Trematodes

Class : cestoda- Tapeworms Class: Trematoda-Flukes

Trematodes
Intestinal flukes— Heterophyes heterophyes Liver flukes— Fasciola hepaticaPulmonary flukes— Paragonimus westermani Blood flukes -- Schistosoma

Blood flukes

Schistosoma haematobium –Vesical veinsSchistosoma mansoni ----Intestinal veinsSchistosoma japonicum---Intestinal veins

Schistosoma haematobium

Schistosoma haematobium
Life cycle: Definitive host: man Intermediate host: Fresh water snails: (Bulinus ,Physopsis &Biomphalaria)

Epidemiology

Pathology


Macroscopic Microscopic

Symptoms

Irritative dermatitis Cough &hemoptysis Febrile reaction Eosinophilia Terminal hematurea Dysurea& frequency of micturition Suprapubic pain pyurea

Diagnosis

Urine examination: General Schistosoma eggs Hatching test Radiology Ultra-sound Blood exam & serology Intradermal skin test

Treatment

Schistosoma mansoni
Distribution Hosts Habitat

Pathology & symptoms

Skin penetration :Immature warms in the lungs Adult warm in the mesenteric veinsEggs in the intestine , liver, lungs….

Diagnosis

Stool examination Sigmoidoscopy & intestinal biopsy Serology , skin test, liver biopsy


Treatment
Oxamniquine orally : 15 mg \kg 2—4 doses Niridazole Praziquantil

Prevention of schistosomiasis

Reduction of sources of infection Prevent water contamination Snail control Avoid infested water people education

Schistosoma dermatitis

Swimmers itch

Liver flukes

Fasciola hepatica Inhabits (sheep,goats & catle) liver & biliary system

Life cycle

Adults in the biliary passages Immature eggs are evacuated with feaces Meracidium invades snails (lymnea spieces) leading (sporocyst, 1st & 2nd generation radia then cercaria) Cercaria encyst as meta cercaria on (aquatic plants & vegitations) ingested by mammals

Pathology & symptoms

Diagnosis
Eggs in the stool& deudenal aspirate Skin test Serology

Treatment

Bithionol 30-50 mg\kg on alternate days for 5-15 doses

Halzoun

Intestinal flukes
Heterophyes heterophyes Egypt & far east In small intestine of man & fish eating mammals 1st intermediate host: snail ( pirenella spieces) 2nd intermediate host: Fish.

Life cycle

Embryonated eggs in stool Ingested by snail(Sporocyst-radia-cercaria) Cercaria leave the snail encyst as matacercaria on scale fins & gills tail of fish. man infection by eating raw or imperfectly cooked fish

Diagnosis: eggs in stool Treatment :Praziquantel

Pulmonary flukes
Parogonimus westermani: Far east Inhabits : Lungs, pluera & bronchi Definitive host: Human ,domesticated &wild animals 1st intermediate host : snail 2nd intermediate host: fresh water crabs &cray fish


Diagnosis : eggs in the sputum or stool Treatment : Bithionol