Parasitology

This is a series of lectures on microbiology useful for undergraduate medical and paramedical students.. This lecture is a comprehensive coverage of all parasites, protozoa and helminths...

1. PARASITOLOGYPARASITOLOGY
Protozoa and HelminthsProtozoa and Helminths
Dr. Ashish V. JawarkarDr. Ashish V. Jawarkar
M.D.M.D.

2. ParasitesParasites
►Organisms which are dependent on other Organisms which are dependent on other
organisms for survivalorganisms for survival
►EukaryotesEukaryotes
►Unicellular – ProtozoaUnicellular – Protozoa
►Multicellular - HelminthsMulticellular - Helminths

3. ►Host – organism that provides nutrition to Host – organism that provides nutrition to
parasiteparasite
►Definitive host – adult stage of parasite is Definitive host – adult stage of parasite is
lodged – undergoes sexual reproduction – lodged – undergoes sexual reproduction –
both males and females are presentboth males and females are present
►Intermediate host – harbours larval stage of Intermediate host – harbours larval stage of
helminths, asexual reproduction of protozoahelminths, asexual reproduction of protozoa

4. For toxoplasmaFor toxoplasma

5. PROTOZOAPROTOZOA

6. ProtozoaProtozoa
►Classified according to organ of motilityClassified according to organ of motility
►Pseudopodia – amoeba Pseudopodia – amoeba
►Cilia – ciliates Cilia – ciliates
►Flagella – flagellatesFlagella – flagellates
►Sporozoa (non motile) Sporozoa (non motile)

7. ►AmoebaAmoeba
E histolytica, N. fowleriE histolytica, N. fowleri
►FlagellatesFlagellates
GiardiaGiardia
T. vaginalisT. vaginalis
LeishmaniaLeishmania
►SporozoaSporozoa
PlasmodiumPlasmodium
ToxoplasmaToxoplasma
►CiliatesCiliates
B. coliB. coli

8. Classification according to site of Classification according to site of
infectioninfection
►IntestineIntestine
E histolyticaE histolytica
G. lambliaG. lamblia
►Genital tractGenital tract
T. vaginalisT. vaginalis
►BloodBlood
PlasmodiumPlasmodium
L. donovaniL. donovani

9. Entamoeba HistolyticaEntamoeba Histolytica

10. Entamoeba HistolyticaEntamoeba Histolytica
►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

11. DistributionDistribution
►World wideWorld wide

12. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

13. LocationLocation
►Parasite found in large intestineParasite found in large intestine

14. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

15. Life cycleLife cycle
►Entire life cycle completed in one host - Entire life cycle completed in one host -
humanshumans

16. Morphological formsMorphological forms
►CystsCysts
Round, 10-15 micronsRound, 10-15 microns
4-6 microns nucleus4-6 microns nucleus
Highly refractile cyst wallHighly refractile cyst wall
Four or more nucleiFour or more nuclei

17. TrophozoitesTrophozoites
►18-40 microns18-40 microns
►Cytoplasm – outer ectoplasm, inner Cytoplasm – outer ectoplasm, inner
endoplasmendoplasm
►Nucleus – 4-6 micronsNucleus – 4-6 microns
►Ingested red blood cellsIngested red blood cells

19. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

20. Diseases causedDiseases caused
►Dysentry - Trophozoites burrow into Dysentry - Trophozoites burrow into
intestinal wall and cause dysentry with intestinal wall and cause dysentry with
ulcersulcers

21. ►Extra intestinal manifestationsExtra intestinal manifestations
Amebic hepatitisAmebic hepatitis
Infection of lungs/brainInfection of lungs/brain

22. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

23. Lab diagnosisLab diagnosis
►Dysentry Dysentry
Examine freshly passed stools or ulcer Examine freshly passed stools or ulcer
scrapings for trophozoite formsscrapings for trophozoite forms
Iodine mount for cystsIodine mount for cysts
►Amoebic hepatitisAmoebic hepatitis
Liver aspirationLiver aspiration

