterior fifth of the body
seminal receptacle retort shaped
cirrus and cirrus sac absent
provided with 3 suckers: o oral and ventral suckers are about equal in size
ventral sucker larger and thick-walled than oral o 2 deeply lobed testes arranged side by side at the
sucker posterior - third of the body
genital sucker (gonotyl) found posterior to the o ovary lobed located post. to the ventral sucker
ventral sucker (not present in Metagonimus) o vitellaria extensively branched and covers the entire
oral smaller compared to ventral sucker length of the body
o cirrus and cirrus pouch absent
ova o uterus tightly coiled into a rosette found near the VS
ovoid-shaped, operculated
embryonated when oviposited
fully developed miracidium present within the egg when
deposited by adult worm
cercaria
- tail keeled with arm spines
- pigmented eyespots
Ova:
broadly ovoidal, thick-shelled with flattened prominent
operculum
measures 80 X 55u
unembryonated when laid
Cercaria:
ellipsoidal body with minute oral stylet
knob-shaped tail with spine
oral sucker larger than ventral sucker
Pathogenesis:
mild local inflammatory reaction at site of attachment
causing damage to intestinal mucosa Ova cercaria
chronic intermittent diarrhea, nausea, colicky abd. pain
eggs of degenerating flukes are spilled into blood stream
and disseminate to different parts of the body
heart - provokes tissue reaction leading to cardiac
failure
spinal cord - result in loss of motor and sensory
function at the level where lesions are located
brain fatal cerebral hemorrhage
Prevention
Avoid eating raw or inadequately cooked fish
Domestic animal should be prevented from eating fish
offal
Thorough cooking kills the parasite
Disease: Paragonimiasis/Endemic Hemoptysis
Lung Fluke o acquired through ingestion of raw or undercooked crab
Paragonimus westermani (Oriental Lung fluke) meat containing encysted metacercaria
= most widely prevalent specie o clinical manif.: nausea, sweating, chronic cough with
bloody sputum, dyspnea and pleuritic chest pain
Geog. Distribution: o human are definitive host
o Endemic in Asia and India o pulmonary infection is easily mistaken for pulmonary TB
o In U.S. occur in immigrants from these areas o invasion stage of the disease may cause few or no
symptoms
Morphology:
o once in the lung, worm stimulate inflammatory response
Adult worm
which enshrouds granulation of the lung capsule which
o thick, fleshy, reddish-brown or coffee-bean color in living
later ulcerate and heal slowly
specimen anteriorly rounded and tapering posteriorly
o egg deposition may produce more pronounced tissue
o integuments covered with scale-like spines
reaction
Lab. Diagnosis: Finding the typical operculated egg in
sputum, pleural fluids and feces
Prevention:
o Adequate cooking of crabs/crayfish before eating
o Proper disposal of human waste