Parasites Petals

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Microbiology/ParasitologyMicrobiology/Parasitology

Laboratory DemosLaboratory DemosPRACS REVIEW 2PRACS REVIEW 2



Classmates,Classmates, These are the pictures from the past Parasitology lab These are the pictures from the past Parasitology labdemos we had. I compiled them for the class with thedemos we had. I compiled them for the class with the

help of some of our batch mates. Please do review more help of some of our batch mates. Please do review moreabout the parasites. This presentation contains mostly, if about the parasites. This presentation contains mostly, if not all, the necessary information about the parasites,not all, the necessary information about the parasites,but this does not supplant everything. Please do reviewbut this does not supplant everything. Please do review

also the techniques and methods in our Laboratoryalso the techniques and methods in our Laboratory

manual. Feel free to correct any errors. I hope this helps. manual. Feel free to correct any errors. I hope this helps.Good luck!Good luck!

Petal



Lung FlukeLung FlukeParagonimus westermani Paragonimus westermani

Phylum: PlatyhelminthesPhylum: PlatyhelminthesClass: TrematodaClass: Trematoda

Family: TroglomatidaeFamily: Troglomatidae

Genus:Genus: ParagonimusParagonimus

Species:Species: westermani westermani

INFECTIVE STAGE = MetacercariaeINFECTIVE STAGE = Metacercariae

DIAGNOSTIC STAGE = EggsDIAGNOSTIC STAGE = Eggs

FIRST IH = SnailsFIRST IH = SnailsSECOND IH = CrabsSECOND IH = Crabs



Lung FlukeLung Fluke

P. westermani P. westermani Adult Adult

Medium Sized FlukeMedium Sized Fluke

Plump, ovoid, reddish brownPlump, ovoid, reddish brown

flukefluke

Dx features:Dx features:

Presence of scalePresence of scale--likelike

integumental spinesintegumental spines

Presence of ventral andPresence of ventral and

oral suckers located on theoral suckers located on the

anterior half of the flukeanterior half of the fluke

Presence of two lobatePresence of two lobate

testes situated side by sidetestes situated side by side

Centrally located lobateCentrally located lobate

ovary anterior to testesovary anterior to testes

Highly branched vitellariaHighly branched vitellaria

occupy the entire bodyoccupy the entire body

length laterallylength laterally



Lung FlukeLung Fluke

P. westermani P. westermani ovaova

Medium UnembryonatedMedium Unembryonated

OperculatedOperculated

Features:Features:

Broad operculated anterior Broad operculated anterior

endend Thickened posterior endThickened posterior end

Expectorated in sputum or Expectorated in sputum or

can be detected in feces incan be detected in feces in

unembryonated/undevelopedunembryonated/undeveloped

stagestage

Thickened

posterior end

Undeveloped

miracidium

Operculated end



MalariaMalariaPlasmodium sp.Plasmodium sp.

Phylum: ApicomplexaPhylum: Apicomplexa

Class: Coccidea (Sporozoa)Class: Coccidea (Sporozoa)

Order: HemosporidiaOrder: Hemosporidia

GenusGenus: Plasmodium: Plasmodium

SpeciesSpecies: falciparum, vivax, ovale, malariae: falciparum, vivax, ovale, malariae

INFECTIVE STAGE = SporozoitesINFECTIVE STAGE = Sporozoites

DIAGNOSTIC STAGE = GametocytesDIAGNOSTIC STAGE = Gametocytes

Biologic Vector = Anopheles MosquitoBiologic Vector = Anopheles Mosquito

Definitive Host = Anopheles MosquitoDefinitive Host = Anopheles Mosquito

Intermediate Host = HumansIntermediate Host = Humans



Morphological Characteristics of Different Malarial Parasites andMorphological Characteristics of Different Malarial Parasites and

their Stagestheir Stages

Form:Form: P. falciparumP. falciparum P. vivax P. vivax P. malariaeP. malariae P. ovaleP. ovale

Infected RBC sizeInfected RBC size Not enlargedNot enlarged EnlargedEnlarged Not enlargedNot enlarged EnlargedEnlarged

ShapeShape Round but may beRound but may be

crenatedcrenated

RoundRound RoundRound Oval, fimbriatedOval, fimbriated

StipplingsStipplings Maurer¶s dotsMaurer¶s dots Shuffner¶s dotsShuffner¶s dots Ziemann¶s or Ziemann¶s or

James DotsJames Dots

Shuffner¶s DotsShuffner¶s Dots

Trophozoites (ringTrophozoites (ring

forms)forms)

Small delicateSmall delicate

rings; multiple w/rings; multiple w/

acole formsacole forms

Small, large rings,Small, large rings,

amoeboidamoeboid

Small, compactSmall, compact

rings, band formsrings, band forms

Small, compactSmall, compact

ringsrings

SchizontSchizont Rare, seen only inRare, seen only in

severe casessevere cases

Irregular contoursIrregular contours Compact, roundCompact, round CompactCompact

No. of MerozoitesNo. of Merozoites 1212--3232 1212--2424 66--12 forms regular 12 forms regular

rosette likerosette like

clustersclusters

44--12 forms12 forms

irregular rosetteirregular rosette--

like cluster like cluster

GametocyteGametocyte bananabanana-- or or

sausage shapedsausage shaped

RoundRound--largelarge Round, compactRound, compact Round, smallRound, small



P. falciparumP. falciparum, early, early

trophozoite; ringtrophozoite; ring

forms; multipleforms; multiple

parasitismparasitism



P. falciparumP. falciparum;;

trophozoite; thintrophozoite; thin

ring like structurering like structure



P. falciparumP. falciparum..

gametocyte; bananagametocyte; banana

or sausage shapedor sausage shaped

structurestructure



P. vivax P. vivax ,,

trophozoite;trophozoite;

amoeboid form;amoeboid form;

one chromatinone chromatin

dot; large infecteddot; large infectedRBCRBC



P. vivax P. vivax ,,

trophozoite;trophozoite;

compact form;compact form;

enlarged RBC;enlarged RBC;

One chromatin dotOne chromatin dot



P. vivax P. vivax , trophozoite, trophozoite



P. vivax P. vivax , schizont;, schizont;

and merozoites;and merozoites;

chromatin dotschromatin dots

inside the largeinside the large

infected RBCinfected RBC



P. vivax P. vivax , schizont;, schizont;

many chromatinmany chromatin

dotsdots



P. malariaeP. malariae;;

trophozoite; bandtrophozoite; band

formform



P. malariae.P. malariae.

schizontsschizonts; regular,; regular,

daisydaisy--likelike

arrangementarrangement

schizont



P. malariaeP. malariae,,

gametocytesgametocytes



P. ovaleP. ovale,,

gametocytegametocyte



Blood HemoflagellatesBlood HemoflagellatesTrypanosoma sp.Trypanosoma sp.

Leshmania sp.Leshmania sp.

Phylum: SarcomastigophoraPhylum: Sarcomastigophora

Superclass: MastigophoraSuperclass: Mastigophora

Order: KinetoplastidaOrder: Kinetoplastida



Comparison among the Flagellates:Comparison among the Flagellates: Trypanosoma sp.Trypanosoma sp.

