PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. HOSTINT 2 NDIN
T HOS
T
PATHOLOGY MOT PHIL Tx
Trichuris
trichiura Whipworm
Barrel-S, 2 plugs unembryo M – curved 360 F – blunt; stichocytes Embryonated Egg in soil/feces embryonated in soil DFS Unembryo
eggs in feces LI, Whipinserted into wall no migration phase to lungs -Prolapse of Anus -IDA, Alb, D -Sometimes appendicitis -symptoms due to unique mode of attachment F-O-R (fecal-oral route) Yup 80-90% warm, tropical regions Albendazol e Mebendazo le Oxantel-Pyrantel Enterobius Vermiculari s Seat Wor m Pin worm D-shape, football spindle-S, cephalic ala, corpus, isthmus, bulb M – curved tail F – pointd tail
Embryonated ova Scotch tape Swab Embryonated Eggs Ileum of SI, Cecum,LI man Gravid female Migrates to Perianal area 1) site - ulceration 2) eggs - prupritus 3) migration -vulvuvag & salphingitis H-M (hand-mouth) inhalation Retro infection Yup (F>M) Mebendazole Pyrantel pamoate Trichinella Spiralis larva – w/ spearlike burrowing tip thread-like ; F – blunt; M – curved w/ 2 lobular appendages; A-end- non-papillated Encysted larvae in
Inad cooked pork
Tissue biopsy Xenodiagnosis Bachman Intradermal test
Muscle tissue
of man, pigs -Rheumatic pain(intestinal flu) - M eosin -swollen eyelids -3 stages of inf: intest,larval,encap -Stage of conval - death due to Myocard or enceph Ingestion of encysted larvae in pork yup Thiabendaz ole Corticoster oid (for allergic rxn) Mebendazo le? Ref (5F 20d, 20F10d, 20F 6d) Capillaria Philippinen sis
peanut shape embryonated eggs in F typical F – 8 in 1 row atypical F – 40 in 2 M – w/ chitin spicule
Larva in raw fish Eggs embryonate in Fresh water DFS -eggs (E) -larva (L) -adults (A) SI (jejunum ) of fish, man larvae in gastric mucosa and intestines -int mal-ab -Borborygmi -Ab Pain -Diarrhea -Villus flat -Atrophy COL -death Ingestion Of larva In raw fish Yup (M>F) I. Norte (N.Luzo n) THA,JP N, EGY,TAI , IRAN Mebendazo le Albendazol e Ascaris Lumbricoid es Most common Intestinal nematode Giant Roun d Wor m Decorticated, Unembryo egg tri-radiate xs F-3 lips; M–2 spicules Embryonated Egg larvae, corticated DFS of eggs Adults in SI Gall bladder, Liver, nares, appendix SI of man (not attach) Liver-lung Migration (larv swallowed)
Lung mig –Asthma; Capil penetration –Pneumonia; Ab Pain due to adult Migration; Int Obst; eosin Ingestion Burrowing of Sin of foot Yup Most Commo n In world Peperazine Citrate Albendazol e Mebendzao le Pyrantel Pam Ancyclosto ma Duodenale Old Worl d Hook worm teeth 3rd stage filariform DFSEIA -ELA SI Lung migration
Ground itch; <500 eggs in feces = light worm, >500 eggs = heavy worm; Hookworm anemia due to suction Oral percutane ous Yes Tropics, subT Pyrantel Pamoate Mebendazo le
8-cell stage
pointed tail, short esophagus
of blood/ bleeding
Microcytic Hypochromic Iron replacemen
t Necator Americanu s New Worl d Hook worm cutting plates DFS EIA -ELA Skin Penetratio n Strongyloid es Stercoralis Thre ad Wor m filarifo rm; no F M Long eso, Prominent Genital primordium, notched tail 3rd stage
