Parasitology

1. INTESTINAL
FLUKES AND LIVER
FLUKES
PRESENTED BY:
STEPHANIE D. BORRES
BSED SCI 2-2A

2. PAGE
01
1. Liver and Instestinal Flukes
1.2 Scientific Classification
1.3 Geographical Distribution
1.4 Common Name
1.5 Habitat
1.6 Distinctive Characteristics
1.7 Mode of transmission
1.8 Host
1.9 Stages
2.0 Pathogenesis and Clinical
Manifestation
2.1 Diagnostic Technique
2.2 Treatment
2.3 Life Cycle
Table of Contents

3. PAGE
01
Liver
Flukes

4. PAGE
03
PAGE
02 Scientific Classification
Kingdom: Animalia
Phylum: Platyhelminthes
Class: Trematoda (flukes)
Subclass: Digenea
Order : Opisthorchiformes
Family : Opisthorchiidae
Genus : Clonorchis
Species: Clonorchis sinensis
Genus Opisthorchis
Species: Opisthorchis felineus
Opisthorchis viverrini
Kingdom: Animalia
Phylum: Platyhelminthes
Class: Trematoda
Subclass: Digenea ("two generations")
Order: Echinostomida
Family: Fasciolidae
Genus: Fasciola
Species: Fasciola hepatica
Fasciola gigantica
Scientific Classification
Geographical Distribution
Geographical Distribution
Fasciola hepatica: Europe, the Middle East, Latin
America (e.g., Bolivia and Peru), the Caribbean, Asia,
Africa, U.S and Australia.
Fasciola gigantica : Asia and Africa, Hawaii and Iran
Clonorchis Sinensis: Eastern Asia and South
Pacific Asia
Opisthorchis viverrini: Northeast Thailand, Laos,
Cambodia, and central and southern Vietnam.
Opisthorchis felineus : Italy, Germany, Belarus,
Russia, Kazakhstan, and Ukraine.

5. PAGE
03
PAGE
02 LIVER FLUKES
Habitat
Scientific Name Common Name
Fasciola hepatica Common liver
fluke, Sheep liver
fluke
Fasciola gigantica Tropical liver fluke
Clonorchis sinensis Oriental Fluke,
Chinese fluke
Opisthorchis
viverrini
Southeast Asian
Fluke
Opisthorchis
felineus
Cat liver fluke
LIVER
BILIARY DUCT,
GALL BLADDER,
LIVER
BILIARY DUCT,
LIVER

6. PAGE
03
PAGE
02
Mode of Transmission: ingestion of
raw and fresh-water vegetation
Distinct
characteristics:
Adult Worm:
• Large, broad, flat
body
•Leaf shaped
• Anterior end forms
a prominent cephalic
cone
• Small oral and
ventral suckersLong
and highly branched
intestinal caeca
• a length of 30 mm
and a width of 13
mm
Distinct characteristics:
Egg:
• Large
• Hen's egg shaped.
• Ovoid
• Operculated
• Bile stained
• Unsegmented
• Measure 130-150 µm
long by 60-90 µm
Fasciola hepatica

7. PAGE
03
PAGE
02 Fasciola gigantica
Egg
Mode of Transmission: ingestion
of raw and fresh-water vegetation
Distinct
characteristics:
Adult Worm
• Larger
• More lanceolate
• Less developed
shoulders
(shorter cephalic
cone)
• Larger ventral
sucker
• Fasciola
gigantica,
though, is even
bigger and can
reach up to 75
mm
Distinct
characteristics:
Larger but very similar
to Fasciola hepatica
ova
*Because of
similarities, it is just
safe to say Fasciola
ova

8. PAGE
03
PAGE
02 Clonorchis sinensis Egg
Mode of Transmission:
eating infected raw or
undercooked fish containing
the larvae
Distinct characteristics:
Adult
• of moderate size, from 1-2.5 cm. by
0.3-0.5 cm.
• broadest in the midportion of the
body tapering towards both ends
Distinct chracteristics:
• a small comma-shaped process at the
abopercular end
• the average length is 29 microns

9. PAGE
03
PAGE
02
Opisthorchis viverrini
Egg Adult
Opisthorchis felineus
Mode of
Transmission:
Raw or
undercooked fish
containing
metacercarie
Egg
Adult
Distinct characteristics:
Adult:
• The adult worms are
monoecious and the
average size is 7.0
(5.4-10.2) × 1.5 (0.8-
1.9) mm.
Egg:
• yellowish-brown,
ovoid eggs have a
distinct operculum,
• Average 27 μm by 15
μm for O. viverrini
Distinct characteristics:
Adult worm:
flat, the length of the body 4-13 mm
Egg:
• 30 µm by 11 µm