Features:Features: T. brucei gambienseT. brucei gambiense T. brucei rhodesienseT. brucei rhodesiense T. cruziT. cruzi

Diseases:Diseases: Gambian Trypanosomiasis; Mild and WestGambian Trypanosomiasis; Mild and West African Sleeping Sickness African Sleeping Sickness

Rhodesian Trypanosomiasis;Rhodesian Trypanosomiasis;East African Sleeping SicknessEast African Sleeping Sickness

American Trypanosomiasis; American Trypanosomiasis;Chaga¶s DiseaseChaga¶s Disease

Diagnostic Stage:Diagnostic Stage: TrypomastigoteTrypomastigote TrypomastigoteTrypomastigote Amastigotes(heart,muscle,liver Amastigotes(heart,muscle,liver ,CNS); trypomastigotes,CNS); trypomastigotes--bloodblood

Infective Stage:Infective Stage: Metacyclic trypomastigotesMetacyclic trypomastigotes Metacyclic trypomastigoteMetacyclic trypomastigote Metacyclic trypomastigotesMetacyclic trypomastigotes

Vector:Vector: Riverine TseRiverine Tse--tse fly (tse fly (Glossina palpalisGlossina palpalis););

Exist as epimastigotesExist as epimastigotes

Woodland tseWoodland tse--tse fly (tse fly (GlossinaGlossina

morsitansmorsitans))-- as epimastigotesas epimastigotes

Reduviid bugsReduviid bugs--kissing bugkissing bug-- Assassin bug ( Assassin bug (Triatoma spTriatoma sp))

PathologyPathology--SymptomatologySymptomatology

11stst yr: Acute stage;yr: Acute stage;

22ndnd yr: Chronic Stage;yr: Chronic Stage;

ChancreChancre-- site of bitesite of bite

Winterbottom¶s signWinterbottom¶s sign-- enlarged superficialenlarged superficialpost. cervical lymph node;CSF Changespost. cervical lymph node;CSF ChangesTerminal Sleeping stageTerminal Sleeping stage deathdeath

Same with gambiense butSame with gambiense butMore rapid and fatal courseMore rapid and fatal courseoften terminates in 1 yr often terminates in 1 yr

Chronic lesion in CSF lessChronic lesion in CSF lessfrequentfrequent death intervenesdeath intervenesbefore cerebrospinal changesbefore cerebrospinal changesoccur occur

ChagomaChagoma-- local inflammatorylocal inflammatorychancrechancre

Acute form Acute form-- Romana¶s sign:Romana¶s sign:unilateral edema of the eyelidsunilateral edema of the eyelidsif bitten near eyeif bitten near eye

Chronic formChronic form-- Mega¶sMega¶ssyndrome: Megaesophagussyndrome: Megaesophagusand Megacolonand Megacolon

Diagnosis:Diagnosis: Clinical Hx;PE; Definitive lab Dx:Clinical Hx;PE; Definitive lab Dx:trypanosomes in blood, Lymph nodes, BMtrypanosomes in blood, Lymph nodes, BM

early, CSFearly, CSF late; serologic, animallate; serologic, animalinoculationinoculation

Same as gambienseSame as gambiense Tissue scrapingTissue scraping-- amastigotesamastigotes

Blood cultureBlood culture-- NovyNovy--MacNealMacNeal& Nicole (NNN)mediium;& Nicole (NNN)mediium;Xenodiagnosis; LD BodiesXenodiagnosis; LD Bodies

Treatment:Treatment: Pentamidine isethionate and suraminePentamidine isethionate and suramineearly; Melarsoprol and tryparsamideearly; Melarsoprol and tryparsamide latelate

Same as gambiense butSame as gambiense butrequires earlier and morerequires earlier and moreintensive treatmentintensive treatment

No satisfactory tx; used inNo satisfactory tx; used inacute stage to prevent chronic;acute stage to prevent chronic;Nifurtimox, BenznidazoleNifurtimox, Benznidazole

Prevention:Prevention: Early detection/tx; hygiene;Early detection/tx; hygiene;

chemoprophylaxis; vector controlchemoprophylaxis; vector control

Same as gambienseSame as gambiense Vector control; healthVector control; health

educ.;protection fr. Bites;educ.;protection fr. Bites;prevent blood trxn, infectionprevent blood trxn, infection



Comparison among the Flagellates:Comparison among the Flagellates: Leishmania sp.Leishmania sp.

Features:Features: L. Tropica ( L. major, L. aethiopica)L. Tropica ( L. major, L. aethiopica) L. mexicanaL. mexicana L. brazilienseL. braziliense L. donovani L. donovani

Diseases:Diseases: Oriental Sore; Old World CutaneousOriental Sore; Old World CutaneousLeishmaniasis; Baghdad Boil;Leishmaniasis; Baghdad Boil;Recidivans or Chronic RelapsingRecidivans or Chronic RelapsingCutaneous Leishmaniasis;Cutaneous Leishmaniasis;

L. tropicaL. tropica-- Dry or Chronic Cut. Leish.Dry or Chronic Cut. Leish.

L. major L. major-- wet or Acutewet or Acute

L. aethiopicaL. aethiopica-- cutaneous andcutaneous anddiffuse/disseminateddiffuse/disseminated

Chiclero Ulcer Chiclero Ulcer

American Leishmaniasis;

American Leishmaniasis;New World; CutaneousNew World; Cutaneous

(mostly)(mostly)

EspundiaEspundia

Mucocutaneous

Mucocutaneous(mostly)(mostly)

KalaKala--azar disease;azar disease;VisceralVisceralLeishmaniasis;Leishmaniasis;Death fever;Death fever;Dumdum fever;Dumdum fever;TropicalTropicalSplenomegalySplenomegaly

DiagnosticDiagnosticStage:Stage:

Amastigotes Amastigotes Amastigotes Amastigotes Amastigotes Amastigotes SameSame

Infective Stage:Infective Stage: Metacyclic PromastigotesMetacyclic Promastigotes Metacyclic PromastigoteMetacyclic Promastigote SameSame SameSame

Vector:Vector: Sandflies (Sandflies (Phlebotomus)Phlebotomus) Sandflies (Sandflies (LutzomyiaLutzomyia)) SameSame SandfliesSandflies

PathologyPathology--SymptomatologySymptomatology

L. tropicaL. tropica-- early: oriental sore at siteearly: oriental sore at siteof bite; late: multiple on exposedof bite; late: multiple on exposedbody surfacebody surface

L. major L. major-- early: multipleearly: multipleLE; late:LE; late:wet oriental sorewet oriental sore

L. aethipicaL. aethipica-- lepromatid,lepromatid,intermediate, tuberculoidintermediate, tuberculoid

Diffuse CutaneousDiffuse CutaneousLeishmaniasisLeishmaniasis-- producesproducesmainly cutaneous lesionsmainly cutaneous lesions

EspundiaEspundia

--produces mainlyproduces mainlymucocutaneousmucocutaneouslesionslesions

Black Sickness (Black Sickness (KalaKala--azar);azar);enlarged but lessenlarged but lessstriking liver; fever,striking liver; fever,splenomegaly,cachsplenomegaly,cach

exia; dermal lesionexia; dermal lesionat site of infectionat site of infection

Diagnosis:Diagnosis: Lesion:presence of elevated andLesion:presence of elevated andindurated margin of ulcer; skinindurated margin of ulcer; skinlesions amastigoteslesions amastigotes Giemsa,Giemsa,Wright¶s stain; NNN medium;Wright¶s stain; NNN medium;Montenegro Immunologic testMontenegro Immunologic test