24. ►Serological testsSerological tests
ELISAELISA
IHAIHA

25. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

26. TreatmentTreatment
►MetronidazoleMetronidazole

27. Giardia LambliaGiardia Lamblia

28. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

29. DistributionDistribution
►World wideWorld wide

30. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

31. LocationLocation
►Small intestine – duodenum and upper part Small intestine – duodenum and upper part
of jejunumof jejunum

32. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

33. Life cycleLife cycle
►Entire life cycle is completed in one host - Entire life cycle is completed in one host -
humanshumans

34. Morphologic formsMorphologic forms
►TrophozoiteTrophozoite
Shaped as a badminton/tennis racquetShaped as a badminton/tennis racquet
Two sucking discs on ventral surfaceTwo sucking discs on ventral surface
Bilaterally symmetricalBilaterally symmetrical
Two nuclei, two axostyles and four flagella Two nuclei, two axostyles and four flagella

35. ►CystCyst
Infective stageInfective stage
Egg shapedEgg shaped

37. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

38. Diseases causedDiseases caused
►steatorrhoea – excessive fat in stoolssteatorrhoea – excessive fat in stools

39. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

40. PathogenesisPathogenesis
►Steatorrhoea is due to malabsorption of fatSteatorrhoea is due to malabsorption of fat
►Disease is never invasive – no dysentryDisease is never invasive – no dysentry

41. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

42. Lab diagnosisLab diagnosis
►Demonstration of cysts and trophozoites in Demonstration of cysts and trophozoites in
stoolstool

43. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

44. TreatmentTreatment
►MetronidazoleMetronidazole

45. Trichomonas VaginalisTrichomonas Vaginalis

46. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

47. DistributionDistribution
►World wideWorld wide

48. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

49. LocationLocation
►Female genital tractFemale genital tract

50. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

51. Life cycleLife cycle
►Human beings are the only hostHuman beings are the only host

52. Morphological formsMorphological forms
►Only one form – trophozoiteOnly one form – trophozoite
►Pear shapedPear shaped
►Single ovoid nucleusSingle ovoid nucleus
►3-5 pairs of flagella3-5 pairs of flagella
►One axostyleOne axostyle
►One undulating mebrane formed by flagellaOne undulating mebrane formed by flagella

53. Life cycleLife cycle

54. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

55. Diseases causedDiseases caused
►Trichomoniasis in females which is a Trichomoniasis in females which is a
sexually transmitted disease – presents as sexually transmitted disease – presents as
UTIUTI
►In males - urethritisIn males - urethritis

56. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

57. Lab diagnosisLab diagnosis
►Demonstrate organism in vaginal discharge Demonstrate organism in vaginal discharge
from females and urethral discharge from from females and urethral discharge from
malesmales
►Saline preparation shows characteristic Saline preparation shows characteristic
corkscrew motilitycorkscrew motility
Please see the link Please see the link https://www.youtube.com/watch?v=9B1PFJXuJUshttps://www.youtube.com/watch?v=9B1PFJXuJUs for motility for motility

58. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

59. TreatmentTreatment
►Metronidazole to both partnersMetronidazole to both partners

60. HAEMOFLAGELLATESHAEMOFLAGELLATES
Leishmania Leishmania
PlasmodiaPlasmodia

61. Leishmania DonovaniLeishmania Donovani

62. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

63. DistributionDistribution
►India - endemicIndia - endemic

64. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

65. LocationLocation
►Reticuloendothelial systemReticuloendothelial system
Bone marrowBone marrow
Liver Liver
SpleenSpleen

66. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

67. Life cycleLife cycle
►Two hosts Two hosts
Humans – definitive host (sexual reproduction)Humans – definitive host (sexual reproduction)
Sandfly – intermediate host (asexual Sandfly – intermediate host (asexual
reproduction)reproduction)

