[166-170] parasites causing diarrhoea

8/13/2019 [166-170] Parasites Causing Diarrhoea

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No. ID Name Topic

10-3-166 Dr Muhammad Huzaifah Bin Hassan

Introduction of Parasites Causing

Diarrhoea, Heterophyes

Heterophyes, Diphylobothrium

Latum

10-3-167 Dr Mohd Hafizuddin Bin Md Nasir Cestoidea : T. Saginata, T. Solium,

H. Nana

10-3-168 Dr Mohd Ridwan Shahputra BinShihabuddin

Ascaris Lumbricoides,Strongloides Stercolaris

10-3-169 Dr Muhammad Ridzwan Bin Abd Aziz Strongloides Stercolaris

(continued),

Ancylostoma Duodenale

10-3-170 Dr Mohamad Zaimey Bin Zulmanaf Protozoa : Giardia Lamblia,Isospora Belli, Cryptosporidia

PARASITES

CAUSING

DIARRHOEA


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INTRODUCTION OF PARASITES

CAUSING DIARRHOEA

HETEROPHYES HETEROPHYES

DIPHYLOBOTHRIUM LATUM

DR MUHAMMAD HUZAIFAH BIN HASSAN

10-03-166

ALEXANDRIA UNIVERSITY


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PARASITES CAUSING DIARRHEA

PARASITES

CAUSING DIARRHEA

HELMINTHS

TREMATODE

HETEROPHYES

HETEROPHYES

CESTODE

DIPHYLLOBOTHRIUMLATUM

TAENIA SAGINATA

TAENIA SOLIUM

HYMENOLOPIS NANA

NEMATODE

HOOKWORMS

ASCARIS

LUMBRICOIDES

STRONGYLOIDESSTERCORALIS

PROTOZOA

GIARDIA LAMBLIA

ISOSPORA BELLI

CRYPTOSPORIDIA


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HETEROPHYES HETEROPHYES

1 MORPHOLOGY

ADULTS

Pale grey & pyriform

Size:3mm x 0.5mm

Covered externally by cuticle

Have 3 Suckers(Oral, Ventral &

Genital)

Have 2 large oval testes

Has a coiled tube uterus

EGG

Size : 30 x 15

Shape : Operculated

Colour : Light Brown Content : Fully

developed miracidium


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2)LIFE CYCLE OF HETEROPHYES

Infective Stages : Infective encysted metacercariae

Method of infection : Eating of the imperfectly cooked or undersalted fish

Diagnosis : Presence of eggs in stools


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3 TREATMENT-Praziquantel-Niclosamide-Paparazine

4)PREVENTION

&CONTROL

- Avoid eating

undersalted fish- Governmentalmedical measures

of water-fecescontaminationreduction


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DIPHYLOBOTHRIUM LATUM

1 MORPHOLOGYADULTS

Long parasite may reach up to 10m

Broader than long

Has midventral genital pore

Size: 4mmx12mm

Testes are multiple and dorsolaterallylocated

Vas deferens continue as a seminal

vesicle, then a cirrus, then open into

the common genital pore

Ovary is oval & located posteriorly

Vagina proceeds from the ootype intocommon genital pore

Uterus is coiled rosette, rising from

the ootype and open into uterine pore

EGG

Size : 65 x 45 Shape : Ovoid & Operculated

Colour : Yellowish brown

Content : Unembryonated eggs


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3 TREATMENT-Niclosamide-Praziquental

4)PREVENTION &

CONTROL

-Treatment of infectedperson

-Properly cooking of fish-Improve sewage system


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SYUKRAN JAZILAN


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CESTOIDEA:

TAENIASAGINATA

TAENIASOLIUM

HYMENOLEPISNANA

DR MOHD HAFIZUDDIN BIN MD NASIR

10-3-167



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Tenia Saginata-Beef Tapeworm

Morphology :Scolex- quadrate in cross section, 1-2mm diameter,no hooksProglottis- flat long segmented, 16-20mm long and 5-7mm wide

Whitish in colour

Embryonated egg, walnut brown with 6-hooked oncosphere in shell.

Size 35 micro-meter

Proglottid has blind tubular uterus, a bilobed ovary and the vagina

with terminal sphincter.


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Life-Cycle :


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Clinical Pictures :allergic reactions (rare)constipation

diarrhea

headache

loss or gain of appetite

nausea

stomach ache

decrease or increase weight

Complication :-appendecitis or cholangitis due migrating proglottis


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Diagnosis :First three months, antibody detection methods can be used to find

antibodies.by identifying eggs (rarely) or proglottids in the stool sample after threemonths

Endoscopic examination

Treatment :Preziquantel

Niclosamide

Prevention and Control :Cook above 60 C or freeze below -18 C for 5 days.

Prevent cattle farm at places contaminated with human feces.

