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,