1. Classification of the infection diseases Sorokhan V.D., MD, PhD Bukovinian State Medical University Department of the infectious diseases and epidemiology
2. Microbiological Classification of Infectious Diseases Protozoa Helminths Parasitic Prion Disseminated Localized Fungal DNA virus RNA virus Enveloped vs non-enveloped Viral Gram-negative Gram-positive Bacterial
3.
4. Gram negative Cocobacilli H. Influenzae, B. Pertussis Brucella spp., F. Tularensis P. Multosida, L. pneumophila Cocci Neisseria spp. Bacilli N. Meningitidis Glucose and maltose + N. Gonnorrhoeae Glucose + Lactose + Lactose - Slow fermenter Citrobacter Serratia Fast fermenter Klebsiella E.Coli Enterobacter Oxidase + V.Cholerae P. aeruginosa Strict anaerode B. fragilis Oxidase - Urease – Y. Pestis S. Dysenteriae Salmonnela spp. Urease + P. Mirabilis H. pylori
5.
6. Gram positive cocci Bacilli, Corinebacterium Clostridium, Listeria, Bacillus Staphylococcus catalase + Streptococcus catalase - S. Aureus Coagulase + Coagulase - β -hemolytic α -hemolytic S. Pneumoniae S. Viridans S. Mutans γ -hemolytic E. Faecalis E. Faecium S. Epidermis Novobiocin sensitive S. Saprophyticus Novobiocin resistant Group A S. Piogenes Group B S.agalactiae
7. Basic laboratory characteristics highly motile Gram-negative, but stains poorly Borrelia burgdorferi Borrelia Aerobic Unencapsulated Small coccobacilli Gram-negative Brucella abortus Brucella canis Brucella melitensis Brucella suis Brucella aerobic Encapsulated Small coccobacilli Gram-negative Bordetella pertussis Bordetella Curved, spiral, or S-shaped with single, polar flagellum Shape microaerophilic characteristic darting motion Gram-negative Campylobacter jejuni Campylobacter Respiration Motility Capsulation Gram staining Important species Genus
13. Facultative anaerobic rapidly motile Short, curved, rod-shaped with single polar flagellum Gram-negative Vibrio cholerae Vibrio Facultative Anaerobe nonmotile encapsulated Small rods Gram-negative, stains bipolarly Yersinia pestis Yersinia highly motile Long, slender, flexible, spiral- or corkscrew-shaped rods Gram-negative, but stains poorly Treponema pallidum Treponema Shape Respiration Motility Capsulation Gram staining Important species Genus
14. Clinical characteristics Large, grayish, nonhemolytic colonies with irregular borders on blood agar Direct immunofluorescence Anthrax vaccine autoclaving of instruments In early infection: Penicillin Doxycycline Ciprofloxacin Cutaneous anthrax Pulmonary anthrax Gastrointestinal anthrax Contact with sheep, goats and horses Inhalation or skin penetration through abrasions of spore-contaminated dust Bacillus anthracis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
15. Direct immunofluorescence PCR amplification Pertussis vaccine, DPT vaccine Macrolide antibiotics Azithromycin Erythromycin Clarithromycin Whooping cough Complications: Secondary bacterial pneumonia Contact with respiratory droplets expelled by infected human hosts. Bordetella pertussis Microscopy using Giemsa or Wright stain PCR serology (low precision rate ) Lyme vaccine wearing clothing that limits skin exposure to ticks insect repellent Early stages: cephalosporins amoxicillin doxycycline If arthritic symptoms have appeared: Longer courses of antibiotics Lyme disease Ixodes ticks reservoir in deer, mice and other rodents Borrelia burgdorferi laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
16. Culture (difficult and time consuming) Agglutination serology Combination therapy of: doxycycline streptomycin or gentamicin Brucellosis Direct contact with infected animal Oral, by ingestion of unpasteurized milk or milk products Brucella abortus Brucella canis Brucella melitensis Brucella suis Symptomatically by fluid and electrolyte replacement Ciprofloxacin in severe cases Acute enteritis Fecal/oral from animals (mammals and fowl) Contaminated meat (especially poultry) Contaminated water Campylobacter jejuni laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