Scrapings/biopsiesScrapings/biopsies--Giemsa stainGiemsa stain

amastigotes; NNNamastigotes; NNNmedium; serology,medium; serology,Montenegro TestMontenegro Test

SameSame Skin lesions:Skin lesions:amastigotes; RESamastigotes; RES--LD bodies; NNNLD bodies; NNNmedium;BM medium;BM smears; serologysmears; serology

Treatment:Treatment: DOC: Pentavalent AntimonialDOC: Pentavalent Antimonial

Sodium StibogluconateSodium Stibogluconate

Pentavalent Antimony;Pentavalent Antimony;

Ampho B; Cortisone Ampho B; Cortisone

SameSame SameSame

Prevention:Prevention: Vector control; protection fr. BitesVector control; protection fr. Bites SameSame SameSame samesame



T. gambienseT. gambiense,,

trypomastigotestrypomastigotes Features:

Elongated, spindle-shaped,

flagellum ends at the kinetoplastthat is situated posterior to

nucleus



Leishmania tropicaLeishmania tropica,,

from culturefrom culture

PROMASTIGOTEPROMASTIGOTE



Leishmania tropicaLeishmania tropica, from, from

infected hamster infected hamster

AMASTIGOTE AMASTIGOTE



Lymphatic Filarial WormsLymphatic Filarial WormsBrugia malayi Brugia malayi

Wuchureria bancrofti Wuchureria bancrofti

Phylum: AschelminthesPhylum: Aschelminthes

Class: NematodaClass: Nematoda

INFECTIVE ST AGE = L3 (Third Stage Larva)INFECTIVE ST AGE = L3 (Third Stage Larva)DIAGNOSTIC ST AGE = MicrofilariaeDIAGNOSTIC ST AGE = Microfilariae

Vector = MosquitoVector = Mosquito



W. bancrofti vs. B. malayi W. bancrofti vs. B. malayi

Characteristic:Characteristic: W. bancrofti W. bancrofti B. malayi B. malayi

SheathSheath PresentPresent PresentPresent

Cephalic SpaceCephalic Space L=W, shortL=W, short L>W longL>W long

Body CurvesBody Curves Regular, LargeRegular, Large Irregular, small, manyIrregular, small, many

Body NucleiBody Nuclei Round, mediumRound, medium--sized, wellsized, well--separatedseparated

Small angular, overlappingSmall angular, overlapping

TailTail No nuclei; pointed endNo nuclei; pointed end 2 widely spaced nuclei at tip2 widely spaced nuclei at tip

blunt endblunt end



Wuchereria bancrofti Wuchereria bancrofti

W ell separated nuclei

sheath



Brugia malayi Brugia malayi

Overlapping

nuclei



Blood FlukesBlood FlukesSchistosoma sp.Schistosoma sp.

Phylum: PlatyhelminthesPhylum: PlatyhelminthesClass: TrematodaClass: Trematoda

Genus: SchistosomaGenus: Schistosoma

Species: japonicum, mansoni, haematonium (others: mekongi, intercalatum)Species: japonicum, mansoni, haematonium (others: mekongi, intercalatum)

INFECTIVE ST AGE = CercariaINFECTIVE ST AGE = Cercaria

DIAGNOSTIC ST AGE = Eggs in FecesDIAGNOSTIC ST AGE = Eggs in Feces

Intermediate host = SnailsIntermediate host = Snails

Mode of Transmission = Skin PenetrationMode of Transmission = Skin Penetration



S. japonicumS. japonicum eggegg

Features:Features:

Has developed miracidiumHas developed miracidium

Lateral knobLateral knob small lateralsmall lateral

spinespineDeveloped miracidium



Cercaria of Cercaria of

SchistosomaSchistosoma

Features:

Forked-tailed when

discharged from the snail

Fork situated at the posterior third of the tail

Oral and ventral suckers are

developed



Miracidium of Miracidium of

SchistosomaSchistosoma

Features:

Ciliated

Pyriform in shape

w/ primitive gut



Comparison Among theComparison Among theS chistosomaS chistosoma SpeciesSpecies

S . japonicumS . japonicum S . mansoni S . mansoni S . haematobiumS . haematobium

GeographicGeographic

DistributionDistribution

Philippines, China, SulawesiPhilippines, China, Sulawesi

in Indonesia, Japan, Taiwanin Indonesia, Japan, Taiwan

Africa, South America, Africa, South America,

West Indies, Puerto RicoWest Indies, Puerto Rico

Middle East, Africa,Middle East, Africa,

Southern Tip of EuropeSouthern Tip of Europe

Snail IntermediateSnail Intermediate

HostHost

Oncomelania hupensisOncomelania hupensis

quadrasi quadrasi

Biomphalaria glabrataBiomphalaria glabrata Bulinus truncatusBulinus truncatus

HabitatHabitat Veins of Small intestineVeins of Small intestine Veins of Large intestineVeins of Large intestine Veins of theVeins of the

genitournary systemgenitournary system

DiseaseDisease Oriental SchistosomiasisOriental Schistosomiasis

Katayama DiseaseKatayama Disease

Schistosomiasis japonicaSchistosomiasis japonica

Intestinal BilharziasisIntestinal Bilharziasis

SchistosomiasisSchistosomiasis

mansonimansoni

Schistosomal hematuriaSchistosomal hematuria

Vesical SchstosimiasisVesical Schstosimiasis

Urinary BilharziasisUrinary Bilharziasis

EggEgg Small lateral spine (lateralSmall lateral spine (lateralknobknob--like)like) Large lateral spineLarge lateral spine Large terminal spineLarge terminal spine

TreatmentTreatment PraziquantelPraziquantel Praziquantel and

Oxamniquine

Praziquantel and

Metrifonate



S chistosomaS chistosoma, adult, adult

Features:Features:

With oral and ventral suckersWith oral and ventral suckers

Narrow elongated shapeNarrow elongated shape

Separate sexes; dioeciousSeparate sexes; dioecious

Male: shorter, more sturdy, grayish, cylindrical anterior end, presence of gynecophoralMale: shorter, more sturdy, grayish, cylindrical anterior end, presence of gynecophoral

canal (which the female is embraced during copulation)canal (which the female is embraced during copulation)

Female: longer, more slender, darker Female: longer, more slender, darker

IntegumentIntegument

Smooth or tuberculated depending on speciesSmooth or tuberculated depending on species

Distinctive to speciesDistinctive to species

Number of testes in the maleNumber of testes in the male

Length of the uterusLength of the uterus

Number of eggsNumber of eggs Excretory SystemExcretory System

Flame cells (collecting tubules leading into small bladder w/ terminal excretory pore)Flame cells (collecting tubules leading into small bladder w/ terminal excretory pore)



S. japonicumS. japonicum, adult in, adult in

copulacopula

Gy necophoral canal

male

female



S. mansoni S. mansoni , in copula, in copula



S. mekongi S. mekongi , in copula, in copula



Intestinal Protozoans: AmoebaIntestinal Protozoans: Amoeba

Entamoeba histolyticaEntamoeba histolytica

Entamoeba coli Entamoeba coli

Endolimax nanaEndolimax nana

Iodamoeba butschlii Iodamoeba butschlii

INFECTIVE STAGE = Mature Cyst INFECTIVE STAGE = Mature Cyst

DIAGNOSTIC STAGE = Cysts and TrophozoitesDIAGNOSTIC STAGE = Cysts and Trophozoites



