Paragonimus westermani PDF

Paragonimus westermani ( Lung fluke ) By Dr/Ayman Abdelmaogod Lecturer of Medical Parasitology P. Westermani Geographical distribution: In Asia :China,Taiwan,Japan,and Tailand. In Africa :Nigeria and Cameroon. In South America : Peru and Ecuador : Morphology  Adult...

Paragonimus westermani ( Lung fluke ) By Dr/Ayman Abdelmaogod Lecturer of Medical Parasitology P. Westermani Geographical distribution: In Asia :China,Taiwan,Japan,and Tailand. In Africa :Nigeria and Cameroon. In South America : Peru and Ecuador : Morphology  Adult worm is oval measuring,14x7mm  Leaf like Life Cycle: The adult worms lives in cystic pockets in the lungs of infected humans. (D.H) It can infect also dogs,cats,pigs and monkeys(R.H.) They can remain viable in the human lungs for 20 years. Eggs are coughed from the lungs and expectorated in the sputum or swallowed and excreted in the faeces. Life cycle ) Egg (diagnostic stage  u55x90Size:  Shape : oval,thick shelled,operculated  Colour : brown  Content: immature  Life Cycle Egg mature in water ,liberating miracidia in about .weeks2-7.)Miracidia,penetrate the snail (Semisulcospira .Which is the first intermediate host  2 Cercaria emerging from snails after about  months(microcercous cercaria)with oval body.and short knob like tail Cercaria penetrate crabs,shirmps(second  intermediate host)forming encysted metacercaria Life Cycle Human infection occurs through eating  insufficiency cooked cray fish(crustacean) containing encysted metacercariae.,they excyst in the small intestine then penetrate intestinal wall to the peritoneal cavity ,also penetrating the diaphragm and pleura to reach the lungs forming cystic cavities and.attain maturity Pathogenesis Adult worms provoke granulomatous  reactions ending by fibrotic encapsulation of.the worms Aberrant migration of the immature worms  may lead to ectopic lesions in the.abdomen,heart,brain Clinical picture:)Parasitic haemoptysis) Chronic productive cough with brownish  purulent sputum containing streaks of blood.and parasitic eggs or adult worms Chest pain  Dyspnea  )20-25%Eosinophilia(  Pleural effusion  Diagnosis.Diet history and travelling to endemic areas  Detection of eggs or adult worms in sputum or .)faeces(sputum and stool examination Immunodiagnosis : to detect early and chronic  cases. e.g ELISA Radiology : plain x ray chest ,C.T chest reveals .nodular or ring shadows or lung cavities treatment 3 mg/Kg 25Praziquantel is the drug of choice  days3 times daily for Prevention&Control Treatment of cases  Good cooking of crabs and other crustacean  Hand wash after handling crustacean in  )endemic areas.(health education.Snail control 