KUNWOR, BISHAL SGD: 8 SECTION: A2

PARASITOLGY LABORATORY

EXERCISE 9

OBSERVATIONS

Draw and label. 15 pts

a. Schistosoma Mansoni Ova

b. Schistosoma japonicum Ova

c. Schistosoma haematobium Ova

d. Fasciola hepatica Ova

e. Fasciolopsis buski Ova

f. Clonorchis sinenses Ova

g. Paragonimus westermani Ova

h. Heterephyes heterophyes Ova

i. Metagonimus yokogawai Ova

STUDY GUIDE QUESTIONS

1. Discuss the generalities of the clinical disease caused by trematodes. 5 pts

Ans: Clinical manifestations of trematode infection vary by species. Symptoms
Depends on the area of infection such as intestinal species infects intestine
and gastrointestinal symptoms; Liver species infects liver and symptoms are
manifested accordingly. Disease name is given behind the name of parasite
infecting. Example: Disease associated with Fasciola is called Fascioliasis, like
wise associated with Schistosoma is Schistosomiasis.
In general symptoms associated with trematode infections are eosinophilia
(increase in number of eosinophils, a leukocyte); tissue damage, jaundice,
diarrhea, Malaise (feeling of overall weakness) and so on.

2. Which liver fluke is associated with cholangiocarcinoma? Explain its

pathogenesis. 5 pts
Ans: Cholangiocarcinoma is bile duct cancer and two trematodes are related
to it Opisthorchis viverrini and Clonorchis sinensis. The pathogenesis of
Clonorchis and opisthorchis related cholangiocarcinoma are bulleted below in
a progressive order:
➢ Chronic inflammation and irritation cholangiocytes (bile duct epithelial
cells) results in hyperplasia and adenomatous change.
➢ Hyperplastic cells are susceptible to carcinogens which induces DNA
damage during active cell proliferation.
➢ Liver fluke infection results in endogenous formation of N-nitroso
compounds around the bile ducts, which in turn may lead to neoplastic
transformation.
➢ Macrophages and other inflammatory cells are activated by parasite
specific T-cells which synthesize nitric oxide, a potential carcinogen.

These mechanisms are responsible for the carcinogenesis process and

result in cholangiocarcinoma.
3. What are the different laboratory techniques for the diagnosis of
schistosomiasis? 5 pts
Ans: The different laboratory techniques for the diagnosis of schistosomiasis
are following:
a. Schistosoma haematobium
➢ Urine microscopy→ detection of terminal spined eggs.
➢ Histopathology of bladder mucosal biopsy →detection of terminal
spined eggs.
➢ Antibody detection (serum)→HAMA-FAST ELISA, HAMA-EITB, IFA, IHA
and cercarial Huller reaction.
➢ Antibody detection (serum and urine)→ CCA and CAA detection by
ELISA or dip stick assay
b. Schistosoma mansoni and Schistosoma japonicum
➢ Stool microscopy→ detect egg with lateral spine
➢ Rectal biopsy
➢ Antigen (such as CCA, CAA, SEA) detection
➢ Antibody detection (ELISA, EITB)

4. What external structure differentiates the adult Echinostoma from the other
flukes? 5 pts
Ans: Adult Echinostoma worms are reddish gray and they measure about less
than 2 cm long. They have oral sucker on anterior end surrounded by crown
of spines. And ventral sucker is present at anterior fifth of body.

5. What is the Heterophyid species that is common in Mindanao? Give its

complications. 5 pts
Ans: Haplorchis taichui is common heterophyid species in Mindanao. The
complication of infections are as follows:
➢ Peptic ulcer disease
➢ Abdominal discomfort/pain
➢ Gurgling Abdomen
➢ Colicky abdominal pain
 ➢ Mucoid diarrhea
➢ Heart failure
➢ Intracerebral hemorrhage
➢ Eggs in spinal cord can result in loss of motor and sensory function at the
level of lesion

6. Illustrate the life cycle of Heterophyids, Fasciola, Schistosoma, and Clonorchis.

10pts

Heterophyids
5
Host becomes infected
Cercariae penetrate the by ingesting undercooked
skin of fresh/brackish a 4 fish containing
water fish and encyst as
metacercariae in the
metacercariae 6
tissue of the fish Metacercariae excyst
in the small intestine

8
Cercariae released
3 from snail
Fish-eating mammals
and birds can be
infected as well
2 7
Snail host ingests eggs.
miracidia emerge from Adult in small intestine
eggs and penetrate the
snail's intestine.

= Infective stage
Embryonated eggs each with
= Diagnostic stage 1 a fully-developed miracidium
are passed in feces.

Figure 1: Life cycle of Heterophyids Inside snail host, miracidia

emerge from the egg and develop into sporocysts,
Rediae and cercariae progressively
 FASCIOLA
5
6
4a 4b 4c
Sporocysts Rediae Cercariae
Free swimming
cercariae encyst on
Metacercariae
on vegetation
aquatic vegetation. ingested by definitive
host. 7
Immature flukes excyst
in duodenum, penetrate
Development in snail tissue intestinal wall, and migrate
through liver parenchyma to
biliary ducts.

Miracidia penetrate snail

4 intermediate host.

Miracidia hatch
3 from eggs, seek out
snail intermediate host.
8
Eggs become Adult fluke in hepatic

= Infective stage
2 embryonated in
water.
biliary ducts
Unembroynated eggs
are passed in feces.
= Diagnostic stage 1

Figure 2: Life cycle of Fasciola

 Schistosoma

5 6
Free-swimming Cercariae
cercariae released penetrate
from snail into water
4Sporocysts develop skin
7
in snail (successive
Cercariae lose tails during
generations) penetration and become
schistosomulae

3 Circulation 8
Miracidia penetrate
snail tissue Migration to portal blood
in liver and maturation
1 into adults
9
2 Eggs shed from
infected human
Eggs hatch and
release miracidia
10
Paired adult wormt
S. iaponirum

S. mansoni S. haematobium

= Infective stage

= Diagnostic stage

Figure 3: Life cycle of Schistosoma

S. Mansoni & S. japonicum adults migrate into Mesenteric venules of
bowel/rectum (laying eggs that circulate to the liver and shed in stools)
S. haematobium adult migrate into Venous plexus of bladder (eggs
shed in urine)
 = Infective stage
Clonorchis
= Diagnostic stage

Metacercariae in flesh
4 or skin of fresh water
fish are ingested by
the definitive host.

5
Free-swimming cercariae
3 encyst in the skin or flesh
Excyst in
duodenum
of freshwater fish.

Eggs ingested by
2 the snail
intermediate host.
6

Sporocyst Embryonated eggs Adults in biliary duct

Miracidia 2b Rediae Cercariae passed in feces. of definitive host.
2c 2d 1
2a

Figure 4: Life cycle of Clonorchis