Flatworms: Trematoda Notes (Lecture Transcript Summary)

Trematoda (Flukes) — Overview

  • Flatworms in the phylum Platyhelminthes; two main classes covered here: Trematoda (flukes) and Cestodes (tapeworms).

  • General morphology: all are flat and dorsoventrally flattened.

  • Trematoda vs Cestodes:

    • Trematodes: not segmented; often leaf-shaped; referred to as flukes.

    • Cestodes: flat and long but segmented (tapeworms); described as more ribbon-like.

  • Trematoda anatomy to know:

    • Anterior end contains the mouth, surrounded by muscular oral suckers.

    • They attach to a host with a muscular structure called the acetabulum (a sucker).

    • They lack an anus and regurgitate their digested material back into the tissue of the organ they infest (colloquially called “fluke puke” during necropsy).

    • Digestive tract: esophagus leads to a blind sac (really the cecum).

  • Important anatomical distinction:

    • There are two acetabula in some contexts, but in this lecture the focus is on the acetabulum as the attachment organ at the mouth region.

  • Reproduction and eggs:

    • Trematodes are hermaphroditic (both male and female reproductive organs within the same animal).

    • Eggs (ova) have a single operculated end (operculum) and are passed out of the uterus via the genital pore into the environment through the host’s feces.

  • Habitat and life cycle:

    • All trematodes live in the gastrointestinal tract (GI tract) of the definitive host, though they may migrate to other tissues depending on the species.

    • Life cycle is indirect, requiring at least one intermediate host (typically a snail).

    • Five larval stages in the life cycle (varicutum → sporocyst → rhodea → cercaria → metasurgi state → merricurnium), with the metacercaria forming the infective stage for the definitive host via ingestion of contaminated vegetation or water. Depending on species, the cercaria can penetrate the definitive host’s skin.

  • Defining example of interest (Fasciola hepatica):

    • Predilection site is the liver (hepatic bile ducts).

    • Acute infection: large parasite burden can cause necrotic liver disease.

    • Chronic infection: fibrotic liver changes due to ongoing obstruction and tissue damage.

    • Diagnosis commonly via ova in fecal sediment exams.

    • PBS/necropsy observations may include liver rot in cattle.

  • General diagnostic and treatment themes:

    • Ova/ova-like eggs are key diagnostic targets in fecal exams.

    • Anthelmintic therapy often involves benzimidazole derivatives (e.g., albendazole) and related azole compounds; specific choices vary by species and host.

    • PPE is important due to zoonotic potential in some species and during necropsy.

    • Drug exposure regimens often require multiple days of treatment (not a single-dose approach) to cover different life stages.

  • Notable cautions and practical implications:

    • Snail intermediate hosts limit prevalence in some regions.

    • Some trematodes can be zoonotic or have zoonotic potential; proper PPE and handling protocols are essential during diagnosis and necropsy.

    • Drug safety margins vary by breed (e.g., Collies may have sensitivity to certain benzimidazoles).

  • Topics for the second section (to be discussed then): Cestodes (tapeworms) and their differences from Trematoda.


Fasciola hepatica (Fassiola hepatica in transcript)

  • Common name and host range:

    • Liver fluke with a strong association to sheep and cattle as typical hosts.

    • Accidental hosts possible.

  • Intermediate host:

    • Snail.

  • Adult morphology:

    • Leaf-like, flat adults with a broader anterior end than posterior.

    • Color ranges from grayish-brown to tannish/brownish; some individuals may appear grayish-brown to brownish.

  • Egg morphology:

    • Ova are yellowish-brown and oval in shape.

    • Each egg has a single end with an operculum (operculum).

    • When observed under the microscope, the operculum is visible at the end of the egg (arrow in images).

  • Site of predilection and pathology:

    • Predilection site is the liver, specifically the bile ducts.

    • Acute infection: necrotic disease of the liver due to a high parasite burden.

    • Chronic infection: fibrotic changes in the liver from ongoing obstruction and tissue remodeling.

  • Diagnostics:.

    • Best diagnostic method is detection of ova in fecal sediment exams.

  • Treatment options mentioned:

    • Iromet Plus (drug name as stated in transcript).

    • Albendazole (Albenzazol as stated).

  • Necropsy findings:

    • Liver rot in cattle due to obstruction and liver tissue damage.

  • Zoonotic and safety considerations:

    • The disease is described as zoonotic in the transcript (oaknotic); proper PPE is advised during handling and necropsy.

  • Other notes:

    • In some cases, flukes may migrate to lungs, but this is not typical for Fasciola hepatica.


Paragonimus kellicotti (Paragonimus kellicotti in transcript) — Lung fluke

  • Host range and ecology:

    • Commonly referred to as the lung fluke.

    • Host range includes dogs and cats as typical definitive hosts.

    • Intermediate hosts include snails and crayfish.

  • Adult morphology and eggs:

    • Adults are barrel-shaped and reddish-brown in color.

    • Eggs are yellowish-brown and have a single end with an operculum (operculum).

    • The eggs have a shell with a thicker opposite wall from the operculum side.

  • Predilection site and disease:

    • Predilection site is the lungs.

    • Pathophysiology can include eosinophilic peritonitis (note: peritoneal involvement is described here; in practice this may reflect pleural or pulmonary involvement depending on case and staging).