filariform Rhab in stool
short buc cav
SI man; Lung Migr aftr skin Penet; repro parthogenesis Eggs hatch SI
Larval migration – Lobular pneu w/ hem; like PUD, Hyper Infection, Peripheral Eosinophilia, malab syndrome - Skin Penetratio n of FL - Free-living - auto infection Yes Tropics, SubT Albendazol e Thiabendaz ole PARASITE A.K.A. EG
G ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST
2ND INT
HOST PATHOLOGY MOT PHIL Tx
Brugia
Malayi kinky, overlapping
nuclei, nuclei reach tail end (terminal, subterminal n.) giemsa – sheath unstained
Larvae In Arthropod Vector Bites at Night Enters Bite wound Bioincub - 1 year Blood smear (thick And Knott Conc) Microfilaria In blood at Night CARD Test – Antigen det DNA probes Lymphatic s Bloodstrea m Peripheral Blood mosquito s W.B. – Culex Quinque Fasciatus Rural-Anoph; Urban-Fatigans; Pacific-aedes Acute – Hypersensitizatn Chronic – (poor prog), elephantiasis (blocks lymphs) Weingarten’s Syndrome – Hyper-eosin of Peripheral blood Skin Larva Enter bite wound Mosquit o Bites at night Yup Warm regions Diethylcarbama zine (not effective on adult worms) Ivermectin corticosteroids supportive – pressure bandaging surgery Wuchereria
Bancrofti smooth, single row of
nuclei, no term nuc, >L than BM giemsa – pink stain Loa Loa shedding of sheath, Larvae crawl into wound Thin blood Smear biopsy Subcutane ous tissue Vector- Dipteran (chrysops ) Calabar swelling Adult in eye hypersensitivity Skin Larva Enter bite wound No Africa Diethylcarbama zine Corticosteroids surgery Dracunculus
Medinensis FierySerpen t Israelit es Guinea worm
larva migrates to lower ext.
Larvae in
copepods Local lesionWorm/Larva e Calcifiqed Worms by x-ray Mesenteric Tissues Larva migrate To lower ext Copepod s Ingest Larva in water Blister w/ Serous exudates Pseudoperitoneal syndromes Ingestio n Of Infectiv e copepo ds NO Middle East, Africa Metronidazole Thiabendazole Oncocerca
Volvulus Larvae Crawl into
Bite wound Biopsy Mazzotti Slit lamp Subcutane ous tissue
Vector-Black fly -River Blindness-Eye lesions - Skin lesions - Scrotum enlargement Skin Larva Enter bite wound NO Africa C. and S. America Diethylcarbama zine Corticosteriods Surgery
Angiostrong ylus Cantonensis Rat Lung worm adult emale
“Barber pole” dark red intestinal tract 3rd stage larva in snails and slugs or rats ingested by man snails – paratenic hosts History -eating, travel leukocytosi s & eosinophilia Skin test needs evaluation Brain Spinal cord Man- Accidental hosts Mollusks, Snails: Achantin a, Pila Planaria, Slugs, prawns Eosinophilic Meningoencephali tis + eosins in CSF, CN involve, diplopia and strabismus CSF >= 500 cells/ml w/ 10-90% eosins Ingestio n Of larva In snails NO TAI, THAI, CAM, VIET, Hawaii, Tahiti None recommended Dead parasite Could exacerbate Tissue reaction Surgical if ncessary Angiostrong ylus costaricensis 3rd stage larva in snails/ slugs ingested by man nd cotton rat (Sigmodon hispidus) Intestines
(gut wall) Mollusks Snails, slugs “acute abdomen” - inflamm of ileocecal region; Ab pain loc to
