TREMATODES
MORPHOLOGY EGG ADULT
plump, ovoid, reddish brown, fluke (resemble coffee bean) ovoid, thickshelled, golden brown operculum unembryonat ed
MOT PREVENTION LUNG TREMATODES
CLINICAL COMPLICATION
DIAGNOSIS TREATMENT
Paragonimus westermani (metacercaria) cysts in lung
INTERMEDIATE HOST Snail
freshwater crabs or crayfish
MOT consumption of raw or improperly cooked, salted, or pricked crabs or crayfish, drunken prawns ingestion of raw viscera or meat of wild boar infected with immature flukes PREVENTION avoid eating raw or improperly cooked crabs or crayfish prevent contamination of cooked food with metacercariae thru proper handling snail control with molluscide
invasion of intestinal wall and abdominal cavity by young flukes fever, chills, diarrhoea, abdominal pain, allergic reactions (urticaria and eosinopilia) young flukes invade pleurae and lungs fever, chest pain, cough, dyspnea, malaise and night sweats haemoptysis chest pain
DIAGNOSIS
finding of characteristic eggs in sputum or faeces serology : ELISA, CFT
TREATMENT Praziquantel,
BLOOD TREMATODES
Schistosome Mansoni (cercariae penetrate through unbroken skin) Inferior mesenteric vein and its branches MOT
cercariae penetrate humans skin with help of proteolytic enzymes
Acute form (Katayamas fever) IgM ; IgG ; IgE hepatomegaly and hepatosplenomegaly (liver function tests relatively normal) Portal hypertension hematemesis from esophagus varices Pipe-stem fibrosis
DIAGNOSIS
Elongate, with a lateral spine projecting from the side
PREVENTION population-based chemotherapy to reduce morbidity providing a safe water supply health education snail control MOT
detection of eggs in faeces : formalinether technique, sedimentation technique
TREATMENT Praziquantel,
Schistosome Japonicum (cercariae penetrate through unbroken skin) Superior mesenteric vein and its branches
cercariae penetrate humans skin with help of proteolytic enzymes
Cercarial dermatitis (Paddy field itch) Acute form (Katayama fever) hepatosplenomegaly, hypersplenism, pancytopenia, ascites, esophagal and gastric varices bleedingoedema, anaemia large bowel: stricture, secondary bacterial or protozoan infection, adenocarcinoma of bowel Pipe-stem fibrosis
DIAGNOSIS
Spherical; minute lateral spine near one end of the egg seen in some strain
PREVENTION population-based chemotherapy to reduce morbidity providing a safe water supply health education snail control
detection of eggs in faeces : formalinether technique, sedimentation technique
TREATMENT Praziquantel,
Schistosome haematobium (cercariae penetrate through unbroken skin) Vesical venous plexus surrounding urinary bladder MOT
cercariae penetrate humans skin with help of proteolytic enzymes
Elongate with conspicuous terminal spine
PREVENTION population-based chemotherapy to reduce morbidity providing a safe water supply health education snail control
DIAGNOSIS detection of eggs in faeces : formalinether technique, sedimentation technique TREATMENT Praziquantel,
