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Cysticercosis: the larva acquired by ova autoinfetion or regurgitation from the adult worm in the intestine ,may penitrate the stoamch wall & go to develop as cysts in muscles, skin&brain(epilepsy,hydrocephalus).
Diagnosis: ova in stool, CT & MRI for brain cysts,ELISA test for antibody detection.
Treatment of cysticercosis is by praziquantel or albendazole combined with prednisolone to prevent brain edema & antiepilepti drugs are given to prevent fits untill full recovery.
Acquired by ingesting ova passed with dogs(granulosus type) or wild animal faeces( foxes, wolves in multilocularis type) into green vegetables which develop into cysts in the liver, lungs, bones, brain or any other body sites .
The multilocularis type behaves as malignant disease.
Prevention: Treatment of Domestic dogs, washing of vegetables.
Diagnosis: chest X ray, U/S, CT, MRI to detect cysts in tissues, CF test & ELISA to detect parasite antigenes.
One of the most common causes of morbidity & mortality in tropical areas, S.Hematobium in Iraq & other areas of middle east, S.Mansoni in Egypt & other parts of Africa & S. Japonicum & Mekonji in south east Asia.
Acquired by walking bare feet in water containing the infective form cercaria.
Patients excrete the eggs by urination in water whih are hatched & develop in fresh water snails into the infective stage ceraria.
After penitrating the skin, it goes throught he lungs, then caried by the blood to their definte site where they live, the vesial plexus of veins in Hematobium & the portal system & liver in other types.
Urine & stool exam for terminal spined eggs in hematobium & lateral spined eggs in other types.
Retal spine biospsy through proctoscpe or biopsy through sigmoidoscope for egg inspection.
Radiography & U/S for complications.
ELISA test of blood to detect shistosomal antigenes.
Trematodes(Fluke). Shistosomiasis (Bilharziasis): Treatment. 7.5mg/kg every 2 weeks * 3 Not useful 40mg/kg once Hematobium Not useful Not useful 40mg/kg*2 in one day Japonicum Not useful 15mg/kg*2*2 days 40mg/kg once Mansoni Metrifonate Oxamniquine Praziquantel Type
Store water for 3 days before use as cercaria will die in 3 days.
Mass treatment of population.
All these are not beneficial in japonicum as there are other animal reservior of infection which contaminate water by eggs.
A: Acute liver granuloma around S mansoni egg in liver. B: Chronic liver granuloma around the remains of a schistosome egg in liver, with dominant fibrous tissue.
C: Macrohaematuria due to ulceration of the bladder wall in urinary schistosomiasis. D: Ultrasonography of irregular bladder wall and polyp; E: IVP showing bilateral hydroureter and hydronephrosis.
F: Severe bloody diarrhoea due to S mansoni . G: 6-year-old boy with gross hepatosplenomegaly. H: 19-year-old man with symptoms of chronic fibrotic liver schistosomiasis—splenomegaly, external varices, ascites, growth retardation. I: ultrasonography of advanced periportal fibrosis &portal venodilatation;