Introduction to Parasitology

Parasitology branch of biology/medicine concerned with the study of parasites Parasites lives in/on a host, feeding off nutrients Ectoparasite living on the host Endoparasite living inside the host Host organism harbouring parasites; mutual (2 organisms benefit one another)/commensal (only 1 specie benefits without inflicting harm on the other) relationship VECTORS Biological Vectors malaria in mosquito Mechanical Vectors fly transmitting amoeba cyst SOURCES OF EXPOSURE Contaminated soil or water Food with infective stage parasite Blood-sucking insects/animals PORTALS OF ENTRY Mouth Skin Nose COMMON ORGANELLES Nucleus Karyosome (nucleolus) Endoplasm (granular) Ectoplasm (clear) Cyst wall DIAGNOSIS Faeces (most common) Sputum Urine

Domestic/wild animals (serving as hosts) From another persons belongings From self = autoinfection

Placenta Genitalia

Locomotion: 1.) Pseudopods 2.) Flagella 3.) Cilia

Aspirates Tissue scrapings Biopsy

Preserved specimens are preserved with the use of formalin/PVA Unpreserved specimens are to be tested within the duration of 30 minutes Macroscopic Examination can be seen with the naked eye E.g. stool specimens containing adult helminths Microscopic Examination ova, larvae, adults, Charcot-Leyden crystals *note: trophozoites can be seen in watery stools; cysts in formed stools; both troph and cysts in semi-formed stools Direct Wet Mounts (stool) Can either be stained or unstained Unstained: NSS (Normal Saline Solution); shows the motility of the parasites Stained: Iodine; observe the structures of the parasite LPO: 10x; HPO: 40x; OIO: 100x Vaseline is used in cover slips(edges) for preservation of specimens Blood films Used in the identification of blood parasites

Must be taken during the peak of patients fever (especially during malaria)

OTHER METHODS Concentration = floatation or sedimentation Scotch Tape Method Serological Test Biopsy

Flagellates
(C. mesnili, G. lamblia, T. hominis, T. vaginalis, D. fragilis) Parasites moving through with the use of flagella (for locomotion) Contain kinetoplast (where the flagella is attached; constitutes energising part of neuromotor apparatus) Reproduce asexually (through binary fission) Reside in the intestines, colon

LIFE CYCLE 1.) Trophozoite active, motile, feeding stage 2.) Cystic resting/dormant, unfeeding stage Giardia lamblia Pear-shaped trophozoite with 4 pairs of flagellas; with sucking discs (found anterior) Tennis racket appearance; Old Man with Glasses falling leaf motility Giardiasis/Travellers Diarrhoea Lives in crypts at duodenal level in the small intestine CYST ovoidal, pale yellow/brown (I2 stained); 2/4 nuclei Crossed fibrils Encystations towards the colon M.O.T.: swallow cysts through food/drinks; intimate contact (anal/oral sex) Prevalent in children, warm climates, homosexuals Chilomastix mesnili Asymmetrically pear-shaped as a result of a spiral groove Cystosome seen on one side (spinal cord) Granular, presence of food vacuoles; 1 large nucleus Borring, progressive movement CYST pear/lemon-shaped cysts Single, large vesicular nucleus Cytosome almost the size of the entire cyst Nipple-like protrusion Trichomonas hominis 3/5 anterior flagella with +1 on margin of undulating membrane Spiked posterior end, protruding through posterior portion Cystosomal cleft opposite of undulating membrane HABITAT: cecal area of large intestine Rapid forward movement NO CYSTIC STAGE Vectors: flies

Trichomonas vaginalis Pear-shaped with central nuclei rapid-jerking motility NO CYSTIC STAGE Cytoplasm has large amounts of siderophil granules HABITAT: human vagina and prostate gland M.O.T.: sexual contact most commonly acquired STI Dx: Whiff test 4 anterior flagella Short undulating membrane and axostyle present for motility Dientamoeba fragilis 2 nuclei on cytoplasm Dientamoebiasis Upon maturation loses its flagella CYSTIC STAGE NOT IDENTIFIED Trophozoites found on stool M.O.T.: faecal-oral route (may also be autoinfection) numerous food vacuoles

Amoeba
Differentiated by their nuclear structures A. Entamoeba E. gingivalis E. coli E. histolytica B. C. Endolimax E. nana Iodamoeba I. buetschlii

