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    Trematoda

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    Trematoda

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    Trematoda

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    of 1

    Fasciola hepatica Heterophyes heterophyes Schistosoma mansoni

    Liver fluke Intestinal fluke Blood fluke


    Other name
    Cosmopolitan Egypt Upper Egypt
    Geographical (Sheep raising countries) (Elmanzala + Borollos lakes) Africa
    dist. Fareast Saudi Arabia
    Yemen
    Tropical America
    Bile ducts Small intestine Radicals of
    Habitat inferior mesenteric veins
    (Large intestine + terminal ileum)
    Clinical ❶ Mild: ❶ Invasion + maturation:
    manifestations ❶ Migratory stage:
    - asymptomatic - pruritis, skin rash, fever, wheezes ,
    cough, hepatomegaly, diarrhea
    mild → asymptomatic
    ❷ Heavy:
    heavy → fever, right
    - abdominal colic ❷ Establishment:
    hypochondrial pain
    intermittent diarrhea - Dysentery
    blood in stool
    ❷ Establishment stage:
    ❸ Complications:
    - acute epigastric pain,
    ❸ Complications: - Intestinal
    repeated attacks of fever,
    - myocarditis (HF) - Extra intestinal
    jaundice + hepatomegaly
    - brain involvement ( hepatic – pulmonary )

    Eosinophilia + +
    Lab. Diagnosis Direct: Direct: Direct:
    - stool sample - stool - stool sample
    - duodenal sample - rectal swab
    - rectal biopsy
    - sigmoidoscopy + biopsy

    Indirect: Indirect:
    - ELIZA – IHAT - Circumoval precipitin test
    - ELIZA – IHAT – IFAT
    Blood:
    Eosinophilia
    Treatment Triclabendazole Praziquantel Praziquantel
    Prevention + 1- No unfiltered water
    1- No raw or inadequately 1- Mass treatment
    Control 2- wash vegetables
    cooked fish 2- Health education
    3- Snail destruction
    2- Molluscicides are ineffective 3- Environmental sanitation
    4- Mass treatment of animals

    Infective stage Encysted metacercaria Encysted metacercaria Cercaria

    Diagnostic stage Immature eggs Mature eggs Mature eggs


    Animals (mainly) Human Human (mainly)
    Definitive host Human Animals Monkeys + Rodents

    #Zoonotic
    st
    Lymnaea truncatula 1 = Pirenella conica Biomphalaria alexadrina
    Intermediate nd
    2 = Fish (Boury+Bolty)
    host
    • Eating infected food • Eating imperfectly cooked fish • Swimming or drinking infected water
    Mode of • Drinking infected water • Eating undersalted fish
    infection " penetration through Unbroken skin
    or mucous membranes "

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