17. None for routine use None Doxycycline Erythromycin Community-acquired respiratory infection Respiratory droplets Chlamydia pneumoniae Cellular cytoplasmic inclusions by immunofluorescence DNA hybridization ELISA for lipopolysaccharides No vaccine Erythromycin or silver nitrate in newborn's eyes Safe sex Azithromycin Erythromycin Tetracyclines Doxycycline Nongonococcal urethritis (NGU) Lymphogranuloma venereum (LGV) Trachoma Inclusion conjunctivitis of the newborn (ICN) Sexual ( NGU , LGV ) Direct or contaminated surfaces and flies (trachoma) Passage through birth canal ( ICN ) Chlamydia trachomatis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
18. Rise in antibody titre Complement fixation indirect immunofluorescence Tetracycline Doxycycline Erythromycin (less efficient) Psittacosis Inhalation of dust with secretions or feces from birds (e.g. parrots) Chlamydophila psittaci Mouse inoculation detects toxin from food, intestinal contents or serum Culture in standard aerobic culture Proper food preservation techniques Antitoxin (horse antiserum ) Botulism Spores from soil and aquatic sediments contaminating vegetables, meat and fish Clostridium botulinum laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
19. ELISA for Toxin ELISA for toxin A or B Endoscopy for pseudomembrane None Discontinuing predisposing antibiotic Fluid and electrolyte replacement Vancomycin or metronidazole if severe Pseudomembranous colitis Spores both indoors and outdoors Human flora , overgrowing when other flora is depleted Clostridium difficile Microscopically Blood agar culture, forming double-zone β - hemolysis Sugar fermentation Organic acid production Appropriate food handling Food poisoning: Self-limiting; Supportive care is sufficient Gas gangrene Acute food poisoning Anaerobic cellulitis Spores in soil Human flora in vagina and GI tract Clostridium perfringens laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
20. (difficult) DPT vaccine Tetanus immune globulin Horse antitoxin, alternatively Sedatives Muscle relaxants Mechanical ventilation Tetanus Spores in soil infecting puncture wounds, severe burns or surgery Clostridium tetani no rapid) Culture on Tinsdale agar , followed by immunologic precipitin reaction DPT vaccine Horse serum antitoxin Erythromycin Penicillin Diphtheria Respiratory droplets Part of human flora Corynebacterium diphtheriae laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
21. Culture in 6.5% NaCl Can hydrolyze esculin in presence of bile No vaccine Hand washing and other nosocomial prevention Penicillin and an aminoglycoside Vancomycin Quinupristin and dalfopristin Nosocomial infections Part of human flora, opportunistic or entering through GI tract or urinary system wounds Enterococcus faecalis and Enterococcus faecium Culture on MacConkey agar and study carbohydrate fermentation patterns: Lactose fermentation (most E. coli strains) . Gas production in glucose fermentation Mannitol fermentation (no vaccine or preventive drug) Food and water preparation Hand washing and disinfection UTI: Co-trimoxazole Fluoroquinolone , e.g. ciprofloxacin Meningitis: Cephalosporin and gentamicin combination Diarrhea: Antibiotics above shorten duration Electrolyte and fluid replacement Urinary tract infections (UTI) Diarrhea Meningitis in infants Part of gut flora , spreading extraintestinally or proliferating in the GI tract Escherichia coli (generally) laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
22. rarely cultured) Serology Avoiding insect vectors Precautions when handling wild animals or animal products Streptomycin Gentamicin Tularemia vector -borne by anthropods Infected wild or domestic animals, birds or house pets Francisella tularensis Culture on chocolate agar with hemin (factor X) and NAD+ (factor V) Quellung reaction Immunofluorescence staining of capsule Detection of capsular antigen in CSF or other body fluids Hib vaccine to infants Rifampin prophylactically Meningitis: (resistance-tests are required first) Third generation cephalosporin , e.g. cefotaxime or ceftriaxone Ampicillin and sulbactam combination Bacterial meningitis Upper respiratory tract infections Pneumonia , bronchitis Droplet contact Human flora of e.g. upper respiratory tract Haemophilus influenzae laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