Entamoeba gingivalis First parasitic amoeba to be described by Antony van Leeuwenhoek Atrial Amoeba Habitat: Buccal Cavity Demonstration of trophozoite in materials or scrapings from the gingival margin of the gums, between teeth or dentures, and the soft tartar of the teeth NO Cystic Stage MOT: via droplet spray (i.e. kissing and sharing of utensils) TROPHOZOITE: 5-35 in diameter exhibits a definite zone of demarcation between the clear ectoplasm and the more granular endoplasm Endoplasm contains food vacuoles with host leukocytes and epithelial cells, at times bacteria, and rarely, RBC Nucleus is nearly spherical with karyosome near its centre Entamoeba coli Worldwide in distribution Non-pathogenic intestinal amoeba Habitat: Large intestine (Cecum)

 MOT: Ingestion of infective cyst from contaminated food and drinks Diagnostic Stage: Trophozoite and Cyst stages CYST: 10-35 in diameter Nucleus contains eccentrically located karyosome May contain 1-8 nuclei, depending on maturity Chromatoidal bars with splintered ends and glycogen vacuoles can be observed in the endoplasm TROPHOZOITE: 15-50 in diameter Nucleus contains eccentrically located karyosome Endoplasm is highly vacuolated, which may contain bacteria and yeasts Ectoplasm is not well demarcated from the endoplasm In wet mounts, movement is sluggish, with multiple pseudopods thrusted at the same time Entamoeba histolytica Worldwide in distribution The only pathogenic and tissue-invading amoeba Causes Amoebiasis, which can be limited to the gut alone or have extraintestinal invasions MOT: ingestion of infective cyst from contaminated food and drinks Diagnostic Stage: Trophozoite and Cyst stages CYST: 10-20 in diameter Nucleus contains karyosome, which is centrally located May contain 1-4 nuclei, depending upon maturity Cytoplasmic inclusions, such as glycogen vacuoles and chromatoidal bars (which have rounded ends; cigar-shaped) may be present may contain ingested RBCs flask-shaped ulcers (in the intestine) progressive, unidirectional movement PATHOGENECITY: Intestinal Amoebiasis Hepatic Amoebiasis or Extraintestinal Lesions Flask-shaped ulcers Amoebic Dysentery Stool has a gelatinous mixture of blood, mucus, and faeces LABORATORY DIAGNOSIS I. Intestinal Amoebiasis 1. Stool Examination Examined within 30 minutes after voiding Wet mounts with NSS Iodine-Hematoxylin or Trichrome Stains Diarrhoeic/Liquid Stools: presence of Trophozoite Formed Stools: presence of Cysts II. Hepatic Amoebiasis/Extraintestinal Lesions 1. Establish presence of Intestinal Amoebiasis 2. Increased WBC 3. Increased Liver Enzymes 4. Needle Biopsy of Abscess 5. Serologic Tests

Sporozoa
GENERAL CHARACTERISTICS: Unicellular Obligate intracellular Parasites Forms spores at some stage of their life cycle No apparent means of locomotion Life cycle may be passed in one host or it may involve passage in two hosts Methods of Reproduction: 1. Schizogony (Asexual) 2. Sporogony (Sexual) GENUS Plasmodium Causative agent of Malaria Blood-borne parasites Can be transmitted via three mechanisms: 1. Bitten by a females Anopheles mosquito 2. Transfusion or Sharing of Contaminated Blood 3. Vertical transmission (through pregnancy) TYPES OF HOST: 1. Intermediate Host: 2. Definitive Host (DF):

where asexual reproduction take place where sexual reproduction take place

SCHIZOGONY Asexual Reproduction Occurs in the intermediate host, when SPOROZOITES are introduced from the mosquito The sporozoites invade the liver cells and eventually the RBC in the peripheral circulation RBC are lysed in the course of the invasion, releasing the parasites. This is responsible for the febrile paroxysms observed in Malaria. End product of schizogony are MEROZOITES and GAMETOCYTES STAGES OF THE PARASITE SEEN IN MAN 1. TROPHOZOITE A. Early Trophozoite or Ring Form B. Growing Trophozoite C. Mature Trophozoite 2. SCHIZONT A. Young Schizont B. Growing or Immature Schizont C. Mature Schizont 3. GAMETOCYTES A. Microgametocyte (Male) B. Macrogametocyte (Female) INFECTED RBC RBC Maturity Morphology

