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Phylum Platyhelminthes (flatworms)
Important information
1. The body of flatworm my consist of 1 part (monozoic) or
many part (polyzoic)
2. There are 3 classification of phylum Platyhelminthes
(turbellaria (free living) & Trematoda & cestode
3. Human Parasitize flukes have been found in most of body
organsالطفيليات التي تتطفل علي البشر وجدت في معظم أعضاء الجسم
Trematode
• Flukes have more than one host definitive host and
intermediate host
• Flukes have heavily muscled sucker to attach well to the host
• Flukes are Monozoic and has two heavily oral muscled
sucker
• Incomplete internal and external digestion
• Nervous system is well developed
• Other anatomical structures (shape and length of intestinal
ceca, hooklets around oral sucker, shape, location, number
of testes) are used for taxonomical differentiation نستخدم هذه
االختالفات للتمييز
Examples for trematodes
• Fasciola (liver fluke) (types of Fasciola hepatica/gigantica)
species
• Schistosoma (blood fluke)
• Paragonimus (lung fluke) not in egypt
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Fasciola
• It has operculated egg البيضه بيكون فيها زي فتحه كده
• Hermaphrodite )يعني كل خليه فيها مذكرو مؤنث مع بعض (متخنثه يعني
Life cycle
1. Eggs leave biliary tree
2. And then go to small intestine and large intestine
3. And secrete with in the stool (diagnostic stage)
4. Eggs become embryonated eggs بيض به جنينin the fresh
water over 2 weeks
5. Embryonated eggs release miracidia swim in the fresh water
till
6. Invade a suitable snail (lymnea snail) (intermediate host)
7. Developed in the snail and released cercariae
8. Cercariae encyst تتحوصلas metacercariae on vegetation
(watercress) (infective stage)
9. Vegetation is eaten by sheep or man (definitive host or
accidental definitive host)
10. Metacercariae excyst تفك التحوصل بتعهاin the duodenum
11. Metacercariae penetrate intestinal wall and goes to liver
through peritoneal cavity بتروح للكبد عن طريق العشاء البرتوني
12. Immature flukes go to liver to get nutrition on RBCs and
hepatic cells
13. And then go to biliary duct
14. Where get mature and produce eggs
In human metacercariae take 3-4 months to develope
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Schistosomiasis
Important information
• Types
1. Schistosomiasis hematobium (urinary tract)
2. Schistosomiasis mansoni
3. Schistosomiasis japonicum Intestinal tract
• Lifecycle
1. Fertilized egg secretes with stool or urine
2. With good condition the eggs hatch تفقسand release
miracidia
3. Miracidia swim and penetrate specific snail (intermediate
host)
4. In the snail stages has two generation of sporocysts يعني بيعمل
دورتين كاملتان من التكاثر الالجنسي جوه القوع او الحلزون
5. And then production and release of cercariae in water
6. Cercariae swim and penetrate human skin (definitive host)
7. Shed(remove or cut) their forked tails ذيولها المتشعبهand
become schistosomulae
8. Schistosomulae migrate تهاجرvia venous circulation to the
lung
9. And then heart and from the hear to the portal vein (liver)
10. In portal vein get mature to male and female worms
11. And eggs goes to elimination tracts
More specific information about each type
موجوده في بوربوينت مش غاوي تعب انا وكل ده بيحصل بعد وصلها للكبد
A. S.japonicum found frequently in the superior mesenteric
veins drainage the small intestine
B. S.mansoni found in superior mesenteric viens drainage the
large intestine
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C. Both species can occupy in both location and can move
between them so we can't say that one species only occurs
in one location
D. S. haematobium most often occurs in venous plexus of
bladder but it can also occurs in rectal venules
E. Female size 7-20 mm and males is slightly smaller deposit
eggs in the small venules of the portal and pervesical system
F. The eggs moved to intestine or bladder
Diagnosis
Eggs in the stool or urine
Infective stage
Cercariae
Mode of transmission
Penetrate skin of human and entre the blood vessels
Factors affecting infection
Host factors
1. Age and sex (male and children)
