child health notes

Apr 16th, 2015
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FlukesTrematodesIntroduction Flukes are endemic worldwide but are moreprevalent in the less developed parts of theworld. They include:- Blood flukes e.g. schistosoma- Fluke species that cause infection in thehuman biliary tree, lung tissue, and intestinaltract.LIVER FLUKES Fasciola hepatica, the sheep liver fluke, infectscattle, other ungulates, and occasionally humans. Humans are infected by ingestion ofmetacercariae attached to vegetation. In the duodenum, the parasites excyst andpenetrate the intestinal wall, liver capsule, andparenchyma. They wander for a few weeks before entering thebile ducts, where they mature. Adult F. hepatica (1 2.5 cm) commence ovipositionapprox. 12 wk after infection; the eggs are large (75 140m) and operculated. They pass to the intestines with bile and exit the body inthe feces On reaching fresh water, the eggs mature and hatch intomiracidia, which infect specific snail intermediate hosts tomultiply into many cercariae. These then emerge from infected snails and encyst onaquatic grasses and plants.Clinical manifestations Usually occur either during the liver migratory phase of theparasites or after their arrival at their final habitat in bile canaliculi. Fever, right upper quadrant pain, and hepatosplenomegaly Peripheral blood eosinophilia is usually marked. As the worms enter bile ducts, most of the acute symptomssubside. On rare occasions, p

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