Fasciolopsis

buski

Echinostoma
ilocanum

Common
Name
1st Intermediate
Host

Giant Intestinal
Fluke
Snail
-Segmentina sp.
-Hippentis sp.

2nd
Intermediate
Host

Freshwater
vegetation
-seed pods of
water caltrop:
Trapa bicornis or
Trapa nutans
-bulb of a
freshwater
chestnut:
Eleocharis
tuberosa
Ingestion of
encysted
metacercariae on
aquatic plants

Garrisons
Fluke
Gyraulus
convexiusculus
& Gyraulus
prashadi
Kuhol
- Pila luzonica
Susong pampang
- Vivipara
angularis
Clam
- Corbicula sp.

Mode of
Transmission

Fasciola sp.
Fasciola
Fasciola
hepatica
gigantica
Sheep Liver
Giant Liver
Fluke
Fluke
Snail
- Lymnea philippinensis

Clonorchis
sinensis

Paragonimus
westermani

Chinese Liver
Fluke
Snail
- Bulinus
fuchsiana

Oriental Lung
Fluke
Snail
- Brotia
asperata

Blades of grass and water plants Fish

(watercrest and kangkong)
Ctenopharyngod
onn idellus

Ingestion of
- Ingesion of metacercariae
metacercariae
- Drinking of water with
nd
from 2
floating metacercariae
intermediate host

Habitat

Small intestine

Small intestine

Small intestine

Infective Stage
Diagnostic
Stage

Metacercariae
Unembryonated
egg

Metacercariae
Unembryonated
eggs

Metacercariae
Unembryonated eggs

Schistosomes
Schistosoma
japonicum
Oriental Blood
Fluke
Onchomelania

Schistosoma
mansoni
Mansons
Blood Fluke
Biomphalaria
& Australorbis

Schistosoma
haematobium
Vesical Blood
Fluke
Bulinus &
Physopsis

Talangka
- Sundathelpusa
philippina /
Parathelpusa
grapsoides

Ingestion of raw
or undercooked
fish and salted
dried fish
harboring the
metacercariae
Biliary duct

Ingestion of raw
or insufficiently
cooked crabs
harboring the
metacercariae
Small intestine

Superior
mesenteric veins
of the small
intestine

Metacercariae
Embryonated
eggs

Metacercariae
Unembryonated
eggs

Cercariae bifid tails (forked)

Embryonated eggs

Skin penetration of cercariae

Mesentric
veins of colon
and rectum

Vesicle and
pelvic plexus of
the venous
circulation;
urinary bladder

Pathology

Fasciolopsiasis:
traumatic,
obstructive, toxic

Echinostomiasis:
inflammation at
the site of adult
attachment,
ulceration,
diarrhea
(sometimes
bloody),
abdominal pains

Fascioliasis:
acute or
invasive phase,
chronic or
latent phase

Fascioliasis:
acute or
invasive
phase, chronic
or latent
phase

causes
halzoun
(pharyngeal
infection)

Clonorchiasis:
intense
proliferation of
intestinal
epithelium
Acute stage: <1
month of
infection, chills
and fever
Chronic stage:
cirrhosis, portal
hypertension
Detection of
parasite
embryonated
eggs in stool

Diagnosis

Detection of
parasite
unembryonated
eggs in stool

Detection of
parasite
unembryonated
eggs in stool

Detection of parasite
unembryonated eggs in stool

Treatment

Praziquantel
- 25mg/kg for 3
doses for one day

Praziquantel
- 25mg/kg for 3
doses for one
day

Bithionol
- 30-50mg/kg on alternate days
for 10-15 days

Bithionol
- 20-50mg/kg
body weight on
alternate days to
complete 10-15
doses
Triclabendazole
- recommended
drug due to
efficacy, safety
and ease of use

Paragonimiasis:
cough,
hemoptysis,
pulmonary TB
symptoms,
misdiagnosed as
PTB

Katayamas
Disease

Swimmers
itch

Bilharziasis
(bloody urine)

Embryonated
egg in feces

Embryonated
egg in feces and
urine

Distended belly

Radiographs,
ova in sputum,
stool or less
frequently in
aspirated
material from
abcesses or
pleural effusions
Praziquantel
- 25mg/kg for 3
doses for one
day
Bithionol
- 15-25mg/kg
per day on
alternate days
for a total of 1015 days

Embryonated egg
in feces and urine

Praziquantel
- single dose of 40-50mg/kg
- 25mg/kg in two doses
- 20mg/kg in three doses

Morphology
Fasciolopsis
buski

Echinostoma
ilocanum

Fasciola sp.
Fasciola

Fasciola

Clonorchis
sinensis

Paragonimus
westermani

Schistosomes
Schistosoma

Schistosoma

Schistosoma

Adul
t

GENERAL
CHARACTERISTIC
S

Largest among
trematodes, 2075mm length &
8-20mm width,
no cephalic
cone

Cephalic Cone

Shoulders
Intestine

Oral Sucker

Egg

Testes
Ovary
GENERAL
DESCRIPTION

UNIQUE
CHARACTERISTIC

Simple or
unbranched

Simple

Surrounded
with circum
oral disk with
collarette of
spines (49-51)
Lobed
Mistakenly
Looks like
identified as
Fasciola egg
Fasciola egg,
(but smaller)
Diagnostic
stage,
Unembryonated
when laid
With germ
ball egg
inside

hepatica
Temperate
liver fluke

gigantica
Tropical liver Narrow,
fluke, large,
oblong
lanceolated

Conical
projection

Conical
projection,
less
developed
(shorter)

Highly
branched
(dendritic)
Small oral
and ventral
suckers

Highly
branched
(dendritic)
Large ventral
sucker

hens egg

hens egg

With large
mass of yolk
cells

With large
mass of yolk
cells

Reddish
brown,
coffee-bean
shaped, found
in pairs or in
threes in
fibrotic
capsules or
cysts in lungs

japonicum
mansoni
haematobium
Dioecious, most romantic: lateral margins of
males are folded ventrally to form a gynecophoral
canal where the females are received during
copulation

Simple or
unbranched
Bigger

Small, does
not hatched
in water

Branched
Lobed
May be seen in
sputum or in
feces (when
sputum is
swallowed)

Fully
embryonated
when laid

Fully
embryonated
when laid

Fully
embryonated
when laid

Lateral knob

Lateral spine

Terminal spine

Color
Shape

Yellow brown

Operculum
Abopercular

operculated

Straw-colored
Oval with a
rounded
posterior end

Dot-like

Oval with a
rounded
posterior end

oldfashioned
electric
bulb,
pitchershaped
operculated
With
abopercular
thickening
(commashaped)

Dark brown
Oval

Flattened
Thickened
abopercular
end

bottle-neck

bottle-neck

bottle-neck