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PARASITES CAUSING DIARRHOEA
No. ID 10-3-166 Name Dr Muhammad Huzaifah Bin Hassan Topic Introduction of Parasites Causing Diarrhoea, Heterophyes Heterophyes, Diphylobothrium Latum Cestoidea : T. Saginata, T. Solium, H. Nana Ascaris Lumbricoides, Strongloides Stercolaris Strongloides Stercolaris (continued), Ancylostoma Duodenale Protozoa : Giardia Lamblia, Isospora Belli, Cryptosporidia

10-3-167

Dr Mohd Hafizuddin Bin Md Nasir

10-3-168 10-3-169

Dr Mohd Ridwan Shahputra Bin Shihabuddin Dr Muhammad Ridzwan Bin Abd Aziz

10-3-170

Dr Mohamad Zaimey Bin Zulmanaf

INTRODUCTION OF PARASITES CAUSING DIARRHOEA HETEROPHYES HETEROPHYES DIPHYLOBOTHRIUM LATUM

DR MUHAMMAD HUZAIFAH BIN HASSAN 10-03-166 ALEXANDRIA UNIVERSITY

PARASITES CAUSING DIARRHEA PARASITES CAUSING DIARRHEA HELMINTHS PROTOZOA TREMATODE CESTODE NEMATODE GIARDIA LAMBLIA HETEROPHYES HETEROPHYES DIPHYLLOBOTHRIUM LATUM HOOKWORMS ISOSPORA BELLI TAENIA SAGINATA ASCARIS LUMBRICOIDES CRYPTOSPORIDIA TAENIA SOLIUM STRONGYLOIDES STERCORALIS HYMENOLOPIS NANA .

5mm Covered externally by cuticle Have 3 Suckers(Oral.HETEROPHYES HETEROPHYES 1)MORPHOLOGY ADULTS • • • • Pale grey & pyriform Size:3mm x 0. Ventral & Genital) • Have 2 large oval testes • Has a coiled tube uterus • • • • EGG Size : 30 x 15µ Shape : Operculated Colour : Light Brown Content : Fully developed miracidium .

2)LIFE CYCLE OF HETEROPHYES • Infective Stages : Infective encysted metacercariae • Method of infection : Eating of the imperfectly cooked or undersalted fish • Diagnosis : Presence of eggs in stools .

Avoid eating undersalted fish .3)TREATMENT -Praziquantel -Niclosamide -Paparazine 4)PREVENTION &CONTROL .Governmental medical measures of water-feces contamination reduction .

DIPHYLOBOTHRIUM LATUM 1)MORPHOLOGY ADULTS • • • • • • • • • Long parasite may reach up to 10m Broader than long Has midventral genital pore Size: 4mmx12mm Testes are multiple and dorsolaterally located Vas deferens continue as a seminal vesicle. rising from the ootype and open into uterine pore • • • • EGG Size : 65 x 45µ Shape : Ovoid & Operculated Colour : Yellowish brown Content : Unembryonated eggs . then a cirrus. then open into the common genital pore Ovary is oval & located posteriorly Vagina proceeds from the ootype into common genital pore Uterus is coiled rosette.

2)LIFE CYCLE OF DIPHYLOBOTHRIUM Infective stage : Fish containing plerocercoid larvae Method of infection : Eating of infected fish with plerocercoid larvae Diagnosis : Findings of characteristics eggs or segments in faeces .

3) TREATMENT -Niclosamide -Praziquental 4)PREVENTION & CONTROL -Treatment of infected person -Properly cooking of fish -Improve sewage system .

SYUKRAN JAZILAN .

CESTOIDEA : TAENIA SAGINATA TAENIA SOLIUM HYMENOLEPIS NANA DR MOHD HAFIZUDDIN BIN MD NASIR 10-3-167 ALEXANDRIA UNIVERSITY .

16-20mm long and 5-7mm wide • Whitish in colour • Embryonated egg.Tenia Saginata-Beef Tapeworm Morphology : • Scolex.quadrate in cross section. Size 35 micro-meter • Proglottid has blind tubular uterus. 1-2mm diameter.flat long segmented.no hooks • Proglottis. a bilobed ovary and the vagina with terminal sphincter. . walnut brown with 6-hooked oncosphere in shell.

Life-Cycle : .

Clinical Pictures : allergic reactions (rare) constipation diarrhea headache loss or gain of appetite nausea stomach ache decrease or increase weight Complication : -appendecitis or cholangitis due migrating proglottis .

