TREMATODA

I. Trematoda hati
 Fasciola hepatica
 Clonorchis sinensis
II. Trematoda usus
 Fasciolopsis buski
 Heterophyes heterophyes
 Metagonimus yokogawai
III. Trematoda paru
 Paragonimus westermani
IV. Trematoda darah
 Schistosoma japonicum
 Schistosoma mansoni
 Schistosoma haematobium
Fasciolopsis
buski
Penyakit : fasciolopsiasis

Hospes : manusia, babi

Distribusi geografik :RRC,Taiwan,Thailand

Vietnam, Indonesia

Habitat : duodenum, jejunum

Fasciolopsis buski dewasa :

 2-7,5 cm x 0,8 – 2 cm
 Lonjong, tebal
 Warna ∞ daging
 Kutikulum berduri
 o.s < v.s
 Caecum tidak
bercabang
 2 testis bercabang,
tandem
 1 ovarium
bercabang
TELUR Fasciolopsis buski

 130-140 x 80 – 85 µ
 Lonjong
 Kekuningan
 Operkulum
 Dinding tipis, jernih
Image: Left: Fasciolopsis buski egg in an unstained wet
mount. Center: Adult fluke of F. buski next to a scale.
Right: Snail in the genus Hippeutis, an intermediate host
for F. buski. Credit: DPDx, Image courtesy of Conchology,
Inc, Mactan Island, Philippines.
Life cycle
Life cycle

 immature eggs are discharged into the intestine

and stool . 
 Eggs become embryonated in water , eggs
release miracidia , which invade a suitable snail
intermediate host . 
 In the snail the parasites undergo several
developmental stages (sporocysts , rediae , and
cercariae ).
 The cercariae are released from the snail and
encyst as metacercariae on aquatic plants . 
 The mammalian hosts become infected by
ingesting metacercariae on the aquatic plants. 
After ingestion, the metacercariae excyst in the
duodenum and attach to the intestinal wall. 
 There they develop into adult flukes (20 to 75 mm
by 8 to 20 mm) in approximately 3 months,
attached to the intestinal wall of the mammalian
hosts (humans and pigs) . 
 The  adults have a life span of about one year.
Gejala :
 nyeri
epigastrium
 mual
 diare
 edema
 ileus akut
Diagnosa :
 gx klinis
(bila didaerah endemi)
 menemukan telur dlm
tinja
Terapi:
 diklorofen
 niklosamid
 praziquantel
Pencegahan
Memasak atau
merendam dalam air
mendidih tumbuhan
air yang akan
dimakan
Heterophyes heterophyes
( Penyakit  Habitat
:Heterophyasis
 Distribusi geografis )Mukosa usus
- Mesir  Definitif host
- Palestina manusia , mamalia
- Jepang  Intermediate host
- Cina I. Pironella conica
- Korea
Cerithidea cingulata
- Taiwan
II. Tilapia nilotica
- Filipina
Mugil japonicus
- Indonesia
Acanthogobius
Morfologi
 Telur
- 29 X 16 mikron
- coklat muda
- memiliki operkulum
- kulit tebal
 Dewasa
- kecil, 1.3 X 0,5 mm
- ventral sucker>oral
- genital sucker
Adults of Heterophyes heterophyes are minute flukes, measuring 1-2 mm in
length.   The tests are large and paired, and are situated near a small ovary. 
The surface of the worm is covered with minute spines.  Adults reside in the
small intestine of the definitive host.
In this figure, the following structures are labeled:  oral sucker (OS), pharynx
(PH), intestine (IN), ventral sucker, or acetabulum (AC), and eggs within the
uterus (UT).
Life cycle
Life cycle

 Adults release embryonated eggs each with a

fully-developed miracidium, and eggs are passed
in the host's feces .  After ingestion by a suitable
snail (first intermediate host), the eggs hatch and
release miracidia which penetrate the snail’s
intestine .  Genera Cerithidia and Pironella are
important snail hosts in Asia and the Middle East
respectively.  The miracidia undergo several
developmental stages in the snail, i.e.
sporocysts , rediae , and cercariae .  Many
cercariae are produced from each redia.  The
cercariae are released from the snail and encyst
as metacercariae in the tissues of a suitable
fresh/brackish water fish (second intermediate
host) .  The definitive host becomes infected by
ingesting undercooked or salted fish containing
metacercariae .  After ingestion, the
metacercariae excyst, attach to the mucosa of the
small intestine and mature into adults
(measuring 1.0 to 1.7 mm by 0.3 to 0.4 mm) .  In
addition to humans, various fish-eating mammals
(e.g., cats and dogs) and birds can be infected by
Heterophyes heterophyes .
Gejala klinis
 Infeksi ringan
- tidak tampak
 Infeksi berat
- diare menahun
- kolik
- rasa tidak enak dan nyeri diperut
- terdapat eosinofili
Diagnosa dan
pengobatan
 Diagnosa
- pemeriksaan tinja  telur

