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10/3/2019 S.Wahyuni/Parasitology 1
Classification
• Crustacea: Copepods
• Myriapoda
– Chilopoda: Centipedes
– Diplopoda: Millipedes
• Arachnida: spider, scorpion, mite, tick
• Insecta: Flies, mosquitoes, fleas, lices / louses,
cockroaches, ants, beetles, bees.
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Class Crustacea
• Aquatic animals
• Head + Thoracic segments
Cephalothorac
• 2 Orders:
– Copepoda (microscopic): Cyclops & Diaptomus
host of D. latum, D. medinensis, G. spinigerum)
Decapoda (macroscopic / 5 pair legs):
shrimps, lobster, crabs, crayfish
intermediate host of Paragonimus westermani
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Lifecycle Dracunculus medinensis
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Lifecycle Diphyllobothrium latum
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Lifecycle Gnathostoma spinigerum
Gnathosto
ma
spinigerum
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Lifecycle Paragonimus westerman
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Class Myriapoda
• Segmented and elongated body
• A pair of legs on each segment
• 2 Order:
– Ordo Diplopoda:
Millipedes (Kaki seribu, Fontaria sp.)
host of Hymenolepis diminuta
– Ordo Chilopoda: Centipedes
(Lipan) are poisonous (Scolopendra sp.)
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Class Arachnida
• Some poisonous and painful biting
• Vector of viral diseases
• 4 order:
– Scorpionida (Kalajengking, Buthus sp.)
beracun
– Aranea (Laba-laba beracun, Lactrodectus
sp.) beracun
– Ixodoidea (Tick=sengkenit, Ixodes sp.)
paralisis motorik
– Sarcoptoidea (Tungau)
• Sarcoptes scabei
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Sarcoptes scabiei var. hominis
• Class Arachnida
• Subclass Acari
• Family Sarcoptidae.
• Human itch mite
• Burrow into the upper layer of the skin but never
below the stratum corneum.
• The burrows: tiny raised serpentine lines that are
grayish or skin-colored and can be 1 cm or more
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• Transmission
– Commonly by the transfer of the impregnated
females during skin-to-skin contact.
– Occasionally transmission may occur via fomites
(e.g., bedding or clothing).
• Predilection:
– Often between the fingers and on the wrists.
• Epidemiology:
– Worldwide, affecting all races and socioeconomic
classes in all climates.
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Life cycle
• 4 stages: egg, larva, nymph & adult
• Females deposit 2-3 eggs/day
• Larva migrate to the skin surface & burrow into the
intact stratum corneum to construct almost invisible,
short burrows (molting pouches)
• Larva then molt to nymph
• After 3-4 weeks nymph change to adult
• Mating occurs after the active male penetrates the
molting pouch of the adult female .
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Life span: 1-2 months
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• Mating only once and leaves the female fertile for the rest of
her life.
• Impregnated females leave their molting pouches and wander
on the surface of the skin until they find a suitable site for a
permanent burrow & lay eggs
• While on the skin’s surface, mites hold onto the skin using
sucker-like pulvilli attached to the two most anterior pairs of
legs.
• Female remains in the skin & continues to lengthen her
burrow and lay eggs for the rest of her life (1-2 months).
• 10% of her eggs eventually give rise to adult mites.
• Males are rarely seen; they make temporary shallow pits in
the skin to feed until they locate a female’s burrow and mate.
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Morphology
• Eggs: Oval, 0.10-0.15 mm
• Larva: Has 3 pairs of legs
• Nymphs: 4 pairs of legs .
• Adults
• Round, sac-like eyeless mites.
• Females are 0.30-0.45 x 0.25-0.35 mm
• Males are slightly more than half that size.
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Clinical Features
• Primary infection: Symptoms may
not appear until 2 moths
• Secondary infection: Symptoms
generally occur within 1 to 4
days.
• Mites under the skin cause a rash
• Predilection: Most frequently
found on the hands, between the
fingers; the folds of the wrist,
elbow or knee; the penis; the
breast; and/or the shoulder
blades.
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• Predilection
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• Scabies rash: may be seen in
buttocks, scapular region and
abdomen but without mites
(result of sensitization from a
previous infection.
• Severe itching: especially at night
and frequently over much of the
body, including areas where mites
are undetectable, is the
most-common symptom of
scabies
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Norwegian scabies
• A severe form
• More common among
immunocompromised & elderly
• Characterized by vesicles and
formation of thick crusts over the
skin, accompanied by abundant
mites but only slight itching.