ParasiteParasite E ntamoeba hy stoliticaE ntamoeba hy stolitica E ntamoeba coli E ntamoeba coli E ndolimax nanaE ndolimax nana I . butschii I . butschii

DiseaseDisease Amoebiasis, amoebic Amoebiasis, amoebicdysentery, amoebic hepatitisdysentery, amoebic hepatitis

Non pathogenicNon pathogenic Intestinal commensa;Intestinal commensa;nonnon--pathogeniclpathogenicl

Commensal; nonCommensal; non--pathogenicpathogenic

Mode of Mode of

transmissiontransmission

Ingestion of water andIngestion of water andveggies, food contaminatedveggies, food contaminatedwith feces positive with cystwith feces positive with cyst

Ingestion of cystIngestion of cyst Ingestion of cystIngestion of cyst Ingestion of cystIngestion of cyst

Life cycleLife cycle DirectDirect DirectDirect DirectDirect DirectDirect

InfectiveInfective

stagestage

Mature Cyst with 4 nucleiMature Cyst with 4 nuclei CystCyst CystCyst Mature cystMature cyst

DiagnosticDiagnostic

stagestage

Trophozoites and cysts inTrophozoites and cysts infecesfeces

Trophozoites and cyst inTrophozoites and cyst infecesfeces

Cyst and trophozoitesCyst and trophozoites Cyst, trophozoites inCyst, trophozoites infecesfeces

DefinitiveDefinitive

hosthost

ManMan ManMan ManMan ManMan

IntermediateIntermediate

hosthost

HabitatHabitat LILI LILI LILI LILI

DistinguishinDistinguishin

gg

morphology:morphology:

Trophozoite w/ pseudopod;Trophozoite w/ pseudopod;has ectoplasm andhas ectoplasm and

endoplasm;centrally locatedendoplasm;centrally located

karyosomekaryosome--Bull eye¶sBull eye¶skaryosome; uniformkaryosome; uniformprogreeive movement;progreeive movement;presence of rbc¶s; cystpresence of rbc¶s; cyst--chromatoidal bodieschromatoidal bodies

TrophozoiteTrophozoite-- granular granular cytoplasm, ingestedcytoplasm, ingested

bacteria, sluggishbacteria, sluggish

movement, largemovement, largeeccentric karyosomes;eccentric karyosomes;CystCyst --Splinter likeSplinter likechromatoidal bodies; 8chromatoidal bodies; 8nucleinuclei

Large irregular Large irregular karyosome; nokaryosome; no

peripheral chromatin;peripheral chromatin;

oval cyst with 4 nucleioval cyst with 4 nuclei

CystCyst-- single nucleus w/single nucleus w/irregular karyosome, noirregular karyosome, no

peripheral chromatin,peripheral chromatin,

large glycogen vacuolelarge glycogen vacuole--stains brown with iodinestains brown with iodine

PathologyPathology Primary lesionPrimary lesion-- intestinal;intestinal;Secondary lesionSecondary lesion--extraintestinal; flaskextraintestinal; flask--shapedshapedulcersulcers

TreatmentTreatment Metronidazole/mebendazoleMetronidazole/mebendazole MetronidazoleMetronidazole MebendazoleMebendazole MetronidazoleMetronidazole



Trophozoite,Trophozoite, E.E.

hystolitycahystolityca

kar y osome



Cyst,Cyst, E. histolyticaE. histolytica



Trophozoite,Trophozoite, E.coli E.coli

kar y osome



Cyst,Cyst, E. coli E. coli



Cyst,Cyst, E. nanaE. nana

kar y osome



Intestinal Flagellate/IntestinalIntestinal Flagellate/Intestinal

CiliateCiliate

Dientamoeba fragilisDientamoeba fragilis

Chilomastix mesnilli Chilomastix mesnilli

Giardia lambliaGiardia lamblia

Balantidium coli Balantidium coli

ParasiteParasite C iliiC ilii G l bliG l bli B liB li D f iliD f ili



ParasiteParasite C . mesnilii C . mesnilii G . lambliaG . lamblia B. coli B. coli D. fragilisD. fragilis

DiseaseDisease NonNon--pathogenicpathogenic Giardiasis, Traveller¶sGiardiasis, Traveller¶s

diarrheadiarrhea

Balantidiasis/BalantidosisBalantidiasis/Balantidosis

Mode of Mode of


Ingestion of cyst fromIngestion of cyst from

contaminated foodcontaminated food

Ingestion of cystIngestion of cyst Ingestion of cystIngestion of cyst Ingestion of cystIngestion of cyst

Life cycleLife cycle DirectDirect DirectDirect DirectDirect DirectDirect

Infective stageInfective stage CystCyst CystCyst CystCyst TrophozoitesTrophozoites


stage:stage:

Cyst and trophozoitesCyst and trophozoites CystCyst CystCyst TrophozoitesTrophozoites

DHDH ManMan ManMan ManMan ManMan

IHIH

HabitatHabitat LI

LI

Duodenum, proximalDuodenum, proximal jejunum jejunum LI

LI

LI

LI

DistinguishingDistinguishing

morphology:morphology:

Trophozoite: 4 anterior Trophozoite: 4 anterior flagella; cytosomalflagella; cytosomalgroove; curvedgroove; curvedposterior; cyst: clear posterior; cyst: clear knob on cystknob on cyst

³old man¶s face´³old man¶s face´

TrophozoiteTrophozoite-- 2 parabasal2 parabasalbodies, 4 pairs of flagella, 2bodies, 4 pairs of flagella, 2nuclei w/ large centralnuclei w/ large centralkaryosomes, dorsalkaryosomes, dorsal--convex,convex,ventralventral--3/4 ovoid w/ concave3/4 ovoid w/ concavesucking disksucking disk

TrophozoiteTrophozoite--bean shapedbean shapedmacronucleus,micronucleusmacronucleus,micronucleus,ant end,ant end-- cytosome, post endcytosome, post end--cytopyge, vacuoles andcytopyge, vacuoles andinclusions; cystinclusions; cyst-- onlyonly

macronucleusmacronucleus

No cyst!!!No cyst!!!

PathologyPathology Malabsorpton SyndromeMalabsorpton Syndrome--steatorrheasteatorrhea

Ulcers, acute infectionUlcers, acute infection--diarrhea , chronic infectiondiarrhea , chronic infection--intermittent diarrheaintermittent diarrhea

Asymptomatic w/ Asymptomatic w/persistent diarrheapersistent diarrhea

TreatmentTreatment MetronidazoleMetronidazole Metronidazole; QuinacrineMetronidazole; QuinacrineHClHCl

Tetracycline, Iodoquinol,Tetracycline, Iodoquinol,MetronidazoleMetronidazole

Iodoquinol,Iodoquinol,TetracyclineTetracycline



Cyst,Cyst, Chilomastix mesnili Chilomastix mesnili N= nucleus (remember lemon shaped cyst)N= nucleus (remember lemon shaped cyst)

n



Trophozoite,Trophozoite, Chilomastix Chilomastix

mesnili mesnili

nucleus



Trophozoite,Trophozoite, G. lambliaG. lamblia

P arabasal

bod y

nucleus

flagella



Cyst,Cyst, G. lambliaG. lamblia

C y st wall



Cyst,Cyst, B. coli B. coli

vacuole

C y st wall



Trophozoite,Trophozoite, B. coli B. coli

macronucleus

vacuole



NematodesNematodes

Ascaris lumbricoides Ascaris lumbricoides

Trichuris trichiuraTrichuris trichiura

Enterobius vermicularisEnterobius vermicularis

Necator americanusNecator americanus Ancylostoma duodenale Ancylostoma duodenale

Strongyloides stercoralisStrongyloides stercoralis

Capillaria philippinensisCapillaria philippinensis

Trichinella spiralisTrichinella spiralis



ParasiteParasite A. lumbricoides A. lumbricoides T.T.

trichiuratrichiura

E.E.

