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Trematodes, also known as flukes, are a group of flatworms that can cause human disease worldwide affecting millions of people from tropical areas. They have complex life cycles that involve snails as intermediate hosts. They can be divided, depending on their mode of transmission, as bloodborne flukes (Schistosoma species); foodborne flukes, which include liver or hepatobiliary flukes (Clonorchis sinensis, Opisthorchis felineus, Opisthorchis viverrini, Fasciola hepatica, and Fasciola gigantica); lung flukes (Paragonimus species); and intestinal flukes (several species). The life cycles are specific for each type of bloodborne and foodborne fluke. The clinical manifestations depend on the fluke’s systemic, visceral, or local tropism (Table 330-1).


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