TREMATODA HATI

SAHAT OMPUSUNGGU
Yang termasuk Trematoda hati

1. Fasciola hepatica
2. Fasciola gigantica
3. Clonorchis sinensis
4. Opistorchis felineus
5. Opistorchis viverrini
6. Dicrocoelium dendriticum
7. Dicrocoelium hospes
FASCIOLA HEPATICA
 FASCIOLA HEPATICA

Sinonim
• Disebut juga: Distomum hepaticum,
Fasciola californica dan Fasciola halli.
 Hospes dan Nama penyakit
 Hospes definitif: ruminansia spt: sapi,
kerbau, kambing- biri-biri, rusa dan unta;
kadang-kadang: manusia, kuda, anjing,
kucing, babi, kelinci, tikus, tupai dsb .
 Hospes perantara:
» Indonesia: keong Limnaea rubiginosa.
» Jepang: keong Austropeplea ollula, Radix
japonicus dan Fossaria truncatula.
 Peny: faskioliasis, distomiasis dan infeksi/
peny cacing hati; pd biri-biri disbt liver rot.
 Distribusi Geografis

 Eropa, Afrika Tenggara, benua Amerika,

Oseania.
 Di Jepang, Korea, Hawai tipenya abnormal,
 Di Indonesia hanya menyerang sapi, kasus
pada manusia belum pernah ada.
 Morfologi
 Cacing dewasa gepeng spt daun, dgn
bentuk kerucut di ujung anterior.
 2-3 cm X 1 cm.
 Batil isap mulut terletak di anterior.
 Batil isap perut di dekat ujung posterior
kerucut.
 Gld vitelina coklat, menyebar di kedua sisi.
 Usus bercabang kompleks.
 Morfologi

 Ovarium di sisi kanan tubuh.

 Kedua testis bercabang kompleks.
 Ovarium, oviduk dan kanalis Laurer
lengkap, reseptakulum seminalis tidak ada.
 Uterus pendek, di anterior batil isap perut.
 Porus genitalis di anterior batil isap perut.
 Telur F. hepatica terbesar di antara
trematoda: 130-150 x 63-90 μ.
 F. hepatica: F. gigantica:
Panjang 4,1 cm Panjang: 3 cm
Kedua cacing berasal dari sapi dan sama-sama bertipe abnormal
(tidak menghasilkan sperma).  = batas testis;  = cirrus
OS = batil isap mulut
C = cirrus
I = usus
CS = kantung cirrus
GP = porus genitalis
SV = vesicula seminalis
VS = batil isap perut
U = uterus
O = ovarium
VD = vas deferens
VC = ductus vitellina
T = testis
VG = glandula vitellina
Fasciola hepatica dewasa dari biri-biri,
pewarnaan carmine (sumber: Hanna)
OS = batil isap mulut
Ph = pharynx
G = usus
Gb = cabang lateral usus
 = porus genitalis
SV = vesicula seminalis
A = batil isap perut
(acetabulum)
O = ovarium
U = uterus
T = testis
V = gladula vitellina
M = glandula Mehlis
Od = oviduct
Ot = ootype
Vd = ductus vitellina
Vr = reservoir vitellina
 Penjelasan gambar F. hepatica

Sumber: Fasciola hepatica: Histology of the Reproductive Organs and Differential

Effects of Triclabendazole on Drug-Sensitive and Drug-Resistant Fluke Isolates
and on Flukes from Selected Field Cases
Robert Hanna
Figure 1. Fasciola hepatica: Carmine-stained whole mount of a fluke from an untreated
field case of chronic fasciolosis in a sheep. Behind the oral sucker (OS) the two main
caeca of the gut (G) bifurcate from the pharynx (Ph), and lateral branches of the gut
(Gb) lie dorsal to the reproductive structures throughout the body. The position of the
genital pore is marked (*), while the seminal vesicle (SV) is located anterior to the
ventral sucker (or acetabulum, A). The two testes are highly branched (T), and these
branches occupy the medial portion of the body, with the very numerous vitelline follicles
(V) distributed in two broad lateral zones, merging at the posterior end of the fluke. The
two main vitelline ducts (Vd), one from each side, supply the vitelline reservoir (Vr) at the
caudal pole of the Mehlis’ gland complex (M). The single dendritic ovary (O), on the left
side of the fluke, delivers oocytes via the oviduct (Od) to the ootype (Ot), where each
oocyte associates with approximately 30 vitelline cells, and an egg-shell is formed
around the cell mass. Completed eggs pass into the proximal coils of the uterus (U), and
are stored there temporarily while being shifted forward towards the genital pore by the
new eggs entering from behind.
Morfologi
KIri: pandangan dorsal
Kanan: pandangan ventral
Usus Fasciola hepatica
Usus Fasciola hepatica
F. hepatica dari sapi
Telur: lonjong, mempunyai operkulum,
120 to 150 µm x 63 to 90 µm.
Aneka bentuk telur F. hepatica
Mirasidium Sporokista Redia induk Redia anak Serkaria

