PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. HOSTINT 2 NDINT
HOST PATHOLOGY MOT PHIL Tx
Trichuris
trichiura Whipworm
Barrel-S, 2 plugs
unembryo M – curved 360F – 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 Albendazole Mebendazole Oxantel-Pyrantel Enterobius
Vermicularis SeatWorm 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 Thiabendazole Corticosteroid (for allergic rxn) Mebendazole? Ref (5F 20d, 20F10d, 20F 6d) Capillaria Philippinensis
peanut shape embryonated eggs in Ftypical 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.Luzon) THA,JPN, EGY,TAI, IRAN Mebendazole Albendazole Ascaris Lumbricoides Most common Intestinal nematode Giant Round Worm Decorticated,
Unembryo egg tri-radiate xsF-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 Common In world Peperazine Citrate Albendazole Mebendzaole Pyrantel Pam Ancyclostoma
Duodenale OldWorld Hook worm
8-cell stage
teeth 3rd stage filariform
pointed tail, short esophagus DFS EIA -ELA SI Lung migration
Ground itch; <500 eggs in feces = light worm, >500 eggs = heavy worm; Hookworm anemia due to suction of blood/ bleeding Microcytic Hypochromic Oral percutaneous Yes Tropics, subT Pyrantel Pamoate Mebendazole Iron replacement Necator
Americanus NewWorld Hook worm cutting plates DFSEIA -ELA Skin Penetration Strongyloides
Stercoralis ThreadWorm filariform;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 Penetration of FL - Free-living - auto infection Yes Tropics, SubT Albendazole Thiabendazole
PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST 2 ND 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 Lymphatics Bloodstream Peripheral Blood mosquitos 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 Mosquito Bites at night Yup Warm regions Diethylcarbamazine (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 Subcutaneous
tissue Vector- Dipteran (chrysops) Calabar swelling Adult in eye hypersensitivity Skin Larva Enter bite wound No Africa Diethylcarbamazine Corticosteroids surgery Dracunculus
Medinensis FierySerpent Israelites Guinea
worm larva migrates to lower ext.
Larvae in
copepods Local lesionWorm/Larvae Calcifiqed Worms by x-ray Mesenteric Tissues Larva migrate To lower ext Copepods Ingest Larva in water Blister w/ Serous exudates Pseudoperitoneal syndromes Ingestion Of Infective copepods NO Middle East, Africa Metronidazole Thiabendazole Oncocerca
Volvulus Larvae Crawl into
Bite wound
Biopsy Mazzotti Slit lamp
Subcutaneous
tissue Vector-Black fly -River Blindness-Eye lesions - Skin lesions - Scrotum enlargement Skin Larva Enter bite wound NO Africa C. and S. America Diethylcarbamazine Corticosteriods Surgery Angiostrongylu s 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 leukocytosis & eosinophilia Skin test needs evaluation Brain Spinal cord Man- Accidental hosts Mollusks, Snails: Achantina, Pila Planaria, Slugs, prawns Eosinophilic Meningoencephalitis + eosins in CSF, CN involve, diplopia and strabismus CSF >= 500 cells/ml w/ 10-90% eosins Ingestion Of larva In snails NO TAI, THAI, CAM, VIET, Hawaii, Tahiti None recommended Dead parasite Could exacerbate Tissue reaction Surgical if ncessary Angiostrongylu s 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 Herring
disease 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 Immunologic Tests under Study Marine Crustaceans And fish Pseudoterranova spp – Not penetr8 stom, Throat irrit, coughed
Ingestion Of raw Marine Food w/ Alcohol, “green” herring, sashimi NO JPN, Netherlands 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 2 ND INT
HOST PATHOLOGY MOT PHIL Tx
Schistosoma Hematobium
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 Penetration Thru Infected water Wala Siguro… Tropics Subtropics Praziquantrel Schistosoma Mansoni Platy-helminthes lateral spine Free-swimming Cercaria Ova in feces (blood, mucus) Rectal biopsy Liver Mesenteric venules, SC, lungs Biomphalaria 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 Praziquantrel Schistosoma Japonicum
Platy-helminthes lateral knob
