May 5, 2020

Trematodes Morphology Laboratory Diagnosis Life Cycle Note

(Flukes) Egg Adult Intermediate Host Definitive/ Infective Stage Mode of Host Location
Accidental Host Transmission
Schistosoma STOOL SAMPLE Oncomelania Hupensis Humans - Definitive Cercaria Cercaria penetrates Liver, Mesenteric
1. Rectal or Liver Biopsy Quadrasi
Japonicum 2. Microscopic Examination
skin thru infected Venules
(Blood Fluke) Developed - Separate sexes water Small Intestine
- MIFC
Miracidium - Rounder in
- Small, lateral and appearance
- Kato-Katz Technique Heart
- Rectal snips and imprints Spleen
difficult to see - The male 3. Locally evaluated immunodiagnostic
spine surrounds the tests Central Nervous
female, facilitating - Indirect hemagglutination System
the copulation - Circumoval Precipitin Test (COPT)
- Enzyme-linked Immunosorbent
Assay (ELISA)
Metagonimus - Pyriform in shape STOOL SAMPLE 1st IH: Humans – Definitive Metacercaria in Ingestion of encysted Small Intestines
- With tapering at 1. Kato thick method Freshwater, brackish
Yokogawai 2. Polymerase Chain Reaction (PCR)
intermediate hosts Miracidia/Cercaria in
Developing the anterior end and water or marine species
(Intestinal fish
Miracidium Rounding at the of snails
Fluke) - Operculum is posterior end
present as well as - Tiny layer of scaly 2nd IH:
shoulders but spines covers the Freshwater fish
discreet organisms, at the species
- Small knob may anterior end
be absent
- Thin shell
Fasciola STOOL, DUODENAL CONENTS, 1st IH: Humans – Accidental Metacercaria on 2nd Ingestion of Bile duct of Sheep
BILE Lymnaea truncatula,
Hepatica - Eggs
intermediate hosts metacercariae Herbivore
Undeveloped - Equipped with so- Lymnaea bulmoides,
(Liver Fluke) SURGERY after treatment encysted on edible Animals
Miracidium called shoulders Lymnaea tomentosa,
- Somewhat oblong
- Adult worms Lymnaea philippinensis aquatic plants and/or
1. Immunologic Methods water
- Presence of a and Lymnaea auricularia
- Enzyme-linked Immunosorbent
distinct operculum Assay rubiginosa ; and Snails
- Western Blot from Planorbidae family
2. Radiological Examinations
- Hepatic Sonography 2nd IH:
- Computed Tomography Ipomea obscura
- Endoscopic Retrograde (Kangkong), and,
Cholangiopancreatography Nasturtium officinale
(Watercress)
Paragonimus STOOL, SPUTUM, PLEURAL 1st IH: Humans – Definitive Metacercaria on 2nd Ingestion of Encapsulate in
EFFUSIONS Antemelania asperata,
Westermani - Eggs
intermediate hosts metacercariae on raw Parenchyma of
Undeveloped - Somewhat oval, and, Antemelania
(Lung Fluke) 1. Microscopy or insufficiently Lung in fibrotic
Miracidium red to brown color dactylus (formerly, Brotia
- Prominent - The cuticle
3. Chest Radiographs asperata) cooked crabs capsules
> Pulmonary Paragonimiasis
operculum, with possesses spines 4. Computer Tomography and Magnetic
shoulders and Resonance Imaging 2nd IH:
obvious terminal > Cerebral Paragonimiasis Mountain crab
shell thickening 6. Immunological Methods Sundathelphusa
opposite - Immunoelectrophoresis philippina (formerly,
operculum - Immunoblotting Parathelphusa
- Enzyme-Linked Immunosorbent grapsoides)
Assay

TREMATODES | Ian Josef R. Vibar


Trematodes (Flukes) Epidemiology
Schistosoma Japonicum - Monkeys, Cattle, Rodents, Dogs
(Blood Fluke) and cats are the known reservoir
hosts
- Far East
- China, Indonesia, Philippines
In the Philippines
- Remains endemic in 12 regions
- Agusan del Sur has the highest
prevalence rate (3.95%) and
Cagayan as the lowest in the list
(0.04%)
Metagonimus Yokogawai - Japan, Siberia, China, Philippines,
(Intestinal Fluke) Spain, Greece and Balkans
- Dogs, Cars, Hogs and Fish-eating
birds harbours the parasite
Fasciola Hepatica - Found worldwide particularly in
(Liver Fluke) regions where Sheep (natural host)
and Cattle are raised
Paragonimus Westermani - Asia, Africa, India, and South
(Lung Fluke) America
- Pigs and Monkeys serve as the
reservoir hosts and animals that
eats crayfish and crabs
Pathogenesis
- Katayama fever
Systemic hypersensitivity
reaction to the Schistosomulae
migrating through tissue.
- Inflammation at the cercaria
penetration site.
- Obstruction of the bowel or
ureters, as well as secondary
bacterial infections and involvment
of the central nervous system and
other tissues
- Granulomas
Lymphatics or Venules via
Intestinal wall
Heart or Brain
- Abdominal pain and discomfort,
Chronic mucous Diarrhea and
Eosinophilia.
- Pains in the liver area of the body
(because of tissue damage) some
of which may extend to the
shoulders and back.
- Headache, fever, and chills
- Eosinophilia, Jaundice, Liver
tenderness, Anemia, Diarrhea, and
Digestive discomfort and Biliary
obstruction
- Pulmonary Distosomiasis
Chronic Bronchitis,
Eosinophilia, Production of blood-
tinged sputum.
- Seizures, Visual difficulties, and
Decreased precision of motor
skills.
When they migrate to brain
May 5, 2020
Treatment or Drug of Choice Prevention and Control
1.) PRAZIQUANTEL 1.) Prompt diagnosis and
treatment of infected persons
2.) ANTIMALARIAL
2.) Avoidance of human contact
3.) ARTEMISINS with potentially contaminated
- Artemether and Artesunate water
4.) SURGERY 3.) Mass treatment, and
4.) National control programs
1.) PRAZIQUANTEL 1.) Avoidance of consuming
undercooked fish
2.) Practicing proper fecal disposal
3.) Controlling of snail population
1.) DICHLOROPHENOL 1.) Exercising human fecal
(BITHIONOL) disposal
2.) TRICLABENDAZOLE 2.)Controlling the snail population
3.) Avoiding consumptions of raw
water plants or contaminated
water
1.) PRAZIQUANTEL 1.) Avoiding human ingestion of
undercooked crayfish and crabs
2.) BITHIONOL
2.) Exercising proper disposal of
human waste products
TREMATODES | Ian Josef R. Vibar