Ascaris lumbricoides. Гельминтозы презентация

Unfertilized eggs

Fertilized eggs

Egg containing a larva

Larva hatching from an egg

Ascaris lumbricoides adult male and female

Ascaris lumbricoides larva in section of lung
250 x 15 µm

Distended abdomen is characteristic of a child with severe ascariasis. (Reprinted from Despommier D et al. Parasitic Diseases. 2001)

Ascaris (roundworm) collection following anthelmintic therapy in a child. (Reprinted from Despommier D et al. Parasitic Diseases. 2001)

Treatment
Mebendazole, 200 mg, for adults and 100 mg for children, for 3 days is effective.

Toxocara canis

Eggs of Toxocara canis
These eggs are passed in dog feces, especially puppies' feces. Human infections with Toxocara do not produce or excrete eggs, and therefore eggs are not a diagnostic finding in human toxocariasis.

Treatment
Albendazole 400 mg bid x 5d
Mebendazole 100-200 mg bid x 5d

Trichuris trichiura
4 cm in length
cecum and ascending
colon
3,000 to 20,000 eggs
per day
The life span of the adults is about 1 year
15 to 30 days

Trichuris trichiura adult male and female

Trichuris trichiura eggs

Treatment
Mebendazole, 200 mg, for adults and 100 mg for children, for 3 days is effective.

Enterobius vermicularis
The life span of the adults is about two months

Three eggs of Enterobius vermicularis
60 µm x 27 µm

Enterobius vermicularis adult male and female
8 mm x 0.5

Enterobius vermicularis adults in section of appendix

Treatment
Two doses (10 mg/kg; maximum of 1g each) of Pyrental Pamoate two weeks apart gives a very high cure rate. Mebendazole is an alternative. The whole family should be treated, to avoid reinfection.

Necator americanes and Ancyclostoma duodenale
1 to 2 years
1 to 2 days
5 to 10 days

Ancylostoma duodenale adult male and female
11 mm x 50 µm

Hookworm eggs examined on wet mount

Treatment
Albendazole 400 mg once
Mebendazole 100 mg bid x 3d or 500 mg once
Pyrantel pamoate 11 mg/kg (max. 1g) x 3d

Strongyloides stercoralis
2.2 mm x 45 µm
1 mm x 60 µm

Treatment
Ivermectin 200 μg/kg/d x 1-2d
Thiabendazole 50 mg/kg/d in 2 doses(max. 3 grams/d) x 2d

Cutaneous Larva Migrans

TREATMENT
Drug of choice: Albendazole 400 mg daily x 3d
OR Ivermectin 200 μg/kg daily x 1-2d
OR Thiabendazole Topically

Clonorchis
16x4 mm.

Clonorchis sinensis adult

Clonorchis sinensis egg

Treatment
Praziquantel 75 mg/kg/d in 3 doses x 1d
OR Albendazole 10 mg/kg x 7d

Paragonimus westermani
10 x 4 mm

Paragonimus westermani adult

Paragonimus westermani egg

Paragonimus westermani adult in section of lung

Treatment
Praziquantel taken orally is quite effective
75 mg/kg/d in 3 doses x 2d
Bithionol* 30-50 mg/kg on alternate days x 10-15 doses
*Availability problems

Fasciola hepatica
(sheep liver fluke)

Fasciola hepatica eggs

Treatment
Triclabendazole* 10 mg/kg once
Bithionol* 30-50 mg/kg on alternate days x 10-15 doses
*Availability problems

Fasciolopsis buski
2-7 cm

Fasciolopsis buski adult
20 to 75 mm by 8 to 20 mm

Fasciolopsis buski egg

Treatment
Praziquantel 75 mg/kg/d in 3 doses x 1d

Tenia solium

Scolex of Taenia solium

Taenia sp. egg

Цистицеркоз
Миграция и инцистация личинок занимает 60 – 70 дней
Мышцы, подкожная клетчатка
ЦНС!
Гибель через 5 – 6 лет и кальцификация

Диагностика
Эозинофилия во время диссеминации, но не всегда после кальцификации!
КТ и МРТ головного, спинного мозга
ELISA с низкой чувствительностью, поэтому отрицательный результат не исключает цистицеркоз!

Лечение
Празиквантель 50-100 mg/kg/d in 3 doses x 30d
Альбендазол 400 mg bid x 8-30d; can be repeated as necessary

Taenia soliumcysticercus, whole and in section of muscle

Cysticercosis: Antibody Detection
CDC immunoblot for cysticercosis

T. saginata

Gravid proglottids

Histopathology of Taenia saginata in appendix.

Diphyllobothrium latum

Diphyllobothrium latum scolex and gravid proglottids

Proglottids of Diphyllobothrium latum

Eggs of Diphyllobothrium latum

Echinococcosis

Echinococcus granulosus adult

Echinococcus granulosus egg

Echinococcus granulosus hydatid cysts in section of lung

Fluid aspirated from a hydatid cyst will shows multiple protoscolices (size approximately 100 µm),

Hydatid cysts

Hydatid cysts

Type I and II hydatid cysts demonstrated on non-contrast CT. The type II cysts appear septated because the walls of multiple daughter cysts abutt one another (white arrows). Some hydatids show edema (black arrows) surrounding the cysts after albendazole treatment. (Courtesy of Dr. von Sinner and Eur J Rad, 1991).

Univesicular uncomplicated type I cyst in a 54-year-old man from Tunisia

Multivesicular type II hydatid with multiple daughter cysts giving a septated appearance to the cyst in a 21-year-old woman

CT scan of the brain showing a large hydatid cyst in the left parieto-temporal region

TREATMENT
Albendazole 15 mg/kg/d (max. 800 mg) x 1-6 months