dipylidium caninum

1. Dipylidium
caninum
(cacing pita anjing)

2. • Penyakit : Dipylidiasis
• Penyebaran : kosmopolit
• Predileksi : rongga usus halus

3. Hospes
• Hospes definitif : anjing, manusia
• Hospes perantara : pinjal
– Ctenocephalides canis
– Ctenocephalides felis
– Pulex iritans
– Trichodectes canis

4. Daur Hidup

5. Daur Hidup
Telur
IH
Dewasa
onchospere
cysticercoid
DH

6. Morfologi
Telur:
Ditemukan dalam keadaan
terkumpul 6-20 telur di dalam suatu
kantung dengan dindingnya berupa
membran tipis
 Egg ball

7. Morfologi
Cacing dewasa:
• Panjang 15-70 cm dengan strobila yang terdiri dari 60-75
proglotid.
• Skoleks kecil berbentuk belah ketupat (rhomboidal scolex).
• Mempunyai 4 batil isap dan rostelum retraktil berbentuk seperti
kerucut yang berkait.
• Bentuk proglotid matur seperti tempayan/vas bunga, tiap proglotid
mempunyai 2 perangkat organ reproduksi.

9. Gejala klinik
• Pada infeksi ringan umumnya tidak menimbulkan gejala
klinik.
• Pada infeksi berat atau pada anak-anak dapat
menimbulkan diare.

10. Diagnosis
• Menemukan proglotid yang bergerak aktif
atau egg ball.

11. Pengobatan
• Niclosamid (Yomesan), dosis tunggal
Dewasa : 2 gr
Anak > 34 kg : 1,5 gr
11-34 kg : 1gr
• Praziquantel 600 mg dosis tunggal

12. Pencegahan
• Mengobati penderita.
• Menghindarkan anak bermain dengan kucing atau anjing.
• Membasmi pinjal.

13. Diphyllobothrium latum
(Fish Tapeworm = Cacing Pita Ikan)

14. Diphyllobothrium latum
(Fish Tapeworm = Cacing Pita Ikan)
• Penyebab Diphyllobothriasis
• Distribusi geografis:
Amerika, Kanada, Eropa Tengah, Afrika
Tengah, Siberia & Jepang
• Hospes
DH : manusia, anjing, kucing
IH : 1.Diaptomus & Cyclops
2. Ikan Air Tawar : Salmon, Pike,
Trout & Whitefish

15. MORFOLOGI:
• Telur
- Oval, dinding tipis, ukuran 45X75µm
- Operculum  satu sisi
- Knob like (tonjolan kecil)sisi lainnya
• Dewasa
- Panjang : 3-10 m ( 3000-4000 proglotid)
- 1 Proglotid gravid ± 1000 telur
- Scolex berbentuk mirip sendok, terdapat
dua lekukan yang berbentuk celah
(bothria)

16. Section of an adult D. latum containing many proglottids. The scolex was not present in this
specimen. Scale is in centimeters. R: Scolex of D. latum. Credit: Florida State Public Health
Laboratory,

17. Telur Diphyllobothrium latum

18. Plerocercoid (sparganum)

19. Scolex dan segmen D. latum

20. Mature proglottid

21. Siklus Hidup :
TELUR CORACIDIUM
Menetas dlm AIR IH1
Coracidium melepas cilia
DH menembus dinding usus IH1
Menuju Habitat (USUS HALUS)
Menjadi DEWASA
PROCERCOID LARVA
IH2
Menuju Otot IKAN
Menjadi PLEROCERCOID LARVA
(SPARGANUM)