right lower quad + palpable tumor-like m Anisakis Herrin g diseas e Terranova sp – juveniles Pseudoterranova sp – not penetrate Eustrongylides sp – perforates large bowel 3rd stage larva in flesh of raw fish; larva migrate from viscera to muscle after death of fish Edoscopy Immunologi c Tests under Study Marine Crustace ans And fish Pseudoterranova spp –
Not penetr8 stom, Throat irrit, coughed Ingestio n Of raw Marine Food w/ Alcohol, “green” herring, sashimi NO JPN, Netherlan ds Remove larvae By biopsy Forceps Surgical Intervention For obstruction Manage conservatively Anisakis simplex (USA)
Stom, int, inflamm Rxn surrounding larva Anisakiasis – local Tissue response; (Eustrongylides spp) Perforation of L bowel
PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST
2ND INT
HOST PATHOLOGY MOT PHIL Tx
Schistoso ma Hematobiu m
Platy-helminthes terminal spine
S. Japonicum
in copula, males have gynecophoric canals Free-swimming Cercaria Eggs, miracidia in urine Adults - Bladder, liver larva – Venous Plexuses Bulinus Snail (Miracidia to cercaria)
Calcified Bladder (dead eggs= “sandy patches”); Painful urination;
Kala-azar; adults coated w/ RBC An and not detected; trapped egg cause clinical symptoms; Terminal Hematuria; infection
linked
To S. typhi and paratyphi carriers
Skin Penetrati on Thru Infected water Wala Siguro… Tropics Subtropi cs Praziquant rel Schistoso ma Mansoni Platy-helminthes lateral spine Free-swimming Cercaria Ova in feces (blood, mucus) Rectal biopsy Liver Mesenteric venules, SC, lungs Biomphalari a Snail Claypipe-stem Fibrosis = Thickening of portal vessels due to
rxn w/ eggs; Hepatosplenomegaly Portal HTN, ascites, eggs
sometimes Deposited in SC, lungs liver enzy,serum alb,
glob(prot) Cercaria Penetrate Skin thru Infected water Nope Africa Brazil Praziquant rel Schistoso ma Japonicum Platy-Cercaria Ova in feces, Rectal biopsy, COPT test, Liver, Mesenteric Venules, SI, heart, Spleen, Oncomelani a
Katayama rxn/ fever, reaction to Eggs in tissue = CNS damage, Hepatosplenomegaly, Portal HTN,
Ascites; mucus/blood in feces, liver enzy,serum alb,
Cercaria Penetrate Skin thru Infected water Yup Mindana o, Visayas Praziquant rel
helminthes lateral knob
(smallest) ELISA CNS Quadrasi, Formosa glob(prot)
Schistoso ma Intercalatu m
Like Schistosoma Mansoni in terms of life cycle, pathology and clinical features Intermediate host – Biomphalaria snail
Schistoso ma Mekongi
Lide Schistosoma Japonicum in terms of life cycle, pathology and clinical features Intermediate host – Lithoglyphopsis aperta
Fasciola Hepatica Fasciolidae Sheep Liver Fluke “popping operculum”
leaf S, w/ shoulders cephalic cone, spinous, dendritic testes Metacerca ria Encysted On aquatic vegetation Unembryo ova in feces, duodenal aspirates Bile duct of Sheep Herbivore animals Snails-Lymnea Philippinens is, Lymnea swinhoe (TAI) (sporocyst- redia-cercaria) Aquatic
vegetation Halzoun – ingestionRaw sheep, goat livers
(dyspnea, deafness, asphyxiation, death) fibrotic vs.
