STH 2024 PDF

HELMINTHS dr. Ni Luh Putu Eka Diarthini, M.Si Departemen Parasitologi FK UNUD Contract lecture  Intestine Nematode (STH) : 1x 50 menit  Intestine Nematode (Non STH): 1x50 menit  HELMINTHS NEMATHELMINTHES/ PLATYHELMINTHES ASCHELMINTHES CESTODA NEM...

HELMINTHS dr. Ni Luh Putu Eka Diarthini, M.Si Departemen Parasitologi FK UNUD Contract lecture  Intestine Nematode (STH) : 1x 50 menit  Intestine Nematode (Non STH): 1x50 menit  HELMINTHS NEMATHELMINTHES/ PLATYHELMINTHES ASCHELMINTHES CESTODA NEMATODA TREMATODA NEMATODES CHARACTERISTIC CYLINDRICAL SHAPE COVERED BY CUTICLE COMPLETE DIGESTIVE SYSTEM SEPERATE SEXES EXIST STAGE : OVA, LARVA, ADULT CLASSIFICATION OF NEMATODES BASED ON HABITAT INTESTINAL NEMATODES BLOOD AND TISSUE NEMATODES INTESTINAL NEMATODES 1. SOIL TRANSMITTED HELMINTHS Ascaris lumbricoides Trichuris trichiura Hookworm : Ancylostoma duodenale & Necator americanus Strongyloides stercoralis 2. NON SOIL TRANSMITTED HELMINTHS Enterobius vermicularis Trichinella spiralis NEMATODES IN ANIMAL CUTANEUS LARVA MIGRANS  Ancylostoma braziliense  Ancylostoma caninum VISCERAL LARVA MIGRANS  Toxocara cati  Toxocara canis SOIL TRANSMITTED HELMINTHS Ascaris lumbricoides DISTRIBUTION  Cosmopolitan tropical and sub tropical areas  Poor sanitation Infection: Ascariasis MORPHOLOGY Adult Worm  Thelargest intestinal Nematodes  : 20-35 cm (like pencil)  : < 30 cm (incurved tail)  Creamy white or pinkish  Cuticle has fine circular striations  Mouth with 3 oval lips  Habitat: Lumen of Small intestine Eggs 1. Fertil corticated - 50-70 x 40-50 µm - Subspherical or round yellowish brown to dark brown - Egg shell is thick showing several layer Outer part is covered with mammilated protein coat 2. Fertil decorticated: thin egg shell, without protein coat 3. Infertil egg  60-90 x 40-60 µm  Elongated ellipsoidal  Brown to dark brown  The shell are thinner and have a more irregular outer  Coarsely mammilated albuminous covering  A large number granules fill up the inside Developmental stages LIFE CYCLE Source: CDC PATHOLOGY and SYMPTOMS  LARVA  Lung: Pneumonitis with eosinophilia (Loeffler syndrome)  ADULT  Abdominal distentions  Diarrhea, vomiting  Malnutrition  Symptom cause migration  Appendicitis, Pancreatitis  Bowel obstruction DIAGNOSIS 1. FECES : egg  Direct Smear Lugol Eosin  Kato-Katz technique Centrifugation technique 2. FOUND THE ADULT WORMS 3. RONTGEN 4. Endoscopy 5. U S G THERAPY Albendazole Mebendazole (Side effect : erratic migrations) CONTROL  BASED ON LIFE CYCLE Trichuris trichiura  Adult worm = Whipworm Having a long, slender, thread-like anterior portion A thicker posterior portion with the appearance of a whip handle The male has a coiled tail and smaller than the female Habitat: Cecum Adult worm penetrate into intestinal mucosa Eggs Eggs 50-54 x 22-23 µm Barrel shaped Brown to dark brown Have a polar plug at either end The shell is composed 2 layer When passed in feces the eggs are the unsegmented stages LIFE CYCLE PATHOGENESIS AND SYMPTOMS  MILD INCECTION: ASIMPTOMATIC  HEAVY INFECTIONS  ABDOMINAL PAIN AND DISTENTION  BLOODY OR MUCOID DIARRHEA  SYMPTOMS LIKE APPENDICITIS  PROLAPS RECTI DIAGNOSTIC FECES: EGGS same as ascarisiasis Adult worm in prolaps recti TREATMENT MEBENDAZOLE ALBENDAZOLE PREVENTION  SAME AS ASCARIASIS  BASED ON LIFE CYCLE HOOK WORM HOOKWORM 1. Ancylostoma duodenale Inf: Ancylostomiasis 2. Necator americanus Inf: Necatoriasis DISTRIBUTION: Tropical and sub tropical area MORPHOLOGY: ADULT WORM A. duodenale LIKE “C” N. americanus LIKE “S” Female about 1 cm Male about 0,8 cm  MOUTHS: BUCCAL CAPSULES N.a: cutting plates A.d: teeth HABITAT: SMALL INTESTINE  Attach to the mucose by buccal capsule  Suck the hosts blood and mucosal substances  An anti coagulating secretion fascilities blood sucking  0,03 ml of blood may be withdrawn by N.a and 0,15-0,26 ml by A.d in 24 hours EGGS: N.a = A.d  55-75 um- 35-40 um  OVAL  THIN-SHELLED TRANSPARANT  BLASTOMERE4-8 cells  LARVAE:  RHABDITIFORM LARVAE (RL)  N.a = A.d  Eggs → RL  FILARIFORM LARVAE (FL)  Infectif form LIFE CYCLE:  N.a : Cutan LIFE CYCLE  Pathology and Symptoms LARVAE Skin: Ground itch Pulmonary symptoms: mild ADULT Anemia (iron deficiency anemia) Gastrointestinal symptoms DIAGNOSIS  Found the eggs in stool  To differentiation of spesies : Harada-Mori technique: → FL Treatment  Albendazole  Mebendazole  Pirantel pamoate CONTROL: based on life cycle Reference 1. Essentiale of Human Parasitology: Heelan Judith S Ingersoll Frances W 2. Markell and Voges Medical Parasitology David T. John William A. Petri.Jr THANK YOU