Parasitic Diseases in Respiratory System

7/24/2019 Parasitic Diseases in Respiratory System

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PARASITIC DISEASES IN

RESPIRATORY SYSTEM

dr.Wiwien S Utami, M.Sc



Löfer's syndrome

Loefer's syndrome is a disease inwhich eosinophils accumulate in the lung in response to a parasitic infection

•1932 by Wilhelm !"er

#osinophilic pneumonia caused by

the parasites Ascaris lumbricoides,Strongyloides stercoralis and thehoo$worms % Ancylostoma duodenale

and Necator americanus

)

http://en.wikipedia.org/wiki/Disease

http://en.wikipedia.org/wiki/Eosinophil

http://en.wikipedia.org/wiki/Lung

http://en.wikipedia.org/wiki/Parasite

http://en.wikipedia.org/wiki/Wilhelm_L%C3%B6ffler_%28doctor%29

http://en.wikipedia.org/wiki/Eosinophilic_pneumonia

http://en.wikipedia.org/wiki/Ascaris_lumbricoides

http://en.wikipedia.org/wiki/Strongyloides_stercoralis

http://en.wikipedia.org/wiki/Hookworm

http://en.wikipedia.org/wiki/Ancylostoma_duodenale

http://en.wikipedia.org/wiki/Necator_americanus

http://en.wikipedia.org/wiki/Necator_americanus

http://en.wikipedia.org/wiki/Ancylostoma_duodenale

http://en.wikipedia.org/wiki/Hookworm

http://en.wikipedia.org/wiki/Strongyloides_stercoralis

http://en.wikipedia.org/wiki/Ascaris_lumbricoides


http://en.wikipedia.org/wiki/Wilhelm_L%C3%B6ffler_%28doctor%29

http://en.wikipedia.org/wiki/Parasite

http://en.wikipedia.org/wiki/Lung

http://en.wikipedia.org/wiki/Eosinophil

http://en.wikipedia.org/wiki/Disease





Symptoms

Symptoms associated it! "ar#aemi$ration

Migration of lar&ae in lungs may cause

hemorrhagic' eosinophilic pneumonia,cough %oe"er(s Syndrome) *reathing di+culties and fe&er omplications caused by parasite

proteins that are highly allergenic -asthmatic attac$s, pulmonary inltrationand urticaria %hi&es)



Dia$nosis

Stoo" microscopy /eggs may be seen ondirect e0amination of feces.

Eosinop!i"ia/ eosinophilia can be found,

particularly during lar&al migrationthrough the lungs



Eosinop!i"ic pne%monia





Treatment

Mebendaole lbendaole yrantel pamoate 4&ermectin iperaine citrate e&amisole



Trematod worms&fukes(

Flat / platyhelminthes

5rematos6 pierced withholes

Leaf-like worm Not segmented

anymore



Cacin$ Trematoda)

!ermaprodit* ata%%nise+s &monocio%s* ata%

diecio%s( masi! cender%n$ in-

breeding masi! den$an sucker

%s%s ,e"%m p%nya an%s ,e"%m %n a bod cavit



-a,itat cacin$ ,er#ariasi

intestinum tenue

4ntest. crassum hepar

paru darah



Para$onim%s estermani

7iastoma pulmonum, 8rientalung lu$e %5rematoda aru)

7istribusi : ;epang, <orea, sia

selatan=tenggara, 4ndonesia%4ndonesia di $ep.Solomon, apua,

;awa, Sumatra)

>ospes / manusia, $ucing,harimau

>ost perantara / $eong melania,udan air tawar



Paragonimus westermani

BENTUK : MIRIP BIJI KOPI

UKURAN : 8 – 16 x 4-8 mm

KUTIKULA TERTUTUP SISIK ,SPT DURI -

DURI KECIL

PENGHISAP ORAL > ENTRAL

!ARING PENDEK MEMBULAT

COECUM TUBULER, TAK BERCABANG

TESTIS " BH, BERLEKUK TAK TERATUR

LETAK BERDAMPINGAN

OARIUM, 6 LOBI, DI SBLH ANTERIOR

KEL#ITELIN GRANULER DI LATERAL BDN



CACING DEWASA

P. westermani

TELUR

UKURAN : 8$-118 %

48-6$ &m

BENTUK : LONJONG

OPERKULUM :

KECIL RATA 'AGAK

TERTEKAN KE DALAM

TELUR BERISI SEL-SEL GRANULA





Pat!o"o$y andSymptomato"o$y

Ad%"ts in!a,it "%n$s* a"t!o%$! ot!eror$ans are a"so in#o"#ed.

Pat!o"o$ica" "esions may ,e c"assi/ed

into 0 sta$es)&1(In#adin$ and mi$ratin$ sta$e) fter

e0cystation the adolescents penetrate the

intestinal wall and migrate to the lungs. &2( S%pp%rati#e sta$e. 5he bleeding and

inltration of neutrophils and eosinophils

surrounding worms form a capsule, abscess.



&3( Cystic sta$e* the cyst wall is formed

due to the progressi&e brosis of the

surrounding tissue. T!e cystic contents

are c!oco"ate or r%sty t!ic+ 4%id it!

e$$s and C!arcot5Leyden crysta"s*

!ic! "oo+s "i+e sesame paste.

