Food and Water-born parasites

• How does a person get in contact with a platyhelminths

  by the consumption of raw or undercooked fish, aquatic plants, snails and raw or undercooked meat from rare to medium well
• General prevention of Platyhelminths

  Discriminate defecation

  treatment of water sources

  spacing of toilet facilities from groundwater sources

  cooking food adequately and well done
• known species of capillariasis

  capillaria philippinensis
• signs and symptoms of capillariasis begins with prodromal abdominal pain and borboygmi
• 2-3 weeks after infenction of capillariasis may lead to diarrhea
• management for capillariasis

  first line: mebendazole 200 mg PO BID x 20 days

  alternative: albendazole 400 mg PO OD x 10 days
• Known species for taeniasis

  taenia solium: pork tapeworm

  taenia saginata: beef tapeworm

  taenia asiatica: asian tapeworm
• egg morphology of the eggs of the taeniasis

  positive for radially-striated
• Taenia solium

  4 large suckers

  13 hooks of each size
• Taenia saginata

  4 large suckers but lacks rostellum and rostellar
• taenia asiatica

  rudimentary hooklet — wart-like formation
• Taenia solium 


  longer than wide

  7-13 primary lateral urine branches
• Taenia saginata

  longer than wide

  7-13 primary lateral urine branches
• Taenia asiatica

  longer than wide

  12-30 primary lateral branches
• In the Philippines

  Taenia saginata are more common than Taenia solium
• Passage of proglottids

  worm segment in the stool
• Taenia saginata are

  highly motile and may travel to other GIT parts
• Taenia saginata is positive to

  mild irritation at the site of scolex attachment
• Taenia solium in humans can develop

  cysticercus or adult tapeworm
• if symptoms occur it is due to

  obstruction or pressure
• if the cysticercus develops in the brain (nuerocysticercosis) it may cause


  neurological problems
• fecalysis is not recommend because it would not show the eggs


  cysticercosis
• Spinal tap or CAT scan is recommended for

  Cysticercosis
• CT scan findings in cysticercosis

  viable larva with no inflammation

  dead larva

  dead scolex
• treatment for neurocysticercosis

  praziquantel 50-75 mg/kg, three dose for 30 days

  mannitol to decrease ICP
• treatment for ocular cysticercosis

  surgical removal

  praziquantel

  corticosteroid not recommended
• treatment for taeniasis

  praziquantel 5-10 mg/kg, single dose
• known species of paragonimiasis

  paragonimus westermani
• adult morphology of paragonomiasis

  Large, robust, ovoid flukes

  hermaphroditic, lobed ovary

  oral and ventral suckers
• paragonomiasis eggs does not usually

  cause infection
• fibrotic capsule forms around the parasite or their group

  lung parenchyma
• it has openings that allow the eggs to escape into the respiratory tract

  fibrotic capsule
• the eggs are moved up and out by the

  ciliary epithelium
• signs and symptoms of paragonimiasis

  hemoptysis and cough
• chest X-ray results of paragonomiasis

  mimics the clinical manifestations of tuberculosis
• treatment for paragonomiasis

  first line: Triclabendazole 20 mg/kg, two doses of 10 mg/kg OD

  Alternative: Praziquantel 25 mg/kg, 3x/day for 3 days
• known species of fascioliasis

  fasciola hepatica

  fasciola gigantica
• fasciola hepatica

  temperate liver fluke
• fasciola gigantica

  tropical liver fluke
• adult morphology of fasciola hepatica

  cephalic cone

  two shoulders

  converging margins