22. Life cycle

23. • Immature eggs are passed in feces . Under appropriate conditions, the eggs mature (approximately 18 to 20 days)
and yield oncospheres which develop into a coracidia . After ingestion by a suitable freshwater crustacean (the
copepod first intermediate host) the coracidia develop into procercoid larvae . Following ingestion of the copepod by
a suitable second intermediate host, typically minnows and other small freshwater fish, the procercoid larvae are
released from the crustacean and migrate into the fish flesh where they develop into a plerocercoid larvae
(sparganum) . The plerocercoid larvae are the infective stage for humans. Because humans do not generally eat
undercooked minnows and similar small freshwater fish, these do not represent an important source of infection.
Nevertheless, these small second intermediate hosts can be eaten by larger predator species, e.g., trout, perch,
walleyed pike . In this case, the sparganum can migrate to the musculature of the larger predator fish and humans
can acquire the disease by eating these later intermediate infected host fish raw or undercooked . After ingestion of
the infected fish, the plerocercoid develop into immature adults and then into mature adult tapeworms which will
reside in the small intestine. The adults of D. latum attach to the intestinal mucosa by means of the two bilateral
groves (bothria) of their scolex . The adults can reach more than 10 m in length, with more than 3,000 proglottids.
Immature eggs are discharged from the proglottids (up to 1,000,000 eggs per day per worm) and are passed in the
feces . Eggs appear in the feces 5 to 6 weeks after infection. In addition to humans, many other mammals can also
serve as definitive hosts for D. latum.

24. Patogenesa & gejala klinis
1. Faktor patogenesa :
- Jumlah cacing dlm tubuh
- Kepekaan hospes
- Hilangnya bahan-bahan esensial yg di
absorsi oleh cacing
2. Gejala klinis
- Diare, nyeri perut, rasa tidak enak di lambung dan
anemia

25. Diagnosa, Pencegahan & Pengobatan
1. Pemeriksaan feces telur atau
proglotid
Pemeriksaan vomitus  proglotid
2. Obat cacing :
- Niclosamid (yomesan) 4 tab (2 g) / po
- Paramomisin 1 g setiap 4 jam
- Prazikuantel  10 mg/kg BB/ d.tunggal
- bila ada anemia+ preparat asam folat
3. Pencegahan : memasak ikan secara
sempurna & pengobatan hospes

26. SPARGANOSIS

27. SPARGANOSIS 01
SPARGANOSIS
 Disebabkan oleh infeksi stadium pleroserkoid
(sparganum) dari cacing Cestoda Pseudophyllidea
genus Spirometra (contoh: Spirometra
mansonoides, Spirometra ranarum) dan kadang-
kadang genus Diphyllobothrium.
 Sparganum berwarna putih, mempunyai ukuran
panjang sampai beberapa sentimeter.
 Parasit ini ditemukan di Asia Timur dan Asia
Tenggara, Jepang, Indo Cina, Afrika, Eropa,
Australia, Amerika Utara-Selatan dan Indonesia.

28. Sparganum :
1. Tidak bercabang
Spirometra mansonoides (cacing dewasanya mirip D. latum,
tetapi lebih kecil)
DH : anjing, kucing, carnivora liar
IH : I. Cyclops dan Diaptomus
II. Ular, katak
Siklus hidup mirip D. latum
2. Bercabang
Larva cacing pita yang bertunas: Sparganum proliferum.
Ditemukan di Jepang dan Amerika Serikat. Cacing dewasa
dan siklus hidupnya tidak diketahui.

30. SPARGANOSIS 02
Manusia mendapat sparganosis karena :
1. Menelan Cyclops yang mengandung procercoid,
yang terdapat dalam air minum.
2. Makan kodok, ular yang mengandung plerocercoid.
3. Mempergunakan daging kodok yang infektif sebagai
obat luka.
GEJALA:
Sakit lokal, giant urticaria, edema, eritem disertai
menggigil, demam, dan hipereosinofilia.
Infeksi mata  konjungtivitis, edema, lakrimasi, ptosis

31. SPARGANOSIS 03
PROGNOSIS
Tergantung lokasi parasit dan pengeluarannya.
DIAGNOSIS
Menemukan sparganum di dalam lesi.
TX
Mengeluarkan sparganum dengan pembedahan.
PENCEGAHAN
 Memasak air sebelum diminum.
 Tidak memakai daging kodok sebagai obat yang
ditempelkan.
 Tidak memakan daging ular atau katak yang
dimasak tidak sempurna.