  • Diagnosis:

    • Tracheal wash cytology can reveal parasitic spheres when stained.

    • Fecal sediment examination may reveal eggs/ova.

  • Zoonotic potential:

    • Not zoonotic (or not commonly zoonotic) according to transcript; precautions still required.

  • Treatment options mentioned:

    • Praziquantel.

    • Fenbendazole (fentbenzanol as stated).

    • Albendazole (albenzanol as stated).

  • Notes on imaging/diagnosis in practice:

    • A tracheal wash can be used to obtain samples from the lungs for microscopic visualization of the parasite.

  • General notes:

    • Like other trematodes, this species requires an indirect life cycle with intermediate hosts before reaching the definitive host.


Neophytus samicola (Neophytus samicola in transcript) — Salmon poisoning fluke

  • Primary clinical association:

    • Common in dogs; not very common in the particular region discussed, but noted in the Pacific Northwest of North America.

    • Associated with salmon poisoning disease when the dog ingests second intermediate hosts (salmon) carrying the parasite.

  • Hosts and life cycle:

    • Intermediate host is a snail.

    • Second intermediate host is salmon (salmon species carry metacercariae that infect the dog when ingested).

  • Egg morphology:

    • Eggs are opiculated with a small blunt point at the end (small blunt point feature).

  • Adult morphology:

    • Adults are the smallest among the trematodes discussed and are white/cream in color.

  • Predilection site:

    • Small intestine.

  • Pathophysiology:

    • Acts as a vector for ricocelia agents and produces salmon poisoning, which can cause hemorrhagic diarrhea in the infected host.

  • Diagnosis:

    • Eggs in stool (fecal examination) can be used for diagnosis.

  • Zoonotic potential:

    • Rare zoonosis; precautionary handling advised but not typically zoonotic.

  • Treatments and pharmacology notes mentioned:

    • Drug classes referenced: azoles, specifically benzimidazoles, phenyl benzazoles, and benzomyzoles (collectively described as azoles in the transcript).

    • Drugs are described as requiring exposure over 3–5 days (three to five days) for effectiveness; some regimens may be a single-dose dewormer in certain circumstances.

    • Some regimens may use a combination of benzimidazoles and phenyl/benzazole derivatives for broader efficacy across different life stages.

    • Common drugs listed for trematodes include praziquantel and albendazole; fenbendazole and related benzimidazoles are mentioned as effective options.

  • Practical cautions:

    • Three-to-five-day exposure regimens are emphasized for effectiveness and safety; overdosing should be avoided.

    • Breed sensitivities to certain drugs (e.g., Collies and praziquantel or related compounds) may require caution.

  • Real-world relevance:

    • Salmon poisoning (Neophytus samicola) has a zoonotic and veterinary significance due to the vector role and potential severity in canines; awareness of regional prevalence is important for diagnosis and treatment planning.


Summary of key takeaways

  • Trematodes (flukes) share a leaf-shaped, flattened body plan and an indirect life cycle with snail intermediate hosts; they lack true segmentation.

  • They attach to host tissue using an oral sucker and acetabulum, lack an anus, and regurgitate digested material back into host tissue.

  • Eggs typically have a single operculum and are shed in feces; life cycles include multiple larval stages leading to metacercariae that infect the definitive host upon ingestion.

  • Fasciola hepatica primarily affects the liver and bile ducts in sheep and cattle, with potential occasional lung involvement; diagnosis via ova in feces and treatment with benzimidazoles/albenzazoles; liver rot is a necropsy finding.

  • Paragonimus calicati is a lung fluke with canine/feline hosts; diagnosis via tracheal wash and fecal eggs; treatment with praziquantel, fenbendazole, or albendazole.

  • Neophytus samicola causes salmon poisoning disease in dogs; a snail and salmon life cycle; hemorrhagic diarrhea is a key symptom; diagnosis via stool eggs; drug regimens emphasize benzimidazole/azole classes and praziquantel where appropriate.

  • Ethical and practical implications include proper PPE during handling (zoonotic risk), region-specific prevalence, and breed sensitivities to certain anthelmintics.

  • Cestodes (tapeworms) will be covered in the next section to contrast their long, ribbon-like, segmented morphology with the flattened, non-segmented trematodes discussed here.


Key terms to review
  • Acetabulum: the muscular sucker used for attachment to host tissue.

  • Operculum: the lid-like opening on trematode eggs; the single end with an operculum is a diagnostic feature.

  • Metacercaria: the infective encysted larval form for many trematodes after a series of larval stages.

  • Eosinophilic peritonitis: an inflammatory response involving eosinophils; mentioned in the context of lung fluke infection.

  • Hemorrhagic diarrhea: a key clinical sign in Neophytus samicola (salmon poisoning) in dogs.

  • Zoonosis: diseases that can be transmitted from animals to humans; PPE is advised for handling suspected cases.


Quick practice prompts
  • Describe the life cycle stages commonly seen in trematodes and identify where the snail intermediate host fits in.

  • Compare and contrast Trematoda and Cestodes in terms of morphology and life cycle.

  • List the primary predilection sites for Fasciola hepatica and Paragonimus calicati and the typical diagnostic methods used.

  • Outline the treatment considerations and potential breed sensitivities when using benzimidazole-based anthelmintics.

  • Explain why Neophytus samicola is particularly significant in certain U.S. regions and what clinical sign is most characteristic in dogs.