Enterobius, Trichinella, CLM & VLM.ppt 4 Students
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Transcript of Enterobius, Trichinella, CLM & VLM.ppt 4 Students
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Enterobius vermicularisTrichinella spiralisCutaneus larva migrans = creeping eruptionVisceral larva migrans
Bagus Uda Palgunadi, drh.,M.Kes.Bagian Parasitologi
Fakultas KedokteranUniversitas Wijaya Kusuma
Surabaya
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Enterobius vermicularis
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Enterobius vermicularis(Oxyuris vermicularis)
• Nama lain :
Cacing kremi = pinworm = seatworm
• Nama penyakit :
Enterobiasis = Oxyuriasis
• Distribusi geografis :
- Kosmopolitan
- Dingin > panas
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Morfologi Telur- Lonjong, asimetris , salah satu sisinya
datar
- 10 X 30 mikron
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Morfologi cacing dewasa• Jantan (2-5 X 0,2 mm) < betina (8-13 X 0,5 mm)• Habitat : cecum ; Definitive host : manusia• Oesophagus bulbus• Anterior alae• Betina menghasilkan 11-15 ribu telur diletakkan
pada perianal / perineal
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Cara penularan
• Autoinfeksi
• Retrofeksi
• Alat – alat tidur ; udara
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Siklus Hidup
• Melalui mulut
Telur infektif tertelan duodenum larva caecum dws
• Retrofeksi
Telur infektif perianal larva caecum dws
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Gejala Klinis
1. Pruritus ani iritasi perdarahan
2. Rectal colic
3. Wanita salphingitis
4. Insomnia
5. Nafsu makan menurun
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Diagnosa
1. Perianal swab ditemukan telur
2. Tinja cacing dewasa
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Pengobatan
1. Pyrantel pamoat: 11 mg/kg BB/po dosis tunggal ; max pemberian 1 gram
2. Piperazin : 65 mg/kg BB/ po dosis tunggal; max 2,5 gram
3. Pyrvinium pamoat : 5 mg/kg BB/oral/max
250 mg/ dosis tunggal
Pencegahan
1. Kebersihan perorangan
2. Cuci tangan sebelum makan
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Trichinella spiralis
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Trichinella spiralis
Nama lain : Trichina worm
Nama penyakit :
- Trichiniosis
- Trichinelosis
Distribusi geografis :
-kosmopolitan
-Amerika serikat, Eropa
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Morfologi larva
Waktu menetas 80-120 X 5,6 mikron
Waktu encyst 900-1300 X35-40 mikron
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Morfologi cacing dewasa• Halus mirip rambut
• Ujung anterior langsing
• Jantan1,5 X 0,04 mm (mati setelah kopulasi)
• Betina 3,5 X 0,06 mm ; Vulva 1/3 anterior tubuh ; Larvipar 1500 larva
Betina Jantan
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Host / Hospes & predileksi / habitat
• Host yg sama berperan sbg Intermediate - Host (IM) & Definitive Host (DH) yaitu : manusia , babi , anjing , kucing , tikus & beruang
• Predileksi : - Larva : pada otot Diafragma, intercostal,
lingua, masseter, deltoid & bicep - Dewasa : pada usus halus
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SIKLUS HIDUP
• Cara penularan : Kista larva po• SH : Kista larva (stadium infektif) Usus
halus ekskistasi dewasa kopulasi menembus mucosa usus larva saluran lymphe pembuluh kapiler peredaran darah ke tempat predileksi enkistasi enkapsulasi pengapuran
• Catatan : - Enkapsulasi 3 bulan- Pengapuran 6 bulan- Kista 10 – 20 tahun
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Gejala Klinis
1. Disebabkan Oleh Cacing dewasa :
- Kejang perut, mual, malaise dan diare
2. Disebabkan oleh Larva :
- Nyeri otot, nyeri persendian, oedema periorbital
- Kelemahan tubuh pada umumnya
- Gangguan mengunyah, menelan & nafas
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Diagnosa
- Biopsi otot larva
- Tes serologi (CFT)
- Tes kulit minggu ke 3-4 benjolan putih dengan diameter 5 mm