traumatic/
necrotic lesions; obs; False vs true (no eggs) Ingestion of Infected Vegetatio n; Infected Liver (false) Cosmo In sheep Raising countrie s Bithionol Fasciola Gigantica Fasciolidae Giant Liver Fluke Larger than F. hepatica no shoulders Metacerca ria Encysted On aquatic vegetation Unembryo
ova Giant Animals- Cattle Biliary tract (BT) Snail Aquatic vegetation Ingestion of Infected Vegetatio n Most Probably Africa, Asia Bithionol Clonorchis Sinensis Opistorchi dae Chine se Liver Fluke branched testes; spatulate Metacerca ria Encysted On Fresh Water fish Embryo ova In feces or Biliary duodenal aspiratesB DA Man BT Operculate Snails (Alocinma, Parafossarul us, Bithynia) Fresh water Fish (FWF) : Cyprinidae, Ctenopha-ryngodon Cholangiocarcinoma of
liver, liver function Impaired but SGPT and
SGOT are normal
Ingestion of Uncooke d fish Rare CHI, JPN, SK, Vietnam Chloroquin e Diphospha te Praziquant el Opistorchis Felineus Opistorchi dae Cat Liver Fluke lancet S reddish-bile color Metacerca ria Encysted On fresh Water fish Embryo ova In feces or BDA Small Animals-Cats, dogs, etc (BT SI) Snails - Bithynia Funiculate FWF Cyprinus Carpio (Taiwan) Periportal fibrosis, Invasion of pancreas, Form bile stones
Ingestion of Infective fish Nope USSR, poland Praziquant el Opistorchis Viverrini Opistorchi
dae knob at abopercular
end
lobed testes like O. felineus
Metacerca
ria Embryo ova In feces Or BDA Civet cat, Dog, fish-eating Snails - Bithynia Goniomphal us, Funiculate, laevis FWF Punteus Orphoides, Hampala dispar Hyperplastic biliary Epithelium (Stim by Nitrosamines); assos. w/ cholangiocarcinoma Ingestion of Infective fish Nope Thailand Udorn Praziquant el Dicrocoeliu m Dendriticu m Dicrocoelli dae Lance t fluke deep golden-brown 2 large testes lancet, flat, transparent, aspiny Metacerca
ria Embryo ova w/ fully dev miracidiu m sheep Snails- Abida, Cochilcopa, Helicella, Zeb Formica Fusca (ants) Same as F. hepatica Portal cirrhosis, Periductal fibrosis Ingestion of ants Wala siguro Praziquantel
PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST
2ND INT
Paragonim us Westerma ni Oriental Lung Fluke operculum at broad end, thick aboper branched
testes side by side; coffee bean; integument w/ spines Metacercari a In crustacean Cercaria w/ spines Unembryo eggs in feces or sputum compleme nt fixation Encapsulate d in Parenchyma of lung; in fibrotic capsules Reservoir – Cats & dogs
Snail -Miracidia (M) Cercaria (C) Antemelania Asperta; Antemelania Dactylus Crabs – Sundathelph usa Philippina C meta-C Granulomato us rxn in lungs; rust-colored sputum, w/ Foul fish Odor Misdiagnosed For PTB Ingestion Of Infected crustacea ns Yes Asia Praziquantel Bithionol Triclabendaz ole Fasciolopsi s Buski indistinguish from F. hep, F. gigantica 2 dendritic testes in tandem Metacercari a In water Plants MC are Sensitive to Dryness Unmebryo Eggs in feces Duodenum of Man or pigs Snails – M C Segmentina, Hippeutis Aquatic Vegetation C meta-C Water caltrop, Water chestnut, Water morning Glory, lotus Worms cause Traumatic, Obstructive and toxic effects; ulceration and mucus prod. Ingestion Of Infected Water Plants Nope SEA, CHN, India, indonesi a Praziquantel Heterophy es Heterophy es H. M. eggs no aboper protub; same hard to distinguish adults; scale-like spines, w/ genital sucker, globular testes Metacercari a In fish Miracidium present in The egg once Deposited by adult Unembryo Eggs in stool Using Kato-Katz method Small Intestines Reservoir – Fish eating mammals Snails : Freshwater, Brackish or Marine M C Many fish in the Phil. (30 Species); in muscles at base of the fin C meta-C Inflamm, Sloughing off Of layers, xs Mucus prod Misdiagnosed For acid Peptic ds (APD), consistent w/ PUD Ingestion of MC Encysted in fish Yes EGY, Greece, CHN, JPN, KOR, TWN, Phil Praziquantel Metagonim us yokogawai Echinosto ma Ilocanum indisting.from fasciolas