 Pengobatan
 Prazikuantel 20 mg/Kg BB/po/dos.tunggal
 Tetrakloroetilen 5 ml/po/dosis tunggal
Pencegahan

 Masak ikan dengan sempurna

 Buang air besar tidak disembarang tempat
 Pendidikan kesehatan
 Hewan sebagai sumber penularan
Metagonimus yokogawai
( Penyakit :Metagonimiasis
)  Distribusi geografis  Habitat
- Jepang - mukosa jejunum
- Korea  Definitif host
- Cina - Manusia, anjing,
- Taiwan
kucing, babi
- Malaysia  Intermediate host
- Rusia
I. Semisulcospira,
- Spanyol
- Balkan Thiara dan Hua
II. Salmon,
Plecoglossus
Morfologi
 Telur
- 28 X 17 mikron
- kuning keabuan
- memiliki operkulum
- dinding tebal
 Dewasa
- kecil 1,4 X 0,6 mm
- vs > os
- testis  posterior
- ovarium  tengah
Metagonimus yokogawai adult flukes are minute intestinal flukes (1-2.5 mm in length)
that resemble Heterophyes heterophyes.  An important distinctive feature is the position
of the ventral sucker (genitoacetabulum), which is to the side of the midline and closely
associated with the genital pore.  Adults reside in the small intestine of the definitive
host.
Adult M. yokogawai. 
In this figure, the following structures are labeled:  oral sucker (OS), pharynx (PH),
intestine (IN), genitoacetabulum (GA), ovary (OV), the large, paired testes (TE), and
eggs within the uterus (EG).
Life cycle
Life cycle

 Adults release fully embryonated eggs each with a

fully-developed miracidium, and eggs are passed
in the host’s feces .  After ingestion by a suitable
snail (first intermediate host), the eggs hatch and
release miracidia which penetrate the snail’s
intestine .  Snails of the genus Semisulcospira are
the most frequent intermediate host for
Metagonimus yokogawai.  The miracidia undergo
several developmental stages in the snail, i.e.
sporocysts , rediae , and cercariae .  Many
cercariae are produced from each redia.  The
cercariae are released from the snail and encyst
as metacercariae in the tissues of a suitable
fresh/brackish water fish (second intermediate
host) .  The definitive host becomes infected by
ingesting undercooked or salted fish containing
metacercariae .  After ingestion, the
metacercariae excyst, attach to the mucosa of the
small intestine and mature into adults
(measuring 1.0 mm to 2.5 mm by 0.4 mm to 0.75
mm) .  In addition to humans, fish-eating
mammals (e.g., cats and dogs) and birds can also
be infected by M. yokogawai .
Gejala klinis

 Infeksi ringan  tanpa gejala

 Infeksi sedang  diare dan sakit perut
 Infeksi berat
- demam
- nyeri perut
- kolik
- eosinofili
Diagnosa dan
pengobatan
 Diagnosa
- menemukan telur dalam tinja

 Pengobatan
- Prazikuantel 20 mg/Kg BB/po/tunggal
- Tetrakloroetilen 5 ml/po/tunggal
Pencegahan

 Masak ikan dengan sempurna

 BAB tidak disembarang tempat
 Pengawasan Hewan sumber penularan
 Hygiene pribadi
ECHINOSTOMATIDAE

 Penyakit : ekinostomiasis
 Hospes : Manusia, tikus, anjing, burung, ikan dan lain-lain.
 Penyebaran Geografis : Filipina, Cina, Indonesia dan India.
Morfologi dan Daur Hidup
 Habitat : usus halus (cacing dewasa)
 Ciri-ciri khas :
 Duri-duri leher (collar sines) 37-51 buah letaknya dua baris berupa tapal kuda
melingkari bagian belakang dan samping batil isap mulut.
 Bentuk lonjong dg ukuran 2,5 mm – 15 mm x 0,4 – 3,5 mm.Warna agak merah ke
abu-abuan.
 Testis agak bulat, berlekuk-lekuk tersusun tandem di bagian posterior.
 Vitelaria sebelah lateral, 2/3 bgn hingga bgn posterior.
 Telur :
 103-137 x 59-75 µ

 Mempunyai operkulum

 Infeksi terjadi apabila manusia memakan Hp. II (keong

besar/sawah) yg tidak matang yg mengandung Metaserkaria
Patologi dan Gejala Klinis

 Kerusakan ringan pada mukosa usustidak menimbulkan gejala

 Pada infeksi berat : radang kataral pada dinding usus, atau
ulserasi
 Pada anak-anak diare, sakit perut, anemia dan edema.
 Diagnosis : menemukan telur dalam tinja.
 Pengobatan :
 Tetrakloroetilen
 Prazikuantel
 Epidemiologi :
 Keong sawah merupakan sumber infeksi apabila tidak dimasak sampai matang.
 Metasercaria hidup & tumbuh >>> cacing dewasa.