CLINICAL PARASITOLOGY LAB TREMAODES

TREMATODES / DIGENEA

» Commonly known as the FLUKES.

» These parasites vary in egg, larva, and adult morphology and
reproduction processes.
» Divided into two groups:
1. HERMAPHRODITIC / MONOECIOUS
❖ Self-fertilizing parasites
❖ Infects organs
❖ Foodborne

2. NON-HERMAPHRODITIC / DIOECIOUS
❖ Parasites that reproduce via separate sexes.
❖ Infect by direct penetration
» Common to all trematodes is their complex life cycles, which
almost always include mollusks (snails) as an intermediate host,

Blood Flukes

Schistosoma japonicum
» COMMON NAME: Blood fluke / Oriental blooder fluke

Schistosoma mansoni
» COMMON NAME: Manson’s blood fluke

Schistosoma haematobium
» COMMON NAME: Bladder fluke / Vesical blood fluke

COMMON Schistosoma spp. disease and condition names:

» Schistosomiasis
» Bilharziasis Schistosoma mansoni
» Swamp fever
» Katayama fever Adult:
» Skin with coarse tuberculations
CHARACTERISTICS: » Male tegument is tuberculated
» NON-HERMAPHRODITIC ❖ Testes is usually 6-9 in cluster
» “Romantic parasite” » Female uterus
» Adult blood fluke is not leaf- ❖ Ovary is located at the anterior half
like Ova:
» INFECTIVE STAGE: Cercaria » 112 – 182 um x 40 – 75 um
» Transmitted through skin » Contains developed miracidium
penetration » Oblong with LARGE LATERAL SPINE
» Female produces non-
operculated eggs
» Requires 2 hosts
» Adult female is larger than
adult male

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CLINICAL PARASITOLOGY LAB TREMAODES

Schistosoma mansoni Schistosoma haematobium Schistosoma japonicum

Schistosoma haematobium
Adult:
» Skin is fine with tuberculation
» Male tegument is tuberculated with smooth granulations
❖ Testes is 4-5 in cluster
» Female uterus
❖ Ovary is located at the posterior half
Ova:
» 110 – 170 um x 38 – 70 um
» Contains developed miracidium
» Oval in shape with PROMINENT / LARGE TERMINAL SPINE

Schistosoma spp. Egg Characteristics

APPERANCE
SIZE EGG AND
SHAPE
RANGE CONTENTS LOCATION
Schistosoma japonicum OF SPINE
112 – 182
Large;
Adult: S. mansoni um by 40 Oblong
lateral
» Skin is smooth – 75 um
» Male tegument is smooth 50 – 85
Somewhat Developed Small;
❖ Testes is 7 and usually linear. S. japonicum um by 38
roundish miracidium lateral
– 60 um
» Female uterus
110 – 170
❖ Location of the ovary is in the center (median / central) Somewhat Large;
S. haematobium um by 38
❖ Can fit up to 500 eggs oblong terminal
– 70 um
Ova:
» 50 – 85 um x 38 – 60 um
» Contains developed miracidium ADULT MALE Schistosoma spp. Characteristics
» Round with SMALL LATERAL SPINE / KNOB – difficult to see Male tegument Testes
S. mansoni Tuberculated Usually 6 – 9 in cluster
S. japonicum Smooth 7 ; usually linear
Tuberculated with
S. haematobium 4 – 5 in cluster
smooth granulations

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CLINICAL PARASITOLOGY LAB TREMAODES
ADULT FEMALE Schistosoma spp. Characteristics NOTE:
➢ Fasciola hepatica, Fasciolopsis buski, and Echinostoma ilocanum
Location of the ovary
have operculated eggs, and contains undeveloped miracidium.
S. mansoni Anterior half ➢ Fasciola hepatica – largest among F. buski and E. ilocanum
S. japonicum Central / Median
S. haematobium Posterior half

LIVER, INTESTINAL, AND LUNG FLUKES

LIVER FLUKES
» Fasciola hepatica – Sheep liver fluke
» Clonorchis sinensis – Chinese liver fluke / Oriental liver fluke
» Opistorchis felineus – Cat liver fluke
INTESTINAL FLUKES
» Fasciolopsis buski – Giant intestinal fluke
» Echinostoma ilocanum – Garrison’s Fluke
» Heterophyes heterophyes – Von Siebolds fluke/Heterophid fluke
» Metagonimus yokogawai – Yokogawa’s fluke

LUNG / PULMONARY FLUKE

» Paragonimus westermani – Oriental lung fluke / Japanese lung
fluke
Adult Fasciolopsis buski, Fasciola hepatica, and Echinostoma ilocanum
CHARACTERISTICS: » Adult Fasciola hepatica has cephalic cone / shoulders with
» HERMAPHRODITIC branched testes, branched ovaries, and branched intestinal caeca
» INFECTIVE STAGE: Metacercaria » Adult Fasciolopsis buski similar to F. hepatica but has no shoulders
» MODE OF TRANSMISSION: Ingestion / cephalic cone with unbranched testes, ovaries, and intestinal
» The body of the adult worm is LEAF-LIKE caeca.
» Female produces operculated eggs » Adult Echinostoma ilocanum has an oral sucker, equipped with
» Requires 3 hosts – 1 definitive host, 2 intermediate host circum oral disk with spine.

