TREMATOD

ES

Liver Flukes
Fasciola
hepatica

Fasciola
gigantica

Intestinal Flukes
Clonorchis
sinensis

Fasciolopsis
buski

Echinostoma
ilocanum

Blood Flukes
S.
japonicum

S. mansoni
(smallest)

Lung Fluke
S.
haemato
bium

Paragonimus
westermani

ADULT
Oral
suckers

Small

Large

Ventral
suckers
Size

Small

Large

smaller

larger

Shape

Bigger

Largest

circum oral
disk with
collarette of
spines (4951)

Narrow
Oblong

coffee
beanshaped
Reddishbrown

Color
Cephalic
cone

Conical
projectio
n

Margins

convergi
ng
2

Shoulders

Intestine

Highly
branched
(dendritic
)

Shorter
Conical
projectio
n
parallel
Less
promine
nt
Highly
branche
d
(dendriti
c)

Simple /
unbranched

Simple or
unbranched

Length

20-75mm

Width

8-20mm

Testes

Simple

Lobed

Lobed ovary,
branched
testis

EGG
A.K.A

old-fashioned

germ ball

bottle-neck

hens egg
Operculum
Shape

electric bulb
operculated

Oval with a rounded

posterior end

egg
operculated

Pitcher shaped
Yellow-brown

Stage

Diagnostic

Similar to

Fasciola egg
Large mass of yolk
cells

Abopercular
thickening
(comma-shaped)
- Does not hatch
in water

non
Lateral knob

Color

Dot-like

Lateral
spine

Flattened
Terminal
spine

Straw-colored

Oval,
dark brown

Fasciola egg
(but smaller)

Unembryonat
ed when laid

Thickened
abopercular
end
sputum or in
feces

Intermediate Host
st

1 IH

Lymnea
philippinensis

Bulinus fuchsiana

Segmentina
sp. Hippentis
sp.

2nd IH

blades of grass
and water plants
(watercrest and
kangkong

Ctenopharyngodonn
idellus (fish)

Trapa bicornis
Trapa nutans
Eleocharis
tuberosa

Pathology

Fascioliasis

Clonorchiasis

Fasciolopsiasis

Ingestion of raw or
undercooked fish
and salted and
dried fish harboring
the metacercariae

Ingestion of
encysted
metacercariae
on aquatic
plants

Mode of
transmissio
n

Fasciola hepatica:
causes halzoun
(pharyngeal
infection)
Ingestion of
metacercariae
Drinking water
with floating

Gyraulus
convexiusculus
Gyraulus
prashadi
Hippentis
umbilicalis
Pila luzonica
(kuhol)
Vivipara
angularis
(susong
pampang)
Corbicula sp.
(clam)
Echinostomiasi
s

Onchomel
ania

Biomphalar
ia and
Australorbi
s

Bulinus
and
Physopsi
s

Brotia
asperata

Sundathelpu
sa philippina
(talangka) or
Parathelpusa
grapsoides
(former
name)
Katayama
s Disease

Swimmers
Itch

Bilharzias
is (bloody
urine)

Paragonimia
sis

Ingestion of
raw or
insufficiently
cooked crabs
harboring

metacercariae

Diagnosis

parasite eggs
in stool

Distended belly

Infective
stage
Treatment

Metacercariae

Cercaria penetrating the skin

Bithionol

Bithionol
Triclabendazole

Praziquantel

Praziquantel

Praziquantel

the
metacercaria
e
Radiographs
aid in
diagnosis

Praziquantel
Bithionol