TREMATODES

No circulatory system: only by effusion; 2 or 3 suckers indirect life cycle; most are zoonotic; only one dioecious family: Schistomatidae; (Free living flukes are under in Class
Turbellaria)
 BLOOD FLUKES
In fresh water, the parasite can survive in water for about 48 hours.
Species Risk Factors Morphology Symptomatology Diagnostic Tests Treatment Comments

1. Schistosoma japonicum, Farmers, sources: -Yellow to yellow-brown Cercaria dermatitis, Circum-oval Precipitin Praziquantel Found in all
causes Katayama disease, water snails, -Male is larger than other Petechial hemorrhages, Test (COPT), rectal provinces in
oriental scistosomiasis or drinking Schistosomes Hepatosplenomegaly biopsy, Serological Mindanao except
schistosomiasis japonica contaminated Male (similar to liver colitis), tests, Kato-Katz, Kato- Agusan because
water, swimming -inconspicuous tubercle, testes are Cerebral schistosomiasis, Thick
of mountains, it
and bathing in anterior, 6-8 testes Swimmer’s itch
is an
contaminated water -Longer and narrower than S. masoni
-Oral sucker with spine covering, autoimmune
extend to the pharyngeal opening disease
-Ventral sucker with smaller spines
-Gynecophoric canal with minute
spines
Female
-fewer spines than in males
-anterior to the acetabulum is devoid
of spines
-3000 eggs/day
Ova- oval, with lateral spine or knob
2. Schistosoma mansoni, Similar to S. Adult worm- with conspicuous Similar with S. japonicum Similar with S. Similar with S. None
mansonian blood fluke japonicum tubercles japonicum japonicum
Male: 6-9 testes
Female: 300 eggs per day
Ova: light yellowish brown, acid fast
in Ziehl–Neelsen stain, with lateral
spine
3. Schistosoma haematobium, Similar to S. Adult worm- minute tubercles Cercarial dermatitis Terminal urine- Metrifonate None
vesical blood fluke that causes japonicum Male: 4-5 testes (Swimmer’s itch) that undergo centrifuge,
urinary bilharziasis or Female: 1,500-3,500 eggs per day results in maculo-papular filtered through a poly
schistosomal haematuria Ova: large, ellipsoid shape, terminal rash, haematuria and carbonate membrane
spine proteinuria, using a nucleopore or
granulomata- eggs a nylon fiber, bladder
trapped in the bladder biopsy, serological test
wall, bladder cancer
 LIVER FLUKES
Species Risk Factors Morphology Symptomatology Diagnostic Tests Treatment Comments

4. Fasciola hepatica, liver fluke Highest in areas -One of the largest flukes
-Eosinophilia FAST-ELISA (95%), Bithionol and Determination to
or sheep liver fluke, causes where extensive -with cephalic cone
-Acute phase (large number of Ultrasound, CT scan Triclabendazole, species level is
fascioliasis or fasciolosis, found sheep and cattle -leaf shape metacercariae are ingested at surgery impossible using
on every continent raising occurs and -Each worm possesses
once): fever, tender hepatomegaly, the eggs,
where dietary ovaries and tandem testes
abdominal pain
Fasciolid eggs,
practices include the -Ceca are branched
Chronic phase- jaundice, severe
Fasciola
consumption of raw -Eggs are operculated
anemia in children, pipestem liver
aquatic vegetables. (inflammation of the bile ducts gigantica in Asia
F. hepatica needs eventually leads to fibrosis), portal
temperate, slow- cirrhosis, death
moving or standing Halzoun- worm settles in the
water for its life pharynx when an individual
cycle. consumes infected liver
Ectopic infection- occur in
peritoneal cavity, intestinal wall,
lungs and subcutaneous tissue
5. Clonorchis sinensis, Chinese Those who prefer Male- testes lie on top of Similar with fascioliasis Similar with Similar with Determination to
or Oriental liver fluke, similar raw or imperfectly one another, branched fascioliasis fascioliasis species level is
with Heterophyes cooked freshwater Ova- with posterior knob impossible using
fish the eggs,
Heterophyid
eggs
6. Opisthorchis viverrini Similar to C. sinensis Male: lobed and Similar with Clonorchis Similar with Clonorchis Similar with Determination to
unbranched testes Clonorchis species level is
Ova: slightly narrower and impossible using
do not have a rim at the eggs,
operculum
Heterophyid
eggs, Opisthorchis
felineus in Europe
 Lung Fluke
Species
7. Paragonimus westermani
causes Paragonimiasis
 Intestinal Flukes
Species
8. Fasciolopsis buski
9. Echinostoma ilocanum
10. Heterophyes heterophyes
Risk Factors Morphology Symptomatology Diagnostic Tests Treatment Comments
Those who prefer -Adult worm is coffee bean Similar with tuberculosis, Sputum concentration Praziquantel None
raw or imperfectly shape hemoptisis-blood in phlegm technique, FECT
cooked fresh water -Male has paired and lobed
mountain crabs and testes
pork -Ova is operculated and has
an abopercular thickening
at the posterior end, larger
than D. latum eggs
Risk Factors Morphology Symptomatology Diagnostic Tests Treatment Comments
Similar with Fasciola -Adult: no cephalic cone, -Diarrhea Similar with Fasciola, Praziquantel Determination to
unbranched ceca -Ulceration stool exam species level is
-Male: testes paired and -Obstruction of the bowel impossible using
dendritic -Death due to intoxication the eggs,
-Operculated eggs are
Fasciolid eggs
similar with but larger than
Fasciola
Similar to Fasciola Adult: reddish gray, -Inflammatory lesions Similar with Fasciola Praziquantel None
anterior end-with collar of -Intoxication
spines (2 rows) -Diarrhea
Male: testes are paired and
lobed
Eggs: Similar to Fasciola
but smaller
Similar with Fasciola Adults- pyriform shape, has -Inflammatory rxn Similar with Praziquantel Determination to
a genital sucker which is -Myocarditis Echinostoma species level is
bigger, only Trematode -Mucoid diarrhea impossible using
with 3 suckers -Granuloma in the brain the eggs,
Male: paired testes and
Heterophyid
ovoid
eggs
Eggs are similar with
Clonorchis, small knob at
posterior end
JUTIZ, FRANCE LOUIE R.