Fasciolopsis Echinostoma

Fasciola sp. Clonorchis Paragonimus

Schistosomes
buski ilocanum Fasciola Fasciola sinensis westermani Schistosoma Schistosoma Schistosoma
hepatica gigantica japonicum mansoni haematobium
Common Giant Intestinal Garrison’s Sheep Liver Giant Liver Chinese Liver Oriental Lung Oriental Blood Manson’s Vesical Blood
Name Fluke Fluke Fluke Fluke Fluke Fluke Fluke Blood Fluke Fluke
1st Intermediate Snail Gyraulus Snail Snail Snail Onchomelania Biomphalaria Bulinus &
Host -Segmentina sp. convexiusculus - Lymnea philippinensis - Bulinus - Brotia & Australorbis Physopsis
-Hippentis sp. & Gyraulus fuchsiana asperata
prashadi
2nd Freshwater Kuhol Blades of grass and water plants Fish Talangka
Intermediate vegetation - Pila luzonica (watercrest and kangkong) - - Sundathelpusa
Host -seed pods of Susong pampang Ctenopharyngod philippina /
water caltrop: - Vivipara onn idellus Parathelpusa
Trapa bicornis or angularis grapsoides
Trapa nutans Clam
-bulb of a - Corbicula sp.
freshwater
chestnut:
Eleocharis
tuberosa
Mode of Ingestion of Ingestion of - Ingesion of metacercariae Ingestion of raw Ingestion of raw
Transmission encysted metacercariae - Drinking of water with or undercooked or insufficiently
metacercariae on from 2nd floating metacercariae fish and salted cooked crabs
Skin penetration of cercariae
aquatic plants intermediate host dried fish harboring the
harboring the metacercariae
metacercariae
Habitat Small intestine Small intestine Small intestine Biliary duct Small intestine Superior Mesentric Vesicle and
mesenteric veins veins of colon pelvic plexus of
of the small and rectum the venous
intestine circulation;
urinary bladder
Infective Stage Metacercariae Metacercariae Metacercariae Metacercariae Metacercariae Cercariae – bifid tails (forked)
Diagnostic Unembryonated Unembryonated Unembryonated eggs Embryonated Unembryonated Embryonated eggs
Stage egg eggs eggs eggs
Pathology Fasciolopsiasis: Echinostomiasis: Fascioliasis: Fascioliasis: Clonorchiasis: Paragonimiasis: Katayama’s Swimmer’s Bilharziasis
traumatic, inflammation at acute or acute or intense cough, Disease itch (bloody urine)
obstructive, toxic the site of adult invasive phase, invasive proliferation of hemoptysis,
attachment, chronic or phase, chronic intestinal pulmonary TB Distended belly
ulceration, latent phase or latent phase epithelium symptoms,
diarrhea Acute stage: <1 misdiagnosed as
 (sometimes causes month of PTB
bloody), halzoun infection, chills
abdominal pains (pharyngeal and fever
infection)
Chronic stage:
cirrhosis, portal
hypertension
Diagnosis Detection of Detection of Detection of parasite Detection of Radiographs, Embryonated egg Embryonated Embryonated
parasite parasite unembryonated eggs in stool parasite ova in sputum, in feces and urine egg in feces egg in feces and
unembryonated unembryonated embryonated stool or less urine
eggs in stool eggs in stool eggs in stool frequently in
aspirated
material from
abcesses or
pleural effusions
Treatment Praziquantel Praziquantel Bithionol Bithionol Praziquantel Praziquantel
- 25mg/kg for 3 - 25mg/kg for 3 - 30-50mg/kg on alternate days - 20-50mg/kg - 25mg/kg for 3 - single dose of 40-50mg/kg
doses for one day doses for one for 10-15 days body weight on doses for one - 25mg/kg in two doses
day alternate days to day - 20mg/kg in three doses
complete 10-15 Bithionol
doses - 15-25mg/kg
Triclabendazole per day on
- recommended alternate days
drug due to for a total of 10-
efficacy, safety 15 days
and ease of use
Morphology

Fasciolopsis Echinostoma
Fasciola sp. Clonorchis Paragonimus
Schistosomes
buski ilocanum Fasciola Fasciola sinensis westermani Schistosoma Schistosoma Schistosoma
hepatica gigantica japonicum mansoni haematobium
Adul GENERAL Largest among Temperate Tropical liver Narrow, Reddish Dioecious, “most romantic”: lateral margins of
t CHARACTERISTIC trematodes, 20- liver fluke fluke, large, oblong brown, males are folded ventrally to form a gynecophoral
S 75mm length & lanceolated “coffee-bean canal where the females are received during
8-20mm width, shaped”, found copulation
no cephalic in pairs or in
cone threes in
fibrotic
capsules or
cysts in lungs
 Cephalic Cone Conical Conical
projection projection,
less
developed
(shorter)
Shoulders
Intestine Simple or Simple Highly Highly Simple or
unbranched branched branched unbranched
(dendritic) (dendritic)
Oral Sucker Surrounded Small oral Large ventral Bigger
with circum and ventral sucker
oral disk with suckers
collarette of
spines (49-51)
Testes Lobed Branched
Ovary Lobed
Egg GENERAL Mistakenly Looks like “hen’s egg” “hen’s egg” Small, does May be seen in Fully Fully Fully
DESCRIPTION identified as Fasciola egg not hatched sputum or in embryonated embryonated embryonated
Fasciola egg, (but smaller) in water feces (when when laid when laid when laid
Diagnostic sputum is
stage, swallowed)
Unembryonated
when laid
UNIQUE With “germ With large With large Lateral knob Lateral spine Terminal spine
CHARACTERISTIC ball” egg mass of yolk mass of yolk
inside cells cells
Color Yellow brown Straw-colored Dark brown
Shape Oval with a Oval with a “old- Oval “bottle-neck” “bottle-neck” “bottle-neck”
rounded rounded fashioned
posterior end posterior end electric
bulb”,
“pitcher-
shaped”
Operculum operculated Dot-like operculated Flattened
Abopercular With Thickened
abopercular abopercular
thickening end
(comma-
shaped)