Stipplings Malarial Present Present Present Pigments RBC Stipplings: Eosinophilic granulations found in the cytoplasm of infected RBC

P. vivax Young Enlarged and Pale Schuffners Dots

P. ovale Young Less enlarged and Globular James Dots

P. malariae Old Normal or Contracted in size Ziemanns Dots

P. falciparum Any Normal or Contracted in size Maurers Dots Present

Stipplings eosinophilic granules are either orange or red Malarial pigments: Haemoglobin products known as Haematin; from incomplete parasitic metabolism TROPHOZOITE A. Early Trophozoite or Ring Form Signet ring appearance with one chromatin dot P. falciparum has ring form with two chromatin dots Thin, blue ring of cytoplasm surrounding a vacuole B. Growing or Developing Trophozoite One chromatin dot Cytoplasm becomes larger and irregular in shape P. malariae develops a cytoplasm with band forms Malarial pigments and stipplings start to appear C. Mature Trophozoite One chromatin dot Larger and thickest cytoplasm with smaller vacuoles SCHIZONT A. Young Schizont Chromatin dot breaks into two Cytoplasm becomes amoeboid or compact B. Growing or Immature Schizont Chromatin continues to break Three or more chromatin dots appear Cytoplasm is still intact with scattered pigments C. Mature Schizont Cytoplasm divides according to the number of chromatin dots Each cytoplasm with its own chromatin dot is a MEROZOITE GAMETOCYTES Arise from merozoites after a few cycles of schizogony Immature, sexual forms of the parasite Usually rounded or ovoidal in shape P. falciparum has KIDNEY BEAN or CRESCENT-shaped gametocytes A. Microgametocyte Male gametocyte Pale blue cytoplasm with diffused chromatin mass B. Macrogametocyte Female gametocyte Deep blue cytoplasm, with a dense mass of chromatin SPOROGONY Sexual Reproduction Occurs when GAMETOCYTES from infected persons are raken in by the female Anopheles mosquito during a blood meal Microgametocytes and Macrogametocytes unite and develop zygotes. Further maturation occurs in the body of the definitive host End product of sporogony are SPOROZOITES MALARIA Caused by either or a combination of the four species of Plasmodium Symptoms include headaches, anaemia, enlarged spleen, joint pain, and fever with recurring fashion

 Severe cases result to massive haemolysis of RBC with haemoglobinuria (Blackwater Fever), Cerebral Malaria, Coma, and Death. Plasmodium Species P. vivax P. ovale P. malariae P. falciparum MALARIA IN THE PHILIPPINES Areas of Prevalence: 1.) Most parts of Mindanao 2.) Mindoro 3.) Palawan 4.) Luzon 5.) Samar 6.) Leyte The Malarial Species (in their order of frequency): 1.) P. falciparum 2.) P. vivax 3.) P. malariae 4.) P. ovale Disease Produced Benign tertian Malaria Ovale tertian Malaria Quartan Malaria Subtertian Malaria Malignant tertian Malaria (most fatal)

Malarial Vectors in the Philippines: 1.) Anopheles minimus var. flavirostris (most common) 2. A. balabacensis (Palawan) LABORATORY DIAGNOSIS 1. Examination of Blood Films Gold Standard Best collected at the PEAK of fever without prior administration of drugs Best method of collection is through skin puncture A. Thin Smear : used to study the relationship of the parasite to the involved RBC : morphology is better defined : MORE SPECIFIC : Wright Stain : RBCs are hemolysed : Parasited appear smaller and less regular in outline : MORE SENSITIVE : Giemsa Stain

B. Thick Smear

ALL stages of the parasite can be seen in the blood films from P. vivax, P. ovale, and P. malariae infections. ONLY RING FORMS and GAMETOCYTES can be in blood films with P. falciparum infections. 2. Serologic Methods A. Malaquick B. Optimal Assay