oral sucker with collar of
spines; 2 lobed testes in tandem, reddish-grey Metacercari a No sporocyst stage Unembryo Eggs in feces Small Intestines Reservoir-rats Snails: -Gyralus Convexluscu lus -Hippeutis Umbilicalis M C Snails: -Pila luzonica “kuhol” and -Vivipara Angularis“su so” C meta-C Inflamm, Ulceration, Diarrhea, intoxiacation Ingestion Of encysted MC in snails Of course N. Luzon, Samar, Leyte, Mindana o Praziquantel Taenia
Solium PorkTapewor m indistinguish from each other and from E. granulosus; hexacanth (6 hooklets); radially striated shell rostellum w/ hooks 4 suckers; ripe proglottid <13 lateral branches; 3m Cysticercou s Cellulosae eggs – cause cysticercosi s Ripe or gravid Proglottid formaldeh yde soln Scolex after therapy Small intestines of man cysticercosis in muscles Hogs, wild Boars, sheep, Deer, dogs, Monkeys, rats, cats eggs cysticercous cellulosae Inflamm, Eosinophilia, leukopenia Dev Cisticercosis (ingestion of eggs), larva in brain, muscle, eye Ingestesti on Of inadeq. Cooked Pork Accidenta l Ingestion of eggs yes cosmo Praziquantel Taenia Saginata Longest Tapeworm Beef tapewor m no rostellum, hooklets ripe >15 branches; 5m; Cysticercou s bovis Ripe or gravid Proglottid Scolex after therapy Man SI
(accidental) Cattle, llama, Giraffe, Carabao eggs cysticercous bovis Epigastric Pain, vertigo, Nervousness, eosinophilia Ingestion Of cysts in beef Niclosamide -damage to point of dissolution
tree-like dicho branching Echinococc us Granulosus smallest Tapeworm In man Parasite Of dog
one long gravid proglottid Eggs – man Hydatid sand dogs x-ray to detect hydatid ds; immunolog ic tests SI of Dog -Cysts Ingested and Release scolices Sheep, man (accidental, intermediat e– in liver and lungs) Obstruction – Growing cysts; Anaphylactic Shock when Cyst ruptures FOR Ingestion Of eggs in feces rare Sugery Prev spillage of eggs) Albendazole
PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST 2
ND INT
HOST PATHOLOGY MOT PHIL Tx
Diphyllobothri um Latum Fish/ Broad t-worm yellow-brown knob like
thickening spatulate, rosette uterus 2 bothria = sucking grooves Plerocercoi d Larva Encyted In fish Operculated Eggs; Proglottids Kato tech SI in man Reservoir Host: Dogs, cats,Bears Paratenic host: Carnivore fish copepods (Cyclops & Diaptomus) Coracidia (CO) Procercoid (ProC) (fish) perch, trout, salmon, pike ProC PleroC Anemia (misdiag for pernicious type Vit B12 def); hyperchromic megaloblastic ; examine for HCl in gastric juice (+ infection) Ingesti on Rare Only 7 cases tempera te zone Praziquan tel Dipylidium
Caninum DogT-worm Double Pored
T-worm egg packets (8-15 eggs) oncosphere w/ 6 hooklets retractile, conical scolex; rose-thorn shape hooklets mature proglottid – with 2 lateral genital pores Cysticercoi d Larva in Arthropod Host when ingested Gravid Proglottids That are passed out/ Crawl out, Egg packets, Melon-shaped Proglottids in Chains (Not stool bec proGlot disint in environment SI of dog or
cat Ctenocephalides
canis (dog
flea)
Ctenocephali des
felis (cat flea) Pulex irritans (human flea) Trichodectes canis (dog louse) Minimal
symptoms Ingestion yup Praziquantel
Hymenolepsis
Nana Dwarft-worm
with
