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in Respiratory System
Transverse sections of
Ascaris larvae in
pulmonary alveoli
Ascaris lumbricoides
Adult phase:
Malnutrition, Impaired Physical Growth
Mild abdominal discomfort Small bowel obstruction
(in children, few as 60 worms)
Wandering ascaris: biliary tract obstruction, cholangitis,
pancreatitis, liver abscess
TELUR
UKURAN : 80-118 X
48-60 m
BENTUK : LONJONG
OPERKULUM :
KECIL RATA (AGAK
TERTEKAN KE DALAM
TELUR BERISI SEL-SEL GRANULA
Paru dengan P.westermani
PARAGONIMIASIS PARU
Paragonimiasis paru, Ro
DAUR HIDUP Paragonimus westermani
Distribusi geografis Paragonimiasis
GEJALA KLINIK
Batuk kering sampai batuk berdahak
Hemoptysis
Nyeri di paru, pleuritis
Demam ringan
Kista di abdomen: nyeri perut,
distended, diare berdarah
Kista di otak : epilepsi, paresis
Lung Flukes:
Paragonimus westermani
Prepared by FZHapan
Lung Flukes:
Pathogenesis and Clinical Manifestations
Paragonimiasis
Cough
Hemoptysis
Symptoms consistent
with pulmonary
tuberculosis
Misdiagnosed as PTB
Prepared by FZHapan
Lung Flukes:
Diagnosis of Paragonimiasis
Radiographs aid in
diagnosis
Definitive diagnosis is
based on the finding of
ova in the sputum, stool
or less frequently in
aspirated material from
abscesses or pleural
effusions
Multi-dot ELISA
Prepared by FZHapan
Lung Flukes:
Treatment of Paragonimiasis
Praziquantel
Drug of choice
25 mg/kg body weight
3x a day for three day
Bithionol
15 25 mg/kg / day
on alternate days for
a total of 10-15 days
Prepared by FZHapan
Lung Flukes:
Epidemiology of Paragonimiasis
Has a global distribution
In the Philippines
Leyte
Sorsogon
Mindoro
Camarines
Samar
Davao
Cotabato
Basilan
Prepared by FZHapan
Pathology and Symptomatology
Adults inhabit lungs, although other organs are
also involved.
Pathological lesions may be classified into 4
stages:
(1)Invading and migrating stage: After excystation
the adolescents penetrate the intestinal wall and migrate to
the lungs.
(2) Suppurative stage. The bleeding and infiltration of
neutrophils and eosinophils surrounding worms form a
capsule, abscess.
(3) Cystic stage, the cyst wall is formed due to the
progressive fibrosis of the surrounding tissue. The
cystic contents are chocolate or rusty thick fluid with
eggs and Charcot-Leyden crystals, which looks like
sesame paste.
(4) Fibrous-scar stage, the worms are dead or
escape from the cyst. The exudate and pus are
expelled or absorbed and replaced by fibrous-scar
tissue.
Clinical manifestation:
Paragonimiasis may be classified into 4 types :
(1)Pulmonary type: the symptoms resemble
pulmonary tuberculosis with low fever, loss of
appetite, night sweating, chest pain, loss of weight
and rusty sputum.
(2) Brain type: manifests epilepsy, hemiplegia,
monoplegia,aphasia, visual disturbence and resembles
cerebral cysticercosis
(3)Abdominal type: abdominal paindiarrhea or
dysentery with blood, mucus and ova in feces.
(4)Subcutaneous type: the wandering and
painless subcutaneous nodules.
Pneumocystis carinii
rRNA sequences
thymidylate synthase
dihydrofolate reductase
beta tubulin
mitochondrial DNA
chitin in the cell wall
Legend: A silver stain of P. carinii cysts from rat lung tissue showing the typical 'deflated ball' shape.
Pneumocystis carinii
http://www.doctorfungus.org
Legend: An electron micrograph of a P. carinii troph from rat lung tissue, showing its binding
to a type I pneumocyte.
Four drugs currently available for therapy of P
carinii pneumonitis are:
pentamidine isethionate
trimethoprim-sulfamethoxazole
atovaquone
trimetrevate
Trimethoprim-sulfamethoxazole is
preferred because of its low toxicity
and greater efficacy.
Normal Chest X-Ray
Courtesy of Up To Date
What is pneumonia?
Infection of the lung
parenchyma
Causative agents
include bacteria,
viruses, fungi
www.netmedicine.com/xray/xr.htm
PCP PCP
www.netmedicine.com/xray/xr.htm
Information obtained from: