Parasitology - Trematodes
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What are trematodes?
- Platyhelminthes - hermaphroditic parasites of vertebrates
- aka Flukes
What intermediate host do trematodes require?
A mollusk (snail or clam)
Fasciolopsis buski - Where?
India, China, SE Asia
Fasciolopsis buski - How do you get it?
Ingestion of metacercariae on vegetation contaminated by infected mollusk
Fasciolopsis buski - Life cycle?
- Eggs passed in feces
- Matures to miracidium - infects mollusk
- Leaves mollusk as Cercaria
- Metacercariae ingested
Fasciolopsis buski - Presentation?
- Attachment of large worms to bowel mucosa
- Inflammation, ulceration
- Diarrhea, malabsorption
- Pernicious anemia (B12 def.)
Fasciolopsis buski - Diagnosis?
O&P in stool
Fasciolopsis buski - Treatment?
Praziquantel (Biltricide) - a platyhelminthicide
Clonorchis sinensis - Where?
Clonorchis sinensis - How do you get it?
Ingestion of metacercaria (usually in infected fresh water fish)
Clonorchis sinensis - Presentation?
- Worms live in bile ducts
- Usually asymptomatic
- Fever, diarrhea, pain, anorexia, hepatomegaly, jaundice
- Biliary obstruction
Clonorchis sinensis - Diagnosis?
- O&P in feces
Clonorchis sinensis - Treatment?
Praziquantel or albendazole
Opisthorchis felineus - Where?
Central and Eastern Europe, Siberia
Opisthorchis felineus - Describe
- Very similar to clonorchis sinensis
- From consumption of uncooked fresh water fish
- Also inhabits the bile ducts
Opisthorchis felineus - Treatment?
Opisthorchis viverrini - Where?
Opisthorchis viverrini - How do you get it?
Consumption of uncooked fresh water fish
- Another liver platyhelminth
- Inhabit bile ducts
Opisthorchis viverrini - Treatment?
Fasciola hepatica - Where?
Fasciola hepatica - How do you get it?
Ingestion of encysted metacercariae on aquatic vegetation
Fasciola hepatica - Presentation?
- Worms in gallbladder and bile ducts
- May be found ectopically
- Fever, chills, RUQ pain
Fasciola hepatica - Diagnosis?
- O&P of stool
Fasciola hepatica - Treatment?
- Lung fluke
- Usually P. westermani
Paragonimus spp. - Where?
East Asia, Africa, Americas
Paragonimus spp. - How do you get it?
Ingestion of raw crayfish or fresh water crabs with encysted metacercaria
Paragonimus spp. - Presentation?
- Metacercariae excyst in the small intestine, penetrate to lungs
- Inflammatory reaction, cough, bloody sputum
- Dangerous if becomes cerebral paragonimiasis
Paragonimus spp. - Diagnosis?
ID of dark golden-brown eggs in sputum or feces
Paragonimus spp. - Treatment?
Praziquantel or bithionol
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