Intestinal trematodes


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Intestinal trematodes

  1. 1. Intestinal Trematodes Prof. CM.Kihamia
  2. 2. FASCIOLOPSIS BUSKI (GIANT INTESTINAL FLUKE) <ul><li>MORPH: Largest fluke. Thick, fleshy, ovate. Flesh-coloured. 2-7.5 x 1-2 cm. </li></ul><ul><li>Oral sucker and ventral suckers present. Typical trematode alimentary canal with unbranched intestinal caeca. </li></ul><ul><li>Two dendritic testes. </li></ul><ul><li>Single branched ovary. </li></ul><ul><li>Vitellaria on lateral sides and a convoluted uterus and genital pore that is anterior to the ventral sucker. </li></ul>
  3. 3. Contd. <ul><li>EGG: Yellowish and oval. 130-140 x 80-85 µ. Thin walled with small operculum. Undeveloped ovum. </li></ul><ul><li>HABITAT: Small intestine esp. duodenum and jejunum. Adults feed on intestinal contents. </li></ul>
  4. 4. LIFE CYCLE: <ul><li>Adults in intestine produce eggs. </li></ul><ul><li>Egg hatches to free-swimming miracidium in 3 weeks. Miracidium penetrates snail within 2 hrs. Segmentina and Hippeutis spp. </li></ul><ul><li>In the snail: Sporocyst  Redia  Daugher redia  Cercaria. </li></ul><ul><li>Cercaria leave the snail and attaches to fresh water plants and becomes metacercaria. </li></ul><ul><li>Water plants include water callrop, water hyacinth, water chestnut and water bamboo. </li></ul><ul><li>These plants are grown in ponds and eaten raw. </li></ul><ul><li>Ponds are fertilized by human faeces. </li></ul><ul><li>When metacercaria is ingested it excysts in the duodenum and is attached to the intestinal wall. </li></ul>
  5. 5. Epidemiology: <ul><li>Common in China, Vietnum, Thailand, Laos, Cambodia. Transmission is by eating fresh water plants with metacercariae. Pigs harbour infection. Incidence is highest in China. Dried plants are safer. </li></ul><ul><li>PATHOLOGY: </li></ul><ul><ul><li>Attached to intestine by suckers. </li></ul></ul><ul><ul><li>Mucosa inflamed, ulcerated and abscesses form. Epigastric pain, nausia, diarrhoea. </li></ul></ul><ul><ul><li>Heavy infection leads to oedema, ascites and anarsaca. </li></ul></ul><ul><ul><li>Toxic products of worm. </li></ul></ul><ul><ul><li>Anaemia, leukocytosis, lymphocytosis, and oesinophilia. </li></ul></ul><ul><ul><li>Good prognosis if worm treated early. </li></ul></ul><ul><ul><li>1000-2000 worms affect intestinal secretions and food passage and intoxication and sensitization. </li></ul></ul>
  6. 6. Diagnosis, Treatment, & Control <ul><li>DIAGNOSIS: </li></ul><ul><ul><li>Eggs in faeces. Diffentiate from F. hapatica , Gastrodiscoides and Echinostoma sp. </li></ul></ul><ul><ul><li>Adult worms vomited or passed in stool. </li></ul></ul><ul><li>TREATMENT: </li></ul><ul><ul><li>Praziquantel is the drug of choice: 15 mg/kg body weight, single dose. </li></ul></ul><ul><li>CONTROL </li></ul><ul><ul><li>Sanitary disposal of human faeces. </li></ul></ul><ul><ul><li>Discourage use of night soil. </li></ul></ul><ul><ul><li>Restrict pigs. </li></ul></ul><ul><ul><li>Snail control. </li></ul></ul><ul><ul><li>Health education. </li></ul></ul><ul><ul><li>Cooking or steeping of water plants. </li></ul></ul>
  7. 7. The End
  8. 8. HETEROPHYES HETEROPHYES <ul><li>MORPH: Pyriform, greyish, 1.3 x 0.5 mm. Oral, Ventral and Genital suckers. </li></ul><ul><li>EGG: Light brown in colour, thick shell, operculated, 29 x 16 µm, Fully developed miracidium. </li></ul>
  9. 9. <ul><li>LIFE CYCLE: </li></ul><ul><li>Adult in man  Egg  Miracidium  Snail (Sporocyst  Redia  Cercaria). Cercaria enter fish and encysts as Metacercaria in fish (mullet ( Mugil cephalus ) and minnow ( Gambusia affinis ). Metacercaria swallowed in undercooked fish, excysts in small intestine and develops into adult in 7 days. </li></ul><ul><li>EPIDEMIOLOGY: </li></ul><ul><li>Egypt, Greece, Israel, China, Japan, Korea, Taiwan, Philippines. </li></ul><ul><li>Fishermen are important in polluting water. </li></ul>
  10. 10. Pathology/Symptomatology <ul><li>: </li></ul><ul><li>Mucosal irritation. </li></ul><ul><li>Intestinal penetration and egg dissemintion. </li></ul><ul><li>Abdominal pains and tenderness. </li></ul><ul><li>Diarrhoea. </li></ul><ul><li>Cardiac and brain granuloma due to deposited eggs. </li></ul><ul><li>DIAGNOSIS: </li></ul><ul><li>Eggs in faeces: differentiate from those of Clonorchis and Opisthorchis. </li></ul>
  11. 11. Treatment & Control <ul><li>TREATMENT: </li></ul><ul><li>Praziquantel 10-20 mg/kg body weight, single dose. </li></ul><ul><li>CONTROL: </li></ul><ul><li>Thorough cooking of fish. </li></ul><ul><li>Health education. </li></ul><ul><li>Sanitary disposal of human faeces. </li></ul>
  12. 12. METAGONIMUS YOKOGAWAI <ul><li>MORPH: Small, 1.4 x 0.6 mm. Pyriform shape with rounded posterior and tapering anterior. Large ventral sucker. </li></ul><ul><li>EGG: Light yellow-brown, thin-shelled, operculated, 28x17 µm, mature miracidium. </li></ul><ul><li>LIFE CYCLE: </li></ul><ul><li>Similar to Heterophyes. Adult in jejunum of man (but also cats, dogs, pigs, and pelican). Egg ingested by snail. Miracidium in intestine of snail. Sporocyst  Mother redia  Daughter redia  Cercaria. Metacercaria in fish. Ingested metacercaria excysts in duodenum and develops into adult in jejunum. </li></ul>
  13. 13. Contd. <ul><li>EPIDEMIOLOGY: </li></ul><ul><li>Far East: Japan, China, Korea, Philippines, Taiwan also Greece and Spain. </li></ul><ul><li>Infection is through consumption of raw fish. </li></ul><ul><li>Infection spread by contamination of water with human and animal excreta. </li></ul><ul><li>PATHOLOGY/SYMPTOMATOLOGY: </li></ul><ul><li>Similar to Heterophyes. </li></ul><ul><li>Heart and CNS granulomatous lesions may occur through eggs. </li></ul><ul><li>DIAGNOSIS: </li></ul><ul><li>Eggs in faeces. </li></ul><ul><li>TREATMENT: </li></ul><ul><li>Praziquantel 10-20 mg/kg body weight single dose. </li></ul><ul><li>CONTROL: </li></ul><ul><li>Thorough cooking of fish. </li></ul><ul><li>Health education. </li></ul><ul><li>Sanitary disposal of excreta. </li></ul><ul><li>THE END. </li></ul>