Hygiene education . antibody detection methods can be used to find antibodies. by identifying eggs (rarely) or proglottids in the stool sample after three months Endoscopic examination Treatment : Preziquantel Niclosamide Prevention and Control : Cook above 60 °C or freeze below -18 °C for 5 days. Prevent cattle farm at places contaminated with human feces.Diagnosis : First three months.

Tenia Solium-Pork Tapeworm Morphology : • Scolex. 4 sucker and double row hook. • Proglottis.globular with rostellum. a trilobed ovary. •Gravid uterus contains 7-13 lateral branch on each side •Egg same with tenia saginata . •Proglottid has.flat long segmented. 7 m long.

Life-Cycle : .

Clinical Pictures : Muscle Cysticercosis symptoms : -Lumps under skin Eye cysticercosis symptoms : -Blurry vision -Disturbed vision -Retinal swelling -Retinal detachment Neurocysticercosis symptoms : -Seizures -Headaches -Confusion -Lack of attention to people and surroundings -Difficulty with balance .

Diagnosis : stool sample Endoscopic examination Treatment : Preziquantel Niclosamide .

walnut brown with 6-hooked oncosphere in shell.20-60 mm long and 1 mm wide with long and slender neck • Embryonated egg.Hymenolepis Nana-Dwarf Tapeworm Morphology : • Scolex.rhomboidal with 4 sucker and short rostellum of 30-30 spines in single row • Proglottis. colorless 40 micron diameter and 2 thin shell . small lobed ovary and uterus occupy the middle part of segment •Eggs oval or spherical. Size 35 micro-meter • Proglottid has 3 globular testis situated in one line.

Life-Cycle : .

dizziness. Complains of headache.Diagnosis : -Stool sample -Endoscopic examination Treatment : -Preziquantel -Niclosamide Clinical Pictures : Usually asymptomatic unless on allergy people. anorexia.periodic diarhea and abdominal pain .

ASCARIS LUMBRICOIDES STRONGLOIDES STERCOLARIS DR MOHD RIDWAN SHAHPUTRA BIN SHIHABUDDIN 10-03-168 ALEXANDRIA UNIVERSITY .

Morphology -great size -largest and second most common parasitic worm in humans   Male   Female 2–4 mm in diameter  15–31 cm long  posterior end is curved ventrally  bluntly pointed tail 3–6 mm wide  20–49 cm long  straight posterior end .

ADULT MALE AND FEMALE WORM OF ASCARIS LUMBRICOIDES Fertilized egg of Ascaris Lumbricoides Unfertilized egg of Ascaris Lumbricoides .

Life cycle .

intestinal perforation etc. Effects of adult worms on host nutrition: Vitamin A and C deficiency . obstruction of bile duct.Pathogenesis • o o o • o o o • o Host immune response: Ascaris pneumonitis and aggregations of macrophages and epitheloid cells Eosinophilic infiltration and granulomatous reaction Fibrosis of periportal tracts in liver and interlobular spaces of lungs Mechanical effect of adult worms: Irritation Volvolus or intestinal obstruction Acute symptom e.g. liver abscesses.

Symptoms   In the lungs  In the intestines asthma or pneumonia  Vague abdominal pain  Persistent cough  Nausea and vomiting  Shortness of breath  Diarrhea or bloody stools  Wheezing In a heavy intestinal infestation • Severe abdominal pain • Fatigue • Vomiting • Weight loss • A worm in vomit or stool .

Diagnosis  Migratory Stage Larvae can be detected in gastric washing  X-ray show shifting mottled lung infiltration  Eosinophilia during tissue migratory stage   Intestinal Infection Finding ova in stool using concentration method  Radiological examination of abdomen  .

Treatment Albendazole  Mebendazole  Pyrantel pamoate (pregnant patient)  Endoscopy  Surgery (rare cases)  .

Prevention and control • • • • Improved sanitation and hygiene in developing countries will reduce the risk in those areas In areas where this disorder is common. routine or preventive (prophylactic) treatment with deworming medications may be advised Mass treatment of infected populations Measures to prevent environmental contamination with human feces .

