Fasciola gegentica Fasciola hepatica Schistosoma mansoni Heterophys heterophys Geographic distribution Cattle-raising countaries Europe Egypt, southern america, africa Mediterranean, far & near east size 6 x 15 cm 3 x 1 cm Habitat Bile ducts Bile ducts Mesentric plexus S.I D.H. Man,cattle,sheep Man, cattle,sheep Man man, fish-eating animals I.H. Lymnaea calliudia Lymnaea trancatula Biomphilaria alexandrina 1st : Piranella conical 2nd : mugil & tilapia Infective stage Encysted metacercaria Encysted metacercaria Cercaria Encysted metacercaria Mode of infection Ingestion of Infective Ingestion of stage infective stage Swimming Ingestion of undercooked fish contain i.s. Cercaria Leptocercaria Furcocercaria lophocercaria Diagnostic stage Immature egg in stool Immature egg in stool Schistosoma mansoni in stool Embryonated egg in stool contain cercaria Suckers Oral smaller than ventral Anterior & ventral Oral ventral genital Leptocercaria Both are equal 1.5 x 05 mm F. gegentica Fasciola hepatica Sch. mansoni H. heterophys Testes In the middle of the body In the middle of the 6-9 testis in body clusters Ovary Branched, antero- Branched, anterolateral to testis lateral to testis Ovoid, in the ant. One ovary in front of one third of body uterus Vatilline gland On both lat. side Intestinal caeca reunit in ant. 1/3 of body Few in the lateral side 30 x 15 um Oval Thick Yellowish brown mature miracidium 2 oral tesis in the post. part of body Common genital Infront to ventral pore sucker Egg : size shape shell color content 140 x 70 u Oval thin, operculated Yellowish Immature ovum 140 x 70 u Oval Thin, operculated Yellowish Immature ovum 150 x 60 u pathogenesis Liver cirrhosis Liver damage General toxemia halazon Liver cirrhosis Liver damage General toxaemia halazon Liver cirrhosis Liver damage General toxemia halazon Infalmmation, irritation, ulceration of intestinal mucosa, embolic effect treatment Dichlorophenol, dihydroemetine, hydrochloride, halazoun Dichlorophenol, dihydroemetine, hydrochloride, halazoun Niridazole, praziquantel, Nicloaeamine Praziguantel, oxamniquine, tarter emetic Oval with terminal lat. Spine Thin Translucent miracidium Taenia saginata Hymanolepis nana E. granulosus Geographic distribution Cosmopolitan cosmopolitan Cosmopolitan size 10-12 m 3-4 cm 3-6 cm Habitat S.I S.I S.I D.H. Man man Dogs, cats, other canines I.H. Cattle & herbivores animals man Cattle, sheep, man Infect stage (larvae) Cysticercus bovis Cercocystic cystocercoid Embryonated egg in feces or hairs of dogs Mode of infection Undercooked beef contain I.S Ingestion of Embryonated egg in contaminated food Ingestion of infective stage Mature segments Border than longer 3 testis, vas def., seminal ves., cirrus one Gravid segments Longer than border with 1520 lat. branches Border than longer & filled with eggs Longer than border Diagnostic stage Egg or gravid segments in stool of man Embryonated egg in feces Hydatid cyst scoleices 4 suckers without hooks 4 suckers with one raw of hooks and rostellum 4 suckers w two raws of hooks T. saginata H. nana E. granulosus Egg : size shape shell color content 30 x 40 u Spheroid Thick, non-operculated Yellowish Hexacanth embryo (Embryophore) 30 x 45 u Spheroid w polar filaments Thick, non-operculated Translucent Mature embryo 30 x 40 u Spheroid thick,non Yellowish embryophore pathogenesis Hunger pain, diarrhea, constipation, indigestion, intestinal obstruction, Loss of weight Light infection : no manifestation Heavy : enteritis, diarrhea, abdominal discomfort, in children dizziness & convulsion due to neurotoxins Pressure atrophy anaphylactic shock treatment Niclosamide, mebendazole Niclosamide , Praziquental : 15mg/kg single dose Surgical removal, aspiration & drainage of hydatid fluid, Mebendazole 20-40 mg/kg/day for3 month Ascaris lumbricoides Ancylostoma Strongyloides stercoralis Geographic distribution cosmopolitan Trophical & subtrophical Tropics & subtropics & mines in temperate zones size M: 20cm M: 1cm M: .7 x 50u F: free: 1mm x 60 u parasitic:2.2 mmx70u Habitat S.I of man lung F: 25 cm F: 1.2 cm S.I of man D.H. : man Parasitic : S.I of man (M) in lumen while (F) in submucosa Free : in the soil Mouth Terminal with 3 lips, one is dorsal & two sub-ventral Buccal capsule has 2 pairs of teeth in ant. Part and 2 cutting plates in post. Part while in N. americanus it has only 2 pairs of cutting plates ** rhabditiform larva 250-500 u, long buccal cavity, rhabditiform esoph. ** filariform larva : 600-700 u, cylindrical esoph. Esophagus Club-shaped Club-shaped M : rhabditiform F : cylindrical Ascaris lumbricoides Post. end Ancylostoma M: curved ventrally F: straight Ant. end Bent dorsally so ventral side becomes ant and dorsal becomes post genitalia M: has one set of genitalia and also 2 retractile spicules F: has 2 sets and the vulva opens ventrally at junction bet ant 1/3 & post 2/3 Egg Size Shape Shell Fertilized egg: 60 x 45 u Oval 2 outer mammilated & inner thick Brownish Immature (one cell stage) Color contents unfertilized egg: 90 x 45 u long & narrow thin w less developed mammillated