Intestinal nematodes
Helminthology the study of worms (from helminth = worm) Nematodes true round worms Free-living nematodes are found in water and in soil; parasitic nematodes are found on plants and animals. CHARACTERISTICS 1.) Shape unsegmented, elongated, and cylindrical Males: ventrally curved posterior end; may have copulatory spindle 2.) Size longest: D. medinensis; largest: A. lumbricoides 3.) Body covering usually smooth, may be covered with spines or ridges 4.) Body cavity filled with fluid called oxyhaemoglobin 5.) Alimentary canal 6.) Excretory system 7.) No definite circulatory/vascular system 8.) Nervous system 9.) Reproductive system (diecious; separate sexes) Common opening: Cloaca male; Vulva female Viviparous discharge of 1st stage larva from uterus Trichinella, Wuchereria, Dracunculus, Brugia Oviviparous lay eggs Unsegmented: A. lumbricoides; Segmented: hookworms; Embryonated: E. vermicularis Ovo-viviparous lay embryonated eggs which hatch immediately S. stercoralis (threadworm) NEMATODE EGGS LAYER: 1.) Vitelline Membrane fertilisation membrane 2.) Chorionic Layer true shell (titin) 3.) Albuminous layer outermost covering OVIPOSITED EGGS MAY CONTAIN: 1.) Single blastomere Ascaris, Trichuris 2.) Early stage of cleavage hookworms 3.) Embryo Strongyloides, Enterobius Polyparasitism many species of parasites occupying the same host TRIUMVIRATE: hookworm, A. lumbricoides, T. trichiura (HAT) ASPHASMID NEMATODES Trichinella spiralis Diseases: Trichinosis/Trichinelliasis Geographic distribution: cosmopolitan, prevalent in countries where pork is eaten raw/poorly cooked M.O.T.: Ingestion of raw/poorly cooked food with encrusted larva HOST: man, hogs, rats, dogs, cats HABITAT: small intestine Encrusted larva are found in the long axis of striated muscles (with spear-like burrowing tip) Dx: detection of larval worms in muscle Trichuris trichiura (whipworm) Diseases: Trichuriasis, Trichocephaliasis, whipworm-infection Geo. dis.: cosmopolitan M.O.T.: ingestion of fully embryonated eggs in contaminated food and drinks HOST: man

HABITAT: cecum + upper colon, walls of the appendix and most posterior level of ileum (large intestine) OVA: barrel-shaped with bipolar protruding mucoid plugs + bile stain (outermost) o Unsegmented stage in stool o Japanese latern o Hatch in the small intestine Dx: Charcot-Leyden crystals o Light: <10 eggs o Heavy: over 50 eggs o Massive: too massive (numerous) to count

Capillaria philippinensis (Pudoc worm) Diseases: Intestinal capillariasis, Pudocs disease Geo. dis.: in the Philippines, Ilocos Norte (1963), Pudoc, Ilocos Sur (1967), Northern Luzon region; Thailand M.O.T.: encycsted larva in fresh water fish HOST: fish, man HABITAT: jejunum OVA: more oval in shape o Bipolar plugs not protuberant o Pitted, thick shell; appearing as striated Dx: Acid Ether Concentration Method PHASMID NEMATODES Strongyloides stercoralis (threadworm) Diseases: Strongyloidiasis, Cochin-China diarrhoea Geo. dis.: cosmopolitan M.O.T.: filariform larva penetrates intact skin HOST: man HABITAT: jejunum; lower duodenum 1.) Rhabditoid larva: feeding stage (open mouth) o Caudal end is pointed; seen in faeces 2.) Filariform larva: infectious, closed mouth stage o Caudal end is forked or notched OVA: rarely found in the stool as they hatch in the intestine o Oval and thin-shelled, smaller, yet resembling hookworm ova Ovoviviparous females Dx: faecal culture Ancylostoma duodenale (Old World hookworm) Disease: Ancylostomiasis Geo. dis.: cosmopolitan M.O.T.: filariform larva penetrates intact skin HOST: man HABITAT: small intestine ADULT: C curve: same curvature of head as of the body o Adult male: tripartile dorsal ray With 3 pairs of cutting teeth: 2 pairs on top; 1 pair on the bottom Copulatory spicules: simple, bristle-like, plain and free at the tip 1.) Rhabditoid larva: feeding stage 2.) Filariform larva: same as S. stercoralis OVA: bluntly round ends o 2/8 segmented cell stage o Colourless vitelline membrane, transparent hyaline shell

