112.3 Digenea Flukes

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What is an Trematoda

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1

What is an Trematoda

Flukes (flatworms)

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2

What are the two groups of flukes

Intestinal/Organ flukes  & Blood flukes

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3

Trematodes require what to complete a life cycles

fresh water

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4

Do the trematodes have one or more intermediate hosts

yes

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5

Who is the first or only intermediate host for trematodes

freshwater snail

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6

What are other intermediate hosts for trematodes

fish, crayfish, crabs, H20 plants (bamboo, water cress/ chestnuts)

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7

What are some Intestinal/Organ Fluke Genera

Fasiolopsis buski: small intestine

Fasciola hepatica: liver; bile ducts

Clonorchis (Opisthorchis) sinensis: bile ducts

Paragonimus westermani: lungs

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8

What does Intestinal/Organ flukes eggs look like

operculated

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9

How can humans get infected with Intestinal/Organ flukes

Humans infected by encysted larvae in raw fish, crabs or raw vegetation-bamboo  & water chestnuts, etc.

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10

Are Intestinal/Organ flukes monoecious

yes

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11

Are Intestinal/Organ flukes leaf-shaped adults

yes

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12

What does blood flukes eggs look like

have a spine, but no operculum

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13

How can humans get infected with blood flukes

Humans infected by  larvae that penetrate the skin

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14

Are blood flukes dioecious

yes

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15

What are dioecious

female  in gynecologic canal  of the male

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16

Are blood flukes cylindrical adults

yes

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17
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Paragonimus (lungs)

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18
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Clonorchis (bile ducts)

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19
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Fasciola (liver; bile ducts)

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20
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Fasciolopsis (small intestine)

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21

What is the first intermediate hosts for Intestinal/Organ Fluke

fresh water snails

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22

What is Fasciolopsis buski and where does the adult live

Giant intestinal fluke

Small intestine

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23

What is the infective stage for Fasciolopsis buski

metacercariae in raw bamboo or water chestnuts

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24

What are the disease manifestations for Fasciolopsis buski

Adults in duodenum cause ulceration and inflammation of mucosa

diarrhea, anorexia, intestinal obstruction

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25

What are the heavy burdens for Fasciolopsis buski

diarrhea, anorexia, intestinal obstruction

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26

What is Fasciola hepatica where does the adults live

Sheep liver fluke

liver; bile ducts

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27

What is the infective stage for Fasciola hepatica

: metacercaria  encysted in  watercress

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28

What are the Disease manifestation for Fasciola hepatica

Adults live in bile duct/gallbladder

diarrhea, abdominal pain, hepatomegaly, cirrhosis, liver obstruction

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29

What are the heavy burdens for Fasciola hepatica

diarrhea, abdominal pain, hepatomegaly, cirrhosis, liver obstruction

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30

How can one tech differentiate between  Fasciolopsis/Fasciola eggs

measure  with micrometer

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31
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Fasciolopsis/Fasciola (Diagnostic egg)

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32

What is the diagnostic stage for Fasciolopsis/Fasciola:

Eggs in stool

Egg large, ellipsoidal with indistinct operculum

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33

What is Clonorchis (Opisthorchis) sinensis and where does the adults live

Chinese liver fluke

bile ducts

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34

What is the infective stage for Clonorchis (Opisthorchis) sinensis

metacercaria encysted in fish

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35

What are the disease manifestations for Clonorchis (Opisthorchis) sinensis

Adults in distal bile ducts

inflammation, fever, diarrhea, bile duct obstruction

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36

What are the heavy burdens for Clonorchis (Opisthorchis) sinensis

inflammation, fever, diarrhea, bile duct obstruction

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37

What is the diagnostic stage for Clonorchis sinensis

embryonated eggs in stool

small, vase-shaped; domed operculum; prominent shoulders

small knob opposite operculum

bile-stained

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38
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Clonorchis sinensis ( Diagnostic egg)

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39
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Clonorchis sinensis

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40

Are Heterophyes heterophyes and Metagonimus yokogawai eggs similar to Clonorchis sinensis but lack a knob

yes

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41

Where is Heterophyes heterophyes and Metagonimus yokogawai more commonly seen at

Far East

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42

What is Paragonimus westermani and where does the adults lives

Oriental lung fluke

lungs

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43

What is the infective stage for Paragonimus westermani

metacercariae encysted in  freshwater crabs/crayfish

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44

What is the Disease manifestations for Paragonimus westermani

Adults live in lungs

inflammation, persistent cough, hemopytsis (bloody sputum)

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45

What are the heavy burdens symptoms for Paragonimus westermani

inflammation, persistent cough, hemopytsis (bloody sputum

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46

What is the Diagnostic Stage for Paragonimus westermani

unembryonated Eggs in sputum  (or stool)

eggs: urn-shaped with small operculum and shoulders

bile stained

Note: Distinguish this egg from D. latum egg

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47
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Paragonimus westermani Diagnostic Egg

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48

What are the characteristics of Paragonimus westermani eggs

urn-shaped

small operculum

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49

What are the characteristics of Diphyllobothrium latum eggs

broadly oval/knob

larger operculum

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50
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Paragonimus westermani

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51
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Diphyllobothrium latum

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52
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Paragonimus westermani

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53

What are some blood flukes species

Schistosoma haematobium:

Schistosoma mansoni:

Schistosoma japonicum:

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54

Where does the adult form of Schistosoma haematobium live at

adults live in veins of urinary bladder; may lead to bladder cancer

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55

Where does the adult form of Schistosoma mansoni live at

adults  in veins of colon

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56

Where does the adult form of Schistosoma japonicum live at

adults in veins of small intestine

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57

What is the infective stage of Schistosoma

cercariae larvae leave snail, swim in water, attach to human skin, lose their forked tail, and penetrate the skin, then enter circulation

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58

Where does the adults in Schistosoma develop/ migrate at

Adults develop in liver/lungs, then migrate in pairs through the hepatic portal vein to the veins of the small intestine, colon, or bladder, depending on the species habitat

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59

How can Schistosoma infect humans

Cercaria larva penetrate skin, lose tail

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60
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S. haematobium  

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S. mansoni     

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S. japonicum          

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63

What is the Disease Manifestations for Schistosomiasis from Cercaria larvae

local dermatitis: red/rash

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64

What is the Disease Manifestations for Schistosomiasis from Larval migration

urticaria, fever, malaise

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65

What is the Disease Manifestations for Schistosomiasis from Eggs

damage to veins & intestinal wall  as eggs penetrate and enter lumen of intestine or bladder

diarrhea or hematuria (S. haemtobium)

ascites, anemia, hypertension, enlarged liver and spleen, hematuria (bloody urine

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66

What is the chronic damage for Schistosomiasis from eggs

ascites, anemia, hypertension, enlarged liver and spleen, hematuria (bloody urine

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67

What is the Diagnostic Stage for Schistosoma haematobium

embryonated eggs in urine (or stool)

egg large, oval

prominent terminal spine

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68
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Schistosoma haematobium ( Diagnostic Egg)

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69

What is the Diagnostic Stage for Schistosoma mansoni

embryonated eggs in stool

eggs large, oval

prominent lateral spine

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70
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Schistosoma mansoni (Diagnostic Egg)

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71

What is the Diagnostic Stage for Schistosoma japonicum

embryonated eggs in stool

eggs large, round

small, indistinct lateral spine

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72
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Schistosoma japonicum (Diagnostic Egg)

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73
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