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Trichinella spiralis. Trichinella spiralis Common name: Trichina worm- The Pork worm Trichinella spiralis means spira, how this coils up in its host . diseases: Trichinosis, Trichiniasis, is a zoonotic disease. it is passed between humans and animals.

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Trichinella spiralis

  • Common name: Trichina worm- The Pork worm
  • Trichinella spiralis means spira, how this coils up in its host.
  • diseases: Trichinosis, Trichiniasis,
  • is a zoonotic disease. it is passed between humans and animals.
  • Habitat: females in mucosa of small intestinal
  • The same animal acts as final and intermediated host
  • is most common in Europe, North America, and Asia,
  • Infective stage: contaminated meat (muscle) containing encyst larvae  (pig)
  • Diagnostic stage: larvae encysted in muscle (human)
    • Can be fatal if large numbers of cysts form in the heart muscle.
slide3

The sperm fertilizes the egg, but the female doesn’t release the eggs until they have hatched within her uterus, which is usually within the fifth or sixth day of infection.

Female worms can produce approximately 1500 newborn larvae (immature L1) during a life span (4-16 weeks), before expulsion by the host immune system.

Viviparous:

Expel active larvae

slide4

Oviparous: Eggs laid in 1-cell stage

or early cleavage stage.

Ovoviviparous: Eggs laid containing embryo or

larva (L1). Some hatch out prior to passage

in feces.

Viviparous: Expel active larvae

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Morphology:

Anterior end: slender with small non papilated mouth.

Male:1.5mm

posterior end ventrally curved

with 2 copulatory appendages

Female: 3.5mm single ovary

Posterior end bluntly rounded

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LARVAE

Measures 80-120 um by 5.6 u at birth

And grows but little until it has entered

A muscle fiber, size 900 um

developed.

slide8

Female worms deposit larvae into:

The mucosa of small intestine

Directly into the lymphatics

Blood stream.

The larvae carried to all parts of body,

but the larvae developing only in striated muscle.

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Epidemiology

  • The disease among humans, rats, and pigs
  • Rats and pigs feeding on garbage that includes infected pork waste, become infected in turn
  • Dead or dying infected rats are themselves eaten by pigs
  • Raw or poorly cooked pork (sausage) harboring infective larvae then becomes the vehicle for human infections
  • Trichinellosis is a cosmopolitan disease that occurs most commonly in Europe and the US
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Pathogenesis:

1--Penetration of the adult females into mucosa

The first symptoms appear between 1- 2 days after ingestion.

The worms migrating in the intestinal epithelium

Inflammation of duodenal and jejunal mucosa:

This causes:

inflammation,

nausea,

vomiting,

sweating, and diarrhea.

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2- The migrating larvae

Ten days after infection the larvae will penetrated the muscle fibers, carried to all parts of body, This causes

  • muscular pain,
  • difficulty breathing
  • Per orbital edema and conjunctivitis
  • heart (myocarditis),
  • lungs (pneumonitis),
  • brain (encephalitis).
    • Can be fatal if large numbers of cysts form in the heart muscle. heart failure or respiratory or kidney malfunction
slide14

Diagnosis :

  • Muscle biopsy at the encystment stage
  • blood test for eosinophilia
  • increased levels of creatine phosphokinase CPK,
  • Serology test Immunoassays, such as ELISA
  • At the diarrheal stage, adult and larvae may be found in feces
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 Treatment

  • Anti-inflammatory drugs. When infected, it is also suggested that you get a lot of rest to help give your body time to recover.
  • Mebendazole is the drug of choice.
slide18

Trichuristrichiura

  • Common name: whip worm
  • Disease:trichuriasis, whip worm infection
  • Final host: human, dogs, pig, monkey
  • Habitat: large intestinal ( cecum, appendix, rectum)
  • Geographical distribution: Cosmopolitan with poor sanitation.
  • Children are more likely to be infected than adults because they are more likely to have have close physical contact with contaminated soil
  • Infective stage: infective larva in egg
  • Transmission occurs through ingestion of eggs, usually on contaminated vegetables or soil.
  • Diagnostic stage: Egg barrel shape with polar plugs
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Morphology:

Adult female worm:

The anterior two-thirds of the body being very thin

(looks like a whip)

and the remaining posterior end is thick and linear.

Size: 3.5-5cm in length

Adult Male worm:

smaller than the female, 3.0-3.5cm.

The posterior end is curved and has a single spicule

enveloped with sheath.

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The anterior end two-thirds of the body being very thin

(looks like a whip).

  • Adult worm penetrates into and embed its whip-like anterior portion in the intestinal mucosa, By small spear

Adult male

Adult female

  • Longer than the male.- posterior end is thick
  • and linear.
  • Shorter than the female. posterior end curved and
  • has a single spicule
  • enveloped with sheath.
  • .
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posterior end curved and

has a single spicule

enveloped with sheath

slide22

Eggs:

Shape: barrel–shaped

Size: 50-55 x 25-30μm

Shell: thick egg shell with 2 polar plugs

Color: Yellow-brown

Content: immature egg cells

 3000-10000 eggs daily daily output

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Life cycle:

• Eggs pass out immature

• Embryo develops inside the egg (that takes about 3weeks at 25C)

• Mature eggs swallowed  1st stage larvae hatch in small intestine and penetrate villi

• Then migrate to large intestine and attach to mucosa with the thin anterior end

• After 2-4 month females mature and lay eggs.

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Pathology:

  • Light infection with Trichiuris are asymptomatic
  • Heavier infections are characterized by

1- diarrhea,

2- anorexia,

3- nausea

4- abdominal pain

5- anemia may be the result of hemorrhaging when the worms mucosal damage))penetrate the intestinal wall

  • Rectal prolapse.

Children’s infection can cause rectal prolapse, The reason is the cecum is damaged by the worm, the cecum can be pushed out from the anus.

slide32

Laboratory diagnosis

1- Eggs or worm in feces. Eggs are oval, barrel shaped,

2- Eosinophilia may occur.

3- In heavy infection proctoscopy or sigmoidoscopy,can show the worms attached to the mucosa.

4- Visual detection of adult worms on prolapsed rectum.