Necator americanus (American hookworm) Diseases: Necatoriasis, Uncinariasis M.O.T.: filariform larva penetrates intact skin HOST: man HABITAT: small intestine ADULT: S curve: head curve is opposite to the curve of the body o With a barb (copulatory spicules) on the posterior end o With cutting plates (not teeth) OVA: longer and narrower than A. duodenale Enterobis vermicularis (pinworm or seatworm) Diseases: Enterobiasis, oxyceriasis Geo. dis.: cosmopolitan M.O.T.: ingestion of food containing ova HOST: man HABITAT: cecum, appendix, colon ADULT: o male posterior end is strongly curved & single copulatory spicule present Size: 25 mm length Lateral cephalic wings (cephalic alae) Distinct, prominent oesophageal bulb o female long, pointed end size: 813 mm length OVA: elongated, ovoidal, flattened at ventral side o Shell proper 2 layers of chitin & thick hyaline Outer albuminous layer Nocturnal migration: hatch in duodenum Dx: Scotch Adhesive Tape Swab (also known as Graham Scotch Tape Anal Swab) Ascaris lumbricoides Disease: Ascariasis Geo. dis.: cosmopolitan M.O.T.: ingestion of food contaminated with eggs containing 2nd stage larva HOST: man HABITAT: jejunum (favourite area), lumen of the small intestine o slight preference for middle ileum ADULT: 3 conspicuous lips finely denticulate o Male: contains pair of cephalic wings (cephalic alae) o Female: conical and straight; longer in length than males OVA: unfertilised and fertilised: contain mammilations (tiny bumps) o may also be decorticated (smooth outer layer, no protusions) o embryonated: coiled embryo found inside the egg Dx: May also cause Ascaris pneumonitis Lung Migration migration of worms toward the lungs Eggs can be found on sputum Ascaris lumbricoides, Strongyloides stercoralis, and hookworms (ASH)

Trematodes (flukes)
Phylum Platyhelminthes (platy = flat; helminths = worms) flatworms CHARACTERISTICS: 1.) Shape leaf-like, unsegmented, flattened dorsoventrally (except for schistosomes) 2.) Size from 1mm to several cm in length 3.) Acetabula/suckers a. most characteristic structure b. cup-shaped depressions c. organs of attachment d. oral, ventral, genital suckers 4.) Reproductive system a. All are hermaphroditic (except for schistosomes, which are diecious) b. ALL parasitic trematodes are OVIPAROUS c. Trematode eggs are OPERCULATED (split where the larvae hatches out) EXCEPT FOR SCHISTOSOMES GENERAL LIFE CYCLE Egg Larva stages (miracidium sporocyst redia cercaria metacercaria) Adult Miracidium: primary host; free-living (in water) o unembryonated, free-living larva with cilia for locomotion Cercaria: tapered tail (except for schistosomes); infective stage for schistosomes Metacercaria: no tail; infective stage to definitive host (man) except for schistosomes require two intermediate hosts (except schistosomes) 1st hosts: snails 2nd hosts: fish, crab, plant, another snail

BLOOD FLUKES (schistosomes) Diecious Non-operculated ova Requires one intermediate host only Cercaria: infective stage to man Infects through skin penetration Suckers armed with delicate spines Intestinal ceca reunite behind ventral sucker to form single cecum Length of reunited cecum varies according to species Cercariae: bifid/forked tails penetrate through unbroken skin Nourishment from blood of host Schistosoma haematobium (vesical blood fluke) D.: vesical /urinary schistosomiasis, schistosomal haematuria IH: snails (Bulinus, Planobis, Ferrisia) HABITAT: o Adult vesical and pelvic venous complexes o Ova urinary bladder and genitalia, found in urine, occasionally in faeces ADULT: o integument is finely tuberculate o intestinal ceca unite late o united ceca is short OVA: spindle-shaped with rounded anterior end and somewhat conical posterior end with terminal spine

