Trematoda Summary for medical parasitology, Geographical distribution Hosts Mode of transmission Diagnosis Treatment

1. Summary

2. Trematode Geographical Distribution
H. Heterophys & M. yokogawai Middle east + far east asia
F. buski Asia
F. Hepatica Worldwide
F. gigntica Tropical and sub tropical
Clonorchis sinensis East Asia
Opisthorchis spp Asia and Europe
Paragonimus spp Africa, America and southeast asia
S. mansoni Sub-Saharan Africa and some South
American
S. Haematobium Africa and Middle East.
S. Japonicum China, the Philippines, and Sulawesi
Geographical Distribution:

3. Species D.H. I.H. I.S D.S.
Faciola spp Human Snail EMC Eggs
C.Sinensis
&Opisthorchis
spp
Human 1st: Snail.
2nd: fish
EMC Eggs
H. Heterophys
& M.
yokogawai
Human 1st: snail
2nd: fish
EMC Eggs
F. buski Human Snail EMC Eggs
Paragonimus
spp
Human 1st: snail
2nd: crausten
EMC Eggs
Schistosoma Human Snail Cercaria Eggs
Hosts:

4. Trematode Mode of Transmission
Faciola spp Ingesion of aquatic vegetation or drinking contaminated water with EMC
C.Sinensis &Opisthorchis spp Ingestion of raw or undercooked fish contaminated with EMC
H. Heterophys & M.
yokogawai
Ingestion of raw or undercooked fish contaminated with EMC
F. buski Ingestion of contaminated vegetables with EMC
Paragonimus spp Ingestion of raw or undercooked creyfish, crabs, shrimps, contaminated
with EMC
Schistosoma Cercaria penetrates skin while aquatic activity
Mode of Transmission:

5. Trematode Main Diagnosis
H. Heterophys, M. yokogawai &F. buski Coproscopy (eggs in Stool)
Trematode Main Diagnosis Comments
F. Hepatica & F.
gigntica
Eosinophilia + Serology + Radiology Coproscopy (-ve fo r3-4 months)
, for spurious infections
C.sinensis &
Opisthorchis spp
Microscopy (eggs in Stool)
Paragonimus
spp
Eosinophilia + Serology + Radiology Coproscopy or Microscopy of
eggs in sputum, (-ve for 2 to 3
months after infection)
Diagnosis:

6. Trematode Main Diagnosis Comments
S. Japonicum, S.
mansoni
Coproscopy (eggs in acute
stage)
Colonoscopy + sigmoidescopy
(chronic stage)
Serology is helpful in
Katayama fever + chronic
stage (negative in acute
stage)
Radiology in chronic stageS. Haematobium Microscopy of urine (eggs in
acute stage)
Cystoscopy (in chronic stage)
Diagnosis:

7. Treatment:
Trematode Treatment
H. Heterophys + M. yokogawai + F. buski Praziquantel: Adult and Pediatrics:
75 mg/kg/d PO in 3 doses x 1d
Clonorchis sinensis + Opisthorchis spp Praziquantel: Adult and Pediatrics:
75 mg/kg/d PO in 3 doses x 2 d
Paragonimus spp Praziquantel: Adult and Pediatrics:
75 mg/kg/d PO in 3 doses x 3 d
S. Mansoni + S. Haematobium Praziquantel 40 mg/kg po in 1 or 2 doses the same day.
S. Japonicum Praziquantel 60 mg/kg po in 2 or 3 doses the same day.
Katayama fever - Short course of high-dose Prednisone with or without
Praziquantel 40-60 mg/kg po in 2 or 3 doses the same day for
3-6 days.
- Repeat Praziquantel in 4-6 weeks when all worms are mature
F. Hepatica/gigntica Triclabendazole 10 mg/kg PO once or twice