10. PAGE
03
PAGE
02
FASCIOLA HEPATICA AND
FASCIOLA GIGANTICA
1st intermediate host:
Snail: Foscaria modicella and
Snail Radix auricularia
2nd intermediate host: none
Definitive host:
Human, Sheep, Cattle
OPISTHORCHIS VIVERRINI AND
OPISTHORCHIS FELINEUS
1st intermediate host:
Snail: Bithynia Siamensis
2nd intermediate host:
Cypriniod Fish
Definitive host:
Human
Host

11. PAGE
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02
CLONORCHIS SINENSIS
Infective Stage:
METACERCARIAE
1st intermediate host:
Snail: Parafoss arulus
manchouricus
2nd intermediate host:
Fish, Pseudocer cospora parva
Definitive host:
Human
Liver flukes Diagnosic Stage
Fasciola hepatica
Unembryonated
Egg
Fasciola gigantica
Clonorchis
sinensis
Embryonated Egg
Opisthorchis
viverrini
Opisthorchis
felineus

12. PAGE
03
PAGE
02 PATHOGENESIS AND
CLINICAL MANIFESTATION DIAGNOSTIC TECHNIQUE
Dyspepsia, Fever, right upper quadrant
abdominal pain, High fever,
Hepatomegaly
Fever, loss of appetite, rash, edema, night
blindness, swollen abdomen, enlargement of
the liver
Flatulence, Fatigue, Dyspepsia, right
upper quadrant abdominal pain, anorexia
Right upper quadrant abdominal pain,
Nausea
Stool exam, ELISA, Western blot,
Radiological Examination,
Computed Tomography (CT),
Endoscopic retrograde
cholangiopancreatography (ERCP)
Cholangiography, ELISA,
Enzyme Immunoassay (EIA),
Polymerase chain reaction
(PCR)
Fasciola Hepatica and Fasciola Gigantica
Opisthorchis Felineus
Clonorchis Sinensis
Opisthorchis Viverrini

13. PAGE
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02
Liver flukes Treatment
Fasciola hepatica
Bithionol
Triclabendazole
Peroxidic
Compounds
Fasciola gigantica
Clonorchis sinensis
Praziquantel,
Artemisinins,
Synthetic
Peroxides
Opisthorchis
viverrini
Opisthorchis
felineus Life Cycle of
Fasciola Hepatica And
Fasciola Gigantica

14. PAGE
03
PAGE
02
Life Cycle of Opisthorchis
and Clonorchis sinensis
Intestinal
Flukes

15. PAGE
03
PAGE
02 Scientific Classification
Kingdom: Animalia
Phylum: Platyhelminthes
Class: Trematoda (flukes)
Subclass: Digenea
Order : Opisthorchiformes
Family : Opisthorchiidae
Family:Heterophidae
Genus:Heterophyes
Species:Heterophyes heterophyes
Metagonimus yokogawai
Kingdom: Animalia
Phylum: Platyhelminthes
Class: Trematoda
Subclass: Digenea ("two generations")
Order: Echinostomida
Family: Fasciolidae
Genus: Fasciola
Species: Fasciolopsis buski
Family :Echinostomatidae
Genus:Echinostoma
Species: Echinostoma ilocanum
Scientific Classification
Geographical Distribution
Geographical Distribution
Fasciolopsis buski: Southern and
Southeastern Asia
Echinostoma ilocanum: Philippines,
China, Taiwan and Indonesia
Heterophyes heterophyes: Nile delta region,
Turkey, Tunisia and Iran
Metagonimus yokogawai: Japan, Korea,
China, Taiwan, Russia, Romania, Israel, the
Balkan States and Spain

16. PAGE
03
PAGE
02 Intestinal Flukes
Scientific Name Common Name
Fasciolopsis buski Giant Intestinal
fluke
Echinostoma
ilocanum
Spiny fluke
Heterophyes
heterophyes
Von Siebold’s
Fluke, Intestinal
fluke
Metagonimus
yokogawai
Japanese Fluke
Habitat: Small Intestine
Fasciolopsis buski
Distinct characteristics:
Adult:
• Large, broadly ovate and narrow
at posterior end
• Do not have cephalic cone
• 2-7.5 x .8-2 cm
• Alimentary trat simple and do
not branch

