Clonorchis

8/22/2019 Clonorchis

1/21

do you know

what disease you

w i ll suf fer f rom by

eating raw fresh

water f ish


2/21

FILUM KELAS ORDER SUBORDER FAMILY GENUS

PLATY -

HELMINTH

TREMATODA

OPISTHORCHIIDA

OPISTHORCHIATA

OPISTHORCHIIDAE

Opithorchis & Clonorchis


3/21

Human liver fluke disease

Eating raw or half-

cooked fresh water fish

and shrimps

Clonorchis sinensis was named after that the worm

was discovered in the bile duct of a Chinese

carpenter in Calcutta, a harbor city of India, in

1874.Worm block bile passage ; Clonorchiasis

Orient from Vietnam to Japan

Opisthorchiasis is infection of bile duct and gall

bladder caused by cat liver fluke Opisthorchis

felinus and other spp. Opisthorchis v iverr in i(Southeast Asian liver fluke)


4/21

ADULT WORM

1. Panjang 12-20mm, lebar 3-5mm

2. Ventral suker lebih kecil berbandingoral sucker

3. Usus(sekum) tidak bercabang

,panjang dan mencapai bahagian

posterior tubuh

4. Testis, bercabang

5. Ovari kecil terletak di tengah tengahanterior dari testis

1. Panjang 7-12mm X 2-3mm

2. Kedua-dua sulur diameter hampirsama

3. Usus(sekum) tidak bercabang

,panjang dan mencapai bahagian

posterior tubuh

4. Kedua-dua testis bercuping

5. Ovarium kecil terletak di tengahtengah anterior dari testis

Sekum usus


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MATURED EGG

1. Ukuran 23-35 m lebar

2. Bentuk jelas

3. Kulit halus,tetapi sangat tebal (garis

ganda)

4. Operkulum mudah dilihat pada bahagian

hujung yang menyempit

5. Pada bahagian hujung yang meluas

terdapat tonjolan kecil

6. Berisi embrio bersilia

7. Warna kuning coklat ,bahagian dalamberwarna kuning pucat

30m

1. Ukuran 20um-30um x 11um-15um

1. Ukuran 26um-34um x 11um-15um

Opisthorchis viverrini

Opisthorchis felineus

Clonorchis sinensis


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Morphology

Metacercaria

Trematode life cycles


7/21

a. Definitive host : Adult parasite in human being and mammal

b. First intermediate host ; worm parasite in aquatic animal (example:snail)

forClonorchis : Bul im us fuc hsianus, Alocim a longicorn is,Parafossaru lus

manchour icus

ForOpi thorchis: Bithyn ia leach i

c. second intermediate host : A cypr inoid f ish:

forClonorchis : Cyprinidiae

ForOpi thorchis viver rinn i & fel ineus:spp Hampala and Punt ius

Life cycle


8/21

Clono rchias is &

Opisthorchias is

Embryonated eggs passed infeces that has a developed

miracidium

Eggs are ingested

by snail(hatch only

upon ingestion byspecific snail)

Cercariae released within 21-

30days upon infection and

freely swimming.must be in 2nd

intermediate host within 24-

48hours,or else will die

Cercariae invade into flesh

of fish forming into cyst

then into metacercariae and

ingested by host


9/21

Pathogenesis

Worm in bile ducts

Mechanical irritation Toxic substances

Erosion of epithelium

Proliferation inbiliary epithelium

Bile retention,fibrosis,cancer


10/21

Clinical manifestation

After 1-3 weeks

fever,chills,abdominal pain,

diarrhea

Tenderhepatomegaly

mild jaundice

eosinophilia SGOT, SGPT

Cholangitis

Cholangiocarcinomacirrhosis ofliver


11/21

1.laboratory d iagnos isDetect eggs make sure diagnosis

a. Stool examination

Direct smear method

Concentration method

b. The duodenum secretion (intubation)

examination; string test

Diagnosis


12/21

2. Immunologic exam inat ionIH test

ELISA

3. Ultrason ic wave exam inat ion


13/21

Treatment1.hyg iene education

Do not eat raw fish

Not let cat eat raw fish too

2.Treatment : Praziquental

3. Not let the feces pass in to the

fresh-water


14/21

Clonochis adult worms in the liver


15/21

In bile duct
http://cmr.asm.org/content/vol17/issue3/images/large/zcm0030420910001.jpeg


16/21

Histopathological findings of clonorchiasis (hematoxylin

and eosin stain). Note the flukes (arrows) within the

dilated bile ducts, biliary epithelial hyperplasia

(arrowheads), and periductal fibrosis.


17/21

Hepatic ultrasonography(right intercostal oblique

plane) in a 60-year-old woman

(a) and a 41-year-old man (b)

with clonorchiasis. Note the

diffuse, uniform dilatation of

the intrahepatic bile ducts

and the increased

echogenicity of the ductal

wall (arrowheads). Flukes oraggregates of eggs are shown

as nonshadowing echogenic

foci within the bile ducts

(arrowheads in panel b).


18/21

Intrahepatic

peripheral

cholangiocarcinoma in a 56-year-old

woman.

Transverse hepaticCT shows a low-

attenuation mass

(T) in the right lobe

of the liver. Notethe dilated

intrahepatic ducts

peripheral to the

tumor.


19/21

cholelithiasis


20/21

Ascites and epigastric


21/21

Documents

Clonorchis