Schistosoma mansoni (Mansons blood fluke) D.: intestinal schistosomiasis, Katayamas disease IH: snails (Biomphalria, Tropicorbis) HABITAT: o Adult mesenteric venules of lower intestine o Ova intestine and mesenteric lymph nodes, found in faeces, occasionally in urine Only blood fluke known to be in eternal copulation ADULT: o Integument is grossly tuberculate o Intestinal ceca unites early o Smallest blood fluke OVA: o Enlongated, ovoidal o Sometimes with S-like curve with long lateral spike (Speech Balloon shape) Schistosoma japonicum (Oriental blood fluke) D.: Oriental schistosomiasis, Katayamas disease IH: snails (Oncomelania quadrasi) HABITAT: o Adult radicles of superior mesenteric veins o Ova intestine and mesenteric lymph nodes, found in faeces ADULT: o Integument non-tuberculate o Intestinal ceca unites very late o United ceca is very short OVA: o Oval to round in shape o With short lateral tubercles Schistosomiasis Pathophysiology CDC: bilharzia, 2nd most devastating parasitic disease after malaria Symptoms caused by bodys reaction to the parasite, not from the parasite itself S/S: itchy skin/rash within a few days, fever, chills, cough, muscles aches in 1-2 months; intestine/liver/bladder inflammation or scarring; anaemia and malnutrition Dx: eggs from urine and faeces o Serologic Tests o Intracutaneous Test o WBC count and Differential count (more eosinophils) LUNG FLUKE Paragonimus westermani (Oriental lung fluke) Geo. dis.: worldwide; in the Philippines Samar, Leyte, Cotabato, Sorsogon, and in Camarines D.: paragonimiasis, pulmonary distomiasis, endemic hemoptysis Indefinite Hosts: o 1H: snail o 2H: crab/crayfish M.O.T.: ingestion of crab/crayfish containing metacercaria ADULT: o Egg/coffee bean-shaped o Thick and fleshy o Suckers of equal size (oral and ventral)

o OVA: o o

Excretory bladder is long and slightly convoluted pouch reaching from posterior end to level of pharynx Broadly ovoidal with distinct flattened operculum and thickened posterior end Immature when laid and matures in water

Paragonimiasis Pathophysiology Acute infection with cough, abdominal pain, discomfort, low-grade fever Infection usually recovers without treatment Person with light infections may have no symptom (asymptomatic) Serious if the fluke travels to the nervous system and manifests symptoms mimicking meningitis S/S: o Pulmonary TB resemblance o Fever o Chest pain o Fatigue o Rust-coloured or Blood-tinged sputum Dx: o Eggs from sputum o Complement Fixation Test o Intracutaneous Test o Chest X-ray

LIVER FLUKES Fasciola hepatica COMMON NAME DIS. 1H 2H DH I.S. M.O.T. Dx. Sheep liver fluke, common liver fluke Sheep liver rot; Fasciolasis hepatica Snail (Lymenea) Watercress Sheep, Goat, Cattle, Man metacercaria ingestion of 2H with metacercaria Recovery of eggs from stool, duodenal, biliary drainage Large, hens egg shaped Ovoidal and yellowish-brown inside egg; yolk cells enclosed in vitelline membrane Recovery of eggs from stool/duodenal aspirates Old-fashioned electric bulb; narrower anterior end with distinct opercular shoulders, small median protuberance at posterior end Snail (Bulimus) Cyprinoid fish (carp) Clonorchis sinensis Chinese/Oriental liver fluke, Clonorchiasis

OVA

INTESTINAL FLUKES Fasciolopsis buski COMMON NAME DIS. 1H 2H DH I.S. M.O.T. Dx. Giant intestinal fluke (largest trematode parasite) Fasciolopsiasis Snail (Segmentina) H2O caltrops (Trapa bicornis, Trapa natans), H2O chestnuts, H2O hyacinths, H2O bamboos, Morning glory, lotus Man, Pig

Echinostoma ilocanum Garrisons fluke (prisoners in Manila in 1907) Echinostomiasis Snail (Gyranulus convexiusculus) Snail (Pila luzonica/Pila conica) Man Metacercaria ingestion of 2H with metacercaria Recovery of eggs from stool

OVA

Large, hens egg shaped with yolk cells Ellipsoidal with clear, thick shell; small operculum Almost identical to F. hepatica

Straw/pale yellow Ovoidal, operculated Immature when laid, with yolk cells May have germinal area

Cestodes
TAPEWORMS Flatworms; long, segmented, no Digestive System, monoecious SIZE: from a few millimetres to several metres in length PARTS: 1. SCOLEX Organ attachment only (not for food) Bothria; cup-like muscular sucking grooves, eversible proboscis 2. NECK Budding zone where other segments are formed Rostellum with chitinous hooks 3. STROBILA Proglottids Immature, Mature, and Gravid (three kinds of segments) FERTILISATION takes between segments; self-fertilisation or cross fertilisation CLASSIFICATION: Pseudophyllidae and Cyclophyllidae MAN is the DEFINITIVE HOST except for Echinococcus (DH for Echinococcus is dogs) PSEUDOPHILLIDAE Diphyllbothrium latum (Tapeworm of Man) A.K.A.: Fish tapeworm, broad tapeworm, Dibothrocephalus latus D.: Diphyllobothriasis, Bothriocephaliasis, Fish Tapeworm infection (F-T infection), Dibothriocephaly, Taenia 1st IH: crustaceans (copepods) 2nd IH: freshwater fishes HABITAT: small intestine