23. Microscopically Corkscrew movement Urease -positivity by radioactively labeled urea Serology by ELISA (No vaccine or preventive drug) Tetracycline , metronidazole and bismuth salt combination Peptic ulcer Risk factor for gastric carcinoma and gastric B-cell lymphoma Colonizing stomach Unclear person-to-person transmission Helicobacter pylori Culture from respiratory secretions on buffered charcoal yeast extract enriched with L- cysteine , iron and α - ketoglutarate Serology, including direct immunofluorescence and radioimmunoassay for antigen in urine Hybridization to ribosomal RNA using DNA probe (no vaccine or preventive drug) Heating water Macrolides , e.g. erythromycin or azithromycin Fluoroquinolones Legionnaire's Disease Pontiac fever Droplet contact, from e.g. cooling towers , humidifiers , air conditioners and water distribution systems Legionella pneumophila laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
24. Dark-field microscopy on fresh blood smear (but doesn't stain well) Serologic agglutionation tests (no vaccine) Doxycycline Prevention of exposure Rodent control Penicillin G Tetracycline , e.g. doxycycline Leptospirosis Food and water contaminated by e.g. urine from wild or domestic animals. Leptospira survives for weeks in stagnant water Leptospira interrogans Isolation from e.g. blood and CSF Beta- hemolysis and catalase production on blood agar Microscopy for morphology and motility (no vaccine) Proper food preparation and handling Ampicillin Co-trimoxazole Listeriosis Dairy products, ground meats, poultry Vertical to newborn or fetus Listeria monocytogenes laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
25. Tuberculoid form: Hard to isolate (diagnosis on clinical findings and histology of biopsies) Lepromatous form: Acid-fast staining from e.g. skin scrapings BCG vaccine shows some effects Tuberculoid form: Dapsone and rifampin Lepromatous form: Clofazimine Leprosy (Hansen's disease) Prolonged human-human contact, e.g. through exudates from skin lesions to abrasion of other person Mycobacterium leprae Ziehl-Neelsen stain showing acid-fast bacteria Hybridization probes for DNA, succeeded by PCR Culture on Lowenstein-Jensen agar BCG vaccine Isoniazid Standard "short" course: First 2 months, combination: Isoniazid Rifampicin Pyrazinamide Ethambutol Further 4 months, combination: Isoniazid Rifampicin Tuberculosis Droplet contact Mycobacterium tuberculosis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
26. (difficult to culture) Serologic tests, e.g. complement fixation test DNA probes on sputum specimens Doxycycline and erythromycin Mycoplasma pneumonia Human flora Droplet contact Mycoplasma pneumoniae Microscopy showing gram-negative diplococci, often with PMNs Culture on chocolate agar , giving positive oxidase test and fermentation of glucose and maltose in 5% CO2 in air NmVac4-A/C/Y/W-135 vaccine Rifampin Penicillin G Cefotaxime Ceftriaxone Meningococcal disease including meningitis Waterhouse-Friderichsen syndrome Respiratory droplets Neisseria meningitidis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
27. Colourless colonies on MacConkey agar . Production of pyocyanine and fluorescein Positive oxidase test . No lactose fermentation. (no vaccine) Topical silver sulfadiazine for burn wounds Aminoglycoside and anti-pseudomonal β - lactam Pseudomonas infection Localized to eye, ear, skin, urinary, respiratory or gastrointestinal tract or CNS, or systemic with bacteremia, secondary pneumonia bone and joint infections, endocarditis, skin, soft tissue or CNS infections. Infects damaged tissues or people with reduced immunity Pseudomonas aeruginosa Serology Immunofluorescence against Rickettsia antigens no preventive drug or approved vaccine) Vector control, such as clothing Prompt removal of attached ticks Doxycycline Chloramphenicol Rocky mountain spotted fever Bite of infected wood or dog tick Rickettsia rickettsii laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
