TREMATODES

MORPHOLOGY EGG ADULT
plump, ovoid, reddish brown, fluke (resemble coffee bean) ovoid, thickshelled, golden brown operculum unembryonat ed

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MOT PREVENTION LUNG TREMATODES

CLINICAL COMPLICATION

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DIAGNOSIS TREATMENT

Paragonimus westermani (metacercaria) cysts in lung

INTERMEDIATE HOST • Snail

freshwater crabs or crayfish

MOT • consumption of raw or improperly cooked, salted, or pricked crabs or crayfish, “drunken prawns” • ingestion of raw viscera or meat of wild boar infected with immature flukes PREVENTION • avoid eating raw or improperly cooked crabs or crayfish • prevent contamination of cooked food with metacercariae thru’ proper handling snail control with molluscide

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invasion of intestinal wall and abdominal cavity by young flukes → fever, chills, diarrhoea, abdominal pain, allergic reactions (urticaria and eosinopilia) young flukes invade pleurae and lungs → fever, chest pain, cough, dyspnea, malaise and night sweats haemoptysis chest pain

DIAGNOSIS


finding of characteristic eggs in sputum or faeces serology : ELISA, CFT

TREATMENT Praziquantel,

BLOOD TREMATODES
Schistosome Mansoni (cercariae – penetrate through unbroken skin) Inferior mesenteric vein and its branches MOT

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cercariae penetrate human’s skin with help of proteolytic enzymes

Acute form (Katayama’s fever) IgM ↑; IgG ↑; IgE ↑ hepatomegaly and hepatosplenomegaly (liver function tests relatively normal) Portal hypertension hematemesis from esophagus varices “Pipe-stem” fibrosis

DIAGNOSIS

Elongate, with a lateral spine projecting from the side

PREVENTION • population-based chemotherapy to reduce morbidity • providing a safe water supply • health education • snail control MOT

detection of eggs in faeces : formalinether technique, sedimentation technique

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TREATMENT Praziquantel,

Schistosome Japonicum (cercariae – penetrate through unbroken skin) Superior mesenteric vein and its branches

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cercariae penetrate human’s skin with help of proteolytic enzymes

Cercarial dermatitis (Paddy field itch) Acute form (Katayama fever) hepatosplenomegaly, hypersplenism, pancytopenia, ascites, esophagal and gastric varices → bleedingoedema, anaemia large bowel: stricture, secondary bacterial or protozoan infection, adenocarcinoma of bowel “Pipe-stem” fibrosis

DIAGNOSIS

Spherical; minute lateral spine near one end of the egg seen in some strain

PREVENTION • population-based chemotherapy to reduce morbidity • providing a safe water supply • health education • snail control

detection of eggs in faeces : formalinether technique, sedimentation technique

TREATMENT Praziquantel,

• Schistosome haematobium (cercariae – penetrate through unbroken skin) Vesical venous plexus surrounding urinary bladder MOT

cercariae penetrate human’s skin with help of proteolytic enzymes

Elongate with conspicuous terminal spine

PREVENTION • population-based chemotherapy to reduce morbidity • providing a safe water supply • health education • snail control

DIAGNOSIS • detection of eggs in faeces : formalinether technique, sedimentation technique TREATMENT Praziquantel,

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