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Trematodes

Trematodes

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Published by: dhainey on Mar 02, 2009
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TREMATODES
()
Flukes
.:
eneralCharac
:
llflukes
-- -
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
2 .. -
requires IH Except Schistosomes
-
egg operculated Except Schistosomes
,
terribly difficult to get rid of once infected may
 10-20
accumulate for years
& :
orphologyStructures
( )
dultworm
, -,
flattened leaf shaped unsegmented worms
-
body covered with non cellular integuments which
 
may be smooth or spiny
,
musculature consist of outer circular middle oblique
 (
and an inner longitudinal integuments serves to
 )
alter the shaped of the worm
2 -
possess cup shaped muscular suckers bearing
 
spines or hooklets surrounding the mouth
 
(
oral sucker found anteriorly surrounding the
 )
mouth used for ingestion and procurement of food
 
/ -
ventral sucker acetabulum found posteriorly in
 ( )
the ventral surface for attachment
 
oral cavity leads to the muscular esophagus from
 2
which the intestine branches to form intestinal
 
ceca which runs parallel to each other ending near
 ( )
the posterior end figure of an inverted
,
no body cavity most of the rest of the body is taken
 
up by reproductive organ and some associated
 
structure
 
lack circulatory system
-
excretory system bilaterally symmetrical and opens
 
at posterior end of body
-
nervous system composed of paired lateral ganglia
 
in the region of pharynx which are directed to nerve
 
trunk
()
series of glandular structure vetilaria lying lateral to
 
the intestinal ceca
 :
gg
,
smooth hard shell and operculated or with lid at one
 ( -)
end except Schistosomes non operculated
 
generally yellow brown or brown colored
Adult worm (sm. intestine of vertebrate host)
lays egg
excreted in water and hatchingested by human
miracidiumliberated metacercaria
enter 1st I.H. (snail)enters & encystin tissueof 2nd I.H.(fish, water vegetation)(intramolluscanphase)
sporocyst
redia1
redia2
cercaria
swim
Life Cycle -Complex
= requiring one or more intermediate host
:
lassificationofTrematodes
.
I Species which inhabit the small intestine
)
a
 
Fasciolopsis buski
)
b
 
Echinostoma ilocanum
)
c
 
Echinostoma malayanum
)
d
 
Heterophyse heterophyse
)
e
 
Metagonimus yokogawai
.
II Specie that inhabit the lung
)
a
 
Paragonimus westermani
.
III Specie that inhabit the liver
)
a
 
Clonorchis sinensis
)
b
 
Opisthorchis felineus
)
c
 
Opisthorchis vinerrini
)
d
 
Fasciola hepatica
)
e
 
Fasciola gigantica
)
 
Eurytrema pancreaticum
.
IV Species which inhabit the portal blood circulation
)
a
 
Schistosoma japonicum
)
b
 
Schistosoma hematobium
)
c
 
Schistosoma mansoni
 
ntestinalFlukes
 
asciolopsisbuski
( )
Giant Intestinal Fluke
 
common intestinal parasite of human and pigs in the
 
Orient
 
lives in the small intestine of its definitive host
 
rather than in the liver
:
isease
 
Fasciolopsiasis
:
eographicalDistribution
, , , ,
Central and South China Taiwan Vietnam Thailand
 
Indonesia and other parts of Orient
:
orphology
:
dultworm
 
live attached to the bowel wall primarily in the
 
duodenum and jejunum
 
, ,
elongate broadly ovoidal large and fleshy
 
anterior end narrower than posterior end
integument spinose
 
absence cephalic cone or shoulder
 
ventral sucker larger than oral sucker located close
 
to it
 
dendritic testes at the posterior half of the body in
 
tanderm
 
ovary branched and lies midline anterior to the
 
testes
 
vitelaria extensive at the lateral site to the caudal
 
end
Ova
( . )
hens egg shape identical to that of F hepatica
-
thin shell with small operculum at one end
 
unembryonated when laid
 
:
OT
 
ingestion of metacercaria encysted on fresh water
 ( )
vegetation bamboo shoots or water chestnuts which
 /
may be consumed raw or peeled w the teeth
:
athogenesisandClinicalinfection
 
pathological changes caused by the worm are
 ,
traumatic obstructive and toxic to the intestinal
 