28. Isolation from blood, feces, bone marrow, urine or rose spots on skin Colorless, non-lactose fermenting colonies on MacConkey agar Serology for antibodies against O antigen Ty21a and ViCPS vaccines Hygiene and food preparation Ceftriaxone Fluoroquinolones , e.g. ciprofloxacin Typhoid fever type salmonellosis (dysentery, colitis) Human-human Fecal-oral through food or water Salmonella typhi Colourless colonies on MacConkey agar (No vaccine or preventive drug) Proper sewage disposal Food preparation Good personal hygiene Fluid and electrolyte replacement for severe diarrhea Antibiotics (in immunocompromised to prevent systemic spread) Salmonellosis with gastroenteritis and enterocolitis Fecal-oral Food contaminated by fowl (e.g. eggs), pets and other animals Salmonella typhimurium laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
29. Culture on Hektoen agar or other media for intestinal pathogens Protection of water and food supplies Vaccines are in trial stage Ciprofloxacin or azithromycin Bacillary dysentery / Shigellosis Fecal-oral Flies Contaminated food or water Shigella sonnei Microscopy showing strongly positive Gram stained cells in grape-like clusters Positive Catalase test and coagulase test Culture on enriched media producing deep yellow, hemolytic colonies (no vaccine or preventive drug) Barrier precautions, washing hands and fomite disinfection in hospitals Incision and drainage of localized lesions Nafcillin and oxacillin Vancomycin for Methicillin -resistant (MRSA) Coagulase-positive staphylococcal infections : Localized skin infections Diffuse skin infection ( Impetigo ) Deep, localized infections Acute infective endocarditis Septicemia Necrotizing pneumonia Toxinoses Toxic shock syndrome Staphylococcal food poisoning Human flora on mucosae in e.g. anterior nares and vagina, entering through wound Staphylococcus aureus laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
30. Microscopy showing strongly positive Gram stained cells in grape-like clusters Positive Catalase test but negative coagulase test Novobiocin -sensitivity (S. epidermidis) Novobiocin -resistance (S. saprophyticus) Culture on enriched media producing white, nonhemolytic colonies None Vancomycin Infections of implanted prostheses , e.g. heart valves and catheters Human flora in skin and anterior nares Staphylococcus epidermidis Microscopy showing gram-positive , encapsulated lancet-shaped diplococci α - hemolysis on blood agar, bile-soluble, optochin-sensitive Positive Quellung reaction 23-serotype vaccine for adults ( PPV ) Heptavalent conjugated vaccine for children ( PCV ) Penicillin G Vancomycin for resistant strains Acute bacterial pneumonia & meningitis in adults Otitis media and sinusitis in children Respiratory droplets Often human flora in nasopharynx (spreading in immunocompromised) Streptococcus pneumoniae laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
31. Culture on sheep blood agar forming small, opalescent surrounded by large zone of β - hemolysis Serology for ASO Very bacitracin -sensitive No vaccine Rapid antibiotic treatment helps prevent rheumatic fever Penicillin G Macrolide , e.g. clarithromycin or azithromycin in penicillin allergy Drainage and debridement for Necrotizing fasciitis Streptococcal pharyngitis Scarlet fever Rheumatic fever Impetigo and erysipelas Puerperal fever Necrotizing fasciitis Respiratory droplets Direct physical contact with impetigo lesions Streptococcus pyogenes Culture on blood or MacConkey agar , enhanced by TCBS Positive oxidase test Preventing fecal contamination of water supplies and food Adequate food preparation Fluid and electrolyte replacement e.g. doxycycline to shorten duration Cholera Contaminated water and food, especially raw seafood Vibrio cholerae laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
32. Gram-negative smear If pneumonic, culture from aspirate on MacConkey or blood agar Formalin-killed plague vaccine Minimize exposure to rodents and fleas Streptomycin primarily Gentamicin Tetracyclin Supportive therapy for shock Plague : Bubonic plague Pneumonic plague Fleas from animals Ingestion of animal tissues Respiratory droplets Yersinia pestis laboratory diagnosis Prevention Treatment Diseases Transmission Species Species of human pathogenic bacteria
