CESTODES - CLINICAL PARASITOLOGY PDF

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Summary

PARASITOLOGY  – PHYLUM  PLATYHELMINTHES  –  CLASS  CESTODA  (CESTODES) 3A-­‐MT. 2013.  MMY  Order Pseudophyllidea Cyclophyllidea SN Diphyllobothrium  latum Taenia  solium Taenia  saginata Hymenolepis  nana Hymenolepis  diminuta Dipyli...

Description

Order% SN% CN%

Pseudophyllidea+ Diphyllobothrium!latum! Broad%fish%tapeworm%

Taenia!solium! Pork%tapeworm%

Cyclophyllidea! Hymenolepis!nana! Hymenolepis!diminuta! Dipylidium!caninum! Dwarf%tapeworm% Rat%tapeworm% Dog%tapeworm% Small+intestine+ Man+(DH+or+IH)+ Rat,+Man+(accidental)+ Dogs,+Man+(accidental)+ Ctenophalides!canis&&! Xenopsylla!cheopis&(rat+flea)& Ctenophalides!canis&&!felis&(dog+&+cat+flea)+ felis&(dog+&+cat+flea)+ Tribolium!spp.+(cockroaches,+beetles)& *With+or+without+IH+ *Pulex!irritans!(human+flea)! Embryonated%ova% Cysticercoid%larva% Cysticercoid%larva%

Taenia!saginata! Beef%tapeworm%

Habitat% FH% st

1 %IH%

IS%

Man,+other+mammals+ Cyclops,!Copepods!spp.,& Diaptomus!spp.+! nd *2 :%Fish+(Cyprinidae,+ salmon,+pike,+perch,+ trout)& Plerocercoid%larva+in+fish%

Man+ Pig%(may+be+ surpassed)+

Cattle,%cow,% carabao%

Cyticercus% cellulosae%%

Cysticercus%bovis%

MOT% (source)%

Ingestion+ (infected+fish)+

Ingestion+ (infected+meat)+

Ova%

Oblong+ Golden+yellow++ Unsegmented+ Operculated+ Immature+ 9712+days+maturation+ distinct+terminal+knob+ (abopercular%knob)+

Round,+Yellow7brown+thick+shell+w/+ striations+*embryophore+ Segmented+ Non7operculated+

Embryo%

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Scolex%

Almond+shaped+ +

Suckers%

2+Slit7like+Bothria/+ suctorial+grooves++ Up+to+3000+segments+ 3710m+ Broader+than+long+ Central+uterine+pore+ Highly+coiled/+rosette7 like/+flower 7like+uterus+

Strobila%% %Segment/% Proglottid% % % %

Ingestion+ (contaminated+ food/water)+ Round+to+oval+ Thin+shell+ Bipolar+thickenings+ 478+polar+filaments+

+ *no+species+identification+

Globular++ Armed+rostellum+ Double+rows+of+257 30+hooks+

Pyriform++ Very+minute/no+ rostellum+ Unarmed/no+hooks+

Ingestion+ (contaminated+food:+ wheat,+grains,+cereals)+ Round+ Striated+shell,+colorless+ “fried+egg/+sunny+side+ up”+appearance+ With+polar+thickenings+ No+polar+filaments++ +

100072000+ 5710m+ 15+or+more+“tree7 like”+uterine+ branches+ +

Echinococcus!granulosus! Hydatid%worm%

Rat,+Man+(accidental)+ Tribolium!confusum& (flour+beetle)+ Tribolium!sp.! Tenebrio!sp.! (rice+&+flour+beetle)+

Dog,+Fox,+Canine&spp.+ Sheep,+Ox+ Man+(dead+end)+ Goat,+Swine+ Cattle,+Horse+ Camel+ Hydatid%cyst% Embryonated%ova%

Ingestion+ (flea/IH+tissue)+

Ingestion+

Enclosed+in+egg+ membrane/capsule+ (8715+individual+eggs+ In+egg+packet)+ Resembles+Taenia+eggs+ +

Spindle+shaped+ Enclosed+in+an+outer+ elongated+membrane+ Spherical+inner+ membrane+ (up+to+8+eggs+only)+

Ingestion+ (cysts+in+organs,+egg+in+ feces)+ Round,+Subspherical+ Thick+yellow+brown+ striated+shell+ (embryophore)+ Same+with+Taenia+ +

Oncosphere/%hexacanth+embryo+w/+3+pairs+of+hooklets+ Rhomboidal+ Club/knobs7haped+ Globular+ Armed+rostellum+ Unarmed+ Armed+rostellum+ 20730+hooks+ Retractable+rostellum+ 177+circlets+of+spines+

4+cuplike+suckers+ 80071000+ 5710m+ Dendritic+uterus+ 5713+uterine+ branches+

Raillietina!garrisoni! Rat%tapeworm%

Subglobular+ Armed+rostellum+ 907140+hammer7 shaped+alternating+ hooks+ +

Globular+ Armed+rostellum+ w/+double+rows+of+28740+ hooks+ +

About+5000+ 60cm+ “rice+grain+ appearance”+ 1+genital+pore+

3+proglottids+only+ 4.5mm+

4+muscular+suckers+ 967200+ 25745mm+ Broader+than+long+ Sac7like+uterus+ Lateral+genital+pore+

80071000+ 60cm+ Rectangular+ Sac7like+uterus+ Lateral+genital+pore+

200+ 60cm+ Melon/+cucumber/+ pumpkin+seed7shaped+ Has+2+sets+of+ reproductive+organs+

