Shiba Kumar Rai Shoji Uga Nobumasa Kataoka Takeo Matsumura ATLAS OF MEDICAL PARASITOLOGY ATLAS OF MEDICAL PARASITOLOGY Shiba Kumar Rai Invited Foreign Rrsrarch Scientist Department of Medical Zoology Faculty of Medicine Shoji Uga Associate professor Department of Medical Technology Faculty of Health Science Nobumasa Kataoka Associate Professor Department of Medical Technology Faculty of Health Science Takeo Matsumura Professor Department of Medical Zoology Faculty of Medicine Kobe University School of Medicine Kobe,Japan Front cover : Scanning electron microphotograph of hookworm(Ancylostoma caninum)mouth Back cover : Scanning electron microphotograph of Spirometra erinacei Copyright : 1996,First edition C Printing press : Kyokuseisya Co.,Ltd. 1-2-7 Ninomiya-cho,Chuo-ku,Kobe651,Japan. Dedicated to Scientists and Sufferers of Parasitic Diseases Acknowledgments It would have been impossible to prepare this atlas without the generous help of friends and colleagues who provided the photographs from their collections. We are grateful to them for the following photographs used in this atlas. Dr. Eisaku Kimura, Department of Parasitology, Aichi Medical University, Aichi (Japan): 95, 96 ; Dr. Hisao Yoshikawa, Department of Biology, Nara Women's University, Nara (Japan): 20, 24; Dr. Jeevan Shrestha, Department of Ophthalmology, Tribhuvan University Teaching Hospital, Kathmandu (Nepal): 85; Mr. Mamoru Nakanishi, FALCO Biosystems, Kyoto (Japan): 8, 49; Drs. Minoru Yamada and Tsunezo Shiota, Department of Parasitology, Kyoto Prefectural University of Medicine, Kyoto (Japan): 2, 5, 6, 9, Il, 12, 13, 21, 22, 23, 25, 26, 31, 32, 33, 52, 53, 56, 60, 61, 65, 94, 125, 126, 128, 131; Dr. Rokuro Kano: 167; Dr. Toshimasa Nishiyama, Department of Parasitology, Nara Medical University, Nara (Japan): 3, 7 and Dr. Yuzo Takahashi, Department of Parasitology, Gifu University School of Medicine, Gifu (Japan): 113, 114. We take this opportunity to express our special gratitude to Professor Takashi Yamadori, Dean, Kobe University School of Medicine for writing foreword of this atlas. We are grateful to Japan Society for the Promotion of Science (JSPS) for inviting and supporting the stay of Shiba Kumar Rai (From Tribhuvan University Teaching Hospital, Kathmandu, Nepal in Japan (December 1, 1995 to March 31, 1996) as an Invited Foreign Research Scientist that provided us an opportunity to work together in various aspects of infectious diseases including the preparation of this atlas. Finally, we offer our sincere thanks to Kobe University School of Medicine, Kobe, Japan for financial support and to Kyokuseisya Co., Ltd., Kobe, Japan for the excellent and timely printing of this atlas. S. K. Rai S. Uga N. Kataoka T. Matsumura Foreword Parasitic infection is one of the major health problem in developing countries in tropical areas. However, because of increasing population and the international air travel, the parasites prevalent in tropics have now being frequently reported from industrialized countries as well. In this context, it gives me a great pleasure to learn that the scientists working in the Faculty of Medicine of this Kobe University School of Medicine have prepared an Atlas of Medical Parasitology with an aim to provide a guide to the medical students and to newly qualified medical practitioners in diagnosing the parasitic diseases. I am confident that this atlas will be highly useful to its users. I highly appreciate their efforts put forward in preparing this atlas. 7-5- I , Kusunoki-cho, Chuo-ku, Kobe 650, Japan. 27th March, 1996. Prof. Takashi Yamadori Dean Kobe University School of Medicine Preface Inspite of tremendous advancement made in the field of infectious diseases during past, many problems still remain. Of the various types of infectious diseases, parasitic infections yet constitute one of the major public health problem particularly in developing countries in tropical and sub-tropical areas. Many people in these areas are suffering from one or more than one parasitic infections and their sequelae. This has been attributed to low socio-economic standards, poor sanitary facilities, Iow education level and limited diagnostic facilities. Rapid and unplanned urbanization has also been found to be associated with the increase of parasitoses. In addition, increasing international travel and business have also contributed to the spread of parasitic diseases in countries once considered to have no or very low rate of parasitic infections. Therefore, the importance of parasitic diseases once said to be confined in developing countries is now emerging in developed countries as well. This atlas has been prepared with an aim to provide a guide to the students of medical sciences and to newly qualified medical practitioners in diagnosing the parasitic diseases. In this atlas, a total of 167 photographs of more than 50 parasites of medical importance and some of the related clinical manifestations have been included. The parasites have been grouped as intestinal and urogenital, and blood and tissue parasites. Parasites like Echinococcus, Toxocara, Anisakis, Gnathostoma, and Spirometra are kept in the group of blood and tissue parasite as they are found in tissues in human. In addition, some of the ectoparasites have also been included. Brief recapitulatory introduction of parasite and respective caption for each of the photograph used have been given on the left. Scanning electron microscopic photographs of some of the parasites have also been included so as to provide an impression about the ultrafine surface structure of the parasites. Inspite of our best efforts, we have been unable to include some other parasites of medical importance, and we apologize for the inconveniences caused by this reason. S. K. Rai S. Uga N. Kataoka T. Matsumura Contents Intestinal and Urogenital Parasites Protozoa Entamoeba histolytica 2 Entamoeba coli 2 Naegleria species 4 Giardia lamblia 4 Cryptosporidium species 6 Isospora species 6 Blastocystis hominis 8 Balantidium coli 8 Trichomonas vaginalis 10 Helminths Ascaris lumbricoides 14 Trichuris trichiura 16 Trichuris vulpis 16 Hookworm (Ancylostoma and Necator) 8 Strogyloides stercoralis 20 Enterobius vermicularis 20 Taenia species 22 Hymenolepis nana 24 Hymenolepis diminuta 24 Diphylobothrium latum 26 Dipylidium caninum 26 Blood and Tissue Parasites Protozoa Plasmodium species 30 Toxoplasma gondii 32 Pneumocystis carinii 34 Leishmania species 36 Trypanosoma species 36 Helminths Wuchereria bancrofti & Brugia malayi 40 Toxocara species 42 Capilaria hepatica 44 Angiostrongylus cantonensis 44 Trichinella spiralis 46 Anisakis species 46 Gnathostoma spinigerum 48 pirometra erinacei 48 Echinococcus granulosus 50 Echinococcus multilocularis 50 Paragonimus westermani 52 Paragonimus miyazakii 52 Schistosoma species 54 Clonorchis sinensis 56 Metagonimus yokogawai 56 Heterophyes heterophyes 58 Fasciola species 60 Others Ectoparasites Sarcoptes scabiei 64 Lice 64 Flea 66 Dermatobia hominis 66