17. PAGE
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02
Fasciolopsis buski Echinostoma ilocanum
Mode of Transmission: swallowing
the infected aquatic vegetation. When
infected plants or its fruits are peeled
with the teeth and swallowed by primary
host infection is caused.
Distinct characteristics:
Adult :
• Reddish-gray
• Tapered posterior end
• Has 49 to 51 collar spines
• testes: deeply bilobed, arranged in
tandem
• 2-10 mm long by 1-2 mm wide
Egg:
• Yellowish brown ellipsoidal
• 130-140 x 80-85 micra
• With clear thick shell and
operculated

18. PAGE
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02
Egg:
• straw-colored
• - operculated
• 80-135 µm long by 55-
80 µm wide.
Mode of Transmission: eating infected
raw or undercooked food, particularly fish,
clams and snails
Echinostoma ilocanum Heterophyes heterophyes
Distinct characteristics:
Adult:
• Elongated, oval or
pyriform and grayish
• 1-1.7x.3.4 mm
Egg:
• Minute, operculate,
ovoidal,
• light brown
• 28-30 x 15-17 micra
Egg
Adult

19. PAGE
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02
Heterophyes heterophyes
Mode of Transmission: eating infected raw
or undercooked fish from freshwater or
brackish water.
Metagonimus yokogawai
Mode of Transmission:
eating undercooked fish caught in water
polluted with infected fecal matter
Egg
Distinct characteristics:
Adult:
• Elongated, oval or pyriform
and grayish
• 1-1.7x.3.4 mm
Egg:
• Minute, operculate, ovoidal,
• light brown
• 28-30 x 15-17 micra
Metagonimus yokogawai
Adult

20. PAGE
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02
Fasciolopsis buski
1st intermediate host:
Snail: Segmentina spp.
2nd intermediate host:
Aquatic vegetation
Definitive host: Pig, Man
Echinostoma ilocanum
1st intermediate host:
Snail: Gyraulus convexiusculus
Hippeutis umbilicalis
2nd intermediate host:
Snail: Pila luzonica (kuhol)
Vivipara angularis (susong pampang)
Definitive host: Man, dog, rats and
other snail eating mammals
Host
Heterophyes heterophyes
1st intermediate host:
Snail: Pirenella conica
2nd intermediate host: Fish
Definitive host:
Man, cat and other flesh eating
mammals
Metagonimus yokogawai
1st intermediate host:
Freshwater snails: Semisulcospira
libertina, Semisulcospira coreana, and
Semisulcospira reiniana.
2nd intermediate host:
Freshwater fish: Plecoglossusaltivelis,
Tribolodon hakonensis, Tribolodon ezoe,
and Lateolabrax japonicus. freshwater
snails
Definitive host:
Man, cat and other flesh eating mammals

21. PAGE
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02
Intestinal flukes Diagnosic Stage
Fasciolopsis buski
Unembryonated
Egg
Echinostoma
ilocanum
Heterophyes
heterophyes
Embryonated Egg
Metagonimus
yokogawai
Infective Stage:
METACERCARIAE
PATHOGENESIS AND
CLINICAL MANIFESTATION
mild anaemia, chromic diarrhoea and asthenia
(Lack of strength and energy). adult worm
causes gastro-intestinal irritation, nausea and
vomiting
Fasciolopsis buski
Echinostoma ilocanum
Catarrhal inflammation, ulcerative lesions,
Peripheral eosinophilia, nemia, malnutrition, or
intestinal perforation
Heterophyes heterophyes,
Metagonimus yokogawai
Peptic Ulcer Disease, Acid peptic disease

22. PAGE
03
PAGE
02 Intestinal flukes Diagnostic
Technique
Fasciolopsis buski Stool exam
Echinostoma
ilocanum
Heterophyes
heterophyes
Kao Thick,
Polymerase chain
reaction (PCR)
Metagonimus
yokogawai
Treatment:
Praziquantel
Life cycle of Fasciolopsis buski

23. PAGE
03
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02
Life Cycle of Echinostoma Ilocanum
Life Cycle of Heterophyes heterophyes
and Metagonimus yokogawai

24. PAGE
03
PAGE
02 References:
https://www.cdc.gov/dpdx/heterophyiasis/i
ndex.html
https://www.cdc.gov/parasites/fasciolopsis/
biology.html
https://mcdinternational.org/trainings/mala
ria/english/dpdx5/html/Echinostomiasis
https://www.cdc.gov/parasites/fasciola/biol
ogy.html
https://www.cdc.gov/dpdx/opisthorchiasis/i
ndex.html
https://www.cdc.gov/parasites/clonorchis/bi
ology.html
https://drive.google.com/file/d/117DUpk85
MKJBKR8Y3LK9AmeBwp7gKdgt/view?usp=d
rivesdk

25. THANK YOU