PENYAKIT
INFESTASI CACING DAN
GIGITAN SERANGGA
strongyloides
hookworm
Larvae hatch
Larvae penetrate from eggs
through intact skin
Highest Worm Burdens in Schoolaged Children and
Growth Curve of Child With Soiltransmitted
Percentiles 17
97
16
90
15
75
14
50
13
25
10 12
3 11
W eight (kg)
10
9
8
7
6
5
4
Thiabenazole for 2 days
3
2
0 3 6 9 12 15 18 21 24 27
Age (months)
PENYAKIT AKIBAT INFESTASI CACING DAN GIGITAN SERANGGA
YANG PENTING DIBIDANG KEDOKTERAN
1. ASCARIASIS
Pre-patency:
2 months
Pneumonitis:
4 – 16 days
after infection,
short duration
(~3 wks)
PATOLOGI DAN GEJALA KLINIK
• Larval phase: eosinophilia,
pneumonitis, Leoffler syndromes
• Adult phase:
– Malnutrition, Impaired Physical Growth
– Mild abdominal discomfort → → Small bowel
obstruction (in children, few as 60 worms)
– Wandering ascaris: biliary tract obstruction,
cholangitis, pancreatitis, liver abscess
• Treatment: Albendazole x 1 dose
Löeffler Syndrome (Pneumonitis)
Transverse sections
of Ascaris larvae in
pulmonary alveoli
Ascaris causing
intestinal
obstruction.
Clinical Features of Ascariasis
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2. ENTEROBIASIS
Pinworms
• AKA: seatworms or threadworms
• Most common in US
– 42 million people
– Mostly children aged 5-14 years
– Commonly institutional settings such as child
care facilities, hospitals, or family members
• Only helminthic infection with approved OTC
treatment
Pinworm transmission
• Embryonated eggs are on clothes,
bedding, bathroom fixtures or dust.
1. inhabit ileocecum.
2. Female migrates out
of anus and deposits
eggs in perianal region
then dies.
3.Eggs hatch within a
few hours and larvae
return to large intestine
via anus
(retroinfection),
4.crawl into
genitourinary tract, or
5.eggs are reingested
by the host.
Clinical presentation and
complications
• Frequently asymptomatic
• Most frequent symptom: nighttime
perianal itching / PRURITUS
NOCTURNAL
• Also: abdominal pain, insomia,
restlessness, anorexia, diarrhea
• Less common: vaginitis, PID, dysuria,
and UTI, leading to infertility
• Bacterial infections secondary to itching
Diagnosing Pinworms
• Visual inspection
– With a flashlight, inspect the
anal area during early morning
hours while child is asleep
• Cellophane tape sample
– Using a tongue depressor,
apply the sticky side of a piece
of tape to the perianal area
and then to a glass slide,.
– microscopic examination by a
physician
3. TRICHINOSIS
Whipworm:
Trichuris trichiuria
• Adult habitat: caecum, colorectum
• No extraintestinal phase
• Lifespan: 1 3 years
• 90% infections are asymptomatic
• Symptoms with heavy infections
– Intensity of infection peaks by age 10
LIFE CYCLE
– Asymptomatic
– Physical Weakness, Anemia
– Stunted Growth, Cognitive Deficits
– Stool frequency (12+/day), nocturnal stooling
– Trichuris dysentery syndrome
– Trichuris colitis
– Rectal prolapse
•Treatment: Albendazole x 3 days.
Trichinella spiralis – MICROSCOPIC
EXAMINATION
Clinical features of trichinosis
• antihelminthic (albendazole) to
kill any intestinal adults
• steroids to relieve inflammatory
reactions
• antipyretics
4. HOOK WORM
NECATOR AMERICANUS
Life cycle of hookworm
III. Pathogenesis and Clinical
Manifestations
• 1. Larval migration
(1) Dermatitis, known as "ground itch" or "stool
poison".The larvae penetrating the skin cause allergic
reaction, petechiae Or papule with itching and burning
sensation. Scratching leads to secondary infection.
(2) pneumonitis (allergic reaction), Loeffier's
syndrome: cough, asthma, low fever, biood-tinged
sputum or hemoptysis, chest-pain, inflammation
shadows in lungs under X-ray. These manifestations go
on about 2 weeks.
2. Adults in small intestine
(1) Epigastric pain as that of a duodenal ulcer.
(2) A large worm burden results in microcytic
hypochromatic anemia (characteristic manifestation).
1-CutaneousLarva Migrans(CLM)
Spesies penting:
1. Wucheraria bancrofti (lymphatic)
2. Brugia malayi (lymphatic)
3. Onchocerca volvulus
(subcutaneous)
• Periodic form : mf in
small numbers in Microfilarial
circulating blood
during the day and
periodicity
peak density at
night (10 pm to 2
to 4 am)
• Subperiodic form :
mf peak between
noon and 8 pm
Diagnosis of Wucheraria
Advanced lymphedema
Hydrocoele
Elephantiasi
s
• Inflammatory
changes in the
lymphatics Pathology
• Chronic
lymphedema :
hyperplasia of
connective tissue,
infiltration of plasma
cells, macrophages &
eosinophils
• Eventual thickening &
verrucous changes:
elephantiasis
Treatment
• Diethylcarbamazine (DEC) : an effective
microfilaricidal drug which can eliminate
adult worms more slowly.
• Combination of DEC & Albendazole
• Combination of DEC & Ivermectin
• Elephantiasis : surgery, rigorous hygiene
7. SCHISTOSOMIASIS
• Definitions:
• Cysticercosis – infection caused by the
entrance of Taenia solium into the body and
the formation of cysticerci (larval form).
• Neurocysticercosis – cysticerci (larval form)
form in the brain.
Pigs are intermediate hosts.
• Feces → intestine → blood vessel → muscle
contact
with
dogs
• [Head louse]
Phthirus Pubis
• Pubic louse
Pruritic infestation on the Scalp
• Dermatitis