METAGONIMIASIS (Metagonimus yokogawai)

Penyebaran Geografis
Negara-negara Timur Jauh (Asia Timur, Asia Tenggara, daerah timur Rusia, dan daerah barat Samudra Pasifik), Siberia, Manchuria, the Balkan states, Israel, dan Spanyol http://www.dpd.cdc.gov/dpdx/

Morfologi
Cacing dewasa Metagonimus yokogawai berukuran +- 1mm Memiliki batil isap kepala dan batil isap perut yang terletak agak lateral Ovarium dan uterus berisi telur Dua testis bulat letaknya serong

(Prianto L.A., 1994)

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Daur Hidup

Adults release fully embryonated eggs each with a fully-developed miracidium, and eggs are passed in the hosts feces . After ingestion by a suitable snail (first intermediate host), the eggs hatch and release miracidia which penetrate the snails intestine . Snails of the genus Semisulcospira are the most frequent intermediate host for Metagonimus yokogawai. The miracidia undergo several developmental stages in the snail, i.e. sporocysts , rediae , and cercariae . Many cercariae are produced from each redia. The cercariae are released from the snail and encyst as metacercariae in the tissues of a suitable fresh/brackish water fish (second intermediate host) . The definitive host becomes infected by ingesting undercooked or salted fish containing metacercariae . After ingestion, the metacercariae excyst, attach to the mucosa of the small intestine and mature into adults (measuring 1.0 mm to 2.5 mm by 0.4 mm to 0.75 mm) . In addition to humans, fish-eating mammals (e.g., cats and dogs) and birds can also be infected by M. yokogawai . http://www.dpd.cdc.gov/dpdx/

Patologi Klinik
Nyeri perut Diare Payah jantung Pendarahan serebral dan spinal (Prianto L.A., 1994)

Penegakan Diagnosa
Diagnosis didasarkan pada identifikasi mikroskopis telur dalam tinja. Namun, telur sulit dibedakan dari Heterophyes heterophyes dan mirip dengan Clonorchis dan Opisthorchis. Diagnosis spesifik didasarkan pada identifikasi cacing dewasa setelah terapi antihelminthic, atau ditemukan pada otopsi. http://www.dpd.cdc.gov/dpdx/

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Microscopy
Cacing dewasa Metagonimus yokogawai hidup di usus manusia, ukurannya 1-2,5 mm yang menyerupai Heterophyes. Heterophyes. Sebuah ciri khas penting adalah posisi pengisap ventral (genitoacetabulum), yaitu sisi garis tengah dan terkait erat dengan pori genital.

Ket gambar: oral sucker (OS), pharynx (PH), intestine (IN), genitoacetabulum (GA), ovary (OV), the large, paired testes (TE), and eggs within the uterus (EG). http://www.dpd.cdc.gov/dpdx/

Manajemen Pengobatan
Drug of choice: Praziquantel: 75 mg/kg/d in 3 doses x 1d (adult) 75 mg/kg/d in 3 doses x 1d (pediatric) (Handbook of Antimicrobial Therapy 17th Ed)

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DAFTAR PUSTAKA
http://www.dpd.cdc.gov/dpdx/HTML/Metagonimiasis.htm Prianto L.A., Juni, dkk. 1994. Atlas Parasitologi Kedokteran. Jakarta: PT. Gramedia Pustaka Utama The Medical Letter, Inc. Handbook of Antimicrobial Therapy 17th Ed. 1000 Main Street. New Rochelle, New York 10801-7537

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