layer brownish refractile granules M: has on set, copulatory busa and 2 spicules F: has 2 sets, the vulva opens bet middle and post. 1/3 60 x 40 u oval thin translucent immature ovum *** there is empty space bet shell & content Ascaris lumbricoides Ancylostoma Diagnostic stage Fertilized, nonfertilized, or decorticated egg Immature eggs in stool Infect stage 2nd stage larvae Filariform larva Mode of infection Ingestion of embryonated egg contain penetration of the filariform larva to inf. stage skin or mucosa memb. of the mouth pathogenesis Migration stage : hemorrhage, verminous pneumonitis, bronchi-like symptoms,fever, cough and expectration of blood tinged sputum Intestinal stage : mechanical effect (int. obstr., peritonitis, occlusion of bile duct, pancreatic duct or appendix) and toxic effect (anorexia, weight loss, discomfort, intest. colic, diarrhea, constipation, antitrypsin interfere w prot digestion Treatment Mebendazole, flubendazole, pyrantel pamoate, levamisole hydrochloride Cutaneous stage : itching, erythema, 2ry bacterial infection Pulmonary stage : Hge., hemoptysis, whezzes, dyspnea, severe infection causes Loeffler’s syndrom Intestinal stage : enteritis, malabsorption, avitaminosis. In chronic ifection: anticoagulant effect of cephalic glands of worm causing severe iron defic. anemia Mebendazole, flubendazole, ketrax ttt of iron defic anemia Strongyloides stercoralis (cont.) Post. End Tapering Egg: size shape Shell color contents 50 x 30 u Oval Thin, hyaline Yellowish 8 cell stage Diagnostic stage Rhabditiform larva in the stool Infective stage Filariform larva Mode of infection Penetration of skin by filariform larva via : walking bare foot in infected soil, invasion of buccal mucosa w food, endogenous autoinfection Pathogenesis Cutaneouos stage: irritation, dermatitis. ** autoinfection due to penetration of filariform larva the skin of perianal area causing larva currens Pulmonary stage : … in severe infection the larvae may pass from the lung to the left side of heart then to the general circulation causing visceral larva migrans VLM Intestinal stage : enteritis, sloughing & ulceration of mucosa, bloody diarrhea, heart burn and duodenal ulcer like symptoms Treatment Mebendazole : (one tablet 100 mg) 1 x 2 x 3 Strongyloides stercoralis (cont.) Pathogenesis Hyperinfection stage : occurs in immunosuppressed patients when R.L. mature to F.L. in the S.I. The F.L. penetrate the intestinal mucosa to venous circulation, to lung, then, ascend through the lungs to be swallowed in GIT till reaching S.I again. This will increase the worm burden causing ulceration of intestinal mucosa, tissue invasion, bronchopneumonia, meningitis, and brain infarction ( CNS manifestaion ) Chronic stage : anemia, pallor, easy fatigability, & lack of concentration T.trichiura E. vermicularis D. medinensis Pathogenesi … rectal prolapse, s hypochromic anemia due to bleeding or pernicious due to toxins Puruitus ani, insomnia, inflammation in vagina, uterus, tubes, UB, may cause appendicitis Local inflamatory reaction in the form of sterile blister, headache, nausea, vomiting, induration & edema treatment mebendazole, flubendazole, pyrantel pamoate Extraction of the adult guinea worm by rolling it a few cm per day, surgically, metronidazole mebendazole , flubendazole 1 tab (100mg) x 2 3 Trichuris trichiura E. vermicularis D. medinensis Geogr. dist cosmopolitan cosmopolitan East & west africa, KSA, yeman, iran, china, & south america length M: 3 cm F: 4 cm M: 5mm F: 10mm M: 3 cm Habitat L.I (caecum) L.I Subcutaneous tissues specially those in contact w water e.g foot, leg I.H. F: 30-100 cm Water cyclops morphlogy Ant 3/5 is thin post 2 circular wing like 2/3 is thick expansions at ant end known as alae, 2 lat thickenings, 3 retractile lips Thread like, Anus or cloaca terminal Sub-terminal Esophagus cellular Double bulb Adult : cylindrical Larva : rhabditiform Post. End M: curved ventrally F: straight & blunt M: curved ventrally F: straight w long pointed tail M: coiled F: hooked In F: ant end is swollen Trichuris trichiura E. vermicularis D. medinensis genitalia M: has one set w M: has 1 set & 1 spicule Vulva lies near the ant end one spicule inside a F: vulva opens at junct bet rectrile sheath ant 1/4 & post3/4 of body F: has one set and vulva opens at the junct bet thin & thick parts Egg: size Shape 50 x 20 u Barrel w 2 polar prominants Thick Brownish Immature (one cell stage) 50 x 20 u D shaped Thick shell, formed of 3 layers, the outer is a sticky Translucent Fully developed larva the larva is 600 x 20 u in size, it has rhabditiform esoph. And it has tapering tail represents ½ of body in length Diagnostic stage Egg in stool Egg on perianal folds, Larva inside egg Diagnosis made from local blister, worm or larva Infective stage Embryonated egg Embryonated egg Rhabditiform larva Mode of infection Ingestion of raw Ingestion, autoinfection, vegetables or water handling, ingalation, contaminated with retroinfection embryonated eggs Shell Color contents Ingestion of water contaminated w water cyclops infected w larva