2. Social class (poor people)
3. Occupation (framers)
4. Habits (polluting water with urine and stool leads to spread of
disease)
انه مقرف+ علم ابن عمك الصغير ان يعمل ببي في البحر ده غلط
Environmental factors
1. Artificial lakes and channels
2. Water pollution
3. Presence of snails
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Prevention and control
1. Treatment of infected cases
2. Health education
3. Environmental sanitation
4. Snail control
Control of schistosomiasis
• Schistosomiasis control program
✓ Chemotherapy
✓ Snail control
✓ Prevention of human contact with infected water
• Chemotherapy
Niridazole & praziquantel
• Snail control
Clean of canals & chemicals
• Prevent of human contact
Health education
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Cestodes (Taenia species)
Important information
• Polyzoic
• Incapable of free living
• There is no digestive tract, it absorbs their nutrients from the
surrounding
• Muscular system is poorly developed
• Excretion happened by a pair of longitudinal excretory canal
which run the entire length of proglottid
اإلخراج بيتم عن طريق زوج من القنوات الطويلة التي تمتد بطول الفرد
• Longitudinal nerve cord shared by complete worm
في عصب زي القناة اإلخراجية كده طويل ويشاركوا جميع الخاليا النــــــاضــــجــــة
• Reproductive system is well developed such as there are
more than 90 reproductive structures
• And both male and female exist in each segment (proglottid)
• Reproduction is sexual and performed internally
• most time it can be done between two different tapeworms
cross fertilize
Taenia parts
Scolex (head)
Mature proglottids
Gravid proglottids
Taeniasis
Parasite Definitive host Intermediate host
t.saginata Man Cattle
T.solium Man Pig
e.granulosa Dog Sheep and cattle
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Lifecycle
1. Eggs and gravid proglottids are passed with the stool
2. Eggs can survive for days to months in the environment
3. Cattle and pigs are infected by eating vegetation that had
eggs or gravid proglottids (intermediate host)
4. It reformed to oncospheres (hexans embryo) hatch and
invade the intestinal wall and migrate to the striated muscle
5. And then become cysticercus and it survive for years in the
animal meat (infection stage)
6. T.solium cysticercus called encysticercus in bovis /t.saginata
cysticercus called encysticercus in cellulosae
7. Human infected by eating raw or undercooked meat
8. Cysticersus develops over 2 months to adult tapeworms in
the intestine and it can survive for years
9. Adult worm attach to the small intestine by scolex and stay
their
Life cycle numbers
t.saginata length: 5 or less but it can reach to 25 m
t.solium length: 2-7m
adults' worms produce proglottids and become gravid بيضه او حامل
and separate from the tapeworm and migrate to the anus or
passed in the stool: approximately 6/day
t.saginata have 1,000 to 2,000 proglottids
t.solium have 1,000 proglottids
eggs contained in the gravid proglottids and release after
proglottids passed in the stool
t.saginata produce up to 100,000 eggs
t.solium produce up to 50,000 eggs
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diagnosis
difficult to diagnosis in first 3 moths
diagnosis presence of gravid proglottids (most common) and
eggs (rarely)
cysticercosis
when larval stage of t.solium (cysticersus) is present in the tissue
of human
human act as intermediate host
human can infected by t.solium eggs in food and drink or by
autoinfection
hydaitdosis
when larval stage of e.granulosus (hydatid cysticersus) is present
in the tissue of human
human act as intermediate host
human can infected by e.granulosus eggs in food and drink
prevention control
• Identification and immediate institution of enteric precaution
for person harboring (host) t.solium are essential to prevent
cysticercosis
• Education to the public to prevent contamination of soil and
animal food and water with human feces
• Inspection and detection cattle and pigs
• Prevent pigs and cattle from reaching to human feces
• Isolate patient who has t.solium until he is successful treatment
• Concurrent disinfection education (hand washing)
