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Other Lung Parasites Course: Cardiopulmonary Dr. Mohammed Elfaki Department of Basic medical science 2024 ‫كلية الطب‬  Lung Parasites  Parasites habitating the lung tissues: e.g. Paragonimus westermani.  Larval stages in th...

Other Lung Parasites Course: Cardiopulmonary Dr. Mohammed Elfaki Department of Basic medical science 2024 ‫كلية الطب‬  Lung Parasites  Parasites habitating the lung tissues: e.g. Paragonimus westermani.  Larval stages in the lung tissues: e.g. E. granulosus (hydatid cyst).  Transient parasites in the lung tissues (part of life cycle): Ascaris, hook worms, and filaria.  Parasites reaching the lung tissues as extra- intestinal sites: E. histolytica  House dust mites. mites 2024 ‫كلية الطب‬ ECHINOCOCCUS GRANULOSUS (Hydatid disease) disease 2024 ‫كلية الطب‬  ECHINOCOCCUS GRANULOSUS Larval stages in the lung tissues of E. granulosus (hydatid disease) Tapeworm. Geographical Distribution: occurs practically worldwide, and more frequently in rural Habitat: small intestine of dogs, cats and other canines. D.H: Dogs, cats and other canines. 2024 ‫كلية الطب‬  :Morphology  Adult: Only 2-8 mm long Usually comprises of- Scolex: with four suckers and 2 circular rows of hooks neck immature proglottid mature proglottid gravid proglottid  Egg: Similar to Taenia egg. Life cycle – D.H.: dogs, cats and other canines. – I.H.: cattle, sheep and Man. Man – Mode of infection to man (I.H.): ingestion of embryonated eggs in feces or hairs of dogs. – Mode of infection to dogs (D.H.): ingestion of hydatid cysts in viscera of sheep or cattle.  Life cycle – Habitat : Small intestine – Infective stage : Egg – Man is accidental host. – MAN IS A BLIND END HOST 2024 ‫كلية الطب‬  :Hydatid cyst At gross examination, the vesicles resemble a bunch of grapes Hydatid cysts – slow growing : 2-3cm/yr – 10 cm Sites of hydatid cyst: liver (65%), lungs(25%), muscle, spleen, kidney, heart, bones, brain etc Hydatid cyst :structure  The hydatid cyst has 3 layers:  The outer pericyst - composed of modified host cells that form a dense and fibrous protective zone  The middle laminated membrane - acellular,allows the passage of nutrients  The inner germinal layer, where the scolices (the larval stage of the parasite) and the laminated membrane are produced. Clinical picture: Asymptomatic for years before the cysts grow large enough to cause symptoms  cysts larger than 5 cm in diameter – pressure symptoms in the affected organs The rate at which symptoms appear typically depends on the location of the cyst Hepatic and pulmonary symptoms are the most common clinical manifestations Rupture of the cysts can produce a host reaction manifesting as fever, urticaria, urticaria eosinophilia, eosinophilia and potentially anaphylactic shock; shock rupture of the cyst may also lead to cyst dissemination Diagnosis :  Treatment: Prevention and control:  Hydatid cysts found in slaughtered animals should be destroyed not to be used to feed the dogs.  Pet dogs should be examined and dewormed.  Avoid playing or kissing dogs. 2024 ‫كلية الطب‬ Transient parasites in the lung tissues (part of life cycle):  Ascaris  Hook worms  Filaria  Ascaris lumbricoides 2024 ‫كلية الطب‬ :Introduction  Common name: Round worm  Largest of intestinal nematodes, 25 cm  causative agent of ‘Ascariasis’  Distribution:- world wide  Habitat:- small intestine, mainly jejunum  Life cycle Man is infected by ingestion of the embryonated egg containing the second stage larva with water or raw vegetables or food or hands contaminated with polluted soil. Eggs hatch in the intestine and the rhabditiform larvae penetrate the intestinal wall to the circulation then to the right side of the heart then to the lungs, then they break out the pulmonary capillaries to reach the alveoli.  Inside the alveoli, they undergo second and third moults to form filariform larvae. The filariform larvae ascend up in the respiratory tract till they reach the trachea then they enter the digestive system to reach the intestine. :Pathogenesis larvae migration in lungs may lead to:  Minute hemorrhage and pneumonitis (verminous pneumonitis).  Fever, cough and expectoration of blood tinged sputum.  Allergic manifestations as bronchial asthma.  Eosinophilia.  LOEFFLER'S SYNDROME (Ascaris Pneumonitis or Verminous Pneumonia) An allergic lung condition caused by invasion of the human lung by the nematode larva of Ascaris,Strongyloides and hook worms (Anclostoma & Necator) Eosinophilic pneumonia :Clinical Picture Extravasation of the nematode larva in the lung tissue :causes Respiratory symptoms: Cough, Hemoptysis , Wheeze , Dyspnea Cellular infiltration by plasma cells, eosinophils and lymphocytes. Release of allergic mediators causing bronchospasm. Peripheral eosinophilia may be observed It varies from mild cough and fever to sever asthmatic Parasites reaching the lung tissues as extra-intestinal sites E. histolytica 2024 ‫كلية الطب‬  ENTAMOEBA HISTOLYTICA Causative agent: Amoebic dysentery Morphology: 2 forms:  Trophozoite Pathogenic stage  Cyst Infective stage Life Cycle Fecal – Oral Route Pulmonary amoebiasis:  It is due to either blood spread from the intestine or direct from the liver.  This results lung in abscess formation, pleural effusion and lung collapse. :Clinical Picture  Fever  Cough  Dyspnea  Pleural effusion  Abscess may rupture through a bronchus leading to chocolate brown sputum. :Diagnosis  Sputum examination: for Trophozoites  CBC leucocytosis  Serology  PCR  X-ray it shows pleural effusion and lung collapse.  U/S will show single or multiple abscesses.  CT Scan.  House dust mites 2022 ‫كلية الطب‬  House dust mites  Dermatophagoides  The dust mites are cosmopolitan  Habitat: mattress 25 °C , 80% humidity  cause allergies  The powerful allergens contained in the mites, their cast skins, skins fecal material and secretions Inhalation of dust mite allergens by hypersensitive individuals can result in acute attacks of bronchial asthma, accompanied by wheezing, shortness of breath, and perhaps even death. Recent studies suggest that at least 45% of young people with asthma are allergic to house dust mites. 2024 ‫كلية الطب‬ Clinical picture: Irritation of the upper respiratory passages., Perennial rhinitis Runny nose Sneezing Coughing Watery eyes Typicalbronchial asthma like symptoms. Dyspnea… wheezing 2024 ‫كلية الطب‬ How can you know that your house is infested with mites? The presence of house dust mites can be confirmed by collecting dust samples from inside the home and examining them under a microscope. Another diagnostic test more accessible to householders can be purchased from drug and allergy supply stores. The detection kits (e.g., Acarex) measure the presence and infestation level by combining dust samples, collected from various places inside the home, with indicator reagents. 2024 ‫كلية الطب‬ Thank you