Fasciola species Adult F. buski, F. hepatica, and E. ilocanum Characteristics

» No cephalic cone / shoulder
Fasciolopsis buski and Fasciola hepatica Egg » Unbranched testes
Fasciolopsis buski
Characteristics » Unbranched ovary
Fasciola buski Fasciola hepatica » Unbranched intestinal caeca
128 – 140 um by 128 – 150 um by » Has cephalic cone / shoulder
SIZE RANGE
78 – 85 um 60 – 90 um » Branched testes
Fasciola hepatica
SHAPE Somewhat long » Branched ovary
EGG CONTENTS Undeveloped miracidium » Branched intestinal caeca
OTHER FEATURES Presence of a distinct operculum » Has an oral sucker
Echinostoma ilocanum » Equipped with circum oral disk
» F. buski and F. hepatica are two different species, but their ova » Has spine
are indistinguishable.

Fasciola hepatica
» Eggs are large and ovoidal
» Yellowish-brown that contains undeveloped miracidium
Fasciolopsis buski
» Large ; operculated – contains operculum (hat-like)
» Eggs are yellowish and ellipsoidal
» Contains thin shell and small operculum
» Egg also contains undeveloped miracidium Fasciolopsis buski Fasciola hepatica

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Clonorchis sinensis Heterophyid flukes
Clonorchis sinensis Egg Characteristics » Their eggs are operculated with narrow operculum
PARAMETER DESCRIPTION » Contains developing miracidium
AVERAGE SIZE 30 by 15 um » Has no abopercular knob opposite to the operculum
EGG CONTENTS Developed miracidium
OPERCULUM Present Heterophyes heterophyes and Metagonimus yokogawai Egg
Presence of distinct shoulders Characteristics
OTHER FEATURES and presence of small knob PARAMETER DESCRIPTION
opposite operculum AVERAGE SIZE 30 by 15 um
EGG CONTENTS Developing miracidium
» Eggs are usually operculated OPERCULUM Present
» Has a wide operculum SHOULDERS Present but discrete
» Contains developed miracidium SMALL KNOB May be absent
» At the opposite side of the operculum is a small knob also referred Heterophyes – thick
SHELL THICKNESS
as ABOPERCULAR KNOB. Metagonimus – thin
» C. sinensis eggs are broadly ovoidal, in contrast to O. felineus that
are ovoid yet elongated. Difference between H. heterophyes, M. yokogawai, and C. sinensis
» Resembles an old-fashioned electric bulb ABOPERCULAR OPERCULUM
SHOULDER
KNOB (operculated egg)
Without
Heterophyes Present;
abopercular With operculum
heterophyes Less distinct
knob
Without
Metagonimus Present;
abopercular With operculum
yokogawai Less distinct
knob
With
Clonorchis
Prominent abopercular With operculum
sinensis
knob

Opistorchis felineus
» Often indistinguishable with Clonorchis sinensis ova
» The eggs are operculated, and possesses PROMINENT OPERCULAR
SHOULDERS and ABOPERCULAR KNOB.
» The ova of Opistorchis spp. ranges form 19 – 30 um in length by
10 – 20 um in width.
Adult Heterophyes heterophyes
» The eggs are distinctly embryonated when passed in feces.
» With central genital sucker – GONOTYL – distinguishable
ADULT Clonorchis sinensis and Opistorchis felineus characteristic
» Closely resembles one another, but C. sinensis has a granular Adult Metagonimus yokogawai
vitellaria and dendritic testes
» Opistorchis felineus have transversed vitellaria and lobed testes. » Closely resembles H. heterophyes but slightly larger with no
» The testes of Opistorchis felineus is not as branched as those of genital sucker.
Clonorchis sinensis

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CLINICAL PARASITOLOGY LAB TREMAODES
Paragonimus westermani REMEMBER:
Paragonimus westermani Egg Characteristics » Paragonimus westermani ova has a flat operculum
PARAMETER DESCRIPTION » Paragonimus westermani has a shell thickening abopercular knob
SIZE RANGE 78 – 120 um long ; 45 – 60 um wide » Clonorchis sinensis has a wide, prominent operculum
SHAPE Somewhat oval » Clonoecis sinensis possesses a small abopercular knob
Undeveloped miracidium surrounded
EGG CONTENTS
by a thin, smooth shell
» Prominent operculum with
shoulders
OTHER FEATURES
» Obvious terminal shell thickening
opposite operculum
» Has a FLAT operculum
» Eggs are operculated with wide operculum
» Contains undeveloped miracidium
» Eggs have abopercular terminal shell thickening, without knob
» Ova are similar to those produced by diphyllobothrium latum

Adult Paragonimus westermani

» Assumes a coffee bean appearance

» Somewhat oval, red-to-brown in color
» Its tegument cuticle contains spine

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CLINICAL PARASITOLOGY LAB TREMAODES
ADULT WORMS