33. nucleus icosahedral non-enveloped adenovirus dsDNA Adenoviridae icosahedral non-enveloped coxsackievirus , hepatitis A virus , poliovirus , rhinovirus + ssRNA Picornaviridae nucleus enveloped Herpes simplex, type 1 , Herpes simplex, type 2 , Varicella -zoster virus , Epstein- barr virus , Human cytomegalovirus , Human herpesvirus , type 8 dsDNA Herpesviridae nucleus icosahedral enveloped Hepatitis B virus dsDNA and ssDNA Hepadnaviridae icosahedral enveloped Hepatitis C virus , yellow fever virus , dengue virus , West Nile virus + ssRNA Flaviviridae enveloped Human immunodeficiency virus (HIV) + ssRNA Retroviridae Replication site Virion shape envelopment Important species Baltimore group Family Comparison table of clinically important virus families and species
34. nucleus spherical enveloped Influenza virus - ssRNA Orthomyxoviridae spherical enveloped Measles virus , Mumps virus , Parainfluenza virus , Respiratory syncytial virus , Human metapneumovirus - ssRNA Paramyxoviridae nucleus icosahedral non-enveloped Human papillomavirus dsDNA Papillomaviridae helical, bullet shaped enveloped Rabies virus - ssRNA Rhabdoviridae icosahedral enveloped Rubella virus + ssRNA Togaviridae icosahedral enveloped Human bocavirus , Parvovirus B19 ssDNA Parvoviridae Replication site Virion shape envelopment Important species Baltimore group Family Comparison table of clinically important virus families and species
35. The clinical characteristics of viruses may differ substantially among species within the same family: Cell culture, antibody detection None None Coxsackie infections fecal-oral, droplet contact Picornaviridae Coxsackievirus virus neutralization hemagglutination assay ELISA None None acute febrile pharyngitis pharyngoconjunctival fever epidemic keratoconjunctivitis infantile gastroenteritis droplet contact (mainly) fecal-oral venereal direct contact (ocular infections) adenoviridae adenovirus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
37. The clinical characteristics of viruses may differ substantially among species within the same family: immunofluorescence immunoperoxidase nucleic acid detection None acyclovir famciclovir foscarnet penciclovir primary HSV-1 infection ( gingivostomatitis in children, tonsillitis & pharyngitis in adults, keratoconjunctivitis ) latent HSV-1 infection ( herpes labialis , cold sores ) direct contact with saliva and lesions Herpesviridae Herpes simplex virus , type 1 antibody detection nucleic acid detection None Pegylated interferon alfa-2 Ribavirin acute hepatitis chronic hepatitis hepatic cirrhosis hepatocellular carcinoma blood (sexual) Flaviviridae Hepatitis C virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
38. The clinical characteristics of viruses may differ substantially among species within the same family: antibody and nucleic acid detection None ganciclovir cidofovir foscarnet infectious mononucleosis Cytomegalic inclusion disease tears urine semen saliva vaginal secretions mother's milk crosses placenta blood Herpesviridae cytomegalovirus cell culture immunofluorescence immunoperoxidase nucleic acid detection contact-avoidance with lesions safe sex acyclovir famciclovir foscarnet penciclovir cidofovir primary HSV-2 infection latent HSV-2 infection aseptic meningitis sexually birth Herpesviridae Herpes simplex virus , type 2 laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
39. The clinical characteristics of viruses may differ substantially among species within the same family: nucleic acid, p24 antibody detection zidovudine (perinatally) blood product screening safe sex HAART AIDS sexual blood mother's milk Retroviridae HIV Nucleic acid and antibody detection None many in evaluation-stage Kaposi sarcoma multicentric Castleman disease primary effusion lymphoma Herpesviridae Human herpesvirus , type 8 laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