mucosa
, ,
there is localized inflammation ulceration abscesses
 
formation and hemorrhages at the sites of worm
 
attachment
, , ,
diarrhea abdominal pain anorexia nausea and
 
vomiting may occur
12
malabsorption syndrome and impairment of Vit B
 
absorption occur in some infected patient
:
iagnosis
 
Demonstration of egg in stool
:
reatment
/ /
Hexylresorcinol Tetrachlor Ethylene Praziquantel
 30/
mg kg body weight
 
chinostomailocanum
()
Garrisons fluke
. :
eogDistribution
 
 
Confirmed to be endemic in the Philippines
, ,
Prevalent in Northern Luzon Leyte Samar and
 
Mindanao
, , , , ,
also found in Indonesia India China Thailand Japan
 
Malaysia and Sumatra
:
isease
 
Echinostomiasis
:
orphology
:
dultworm
,
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
 
va
 
ovoidal and operculated
 
immature when passed in feces
 
Life Cycle:
= involves 2 snailintermediate host
:
athogenesisandClinicalmanif
 
adult worm attaches to the wall of the small
 
intestine producing inflammatory reaction leading to
 
diarrhea
 
light infection usually asymptomatic
 
heavy infection can result to mild ulceration of the
 
intestinal mucosa producing bloody diarrhea and
 
abdominal pain
 
absorption of the metabolites of the worm may
 
result in general intoxication
.: , ,
clinical manif abdominal colic episodes of diarrhea
 
restlessness and pruritus
:
iagnosis
.
Demonstration of charac ova in stool
:
reatment
//
 Tetrachlorethylene Praziquantel Hexylresorcinol
Prevention
:
 Through cooking of the snail that serves as
 
the second intermediate host of the parasite
 
 
chinostomamalayanum
:
eographicaldistribution
= , , ,
Malay Peninsula India China Sumatra
:
orphologyAdult
 
ovoid and bluntly rounded
 
oral suckers surrounded with spines
testes deeply indented at tandem
-
excretory system Y shape appearance and
 -
pouch like excretory bladder
Ova
:
yellow to yellowish brown
 
. .: =
C
.
Same as E ilocanum
1 .. ()
st IH snail Lymnae Lueleola
2 .. ()
nd IH snail Indoplanorbis
:
athologyandSymptomatology
.
Same as E ilocanum
 
:
iagnosis
 
Finding ova in the stool
:
reatmentandPrevention
.
Same as E ilocanum
 
etagonimusyokogawai
( )
 Yokogawai fluke
:
isease
 
Metagonimiasis
:
eographicaldistribution
 
, , ,
Spain Israel USSR Prevalent in the Far East
: :
orphologyAdultworm
-,
pyriform shape broadly rounded posteriorly and
 
pointed anteriorly
 
size somewhat larger than heterophyes
 
ventral sucker deflected to the right
-
vitellaria in a fan shaped distribution
2 -
oval unequal size testes at posterior third of the
 
body
 
va
,
minute ovoidal and operculated
 
absence of knob at abopercular end
 
fully embryonated when laid
 
ercaria
,
tail keeled armed with spines
 
pigmented eyespots
 
:
athologyandClinicalFeature
 
causes mild inflammatory reaction in the intestine
 
ectopic ova can cause granuloma in other organ
 
especially in the liver and brain
. :
abDiagnosis
 
Finding ova in the stool
 
:
reatment
 = &
 Tetrachlorethylene Praziquantel
&
Bithionol Niclosamide have been shown to
 
decrease egg production
:
revention
 
 
Avoid eating raw or inadequately cooked fish
 
Domestic animal should be prevented from eating
 
fish offal
 
eterophyesheterophyes
 
=
smallest of the fluke but the deadliest
:
isease
 
Heterophyiasis
:
eographicaldistribution
, ,
Egypt Turkey
(, , &
Prevalent in the Far East Japan Korea Central
 ) , &
South China Taiwan Philippines
:
orphology
:
dultworm
-, ,
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
3 :
provided with suckers
-
ventral sucker larger and thick walled than
 
oral sucker
()
genital sucker gonotyl found posterior to
 ( )
the ventral sucker not present in Metagonimus
oral smaller compared to ventral sucker
ova
 
-,
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

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