Stadium larva F. hepatica di tubuh keong mulai

dari: masuk, berkembang dan keluar
Miracidium

Berbagai penampilan mirasidium F. hepatica

Berbagai penampilan
serkaria F. hepatica
Serkaria F. hepatica Redia anak F. hepatica
 Siklus Hidup
• Telur keluar bersama tinja hosp def → jatuh
di air → menetas → keluar mirasidium →
menembus tubuh keong → berubah menjadi
sporokista → redia → serkaria → serkaria
keluar dari tubuh keong → menempelkan
diri di tanaman air → menjadi metaserkaria
sbg kista → tanaman air yg mengandung
kista metaserkaria dimakan ruminansia dan
manusia → metaserkaria berubah menjadi
dewasa dan tinggal di kelenjar/saluran
empedu.
Austropeplea ollula
Patogenesis, Patologi dan Klinis

 Kerusakan parenkim hati dan sirosis.

 Umumnya gejala ringan.
1. Melalui rongga perut; 2. Melalui muara saluran empedu/pankreas
Cara masuk metaserkaria trematoda hati
ke kelenjar/saluran empedu
 Diagnosis dan Pengobatan
 Klinis: kolesistitis/kolesistolitiasis disertai
peningkatan lekosit eosinofil.
 Parasitologis: pemeriksaan tinja / aspirasi
cairan duodenum / cairan empedu utk
menemukan telur.
 Pada tinja orang habis makan daging hati
sapi bisa ditemukan telur F. hepatica, jadi
perlu periksa ulang.
 Tes fungsi hati dan tes imunologis.
 Obat untuk faskioliasis adalah bitionol.
 Epidemiologi dan Profilaksis

 Infeksi bisa terjadi karena makan selada air

mentah seperti Nasturtium officinale yg tumbuh di
bantaran sungai.
 Juga karena makan hati/usus sapi kurang matang
yg mengandung cacing muda.
 Profilaksis: menghindari makan tanaman mentah
atau daging sapi mentah.
 Pencegahan pada hewan: pengawasan terhdp
rumput dan batang padi makanan sapi; keongnya
hidup di sawah..
 Perlu pengelolaan kotoran sapi dgn baik.
 Teratai, hospes
intermedier kedua
F. hepatica
di Thailand
 Fasciola gigantica
• Kasus pd manusia: Afrika, Iran dan Hawai.
• Cacing dewasa: besar, tipis dan panjang.
• Struktur dalam: mirip F. hepatica, namun testis
lbh anterior, batil isap perut lebih besar dan
"bahu" (kanan kiri posterior kerucut) tidak begitu
menonjol.
• Dewasa: 25-75 x 12 mm, telur: 150-190 x 78-100
μ, (lebih besar daripada telur F. hepatica).
• Hospes perantara: keong Austropeplea ollula di
Hawai, Lymnaea auricularia rufescens di
Pakistan dan L. natalensis di Afrika Selatan.
• Indonesia: L. rubiginosa (eksperimen).
• Beberapa cacing di Hawai, tipe abnormal (tdk
memp sperma).
F. gigantica
 Contoh perkembangan telur F. gigantica hingga menetas
(A) Unembryonated egg. (B) Embryonated egg. (C) Egg with fully
matured miracidium. (D) Egg with escaping miracidium. Scale
bar=0.05 mm.
(Phalee et al. Experimental Life history and Biological Characteristics of Fasciola
gigantica (Digenea: Fasciolidae); Korean J Parasitol. 2015;53(1):59-64
Publication date (electronic) : 2015 February 27
doi : https://doi.org/10.3347/kjp.2015.53.1.59
 Contoh perkembangan larva F. gigantica di tubuh keong
The miracidium lost its ciliated covering and became a young sporocyst on day 3. The young sporocyst had packed
germinal cells and eyespots (no. 1 in Fig. 2). On day 7 post incubation, the young sporocyst transformed to become a
mature sporocyst, redia-like in shape, but with no pharynx or primitive gut (no. 2). On day 10 post incubation, the mature
sporocyst transformed to become a young redia, with the visible pharynx and primitive gut, the unique characteristics of the
redia (no. 3). Each germinal cell in the sporocyst developed and formed into the germinal ball on day 14 post incubation
(no. 4). Young daughter rediae and cercariae were present on day 21 (no. 5). On day 24, daughter rediae and young
cercariae became fully developed (no. 6), and then the fully developed cercariae were separated from the rediae through a
Perkembangan metacercariae F. gigantica di batang padi.
(A) Metaserkariae (anak panah) menempel pada batang padi. B) metaserkaria.
(C) Kapsul metaserkaria. Garis skala = 0.05 mm.
 Morfologi larva F. gigantica.
(A) Egg. (B) Miracidium. (C) Young sporocyst. (D) Mature sporocyst. (E) Mother redia.
(F) Daughter redia. (G) Cercaria. (H) Encapsulated metacercaria. (I) Metacercaria. Scale
bars (A-D)=0.03 mm; (E-G)=0.1 mm; (H-I)=0.05 mm.
Different stages of F. gigantica recovered from albino mice.
Scale bar = 1 mm.