Bailey & Scott's Diagnostic Microbiology: Liver and Lung Trematodes Flashcards


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1

liver flukes

adult trematodes living in biliary ducts, encapsulated in the lungs; freshwater snail is intermediate host; dogs, pigs, and rabbits are reservoir/definitive hosts; caused by feces contaminating water when eggs enter snail and develop, fish eat the snail, and metacercariae are ingested

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liver fluke lab diagnosis

eggs recovered in stool with sedimentation concentration; acute and chronic serology tests; NAAT

3

Fasciola hepatica

worldwide distribution, more common in areas where cattle and sheep are raised and humans consume raw watercress (Europe, Middle East, and Asia); sheep liver fluke; snails and water plants are IH; human infections rare

4

Fasciola hepatica clinical presentation

light infections lead to fever, abdominal pain, diarrhea, jaundice, and liver tenderness; heavy infections larvae migrate to intestinal walls, lungs, heart, skin, or brain; months in acute phase-migration, chronic phase-adult fluke within bile ducts causing intermittent biliary obstruction and inflammation

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Fasciola hepatica eggs

elliptoid, operculated, unembryonated measuring 130-150 um long by 70-90 um wide

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Fasciola hepatica adults

measure 30mm long by 15 mm wide, large and broadly flattened; anterior end cone-shaped; reside in bile ducts of liver

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Clonorchis sinensis

Chinese liver fluke common in Korea, China, Taiwan, and Vietnam caused by ingestion of contaminated raw, pickled, smoked, salted, or dried fish

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Clonorchis sinensis clinical presentation

light infections usually asymptomatic, heavy infections lead to bile duct obstruction; acute-migration and chronic phase-cholangitis, cholelithiasis, acute pancreatitis

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Clonorchis sinensis eggs

28-34 by 14-18 um ovoid, thick brownish-yellow shell operculum with distinct shoulders; hook-like protrusion at abopercular end; miracidium visible inside egg

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Clonorchis sinensis adults

10-25 by 2-5 mm wide biliary passages of liver of definitive host

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Opisthorchis viverrini

Common in Southeast Asia-Northeast Thailand, Cambodia, Laos, and Vitenam-estimated 10 million people infected

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Opisthorchis viverrini clinical presentation

light infections usually asymptomatic, heavy infections lead to bile duct obstruction; acute phase-migration, chronic phase leads to cholangitis, cholelithiasis, acute pancreatitis, and associated with bile duct carcinoma

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Opisthorchis viverrini eggs

19-30 by 10-20 um

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Opisthorchis viverrini adults

7 mm long by 1.5 mm wide and reside in bile ducts of definitive host; differ from Clonorchis in shape of testes

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Paragonimus spp.

lung flukes; three common species with different geography

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Paragonimus westermani

lung flute transmitted by ingestion of improperly cooked or raw crabs or crayfish; worms live in lungs and produce eggs found in sputum or feces; species widely distributed but most common in Southeast Asia including Japan; Reservoir dog and cat, IH freshwater snail, secondary IH crab or crayfish

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Paragonimus mexicanus

Paragonimus species common to Central and South America; pigs are reservoir hosts, freshwater snail IH, crab or crayfish secondary IH

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Paragonimus kellicotti

Paragonimus species common to North and South America

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Paragonimus westermani clinical presentation

acute phase invasion and migration-diarrhea, abdominal pain, fever, cough, urticaria, hepatosplenomegaly, pulmonary abnormalities, and EOS; chronic leads to pulmonary manifestations including cough, discolored sputum expectorated, hemoptysis, and chest radiographic abnormalities; PMN's and EOS, fibrotic capsules and cysts form, and pronounced pulmonary inflammation

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Paragonimus westermani eggs

80-120 by 45-65 um yellow-brown, ovoid with thick shell; operculum clearly visible at one end with shoulders; unembryonated when passed

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Paragonimus westermani adults

8-16 mm large, robust, ovoid flukes; hermaphroditic with lobed ovary located anterior to two branching testes with oral and ventral suckers

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Paragonimus westermani lab diagnosis

eggs recovered from sputum or pleural effusions or stool using sedimentation-concentration; sero sometimes useful, NAAT, and lung lesions visual on x-ray