Hygiene education


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Tenia Solium-Pork Tapeworm

Morphology :Scolex- globular with rostellum, 4 sucker and double row hook.Proglottis- flat long segmented, 7 m long.

Proglottid has, a trilobed ovary.

Gravid uterus contains 7-13 lateral branch on each side

Egg same with tenia saginata


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Life-Cycle :


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Clinical Pictures :Muscle Cysticercosis symptoms :

-Lumps under skin

Eye cysticercosis symptoms :

-Blurry vision

-Disturbed vision

-Retinal swelling-Retinal detachment

Neurocysticercosis symptoms :

-Seizures

-Headaches-Confusion

-Lack of attention to people and surroundings

-Difficulty with balance


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Diagnosis :stool sample

Endoscopic examination

Treatment :Preziquantel

Niclosamide


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Hymenolepis Nana-Dwarf Tapeworm

Morphology :

Scolex- rhomboidal with 4 sucker and short rostellum of 30-30 spinesin single row

Proglottis- 20-60 mm long and 1 mm wide with long and slender neck

Embryonated egg, walnut brown with 6-hooked oncosphere in shell.

Size 35 micro-meter

Proglottid has 3 globular testis situated in one line, small lobed ovaryand uterus occupy the middle part of segment

Eggs oval or spherical, colorless 40 micron diameter and 2 thin shell


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Life-Cycle :


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Clinical Pictures :Usually asymptomatic unless on allergy people.

Complains of headache, dizziness, anorexia,periodic diarhea and abdominalpain

Diagnosis :-Stool sample

-Endoscopic examination

Treatment :-Preziquantel-Niclosamide


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ASCARISLUMBRICOIDES

STRONGLOIDESSTERCOLARIS

DR MOHD RIDWAN SHAHPUTRA BIN SHIHABUDDIN

10-03-168



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-great size

-largest and second most common parasitic worm in humans

24 mm in diameter

1531 cm long

posterior end is curved

ventrally

bluntly pointed tail

36 mm wide

2049 cm long

straight posterior end

Male Female

Morphology


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ADULTMALEANDFEMALEWORMOFASCARIS

LUMBRICOIDES

Fertilized egg of Ascar is

Lumbr ico ides Unfertilized egg ofAscaris Lumbricoides


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Life cycle

P h i


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Host immune response:

o Ascaris pneumonitis and aggregations of macrophages andepitheloid cells

o Eosinophilic infiltration and granulomatous reaction

o Fibrosis of periportal tracts in liver and interlobular spaces oflungs

Mechanical effect of adult worms:

o Irritation

o Volvolus or intestinal obstruction

o Acute symptom e.g. liver abscesses, obstruction of bile duct,

intestinal perforation etc. Effects of adult worms on host nutrition:

o Vitamin A and C deficiency

Pathogenesis

S t


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In the lungs

asthma or pneumonia

Persistent cough

Shortness of breath

Wheezing

In the intestines

Vague abdominal pain

Nausea and vomiting

Diarrhea or bloody stools

In a heavy intestinal infestation

Severe abdominal pain

Fatigue

Vomiting

Weight loss

A worm in vomit or stool

Symptoms

Di i


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Migratory Stage Larvae can be detected in gastric washing

X-ray show shifting mottled lung infiltration

Eosinophilia during tissue migratory stage

Intestinal Infection

Finding ova in stool using concentration method Radiological examination of abdomen

Diagnosis

T t t


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Albendazole

Mebendazole

Pyrantel pamoate (pregnant patient)

Endoscopy Surgery (rare cases)

Treatment

P ti d t l


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Improved sanitation and hygiene in developing countries

will reduce the risk in those areas

In areas where this disorder is common, routine or

preventive (prophylactic) treatment with deworming

medications may be advised

Mass treatment of infected populations

Measures to prevent environmental contamination with

human feces

Prevention and control


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STRONGYLOIDESSTERCORALIS(MORPHOLOGY)

Parasitic stage Male

o 0.9 mm in length

o with a curved tail and twospicules

Female

o 2.0 to 2.5 mm

o with filariform oesophagusand the vuval opening

Both genders possess a tinybuccal capsule and acylindrical esophaguswithout a posterior bulb.

Free-living stage

oesophagi of both sexes

are rhabditiform

Males can be

distinguished fromfemales by two structures:

the spicules and

gubernaculum


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FREE-LIVINGADULTMALES. STERCORALIS.