VermicularisVermicularis

N.N.

americanusamericanus

A. A.

duodenaleduodenale

S.S.

stercoralisstercoralis

C.C.

philippinensis philippinensis

CommonCommon

namename

Giant wormGiant worm WhipwormWhipworm Pinworm,Pinworm,seatwormseatworm

New worldNew worldhookwormhookworm

Old worldOld worldhookwormhookworm

ThreadwormThreadworm --

DiseaseDisease Ascariasis Ascariasis TrichuriasisTrichuriasis Enterobiasis,Enterobiasis,oxyuriasisoxyuriasis

NecatoriasisNecatoriasis Ancylostomia Ancylostomiasis,sis,

CochinCochin--chinachina

diarrhea,diarrhea,strongyloidostrongyloidosissis

Pudoc¶sPudoc¶sdiseasedisease

MorphologMorpholog

icalical

featuresfeatures

3 oval lips3 oval lips Attenuated Attenuatedpointed endpointed end

Cephalic alaeCephalic alae Semilunar Semilunar cutting platescutting plates

2 pairs of 2 pairs of teeth, equalteeth, equalsizesize

Female:Female:parthenogenparthenogenetic;etic;

filariformfilariformlarvae:larvae:forked tail;forked tail;

rhabditiform:rhabditiform:short buccalshort buccalcavity,cavity,conspicuousconspicuousgenitalgenitalprimordiumprimordium

HabitatHabitat SmallSmall LargeLarge LargeLarge SmallSmall SmallSmall SmallSmall SmallSmall



intestineintestinegg

intestine,intestine,cecumcecum

ggintestineintestine intestineintestine intestineintestine intestineintestine intestineintestine

InfectiveInfective

stagestage

EmbryonatedEmbryonated

eggegg


egg (barrelegg (barrelshapedshapedw/bipolar w/bipolar mucus pllug)mucus pllug)


egg (Degg (D--shaped)shaped)

FilariformFilariform

larvalarva

FilariformFilariform

larvalarva

Filaform larvaFilaform larva 33rdrd larvalarva

stagestage


stagestage

EggEgg EggEgg Egg/adultEgg/adultwormworm

EggEgg EggEgg RhabditiformRhabditiformlarvalarva

Egg (peanutEgg (peanutshaped)shaped)

DiagnosisDiagnosis Eggs in fecesEggs in feces Eggs in fecesEggs in feces ScotchScotchtape/adhesivetape/adhesivetapetape

Eggs inEggs infeces/feces/Harada moriHarada morimethodmethod

Eggs in fecesEggs in feces RhabditiformRhabditiformlarva in feceslarva in feces

Eggs in fecesEggs in feces

ClinicalClinicalmanifestationmanifestation Obstruction;Obstruction;loeffler¶sloeffler¶ssyndromesyndrome(larva)(larva)

RectalRectalprolapseprolapse NocturnalNocturnalpruritus anipruritus ani Larva:grounLarva:ground itch/dewd itch/dewitchitch

Adult: Adult:microcyticmicrocytichypochromichypochromicanemia of anemia of iron anemiairon anemiadeficiencydeficiency

typetype

Larva:groundLarva:grounditch/dew itchitch/dew itch

Adult: Adult:microcyticmicrocytichypochromichypochromicanemia of anemia of iron anemiairon anemiadeficiencydeficiencytypetype

Malabsorption

Malabsorptionsyndrome/stesyndrome/ste

atorrhea/larvaatorrhea/larvacurrenscurrens

Borborygmi/ur Borborygmi/ur gling stomachgling stomach



Egg,Egg, A. lumbricoides A. lumbricoides (know the differences among the features:(know the differences among the features:

embryonated, unfertilized, decorticated!!!)embryonated, unfertilized, decorticated!!!)decorticated

fertilized



Adult male and female, Adult male and female,

Ascaris lumbricoides Ascaris lumbricoides



Egg,Egg, T. trichiuraT. trichiura (barrel shaped (barrel shaped-- bipolar mucus plugs (in arrow))bipolar mucus plugs (in arrow))



Adult male, Adult male, T. richiuraT. richiura

Curved end

whiplike



Adult female, Adult female, T. trichiuraT. trichiura



Ova,Ova, E. vermicularisE. vermicularis

(clear D(clear D--shaped egg)shaped egg)



Adult Adult femalefemale, E. vermicularis, E. vermicularis

Cephalic alae



Adult male, Adult male, E. vermicularisE. vermicularis

Cephalic alae



Adult male, Adult male, N. americanusN. americanus

Buccal capsule



Adult female, Adult female, N. americanusN. americanus

C onspicuous pair of semilunar cutting plates



Adult male, Adult male, A. A.

ceylanicumceylanicumBuccal capsule



Adult female, Adult female, A. ceylanicum A. ceylanicum

2 pairs of teeth,

Unequal size



Hookworm ovaHookworm ova

Thin shell



Hookworm, filariformHookworm, filariform

larvalarva

esophagus

Pointed tail



Hookworm,Hookworm,

rhabditiform larvarhabditiform larva

P ointed end



Ova,Ova, C. philippinensisC. philippinensis (Remember: peanut shaped)(Remember: peanut shaped)



Adult male or female, Adult male or female,

C. philippinensisC. philippinensis



Encysted larva,Encysted larva,

T. spiralisT. spiralis



Adult male, Adult male, T. spiralisT. spiralis



Adult female, Adult female,

T.spiralisT.spiralis



Intestinal TrematodesIntestinal Trematodes

Fasciolopsis buski Fasciolopsis buski

Echinostoma ilocanumEchinostoma ilocanum

Heterophyes heterophyesHeterophyes heterophyes

Metagonimus yokogawai Metagonimus yokogawai

Phylum: PlatyhelminthesPhylum: Platyhelminthes

Class: TrematodaClass: Trematoda

Comparison among the Intestinal TrematodesComparison among the Intestinal Trematodes



Comparison among the Intestinal TrematodesComparison among the Intestinal Trematodes

ParasiteParasite F . buski F . buski E . IlocanumE . Ilocanum H . heterophy esH . heterophy es M . y okogawai M . y okogawai

Common nameCommon name Giant Intestinal FlukeGiant Intestinal Fluke Garrison¶s flukeGarrison¶s fluke NoneNone NoneNone

DiseaseDisease FasciolopsiasisFasciolopsiasis EchinostomiasisEchinostomiasis HeterophiasisHeterophiasis MetagonimiasisMetagonimiasis

