Trematodes

Monday, 30 March 2020 2:21 pm

Trematodes
▫ Trematodes (flukes) are a class of helminths pathogenic to humans.
▫ Trematodes are flat, hermaphroditic (except the schistosomes), and have at Life Cycle: Egg > Larva (Miracidium>Sporocyst>Redia>
least two suckers: One opens into the digestive tract and one is for attachment. Clonorchis sinensis (Chinese or oriental liver fluke)
Cercaria>Metacercaria) > Adult
▫ HERMAPHRODITIC, EXCEPT: Schistosomes which are cylindrical and have
separation of sexes
▫ Eggs are operculated except for the Schistosome (non-operculated)
▫ Infective stage to the final host is the metacercaria, EXCEPT for the
Schistosomes (cercaria) Paragonimus westermani (lung fluke)
▫ Mode of Transmission is oral, EXCEPT Schistosome
▫ Requires 2 intermediate hosts, EXCEPT for the Schistosomes (only 1) ▫ Most important liver fluke of man /can cause
○ 1ST IH: SNAIL clonorchiasis
○ 2ND IH: Fish, crab, plant/vegetation, snail ▫ Branched testes, dentritic
Morphologic terms associated with trematodes ▫ Humans acquire the disease by eating undercooked fish
▫ Cercaria: Final stage of development occurring in snails; motile by means of a containing encysted metacercariae
tail ▫ Egg: Old-fashioned electric light bulb
▫ Metacercaria: Encysted form occurring in the second intermediate host (fish or ▫ Causes endemic hemoptysis ▫ 1st IH Snail
crayfish) ▫ P. westermani causes pulmonary infections characterized ▫ 2nd IH Fishes
▫ Miracidium: First larval stage that emerges from the egg in fresh water by chest pain, cough, bronchitis, and sputum with blood. ▫ MOT Ingestion
▫ Sporocyst: Emerges from the miracidium as a saclike structure containing the ▫ Egg: golden brown w/ thickened abopercular end ▫ Lab diagnosis: Immunologic test and enterotest/DFS
larva e. opposite the operculum ▫ Infective stage: METACERCARIA
▫ Redia: Intermediate larval stage occurring in the Sporocyst ▫ Adult Resembles coffee bean
▫ Schistosomulum: Resulting form when the cercaria penetrates human skin and ▫ paralobate testes (TANDEM TESTES)
loses its tail ▫ 1st IH Snail Opisthorcis felineus
Life cycle ▫ 2nd IH Crabs ▫ Cat liver fluke
Egg Stage -Larval Stage: miracidium>sporocycst>redia>cercaria>metacercaria - ▫ Disease associated: opistorchiasis felineus
Adult Stage ▫ MOT Ingestion
▫ Lab. Diagnosis: Examination of sputum and stool ▫ Adult worm: Lancet shape
▫ Eggs are usually passed with feces into the water, where they hatch.
▫ Infective stage: METACERCARIA ▫ LOBE testes
▫ Free-swimming miracidia are released, which are then ingested by snails (the
▫ Egg: ovoid and smaller than C.sinensis
intermediate host).
▫ Lab diagnosis: DFS
▫ Sporocytes (schistosomes) or redia (trematodes) develop in the snail, resulting in
the replication of hundreds of cercariae ▫ Infective stage: METACERCARIA
Fasdola hepatic (liver fluke) 1st IH: Snail
▫ Cercariae are infective to humans, in whom they are acquired by swimming in
2nd IH: Fish
infested water.
▫ Diagnosis: Examination of feces for adult forms or ova or, in the case of Echinostoma ilocanum
schistosomes, feces and urine examination for ova ▫ Echinostomiasis
▫ Tremotodes can infect many organs, especially the intestines, liver, and lungs. ▫ Adult Horse shoe shape collar of spine
Schistosoma ▫ only flukes whose oral sucker is with spine:
CIRCUMORAL DISK WITH SPINE
▫ Blood flukes
▫ Egg: Germ ball
▫ Male: w/ gynecophoral canal where the female is held 1st IH: Snail
▫ Species pathogenic for humans include S. mansoni, S. haematobium, S. ▫ Causes sheep liver rot Prevalent in sheep raising
countries / sheep liver fluke 2nd IH: Pila Luzonica (Snail)
japonicum, and less frequently S. mekongi and S. intercalation. Infective stage: METACERCARIA
▫ Schistosoma spp. cause schistosomiasis, which is characterized by abdominal ▫ Egg: Hen’s egg shaped
pain bloody diarrhea, and hepatosplenomegaly. ▫ Adult: w/ cephalic cone Leaf-like hermaphrodite
/shouldered appearance
Heterophyes heterophyes
▫ Lab diagnosis: Circumoval precipitin test (COP) of Oliver and Gonzales ▫ Smallest but deadliest fluke of man /Heterophyid
Schistosoma haematobium: Fasdolopsis buski (intestinal flukes)
infection
▫ Can cause fascilopiasis
▫ Adult w/ 3rd sucker (gonotyle)
▫ Largest fluke parasitizing man
▫ Ressembles Heterophyes but NO THIRD SUCKER
▫ No cephalic cone, unbranched intestinal ceca
▫ Infective stage: METACERCARIA
▫ Egg Hen’s egg shaped / Indistinguishable from 1st IH: Snail
Fasciola 2nd IH: Fish
Fasciola gigantica
▫ Tropical liver fluke Metagonimus yokogawai
▫ Infects cattle in the Philippines ▫ Ventral and oral sucker
Vesical blood fluke causing bilharziasis or urinary schistosomiasis (hematuria)/ Egg: ▫ Less developed shoulder and has large ventral sucker ▫ Infective stage: METACERCARIA
Large terminal spine/ specimen 24-hr unpreserved urine/ IH: Bulinus, Physopsis Lab diagnosis: Immunologic test
Schistosoma japonicum: 1st IH: Snail Heterophyes taichui
2nd IH: Plant
▫ Large ventral sucker
Infective stage: METACERCARIA
▫ Egg: operculated yellow brown ovoidal
▫ Infective stage: METACERCARIA

Causes Katayama’s disease, snail fever, oriental schitosomiasis/ Superior mesenteric

veins in the small intestines / Egg: w/ small knob-like or recurved hook on one side/
IH: Oncomelania quadrasi / oriental blood fluke
Schistosoma mansoni:

Superior mesenteric veins of the colon and rectum (large intestine) /Intestinal
billarzhiasis / manson's blood fluke / Egg: w/ lateral spine / IH: Biomphalaria,
Tropicorbis Planorbis

Schistosoma mekongi: ressembles Schistosoma japonicum/Domestic pigs/Reservior

host
Schistosoma intercalatum: Habitat: Mesenteric veins / Closely ressembles S.
haematobium but can be differentiated by ‘SLIGHT BEND” in the terminal spine/ Egg
shell is ZIEHL-NEELSEN POSITIVE o Specimen for Diagnosis: Feces/ urine

Parasitology Page 1