32. TREMATODA
dr. Kartika I

33. TREMATODA 01
Ciri umum
1. Bentuk tubuh seperti daun (kecuali
Schistosoma
2. Mempunyai oral sucker & ventral sucker
3. Rongga badan Θ
4. Alat pencernaan tidak lengkap
5. Hermafrodit (kecuali Schistosoma)
6. Ovipar
7. Telur berkembang di air
8. Telur beroperkulum (kecuali Schistosoma)

36. TREMATODA 02
I. Trematoda hati
 Fasciola hepatica
 Clonorchis sinensis
I. Trematoda usus
 Fasciolopsis buski
 Heterophyes heterophyes
 Metagonimus yokogawai
I. Trematoda paru
 Paragonimus westermani
I. Trematoda darah
 Schistosoma japonicum
 Schistosoma mansoni
 Schistosoma haematobium

37. SCHISTOSOMIASISSCHISTOSOMIASIS
 CausaCausa
1. Schistosoma haematobium1. Schistosoma haematobium
2. Schistosoma mansoni2. Schistosoma mansoni
3. Schistosoma japonicum3. Schistosoma japonicum
 Distribusi geografisDistribusi geografis
S.haematobiumS.haematobium: Afrika, Irak, Timur tengah: Afrika, Irak, Timur tengah
S. mansoniS. mansoni :Afrika, Amerika, Timur tengah:Afrika, Amerika, Timur tengah
S. japonicumS. japonicum :Asia timur, Asia tenggara:Asia timur, Asia tenggara

38. MORFOLOGIMORFOLOGI
 TELURTELUR
S. haematobiumS. haematobium : 150 x 50 mikron (spina: 150 x 50 mikron (spina
terminal)terminal)
S. mansoniS. mansoni : 150 x 60 mikron (spina lateral): 150 x 60 mikron (spina lateral)
S. japonicumS. japonicum : 100 x 65 mikron (lateral knob): 100 x 65 mikron (lateral knob)

40.  DewasaDewasa
 1. Jantan1. Jantan : -: - gemuk pendek, 8 – 16 mmgemuk pendek, 8 – 16 mm
- oral sucker, ventral sucker- oral sucker, ventral sucker
- canalis gynaecophorus- canalis gynaecophorus
- Alat kelamin :- Alat kelamin :
S. haematobiumS. haematobium :4-5 testis:4-5 testis
S. mansoniS. mansoni : 8-9 testis: 8-9 testis
S. japonicumS. japonicum : 6-8 testis: 6-8 testis

41.  BetinaBetina :: - langsing, 25 mm- langsing, 25 mm
- ovarium/produksi telur- ovarium/produksi telur
S. haematobiumS. haematobium : 1/3posterior/20-30: 1/3posterior/20-30
S. mansoniS. mansoni : ½ anterior/1-14: ½ anterior/1-14
S. japonicumS. japonicum : ditengah/50-100: ditengah/50-100