68. Morphologic formsMorphologic forms
►Promastigote stage –Promastigote stage –
Stage with flagellaStage with flagella
Nucleus in centreNucleus in centre
One kinetoplast at anterior endOne kinetoplast at anterior end
Flagella at anterior end Flagella at anterior end
►Amastigote stage – Amastigote stage –
Seen in humansSeen in humans
Egg shapedEgg shaped
Nucleus at centreNucleus at centre
Kinetoplast at right angleKinetoplast at right angle

70. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

71. Diseases causedDiseases caused
►Kala Azar a/k/a Visceral LeishmaniasisKala Azar a/k/a Visceral Leishmaniasis
►Fever with enlargement of spleen, Fever with enlargement of spleen,
lymphnodeslymphnodes

72. ►Misdiagnosed as malariaMisdiagnosed as malaria

73. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

74. PathogenesisPathogenesis
►Affects immune systemAffects immune system
►Complications due to oppurtunistic Complications due to oppurtunistic
infectionsinfections

75. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

76. Lab diagnosisLab diagnosis
►DirectDirect
Demonstration of LD body in bone marrow Demonstration of LD body in bone marrow
smearssmears
Culture in NNN mediumCulture in NNN medium
►Indirect Indirect
Indirect Haemagglutination testIndirect Haemagglutination test
ELISAELISA

78. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

79. TreatmentTreatment
►Amphotericin BAmphotericin B

80. SPOROZOA SPOROZOA
PlasmodiumPlasmodium

81. MalariaMalaria
►Sporozoite – no special organs of locomotionSporozoite – no special organs of locomotion
►Mal-air = Bad airMal-air = Bad air
►Plasmodium discovered by Sir Ronald Ross in Plasmodium discovered by Sir Ronald Ross in
Secunderabad, APSecunderabad, AP
►Four speciesFour species
P. vivaxP. vivax
P. falciparumP. falciparum
P. ovaleP. ovale
P. malariaeP. malariae

82. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

83. DistributionDistribution

84. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

85. LocationLocation
►Liver cellsLiver cells
►Red Blood cellsRed Blood cells

86. Life cycleLife cycle
►Definitive host – Female anopheles Definitive host – Female anopheles
mosquitomosquito
►Intermediate host – HumansIntermediate host – Humans

89. Pre erythrocytic schizogony
Erythrocytic schizogony
Gametogony

90. Morphological formsMorphological forms
►Pre erythrocytic schizogony – sporozoitesPre erythrocytic schizogony – sporozoites
►Erythrocytic schizogony – trophozoite, Erythrocytic schizogony – trophozoite,
schizont and merozoiteschizont and merozoite
►Gametogony – gamets (micro and macro)Gametogony – gamets (micro and macro)
►Mosquito – ookinete, oocyst, sporozoiteMosquito – ookinete, oocyst, sporozoite

91. Morphologic formsMorphologic forms
►schizontsschizonts

92. Ring forms (trophozoites)Ring forms (trophozoites)

93. gametocytegametocyte

95. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

96. Disease causedDisease caused
►MalariaMalaria
►Fever with chills – co incides with release of Fever with chills – co incides with release of
parasites in bloodparasites in blood
►SplenomegalySplenomegaly
►Hemolytic anemiaHemolytic anemia
►Black water fever – intravascular hemolysisBlack water fever – intravascular hemolysis
►Pernicious malaria – in P. falciparumPernicious malaria – in P. falciparum
Cerebral malaria – brain capillaries clogged with Cerebral malaria – brain capillaries clogged with
parasitesparasites
Algid malaria – liver failureAlgid malaria – liver failure
septicemiasepticemia

97. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

98. PathogenesisPathogenesis
►Due to release of parasites in blood – Due to release of parasites in blood –
cytokines are released which cause fever cytokines are released which cause fever
and chillsand chills
►Hemolytic anemiaHemolytic anemia

99. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

100. Lab diagnosisLab diagnosis
►Examine blood smears for ring Examine blood smears for ring
forms/schizontsforms/schizonts
►Antigen detection testsAntigen detection tests

101. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

102. TreatmentTreatment
►ChloroquineChloroquine
►ArtimesinArtimesin
►MefloquineMefloquine
►PrimaquinePrimaquine

103. HELMINTHSHELMINTHS

104. HelminthsHelminths
►Commonly called – ‘worms’Commonly called – ‘worms’
►Three groupsThree groups
Nematodes – unsegmented bodyNematodes – unsegmented body
Cestodes – segmented body – tape likeCestodes – segmented body – tape like
Trematodes – leaf like - flukesTrematodes – leaf like - flukes

106. ►NematodesNematodes
Round wormRound worm
Hook wormHook worm
Thread worm/pin wormThread worm/pin worm
Filarial wormsFilarial worms
►CestodesCestodes
T. saginata – Beef tape wormT. saginata – Beef tape worm
T. solium – pork tape wormT. solium – pork tape worm
E. granulosus – Dog tape wormE. granulosus – Dog tape worm
►TrematodesTrematodes
Intestinal flukes - Intestinal flukes -
Liver flukes – C. sinensis, f. hepaticaLiver flukes – C. sinensis, f. hepatica
Lung flukes – P. westermaniiLung flukes – P. westermanii
Blood flukes – S. hematobiumBlood flukes – S. hematobium

107. Round wormRound worm
(Ascaris Lumbricoides)(Ascaris Lumbricoides)
►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

108. DistributionDistribution
►World wideWorld wide

109. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

110. LocationLocation
►Small intestine (jejunum)Small intestine (jejunum)

111. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

112. Life cycleLife cycle
►Humans are the only hostsHumans are the only hosts

113. Morphologic formsMorphologic forms
►Adult wormsAdult worms
Resemble earth wormsResemble earth worms
Male – female separateMale – female separate
2.5 to 4 cm in length, 5 mm in diameter2.5 to 4 cm in length, 5 mm in diameter
Female worm lays 2.5 lakh eggs every day!!!!!Female worm lays 2.5 lakh eggs every day!!!!!

114. Morphological formsMorphological forms
►EggsEggs
Bile stainedBile stained
Fertilised/unfertilisedFertilised/unfertilised
Single unsegmented ovum with clear Single unsegmented ovum with clear
crescenteric areascrescenteric areas

115. Life cycleLife cycle

116. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

117. Diseases causedDiseases caused
►Malabsorption of nutrientsMalabsorption of nutrients
►CoughCough
►Intestinal obstructionIntestinal obstruction

118. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

119. Lab diagnosisLab diagnosis
►Stool examinationStool examination
eggseggs

120. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

121. TreatmentTreatment
►AlbendazoleAlbendazole
►MebendazoleMebendazole

122. Hook wormHook worm
(Ancylostoma Duodenale / (Ancylostoma Duodenale /
Necator Americanus)Necator Americanus)

123. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

124. DistributionDistribution
►World wideWorld wide
►Tropical and subtropical countriesTropical and subtropical countries

125. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

126. LocationLocation
►Small intestine, mainly jejunumSmall intestine, mainly jejunum

127. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

128. Life cycleLife cycle
►Only one host - humansOnly one host - humans

130. Morphologic formsMorphologic forms
►EggsEggs
Not bile stainedNot bile stained

131. Adult wormsAdult worms
►1-2 cm1-2 cm
►CylindricalCylindrical
►Anterior end is bent – hook likeAnterior end is bent – hook like

132. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

133. Diseases causedDiseases caused
►Iron deficiency anemia due to chronic blood Iron deficiency anemia due to chronic blood
lossloss

134. ►Itch at the site of entry into the skinItch at the site of entry into the skin
►Cutaneous larva migransCutaneous larva migrans

135. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

136. Lab diagnosisLab diagnosis
►Stool – look for eggsStool – look for eggs
►Indirect – Indirect –
Iron deficiency anemia on PSIron deficiency anemia on PS
Stool – occult bloodStool – occult blood
EosinophiliaEosinophilia

137. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

138. TreatmentTreatment
►AlbendazoleAlbendazole
►MebendazoleMebendazole
►PyrantelPyrantel

139. Thread worm / Pin wormThread worm / Pin worm
(Enterobius Vermicularis)(Enterobius Vermicularis)

140. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

141. DistributionDistribution
►World wideWorld wide

142. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

143. LocationLocation
►Large intestine – cecum and appendixLarge intestine – cecum and appendix

144. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

145. Life cycleLife cycle
►Humans are the only hostHumans are the only host

147. Morphologic formsMorphologic forms
►EggsEggs

148. ►Adult wormsAdult worms

149. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

150. Diseases causedDiseases caused
►Pruritis aniPruritis ani
►Nocturnal enuresisNocturnal enuresis

151. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

152. Lab diagnosisLab diagnosis
►NIH swab (National institute of health) for NIH swab (National institute of health) for
demonstrating eggsdemonstrating eggs
►Demonstration of adult worms in stoolDemonstration of adult worms in stool

153. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

154. TreatmentTreatment
►AlbendazoleAlbendazole
►MebendazoleMebendazole
►PyrantelPyrantel

155. FILARIASISFILARIASIS
(W. bancroftii, B. malayii)(W. bancroftii, B. malayii)

156. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

157. DistributionDistribution
►World wide – including IndiaWorld wide – including India

158. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

159. LocationLocation
►Adult worm – lymphaticsAdult worm – lymphatics
►Microfilaria - bloodMicrofilaria - blood

160. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

161. Life cycleLife cycle
►Humans – definitive hostHumans – definitive host
►Culex/anopheles/aedes mosquito – Culex/anopheles/aedes mosquito –
intermediate hostintermediate host

163. Morphological formsMorphological forms
►Adult wormAdult worm
Female – 10 cmFemale – 10 cm
Male – shorterMale – shorter
Lay eggs containing embryo (microfilaria)Lay eggs containing embryo (microfilaria)

164. ►MicrofilariaMicrofilaria
290 microns290 microns
Present in peripheral blood Present in peripheral blood

165. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

166. ElephantiasisElephantiasis
►Adult worm causes blockage of lymphatic Adult worm causes blockage of lymphatic
channelschannels

167. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

168. Lab diagnosisLab diagnosis
►Microfilaria demonstrationMicrofilaria demonstration
Parasites seen in blood between 10 pm and 2 Parasites seen in blood between 10 pm and 2
amam
Co incides with feeding time of mosquitoesCo incides with feeding time of mosquitoes

169. ►Adult worm demonstrationAdult worm demonstration
Lymphnode biopsyLymphnode biopsy

170. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

171. TreatmentTreatment
►DEC (Diethylcarbamazine) helps treat DEC (Diethylcarbamazine) helps treat
filariasisfilariasis
►But elephantiasis once developed cannot be But elephantiasis once developed cannot be
curedcured

172. CestodesCestodes
Taenia SaginataTaenia Saginata
Taenia SoliumTaenia Solium
E. GranulosusE. Granulosus

173. Taenia Saginata/Taenia soliumTaenia Saginata/Taenia solium
(beef tapeworm/pork tape worm)(beef tapeworm/pork tape worm)
►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

174. DistributionDistribution
►SaginataSaginata
►World wide in beef eating populationWorld wide in beef eating population
Not seen in India in regions where beef is not Not seen in India in regions where beef is not
eateneaten
►SoliumSolium
World wide in pork eating populationWorld wide in pork eating population

175. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

176. LocationLocation
►Small intestineSmall intestine

177. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

178. Life cycleLife cycle
►SaginataSaginata
Definitive host – humansDefinitive host – humans
Intermediate host – cows and buffalosIntermediate host – cows and buffalos
►SoliumSolium
Definitive host – humansDefinitive host – humans
Intermediate hosts - pigsIntermediate hosts - pigs

