PARASITE INFECtIVE EGGS ADULT LAB DIAGNOSIS

STAGE

Egg Size range: F. buski, 128-140 µm by F. Hepatica – Comparable to the Stool – Specimen of choice
78-85 µm size of buski 3 by 1 cm ( same size)
Fasciolopsis buski F. hepatica, 128-150 µm by 60-90 µm F hepatica – has shoulders Fasciolopsis Buski – speciation
Shape: Somewhat oblong F. buski – no shoulders Fasciola Hepatica – Enterotest,
Egg contents: Undeveloped miracidium ELISA, Gel diffusion
Other features: Presence of a distinct
operculum

Fasciola hepatica

Egg Average size: 30 by 15 µm Size: 2 by 0.5 cm Stool – Specimen of choice

Clonorchis sinensis
Egg contents: Developed miracidium
Operculum: Present
Other features: Presence of distinct
Shoulders and presence of small knob
opposite operculum
*end of the adult worm is *may also use duodenal
narrower than the midportion Asperates
of the body
Enterotest
Surgery or autopsy – Rare

Egg Average size; 30 by 15 µm Heterophyes Stool – Specimen of choice

Heterophyes heterophyes
Metagonimus yokogawai
Egg contents: Developing miracidium
Operculum: Present
Shoulders : Present but discrete
Small knob: May be absent
Shell thickness: Heterophyes, thick;
Metagonimus, thin
Small 1.0 by 0.5mm
Shape: Pyriform , Microscopic examination
Grayish in color (careful)
fine spines that is scaly
*difficult to achieve because the
Metagonimus eggs of chlonorchis, heterophyes,
Small 1.5 by 0.5mm and metagonimus is so similar
Shape: Pyriform with tapering at the
anterior end and rounding at the
posterior
Tiny layer of scaly spines (covering)
That is heavily distributed in the
Anterior end
 PARASITE INFECtIVE EGGS ADULT LAB DIAGNOSIS
STAGE

Egg Size range: 78-120 µm long; 45-60
µm wide
Shape: Somewhat oval
Egg contents : Undeveloped
Paragonimus westermani miracidium surrounded by a thin,
smooth shell
Other features: Prominent
operculum with shoulders; obvious
terminal shell thickening opposite
operculum
Size: 1 by 0.7cm
Shape: typical somewhat oval
Color: Red to brown
Cuticle: posseses Spines
(similar to adult trematodes)
SPUTUM – specimen of choice
*eggs commonly found in
bloody samples
Stool samples- occasionally
found (when sputum is
swallowed)
Serologic test
 PARASITE LIFE CYCL;E NOTES EPIDEMIOLOGY CLINICAL SYMPTOMS TREATMENT&

PREVENTION

Ingestion of raw Intermediate host: Snail
infected water plants
F. buski – areas from far east
F. buski (China, Thailand , Taiwan ,
- adult worm reside in Vietnam, India and Indonesia)
Small intestine Reservoir hosts - rabbit, pigs ,
Fasciolopsis buski Dogs
F. hepatica Food sources: water chesnut,
- adultworm resides in lotus and water caltrop
Bile ducts (biliary tract)
F. hepatica- worldwide
Natural host: Sheep
Accidental host: Human
Fasciola hepatica
Fasciolopsiasis
 Abdominal discomfort  Praziquantel
 Inflammation & bleeding  Dichloropheno (bithionol)
of affected area
 Jaundice  Triclabendazole
 Diarrhea - More effective;
 Gastric discomfort not available in US
 Edema
 Malabsorption syndrome
 Intestinal obstruction
 Death (rare) PREVENTION:
- Proper fecal disposal
Fascioliasis - Proper sanitation
 Headache, fever, chills - Controlling snail
 Pains in the liver area
population
 Pain in shoulders and back
 Eosinophilia - Avoiding human
 Jaundice consumption of raw
 Liver tenderness water plants or
 Anemia
contaminated water
 Diarrhea
 Digestive discomfort
 Biliary obstruction

Endemic in Far east  Asymptomatic  Praziquantel

Ingestion of undercooked (China, korea , Taiwan ,
fish contaminated with Vietnam, and japan)
Encysted metacercariae *more than 35 million people
Clonorchis sinensis
are infected
Fluke takes place in Liver * the number has tripled to
Worms resides the 15M in china last decade
Bile duct Reservoir host: Fish-eating
mammals, dogs, and cats
 Increase lead to
aquaculture
 Chlonorchiasis  Albendazole
- Fever
- Abdominal pain
- Eosinophilia PREVENTION:
- Diarrhea - Proper sanitation
- Anorexia - Proper fecal disposal
- Epigastric discomfort
- Avoid ingestion of
- Occasional jaundice
- Enlargement & tenderness of liver raw, undercooked or
- Leukocytosis freshwater fish or shrimp
- Liver dysfunction
 PARASITE LIFE CYCL;E NOTES EPIDEMIOLOGY CLINICAL SYMPTOMS TREATMENT&

PREVENTION

Heterophyes:  Asymptomatic  Praziquantel

Ingestion of Parts of Africa
undercooked Near east and far east
contaminated fish ( Taiwan, Philppines, Korea,
Heterophyes heterophyes japan , Israel, Egypt
Adult worms resides in (lower nile valley)
Small intestine Harbors: wild and domestic
animals (fish- eating mammals)
Metagonimus yokogawai
Metagonimus:
(Japan, Siberia, China,
Philippines, Spain, Greece and
Balkans)
Harbors: Dogs, cats, hogs, and
fish-eating birds (pelicans)
 Heterophyiasis / Metagonimiasis
- Abdominal pain PREVENTION:
- Abdominal discomfort - Proper sanitation
- Chronic mucous
- Proper fecal disposal
Diarrhea
- Eosinophilia - Avoid consuming
*eggs of both organisms- undercooked fish
escape in venules and - Halting or control
lymphatics via intestinal wall the population of the
penetration Hosts such as (snails)
- they migrate in diff. areas
of the body like Heart or Brain
 Granulomas

 Paragonimiasis  Praziquantel
Ingestion of Asia, Africa, India and South (pulmonary distomiasis)  Bithionol
undercooked crayfish America - Pulmonary discomfort (alternative)
or crabs and - Cough, fever, chest pain
fresh water products Reservoir hosts: Pigs, Monkeys - Increased production of
And othe animals whose diet is blood-tinged sputum PREVENTION:
- Immature flukes crayfish - Chronic bronchitis - Avoid eating
Paragonimus westermani migrate thru the - Eosinophilia Undercooked crayfish
intestinal wall thru - Production of fibrous and crabs
peritoneal cavity into Tissue ( seen in patient w/TB) - Exercising proper
the diaphragm and disposal of human
finally into lung tissue  Cerebral Paragonimiasis
waste products
- Seizures
They aklso migrate to - Visual difficulties
the other parts of the - Decrease precision of
boy such as motor skills
brain or liver .