%

Geni.Pore% Vitellaria%

Ventral+ Diffuse+

PARASITOLOGY+–+PHYLUM+PLATYHELMINTHES+–+CLASS+CESTODA+(CESTODES)+

Lateral+

2+lateral+genital+pores+

*notes:+Hydatid%Cyst+ Connective%Tissue+(host)+– outer+ Laminar%layer+–+middle+ Germinal%layer+–+inner+ Brood%capsules+w/+ protoscolices++ Hydatid%sand+–in+hydatid%fluid+

Lateral+

Compact+ +

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3A7MT.+2013.+MMY++

Life%Cycle%

Egg% (feces,+mature+in+water)+ + Coracidium+ st (ingested+by+1 +IH)+ + Procercoid% st nd (in+1 +IH,+ingested+by+2 )+ + Plerocercoid%(Sparganum)% nd (in+2 +IH,+ingested+by+FH)+

Pathology%

Diphyllobothriasis% Sparganosis+–+due+to+ larva+ (ingestion+of+procercoid+ in+cyclops)+ Brothriocephalus% anemia+ (Pernicious/Megaloblast ic%anemia)+–+due+to+lack+ of+Vit+B12+ (cyanocobalamine)+

Dx%stage%

Eggs/ova+in+stool+

Diagnosis%

Stool%exam%–+DFS,+KK,+CT+ Double%slide%compression% method+–+flatten/stretch+ segment+b/w+2+slides+ India%ink%stain–+to+visualize+ branching+uterus+

Rx%

Notes%

Egg% (in+feces,+ingested+by+IH)+ + Oncosphere/%Hexacanth% (in+intestines+of+IH)+ + Cysticercus% (in+muscles,+ingested+by+man)+ + Adult% (in+small+intestine+of+man)+ Cysticercosis+–+due+to+ larva;+accidental+ ingestion+of+egg;+ more+dangerous+ Neurocystecercosis% (NCC)+–+migration+of+ larva+to+the+brain;+ headache,+coma+ Taeniasis%solium+–+ due+to+adult;+ abdominal+ discomfort,+hunger,+ malabsorption+

*Direct%Cycle% *No+direct+cycle+ + Egg%directly+ ingested+by+man% *Indirect%cycle:+ Egg%(in+feces,+ingested+by+IH)+ Oncospheres/%Hexacath+ (penetrate+intestinal+villi)% Cysticercoid% (in+IH,+ingested+by+man)% % *Autoinfection:% Embryo+released+in+intestines+ Hymenolepiasis% Intestinal+irritation+(enteritis)+ Pruritus+ Diarrhea+ Abdominal+pain+ Epigastric+pain+ Intestinal+Discomfort+ Nausea+ Dizziness+ Vomiting+ Anorexia+

Taeniasis%saginata+ –+due+to+adult+ *no+cysticercosis+ +

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Dipylidiasis%% Intestinal/abdominal+ discomfort+ Epigastric+pain+ Diarrhea+ Allergic+reactions+ Appetite+loss+ indigestion+ Anal%puritus+7+caused+ by+migrating+gravid+ proglottids+ + Eggs,+gravid+proglottids+ Stool%exam% Scotch%Tape%Swab% Double%Slide% Compression% India%Ink% +

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Eggs/ova,+gravid+proglottid/segment+ Stool%exam+ Double%slide%compression%method% India%ink% Scotch%Tape%Swab*% +

Stool%exam+ (recovery+ scolex/eggs)%

Eggs/ova+ Stool%exam+(eggs)+

Niclosamide+&+Praziquantel+

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Gravid%proglottids% (intact+in+feces,+in+perianal+region)+ % Egg% (released,+ingested+by+IH)+ + Oncosphere% (penetrate+IH’s+intestine)+ + Cysticercoid% (in+IH’s+homocoel/body+cavity,+ingested+by+DH,+ break+lumen+of+intestine)+ Asymptomatic++ (man+is+unsuitable+ host)+

Hydatidosis%(Cystecercosis)+ –+due+to+larva+ Liver:+jaundice+ Lung:+bloody+sputum,+chest+ pain,+coughing,+shortness+of+ breath+ Brain:+epilepsy+ Necrosis+of+infected+tissues,+ pressure%buildup+ Anaphylactic+shock,+ eosinophilia,+allergic+ reactions+ MAY+CAUSE+DEATH%

Egg/+scolex+ Stool+exam:+ova+ Gravid+segment+

Hydatid+cysts+ Biopsy+of+Hydatid+cyst+ X7Ray,+MRI,+Ultrasound,+ CT+scan+ Serologic:+Casoni%Test,% ELISA,+Western+Blot,+ Indirect+ hemagglutination+ Surgical+Removal+of+cysts+ (PAIR)+ Mebendazole,+Albendazole,+ Praziquantel,+Hibitane+

Niclosamide,+Praziquantel,+Bithionol+

Taenia%saginata% asiatica%–+common+ in+Phils.+ *accessory%ovary+– smaller,+not+yet+ gravid+=+bladder% cyst+

PARASITOLOGY+–+PHYLUM+PLATYHELMINTHES+–+CLASS+CESTODA+(CESTODES)+

Smallest+tapeworm+ of+man+ Previously+ Vampirolepis&nana&

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Eggs+(in+feces,+ingested+ by+IH,+hatches+in+small+ bowel)+ % Oncosphere% (penetrates+intestinal+ wall,+migrate+through+ circulatory+system,+liver,+ lungs,+organs)+ % Hydatid%cyst% (ingested+by+DH)+

Other+name:+! Raillietina! madagascariensis+

Other+CN:+ Double%pored% tapeworm% Pumpkin%seed% tapeworm+

Usually+in+toddlers+because+of+pets+

Smallest+tapeworm+ Related+to+E.&multilocularis,& E.&vogeli&and&E.&oligarthrus& Puncture%(w/+fine+needle)+ Aspirate%(hydatid+fluid)+ Inject+(protoscolicidal)+ Reaspirate% No+local+transmission+(?)+

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