1E: Liver Flukes

Aquatic plants & contaminated water

2 places where liver flukes originate from.

Liver & biliary passages of humans & ruminants

2 locations where liver flukes go to.

Necrotic lesions

The immediate effect of a liver fluke infection.

Hepatic fascioliasis or chlonorchiasis

The effect of necrotic lesions caused by liver flukes.

Fasciola hepatics, F. gigantica, & Clonorchis sinensis

3 species of liver flukes.

Fasciola hepatics & F. gigantica

2 liver fluke species associated with snails & plants.

Clonorchis sinensis

The liver fluke species associated with snails & fish.

Prominent shoulders & a large broad flat body

The physical characteristics of Fasciola hepatica.

20-50mm

The length of Fasciola hepatica.

6-12mm

The width of Fasciola hepatica.

Operculated

The egg of Fasciola hepatica.

Less prominent shoulders, larger, also operculated

The physical characteristics of F. gigantica in relation to F. hepatica.

Unembryonated egg released from feces ⟶ embryonation in water ⟶ Miracidia hatch from egg ⟶ Look for 1st intermediate host snail ⟶ Sporocyst ⟶ Radial ⟶ Cercaria ⟶ Look for 2nd intermediate host aquatic plant ⟶ Metacercariae ⟶ Ingested by humans/sheep/cattle ⟶ Excyst in duodenum ⟶ Adult in hepatic biliary duct of human host

The 12 steps in the life cycle of F. gigantica infections.

Lymnaea philippinensis & Lymnaea auricularia rubiginosa

2 first intermediate hosts of F. gigantica.

Nasturtium officinale, Ipomea obscura, & Ipomea aquatica

3 second intermediate hosts of F. gigantica.

Nasturtium officinale

A second intermediate host of F. gigantica also known as a watercress.

Ipomea aquatica

A second intermediate host of F. gigantica also known as a kangkong.

Burrows in liver ⟶ necrotic legions ⟶ hepatic fascioliasis

The 3 steps in the pathology of F. gigantica infections.

Intense right upper quadrant abdominal pains

How F. gigantica infections manifest.

Egg in stool (duodenum) , Surgery (adult worms), & PCR

3 means of diagnosis of F. gigantica infections.

Egg in stool (duodenum)

The definitive method of diagnosing F. gigantica infections caused by adults in the biliary track causing bile to carry the eggs.

Species-level identification

The importance of PCR in the diagnosis of F. gigantica infections.

Bithionol & Triclabendazole

2 medications used to treat F. gigantica infections.

30-50 mg

The dosage of bithionol given during treatment of F. gigantica infections.

10mg/kg

The dosage of triclabendazole given during treatment of F. gigantica infections.

Washing of vegetables & control of snail hosts

2 means of preventing F. gigantica infections.

China

The country of origin of Clonorchis sinensis.

Humans, dogs, & cats

3 organisms which Clonorchis sinensis is a parasite.

Bile duct & gallbladder of humans & fish-eaters

2 locations within the body where Clonorchis sinensis.

Small protuberance at the end of the abopercular end

The physical description of Clonorchis sinensis eggs.

Ingestion of metacercariae in fish

The mode of transmission of Clonorchis sinensis.

Embryonated eggs in feces ⟶ 1st intermediate host snail ingests eggs ⟶ Metacercariae ⟶ Miracidium ⟶ Sporocyst ⟶ Radiae ⟶ Metacercariae ⟶ Encyst in fins & flesh of fish ⟶ Human consumption ⟶ Metacercariae excyst in duodenum ⟶ Migrate to ampulla of vater ⟶ Attach to mucosa of common bile duct VIA suckers ⟶ DIstal biliary capillary

12 steps in the life cycle of Clonorchis sinensis infections.

Pancreatic duct & Gallbladder

2 locations in the body where adult Clonorchis sinensis worms are found.

Tissue fluids, RBCs, & Mucus

3 things that adult Clonorchis sinensis worms feed on.

Released from worm

When Clonorchis sinensis are considered full mature

Released from worm ⟶ Passes with the bile ⟶ intestine ⟶ feces

What happens to fully matured Clonorchis sinensis worm eggs.

After first host ingestion

When Clonorchis sinensis miracidium hatch.

P. manchorius, P. anomaloispiralis, P. stratulus, Melanoides tuberculatus, Thiara granifera, & Bulimus striatulus

6 first intermediate hosts of Clonorchis sinensis.

Parafossarulus

The genera of Clonorchis sinensis first intermediate hosts.

Cyprinid fish

The second intermediate host of Clonorchis sinensis.

Weight loss, fatigue, altered appetite, & abdominal distress

4 symptoms of a Clonorchis sinensis infection.

Hepatomegaly & Liver Cirrhosis

2 signs of acute stage Clonorchis sinensis infection.

Hepatomegaly

Liver enlargement.

Liver Cirrhosis

Tenderness of the liver.

Egg in stool (duodenum), ELISA, & Radiological Examination

3 means of diagnosing Clonorchis sinensis infections.

Radiological Examination

A means of diagnosing Clonorchis sinensis that can be used if stool is not viable.

25mg/kg praziquantel 3x a day

The treatment plan given for Clonorchis sinensis infections.

Eat sufficiently cooked fish, Safe food preparation, & Public health promotion

3 means of preventing & controlling Clonorchis sinensis infections.