179. Morphological formsMorphological forms
►Adult worm (saginata)Adult worm (saginata)
Inside humansInside humans
Segmented – called proglottids – contain eggs – Segmented – called proglottids – contain eggs –
passed in fecespassed in feces

180. Morphological formsMorphological forms
►Adult worm – soliumAdult worm – solium
Similar except for additional rostellum / hookletsSimilar except for additional rostellum / hooklets

181. ►Eggs (same for both)Eggs (same for both)
Spherical and bile stainedSpherical and bile stained

182. Life cycleLife cycle
CYSTICERCU
S

183. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

184. Diseases causedDiseases caused
►Disease is asymptomatic and remains Disease is asymptomatic and remains
undiagnosedundiagnosed
►Problem is that humans may act as Problem is that humans may act as
occasional intermediate hosts in case of T. occasional intermediate hosts in case of T.
soliumsolium
Called cysticercosisCalled cysticercosis
Patients present with seizures/convulsionsPatients present with seizures/convulsions

186. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

187. Lab diagnosisLab diagnosis
►Not really possible!!Not really possible!!
►Unless there is cysticercosisUnless there is cysticercosis
CT SCANCT SCAN
BiopsyBiopsy

188. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

189. TreatmentTreatment
►MepacrineMepacrine

190. Echinococcus GranulosusEchinococcus Granulosus
(Dog tape worm)(Dog tape worm)

191. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

192. DistributionDistribution
►World wideWorld wide
►Where sheep and cattle are bredWhere sheep and cattle are bred
►There must be a close association between There must be a close association between
humans, sheep and dogshumans, sheep and dogs

193. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

194. LocationLocation
►LiverLiver
►LungsLungs
►Wherever embryos settleWherever embryos settle

195. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

196. Life cycleLife cycle
►Dog is definitive hostDog is definitive host
►Sheep are intermediate hostsSheep are intermediate hosts
►Humans are accidental intermediate hostsHumans are accidental intermediate hosts

197. Morphological formsMorphological forms
►Adult wormAdult worm
Inside definitive hostsInside definitive hosts
Has head, neck and stobilaHas head, neck and stobila
Has 4 segmentsHas 4 segments
Head has suckers (rostellum)Head has suckers (rostellum)

198. ►EggsEggs
Indistinguishable from T. saginata/soliumIndistinguishable from T. saginata/solium

199. ►Larva (hydatid cyst)Larva (hydatid cyst)

200. Life cycleLife cycle

201. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

202. Diseases causedDiseases caused
►Hydatid cyst can remain undetected for Hydatid cyst can remain undetected for
many yearsmany years
►It causes symptoms depending on the It causes symptoms depending on the
organ in which it has formedorgan in which it has formed
►Rupture of cyst can cause anaphylactic Rupture of cyst can cause anaphylactic
shockshock

203. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

204. Lab diagnosisLab diagnosis
►Casoni’s testCasoni’s test
►EosinophiliaEosinophilia
►Serological testsSerological tests
►Examination of cyst fluidExamination of cyst fluid
►CT scan, USG, X rayCT scan, USG, X ray

205. ►DistributionDistribution
►LocationLocation
►Life cycleLife cycle
►Diseases causedDiseases caused
►PathogenesisPathogenesis
►Lab diagnosisLab diagnosis
►TreatmentTreatment

206. TreatmentTreatment
►Surgical removal without rupture Surgical removal without rupture

207. TREMATODESTREMATODES
►Least commonly reported in IndiaLeast commonly reported in India
►Refer to examples at the starting of this Refer to examples at the starting of this
lecturelecture
►Detailed discussion is beyond the scope of Detailed discussion is beyond the scope of
this lecturethis lecture

208. Thanks !!!Thanks !!!
►LIKE THIS LECTURE!!!!LIKE THIS LECTURE!!!!