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Pengobatan
- Simptomatis analgesik
- Thiabendazol : 25 mg /kg BB / 2dd / 5-7 hari
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Epidemiologi & Pencegahan
- Memasak daging secara sempurna Larva mati pada suhu 60-70 °C
- Perhatian : Larva tidak mati (tahan hidup ) pada daging asap/asin
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Cutaneus larva migrans( creeping eruption)
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Cutaneus Larva Migrans(Creeping Eruption)
Lesi pada kulit yang terjadi akibat migrasi dari larva cacing un-natural host
Penyebab : larva cacing tambang anjing / kucing :
1. Larva Ancylostoma braziliense
2. Larva Ancylostoma caninum
Distribusi Geografis
Sub Tropik & Tropik (Indonesia)
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Morfologi dewasa
1. Ancylostoma braziliense
- jantan 4,7 - 8,5 X 0,3 mm
- betina 6,1 – 10,5 X 0,4 mm
- dua pasang gigi kecil ditengah
2. Ancylostoma caninum
- jantan 10 X 0,4 mm
- betina 14 X 0,6 mm
- 3 pasang gigi di ventral
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Siklus hidup :Penularan melalui kulit
Siklus Hidup
1. Pada kucing/anjing (Natural host)
Larva infektif kulit pered. Darahlung migrasi trachea lambung
usus
halus dewasa
2. Pada manusia (un-natural host)
Larva infektif kulit epidermis 2-3
hari membentuk terowongan yang ber-
liku-liku (creeping eruption) minggu /bulan
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Gejala Klinis
- Creeping eruption
- gatal
- kulit garis merah
- Dermatitis infeksi secunder
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Diagnosa
- Berdasarkan Gambaran klinis yang khas pada kulit creeping eruption
- Biopsi
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Pengobatan :
1. Freezing dengan Chlorethyl
2. Thiabendazole 25 mg /kg BB / 2 dd / 2-5 hari
3. Antibiotik bila ada infeksi secunder
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Pencegahan
1. Pengobatan pada anjing & kucing peliharaan secara berkala & teratur.
2. Menghindari kontak langsung dengan larva cacing infektif di tanah
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Visceral larva migrans
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Visceral Larva Migrans
Adalah Suatu gejala/sindroma yang diakibatkan oleh migrasi larva cacing yang mencapai organ-organ extra intestinal pada un- natural host
Penyebab :1. Larva Toxocara canis (cacing gelang anjing)2. Larva Toxocara cati (cacing gelang kucing )3. Larva nematoda lainnya
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Morfologi
Telur = Ascaris lumbricoides (pada manusia) 75 X 85 mikron
Toxocara canis :
- jantan 3,6 – 8,5 cm
- betina 5,7 – 10 cm
Toxocara cati (Ascaris mystax) :
- jantan 2,5 – 7,8 cm
- betina 2,5 – 14 cm
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Siklus HidupPenularan Cara infeksi : PO
1. Pada anjing/kucing (natural host)
Telur infektif usus halus larva menembus mucosa usus peredaran darah lung migrasi trachea lambung usus halus dewasa
2. Pada manusia (un -natural host)
Telur infektif manusia usus halus larva menembus mucosa usus halus peredaran
darah / pembuluh limfe organ extra intestinal
(hepar ,pulmo, limpa / lien, mata dll) lesi
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Gejala klinis
1. Eosinofilia
2. Hepatomegali
3. Hiperglobulinemia
4. Demam
5. Spleenomegali
6. Koroiditis
7. Iritis
8. Perdarahan bolamata
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Diagnosa
1. Biopsi hepar menemukan larva
2. Reaksi serologis tes kulit dengan antigen yang dibuat dari berbagai macam nematoda
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Pengobatan
1. Prednisone 20 -40 mg
2. Thiabendazole 25 mg /kg BB / 2 dd /5 Hr
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Pencegahan
1. Pengobatan pada anjing & kucing peliharaan secara berkala
2. Hindari kontak dengan telur infektif yang ada di tanah
3. Biasakan cuci tangan sebelum makan