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Intestinal trematodes
 

Intestinal trematodes

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    Intestinal trematodes Intestinal trematodes Presentation Transcript

    • Intestinal Trematodes Prof. CM.Kihamia
    • FASCIOLOPSIS BUSKI (GIANT INTESTINAL FLUKE)
      • MORPH: Largest fluke. Thick, fleshy, ovate. Flesh-coloured. 2-7.5 x 1-2 cm.
      • Oral sucker and ventral suckers present. Typical trematode alimentary canal with unbranched intestinal caeca.
      • Two dendritic testes.
      • Single branched ovary.
      • Vitellaria on lateral sides and a convoluted uterus and genital pore that is anterior to the ventral sucker.
    • Contd.
      • EGG: Yellowish and oval. 130-140 x 80-85 µ. Thin walled with small operculum. Undeveloped ovum.
      • HABITAT: Small intestine esp. duodenum and jejunum. Adults feed on intestinal contents.
    • LIFE CYCLE:
      • Adults in intestine produce eggs.
      • Egg hatches to free-swimming miracidium in 3 weeks. Miracidium penetrates snail within 2 hrs. Segmentina and Hippeutis spp.
      • In the snail: Sporocyst  Redia  Daugher redia  Cercaria.
      • Cercaria leave the snail and attaches to fresh water plants and becomes metacercaria.
      • Water plants include water callrop, water hyacinth, water chestnut and water bamboo.
      • These plants are grown in ponds and eaten raw.
      • Ponds are fertilized by human faeces.
      • When metacercaria is ingested it excysts in the duodenum and is attached to the intestinal wall.
    • Epidemiology:
      • Common in China, Vietnum, Thailand, Laos, Cambodia. Transmission is by eating fresh water plants with metacercariae. Pigs harbour infection. Incidence is highest in China. Dried plants are safer.
      • PATHOLOGY:
        • Attached to intestine by suckers.
        • Mucosa inflamed, ulcerated and abscesses form. Epigastric pain, nausia, diarrhoea.
        • Heavy infection leads to oedema, ascites and anarsaca.
        • Toxic products of worm.
        • Anaemia, leukocytosis, lymphocytosis, and oesinophilia.
        • Good prognosis if worm treated early.
        • 1000-2000 worms affect intestinal secretions and food passage and intoxication and sensitization.
    • Diagnosis, Treatment, & Control
      • DIAGNOSIS:
        • Eggs in faeces. Diffentiate from F. hapatica , Gastrodiscoides and Echinostoma sp.
        • Adult worms vomited or passed in stool.
      • TREATMENT:
        • Praziquantel is the drug of choice: 15 mg/kg body weight, single dose.
      • CONTROL
        • Sanitary disposal of human faeces.
        • Discourage use of night soil.
        • Restrict pigs.
        • Snail control.
        • Health education.
        • Cooking or steeping of water plants.
    • The End
    • HETEROPHYES HETEROPHYES
      • MORPH: Pyriform, greyish, 1.3 x 0.5 mm. Oral, Ventral and Genital suckers.
      • EGG: Light brown in colour, thick shell, operculated, 29 x 16 µm, Fully developed miracidium.
      • LIFE CYCLE:
      • Adult in man  Egg  Miracidium  Snail (Sporocyst  Redia  Cercaria). Cercaria enter fish and encysts as Metacercaria in fish (mullet ( Mugil cephalus ) and minnow ( Gambusia affinis ). Metacercaria swallowed in undercooked fish, excysts in small intestine and develops into adult in 7 days.
      • EPIDEMIOLOGY:
      • Egypt, Greece, Israel, China, Japan, Korea, Taiwan, Philippines.
      • Fishermen are important in polluting water.
    • Pathology/Symptomatology
      • :
      • Mucosal irritation.
      • Intestinal penetration and egg dissemintion.
      • Abdominal pains and tenderness.
      • Diarrhoea.
      • Cardiac and brain granuloma due to deposited eggs.
      • DIAGNOSIS:
      • Eggs in faeces: differentiate from those of Clonorchis and Opisthorchis.
    • Treatment & Control
      • TREATMENT:
      • Praziquantel 10-20 mg/kg body weight, single dose.
      • CONTROL:
      • Thorough cooking of fish.
      • Health education.
      • Sanitary disposal of human faeces.
    • METAGONIMUS YOKOGAWAI
      • MORPH: Small, 1.4 x 0.6 mm. Pyriform shape with rounded posterior and tapering anterior. Large ventral sucker.
      • EGG: Light yellow-brown, thin-shelled, operculated, 28x17 µm, mature miracidium.
      • LIFE CYCLE:
      • Similar to Heterophyes. Adult in jejunum of man (but also cats, dogs, pigs, and pelican). Egg ingested by snail. Miracidium in intestine of snail. Sporocyst  Mother redia  Daughter redia  Cercaria. Metacercaria in fish. Ingested metacercaria excysts in duodenum and develops into adult in jejunum.
    • Contd.
      • EPIDEMIOLOGY:
      • Far East: Japan, China, Korea, Philippines, Taiwan also Greece and Spain.
      • Infection is through consumption of raw fish.
      • Infection spread by contamination of water with human and animal excreta.
      • PATHOLOGY/SYMPTOMATOLOGY:
      • Similar to Heterophyes.
      • Heart and CNS granulomatous lesions may occur through eggs.
      • DIAGNOSIS:
      • Eggs in faeces.
      • TREATMENT:
      • Praziquantel 10-20 mg/kg body weight single dose.
      • CONTROL:
      • Thorough cooking of fish.
      • Health education.
      • Sanitary disposal of excreta.
      • THE END.