Cestodes
Human Echinocococcosis (hydatidosis or hydatid disease) is caused by
Embryonated eggs in feces
Echinococcus granulosus infective stage
Hydatid cysts in liver, lungs, etc
Echinococcus granulosus diagnostic stage
Remains silent for years before enlarging cysts cause symptoms in affected organs
Hepatic involvement - can result in abdominal pain, mass in hepatic area and biliary duct obstructions
Pulmonary Symptoms - produces chest pain, cough, hemoptysis
Clinical Presenation of Echinococcus granulosus (hepatic, pulmonary)
Worldwide, frequently in rural, grazing areas where dogs ingest organs from infected animals
Geographical Distribution of Echinococcus granulosus
Serology testing: indirect hemagglutination (IHA), indirect fluorescent antibody (IFA) and EIA test
Lab diagnosis of Echinococcus granulosus is done via
Chemotherapy, cyst puncture and PAIR (percutaneous aspiration, injection of chemicals, and reaspiration)
Treatment of Echniococcus granulosus
Nematode (roundworm)
Strongyloides stercoralis is caused by
Filariform larvae
Strongyloides stercoralis infective stage
Rhabditiform larvae
Strongyloides stercoralis diagnostic stage
Frequently asymptomatic
GI Symptoms - abdominal pain and diarrhea
Pulmonary Symptoms including Loeffler Syndrome - Fever, malaise, cough, wheezing, and
dyspnea
Dermatologic symptoms - urticarial rashes in buttocks and waist
Strongyloides stercoralis clinical presentation (GI, pulmonary, derm)
Microscopic ID of larvae in stool or duodenal fluid
Diagnosis of Strongyloides stercoralis
Ivermectin (first line) or albendazole (alternative)
Treatment of Strongyloides stercoralis
Trematode (fluke)
Paragonimus westermani is a species of
Metacercariae
Infective stage of Paragonimus westermani
Unembryonated eggs
Diagnostic stage of Paragonimus Westermani
Diarrhea, abdominal pain, fever, cough, urticaria, hepatosplenomegaly, pulmonary abnormalities and eosinophilia
Clinical Presentation of Paragonimus Westermani in acute phase (Invasion & Migration)
cough, expectoration of discolored sputum, hemoptysis, and CXR abnormalities
Clinical Presentation of Paragonimus Westermani in chronic phase
Americas, Africa, SE Asia
Geographic distribution of Paragonimus Westermani
Morphology of eggs in stool or sputum
Lab diagnosis of Paragonimus Westermani
Praziquantel (Pregnancy category B) or Triclabendazole (not first choice and not FDA approved)
Treatment of Paragonimus Westermani