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Textbook of Medical Parasitology, 6Th Edition Textbook of MEDICAL PARASITOLOGY ANTONI VAN LEEUWENHOEK Born: 24.10.1632 - Died: 30.8.1723 Delft-Holland This man, born poor, with little education, a draper in his hometown of Delft had surprising visitors! They included great men of science as well as the Royalty like the Tsar Peter the Great, Frederick the Great of Prussia and King James II of England. This was due to his hobby of grinding fine lenses through which he looked at various objects and brought forth the wonder world of small things that none had seen before. He kept clear descriptions and accurate drawings of what he saw and communicated them to the Royal Society in London. A strict check convinced the Society of their authenticity. The unlettered Antoni was elected a Fellow of the Royal Society! The papers sent by him over decades can still be seen in the Philosophical Transactions of the Royal Society. The discoveries he made are legion. He described the first protozoan pathogen Giardia. He also discovered many types of bacteria, human and animal spermatozoa and eggs of various animals realizing their importance in reproduction. He could not recognize the significance of the different types of bacteria and to him, they were just ‘little animalcules’. His fault was in being much before the time, for it took two centuries more for people to accept the microbial origin of infectious diseases. But that should not deter us from acknowledging the great contributions made by Leeuwenhoek to Biology and many other branches of Science. He was truly the Founder of Microbiology. TextbookTextbook ofof MEDICALMEDICAL PARASITOLOGYPARASITOLOGY SIXTH EDITION CK Jayaram Paniker MD Formerly Director and Professor of Microbiology and Principal, Medical College Calicut Dean, Faculty of Medicine Calicut University Emeritus Medical Scientist Indian Council of Medical Research JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD New Delhi Published by Jitendar P Vij Jaypee Brothers Medical Publishers (P) Ltd EMCA House, 23/23B Ansari Road, Daryaganj New Delhi 110 002, India Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021, +91-11-23245672 Fax: +91-11-23276490, +91-11-23245683 e-mail: [email protected] Visit our website: www.jaypeebrothers.com Branches • 2/B Akruti Society, Jodhpur Gam Road, Satellite Ahmedabad 380 015, Phone: +91-079-30988717, +91-079-26926233 • 202 Batavia Chambers, 8 Kumara Krupa Road, Kumara Park East Bangalore 560 001, Phones: +91-80-22285971, +91-80-22382956, +91-80-30614073 Tele Fax: +91-80-22281761 e-mail: [email protected] • 282 IIIrd Floor, Khaleel Shirazi Estate, Fountain Plaza, Pantheon Road Chennai 600 008, Phones: +91-44-28262665, +91-44-28269897 Fax: +91-44-28262331 e-mail: [email protected] • 4-2-1067/1-3, Ist Floor, Balaji Building, Ramkote, Cross Road Hyderabad 500 095, Phones: +91-40-55610020, +91-40-24758498 Fax: +91-40-24758499 e-mail: [email protected] • “KURUVI BUILDING”, 1st Floor, Plot/Door No. 41/3098-B &B1, St. Vincent Road Kochi 682 018, Ph: +91-0484-4036109 e-mail: [email protected] • 1A Indian Mirror Street, Wellington Square Kolkata 700 013, Phones: +91-33-22456075, +91-33-22451926 Fax: +91-33-22456075 e-mail: [email protected] • 106 Amit Industrial Estate, 61 Dr SS Rao Road, Near MGM Hospital, Parel Mumbai 400 012, Phones: +91-22-24124863, +91-22-24104532, +91-22-30926896 Fax: +91-22-24160828 e-mail: [email protected] • “KAMALPUSHPA”, 38 Reshimbag, Opp. Mohota Science College, Umred Road Nagpur 440 009, Phones: +91-712-3945220, +91-712-2704275 e-mail: [email protected] Textbook of Medical Parasitology © 2007, CK Jayaram Paniker All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher. This book has been published in good faith that the material provided by author is original. Every effort is made to ensure accuracy of material, but the publisher, printer and author will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters to be settled under Delhi jurisdiction only. First Edition: 1988 Second Edition: 1989, Reprint: 1991 Third Edition: 1993, Fourth Edition: 1997, Reprint: 1999 Fifth Edition: 2002, Reprint: 2003, 2004 Sixth Edition: 2007 ISBN 81-8061-937-0 Typeset at JPBMP typesetting unit Printed at Ajanta Offset Preface to the Sixth Edition This, the 6th edition ot the Textbook of Medical Parasitology comes after 18 years of its birth, which is a milestone! In India, an 18 year-old can vote and choose who is to rule the land. By the same analogy, this book has come of age and can decide its own fate. Till now the Author was guided largely by the views of the students and teachers using the book. While they were generally happy with the narrative style, many had asked for improvements in pictures, both in their numbers and quality. So the emphasis this time has been here. Several pictures have been added, many in pretty colours, hoping they may attract and arrest the readers’ attention. The ultimate judges of a textbook are the students and the teachers. As in the past, we solicit their opinion and suggestions for improving the quality of the book. Shanthi, East Hill Road CK Jayaram Paniker Calicut-673006 (Kerala) Preface to the First Edition Parasitic infections continue to account for a large part of human illness. Antimicrobial drugs and vaccines that have made possible the effective control of most bacterial and viral diseases have not been as successful against parasitic infections. The numbers of persons afflicted by parasites run into many millions. Malaria still affects over 500 millions, pinworm and whipworm 500 millions each, hookworm 800 millions and roundworm a billion persons. Filariasis, leishmaniasis and schistosomiasis remain serious public health problems. Infections due to opportunist parasites are becoming increasingly evident in the affluent countries. In recent years there has been a resurgence in the study of parasitic infections. Much new knowledge has been gained making possible precise diagnosis and more effective control of parasites and the diseases they cause. This textbook attempts to present the essential information on parasites and parasitic diseases, with emphasis on pathogenesis, epidemiology, diagnosis and control. Every effort has been made to incorporate recent advances in the subject. It is hoped that medical students, teachers and physicians will find this book useful. Their comments and suggestions for improvement of the book will be most welcome. SHANTHI, East Hill Road CK Jayaram Paniker Calicut, Kerala 673 006 Contents 1. General Introduction ............................................................................................... 1 2. Protozoa: General Features .................................................................................. 10 3. Amoebae .................................................................................................................... 14 4. Flagellates ................................................................................................................. 36 5. Malaria Parasites ..................................................................................................... 65 6. Miscellaneous Sporozoa and Microspora ........................................................ 96 7. Ciliate Protozoa ..................................................................................................... 111 8. Helminths: General Features ............................................................................. 113 9. Trematodes: Flukes............................................................................................... 116 10. Cestodes: Tapeworms........................................................................................... 138 11. Nematodes: General Features ............................................................................ 158 12. Trichinella Spiralis............................................................................................... 161 13. Whipworm .............................................................................................................. 165 14. Strongyloides ......................................................................................................... 169 15. Hookworm .............................................................................................................. 175 16. Pinworm .................................................................................................................. 183 17. Roundworm ............................................................................................................ 188 18. Filarial Worms ....................................................................................................... 195 19. Guinea Worm ........................................................................................................ 213 20. Miscellaneous Nematodes .................................................................................. 217 21. Diagnostic Methods in Parasitology............................................................... 221 Index .......................................................................................................................... 233 General Introduction CHAPTER 1 1 General Introduction The earliest agents of human infection to have been observed were helminthic
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