AdultAdult Largest, oral sucker=1/4 of Largest, oral sucker=1/4 of ventral sucker, w/ventral sucker, w/transverse spines, 2transverse spines, 2dendritic testes in tandemdendritic testes in tandemin post. Half, singlein post. Half, singlebranched ovary in thebranched ovary in themiddle; unbranched cecamiddle; unbranched cecaw/ lateral indentationsw/ lateral indentations

Reddish gray,Reddish gray,covered w/ plaquecovered w/ plaque--like scales; anterior like scales; anterior end=circumoral diskend=circumoral diskw/ crown of 49w/ crown of 49--5151spines; oral sucker=spines; oral sucker=center of disk; ventralcenter of disk; ventralsucker= anterior 5sucker= anterior 5thth of of body; testes=depplybody; testes=depply

lobed, tandem;lobed, tandem;ovary=front of testesovary=front of testes

Pyriform; scale likePyriform; scale likespines; large centralspines; large centralsuckers= ant. Middlesuckers= ant. Middlethird of body; genitalthird of body; genitalsucker at the left postsucker at the left postborder; 2 ovoid testesborder; 2 ovoid testes

Pyriform; round postPyriform; round postand tapering ant end;and tapering ant end;scale like spinesscale like spinesmore numerous atmore numerous atthe anterior end;the anterior end;large ventral sucker large ventral sucker at rt of midline;at rt of midline;genital opening at antgenital opening at antrim; globose ovary atrim; globose ovary at

the junction of middlethe junction of middleand lower thirdand lower thirdofbody; fanofbody; fan--shapedshapedvitellariavitellaria

EggEgg Yellowish, ellipsoidal,Yellowish, ellipsoidal,Clear, thin shell, smallClear, thin shell, smalloperculum; undevelopedoperculum; undevelopedwhen passed in feceswhen passed in feces

Straw colored, ovoid,Straw colored, ovoid,operculated;operculated;immature whenimmature whenpassed in feces;passed in feces;same w/ F. buski andsame w/ F. buski andF. hepaticaF. hepatica

Light brown, thickLight brown, thickshell, operculated;shell, operculated;fully developedfully developedmiracidia atmiracidia atoviposition; slightoviposition; slightshoulder at theshoulder at theopercular rim; knob atopercular rim; knob atpost polepost pole

Light yellLight yell-- brown; thinbrown; thinshell; operculated;shell; operculated;nodular thickening atnodular thickening atpost end;post end;embryonated (matureembryonated (maturemiracidium) atmiracidium) atovipositionoviposition

MiracidiumMiracidium Cilia covered spine headCilia covered spine head



MiracidiumMiracidium Cilia covered, spine head,Cilia covered, spine head,pigmented eye spot, 2pigmented eye spot, 2flame cells, cephalicflame cells, cephalic

glands and germinal cellsglands and germinal cells

CercariaCercaria Slender muscular tails;Slender muscular tails;heavy bodiesheavy bodies

Simple tail body;Simple tail body;miniature formminiature form

MetacercariaMetacercaria Outer friable cyst wall; firmOuter friable cyst wall; firminner wallinner wall

Life cycleLife cycle IndirectIndirect IndirectIndirect IndirectIndirect IndirectIndirect

Definitive hostDefinitive host Humans, dogHumans, dog Man, mammals, birdsMan, mammals, birds Man, domesticatedMan, domesticatedand fish eatingand fish eating

mammalsmammals

Man and other fishMan and other fisheating mammalseating mammals

11stst IHIH Planorbid snails:Planorbid snails:Segmentia, Gyraulus,Segmentia, Gyraulus,

Hippeutus spHippeutus sp..

Planorbid snails:Planorbid snails:Gyraulus, HippeutusGyraulus, Hippeutus

spsp..

Blackish water snails:Blackish water snails:Prinella, CerithediaPrinella, Cerithedia

Snails:Snails:Simisulcospira,Simisulcospira,

Thiara, HuaThiara, Hua

22ndnd

IHIH Waer plantWaer plant KuholKuhol ± ± Pilo luzonaPilo luzona Fish: Tilapia,Fish: Tilapia, Mugil,Mugil, Acanthobius Acanthobius

Salmonoid:Salmonoid: Salmo,Salmo,PlectoglossusPlectoglossus

Cyprinoid Cyprinoid fishes:fishes:Richardsonium,Richardsonium,

OdontobuntisOdontobuntis

HabitatHabitat SISI SISI SISI SISI



HabitatHabitat SISI SISI SISI SISI

Mode of Mode of


Ingestion of Ingestion of contaminated plantscontaminated plants

Ingestion of infectedIngestion of infectedsnailssnails

Ingestion of infectedIngestion of infectedfishfish

Ingestion of infectedIngestion of infectedfishfish

Infective stageInfective stage MetacercariaMetacercaria MetacercariaMetacercaria MetacercariaMetacercaria MetacercariaMetacercaria

Diagnostic stageDiagnostic stage EggEgg EggEgg EggEgg Embryonated eggEmbryonated egg

Specimen of choiceSpecimen of choice FecesFeces FecesFeces FecesFeces FecesFeces

Pathology andPathology and

SymptomatologySymptomatology

Trauma, obstruction,Trauma, obstruction,toxicitytoxicity--periorbitalperiorbitaledemaedema

Same withSame withFasciolopsis;Fasciolopsis;diarrhea sometimesdiarrhea sometimesbloofybloofy

In heavy infections:In heavy infections:mucoid diarrhea,mucoid diarrhea,eosinohilia,eosinohilia,granuomatousgranuomatouslesions of the heartlesions of the heartand brainand brain

Same withSame withheterophyesheterophyes

Treatment/DOCTreatment/DOC Praziquantel,Praziquantel,niclosamideniclosamide

Praziquantel,Praziquantel,hexylresorcinol,hexylresorcinol,tetrachloroethylenetetrachloroethylene

PraziquantelPraziquantel PraziquantelPraziquantel



Egg,Egg, Fasciolopsis buski Fasciolopsis buski

operculum



Metagonimus yokogawai Metagonimus yokogawai

Oral sucker

ceca

testes

Round ovar y



Adult Adult, Echinostoma ilocanum, Echinostoma ilocanum

vitellaria

scales

Lobed testes

Oral sucker

Ventral

sucker

ovar y



Liver FlukesLiver Flukes

Phylum = PlatyhelminthesPhylum = Platyhelminthes

Class = TrematodaClass = Trematoda

Subclass = DigeneaSubclass = Digenea

Suborder = AmphistomataSuborder = Amphistomata

Paramphistomatidae = Gastrodiscoides (Paramphistomatidae = Gastrodiscoides (the only Fluke in the Large Intestinesthe only Fluke in the Large Intestines))

Suborder = DistomataSuborder = Distomata

Troglomatidae =Troglomatidae = ParagonimusParagonimusFasciolidae =Fasciolidae = F asciolaF asciola & Fasciolopsis& Fasciolopsis

Opisthorchidae =Opisthorchidae = C lonorchis & OpisthorchisC lonorchis & Opisthorchis

Heterophyidae =Heterophyidae = Heterophyes & MetagonimusHeterophyes & Metagonimus

