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    Parasitology 18 Lung Flukes

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    JayricDepalobos
    1. Pulmonary flukes (Paragonimus westermani) are reddish-brown flukes that can cause lung disease in humans called paragonimiasis. 2. Humans can be infected by eating raw or undercooked freshwater crabs that contain the infective metacercariae stage of the fluke. 3. Symptoms range from asymptomatic to coughing up blood, chest pain, and lung damage depending on the infection level. Diagnosis involves detecting fluke eggs in sputum or biopsy samples. Praziquantel is the treatment of choice.

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    Parasitology 18 Lung Flukes

    Uploaded by

    JayricDepalobos
    65 views25 pages
    1. Pulmonary flukes (Paragonimus westermani) are reddish-brown flukes that can cause lung disease in humans called paragonimiasis. 2. Humans can be infected by eating raw or undercooked freshwater crabs that contain the infective metacercariae stage of the fluke. 3. Symptoms range from asymptomatic to coughing up blood, chest pain, and lung damage depending on the infection level. Diagnosis involves detecting fluke eggs in sputum or biopsy samples. Praziquantel is the treatment of choice.

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    1. Pulmonary flukes (Paragonimus westermani) are reddish-brown flukes that can cause lung disease in humans called paragonimiasis. 2. Humans can be infected by eating raw or undercooked freshwater crabs that contain the infective metacercariae stage of the fluke. 3. Symptoms range from asymptomatic to coughing up blood, chest pain, and lung damage depending on the infection level. Diagnosis involves detecting fluke eggs in sputum or biopsy samples. Praziquantel is the treatment of choice.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    65 views25 pages

    Parasitology 18 Lung Flukes

    Uploaded by

    JayricDepalobos
    1. Pulmonary flukes (Paragonimus westermani) are reddish-brown flukes that can cause lung disease in humans called paragonimiasis. 2. Humans can be infected by eating raw or undercooked freshwater crabs that contain the infective metacercariae stage of the fluke. 3. Symptoms range from asymptomatic to coughing up blood, chest pain, and lung damage depending on the infection level. Diagnosis involves detecting fluke eggs in sputum or biopsy samples. Praziquantel is the treatment of choice.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 25

    Pulmonary

    Flukes
    (Paragonimus
    westermani)
    Diseases:
    Paragonimiasis
    Lung Fluke disease
    Pulmonary distomiasis
    Endemic hemoptysis
    Parasitic hemoptysis
    Paragonimus westermani
    ADULT
    reddish-brown fluke
    1. 7 -12mm x 4 -6 mm width, 3.5-5mm
    thick (resembles a coffee bean)
    2. spinous cuticle
    3. irregularly deeply lobed testes situated
    opposite each other
    4. Ovary anterior to the testes, posterior to
    the ventral sucker, with long unbranched
    lobes
    5. vitellaria branched extensively
    Paragonimus westermani
    possess oral and ventral suckers.
    Paragonimus westermani

    CERCARIAE
    covered with spines
    has ellipsoidal body and a small tail
    stylet present at dorsal side of oral
    sucker

    METACERCARIAE
    round
    measures 381-457 um
    Paragonimus westermani
    EGG
    Color: yellowish-brown
    Shell: thick
    Shape: oval
    Flattened but prominent operculum
    Abopercular portion: thickened
    Unembryonated at oviposition
    Dimensions: 80-118um x 48-60 um
    Paragonimus westermani

    1st IH: Antemelania asperata, Antemelania


    dactylus (Brotia dactylus)
    2nd IH: mountain crabs Sundathelphusa
    philippina (Parathelphusa grapsoides)
    A, B: Eggs of Paragonimus sp. taken from a lung biopsy
    stained with hematoxylin and eosin (H&E). These eggs
    measured 80-90 m by 40-45 m. The species was not
    identified in this case.
    C: Adult of Paragonimus sp., taken from a lung biopsy specimen
    stained with hematoxylin and eosin (H&E). Note the presence of
    the oral sucker. The species was not identified in this case.
    D: Higher magnification of Figure C, showing a close-up of the
    cuticle.
    PATHOLOGY AND
    SYMPTOMATOLOGY
    in the lungs, worms provoke a
    granulomatous reaction that proceeds to
    the development of fibrotic encapsulation
    within the cyst is a blood-tinged purulent
    material containing eggs
    early stages : asymptomatic
    heavy infections: dry cough, later produce
    bloodstained or rust-colored sputum
    with foul fish odor (pronounced in the
    morning)
    PATHOLOGY AND
    SYMPTOMATOLOGY
    chest pains, dyspnea, hemoptysis, low-
    grade fever, fatigue, myalgia
    often misdiagnosed for PTB
    symptoms less severe after five to six
    years
    lodge in abdominal wall, abdominal cavity,
    mesenteric lymph nodes, omentum,
    pericardium, myocardium and intestinal
    wall causing erratic paragonimiasis
    Abdominal pain, rigidity & tenderness
    PATHOLOGY AND
    SYMPTOMATOLOGY
    cerebral involvement - most serious
    complications
    may cause:
    Jacksonian epilepsy
    Cerebral hemorrhage
    Edema
    Visual disturbances
    Meningitis
    prognosis with light infection is good and
    chemotherapy has a high cure rate
    DIAGNOSIS
    DEFINITIVE DIAGNOSIS:
    based on detection of characteristic
    eggs in sputum, stool, or less frequently,
    aspirated material from abscesses or pleural
    effusions
    Radiographs: ring-shadowed opacity,
    comprising several contiguous cavities
    (bunch of grapes appearance)
    serology helpful in extrapulmonary
    paragonimiasis
    DIAGNOSIS
    standard serological test:
    complement fixation (CF) has
    advantage to detect rapid decline in
    antibody levels
    Enzyme immunoassay (EIA) and
    Immunoblot (IB)
    TREATMENT
    DOC: Praziquantel
    25 mg per kg TID for 3 days
    Cerebral involvement- short-term
    corticosteroids

    Alternative: Bithionol
    Triclabendazole
    EPIDEMIOLOGY

    Global distribution in freshwater


    crabs
    Human infections reported from
    39 countries
    Major endemic areas: Japan,
    South Korea, Thailand, Taiwan,
    China, and the Philippines
    Leyte, Sorsogon, Mindoro,
    Camarines, Samar, Davao,
    Cotabato, Basilan
    EPIDEMIOLOGY
    A person is infected by eating
    uncooked infected freshwater crabs
    and crayfish.

    It is customary in the Orient to


    consume these uncooked crustaceans
    in brine, vinegar, or wine as drunken
    crabs, in which the metacercariae may
    survive for several hours.

    Also, metacercariae, dislodged during


    food preparation, may contaminate
    eating and cooking utensils.
    PREVENTION
    The most practical method of
    preventing human infection is to
    avoid eating raw, freshly pickled,
    or imperfectly cooked crustaceans
    and to refrain from drinking unfiltered
    or unboiled creek water in endemic
    districts.
    The best line of attack is public
    education, since the elimination of
    reservoir hosts, crustaceans and
    snails, is not feasible.

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