• Investigation of contact and source of infection
• Treatment of infected cases
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Primary prevention
For taeniasis
• Cook the meat well before eating
• Examination of cattle before slaughtering for meat
For echinococcosis
• Improve personal hygiene
• Wash food before eating it
• Treat dogs
Secondary prevention
Early diagnosis and treatment
For recapping
Animal lifecycle
Sheep Definitive host flukes
Lymnea snail Intermediate
host
Biliary tree in habitat
liver
Encysted Infective stage
metacercaria
Eang Mode of
metacercaria in transmission
food
Eggs in the stole Diagnostic stage
Human Definitive host schistosomiasis
Cercaria Infective stage
Skin penetration Mode of
transmission
Special snail Intermediate
host
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Portal vein (liver) Habitat
Eggs in the stool Diagnostic stage
Human Definitive host t.solium
Cattle Intermediate
host
encysticercus in Mode of
cellulosae transmission
in animal meat Infective stage
Small intestinal Habitat
of human
gravid proglottids Diagnostic stage
(most common)
and eggs (rarely)
Human Definitive host t.saginata
Pig Intermediate
host
encysticercus in Mode of
bovis transmission
in animal meat Infective stage
Small intestinal Habitat
of human
gravid proglottids Diagnostic stage
(most common)
and eggs (rarely)
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Phylum aschelminthes
(Round worms)
Species
• Small intestine
1. Ascaris lumbricoides
2. Hookworms (ancylostoma duodenale, necator americanus)
3. Strongyloides stercoralis (facultative parasite)
• Large intestine
1. Enterbius vermicularis
2. Trichuris trichiura
• Tissue nematodes
1. Trichinella spiralis
2. Wuchureria bancrofti
3. Brugia spp
4. Loa loa
5. Onchocerca volvulus
Characteristics
• Slender worm with tapering end
)يعني مسلطح مع نهايات حاده (شبه السكينه كده
• No segmentation
• Most free living
• Important decomposer in soil, oceans, and lakes
مهم للبيئه وعايش فيها
• Triploblastic (developed from all 3-germ layer)
طبقات في البيضه3 بتسلخ مرتين يعني بيعمل
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• Pseudocoelomates بص هي حاجه في تركيب الكائن نفسه مش مهم
Diversity (types)ممكن تقول التكيف برضوا
• Numerous of
1. Number of species
2. Number of individuals
بتوافر كتيير سواء الفاصيل او عدد االفراد بتاع كل قصيله
• Live virtually every where
بتعيش في كل مكان
• 90,000 known species unknown 10x more
الف ولكن في عشر اضعاف العدد غير معروف لسه90 العدد المعروف ليهم حوالي
Ascaris lumricoides
Life cycle
1. Fertilized and unfertilized eggs passed with feces (diagnostic
stage)
2. Unfertilized not infective but fertilized eggs in optimum
environment start larvae stage within 18 days
3. Fertilized egg cell form rhabditid larva and then form filari
larva (infective stage)
ملحوظه األسماء ديه مش موجوده في البور وال في الموقع بس الدكتور قالهم فممكن
يكون فيهم أخطاء امالئيه
4. The eggs got swallowed (enter definitive host)
5. Larvae hatches invade the intestinal mucosa and goes to the
portal vein and then liver and from the liver to the heart and
then lung
6. Larvae stay 10 to 14 days in the lung
7. And penetrate the alveolar walls and goes to bronchial tree
and
8. Throat to be swallowed
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9. Goes to small intestine again and develop to be adult worm
10. And start eggs formation and fertilization
More important info
• Females produce approximately of 200,000 eggs per day
• Infective stage requires 2 to 3 months from ingestion
• Female can live 1 to 2 years
• Ascaris left the host body from rectum at night
سؤال خسيس ملهوش دعوه بالواقع بس يقيس فهمك للمكتوب
في دوره الحياة دية؟؟ هسيب االجابه في االخرintermediate host ليه مفيش
Prevention
• Detection and treatment of infected cases
• Proper sanitation, proper hand hygiene
• Health education to prevent soil and water contamination
with faeces
شوف لتاني مره علم ابن عمك الببي في غير التيولت غلط بيجيب امراض
هيطلع دوده من منخيره بعد كده
• Eliminating the use of nightsoil سماد الطبيعيas fertilizer for
crops
• Once the eggs in the environment they can persist for long
