INFEKSI PARASIT

Kelompok 2

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 Trichinosis
Trichinosis adalah infestasi cacing bulat
Trichinella spiralis pada usus dan jaringan
(pada manusia dan mamalia)
Hospes: babi dan kadang beruang.
Dalam jumlah yang banyak cacing ini
menyebabkan diare.
saat migrasi larvae ke jaringan menyebabkan
myositis, demam, eosinofilia, myocarditis
dan kadang ensefalitis.
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 Trichinosis
Larvae trichinella
menyebabkan nekrose otot dan klasifikasi fokal.
Larvae ini mampu bertahan sampai 5-10 tahun
setelah encystasi.
Bila mengenai otak membentuk granulomatus
nodul dan vaskulitis pembuluh darah kecil.

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 Klinis
Berat ringannya gejala tergantung dari jumlah
larvae.
Semua jaringan saraf dapat terkena invasi
cacing ini, termasuk saraf tepi.
Invasi di susunan saraf pusat meneybabkan
kejang, delirium dan psikosa

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 Trichinella spiralis

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 Trichinella spiralis
Disease: Trichinelliasis, trichiniasis or trichinosis.
Distribution: Pork-eating countries.
Habitat: Small intestine for adult stage and muscles for
larval stage.
D.H. and I.H.: Pigs, rats & occasionally man.
Reservoir host: Pigs and rats

T. spiralis is considered one of tissue nematodes as its

larvae migrate into tissues for ever and produce serious
symptoms, whereas its intestinal phase is transient
and may be asymptomatic.
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 Morphology
Male: 1.5 mm with 2 caudal papillae.
Female: 3.5 mm, larviparous, vulva opens at junction of anterior
1/5 with the rest of the body.
Both have a cellular oesophagus.

Encysted larva (infective stage):

Lemon-shaped cyst (0.5 x 0.2 mm), enclosed in fibrous layer of
host origin & lies longitudinally along the longitudinal axis
of muscle fibers.
Mode of Infection
Ingestion of raw or undercooked pork meat containing viable
encysted larvae

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 Life cycle of Trichinella spiralis

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1. After ingesting infected meat, the
capsule of the encysted larvae
is digested by gastric juice and the
larvae are released in the
duodenum or jejunum where they
molt four times to become mature
worm.
2- After fertilization, the male dies
and the female burrows deeply in
the intestinal mucosa & begins to
deliver larvae 4-7 days after
the infection, [Each lays about
1500 larvae in its life span; about 2
months].
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3- The larvae penetrate the intestinal
wall and migrate through the lymphatic
vessels to the blood stream,
which carries them to various organs.
Skeletal muscles and diaphragm are
most frequently parasitized. Others
include the tongue, masseter and
ocular muscles.
4- Larvae increase in size 10 times,
become coiled & encysted within
muscle fibers by the 5th week.
5- Calcification occurs from 6-18
months
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Pathogenesis & Clinical picture
1- Intestinal invasion [on the 1st week]: by
adult worms may be asymptomatic or causes
gastrointestinal disturbances in the form of nausea,
vomiting, colic & diarrhea (simulating acute food
poisoning).
2- Migration of larvae [on the 2nd week] produces
allergic symptoms as fever, oedema chiefly orbital,
headache & eosinophilia.
Penetration of larvae in muscles produces muscle
pain & difficulty in mastication, breathing or
swallowing.
3- Stage of encapsulation [on the 3rd week]:
Symptoms subsides & muscle pain persists for
months.
In severe infection: Death may occur from
myocarditis, pneumonia or encephalitis.
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 Diagnosis
I- Clinical
A history of eating pork with fever,
eosinophilia, facial oedema and myositis is
suggestive.

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 Diagnosis
II- Laboratory
1- Stool examination for adults & larvae at the
diarrheal stage.
2- Muscle biopsy (3-4 weeks after infection)
for larvae in encystation stage [using
trichinoscopy or Muscle digestion or
Xenodiagnosis].
3- Eosinophilia: 10-90 % in 3rd - 4th week.

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 Diagnosis
II- Laboratory
4- Intradermal test (Bachman test: on 3rd
weeks after infection):
0.1 cc of 1:10,000 dilution of larva antigen
is injected I.D.
cases; the test gives local wheal within 20
minutes.
5- Serological tests: as IFAT or ELISA.
6- X ray: shows calcified cysts
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 Treatment
1- Mebendazole affects the adult stage:
200-400 mg 3 times daily for 10 days. Or
2- Thiabendazole affects the larval stage:
25 mg/Kg twice daily for 3 days.
3- Symptomatic treatment for fever, headache and
muscle pain.
4- Corticosteroids to reduce the inflammatory
reactions.

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 Prevention and Control
1- Proper cooking of pork meat.
2- Inspection of pork meat in slaughter
houses.
3- avoid feeding raw garbage to pigs.
4- Rat control.

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DAFTAR PUSTAKA