Name: Fasciola hepatica (liver fluke)

Pathogenesis "Liver Rot", Fascioliasis - obstruction of bile duct, enlarged liver, abcesses, eosinophilia

Distribution Worldwide

Infective Stage Metacercaria

Intermediate host Aquatic snail - Lymnea

Host/Niche Cattle, Sheep, Humans / liver and bile duct

Transmission Fecal contamination of water, eating aquatic vegetation

Morphology Leaf-shaped, large cone shaped projections on anterior end, extensive vitellaria

Fascioloides magna (liver) Fasciola gigantica (liver) Fasciolopsis buski (intestinal)

Similar to Fasciola hepatica, sheep host die, cattle dead end hosts, deer; no anterior cone or shoulders Very similar to Fasciola hepatica but no human hosts, obviously larger, different snail vector; Asia Afica and Hawaii Feed on intestinal epithelial cells, ulcerations, Common hemorrhage and abcesses of SI, 25K eggs per day parasite in Orient

Metacercaria on underwater vegetation (boiling kills) Metacercaria in 2nd intermediate host

Snail

Largest fluke in Humans, Pigs / Intestines Humans, Dogs, Cats (RH) / lumen of bile duct Sheep, Cattle, Goats, Pigs, (rare in man) / bile ducts

Underwater vegetation (water chestnuts, bamboo)

Clonorchis sinensis (Chinese liver)

Light infection: asymptomatic; chronic infection cholangiocarcinoma (bile duct cancer); Dx: eggs in stool

Dicrocoelium dendriticum (lancet)

General biliary dysfunction by adults in bile gut, Dx: eggs in stool

Far East: China, Japan Vietnam, Korea (25% Chinese immigrants) North America, Europe, Asia, Australia

1st: aquatic snail; 2nd: freshwater fish (grass carp) 1st: land snail (Cionella lubrica) 2nd: common brown ant (formica fusca) 1st: snail; 2nd: dragon fly nymph

Ovum must be eaten by snail host. See life cycle

Large adult (20-75mm L, 20mm W) branched ovaries anterior to testes, no branched ceca, acetabulum large/close to oral sucker, testes tandem in posterior, extensive vitellaria Adults with lancet appearance, weakly developed suckers, branched testes in tandem near posterior end, tegument lacks spines Pointed on both ends in adults, simple ceca, unbranced (lobate) testes, anterior to ovary

Metacercaria in 2nd intermediate host

No aquatic part to life cycle

Prosthogonimus macrorchis (Bird oviduct)

Male birds: bursa atrophies; Female: damage to oviduct > decreased or prevention of egg laying

Metacercaria in 2nd intermediate host Japan, China, Korea. (Asia), Africa, Central/South America Metacercaria in 2nd intermediate host

Bird / Bursa or Fabricius of oviduct Humans, various RH / lungs, induce host formation of fibrotic capsule Humans / villi of small intestines

Paragonimus westermani (Lung)

Lung lesions (pseudotubercles), deep blood tinged cough, pleural pain, dyspnea; Dx: eggs in sputum

1st: aquatic snail; 2nd: crustacean (crawfish, crab)

Egg hatches eaten by snail, cercaria encyst in fly muscle, eaten by bird Eating raw or undercooked crustaceans

Huge testes, vitellaria concentrated

Coffee bean fluke, small dark reddish brown color, thick testes oblique to each other, finger like lobed ovary, ovary and uterus easy to see; Eggs ovoid and operculated (flat end)

Heterophyes heterophyes (tiny intestinal)

Potential human pathogens; gastric diseases, malaise, fatigue, diarrhea, fatal if damages heart; Dx: eggs > feces

Africa, Asia, Middle/Far East

Metacercaria in 2nd intermediate host

1st: snail; 2nd: fresh and brackish water fish (mullet)

Eating raw/undercooked infected fish

Schistosoma haematobium (urinary)

Schistosoma mansoni (intestinal)

Eggs cause pathology, traverse tissues, trapped eggs secrete SEA's which trigger inflammation > chronic granulomatous fibrosing lesions. Schistosomiasis (3 phases)- 1) Migratory: asymptomatic, penetration to maturity/egg production; 2) Acute: "Katayama fever" heavy infection, mainly mansoni and japonicum; 3) Chronic: granulomas of macs, etc become fibrous (pseudotubercules), eggs in liver form granulomas > cause fibrosis, eggs in gut wall ulcerate, can have bloody diarrhea (haematobium causes bloody urine), some progress to severe - fibrosis causes enlarged liver and spleen and ascites (accumulation of abdominal fluid); urinary can develop squamous cell carcinomas; Dx: eggs in excreta

Most of Africa, Middle East

Africa (Egypt, Sudan) Middle East, South America, Caribbean Japan, China, Malaysia, Philippines, Indonesia

Schistosoma japonicum (intestinal)

Cercaria; eggs not operculated (require water) find snail in 5-6 hours, NO REDIA, free swimming cercariae must find host in 1-3 days; schistosomule once enters circulation

Snail, no second intermediate host; no snail hosts for human Schistosoma indigenous to USA

Humans, birds, turtles, fish / Veins of urinary bladder plexus Veins draining large intestine (inferior mesenteric plexus) Veins draining small intestine (superior mesenteric veins)

Human waste contamination of water sources, appropriate species of snail as intermediate host, using human waste as fertilizer for crops; washing, bathing, using water from contaminated streams. Control: Education, Rx with praziquantel, vector control, no vaccine

Ova (terminal spine)

Ova (lateral spine)

Ova (rudimentary spine)