filaments like D. caninum scolex but
with less hooklets; ripe segment Embryo Eggs in Contam food and Water Cyticerci -Can complete Cycle in single Host Embryo Eggs in feces Proglottids not Recovered bec They degenerate
SI of man Insects, rice And flour beetles Enteritis due to Necrosis and Desquamatio n Of intestinal Epithelial cells Direct/indirec t pathways FOR Auto Infectio n yup Praziquan tel
(autoinf) Hymenolepsis
Diminuta Rat T-worm
w/o filaments bile-stained; fan-like gravid segment; rudimentary, unarmed rostellum Cysticercoi d Larvae in insects Eggs in stool (more circular, larger, lack bipolar thickening vs H. nana SI of man Fleas, beetles, cockroaches, mealworms & earwigs Minimal and Non-specific Ingestion Of Infecte d insects yes In rats <8% Praziquan tel Sparganosis Mansoni, Erinacei, Ranarum Spirome tra
mistaken for D. latum; pseudosegmentation w/ slit-like invagination Plerocercoi d In toads, frogs, snakes, paratenic hosts - pigs White larvae
In lesion Adult – Intestines of Cat/man Larvae – any part, eye, subQT, muscles Cyclops,
copepods Frogs, Snakes, Toads, rats Painful edema Due to migrating Larvae Eosinophilia, Edema and erythema Ingesti on Of Infecte d interM hosts
Not sure surgical
PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC HOST
LOC. INT HOS T 2ND INT
HOST PATHOLOGY MOT PHIL Tx
Entamoeba Histolytica Ameba greenish-yellow quadrinucleate, thick, rodlike chromatoidal bodies CB, central karyosome (K), w/ chromatin dots active, progressive, directional; pseudopod PSD: finger-shape, hyaline; w/ ingested RBC Qudri
cysts -TrophozoitesIn liquid stools -Cysts in Formed stools Culture, serology to detect invasive Amebiasis (IHAT) ELISA most Sensitive indicator Large Intestin es (cecal and sigmoid o-rectal) liver in extraint amebia sis Flasklike Primary ulcer; Histo changes: Histolysis, Thrombosis, Petechiae, Round Cell Infiltration, Necrosis Bacilliary vs Amebic dysentery Ingestion Of Infective cysts Yes Most Comm on Are Asymp to carrier s Supportive, Chemotherapy Asympto – Diiodohydroxyqui n Mod severe Metronidazole Severe – D + M Hepatic – M + emetine Naegleria
fowleri No cyst only Flagellated form
Large, usually Central K slug-like; PSD: blunt; Trophozoi te TrophozoitesIn CSF and tissue Flagellate form in CSF Brain Meningoencephalitis Severe frontal Headache,Blocked nose,
Altered taste and smell Kernig’s sign; Leukocytosis w/ neuts, prot, glu EntersThru Nose Penetrate Cribriform Plate Multiply in brain rare all types of soil Amphotericin Amp + miconazole and rifampicin Acanthamo eba
large central K; sluggish; PSD: spine-like
trophozoi
te Cysts and Trophs inTissue Giemsa or PAS of
CNS
cornea Amebic Encephalitis(immunocompromise d) Amebic Keratitis (assoc w/ use of Thru Lower respi Tract or Thru ulcerated, Broken skin Rare All types Of soil Propamidine, Miconazole, neomycin Corneal grafting
double cell wall No peripheral
chrom Scrapings orCornial biopsy contam contact lenses)
Entamoeba coli yellow-brown; 1-8 nuclei, K eccentric; CB : splinter-like sluggish, rarely prog
and dir; PSD: short, blunt; Bacteria/ debris Inclusions Entamoeba
Gingivalis Mod active, progPSD : blunt, hyalin Endolimax nana pale green; 1-4 nuc; K irreg CB : bacilliform sluggish prog; PSD:blunt /hyaline; K – L, cent Iodamoeba butschlii 1 nuc yellow green; K surr w/ granules; endosome slug, prog; PSD : Blunt/Hyaline Entamoeba hartmanii 1-4 nuc; K small/Central; Diffuse glyco mass
non prog; PSD : fingerlike
PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC HOST LOC.
