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TREMATODES
COMMON NAME
Fasciola Hepatica Sheep Liver Fluke Fasciola Gigantica Tropical Liver Fluke Clonorchis Sinensis Chinese Liver Fluke Opisthorchis Felineus Cat Liver Fluke Fasciolopsis Buski Giant/Large Intestinal Fluke Heterophyes Heterophyes Heterophyid Fluke Metagonimus Yokogawai Heterophyid Fluke Echinostoma Ilocanum Garrison’s Fluke Paragonimus Westermani Oriental Lung Fluke Schistosoma Japonicum Oriental Blood Fluke Schistosoma Mansoni Manson’s Blood Fluke Schistosoma Haematobium Vesical Blood Fluke Dicrocoelium Dendriticum Fasciola Dendricitum Fasciola Lanceolata Lanceolate FLuke Lancet Fluke Eurytema Pancreaticum Pancreatic Fluke HABITAT Lungs (Pulmonary) Paragonimus Westermani Liver ● Biliary passages Fasciola Hepatica ● Bile ducts, gallbladder Clonorchis Sinensis Dicrocoelium Dendriticum Intestinal Haplorchis Taichiu Gastrodiscoides Hominis ● Small Intestine Fasciolopsis Buski Echinostoma Ilocanum Heterophyes Heterophyes Metagonimus Yokogawai ● Superior Mesenteric Veins of Small Intestine Schistosoma Japonicum ● Inferior Mesenteric Veins of Large Intestines, Colon, Rectum Schistosoma Mansoni Vesical, prostatic, uterine/renal venous plexuses of Urinary Bladder Schistosoma Haematobium FINAL HOST (EXCYST) Sheep Fasciola Hepatica Other vertebrates Fasciola Hepatica Schistosoma Japonicum (carabao, cattle, rat) Man Fasciola Hepatica Fasciolopsis Buski Clonorchis Sinensis Echinostoma Ilocanum Paragonimus Westermani Schistosoma Japonicum Schistosoma Mansoni Schistosoma Mansoni Fish-eating Mammals Clonorchis Sinensis RESERVOIR HOST Rabbits Fasciolopsis Buski Pigs Fasciolopsis Buski Paragonimus Westermani Dogs Fasciolopsis Buski Clonorchis Sinensis Heterophyes Heterophyes Metagonimus Yokogawai Fish-eating Mammals Clonorchis Sinensis Heterophyes Heterophyes Metagonimus Yokogawai Cats Clonorchis Sinensis Heterophyes Heterophyes Metagonimus Yokogawai Monkey Paragonimus Westermani ACCIDENTAL HOST Man Fasciola Hepatica INTERMEDIATE HOST (ENCYST) Snail ● Oncomelania hupensis quadrasi Schistosoma Japonicum ● Biomphalaria sp. Schistosoma Mansoni ● Bulinus sp. Schistosoma Haematobium 1 ST INTERMEDIATE HOST Snail Planorbidae Fasciola Hepatica ● Lymnea sp. ● L. truncatula ● L. bulmoides ● L. tomentosa Fasciola Hepatica ● L. auricularia ● L. acuminata ● L. natalensis ● L. philippinensis ● L. auricularia rubiginos Fasciola Gigantica
● Segmentina ● Hippeutis ● Gyraulus sp. Fasciolopsis Buski ● Bulimus Fuchsiana ● Aloncima sp. ● Parafossarulus ● Semisulcospira ● Melanoides Clonorchis Sinensis ● Gyraulus Convexiusculus ● Hippetius umbilicalis Echinostoma Ilocanum ● Antemelania asperata Paragonimus Westermani ● Bithynia Opisthorchis Felineus Opisthrochis Viverrini ● Cionella lubrica Dicrocoelium Dendricitum ● Macrochlamys Indica Eurytema Pancreaticum 2 ND INTERMEDIATE HOST Aquatic Plants Fasciola Hepatica ● Ipomoea obscura (morning glory/kangkong) Fasciolopsis Buski Fasciola Gigantica ● Eliocharis tuberosa (water chestnut) ● Eichornia sp. (caltrop) ● Trapa sp. (water lotus) ● Nymphaea lotus Fasciolopsis Buski ● Nasturtium officinale (watercress) Fasciola Gigantica Fish ● Any Heterophyes Heterophyes Metagonimus Yokogawai ● Cyprindae sp. (fish/shrimp/golden or freshwater carp/carpa) Clonorchis Sinensis Opisthorchis Felineus Opisthorchis Viverrini ● Cobitida Opisthorchis Felineus Opisthorchis Viverrini ● Vivipara angularis (susong pampang) Echinostoma Ilocanum Pila luzonica, pila conica (snail) Echinostoma Ilocanum Sundathelphusa philippina Paragonimus Westermani Formica Fusca (ants) Dicrocoelium Dendriticum Technomyrmex Deterquens Eurytema Pancreatiicum Grasshoppers DIAGNOSTIC STAGE Unembryonated Egg Fasciola Hepatica Stool Eggs Fasciolopsis Buski Echinostoma Ilocanum Fasciola Gigantica Sputum Eggs Paragonimus Westermani Stool Ova Clonorchis Sinensis Schistosoma Japonicum Schistosoma Mansoni Urine Ova Schistosoma Haematobium ALTERNATIVE DIAGNOSTIC STAGE Stool Eggs Paragonimus Westermani INFECTIVE STAGE Metacercaria Fasciola Hepatica Fasciolopsis Buski Clonorchis Sinensis Echinostoma Ilocanum Paragonimus Westermani Cercaria Schistosoma Japonicum Schistosoma Mansoni Schistosoma Haematobium MODE OF TRANSMISSION Ingestion Fasciola Hepatica Fasciolopsis Buski Clonorchis Sinensis Echinostoma Ilocanum Heterophyes Heterophyes Paragonimus Westermani Skin Penetration Schistosoma Japonicum Schistosoma Mansoni Schistosoma Haematobium DIAGNOSIS DFS / Stool Fasciola Hepatica Fasciolopsis Buski Clonorchis Sinensis Echinostoma Ilocanum Heterophyes Heterophyes Metagonimus Yokogawai Paragonimus Westermani Schistosoma Japonicum Schistosoma Mansoni Duodenal or bile aspirate / Duodenal drainage Fasciola Hepatica Clonorchis Sinensis Opisthorcis Felineus Schistosoma Japonicum Schistosoma Mansoni Recovery of adult worms Fasciola Hepatica Serologic Test Fasciola Hepatica Fasciola Gigantica ● Dot-ELISA Paragonimus Westermani Coprological Fasciola Gigantica Coproovoscopy Opisthorchis Felineus Opisthorchis Viverrini Cholangiography Opisthorchis Felineus
INFECTIVE STAGE
Plerocercoid Larva Diphyllobothrium Latum or Dibothriocephalus Latus Cysticercus Cellulosae Larva Taenia Solium Cysticercus Bovis Taenia Saginata Cysticercoid Larva Hymenolepis Diminuta Hymenolepis Nana Dipylidium Caninum Raillietina Garrisoni Echinococcosis Echinococcus Granulosus MODE OF TRANSMISSION Ingestion ● Undercooked fish Diphyllobothrium Latum or Dibothriocephalus Latus ● Cysticercoid Larva Dipylidium Caninum UTERUS Coiled, rosette-like, central Diphyllobothrium Latum or Dibothriocephalus Latus Tree-like Taenia Saginata Saclike, filled with eggs Hymenolepis Diminuta Hymenolepis Nana Egg Pockets Dipylidium Caninum LENGTH 3 - 10 m Diphyllobothrium Latum 6 - 10 m Taenia Solium 60 cm ( 0. 6 m ) Hymenolepis Diminuta Raillietina Garrisoni 25 - 45 mm ( 0. 025 - 0. 045 m) Hymenolepis Nana SCOLEX Bothria (unarmed) Diphyllobothrium Latum or Dibothriocephalus Latus Spatulate (spoon/almond) Double row hooklets Taenia Solium Echinococcus Granulosus 4 cuplike suckers Taenia Solium Hymenolepis Diminuta Hymenolepis Nana Dipylidium Caninum (deep) Echinococcus Granulosus Armed rostellum Taenia Solium Hymenolepis Nana Dipylidium Caninum Raillietina Garrisoni Unarmed rostellum Taenia Saginata Hymenolepis Diminuta Pyriform Taenia Saginata No hooks Taenia Saginata Hymenolepis Diminuta Dipylidium Caninum Knob-shaped Hymenolepis Diminuta Small, club-shaped Hymenolepis Diminuta Dipylidium Caninum (not small) Rhomboidal Hymenolepis Nana Retractable rostellum Single row hooks Globular Dipylidium Caninum Median Conical rostellum Rose-thorn shaped hooks Prominent rostellum ( 24 - 28 ) Echinococcus granulosus 2 alternating circular rows Raillietina Garrisoni 90 - 140 hammer-shaped hooks PROGLOTTIDS 3 , 000 Diphyllobothrium Latum or Dibotriocephalus Latus 800 - 1 , 000 Taenia Solium (gravid) Hymenolepis Diminuta 175 - 200 Hymenolepis Nana 3 Echinococcus Granulosus EMBRYO Coracidium Diphyllobothrium Latum or Dibotricephalus Latus Hexacanth Taenia Saginata Hymenolepis Diminuta Radial Striations Taenia Saginata EGG/OVA 6 hooklets (oncosphere) Taenia Solium Taenia Saginata Hymenolepis Diminuta Hymenolepis Nana Dipylidium Caninum Embryonated Taenia Solium Thick-shelled Mature, Non-operculated Taenia Saginata Fried-egg appearance Hymenolepis Diminuta No polar filaments Striated shell
Polar thickening Hymenolepis Diminuta Hymenolepis Nana Thin-shelled Hymenolepis Nana Polar filaments Non-striated shell Spindle-shaped, elongated Raillietina Garrisoni ADULT Gravid segments (proglottid) Diphyllobothrium Latum or Dibotriocephalus Latus ● Square Taenia Solium ● Longer than wide Taenia Saginata ● Twice as wide as long Hymenolepis Diminuta Hymenolepis Nana ● Melon/cucumber Dipylidium Caninum ● Pumpkin seed ● Rice grain Raillietina Garrisoni Mature (proglottid) Taenia Saginata Dipylidium Caninum TREATMENT Praziquantel Diphyllobothrium Latum or Dibotriocephalus Latus Taenia Solium Taenia Saginata Hymenolepis Diminuta Hymenolepis Nana Dipylidium Caninum Raillietina Garrisoni Niclosamide Diphyllobothrium Latum or Dibotriocephalus Latus Taenia Solium Hymenolepis Diminuta Hymenolepis Nana Dipylidium Caninum Raillietina Garrisoni Bithionol Hymenolepis Nana Dipylidium Caninum Raillietina Garrisoni Quinacrine Hymenolepis Diminuta DIAGNOSIS Stool Examination Diphyllobothrium Latum or Dibotriocephalus Latus Taenia Solium Taenia Saginata Hymenolepis Nana Dipylidium Caninum Echinococcus Granulosus Imaging (X-ray, CT scan) Diphyllobothrium Latum or Dibotriocephalus Latus Molecular Multi-Dot ELISA No species identification Taenia Solium Taenia Saginata Hymenolepis Nana Eggs/Ova Hymenolepis Diminuta Railliettina Garrisoni Dipylidium Caninum Scolex Diphyllobothrium Latum or Dibotriocephalus Latus Taenia Solium Taenia Saginata Hymenolepis Diminuta (rare) Dipylidium Caninum Raillietina Garrisoni Skin test (Casoni test) Echinococcus Granulosus
