CLASS TREMATODA (FLUKES)

 Characteristics
 Dorsoventrally flattened EXCEPT Schistosoma
 Have 2 suckers
Oral and ventral suckers for attachment
 Life cycle
Egg – operculted ova EXCEPT for Schistosoma
Larva
Miracidium->sporocyst->redia->

cercaria->metacercaria
adult
 Definitive
host: Man
Harbors adult worm
Infective stage: metacercaria
EXCEPT Schistosoma

 Manner of transmission
Metacercaria ingestion
Skin penetration of cercaria
Intermediate host
 Harbors larval form
 Have 2 intermedite host EXCEPT Schistosoma

First intermediate host

ALWAYS A SNAIL
infective stage is miracidium

Second intermediate host

Infective stage: metacercaria
Aquatic vegetation: Fasciola
Fresh water fish: Chlonorchis
Clams or crabs: Paragonimus
 Liver Flukes
1. Fasciola hepatica
 Sheep liver fluke

 Habitat: liver

 Transmission: ingestion of contaminated

aquatic vegetation
Manifestation:
Abd.Colic, obstructive jaundice, cough,
vomiting

Diagnosis:
Fecalysis
Bachmanintradermal test
Complement fixation test
 Treatment:
 Bithionol(drug of choice)
 Emetine hydrochloride
 Praziquantel

 Prevention:
 Mulluscicides
 Sanitary protection of waterbeds
2. Chlonorchis sinensis (Opistorchis
sinensis)
Chinese liver fluke
Habitat: liver
Transmission: ingestion of raw or
uncooked freashwater fish
Manifestation:
mild
Progressive: Irregular appetite, fullness of
abdomen, diarrhea, edema, hepatomegaly
Severe: cirrhosis, portal hypertension
 Diagnosis:
Fecalysis
Duodenal aspiration

 Treatment: chloroquine, praziquantel

 Prevention:
thorough cooking of fish,
sewage disposal
 Intestinal Flukes
 Fasciolopsis buski
Giant intestinal fluke
Habitat: duodenum and jejunum
Disease: Fasciolopsiasis
Transmission:
Ingestion of contaminated aquatic
vegetables
Manifestations
Toxic iarrhea, ascites, edema
 Diagnosis:
Historyand PE
Fecalysis

 Treatment: Praziquantel

 Prevention
Thorough washing of vegetables
Avoid water chestnuts in infected waters
Prohibit use of night soil
 Lung Fluke
 Paragonimus westermani
Oriental Lung Fluke

Habitat: lung

Disease: Paragonimiasis

Transmission: eating freshwater crabs

 Manifestations:
Productive cough, occasionaly
hemoptysis
Chest pain, night sweats, abdominal
pain, diarrhea, epilepsy

 Diagnosis:
 Chest xray
 Sputum exam
 Fecalysis
 Complement fixation test

 Treatment: Praziquantel
 Blood Flukes
 Schistosomes
Dioecious

Always in copula, “romantic parasite”

Three species
Schistosoma japonicum
Schistosoma hematobium
Schistosoma mansoni
 Schistosoma mansoni
 Manson’s blood fluke
 Habitat:
inferior mesenteric plexus
rectum
 Disease:

Bilharziasis
Intestinal schistosomiasis
 Intermediate host
Snail:Biomphalaria, Australorbis
Eggs: non-operculated, with lateral
spine
Cercaria has forked tail

 Diagnosis: fecalysis  urine

 Schistosoma hematobium
 Vesicle blood fluke

 Habitat:
vesical and pelvic plexus of
venous circulation

 Disease: urinary bilharziasis

 Intermediate host:
Snail:Bulimus, Planorbarius, Physopsis
Eggs: non-operculated, with terminal
spine
Cercaria: forked tail

 Diagnosis: urinalysis  fecalysis

 Schistosoma japonicum
 Oriental blood fluke

 Habitat:
superior mesenteric veins of small
intestine

 Disease: Oriental schistosomiasis

 Intermediate host:
Snail:Oncomelania quadrasi
Eggs: with abbreviated spine
Cercaria: forked tail

 Diagnosis: fecalysis only

 Clinical manifestations
 Dermatitis: Swimmer’s itch

 Diarrhea,
splenomegaly,
lymphadenopathy

 Hematuria, urethral obstruction

 Headache, disorientation, amnesia,

coma
Treatment: Praziquantel

Prevention:
Proper waste disposal
molluscides
 Quiz Time

Please get 1/8 paper

1. Paragonimus westermani
A. liver fluke C. intestinal fluke
B. lung fluke D. blood fluke
2. Definitive host of trematodes
A. pigs C. cow
B. man D. snail
3. Synonymous with Trematodes
A. tapeworm C. hookworm
B. flukes D. roundworm