5 mm with filariform oesophagus and the vuval opening Both genders possess a tiny buccal capsule and a cylindrical esophagus without a posterior bulb.STRONGYLOIDES STERCORALIS (MORPHOLOGY)  • Parasitic stage Male 0.9 mm in length with a curved tail and two spicules Female 2.0 to 2.   Free-living stage o o • o o • oesophagi of both sexes are rhabditiform  Males can be distinguished from females by two structures: the spicules and gubernaculum .

Presence of row of eggs within the female’s body Fertilized egg of S. Stercoralis . PRESENCE OF THE SPICULE (RED ARROW) Adult free-living female S.FREE-LIVING ADULT MALE S. STERCORALIS. stercoralis.

Life cycle .

STRONGLOIDES STERCOLARIS (continued) ANCYCLOSTOMA DUODENALE DR MUHAMMAD RIDZWAN BIN ABD AZIZ 10-3-169 ALEXANDRIA UNIVERSITY .

ulceration. melena. anemia) • VLMS .Pathogenesis & C/p • Cutaneous • Pulmonary • Intestinal (malabsorption with steatorrhea.

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Diagnosis
• • • • Stool Duodenal aspiration Sputum examination Blood picture (eosinophilia 10-40%)

Treatment and prevention
• • • • • Treat with: IVERMECTIN Sanitary disposal of human faeces Skin protection Health education Larvicidal to kill filariform in soil

ANCYLOSTOMA DUODENALE
• Morphology

Life cycle .

Pathogenesis and C/P • Cutaneous (ground itch) • Pulmonary (verminous pneumonia) • Intestinal(bleeding) GIT (polyphagia. mental retardation. butterfly pigmentation in face) . geophagia. colic. flatulence. stool becomes semi-formed reddish brown) Anemia & hypoproteinaemia Endocrine and nervous (somatic infantilism.

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Diagnosis • Stool (egg or worms) • Stoll’s egg counting technique to diagnose burden of infection .

Prevention and control • • • • • Treatment : mainly by Albendazole Sanitary disposal of human faeces Skin protection Health education Larvicidal to kill filariform in soil .

PROTOZOA : GIARDIA LAMBLIA ISOSPORA BELLI CRYPTOSPORIDIA DR MOHAMAD ZAIMEY BIN ZULMANAF 10-03-170 ALEXANDRIA UNIVERSITY .

Giardia Lamblia • Morphology .

Life cycle .

duodenal aspiration. malabsoprtion) • Diagnosis : Direct (stool examination. entero test capsule). symptomatic (diarrhoea.• Clinical picture : asymptomatic. Immunological (ELISA) .

• Treatment : Metronidazole (flagyl). Tinidazole (fasigyn) • Prevention and control : avoid human excreta as fertilizers. treatment of cysts passers .

Isospora Belli • Morphology .

Life cycle .

malabsorption • Diagnosis : Stool Examination (simple saline/Iodine smear. weight loss. abdominal colic. Zinc floatation. modified Ziehl Neelsen acid fast stain). Blood picture .• Clinical picture : Diarrhoea.

• Treatment : Co-trimoxazole • Prevention and control .

Cryptosporidia • Morphology .

Life cycle .

sputum examination . modified Ziehl Neelsen acid fast stain). entero capsule test.• Clinical picture : low grade fever. respiratory infection • Diagnosis : Stool examination (Formol Ether/Sheather’s sugar floatation. intestinal biopsy.

• Treatment : Nitazoxanide • Prevention and control : Personal hygiene. proper sanitation .

07/20/2009.cdc. [accessed at 20 May 2013] Module 18 Semester 6 2012-2013 Year 3. Giardia Lamblia. available from : http://www.gov/parasites/crypto/ [accessed at 15th May 2013] Parasites and Health:Heterophyiasis. Isospora Belli & Cryptosporidia.htm.dpd. available from : http://www. Pathobiology.07/20/2009.cdc. available from : http://www. [accessed at 20 May 2013] Parasites and Health: Diphylobothriasis. available from : http://www.References • Centers for Disease Control and Prevention : Parasites – Giardia.cdc. Phylum Sarcomastigophora.dpd. Faculty of Medicine-Alexandria University : Protozoal Intestinal Infection.gov/dpdx/HTML/heterophyiasis.gov/dpdx/HTML/diphyllobothriasis.htm.gov/parasites/giardia/ [accessed at 14th May 2013] • • • • Centers for Disease Control and Prevention : Parasites – Cryptosporidium (also known as “Crypto”). & Apicomplexa. page 38-94 [cited at 5th April 2012] . subphyla Mastigophora.cdc.