period of time
بنسبه للسؤال الي فوق االجابه عشان مفيش أصال تكاثر الجنسي حصل تقريبا نواه
البيضه نضجت بقيت خليه الخليه دخلت االنسان نضجت في الرئه وبعد كده راحت
األمعاء وبلغت هناك وكونوا بيض تاني
ده هوست بيحصل فيه التكاثر الالجنسي الي بيكون الخالياIntermediate host
الي بتنقل للكائن الديفنتف عشان يحصل فيه تكاثر جنسي
يارب تكون فهمت
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Ancylostoma duodenale
Life cycle
1. Eggs in the stool (diagnostic stage)
2. In good conditions after 1 to 2 days it released rhabditiform
larvae and after 5-10 days released filariform larvae
(infective stage)
3. Larvae penetrate the skin to the veins and heart and then
lung (enter definitive host)
4. And penetrate pulmonary alveoli and goes to bronchial tree
5. And throat to be swallowed
6. And then the small intestinal where it's become adult
(habitat)
7. And it lives in the lumen of the small intestine where they
attach to the intestinal wall which cause blood loss by the
host
8. Most adult worms are eliminated in 1 to 2 years, but it can
reach several years
More info
• Ancyloctoma duodenale larvae can become dormant ()ساكنه
in the muscle or intestine and infection can occur by oral or
transmammary الرضاعهrout
• necator americanus requires a transpulmonary migration
phase
بيقولك ليها مرحله بتنتقل فيها عن طريق الرئه زي اخوتها يعني
Prevention and control
• treatment of infected cases
• health education
• improve sanitation and controlled feces
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• wearing shoes in the endemic areas
tissue nematodes
habitat in the tissue
الدكتور جه هنا وشرح الحاجة بلغبطه سيكا فهنمشي بنقط تحت بعض الن مش عندنا ليف
سيكل كامله
wuchereria bancrofti (bancroftian
filariasis) elephantiasis
• habitat in the lymphatic tissue= adult live in the lymph nodes
• females produce microfilariae and are found in the blood at
night only
• microfilariae are the diagnostic stage; we take blood sample
from the patient at night to diagnose
• microfilariae transmitted by anopheles' mosquitoes (vector)
• microfilariae are infective stage
• adult worm has a short lifetime
• repeated infection with filariasis can result blockage of the
lymph nodes
• which cause swelling of the lymph nodes
sign and symptoms
• endemic area
• lymphatic obstruction
• white or milky substance in the urine
diagnosis
• endemic area
• nocturnal blood sample
o micro filaria worm
o multi nucleated
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o double chases
• surgical diagnosis looking for antibodies
trichinella spiralis (trichinellosis
/ trichinosis)
life cycle
1. juveniles ( )زي البيضه كدهare digested from undercooked meat
2. grow to maturity and start sexual production in the small
intestine in few weeks
3. they produce juveniles and male die after fertilizing and
female die after producing larvae
4. juveniles migrate into muscle host (diagnostic stage) (patient
will complain of swelling in the muscle)
5. carnivores and omnivores animals and human (accidentally)
are infected when they eat under cooked meat
بيتم أصابه الكائنات اكله الحم او الكائنات التي تاكل العشب والحم معانا عن طريق الحم
الني
في االنسان في حاله أصابه االنسانmuscle swelling معلومه صغيره بيحصل
أصال مش بتصيب االنسان بشكل اساسيtrichinellaو
Diagnosis
1. blood sample
2. surgical diagnosis
recapping
Ascaris lumricoides Habitat Small intestine
Definitive host Man
Infective stage Fertilized egg
Diagnostic stage Eggs in the stool
Ancylostoma Habitat Small intestine
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duodenale Definitive host Man
Diagnostic stage Eggs in the stool
Infective stage Larvae penetrate the
skin
Filariasis Habitat Lymph nodes
Definitive host Human
Diagnostic stage Worm in nocturnal
blood sample
Infective stage Microfilariae
Trichinosis habitat Small intestine
Definitive host Carnivores and
omnivores animals and
human (accidentally)
Diagnostic stage juveniles in the blood
sample
Infective stage Juveniles in the raw
meat
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Phylum protozoa
Characteristics
• Unicellular
• Belong to eucaryota (subkingdom )مملكة فرعيه