INT
HOST 2
ND INT
HOST PATHOLOGY MOT PHIL Tx
Balantidiu m Coli Largest prot parasite Only ciliate bean-shaped nuc cytostome; cytopyge; cyst DFS of Troph and Cysts in Feces Sigmoidosc opy SI Cysts Troph LI (cecal area) troph Ulcer w/ rounded Base and wide Neck (vs flask shape) Diarrhea and Dysenter (indisting. from Amebic) FOR Ingestion of Contam Food And water Siguro Uncommon In Temperate; Assoc w/ Pigs in tropics Tetracyclin e Metronidaz ole Iodoquinol Giardia
Lamblia “gaybow el syn” young – 2 nuc; mature – 4 nuc; flagella retracted into axonemes pyriform/tear-drop; bi-symm; erratic tumbling motion; 8 flag Quadri
cysts DFS Cysts and Trophs Biopsy, Entero-test, IF and antigen detection SI Duo, jeju, upper il Attaches To int villi Via adhes Disc on ven
Villus flat and crypt Hypertrophy;electroly tes,
glu, fluid abs, disacchs; diarrhea most common symptom (89%); spont recovery in 6 wks; chronic – steato,
diarr altern w/ constip
FOR siguro Outbreaks Are water-borne Oral Metronidaz ole Tinidazole Furozolidon e Quinacrine paromomyc in
Trichomon as vaginalis No cyst stage pyriform; jerky movements; 4 free flag +1 undulating; axos Troph Trophozoite s In urine, Urethral sec, Vaginal sec, Cervical sec, Semen, Prostatic sec Female – Vaginal epi Male – Urethra, Epididymis , Prostate g -Vaginal discharge – Liquid, green to yellow, Irritating -Speculum – Strawberry Cervix (diagnostic) -Vaginitis; urethritis Sexual intercourse Passed thru Birth canal Yes Hostpitality Girls – 24% Other groups - 3-8% Oral Metronidaz ole Acid douches Dientamoe ba Frgilis No known cystic stage rosette-shaped nuclei; no peri chromatin; K w/ 4-6 granules; no flag Troph Binucleate Trophs in fresh Stool samples In lumen
Of LI -Increase excess mucus
-Hypermotility of the bowel
-Colicky ab pain; anal Pruritis; Peripheral eosinophilia
-Mimics IBS (irrit bow syn) Co-infection With E. vermiculari s Siguro …as long as may infection w/ E. vermic -in pre-schools in Germany, Israel, Holland Iodoquinol Tetracyclin e Metronidaz ole Leishmani a Tropica Old Worl d Cut Leis h w/ ovoid or rounded bodies promastigote Pro M in skin tissue biopsy Lives Intracellul ar In Macropha ges PMS and Endothelia l Cells Pro M A-Mast Sand fly Pheobotom us Spp A-Mast Pro M in gut of fly Cutaneous leishmaniasis Lesions resembling Lepromatous leprosy Bite of Sandly vector Wala Africa, India South amercia Antimony Compounds Second line Drugs: Amp B, Pentamidin e (Kala-azar), Metronidaz ole Nifurtimox Leishmani a Donovani amastigote 1 free flagella arising from kinetoplast Bone marrow, Spleen or Lymph nodes Visceral Leishmaniasis or Kala-azar Splenomegaly, presence of Parasites in RE cells; Leishmani a Braziliensi s New Worl d Cut Leis h amastigote Serology – For supportive diagnosis Mucocutaneous or American Leishmaniasis Tapir nose Erosion of pinna of forest workers Trichomon as Tenax
Smaller and longer than
T. vaginalis
Troph swabbing Oral cavity
-tartar Droplets, kissing yes
Chilomasti x Mesnili knob -like prod,
LemonS spiral forW;3 antflag + 1
cysts Cysts in Semi-formed Stools; Trophs in Liquid stools Cecal region Of LI FOR Rare <1%
PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC HOST LOC. HOSTINT 2
ND INT
HOST PATHOLOGY MOT PHIL Tx
Trypanoso
Gambiens
e SleepngSicknes tissuesOr CSF
Serology for Large scale Screening ELISA, IF CSF Host: Domestic Animals and CNS -Chronic inflammation Of lymphatics -Atrophy of dendrons Of ganglion cells -Winterbottom’s sign, Kerandels sign Congenital Transmissio n possible West and Central Africa Pentamidine Suramin Melarsopenol Tryparsamide Melarsen Trypanoso ma Rhodesien se East African Sleepng Sicknes Tsetse Fly Reservor Host: Game animals NO Uh..east Africa? Trypanoso ma Cruzi Chaga’s
