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Trematodes

Trematodes. Gregory L. Brower, D.V.M., Ph.D. Cell Biology and Anatomy School of Medicine Columbia, South Carolina. Trematodes (Flukes). Schistosoma S. mansoni S. hematobium S. japonicum Fasciolopsis buski Fasciola hepatica. Opisthorchis O. sinensis O. felineus O. viverini

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Trematodes

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  1. Trematodes Gregory L. Brower, D.V.M., Ph.D. Cell Biology and Anatomy School of Medicine Columbia, South Carolina

  2. Trematodes (Flukes) • Schistosoma • S. mansoni • S. hematobium • S. japonicum • Fasciolopsis buski • Fasciola hepatica • Opisthorchis • O. sinensis • O. felineus • O. viverini • Paragonimus • P. westermani • P. kellicotti

  3. Schistosomiasis • It is believed that Napoleon's army in North Africa was defeated not by the enemy but by infestation of his soldiers with Schistosomal infections.

  4. Schistosomiasis:Geographical Distribution

  5. 1 cm The Schistosome

  6. Schistosoma:Life Cycle

  7. A Case of Hematuria An 8-year-old son of an Egyptian immigrant family is referred to the nephrology clinic with a 2-yr history of painless macroscopic hematuria. Smear from a centrifuged urine sample revealed this object: NEJM 2000

  8. Site Symptoms Pathogenesis Skin Dermatitis (swimmers’ itch) parasitic toxic material, skin damage GI abdominal pain, ascites, diarrhea, bloody stool (mansoni & japonicum inflammatory response to eggs (mucosal fibrosis) chronic cystitis and urethritis Urogenital granulomatous fibrosis due to egg-deposits Schistosomiasis:Symptoms

  9. Schistosomiasis:Symptoms Cercarial Dermatitis

  10. Schistosomiasis:Histologic Appearance

  11. 50 m Schistosomiasis:Diagnosis • History • Symptoms • Histology • Eggs in the urine or stool S. Hematobium Terminal Spine S. Mansoni Lateral Spine S. Japonicum Smaller egg Minute Spine

  12. Schistosomiasis:Treatment and Control • Praziquantel is effective • Avoid swimming in snail infested water • Sanitary disposal of sewage • Elimination of snails

  13. Schistosomiasis:Treatment and Control

  14. Fasciolopsisbuski:Giant Intestinal Fluke Geographic Distribution

  15. 5 cm Fasciolopsisbuski:Morphology

  16. Fasciolopsisbuski:Life Cycle

  17. Fasciolopsisbuski:Life Cycle

  18. Fasciolopsisbuski: Symptoms • Epigastricpain • Nausea • Diarrhea • Generalized edema and ascitisin heavier infections

  19. Fasciolopsisbuski :Diagnosis • Symptoms • History of eating uncooked water chestnuts in endemic areas • Eggs in stool

  20. Fasciolopsisbuski: Treatment and Control • Praziquantel is effective • Avoid eating uncooked water chestnuts in endemic areas • Sanitary disposal of sewage • Elimination of snails

  21. 1 cm Fasciola hepatica:Life Cycle

  22. Fasciola hepatica:Life Cycle

  23. Fasciola hepatica : Symptoms • Upper quadrant tenderness and pain • Chills and fever • Eosinophilia • Hepatitis • Hyperplasia and blockage of bile duct

  24. 50 m Fasciola hepatica :Diagnosis • Symptoms • History of eating uncooked watercress from infested locale • Eggs in stool

  25. Fasciolahepatica: Treatment and Control • This species of fluke is Praziquantel resistant • Triclabendazole is effective • Avoid eating uncooked watercress in endemic areas • Elimination of snails

  26. Treatment of Hermaphrodiditic Flukes

  27. Opisthorchissinensis: Geographic Distribution

  28. 1 cm Opisthorchissinensis: Morphology

  29. Opisthorchissinensis: Life Cycle

  30. Opisthorchissinensis: Symptoms • Epigastricpain • Indigestion • Liver necrosis and tenderness • Liver dysfunctions related to fluke burden • Diarrhea, hepatomegaly, jaundice and ascitesin heavier infections

  31. 30 m Opisthorchissinensis: Diagnosis • Symptoms • History of eating improperly cooked fish in endemic areas • Eggs in the stool

  32. Opisthorchissinensis: Treatment and Control • Praziquantel is effective • Avoid eating improperly cooked fish in endemic areas • Sanitary disposal of sewage • Elimination of snails

  33. Paragonimuswestermani:Geographic Distribution

  34. 5 mm Paragonimuswestermani:Morphology

  35. Paragonimuswestermani:Life Cycle

  36. Paragonimuswestermani: Symptoms • Dry cough, pleurisy • Pulmonary pain • Blood-stained rusty brown sputum • Fluke may migrate to brain, produce eggs and cause epilepsy-like symptoms

  37. 50 m Paragonimuswestermani:Diagnosis • Symptoms • History of eating improperly cooked crab-meat in endemic areas • Eggs in the sputum

  38. Helminthic Eggs

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