• Each cell is complete organism that mean each cell of
protozoa capable of perform physiological function like
1. Elimination
2. Nutrition and breathing (metabolism)
3. Reproduction
4. Locomotion طريقه الحركة
• Parasitic to human but they keep general characteristics of
their free living counter parts
ولكنها تحافظ علي الخصائص العامه لنظائرها التي تعيش بحريه،تتطفل علي البشر
مش فاهم حاجه صح وحياتك وال انا بس الدكتور متكلمش عنها اعتبرها ملغيه
• They can survive in the adverse system of the host
عايز يقولك انهم ممكن ينجوا من مناعه جسمك
Classification
احنا بنقسم تبعا لكذا حاجه مثال طريقه التنفس باالكسجين وال منغير وطريقه الحركه الغذاء
وكتير والي تحت الي الزم تعرفهم
• Aerobic and anaerobic محتاجه اكسجين وال ال
• Locomotor system
• Nutrition
• Reproduction
• Habitat
دلوقتي هنتكلم علي اهم األنواع و هناخد كام مثال ليهم
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Class rhizopoda (amoeboid protozoans)
Members use pseudopodia (false feet) for locomotion
الحركه بتعتها ضعيفه اوي
Example (entamoeba histolytica)
General information
• Geographical distribution: cosmopolitan prevalent tropics and
sub tropicsالمناطق االستوائيه و شبه االستوائيه
• Pathogenesis: pathogenic
• Habitat
o Primary site: intestinal mucosa of large intestine (colon)
o Secondary site: lung, liver &brain
• No intermediate host
• Reservoir host: other mammals (pig &cattle)
• Infective stage: mature quadrinucleated cyst
• Mode of transmission: ingestion
• Laboratory diagnosis: cysts or trophozoites in feces
Note: you can see trophozoites in first 10min of taking
sample
Life cycle
1. Cysts and trophozoites are passed in feces
2. Ingestion of mature cysts from fecally contaminated food,
water or hands
3. Excystation occurs in the small intestine and trophozoites
4. And get migrate in large intestine
5. Trophozoites may remain confined to the intestinal lumen
(noninvasive infection) with individuals continuing to pass
cysts in their stool (individual called asymptomatic carriers)
or it invade the intestinal mucosa (intestinal disease) or blood
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vessels reaching extraintestinal sites (liver, brain, and lung)
(extraintestinal disease)
طبعا انت مش فاهم كلمه بص في تالت سينريوهات ممكن يحصلوا في حاله اصابتك
األول انها هتتكاثر جوه الكولون بس مش هتهجم علي جدارtrophozoitesبال
(حامل للمرض مش مصاب بيه شبه كده كورونا ممكن تتصاب بيه بس ميظهرش عليك
اعراض ساعتها بتكون حامل للمرض مش مصاب بيه) ملحوظه انت جتلك االنفكشن
بس مجلكش المرض فاهم الفرق
تغزو جدار األمعاء و ساعتها بتبقا مصابtrophozoitesتاني سناريو هو ان ال
تهاجر وتغزو حته تاني خالص زي الكبد وtrophozoitesفي بقا سناريو تالت ان ال
الدماغ او الرئه او حتي الدم
6. There is two mode of reproduction trophozoites capable of
binary fission( )االنشطار الثنائيand produce cysts
7. Cysts and trophozoites are passed in feces
8. Cysts survive days and weeks in the environment but
trophozoites destroyed rapidly
9. Trophozoites cannot survive in gastric environment (not
infective)
Prevention
• Prevent ingestion of fecally contaminated food or water (best
method)
• Filtering or purifying water (iodine or boiling) in endemic area
• Washing fruits and vegetables
• Improve sanitation
• Travelers to endemic area shoulde use bottled water and ice
cubes and washing fruits and vegetables with clean water
• Proper treatment
• Health education
وتاني نوع عندناprotozoa متسرحش احنا كنا بنتكلم على تقسيمه
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Class zoomastigophora (flagellate protozoans)
These organisms move by flagellum
Types
• Intestinal flagellate
• Tissue flagellate
• Blood flagellate
Example (giardia lamblia)
Habitat: duodenum (intestine)
Diagnosis: cysts and trophozoites in feces (trophozoites move
faster and easier to see)
Infection: ingestion of cysts (most happen in children)
Signs of infection diarrhea and duodenities
Class ciliate (ciliated prozoans)
These organism move cilia (small , hair like)
Example (Balantidium coli)
Class piroplasmasida
There bodies are
• Small
• Pyriform to ameboid
They possess no (spores, flagella or cilia)
Example (babesia)
Class sporozoa
• It has both sexual and asexual cycle