44. Life cycleLife cycle

45. Life cycleLife cycle
 Eggs are eliminated with feces or urine . Under optimal conditions the eggs hatchEggs are eliminated with feces or urine . Under optimal conditions the eggs hatch
and release miracidia , which swim and penetrate specific snail intermediate hosts .and release miracidia , which swim and penetrate specific snail intermediate hosts .
The stages in the snail include 2 generations of sporocysts and the production ofThe stages in the snail include 2 generations of sporocysts and the production of
cercariae . Upon release from the snail, the infective cercariae swim, penetrate thecercariae . Upon release from the snail, the infective cercariae swim, penetrate the
skin of the human host , and shed their forked tail, becoming schistosomulae . Theskin of the human host , and shed their forked tail, becoming schistosomulae . The
schistosomulae migrate through several tissues and stages to their residence in theschistosomulae migrate through several tissues and stages to their residence in the
veins ( , ). Adult worms in humans reside in the mesenteric venules in variousveins ( , ). Adult worms in humans reside in the mesenteric venules in various
locations, which at times seem to be specific for each species . For instance,locations, which at times seem to be specific for each species . For instance, S.S.
japonicumjaponicum is more frequently found in the superior mesenteric veins draining theis more frequently found in the superior mesenteric veins draining the
small intestine , andsmall intestine , and S. mansoniS. mansoni occurs more often in the superior mesenteric veinsoccurs more often in the superior mesenteric veins
draining the large intestine . However, both species can occupy either location, anddraining the large intestine . However, both species can occupy either location, and
they are capable of moving between sites, so it is not possible to state unequivocallythey are capable of moving between sites, so it is not possible to state unequivocally
that one species only occurs in one location.that one species only occurs in one location. S. haematobiumS. haematobium most often occurs inmost often occurs in
the venous plexus of bladder , but it can also be found in the rectal venules. Thethe venous plexus of bladder , but it can also be found in the rectal venules. The
females (size 7 to 20 mm; males slightly smaller) deposit eggs in the small venules offemales (size 7 to 20 mm; males slightly smaller) deposit eggs in the small venules of
the portal and perivesical systems. The eggs are moved progressively toward thethe portal and perivesical systems. The eggs are moved progressively toward the
lumen of the intestine (lumen of the intestine (S. mansoniS. mansoni andand S. japonicumS. japonicum) and of the bladder and ureters) and of the bladder and ureters
((S. haematobiumS. haematobium), and are eliminated with feces or urine, respectively . Pathology of), and are eliminated with feces or urine, respectively . Pathology of
S. mansoniS. mansoni andand S. japonicumS. japonicum schistosomiasis includes: Katayama fever, hepaticschistosomiasis includes: Katayama fever, hepatic
perisinusoidal egg granulomas, Symmers’ pipe stem periportal fibrosis, portalperisinusoidal egg granulomas, Symmers’ pipe stem periportal fibrosis, portal
hypertension, and occasional embolic egg granulomas in brain or spinal cord.hypertension, and occasional embolic egg granulomas in brain or spinal cord.
Pathology ofPathology of S. haematobiumS. haematobium schistosomiasis includes: hematuria, scarring,schistosomiasis includes: hematuria, scarring,
calcification, squamous cell carcinoma, and occasional embolic egg granulomas incalcification, squamous cell carcinoma, and occasional embolic egg granulomas in
brain or spinal cord.brain or spinal cord.
 Human contact with water is thus necessary for infection by schistosomes. VariousHuman contact with water is thus necessary for infection by schistosomes. Various
animals, such as dogs, cats, rodents, pigs, hourse and goats, serve as reservoirs foranimals, such as dogs, cats, rodents, pigs, hourse and goats, serve as reservoirs for
S. japonicumS. japonicum, and dogs for, and dogs for S. mekongiS. mekongi..

46.  Definitif hostDefinitif host : manusia /mamalia: manusia /mamalia
 Intermediate hostIntermediate host ::
S. haematobiumS. haematobium : Bulinus, Physopsis: Bulinus, Physopsis
S. mansoniS. mansoni : Biomphalaria, Australorbis: Biomphalaria, Australorbis
S. japonicumS. japonicum : Oncomelania: Oncomelania
 HabitatHabitat
S. haematobiumS. haematobium : Plexus vena kandung kemih: Plexus vena kandung kemih
S. mansoniS. mansoni : Plexus vena mesenterica inferior: Plexus vena mesenterica inferior
S. JaponicumS. Japonicum : Plexus v. mesenterica superior: Plexus v. mesenterica superior

47. Gejala klinis
1. Masa tunas biologik
- kelainan kulit
- gatal-gatal
- keradangan akut pada jaringan hati
2. Stadium akut
- kerusakan jaringan
- perdarahan dan pembentukan jaringan ikat
3. Menahun
- sirosis
- pembesaran limpa
- ikterus
Diagnosa
1. Pemeriksaan tinja, urin
2. Gejala klinis
3. Imunologi

48. Pengobatan dan PencegahanPengobatan dan Pencegahan
 PengobatanPengobatan ;;
- Prazikuantel 20 mg/Kg BB/3x1- Prazikuantel 20 mg/Kg BB/3x1
- Ambilhar 25 mg/Kg BB/3x1/5-7 hari- Ambilhar 25 mg/Kg BB/3x1/5-7 hari
 PencegahanPencegahan
- Pengobatan masal- Pengobatan masal
- Mencegah pencemaran perairan- Mencegah pencemaran perairan
- Pemberantasan siput yang menjadi- Pemberantasan siput yang menjadi
hospes perantarahospes perantara