Capillaria hepatica

Parasite of rodents, dogs, and monkeys Man is an incidental host Infected if eat raw meat

6/18/2012

S. Wahyuni, Parasitology Dept, Medical Faculty, Unhas

Life cycle
In a host the ova are deposited in the liver fully embryonated within 30 days a new host eats infected liver the ova hatch in the intestine the larvae after piercing the intestinal wall migrate to th liver the li become mature in 4 weeks
6/18/2012 S. Wahyuni, Parasitology Dept, Medical Faculty, Unhas 2

Pathogenicity the accumulations of ova cause an inflammatory reaction in the liver with the production of fibrous connective tissue p in heavy infections extensive tissue p cirrhosis destruction & hepatic Diagnosis microscopic examination of the liver at post mortem
6/18/2012 S. Wahyuni, Parasitology Dept, Medical Faculty, Unhas 3

Fasciola hepatica
Classified as trematodes The sheep liver fluke Parasite of herbivores that can infect humans accidentally F hepatica h ti : up to t 30 x 13 mm Reside in the large biliary ducts of the mammalian host. Worldwide distribution
6/18/2012 S. Wahyuni, Parasitology Dept, Medical Faculty, Unhas 4

wet mounts with iodine ellipsoidal size 120-150 x 63 to 90 m. have a small, small barely distinct operculum have a thin shell which is slightly thicker at the abopercular end. passed d unembryonated. b t d

distinct operculum in upper end of the eggs in A and B). ) The operculum can be opened (egg C),

6/18/2012

S. Wahyuni, Parasitology Dept, Medical Faculty, Unhas

4 months genus Lymnae

6/18/2012

S. Wahyuni, Parasitology Dept, Medical Faculty, Unhas

Clinical Features
acute p phase ( (caused by y the migration g of the immature fluke through the hepatic parenchyma): abdominal pain, hepatomegaly, fever, , vomiting, g, diarrhea, , urticaria & eosinophilia can last for months. chronic phase (caused by the adult fluke within the bile ducts): the symptoms are more discrete and reflect intermittent biliary obstruction and inflammation. Occasionally, O i ll ectopic i l locations i of fi infection f i ( (such h as intestinal wall, lungs, subcutaneous tissue, and p pharyngeal y g mucosa) ) can occur.
6/18/2012 S. Wahyuni, Parasitology Dept, Medical Faculty, Unhas 7

6/18/2012

S. Wahyuni, Parasitology Dept, Medical Faculty, Unhas

Laboratory Diagnosis
Eggs: gg in the stools or in material obtained by y duodenal or biliary drainage. False fascioliasis (pseudofascioliasis) refers to the h presence of f eggs in i the h stool l resulting l i not from an actual infection but from recent ingestion of infected livers containing eggs can be avoided by having the patient follow a liver-free diet several days before a repeat stool examination. i ti Antibody detection tests are useful especially in the early invasive stages stages,.
6/18/2012 S. Wahyuni, Parasitology Dept, Medical Faculty, Unhas 9