CLASSIFICATION OF LIVER FLUKESCLASSIFICATION OF LIVER FLUKES



CL ASSIFIC ATION OF LIVER FLUKESCL ASSIFIC ATION OF LIVER FLUKES

A. Classification of Liver Flukes According to Size A. Classification of Liver Flukes According to Size

1. Large (21. Large (2--8cm)8cm) F asciola hepaticaF asciola hepatica

F asciola giganticaF asciola gigantica

2. Medium (12. Medium (1--2cm)2cm) C lonorchis sinensisC lonorchis sinensis

Opisthorchis felineusOpisthorchis felineus

Opisthorchis viverinni Opisthorchis viverinni

B. Classification of Liver Flukes According to Intermediate HostB. Classification of Liver Flukes According to Intermediate Host

1. Water Plant Borne1. Water Plant Borne F asciola hepaticaF asciola hepatica


2. Fish2. Fish--BorneBorne C lonorchis sinensisC lonorchis sinensis



C. Classification of Trematode EggsC. Classification of Trematode Eggs

1. Large Unembryonated Eggs (1001. Large Unembryonated Eggs (100--160u)160u) F asciola hepaticaF asciola hepatica


2. Small Embryonated Eggs (232. Small Embryonated Eggs (23--32u)32u) C lonorchis sinensisC lonorchis sinensis



Fasciola spp Clonorchis sinensis Opisthorchis spp



Fasciola spp Clonorchis sinensis Opisthorchis spp

General Characteristics (Thanks Jimboy! For this Summary. )

Disease Fascioliasis

Liver Rot

Pharyngeal Fascioliasis

Halzoun

Clonorchiasis Opisthorchiasis

Common Name Sheep Liver Fluke (F.

hepatica)

Liver Fluke (F. gigantica)

Chinese / Oriental Liver

Fluke

Cat Liver Fluke

Life Cycle Indirect Indirect Indirect

Infective Stage Metacercariae Metaceracariae Metaceracariae

Definitive Host Man, Sheep, Cow, Deer,

etc

Man and Dog Man and Dog

Diagnostic Stage Ova in Feces Ova in Feces Ova in Feces

First Intermediate Host Lymneid Snail Planorbid (Operculate)

Snails

Planorbid Snails

Second Intermediate

Host

Water Plants Freshwater Fish

(Cyprinoid)

Freshwater Fish

(Cyprinoid)

Reservoir Host None None

Habitat Bile Ducts & Biliary

Passages

Bile Ducts & Biliary

Passages

Bile Ducts & Biliary

Passages



M orphology

Shape Leaf Shape Oblong, Lanceolate

Shaped

Oblong, Lanceolate

ShapedSuckers Oral < Ventral Oral > Ventral Oral = Ventral

Testes Dendritic; Tandem Branched; Tandem Lobate; Oblique

Ovary Fan-Shaped Oval Oval

Egg Unembryonated Embryonated Embryonated

Intestinal Ceca Branched Simple Simple

Vitellaria Branched Diffuse, Irregularly

Distributed

Cluster / Compressed

Follicles

Unique Feature Cephalic Cone /

Shoulder

Eggs smaller than C.

sinensis



Haplorchis taichui Haplorchis taichui



Adult, Adult, Clonorchis sinensisClonorchis sinensis

Intestinal ceca



Egg,Egg, Opisthorchis viverrini Opisthorchis viverrini



Adult, Adult, Opisthorchis viverrini Opisthorchis viverrini

vittelaria

Ventral sucker

Intestinal ceca



Egg,Egg, Fasciola hepaticaFasciola hepatica

operculum

Thin shell



Intestinal CestodesIntestinal Cestodes

Taenia soliumTaenia solium

Taenia saginataTaenia saginata

Diphyllobothrium latumDiphyllobothrium latum

Hymenolepsis nanaHymenolepsis nana

Hymenolepsis diminutaHymenolepsis diminuta

Dipylidium caninumDipylidium caninum

ParasiteParasite T . soliumT . solium T . saginataT . saginata D. latumD. latum H . nanaH . nana H . diminutaH . diminuta D. caninumD. caninum

CommonCommon Pork tapewormPork tapeworm Beef tapewormBeef tapeworm Broad fishBroad fish Dwarf tapewormDwarf tapeworm Rat tapewormRat tapeworm Dog tapewormDog tapeworm



NameName

pp pptapewormtapeworm

pp pp g pg p

DiseaseDisease Taeniasis; porkTaeniasis; porktapewormtapeworminfection; humaninfection; human

cystecercosiscystecercosiscellulosaecellulosae

TaeniasisTaeniasissaginata; beef saginata; beef tapewormtapeworm

infectioninfection

DyphyllobothriasisDyphyllobothriasis;broad fish;broad fishtapewormtapeworm

infectioninfection

HymenolepiasisHymenolepiasisnana, dwarf nana, dwarf tapewormtapeworm

infectioninfection

HymenolepiasisHymenolepiasisdiminutadiminuta

Dipylidiasis; dogDipylidiasis; dogtapewormtapeworminfectioninfection

Life cycleLife cycle IndirectIndirect IndirectIndirect IndirectIndirect DirectDirect IndirectIndirect IndirectIndirect

DHDH ManMan ManMan ManMan ManMan RatsRats DogsDogs

IHIH PigsPigs CattleCattle Copepods(1Copepods(1stst),),freshwater fishfreshwater fish(2(2ndnd))

Rat fleasRat fleas Dog fleasDog fleas

SizeSize 800800--10001000segments; 2segments; 2--44

metersmeters

44--66meters;1,000 tometers;1,000 to

2000 proglottids2000 proglottids

LongestLongesttapeworm of tapeworm of

humans; 3humans; 3--1010meters; 3,000meters; 3,000proglottidsproglottids

Short; 200Short; 200proglottidsproglottids

Larger thanLarger thanH.nana;H.nana; 800800--

1000 proglottids1000 proglottids

6060--175175proglottidsproglottids

ScolexScolex Globular with 4Globular with 4cupcup--shapedshapedsuckers;suckers;rostellum armedrostellum armedwith 2 rows of with 2 rows of 2525--30 hooks30 hooks

Pyriform; 4Pyriform; 4prominentprominenthemisphericalhemisphericalsuckerssuckers

Spatulate; almondSpatulate; almondshaped; 2 deepshaped; 2 deepdorsoventraldorsoventralsuctorial groovessuctorial groovescalled bothriacalled bothria

Small, globular,Small, globular,short retractileshort retractilerostellum; singlerostellum; singlering of smallring of smallhooks and 4 cuphooks and 4 cupshaped suckersshaped suckers

ClubClub--shaped;shaped;rudimentaryrudimentaryapical unarmedapical unarmedrostellum; four rostellum; four small suckerssmall suckers

MatureMature

proglottidproglottid

Square;Square;unilateral or unilateral or irregularlyirregularlyalternate genitalalternate genitalpores; trilobedpores; trilobedovaryovary

Broad andBroad and

shorter;shorter;irregularlyirregularlyalterante lateralalterante lateralporespores

Broader thanBroader than

long;both femalelong;both femaleand maleand malereproductivereproductiveorgansorgans

Trapezoidal; 4xTrapezoidal; 4x

broad as long;broad as long;single genitalsingle genitalpore on its leftpore on its leftside; 3 roundside; 3 roundtestes andtestes and

bilobed ovarybilobed ovary

ResembleResemble H.H.