Complications due to infestation
are usually caused by secondary
bacterial infections.
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Diagnosis
Clinical:
– Appearance and distribution of the rash and the presence
of burrows.
Skin scraping:
– Should be made at the burrows
– To isolate the mites, ova or its feces
Skin pricking:
– To extract mites from open burrow
– Use a needle to prick burrow toward the end where the
mite is living
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Treatment
Topical:
• Treatment of choice: Permethrin cream (5%) topical.
• Alternative: Crotamiton and ivermectin
• Lindane lotion (1.0 %), not recommended as a first-line therapy
• Restricted to patients who have failed treatment with, or cannot
tolerate
Oral:
• Ivermectin for crusted scabies immunocompromised persons; a
second dose is taken two weeks later.
Other:
• All clothes, bedding, and towels used of infested person should
be washed in hot water, and dried in a hot dryer.
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Laboratory Diagnosis
• Skin scraping:
– Location: at the burrows between the fingers or the folds of
the wrist. Best performed at the end of the burrows in non-
excoriated and non-inflamed areas
– Use a sterile scalpel blade containing a drop of mineral oil.
– Adherence of the mites to the blade transferred to a glass
slide
– Add 1-2 drops of mineral oil to the slide
– Coverslip for microscopic examination
• Skin Prick: open the burrow with a needle and working it
toward the end where the mite is living
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Class Insecta
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Diptera
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Diptera-mosquitoes
• Long proboscis
• Specific wing venation
• Male do not suck blood
• Female mostly need
blood meal for egg
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Culidae
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Mosquito life cycle
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Characteristic
Anopheles Aedes Culex Mansonia
Disease Malaria DHF, Chikunguya Japanese encephalitis Filariasis
(elephantiasis)
Agent Plasmodium spp. Dengue virus, JE virus W. Bancrofti
Chikunguya virus B. malayi
Resting Make angle to Paralel to wall Paralel to wall Paralel to wall
position wall
Palpi:
Male Long, tip enlarge Long as proboscis Longer than proboscis Long as proboscis
Female Long Short Short
Larva No siphon Short, tick siphon Long, slender siphon Short, piercing type
Paralel to surface Angle to surface Angle to surface On water plan
Pupa Short trumpet Medium trumpet Long trumpet Piercing trumpet
Water surface Water surface Water surface On water plan
Egg Water surface Container wall Water surface On water plan
arrangement Soliter Soliter Raft Rosette
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Diptera flies
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Important flies
• House fly
• Black fly
• Tze tze fly
• Sand fly
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Flies-Simulidae (Black flies)
• Has 3 genera, 41 subgenera
& several hundred species
• Small stout bodied, humped
back, short legs, conspicuous
eyes (holoptic in male and
dichoptic in females)
• Lay eggs at / just below
water level in a non pollutant
running water (stream, water
falls, river)
• Vectors of Onchocerca spp
(river blindness) in man and
animal
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• The saliva contains anticoagulants
• Simulium bites can cause localized tissue damage
• Can cause anaemia if the number of feeding flies is
sufficient
• The host’s reaction to fly attacks may include systemic
illness, allergic reactions or even death, presumably
mediated by histamine.
• The systemic reaction is known as “black fly fever”,
characterized by headaches, fever, nausea, adenitis,
generalized dermatitis, and allergic asthma.
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Agent of Myasis
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• The larvae feed in a subdermal cavity for 5-10 weeks,
breathing through a hole in the host's skin.
• larvae may migrate from the subdermis to other
tissues in the body, often causing extreme damage in
the process.
• Mature larvae drop to the ground and pupate in the
environment.
• After 1 month: the adults emerge to mate and repeat
the cycle.
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Life cycle
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Morphology
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Clinical Features
• D. hominis: cutaneous swellings that may produce
discharges and be painful.
• C. hominovorax: causes wound myiasis, can be more
serious, as this species may travel through living tissue
in the body
• Oestrus ovis: ophthalmomyiasis
• Phormia and Phaenicia: facultative myiasis, where
adult flies lay their eggs in pre-existing, festering
wounds and do not invade healthy, living tissue.
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• Laboratory Diagnosis:
– Larvae in tissue.
– Travel history can also be helpful for genus or
species-level identification.
• Treatment:
• Removal of the larvae from tissue.
