9. 4)Lifecycle
• i) Definitive host :Mammals , humans or animals
• Ii) Intermediate host : freshwater molluscs or snail
• Second intermediate host : Fish or Crab (encystment)
• Schistosomes not need 2nd intermediate host
10. Rediae : 2nd generation
No rediae in schistosomes
11. Difference in life cycle of other trematodes and schistosomes
Metacerceria larvae (I.F in s.i.h -fish)
human by ingestion
lung, liver, intestine, bile duct
Adult worm
self fertilized (egg)
feses and sputum
miracidium larvae
Ingested by snail (1st i.h)
sporocyte
redia(1st & 2nd )
infective to man cercaria
metacercaria S.i.h (fish)
cerceria larvae (water)
Human Skin penetration
Enter venus circulation intestine &kidney
Adult worm
Cross fertilized
Egg in urine and stool
Miracisium in water
Snail (1st i.h)
Sporocyte (1st and 2nd )
Cercaria in water
Clonorchis
&
opisthorchis
12. 5)MODE OF INFECTION
• i) Ingestion (cercaeria):
• A) Vegetables: F.Hepatica , F.buski , W.watsoni
• B) fish: C.cinensis , H.heterophyes , M.yokogawai
• C) fish of crab or crayfish: P.westermani
• Ii) skin penetration: S.haematobium , S.mansoni , S.japonicum
13. 6) Blood Flukes
• A) Schistosomes :
• Sex seperate (dioecious)
• Schistossommiasis (water born disease)
• Africa , Latin America and Asia
• Schistosoma haematobium, S. japonicum, S. mansoni , S. mekongi and S.
intercalatum
14. • B) Order :strigeida
• C) Superfamily : schistosomatoidea
• D) Family : schistosomatidae
• E) Morphology: : adult worm , egg and larva
•
15. • Ii) eggs:
• 1) 70-180 micro m X 40-73 breadth
• 2) non operculated with spine
• S.haematobium :terminal
• S.mansoni: lateral
• S.japonicum: lateral rudimentary spine
19. Egg cell: not acidfast
Miracidium larvae in egg
:acid fast
Egg shell : acid
fast
Egg shell : acid
fast
20. f) Mechanism of Egg Expulsion
LAID
• EGG LAID enter into vesicle wall by spine
Small venus and pelvic
pelvic plexus ,
(mescentric portal
system ,pulmonary
arteries )
Release :
lytic
substance
passes
Lumen of urinary
bladder
Discharged :
urine
Skin –local
tissue
irritation
Egg –in feces
22. i)
Antigen from egg stimulate HMI Immune complex and serum sikness (c/d katyama
fever)
h) Pathogenesis and clinical features
Cercariae (skin penetration )
dermatitis , pruritis
Lung :cough with
fever
23. • a) urogenital disease : (s.hematobium)
• Symptomatic after 3 months
• EGG: pathogenic
• Egg urinary bladder (dysuria and hematuria)
D.Hypersensitivity
Urinary
bladder
Granuloma of
macrophage ,
lymphocyte
etc
Granuloma
join together
Granular
metaplasia
Heavy
infection
Elephanthasis
of scrotum
and penis
Important
pathogen in HIV
ii) Chronic schistosomiasis
26. • vii) cerebral schistosomiasis : s.japonicum
• 2-4% of cases
• Symptoms : jacksonian convulsion and grand male
fever
27. j) LABORATORY DIAGNOSIS
Urine microscopy
: urine and stool
(rarely) for
nonoporculated
egg
Collection time :
12pm to 3pm
Histopathology :
egg in bladder
mucosa biopsy
Ab detection in
serum
IgE & igG4 :
I) HAMA – FALCON
ASSAY SCREENING
TEST –ELISA
II) HAMA –EITB
(ENZYME LINKED
IMMUNOTRANSFER
BLOT
1) ANTIGEN
DETECTION : A)
Circulating
cathodic antige
(CCA) in serum
and urine by
ELISA
B) ELISA based
specific
monocolonal AB
against (M Ab –
SEA)
28. h) TREATMENT
• A) Praziquantel : 20 mg /kg/dose , two dose in
single day
• B) Metrifonate : inhibits acetylcholine
receptor on adult male worm . Multiple dose
for a week
29. 7)Liver flukes
• 1)Fasciola hepatica and F.gigantica
• 2)Colonorchis sinensis
• 3)Opisthorichis species
• 4)Dicrocoelium dendriticum
30. 1)Fasciola hepatica
• i) largest and most common in human(Greater liver fluke)
• Ii) Sheep (sheep liver fluke)
• Iii) G.D : Egypt
• Iv) host: Herbivorous animals and accidently man
• V)Habitat :liver and bile duct
• Vi) Disease: Fascioliasis(Liver Rot)
31. • Vii) Morphology :
• A) Adult:
• Leaf
• length 30mm long and 15mm
broad.
• Anteriorly (conical) and
posteriorly (round)
• Testes: Two
• Ovary: One
32. • B) Eggs:
• 140umx80um
• Oval
• Operculated
• immature embryo
• Bile stained
52. Lung fluke (paragonium
westermani/oriental lung fluke)
Properties paragonium westermani
Epidermiology Manipur , north east states of india
Habitat Paranchyma of lung
Adult worm Reddish brown , broad anterior end ,
Excretory bladder : divided body into 2
part
egg Oval , golden brown, 80-120 micro m X 45-
65 micro m
larvae Metacerceria (I.F) ,
Host D.H- (Man , dog , cat) , 2 I.H – (Snail , crab)
53.
54.
55. Pathogenesis
Intestinal complication Pulmonary paragonimiasis Extrapulmonary
paragonimiasis
Abdominal tederness Initially : eosinophilic
granulomatous inflamation
Cerebral paragonimiasis :
fever , headeche vomiting
and motor weakness
Nausea Cyst surrounding worm Cutaneous paragonimiasis :
subcutaneous nodule
Vomiting Cyst (blood & fluid )
Cyst break into bronchioles
Expectoration of brownish
blood sputum with offensive
fishy order
Bronchitis, bronchiectasis
,pneumonia and lung abscess
56. Laboratory diagnosis
1) Sputum
microscopy : early
morning sample mount
with saline (operculated
egg)
2) Formal ether
method
3) Stool
microscope in
children (sputum difficult
to collect)
Serology :
1) Ab detection :
a) Rapid test : dot immunogold
filtration assay , ELISA (IgG
or IgE)
2) Antigen detection : dot
ELISA (ACTIVE INFECTION)
MRI , CT scan (cyst
in CNS)