nananana

Pumpkin seedPumpkin seed

proglottidproglottid

GravidGravid 77--12 lateral12 lateral

branchesbranches

>13 (15>13 (15--30)30)

laterallateral

Sacculate;Sacculate;

uterusuterus

Saccular Saccular

uterus filleduterus filled

MembranousMembranous

capsulescapsules



branchesbranches laterallateralbranches; nobranches; no

uterine poreuterine pore

uterusuteruscontains 80contains 80--

180 eggs180 eggs

uterus filleduterus filledwith eggwith egg

massesmasses

capsulescapsules

(15(15--25 eggs)25 eggs)

HabitatHabitat SISI SISI SISI SISI SISI SISI

Infective stageInfective stage CystecercusCystecercuscellulosaecellulosae

CystecercusCystecercusbovisbovis

PlerocercoidPlerocercoid EmbryonatedEmbryonatedeggegg

EmbryonatedEmbryonatedeggegg

Eggs inEggs inpackets or packets or

gravidgravid

proglottidsproglottids

EggEgg HexacanthHexacanth

embryo wth sixembryo wth six

hookletshooklets

Same withSame with T.T.

soliumsolium; yellow; yellow

brown; radiallybrown; radially

striatedstriated

embrophoreembrophore

YellowishYellowish--

brown; ovoidalbrown; ovoidal

2 membranes2 membranes

enclosing aenclosing a

hexacanthhexacanth

embryo with 6embryo with 6

hookletshooklets

No polar No polar

filaments onfilaments on

the inner the inner

membranemembrane

No polar No polar

filaments onfilaments on

the inner the inner

membranemembrane

PathologyPathology Loeffler¶sLoeffler¶s

syndromesyndrome--

larvae;adultlarvae;adult--

inflammation of inflammation of

themucosathemucosa

PathologyPathology

mainly due tomainly due to

its large size;its large size;

adult wormsadult worms

rarely causerarely cause

symptomssymptoms

Adult Adult-- systemicsystemic

toxemia;toxemia;

mechanicalmechanical

obstruction;botobstruction;bot

riocphalusriocphalus

anemiaanemia

Enteritis; abdEnteritis; abd

pain w/wopain w/wo

diarrhea;diarrhea;

anorexia,anorexia,

vomiting, H A,vomiting, H A,

dizinessdiziness

Light and mild;Light and mild;

life span inlife span in

personperson-- shortshort--

55--6 weeks6 weeks

Light or mild;Light or mild;

llifespan isllifespan is

short inshort in

personspersons-- 55--

6weeks6weeks

DiagnosisDiagnosis Proglottids andProglottids and

eggs in feces;eggs in feces;

cysticercuscysticercus

cellulosae incellulosae in

biopsybiopsy

Proglottids andProglottids and

eggs in feces;eggs in feces;

OperculatedOperculated

eggs or eggs or

evacuatedevacuated

proglottids inproglottids in

feces or vomitfeces or vomit

CharacteristicCharacteristic

eggs in feceseggs in feces


eggs in stooleggs in stool


eggs in stooleggs in stool

TreatmentTreatment Praziquantel;Praziquantel;

niclosamide;niclosamide;

paramomycinparamomycin

NiclosamideNiclosamide NiclosamideNiclosamide Praziquantel;Praziquantel;


paromomycinparomomycin

Praziquantel;Praziquantel;



Praziquantel;Praziquantel;





Egg,Egg, TaeniaTaenia



Cysticercus,Cysticercus, T. soliumT. solium

Invaginated scolex

bladder



Scolex,Scolex, Taenia soliumTaenia solium

Armed

rostellum sucker

neck



Scolex,Scolex, T. saginataT. saginata

suckers



Egg,Egg, D. latumD. latum



E gg, H . nana

Hexacanth embr y o

P olar filaments

E gg, H . diminuta

E mby o w/ six hooketss



Egg,Egg, D. caninumD. caninum

Oncosphere



Mature gravid,Mature gravid,

Dipylidium caninumDipylidium caninum

Ti C t dTi C t d



Tissue CestodesTissue Cestodes

Echinococcus granulosusEchinococcus granulosus

Echinococcus multilocularisEchinococcus multilocularis

Phylum: PlatyhelminthesPhylum: Platyhelminthes

Class:CestodaClass:Cestoda

ParasiteParasite E . granulosusE . granulosus E . multilocularisE . multilocularis

Common NameCommon Name Hydatid wormHydatid worm Hydatid worm (alveolar hydatid disease)Hydatid worm (alveolar hydatid disease)



DiseaseDisease EchinococcosisEchinococcosis Alveolar echinococcosis Alveolar echinococcosis

MorphologicalMorphological

characteristics:characteristics:

SizeSize Smallest tapeworm; 3Smallest tapeworm; 3--6mm6mm Similar to E. granulosusSimilar to E. granulosus

ScolexScolex Globular; prominent rostellum w/double crown of Globular; prominent rostellum w/double crown of

3030--36 hooks; 4 prominent suckers36 hooks; 4 prominent suckers

Similar to E. granulosisSimilar to E. granulosis

Gravid proglottidsGravid proglottids Median uterus, 12Median uterus, 12--15, 1215, 12--15 branches distended15 branches distended

with eggswith eggs

SameSame

habitathabitat SI of dog/manSI of dog/man SSISSI

Life cycleLife cycle IndirectIndirect IndirectIndirectInfective stageInfective stage Eggs ingested by sheep or manEggs ingested by sheep or man EggsEggs

Diagnostic stageDiagnostic stage Eggs in fecesEggs in feces Eggs in fecesEggs in feces

EggEgg Thick striated shellThick striated shell Taenia likeTaenia like

Definitive host/Definitive host/

Accidental host Accidental host

Dogs and other canines/Dogs and other canines/

manman

Dogs/Dogs/

ManMan

Intermediate hostIntermediate host Sheep (most common), cattle, horses, camelsSheep (most common), cattle, horses, camels Field mice, wolves, squirrel, and shrewField mice, wolves, squirrel, and shrewPathologyPathology Inflammatory reaction from unilocular cystInflammatory reaction from unilocular cyst Alveolar cyst in the liver followed by the Alveolar cyst in the liver followed by the

lungs and the brainlungs and the brain

DiagnosisDiagnosis Presence of slowly growing cystic tumor; historyPresence of slowly growing cystic tumor; history

of residence in endemic area; close associationof residence in endemic area; close association

with dogs; protosclices, broad capsule or with dogs; protosclices, broad capsule or

daughter cysts in hydatid cyst in fluiddaughter cysts in hydatid cyst in fluid

Post mortem examinationPost mortem examination

TreatmentTreatment Surgery; albendazoleSurgery; albendazole Operation/surgery;mebendazoleOperation/surgery;mebendazole



E. granulosusE. granulosus

scolex

Mature segment

Immaturesegment



Miscellaneous :Miscellaneous :

Macroscopic DemosMacroscopic Demos





G ravid segment, T . solium Mature segment, T . solium



More than 12 lateral branches





H y menolepsis diminuta







The End The End Thanks to Randy, Jaime, Moi, Donski and most Thanks to Randy, Jaime, Moi, Donski and most

especially to Anmaespecially to Anma--(I got almost all the pics from(I got almost all the pics from her). her).

Peace! Peace!

--FMPBFMPB--

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Parasites Petals