PRESENCEOFTHESPICULE

(REDARROW)

Adult free-living female S.

stercoral is. Presence of row of eggswithin the females body

Fertilized egg of S. Stercoralis

Lif l


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Life cycle


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DR MUHAMMAD RIDZWAN BIN ABD AZIZ

10-3-169


STRONGLOIDES

STERCOLARIS(continued)

ANCYCLOSTOMA DUODENALE

P th i & C/


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Pathogenesis & C/p

Cutaneous

Pulmonary

Intestinal (malabsorption with steatorrhea,

ulceration, melena, anemia)

VLMS


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Di i


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Diagnosis

Stool

Duodenal aspiration

Sputum examination

Blood picture (eosinophilia 10-40%)

T t t d ti


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Treatment and prevention

Treat with: IVERMECTIN

Sanitary disposal of human faeces

Skin protection

Health education

Larvicidal to kill filariform in soil

ANCYLOSTOMA DUODENALE


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ANCYLOSTOMA DUODENALE

Morphology

Life cycle


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Life cycle

Pathogenesis and C/P


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Pathogenesis and C/P

Cutaneous (ground itch)

Pulmonary (verminous pneumonia)

Intestinal(bleeding)

GIT (polyphagia, geophagia, flatulence, colic, stool

becomes semi-formed reddish brown)

Anemia & hypoproteinaemia

Endocrine and nervous (somatic infantilism, mental

retardation, butterfly pigmentation in face)


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Diagnosis


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Diagnosis

Stool (egg or worms)

Stolls egg counting technique to diagnose burden

of infection



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Treatment : mainly by Albendazole

Sanitary disposal of human faeces

Skin protection

Health education

Larvicidal to kill filariform in soil


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DR MOHAMAD ZAIMEY BIN ZULMANAF

10-03-170


PROTOZOA :

GIARDIA LAMBLIA

ISOSPORA BELLI

CRYPTOSPORIDIA

Giardia Lamblia


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Giardia Lamblia

Morphology

Life cycle


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Life cycle


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Clinical picture : asymptomatic,

symptomatic (diarrhoea,

malabsoprtion)

Diagnosis: Direct (stoolexamination, duodenal

aspiration, entero test capsule),

Immunological (ELISA)


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Treatment: Metronidazole (flagyl), Tinidazole

(fasigyn) Prevention and control : avoid human excreta

as fertilizers, treatment of cysts passers

Isospora Belli


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Isospora Belli

Morphology

Life cycle


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Life cycle


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Clinical picture : Diarrhoea,

weight loss, abdominal colic,malabsorption

Diagnosis: Stool Examination

(simple saline/Iodine smear,Zinc floatation, modified Ziehl

Neelsen acid fast stain),

Blood picture


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Treatment: Co-trimoxazole Prevention and control

Cryptosporidia


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Cryptosporidia

Morphology

Life cycle


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Life cycle


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Clinical picture : low grade

fever, respiratory infection Diagnosis: Stool examination

(Formol Ether/Sheathers

sugar floatation, modifiedZiehl Neelsen acid fast stain),

entero capsule test, intestinal

biopsy, sputum examination


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Treatment: Nitazoxanide

Prevention and control : Personal hygiene,

proper sanitation

References


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References

Centers for Disease Control and Prevention : ParasitesGiardia, available from :

http://www.cdc.gov/parasites/giardia/[accessed at 14th

May 2013]

Centers for Disease Control and Prevention : ParasitesCryptosporidium (also known as Crypto),available from : http://www.cdc.gov/parasites/crypto/[accessed at 15thMay 2013]

Parasites and Health:Heterophyiasis.07/20/2009, available from :http://www.dpd.cdc.gov/dpdx/HTML/heterophyiasis.htm . [accessed at 20 May 2013]

Parasites and Health: Diphylobothriasis.07/20/2009, available from :http://www.dpd.cdc.gov/dpdx/HTML/diphyllobothriasis.htm. [accessed at 20 May 2013]

Module 18 Semester 6 2012-2013 Year 3, Pathobiology, Faculty of Medicine-Alexandria University :Protozoal Intestinal Infection, Phylum Sarcomastigophora, subphyla Mastigophora, Giardia Lamblia,& Apicomplexa, Isospora Belli & Cryptosporidia, page 38-94 [cited at 5 thApril 2012]
http://www.cdc.gov/parasites/giardia/http://www.cdc.gov/parasites/giardia/http://www.cdc.gov/parasites/crypto/http://www.cdc.gov/parasites/crypto/http://www.dpd.cdc.gov/dpdx/HTML/heterophyiasis.htmhttp://www.dpd.cdc.gov/dpdx/HTML/heterophyiasis.htmhttp://www.dpd.cdc.gov/dpdx/HTML/diphyllobothriasis.htm.http://www.dpd.cdc.gov/dpdx/HTML/diphyllobothriasis.htm.http://www.dpd.cdc.gov/dpdx/HTML/diphyllobothriasis.htm.http://www.dpd.cdc.gov/dpdx/HTML/diphyllobothriasis.htm.http://www.dpd.cdc.gov/dpdx/HTML/heterophyiasis.htmhttp://www.dpd.cdc.gov/dpdx/HTML/heterophyiasis.htmhttp://www.cdc.gov/parasites/crypto/http://www.cdc.gov/parasites/giardia/


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[166-170] parasites causing diarrhoea

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