Trematodes

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-Varun C N Trematodes

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Varun- Trematodes 2

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3 important species S hematobium S mansoni S japonicum Schistosoma Varun- Trematodes 3

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Characters Unisexual Males are shorter and stouter than females Male possess a gynaecophoric canal, for holding the female Suckers are armed with spine Non Operculated eggs Adult Worms reside on Venous plexuses of definitive host Varun- Trematodes 4

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Varun- Trematodes 5

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Feature S hematobium S mansoni S japonicum Male Covered with minute tuberculation Covered with conspicuous tuberculation Covered with minute acuminate spine Female Ovary Posterior 1/3 rd of body Anterior half of body Middle of body Eggs discharged in Urine Faeces Faeces Infective form Fork-tailed cercariae that can penetrate intact skin Habitat Veins of vesical and pelvic plexus Mesentric vein draining sigmoido -rectal region Mesentric vein draining Ileo - cecal regions Definitive Host Man Man Man and Domsetic animals Intermediate Host Bulinus Species Biomphalaria Sp Oncomelania Sp Varun- Trematodes 6

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Bulinus Species Biomphalaria Sp Oncomelania Sp Varun- Trematodes 7

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Egg Feature S hematobium S mansoni S japonicum Shape Elongated Elongated Oval Shell Thin and Smooth Thin and Smooth Smooth thick shell Spine Terminal Lateral Small lateral Knob Taken from: http://www.kstate.edu/parasitology/625tutorials/Trematodes01.html Varun- Trematodes 8

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Varun- Trematodes 9

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Life Cycle Definitive Host-Human Intermediate Host- Snails Mode of infection- Exposure to Free swimming cercaria Infective form- Cercaria Mode of entry of Cercaria- Active penetration Intermediate forms- Miracidium Sporocyst (1 st and 2 nd Generation) Cercaria Varun- Trematodes 11

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Clinical Manifestations: Katayama fever High fever Hepato -splenomegaly Lymphadenopathy Eosinophilia Granulomatous inflammation Bladder cancer Paddy field dermatitis Varun- Trematodes 12

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Case of Hepato-splenomegaly due to schistosomiasis http://www.examiner.com/ Hematuria Varun- Trematodes 13

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Laboratory Diagnosis: For, S. japonicum and S. mansoni detection of the eggs in the feces after an iodine staining or Formol-ether concentration method. For S. haematobium terminal urine should be collected as the terminal drops contain a large proportion of the eggs. The urine can either be centrifuged and the deposit examined microscopically for ova. Eggs can sometimes be found in seminal fluid in males. Rectal swab examination Biopsy samples and histology Serology Varun- Trematodes 14

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Prophylaxis Prevent water pollution Eradication of Molluscan host Don’t walk in waters without proper protection Treat the infected Varun- Trematodes 15

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Fasciola Hepatica (Liver Fluke) Varun- Trematodes 16

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Adult worm: Large leaf shaped fluke Anterior end is distinct with a conical projection Two Suckers- Oral and Ventral The intestinal ceca , testes and vitelline follicles are branched. Life span- 10 Years Can produce up to 25000 eggs per day Eggs: Large, elliptical Yellowish brown Bile stained Operculated Contains immature larva Cannot be distinguished from F buski Varun- Trematodes 17

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Varun- Trematodes 18

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Life Cycle: Definitive Host- Sheep, Cattle, Human First Intermediate host- Snails (Lymnaea) Second Intermediate host- Aquatic vegetation Infective form- Metacercaria Mode of infection- Ingestion Varun- Trematodes 19

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Varun- Trematodes 20

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Varun- Trematodes 21

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Siamese Watercress Curry Varun- Trematodes 22

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In the chronic phase of fascioliasis adults in the large biliary ducts cause liver inflammation and obstruction of the biliary fluid. During the migration of the larvae (this acute phase of the disease lasts many weeks) symptoms include: diarrhea eosinophilia (high number of white blood cells) fever nausea stomach ache vomiting. Varun- Trematodes 23

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Lab Diagnosis: Detection of the eggs in the feces after an iodine staining or Formol-ether concentration method. Moderate to high eosinophilia Immunodiagnostic tests Surgically remove theorganism and then confirm the species Varun- Trematodes 24

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Fasciolopsis buski Varun- Trematodes 25

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Adult worm It is the largest trematode infecting humans Fleshy, dark red, leaf shaped structure No cephalic cone Two Suckers- Oral and Ventral The intestinal ceca , testes and vitelline follicles are branched Life span- 6 months Can produce up to 25000 eggs per day Eggs Large, elliptical Yellowish brown Bile stained Operculated Contains immature larva Cannot be distinguished from F hepatica Varun- Trematodes 26

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Varun- Trematodes 27

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Varun- Trematodes 28

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Life Cycle: Definitive Host- Human, Pigs First Intermediate host- Snails (Segmentina, Hippeutis) Second Intermediate host- Aquatic vegetation (Water caltrop) Infective form- Metacercaria Mode of infection- Ingestion Varun- Trematodes 29

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Varun- Trematodes 30

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Varun- Trematodes 31

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Lab Diagnosis: Detection of the eggs in the feces after an iodine staining or Formol-ether concentration method. Moderate to high eosinophilia Immunodiagnostic tests- ELISA Surgically remove the organism and then confirm the species Varun- Trematodes 32

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Some more…… Varun- Trematodes 33

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Clonorchis sinensis (Oriental liver fluke) Varun- Trematodes 34

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Paragonimus westermani Varun- Trematodes 35

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Gastrodiscoides hominis Varun- Trematodes 36

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Opisthorchis felineus Varun- Trematodes 37

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Varun- Trematodes Thank you for your kind attention You can also follow me at my blog. www.microboids.net 38