TREMATODES PHYLUM : PLATYHELMINTHES - PowerPoint Presentation

1. TREMATODES PHYLUM : PLATYHELMINTHESCLASS : TREMATODA

2. Types of TrematodesLIVER FLUKE : Fasciola, Clonorchis, DicrocoeliumINTESTINAL FLUKE : Fasciolopsis, HeterophyesLUNG FLUKE : ParagonimousBLOOD FLUKE : Schistosoma

3. Infective stage from the life cycle of parasiteTREMATODES AS ENDOPARASITESDisease caused and its symptomsDiagnosis of the disease

4. INTESTINAL FLUKES1. Fasciolopsis2. Heterophyes

5. FasciolopsisCentral and Southeast AsiaElongate oval fluke 2 to 7 cm long

6. LIFE CYCLE OF FASCIOLOPSIS

7. ORGAN AFFECTEDSmall Intestine DISEASE NAMEFasciolopsiasisINFECTIVE STAGE TO HUMANMetacercariaSYMPTOMSChronic Diarrhoea, Asthenia, Mild Anaemia, Eosinophilia and Oedema PATHOLOGYAttaches itself to the intestinal mucosa causing inflammation, ulceration, abscesses DIAGNOSISEggs in faeces TREATMENTPraziquantel (Single dose of 75 mg/kg/day in 3 divided doses for one day).Fasciolopsis

8. Mode of Action of Praziquantel

9. Side effects

10. HeterophyesAdult of H. heterophyes, stained with carmine. In this figure, the following structures are labeled: oral sucker (OS), pharynx (PH), intestine (IN), ventral sucker, or acetabulum (AC), and eggs within the uterus (UT).Common in North Africa, Asia minor , Korea , China, Japan, Taiwan, and the PhilippinesInfection is acquired by eating raw fish, a common food in coastal areas

11. LIFE CYCLE OF HETEROPHYES

12. ORGAN AFFECTEDSmall Intestine DISEASE NAMEHeterophyiasis/ dwarf fluke infection.INFECTIVE STAGE TO HUMANMetacercariaSYMPTOMSPeptic ulcers, upper abdominal discomfort, gurgling abdomenPATHOLOGYCauses a mild inflammatory reaction at its site of contact with the intestine but in heavy infections cause damage to the mucosa.DIAGNOSISEggs in feces TREATMENTNiclosamide Praziquantel (a single dose 20mg/Kg for 3 days) Heterophyes

13. Side effects:Diarrhea, anorexia, nausea and vomiting. Skin rashes or urticaria Contraindications and precautions: Safety of the drug has not been established in children under 8 years of age.Mode of action:The adult worms are rapidly killed, presumably due to inhibition of oxidative phosphorylation.

14. LIVER FLUKESFasciolaClonorchisDicrocoelium

15. FasciolaFound in Rural areas of temperate and tropical regionsAdult has a flat leaflike bodyAbout 20-30 mm long by 8-15 mm wideHas an anterior elongation where oral and ventral suckers are located

16. LIFE CYCLE OF FASCI0LA

17. FasciolaORGAN AFFECTEDLiverDISEASE NAMEFascioliasisINFECTIVE STAGE TO HUMANMetacercariaSYMPTOMSVomiting, persistent diarrhoea, jaundice, with peripheral eosinophiliaPATHOLOGYImmature flukes migrate through the liver parenchyma for 6-8 weeks giving rise to a tender hepatomegaly DIAGNOSISYellow-brown eggs in the stoolTREATMENTBithionolTriclabendazole

18. Mode of actionSide effectsDiarrhea accompanied by anorexia, nausea and vomiting. Skin rashes or urticaria

19. Inhibition of the parasites motility, probably related to the destruction of the microtubular structure, resulting in the death of the parasite.Inhibiting the release of proteolytic enzymes, a process that appears critical to the survival of the parasite. Mechanism of actionGastrointestinal disturbances (abdominal cramps; diarrhea). Side effects

20. ClonorchisThe Chinese liver fluke is distributed in Asia (Far East region).The infections result from eating raw or half-cooked fresh water fish and shrimpsEggs looks like a sesame seed under the low power and a water melon seed under the high power

21. Life Cycle of ClonorchisParafossarulus anchouricusBithynia longicornisMelanoides tuberculataSemisulcospira libertina Assiminea luteaTarebia granifera