• It requires two host to complete life cycle
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• It use small pseudopods for feeding
• And use body flexion to motility
Example (plasmodium spp)
Types of plasmodium (agent)
• Plasmodium vivax (incubation 14 day)
• Plasmodium malariae
• Plasmodium falciparum (malignant malaria) (incubation 12
day)
• Plasmodium ovale
Malaria
General information
• Malaria is acute disease caused by plasmodium group and
transmitted by anopheles' mosquito
• Disease is seen all over the world especially in developing
countries
Epidemiological factorsاسباب انتشار العدوا
• Malaria is seen warm, humid climate with frequent rainfall
• Presence of female anopheles' mosquito
Malaria index
• Annual parasite incidence (API): number of confirmed cases
per 1000 population in 1 year
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Life cycle
علي فكره خدنها في ثانوي
In human
1. Sporozoites infect human through female anopheles
2. Sporozoites infect liver cells
3. And get mature inro schizonts
4. Schizonts rupture and release merozoites
5. After replication in the liver, parasites undergo asexual
multiplication in the erythrocytes (RBCs) but there is two
scenarios
a. Merozoites infect RBCs and cause ring stage
(trophozoites) and mature into schizonts and Schizonts
rupture releasing merozoites
b. Merozoites infect RBCS and differentiate into sexual
erythrocytic stage(gametocytes)
In female anopheles
1. Mosquito ingested gametocytes (male microgametocytes
and female macrogametocytes)
2. Parasites' multiplication in the mosquito (sporogonic cycle)
3. In the mosquito stomach, microgametocytes penetrate
macrogametocytes generating zygotes
4. Zygotes become motile an elongated ()زي سن السرنجه كده
(called ookinetes)
5. Ookinetes invade midgut wall and developed into oocysts
6. Oocytes grow and rupture and release sporozoites
7. Which find their way to mosquito's salivary glands
8. And invade humans again
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بص األول االسبرورزويتات بتروح لإلنسان عن طريقه النموسه بتطلع علي دم ومن دم
علي كبد وبتتكاثر ال جنسيا فيه عن طريقه انها تغزوا خاليا الكبد و بعد تقطعها و تطلع
الميزو زويتات الي بتغزوا كرات الدم الحمرا
في حاله بقا الغزو بتاعه كرات الدم الحمرا ممكن تحصل حاجه من االتنين يا اما تتغذي
الميزو زويت علي الخليه و تقطعها و تطلع بعد كده او تغير شكلها لمشيج مذكر او مؤنث
لما النموسه بقا بتبلع المشجين دول بيتكاثروا ال جنسيا االةل بالتضاعف خالل دوره اسمها
فوق و بعد كده بيخترقوا بعض و بيطلع الزيجوت الي بيغير شكله عشان يكون عامل زي
سن االبره و يخترق معده وبتروح للميدجت عشان تتحوصل بعد ببتقطع و عشان تتحرر
االسبوروزويتات الي بتروح لغدد النموسه و بتصيب االنسان تاني
Prevention
Primary prevention
• Environment improvement
• Anti-mosquito measures
• Anti-larval measures
• Prevent mosquito bites by nets
• Chemoprophylaxis – chloroquine
Secondary prevention
• Early diagnosis and treatment
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Medical entomology
Study of arthropods and disease they transmit
Arthropods could be vectors of disease or cause discomfort to the
human
Mosquitoes
• Female anopheles' mosquito is a vector of malaria
• Female culex mosquito is a vector of filariasis
• Female aedes is a vector of dengue and yellow fever
House flies (musca domestica) دبان
• Mechanical carrier of some disease
• Cause noise and discomfort
Lice (pediculus human capitis)
• Spread of typhus fever
Fleas
Rodent fleas especial are able to transmit disease (typhus and
plague)
Bedbugs (cimex lectularius)
• Their bites can be very uncomfortable (face, arms and legs)
• They don't carry any disease
Ticks
Are responsible for spreading diseases such as babesiosis,
typhus, tick-born encephalitis and lyme disease
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Mites
Small mite cause scabies and burrows into outer layers of the
skin and cause itch
Mites don't carry any disease
Spiders
Most of spiders are harmless
But few species are harmful to human their bites associated with
significant pathology and rare reports of death
Scorpions
Their sting may cause death
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