2. 1. List types of anemia caused by parasites
2. identify parasites causing anemia
3. discuss morphology, life cycle, pathogenesis ,
diagnostic methods, prevention and management of
anclystoma duodenale
4. illustrate morphology, life cycle, pathogenesis,
diagnostic methods, prevention and management of
D.latum
OBJECTIVES
3. What is anemia?
Anemia is a deficiency of peripheral red blood
cells count, reduction of hemoglobin following by
reduction of oxygen transport capacity of the
blood.
4. In all type of anemia, there are several symptoms occur
such as :
• fatigue, shortness of breath and fast heartbeat
• Dizziness and weakness
• Headache and sore tongue
• Pale and dry skin
• Chest pain
What are
symtomps of
anemia?
5. What are types of anemias?
(1) POST HEMORRAGIC ANEMIA
- after loss of large amount of blood due to perforated peptic
ulcer or raptured vessels
-it is a normocytic anemia and compensatory bone marrow
hyperplasia occurs and RBCs concentration return to the normal
within 3-6 weeks
-peripheral blood shows reticulocytosis, leukocytosis,
thrombocytosis
6. (2) HEMOLYTIC ANEMIA
-congenital(hereditary) causes as spherocytosis, sickle cell
anemia and thalassemia
-acquired causes as :
1-infections as malaria or septicemia
2- drugs or chemicals as phosphorus
-it is normocytic normochromic anemia associated with
reticulocytosis, thrombocytosis and leukcocytosis
7. (3) IRON DEFICIENCY ANEMIA
it is microcytic hypochromic anemia associated with bone
marrow hyperplasia
it is caused due to
-decrease of iron in diet
-chronic hemorrhages
-ankylostomiasis
-malabsorption
8. (4) Anemia caused due to bone marrow hypofunction
1- aplastic anemia : it mainly occurs due to autoimmune
reactions , radiation and chemotherapy treatments and use
of certain drugs
- it is a normocytic associated with leucopenia and
thrombocytopenia .
2- myelophthisic anemia: it is a normocytic anemia due to
destruction of bone marrow by tumors
9. (6)Macrocytic normochromic anemia
it is caused by
1-deficiency of extrinsic factors as vitamin b12 or folic
acid .
2-deficiency of intrinsic factor produced from gastric
mucosa .
(macrocytic normochromic anemia associated with
leucopenia and thrombocytopenia)
21. Morphology
Egg :
Size : 60 x 40 u
Shape : Oval , thin,
shelled and rounded poles
Colour :translucent
Content : immature ovum
with 4 cell stages
22. The adult is cylindrical nematode formed of :
1- Buccal capsule formed of ventral
teeth , 2sub ventral lancets and
dorsal cutting plates .
2- Club shaped esophagus .
3- The adult male has single set of
reproductive organs, its posterior end
has membranous bursa
4- the adult female is longer than male , has double set of
reproductive organs and its posterior end is pointed .
24. Life cycle
Adult in small intestine → eggs in faeces
→soil → first stage rahbditiform larva
→(first moult ) second stage rahbditiform
larva → ( second moult ) first stage
filariform larva →penetrates the skin →
circulation → right side of the heart →
lung→ ( third moult ) second stage
filariform larva → penetrates the alveoli →
trachea→ larynx → pharynx → oesophagus
→ stomach → small intestine →( fourth
moult ) adult
25. Man
Definitive host
No ( special to man
)
Reservoir host
First stage filariform
larva
Infective stage
Small intestine (
jejunum )
Habitat
Penetration of the
skin by first stage
filariform larva
Mode of infection
26. Pathogenesis and clinical picture
1- Skin lesion ( cutaneous
phase ) :
Itching , erythema and
vesiculation at the site of
penetration due to 2nd
bacterial infection ( hook
worm dermatitis )
28. 3- Intestinal lesion :
- Hemorrhage and the worms cause
minute ulcers ( Nausea, Vomiting,
Abdominal pain, diarrhea).
- Hypochrmoic microcytic anemia
due to chronic blood loss and
depletion of iron stores resulting in
fatigue and tachycardia .
- Melena & occult blood.
4- Toxins :
Mental and physical retardation.
29. DIAGNOSIS
Clinical history
Laboratory examination :-
- stool examination for eggs
- Cbc : anemia and
eosinophilia
- testing for occult blood in
stool
30. Management
Albendazole (400 mg) single
oral dose
Mebendazole (100 mg) twice
daily for 3 days
Iron supplement
Protein rich diet
31. Prevention and Control
Mass treatment
Health education
Wearing shoes and gloves
Sanitary disposal of human excreta
Disinfection of human excreta used as fertilizers
35. Life cycle of Diphyllobothrium latum
1) Adult lives in small intestine of the human, immature eggs pass in feces.
2) In fresh water egg hatches in about 2 weeks liberating a coracidium “ (12 –
24 h)”.
3) Coracidium swallowed by cyclops “or any crustacean”, and
penetrates the intestinal wall to become “procercoid larva” in about 2 weeks.
4) Infected cyclops eaten by fresh water fish (salmon,perch….) and procercoid
larva developes into plerocercoid larva in about 2 weeks.
5) The final host is infected by ingestion undercooked fish containing
plerocercoid larva.
6) In the intestine, larva becomes attached to the intestinal wall and grows to
maturity “Eggs appear in feces after 6 weeks”
36. Pathogenesis and clinical picture
1) Infection may be asymptomatic.
2) Intestinal disturbances as colic, hunger pains, nausea, vomiting,
diarrhea and loss of appetite.
3) Neurologic manifestations in the form of headache, insomnia or
convulsions.
4) Large number of worms may produce intestinal obstruction.
37. Pathogenesis and clinical picture
5) Pernicious anemia (macrocytic hyperchromic) due to:
some toxins secreted by the parasite.
Vitamin B12 deficiency because the parasite competes with the
host for this vitamin.
38. p.o.c D.LATUM
Habitat Small intestine
Infective stage Plercoceroid larva
Diagnostic stage Eggs and segments in stool of patient
M.O.F Ingestion of properly cooked salmon fish
containing plercoceroid larva
Type of anemia Pernicious anemia
39. DIAGNOSIS
Clinical history
-Imported fish
-Colics
-Headache
Laboratory examination
-Macrocytic nomochromic
anemia
40. PARASITOLOGICAL EXAMINATION
1. DIRECT :-
- Immature eggs : Eggs expelled from
uterine opening without maturation
- Mature segments : Broad with rosette-
shaped uterus
42. Prevention and Control
Diagnosis & Treatment of patients
Treatment of Reservoir hosts
Control of cyclops
Proper cooking & freezing of fish
Health education
Enviromental sanitation
