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Trematodes. Gregory L. Brower, D.V.M., Ph.D. Cell Biology and Anatomy School of Medicine Columbia, South Carolina. Trematodes (Flukes). Schistosoma S. mansoni S. hematobium S. japonicum Fasciolopsis buski Fasciola hepatica. Opisthorchis O. sinensis O. felineus O. viverini

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trematodes

Trematodes

Gregory L. Brower, D.V.M., Ph.D.

Cell Biology and Anatomy

School of Medicine

Columbia, South Carolina

trematodes flukes
Trematodes (Flukes)
  • Schistosoma
    • S. mansoni
    • S. hematobium
    • S. japonicum
  • Fasciolopsis buski
  • Fasciola hepatica
  • Opisthorchis
    • O. sinensis
    • O. felineus
    • O. viverini
  • Paragonimus
    • P. westermani
    • P. kellicotti
schistosomiasis
Schistosomiasis
  • It is believed that Napoleon's army in North Africa was defeated not by the enemy but by infestation of his soldiers with Schistosomal infections.
slide7

A Case of Hematuria

An 8-year-old son of an Egyptian immigrant family is referred to the nephrology clinic with a 2-yr history of painless macroscopic hematuria. Smear from a centrifuged urine sample revealed this object:

NEJM 2000

schistosomiasis symptoms

Site

Symptoms

Pathogenesis

Skin

Dermatitis (swimmers’ itch)

parasitic toxic material, skin damage

GI

abdominal pain, ascites, diarrhea, bloody stool (mansoni & japonicum

inflammatory response to eggs (mucosal fibrosis)

chronic cystitis and urethritis

Urogenital

granulomatous fibrosis due to egg-deposits

Schistosomiasis:Symptoms
schistosomiasis symptoms9
Schistosomiasis:Symptoms

Cercarial Dermatitis

schistosomiasis diagnosis

50 m

Schistosomiasis:Diagnosis
  • History
  • Symptoms
  • Histology
  • Eggs in the urine or stool

S. Hematobium

Terminal Spine

S. Mansoni

Lateral Spine

S. Japonicum

Smaller egg

Minute Spine

schistosomiasis treatment and control
Schistosomiasis:Treatment and Control
  • Praziquantel is effective
  • Avoid swimming in snail infested water
  • Sanitary disposal of sewage
  • Elimination of snails
fasciolopsis buski s ymptoms
Fasciolopsisbuski: Symptoms
  • Epigastricpain
  • Nausea
  • Diarrhea
  • Generalized edema and ascitisin heavier infections
fasciolopsis buski diagnosis
Fasciolopsisbuski :Diagnosis
  • Symptoms
  • History of eating uncooked water chestnuts in endemic areas
  • Eggs in stool
fasciolopsis buski treatment and control
Fasciolopsisbuski: Treatment and Control
  • Praziquantel is effective
  • Avoid eating uncooked water chestnuts in endemic areas
  • Sanitary disposal of sewage
  • Elimination of snails
fasciola hepatica symptoms
Fasciola hepatica : Symptoms
  • Upper quadrant tenderness and pain
  • Chills and fever
  • Eosinophilia
  • Hepatitis
  • Hyperplasia and blockage of bile duct
fasciola hepatica diagnosis

50 m

Fasciola hepatica :Diagnosis
  • Symptoms
  • History of eating uncooked watercress from infested locale
  • Eggs in stool
fasciola hepatica treatment and control
Fasciolahepatica: Treatment and Control
  • This species of fluke is Praziquantel resistant
  • Triclabendazole is effective
  • Avoid eating uncooked watercress in endemic areas
  • Elimination of snails
opisthorchis sinensis symptoms
Opisthorchissinensis: Symptoms
  • Epigastricpain
  • Indigestion
  • Liver necrosis and tenderness
  • Liver dysfunctions related to fluke burden
  • Diarrhea, hepatomegaly, jaundice and ascitesin heavier infections
opisthorchis sinensis diagnosis

30 m

Opisthorchissinensis: Diagnosis
  • Symptoms
  • History of eating improperly cooked fish in endemic areas
  • Eggs in the stool
opisthorchis sinensis treatment and control
Opisthorchissinensis: Treatment and Control
  • Praziquantel is effective
  • Avoid eating improperly cooked fish in endemic areas
  • Sanitary disposal of sewage
  • Elimination of snails
paragonimus westermani symptoms
Paragonimuswestermani: Symptoms
  • Dry cough, pleurisy
  • Pulmonary pain
  • Blood-stained rusty brown sputum
  • Fluke may migrate to brain, produce eggs and cause epilepsy-like symptoms
paragonimus westermani diagnosis

50 m

Paragonimuswestermani:Diagnosis
  • Symptoms
  • History of eating improperly cooked crab-meat in endemic areas
  • Eggs in the sputum