Disease Epimastigote Trypomastigote T-mastigote Blood smear Serology – CF Xenodiag biopsy Histiocytes RE cells (adipose, myocardial, RE, Neuroglial) Reduviids, Triatomid Bugs Reservoir: Wild mammals -Engulfed by histocytes
and invade adipose tissue -inflamm response w/ fibrotic encapsulation = chagoma; Romana’s sign -Bite of Vector -feces -transplacent al -accidental ingestion -blood trans No Income Groups In Suburb an rural 8-amino quinolones Primaquine, Nifurtomax (Bayer 2502) Toxoplasm a gondii (man ) bradyzoite, cyst (cat ?) male and female gametocytes pseudocyst and oocyst w/ Sporozoites -Oocyst prod By sexual Cycle in cat; Pseudocyst s-asexual Serology – IgM detection By ELISA; IFA for IgG And IgM; PCR Of Toxo DNA In SI of Cat (sexual And asexual Cycle); in Tissues in Asexual cycle Definitive – CAT Mouse or Rat Man, pigs, Sheep, Accidental Intermedi ate hosts Brain lesions; hepatitis; Chorioretinitis; Lymphadenitis 2 types of postnatal ds
1) mild lymphatic (lide infectious Mononucleosis) 2) acute fulminating Ingestion, Transplacen etal Yes Cosmo Many are Chronic Ill but are asympt o Pyrimethamine (Daraprim), Trisulfapyri-Midines; Preg – spiramycin, Clinamycin; AIDS – Atovaquone Isospora Belli immature cyst Schizont, gametes Inside host Mature oocyst w/ sporozoites Immature Cysts in feces -Oocysts/ Sprorcysts in dudenum SI of man Definitive – MAN Malabsorption syndrome;
Shortened villi, hyper-Trophied crypts, infilt Of lamina propria, w/ Eosins, polys, rounded cells FOR Not sure Pyrimethamine Sulfadiazide or Trimetroprim Pneumocy stis Carinii cysts Surgical open Lung biopsy; BronchoAlL av; Bronchosco py; Methenami ne Silver stain interstitial pneumonia; fatal pneumonia in infants; hypogammaglobuline mia, leukemia, Hodgkin’s, etc
-lungs are gray and airless;
death due to asphyxia
Droplets, Close contact Yes cosmo Bactrim
GAMETE SCHIZONT TROPHOZOITE
Plasmodiu m Falciparum Mosquito – Gametocyt es; Man – Sporozoites Hypnoxoite – Latent stage, Cause relapse Peripheral Blood smears -thick -thin QBC, Para sight F test (dipstick test), IFA RBC (Man) Vivax – young Malariae – old Falciparum –all Mosquito : 1)Stomach – Gamete Anopheles Flavirostri s Minimus Anopheles -litoralis -balabacen sis
--Tissue anoxia – basic pathophysio change in malaria -4 mechanisms leading to tissue anox: 1. anemia-hemolysis 2. changes in
blood flow 3. changes in capillary
endothelium 4. histotoxic shock
-parasite virulence factors:
Bite of female Mosquito Passage of Blood w/ Erythrocytic Parasite by: -blood trans -contam syringe -neonatal Yes Malaria Free areas -manila -aklan -capiz -guimara -siquijor -biliran
Vivax and Ova – Chloroquine + Primaquine Falci and Mal -Chloroquine Chloroquine Resistant – Falc Plasmodiu m Vivax Plasmodiu m Malariae
Sporogany – Mosquito LC; Schizogony – Human LC - exoerythro (merozoites ) - erythro (gametocyt es) form, 2)Stomach wall – oocyst and sporozoite release 3)salivary glands - sporo mangyanu s -maculates 1. multiplication capacity 2. red cell selectivity 3. cytoadherence and
resetting ability 4. potential to
induce cytokine release 5. antigenicity
6. antimalarial drug resistance
Blackwater fever, liver dys, hypogly,
Acidosis, GI dys, placenta dys, pulmo
edema, renal failure, coagulo and thrombocyto, coma -congenital -iloilo -leyte N -leyte S -N Samar -Camiqui n -Cebu -Catand. Plasmodiu m Ovale