22. ORGAN AFFECTEDLiver (mainly in bile duct and gall bladder)DISEASE NAMEClonorchiasis (biliary cirrhosis)INFECTIVE STAGE TO HUMANMetacercariaSYMPTOMSAscites, splenomegaly, anemia, comaPATHOLOGYBile is stored increasingly in hepatic cells and diffuses between them.Degeneration of local hepatic cells.Necrosis of local hepatic cells.DIAGNOSISEggs in faeces TREATMENTTriclabendazole, Praziquantel (75mg/kg/day in 3 divided doses for one day),Bithionol, Albendazole (10 mg/kg orally once a day for 7 days)Clonorchis

23. Mode of action

24. Mild and transient epigastric distress, diarrhea, headache, nausea, dizziness, and insomnia can occur. In long-term use it can cause abdominal distress, headaches, fever, fatigue, increases in liver enzymes and pancytopenia.Side Effects

25. DicrocoeliumDue to the highly specific nature of this parasite’s life cycle, human infections are generally rareEndemic or potentially endemic in 30 countries

26. Life cycle of DicrocoeliumCochlicopa lubrica

27. ORGAN AFFECTEDBile ducts of humansDISEASE NAMEINFECTIVE STAGE TO HUMANMetacercariaSYMPTOMSBloating and diarrhea PATHOLOGYEnlarged liver (hepatomegaly) or inflammation of the liver (cirrhosis)DIAGNOSISEggs in faeces TREATMENTPraziquantel, Triclabendazole Dicrocoelium

28. LUNG FLUKESParagonimous

29. ParagonimousThe adult stage might attain a length of up to 15 millimetres Worldwide roughly 20 million people are infected with Paragonimus

30. Semisulcospira

31. ORGAN AFFECTEDLungDISEASE NAMEParagonimiasisINFECTIVE STAGE TO HUMANMetacercariaSYMPTOMSinclude abdominal pain, diarrhoea, fever, and hivesPATHOLOGYBad cough, bronchitis, and blood in sputum (hemoptysis),Ulcers in lungsDIAGNOSISEggs in faeces TREATMENTPraziquantelParagonimous

32. BLOOD FLUKE Schistosoma

33. SchistosomaThe genus has been divided into four groups -indicum, japonicum, haematobium and mansoni

34. SchistosomaS. haematobiumS. mansoniS. japonicumDISEASE D ORGANBlood IntestineIntestinal and hepaticLOCATION Venus plexus around the urinary bladderMesenteric plexus of Sigmoido- rectal areaMesenteric plexus of ileo-caecal areaPATHOGENICITYHaematuria and fibrosis of the bladder, Calcification of bladder and hydronephrosis.Dysenteric attack, ectopic lesions , haepatomegaly, periportal cirrhosis and myelitisIntestinal granulomasTREATMENTPraziquantel metrifonate Praziquantel oxamniquinesame as Schistosoma haematobium

35. Life cycle of SchistosomaABC

36. It causes worms to shift from the mesenteric veins to the liverThe male worms are retained; The female worms return to the mesentery, but can no longer release eggs.DNA synthesis inhibitionMode of action

37. Side effectsThe only significant common side effect reported is mild to moderate dizziness with or without drowsiness, nausea, vomiting, abdominal pain and diarrhoea. More severe neuropsychiatric symptoms such as severe headache, hallucinations, episodes of fainting, severe amnesia, total disorientation in space and time and confusion have been rarely reported.Discoloration of the urine from orange to red may follow after the drug treatment (most likely due to a metabolite). Contraindications: Patients with pre-existing central nervous system disturbances such as epilepsy or psychiatric disorders should be treated with caution.

38. METRIFONATE It is an organophosphorus compound used first as an insecticide and later as an anhelminthic, especially for treating S. haematobiumPhysical properties:Weight: 257Soluble in waterDoses:7.5 to 10 mg/kg and a widely adopted schedule of 7.5 mg/kg, given in three oral doses at an interval of 14 days.Route of administration: OralBrand Name: Bilarcil, (Formulated as tablets containing 100 mg of active substance) Chemical structure

39. Mechanism of ActionIt is a prodrug, at physiological pH, it is converted nonenzymatically to dichlorovos. It is a potent cholinesterase inhibitor. This inhibition temporarily paralysis the adult worms resulting in their shift from the bladder venous plexus to small arterioles of the lungs, where they are trapped encased by the immune system and die.This drug is not effective for the eggs of S. haematobium.Side effects: Fatigue, muscular weakness, muscle tremor, sweating, fainting, abdominal colic, diarrhoea, nausea, vomiting or bronchospasm. Contraindications: It should not be used after recent exposure to insecticides or drugs that might potentiate cholinesterase inhibition. It is contraindicated in pregnancy.

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