40. The clinical characteristics of viruses may differ substantially among species within the same family: antibody detection MMR vaccine None measles postinfectious encephalomyelitis droplet contact Paramyxoviridae measles virus Hemagglutination assay antigen detection Influenza vaccine amantadine rimantadine amantadine rimantadine zanamivir oseltamivir influenza ( Reye syndrome ) droplet contact Orthomyxoviridae Influenza virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
41. The clinical characteristics of viruses may differ substantially among species within the same family: Visual inspection Antigen detection Nucleic acid detection HPV vaccine wart tissue avoidance safe sex liquid nitrogen laser vaporization cytotoxic chemicals interferon cidofovir direct contact hyperplastic epithelial lesions ( common , flat , plantar and anogenital warts , laryngeal papillomas , epidermodysplasia verruciformis ) 55+ (hands/ feet) 30+ (anogenital/ some are oral/ throat/ respiratory) Malignancies for some species ( cervical carcinoma , squamous cell carcinomas ) direct contact Papillomaviridae Human papillomavirus antibody detection MMR vaccine None Mumps droplet contact Paramyxoviridae Mumps virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
42. The clinical characteristics of viruses may differ substantially among species within the same family: antibody detection MMR vaccine None measles postinfectious encephalomyelitis droplet contact Paramyxoviridae measles virus Hemagglutination assay antigen detection Influenza vaccine amantadine rimantadine amantadine rimantadine zanamivir oseltamivir influenza ( Reye syndrome ) droplet contact Orthomyxoviridae Influenza virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
43. The clinical characteristics of viruses may differ substantially among species within the same family: Antibody detection None None croup pneumonia bronchiolitis common cold droplet contact Paramyxoviridae Parainfluenza virus Antibody detection None None croup pneumonia bronchiolitis common cold droplet contact Paramyxoviridae Parainfluenza virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
44. The clinical characteristics of viruses may differ substantially among species within the same family: Histology (postmortem) Pre- and postexposure prophylaxis Post-exposure prophylaxis Rabies Animal bite droplet contact Rhabdoviridae Rabies virus Antibody detection Polio vaccine None Poliomyelitis fecal-oral Picornaviridae Poliovirus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
45. The clinical characteristics of viruses may differ substantially among species within the same family: Antibody detection MMR vaccine None German measles congenital rubella droplet contact Togaviridae Rubella virus antibody and antigen detection hand-washing avoidance palivizumab in high risk individuals ( ribavirin ) bronchiolitis pneumonia influenza-like syndrome severe bronchiolitis with pneumonia droplet contact, hand-to-mouth Paramyxoviridae Respiratory syncytial virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
46. The clinical characteristics of viruses may differ substantially among species within the same family: Cell culture antigen and nucleic acid detection Varicella vaccine varicella-zoster immuneglobulin Varicella: acyclovir famciclovir valacyclovir Zoster: acyclovir famciclovir Varicella herpes zoster droplet contact Herpesvirida Varicella-zoster virus laboratory diagnosis Prevention Treatment Diseases Transmission Family Type
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58. Categorization Ascariasis , dracunculiasis , elephantiasis , enterobiasis (pinworm) , filariasis , hookworm , onchocerciasis , trichinosis , trichuriasis (whipworm) Schistosomiasis , swimmer's itch Tapeworm infection Example diseases in humans Lips, teeth, filariform extremities, and dentary plates Oral sucker and ventral sucker or acetabulum Sucker or bothridia, and rostellum with hooks Attachment organs Cylindrical Unsegmented plane Segmented plane Shape Nematodes (roundworms) Trematodes (flukes) Cestodes (tapeworms)