HYMENOLEPIS DIMINUTA ECHINOCOCCUS GRANULOSUS ECHINOCOCCUS MULTILOCULARIS By Sree keerthi

HYMENOLEPIS DIMINUTA COMMON NAME:rat tapeworm. Parasite of rat,mouse & man. HABITAT Adult worm resides in distal portion of ileum.

MORPHOLOGY Worm measures 20 to 60cms in length Larger than Hymenolepis nana Scolex-4 suckers,retractile rostellum but has no hooklets. Proglottids-800 to 1000.,mature proglottids contain ovary(centre),testis on either side. Egg:infective to man,polar filaments absent

LIFE CYCLE

PATHOGENESIS Rodents become infected by ingestion of arthropod hosts. Man acquires infection accidentally by ingestion of infected fleas containing cysticercoid larvae.

CLINICAL MANIFESTATIONS Most common in children. Usually asymptomatic but noted symptoms are mild diarrhoea,abdominal pain & vague GIT manifestations.

LAB DIAGNOSIS MICROSCOPY - demonstration of eggs in faeces

TREATMENT Praziquantel Niclosamide. PROPHYLAXIS Personal hygeine Rodent control.

ECHINOCOCCUS GRANULOSUS COMMON NAMES Hydatid tapeworm or dog tape worm. HABITAT Adult worms are found attached to wall of intestinal mucosa of dogs $ wild canines Larval stage found in humans $ herbivorous animals

MORPHOLOGY M HOOKLETS SUCKERS SCOLEX PROGLOTTIDS

EGG

HYDATID CYST

LIFE CYCLE

PATHOGENESIS Depending on modes of development cystic echinococcosis is of two types 1.primary cystic echinococcosis: -occurs after peroral infection with E.granulosus eggs that gives rise to hydatid cyst in different parts of the body. -most commonly these are found in liver and lung 2.secondary cystic echinococcosis: -occurs by rupture of primary hydatid cyst by trauama

Cont…………… -in this condition protoscolices are carried by blood circulation to different sites which develop into secondary hydatid cyst. The growing cyst surrounded by three layers : 1.pericyst containing fibrous tissue. 2.middle layer containing fibroblasts,eosinophils& blood vessels. 3.inner layer containing radially arranged gaint cells &eosinophils.

CLINICAL MANIFESTATIONS 1.Liver cysts :hydatid cyst in liver causes chronic abdominal discomfort,occasioally palpable or visible abdominal mass. If cyst becomes infected with bacteria, it resembles an abscess If cyst ruptures either spontaneously/trauma/surgery.There will be serious allergic reactions including skin rash,anaphylactic shock or death

2.lung cysts Cysts are asymptomatic until they become large enough to cause cough,shortness of breath,chest pain. Cyst rupture may lead to expectoration of hydatid fluid or membranes followed by the infection &lung abscess. If rupture occur into the lung,it cause pneumothorax,empyema,allergic reactions & even anaphylactic shock

3.other sites Spleen Kidney CNS Bones Heart Muscles FGT Eyes

BRAIN CYST

LIVER CYSTS

LAB DIAGNOSIS 1. CASONI skin test It is immediate hypersensitivity skin test Ag used is sterile hydatid fluid drawn from unilocular hydatid cysts from sheep, pig, cattle, man

Test arm 0.2 ml of antigen injected ID In postive case develops large wheal, measuring 5cm or more in dia with multiple pseudopodia with in 30 mins Control arm Equal amt of sterile normal saline injected Control fades immediatly

2. DLC may reveal eosinophilia 20 to 25% 3. Serological test ELISA RIA CFT IHA LAT 4. Examination of cyst fluid 5. Histological examination 6.Radio diagnosis

Treatment 1.Surgical removal of hydatid cyst 2.Praziquantel & albendazole Prophylaxis 1. Strict personal hygiene 2. Reduction of stray dog population 3. Dogs should not b allowed to eat d carcase of slaughted a nimals

ECHINOCOCCUS MULTILOCULARIS MORPHOLOGY Smaller than echinococcus granulosus mm Eggs are typical Taenia li ke

LIFE CYCLE

PATHOGENESIS Alveolar echinococcosis/Alveolar or multilocular Hydatid cyst. ORGAN-Liver. Destruction of liver parenchyma-Hepatic failure. Lesions spread to surrounding tissues $ body sites via Lymphatic/Haematogenous routes. Central necrosis $ cavitation occurs $ cavity contains little or no flu id.

LAB DIAGNOSIS BIOPSY of affected organ,identification depends on recognition of germinal & laminated membranes. Radiodiagnosis:CT Scan,Ultra sound. Immunological Tests

TREATMENT Surgical removal of Hydatid cyst Praziquantel & Albendazole. PROPHYLAXIS Strict personal hygiene. Reduction of stray dog population.

THANK YOU