• Heavy infestations of C. hominovorax: surgery if
the larvae have migrated beyond subdermal tissue
• Antibiotic for secondary bacterial infections
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Siphonaptera
(kutu binatang, flea, pinjal)
Host Disease Vector of
Xenopsylla No No Yes
cheopsis
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Phthirus pubis
• Cause by pubic or crab louse
• Belongs to ordo Psocodea
• Ectoparasite
• Host: Only humans
• Have three stages: egg (laid on a hair shaft),
nymph and adult.
• Geographic Distribution: worldwide.
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• Females will lay app. 30 eggs during
their 3-4 week life span.
• After a week eggs hatch and become
nymphs
• Nymphs undergo 3 molts before
becoming adults .
• Adults are found only on the human
and require human blood to survive.
• Die within 24-48 hours without a
blood feeding.
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Morphology
• Adult
—1.5-2.0 mm long and are dorsoventrally-flattened.
—The second and third legs have a large modified claw with
a thumb-like projection, used for grasping on to hair
shafts.
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• Clinical Features:
– Mostly asymptomatic
– A tickling feeling of something moving in the hair,
– Itching (allergic reaction to louse saliva) and irritability.
– Pruritis may be very intense
– Discoloration of the skin for an extended length of time.
• Modes of Transmission:
– Commonly person to person by sexual contact with
someone who is already infested.
– Fomites (bedding, clothing) is rare.
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• Laboratory Diagnosis:
– Finding a live nymph, adult louse, or a nit on the
hair of a person
– Usually in pubic or perianal area. May also be
found on armpit, moustache and chest hairs.
• Treatment:
• Requires using either a prescription or an
over- the-counter (OTC) medication
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Pediculus humanus capitis
• Ectoparasite
• Cause a head louse
• Belongs to order Psocodea
• Host: only humans.
• Feeds on blood several times daily and resides close to
the scalp to maintain its body temperature.
• Geographic Distribution:
–Worldwide.
–Preschool and elementary-age children (3-11)
–Females are infested more often than males, through
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Life Cycle
• Has 3 stages: egg, nymph, & adult.
• Eggs take 6-9d to hatch
• Nymph mature after three molts
and become adults 7 days after
hatching.
• Adult can lay up to 8 nits/day
• Lifetime: 30 days on a person’s
head.
• Need to feed on blood several times
daily.
• Die within 1-2 days without blood
meals
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Eggs:
• Called nits
• Hard to see, are often confused for
dandruff or hair spray droplets.
• Are cemented at the base of the hair
shaft nearest the scalp
• Size 0.8 x 0.3 mm, oval and usually
yellow to white.
• Viable eggs are usually located within 6
mm of the scalp.
• Egg hatches to release a nymph
• Nit shell remains attached to the hair
shaft.
Nymphs: Looks like an adult but is about
the10/3/2019
size of a pinhead. S.Wahyuni/Parasitology 64
Adults:
• Size of a sesame seed, females >
males
• Has 6 legs (each with claws)
• Grayish-white .
• In persons with dark hair, the adult
louse appear darker.
• Can lay up to 8 nits/day.
• Can live up to 30 days
• Need to feed on blood several times
daily.
• Die within 1-2 days without blood
meals
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Clinical Features:
• Commonly are asymptomatic.
Modes of Transmission:
• Commonly head-to-head contact with a person who is already
infested
• Less commonly, via fomites may occur
Laboratory Diagnosis:
• Finding a live nymph or adult louse on the scalp/ hair
• Finding numerous nits within 6 mm of the scalp is highly
suggestive of active infestation.
• Finding nits only more than 6 mm from the scalp is only
indicative of previous infestation.
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Hemiptera
(Kutu busuk, Bugs)
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Bed bugs
• Causal Agent:
– Cimex lectularius
– Cimex hemipterus.
• Geographic Distribution:
– Cimex lectularius is cosmopolitan
– C. hemipterus is distributed in the tropics
and sub- tropics.
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• Adults & nymphal stages
need warm blood meals
• Take 5-10 m to obtain a full
blood meal
• Female lay egg 5/day
• Mating: male penetrates
the female’s abdominal wall
with his external genitalia &
inseminates into her body à
‘traumatic insemination’
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Morphology
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• Clinical Features:
– Inflammation associated with their bites (allergic
reactions to their saliva).
• Laboratory Diagnosis:
– Identification of adults or nymphs collected in
sheltered areas near where the patient was bitten.
– Bed bugs possess stink glands & emit a distinctive odor
• Management:
usually self-limiting
eliminate the source of the bed bugs
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