&0( 6i,ro%s5scar sta$e* the worms are

dead or escape from the cyst. 5he e0udateand pus are e0pelled or absorbed and

replaced by brous-scar tissue.



C"inica" mani7estation)

aragonimiasis may be classied into ? types

/

&1(P%"monary type) the symptoms resemble

pulmonary tuberculosis with low fe&er, loss of

appetite, night sweating, chest pain, loss of

weight and r%sty sp%t%m.

&2( 8rain type/ manifests epi"epsy,

hemiplegia, monoplegia,aphasia, &isual

disturbence and resembles cerebral



&3(A,domina" type/ abdominal

pain ， diarrhea or dysentery with blood,

mucus and o&a in feces. &0(S%,c%taneo%s type) the wandering

and painless subcutaneous nodules.



Dia$nosis

1. Sp%t%m e9amination) &1( A"+a"i

di$esti#e met!od &1:;NaO-(* &2(

Direct sp%t%m smear

2. Stoo" e9amination) &1( A"+a"i

di$estion * &2( <ater sedimentation

met!od* &3( Direct 7eca" smear

3. 8iopsy 7or S%,c%taneo%s type

0. CT 7or ,rain type

=. Imm%no"o$ica" tests 7or re7erence.



PARAGONIMIASIS PARU



aragonimiasis paru,@o





7istribusi geograsaragonimiasis



Treatment and Pre#ention

1.Treatment) Dr%$ o7 c!oice is

pra>i?%ante". Ot!er e@ecti#e dr%$s

inc"%de !e9ac!"oropara9y"o"* ,it!iono"

&,itin(.

2. Pre#ention)

&1( -ea"t! ed%cation*

&2( A#oid eatin$ ra 7res! ater cra,s

and cray/s!es.

&3( A#oid sp%t%m and stoo" $ettin$ into

ater.



Epidemio"o$y

T!is disease is pre#a"ent in 6ar

East* A7rica and So%t! America.

T!ere are endemic 7oci in 22

pro#inces in Nort!east* East and

So%t!est o7 C!ina.

Its pre#a"ence is re"ated to eatin$

ra cra,s and cray/s!es and t!e

nat%ra" 7oci.



PNEUMOCYSTIS CARINII

Deadly AIDS Opportunist



Pneumocystis carinii pneumonitis

(PCP) is a common opportunistic

disease that occurs almost eclusi!el"in persons #ho ha!e pro$ound

immunode$icienc"%

PCP #as and still is the most common

li$e&threatenin' opportunistic in$ection

occurrin' in patients #ith I disease%



The taonom" o$ P carinii has not *een

esta*lished% It is either a proto+oan or a $un'us%

Recent studies sho# P carinii more closel"resem*le $un'i than proto+oa%

rRNA sequences

thymidylate synthase

dihydrofolate reductase

beta tubulin mitochondrial DNA

chitin in the cell wall

O E Eriksson has a treatise which places P

carinii in a new family Pneumocystidaceae andin a new order Pneumocystidales

(Ascomycota).



Li7e Cyc"e



Pneumocystis carinii

• Title, E! Ima"e of Pneumocystis carinii • -isease(s), #neumocystis pneumonia

• .e'end, An electron micro"raph of P. carinii cyst from rat lun" tissue$

• /enus0Species, Pneumocystis carinii

• Ima'e T"pe, !icroscopic !orpholo"y

h t t p : / / w

w w . d o c t

o r f u n g u s

. o r g

P i i ii




• Title, #neumocystis carinii %infected

Rat &un" 'issue

• -isease(s), #neumocystis pneumonia

• .e'end, An ()E stain of a rat lun" infected with P. carinii $ It does not show any or"anisms but shows the

proteinaceous e*udate which results from Pneumocystis infection and ultimately causes reduced "as e*chan"e$



h t t p : / / w

w w . d o c t

o r f u n g u s

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P ti i ii




• Title, Pneumocystis carinii Sil+er Stain

-isease(s), #neumocystis pneumonia

• .e'end, A sil+er stain of P. carinii cysts from rat lun" tissue showin" the typical ,deflated ball, shape$



h t t p : / / w

w w . d o c t

o r f u n g u s

. o r g



C"inica" Presentation

auses neumonitis, neumocystispneumonia %)

ung epithelium becomes desAuamated

al&eoli ll with foamy e0udate containingparasites

e&er, non producti&e cough, breathingdi+culty on e0ertion, respiratory failure,

cyanosis 7eath by asphy0ia



Dia$nosis

linical symptoms Sputum or bronchial la&age Special staining with toluidine blue,

methenamine sil&er Bram-Weigert stain for cysts #4S, immunoCuorescence assay, 7D

amplication being de&eloped



• 1our dru's currentl" a!aila*le $or therap" o$ P

carinii pneumonitis are,

pentamidine isethionate

trimethoprim%sulfametho*a-ole

ato+aquone trimetre+ate

'rimethoprim%sulfametho*a-ole ispreferred because of its low to*icity

and "reater efficacy$


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Parasitic Diseases in Respiratory System