M.O.T.: plerocercoid larva/sparganum (eating of insufficiently cooked fish) MORPHOLOGY: o Adult: ivory/greyish in colour; 4000 proglottids; almond-shaped scolex with 2 suctorial grooves; gravid proglottids have dark, rosette-like coiled uterus in the midpart o OVA: single-shelled, yellow-brown in colour; ciliated embryo/coradium; inconspicuous operculum Dx: recovery of eggs in faeces; scolex and proglottids recovered

CYCLOPHILLIDAE TAENIA sp. Taenia solium A.K.A. Disease/s HABITAT LENGTH SCOLEX GRAVID PROGLOTTIDS TERMINAL OVA IH LARVA M.O.T. LIFE SPAN Dx 7 10 metres Quadrate, with rounded rostellum, 4 suckers and hooklets < 13 branches With rostellum Spherical, striated with hexacanth embryo Pig, Man Cysticercus cellulosae Eating raw pork with larva; Eating food with encysted eggs 25 years Eggs are gravid and recovered in not applicable to T. saginata faces/perianal swabbing ** more gravid branches in T. saginata than T. solium Cattle Cysticercus bovis Eating raw beef with larva Pork Tapeworm, Armed Tapeworm Taeniasis solium, Pork Tapeworm Infection, Cysticercosis Taenia saginata Beef T., Unarmed T. Taeniasis saginata, Beef Tapeworm Infection

Small intestine 25 m Quadrate, no rostellum, suckers, hooks (hence unarmed) > 13 branches

HYMENOLEPSIS sp. Hymenolepsis nana A.K.A. ADULT SCOLEX GRAVID PROGLOTTIDS IS Dwarf T. 25 40 mm length Hymenolepsis diminuta Rat T. 10 60 cm length

Rhomboid, with suckers and armed rostellum 80 100 ova Eggs (direct), Cystercercoid larva (indirect) Spherical, contains an oncosphere with 3 pairs of hooklets, inner envelope has 2 polar thickenings which give rise to 4 8 polar filaments Man, Rats, Mice Eystercercois larva Subspherical, contains an oncosphere with 6 hooklets in a fan shape, inner membrane with 2 polar thickenings without filaments Man, Rats

OVA

DH M.O.T. Dx

Eating eggs from contaminated food and Ingestion of cystecerci (body of infected beverages insect) Recovery of eggs from faeces

Echinococcus granulosus A.K.A.: Taenia echinococcus, Hydatid worm Disease: Unilocular echinococcus Geo. Dis.: cosmopolitan, prevalent in sheep-raising countries M.O.T.: ingestion of food with embryonated eggs DH: Dogs, Wolves (principal) IH: domesticated animals (sheep, cattle, goats, camel, hogs, horses); Man is ACCIDENTAL IH (intermediate host) MORPHOLOGY: o Adult: smallest tapeworm of medical importance o Scolex is pyriform in shape o Has 4 suckers, prominent rostellum with 2 rows of rostellar hooks (28 40) o 1 immature proglottid segment o Mature prog.: narrowest among the 3 segments o Gravid prog.: Broadest and longest segment Length is more than half of the whole body o OVA: similar with Taenia sp. o LARVA: hydatid cyst, hydatid larva; Echinococcus larva Dx: X-ray, Ultrasound, MRI **Hydatid cyst in liver accounts for 70% total population; 20% in lungs and 10% in other tissues

DIFFERENCE BASIS SHAPE CESTODE Tape-like; segmented TREMATODE Leaf-like; unsegmented Monoecious (except for Schistosomes, which are diecious) Suckers, without hooks NEMATODE Elongated, cylindrical, unsegmented Diecious No suckers and hooks; Well-developed buccal cavity Present anus; Complete PRESENT

SEXES

Monoecious

CAEPHALIC REGION ALIMENTARY CANAL BODY CAVITY

Suckers, often with hooks

ABSENT ABSENT

Incomplete; no anus