Lung & Liver Flukes

C sinensis is a type of _____ fluke

LIVER

Humans are infected with S. sinensis from ingesting uncooked _____

freshwater fish

C. sinensis is _____ in size that the Fasciola spp.

SMALLER

C. sinensis can live up to _____ in the human _____ tract

25 years; biliary

C. sinensis mostly causes _____ disease and only 50% of people get sick because the worms are _____ and don’t _____ the bile duct

asymptomatic; smaller; block

how do you diagnose C. sinensis?

eggs in stool

What are the TWO distinguishing features of C. sinensis eggs?

opercualted with shoulder; SMALLER

what is the geographic distribution of Clonorchis?

E and SE asia

True or False: Clonorchis can be found in the USA, despite not being an endemic area

TRUE → usually from immigrants bringing fish containing metacercariae

_____ does NOT kill the metacercariae → must be cooked

smooking/pickling

what is the infectious stage of C. sinensis for humans?

metacercariae

how do humans acquire C. sinensis?

ingestion of raw freshwater seafood

once ingesting the metacercariae; it will except in the _____ and adult will reside in the _____

duodenum; biliary duct

About how big are C. sinensis adults?

1-2.5 cm

Adult C. sinensis undergo _____ and produce _____ eggs that are released in the stool

self-fertilization; embryonated (DIFFERENT FROM F. buski and F. hepatica which released unembryonated eggs!)

The C. sinensis cercariae released from snails will encyst in the _____

skin of freshwater seafood

what type of host are humans for C. sinensis.

definitive

C. sinensis can cause _____ and _____ of the biliary ducts

finlammation; intermittent obstruction

what are the 4 main acute symptoms of C. sinensis?

abd. pain, nausea, diarrhea, eosinophilia

what at the the 4 main CHRONIC symptoms of C. sinensis?

cholangitis, cholelithiasis; pancreatitis; cholangiocarcinoma

what are the two primary ways of diagnosing C. sinensis?

eggs in stool or duodenal aspirate

C. sinensis eggs will not be excreted into stool when the _____ is _____

bile duct; obstructed

adult C. sinensis flukes can be recovered during _____

surgery

What is the primary treatment for C. sinensis?

prizaquantel or albendazole

Paragonimus westermani is known as the _____ fluke

lung

What is the geographic distribution of P. westermani?

Asia, India, Africa

P. westermani is transmitted to humans via cysts in undercooked _____

CRAB meat

P. westermani gggs are released in the tissue and thus case an _____ response followed by _____ reactions and eventually _____

immune; granulomatous; fibrosis

what are the 4 main symptoms of P. westermani?

cough, pleurisy, pulmonary pain, hemoptysis

how do you diagnose P. westermani?

eggs in SPUTUM

P. westermani eggs are REARELY found in the _____, but if they are, it is due to the individual _____ the eggs

feces; swallowing

_____ causes the USA-version of P. westermani in crayfish

P. kellicotti

after ingesting undercooked crab, the metacercariae will excyst in the _____ and adults will live in _____ found in the _____

duodenum; cystic cavities; lungs

P. westermani is shed into the environment via _____ eggs that are released in _____ or _____

unembryonated; sputum; stool (rare)

what is the second intermediate host for P. westermani?

Crab/crustaceans

P. westermani eggs, similarly to the other flukes, are _____, but it can be destroyed during an _____ stain which is used for TB testing (causing false _____)

opercualted; acid-fast; negatives

P. westermani can also be visualized in _____

lung tissue biopsies

how can P. westermani eggs be differentiated from the other flukes?

found in sputum not stool! (also medium sized)

What fluke is this?

Clonorchis sinensis

What fluke is this?

P. westermani