flukes in other locations than blood - cuhas official website · opisthorchis viverrini...
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Flukes in other locations than bloodINTESTINAL FLUKES:
• Fasciolopsis buski
• Heterophyes heterophyes
• Metagonimus yokogawai
• Echinostoma spp
LIVER FLUKES:LIVER FLUKES:
• Clonorchis sinensis
• Opisthorchis viverrini
• Fasciola hepatica/gigantica
LUNG FLUKES:
• Paragonimus westermani
• Paragonimus mexicanus & P. spp.1
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Intestinal flukes
• Fasciolopsis buski
• Heterophyes heterophyes
• Metagonimus yokogawai• Metagonimus yokogawai
• Echinostoma spp (self-reading)
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Fasciolopsis buski
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Egg Fasciolopsis buski130-150 µm long by 60-90 µm wide
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Adult Fasciolopsis buski20-75 mm long
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Fasciolopsiasis
Water chestnuts vector (Planorbidae)
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Fasciolopsiasis Diagnosis & Management
DIAGNOSIS:
• Faecal examination: Stoll’s dilution, formalin-
ether concentration, direct smear, Kato
• Distinguishing from Fasciola eggs is difficult
MANAGEMENT:MANAGEMENT:
• Drug of choice: Praziquantel (15mg/kg)
• Risk of exacerbating obstruction or acute
toxaemia with treatment !!
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Heterophyes heterophyes
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Adult of H. heterophyes.Oral sucker (OS), pharynx (PH), intestine (IN), ventral sucker, or
acetabulum (AC), and eggs within the uterus (UT)
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Chlonorchiasis
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Opisthorchiasis
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O. felineus – adult
O. viverrini – egg 12
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An intrahepatic bile duct of a rabbit
infected with Clonorchis sinensis.
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Opisthorchiasis & clonorchiasis Epidemiology
O. felineus O. viverrini C. sinensis
Europe in animals Asia Taiwan, Hongkong,
China
Man infected by
eating raw fish
Man infected by
eating raw fish
Man infected by
eating raw fisheating raw fish eating raw fish eating raw fish
• Prevalence & intensity of infection increase with
age and is higher in males
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Cholangiocarcinoma
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Fasciola spp
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Fascioliasis Cycle
F. hepatica Def. host: sheep Temperate &sub-
tropical climate (South
Europe, Middle-East,
Central/ South America,
Africa
Vector: snail
F. Lymnaeidae
F. gigantica Def. host: mainly
cattle
South-East Asia & Africa Vector: snail
F. Lymnaeidae
• Both species can co-exist• Both species can co-exist
• Cysts are ingested by humans and excyst in duodenum then migrate through intestinal wall to the bile ducts. Eggs are produced after 3-4 m
• May live many years
• High humidity, moderate T°c & rainfall favourtransmission
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Fascioliasis
Water cress
Fossaria truncatula
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F. hepatica adult
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F. gigantica adultsup to 75 mm
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F. hepatica egg130-150 µm long by 60-90 µm wide
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LUNG FLUKES Paragonimiasis
• Agents:
Paragominus
westermani
P. miyazakii
P. skrjabini
P. heterotremus
ASIA
P. skrjabini
P. heterotremus
P. africanus
P. uterobilateralis
AFRICA
P. mexicanus
P. ecuadoriensis
LATIN/SOUTH
AMERICA
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Paragonimus spp.
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Paragonimus westermani
Adult (18-20 mm) Egg (80-120 µm)
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Fresh water food as sources of
infection
Trematodes Habitat in man
Fish Clonorchis sinensis Biliary system
Opisthorchis viverrini
Opisthorchis felineus
Crab and crayfish Paragonimus spp Pleural cavity and lungs,
occasional brain invasion
Water plants Fasciola hepatica Liver and biliary system
Table 83.1 -- Sources of common food-borne trematodes and affected organs in manFrom Manson’s Tropical Diseases, 22nd edition
Fasciola gigantica
Fasciolopsis buski Small intestine
Snails, clams fish and tadpoles Echinostomes Small intestine
Various species of fish, shrimps,
insect
Heterophyes spp Small intestine
Larvae and other aquatic foods Haplorchis spp
Metagonimus spp
Stellantchasmus spp
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