(smallest)
Cercaria Ova in feces, Rectal biopsy, COPT test, ELISA Liver, Mesenteric Venules, SI, heart, Spleen, CNS Oncomelania Quadrasi, Formosa
Katayama rxn/ fever, reaction to Eggs in tissue = CNS damage, Hepatosplenomegaly, Portal HTN,
Ascites; mucus/blood in feces, liver enzy,serum alb, glob(prot)
Cercaria Penetrate Skin thru Infected water Yup Mindanao, Visayas Praziquantrel Schistosoma
Intercalatum Like Schistosoma Mansoni in terms of life cycle, pathology and clinical featuresIntermediate host – Biomphalaria snail Schistosoma
Mekongi Lide Schistosoma Japonicum in terms of life cycle, pathology and clinical featuresIntermediate host – Lithoglyphopsis aperta Fasciola Hepatica Fasciolidae Sheep Liver Fluke “popping operculum”
leaf S, w/ shoulders cephalic cone, spinous, dendritic testes
Metacercaria Encysted On aquatic vegetation Unembryo ova in feces, duodenal aspirates Bile duct of Sheep Herbivore animals Snails-Lymnea Philippinensis, 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 Vegetation; Infected Liver (false) Cosmo In sheep Raising countries Bithionol Fasciola Gigantica Fasciolidae Giant Liver Fluke Larger than F. hepatica no shoulders Metacercaria Encysted On aquatic vegetation Unembryo
ova Giant Animals- Cattle Biliary tract (BT)
Snail Aquatic
vegetation Ingestion ofInfected
Vegetation Most Probably Africa, Asia Bithionol Clonorchis Sinensis Opistorchidae Chinese Liver Fluke branched testes; spatulate Metacercaria Encysted On Fresh Water fish Embryo ova In feces or Biliary duodenal aspiratesBDA Man BT Operculate Snails (Alocinma, Parafossarulus, Bithynia) Fresh water Fish (FWF) : Cyprinidae, Ctenopha-ryngodon Cholangiocarcinoma of liver, liver function Impaired but SGPT and SGOT are normal
Ingestion of Uncooked fish Rare CHI, JPN, SK, Vietnam Chloroquine Diphosphate Praziquantel Opistorchis Felineus Opistorchidae Cat Liver Fluke lancet S reddish-bile color Metacercaria 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 Praziquantel Opistorchis Viverrini Opistorchidae knob at
abopercular end lobed testes like O. felineus
Metacercaria Embryo ova In feces Or BDA Civet cat, Dog, fish-eating Snails - Bithynia Goniomphalus, Funiculate, laevis FWF Punteus Orphoides, Hampala dispar Hyperplastic biliary Epithelium (Stim by Nitrosamines); assos. w/ cholangiocarcinoma Ingestion of Infective fish Nope Thailand Udorn Praziquantel Dicrocoelium Dendriticum Dicrocoellida Lancet fluke deep golden-brown 2 large testes lancet, flat, transparent, aspiny
Metacercaria Embryo ova w/ fully dev miracidium
sheep Snails- Abida, Cochilcopa, Helicella, Zeb
Formica
Fusca (ants) Same as F. hepatica Portal cirrhosis, Periductal fibrosis
Ingestion of
e
PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST 2
ND INT
HOST PATHOLOGY MOT PHIL Tx
Paragonimus
Westermani OrientalLung Fluke operculum at broad end, thick aboper branched testes side by side; coffee bean; integument w/ spines Metacercaria In crustacean Cercaria w/ spines Unembryo eggs in feces or sputum complement fixation Encapsulated in Parenchyma of lung; in fibrotic capsules Reservoir – Cats & dogs
Snail -Miracidia (M) Cercaria (C) Antemelania Asperta; Antemelania Dactylus Crabs – Sundathelphusa Philippina C meta-C Granulomatous rxn in lungs; rust-colored sputum, w/ Foul fish Odor Misdiagnosed For PTB Ingestion Of Infected crustaceans Yes Asia Praziquantel Bithionol Triclabendazole Fasciolopsis Buski indistinguish from F. hep, F. gigantica 2 dendritic testes in tandem Metacercaria 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, indonesia Praziquantel Heterophyes Heterophyes H. M. eggs no aboper protub; same
hard to distinguish adults; scale-like spines, w/ genital sucker, globular testes
Metacercaria 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 Metagonimus yokogawai Echinostoma Ilocanum indisting.from fasciolas
oral sucker with collar of spines; 2 lobed testes in tandem, reddish-grey Metacercaria No sporocyst stage Unembryo Eggs in feces Small Intestines Reservoir-rats Snails: -Gyralus Convexlusculus -Hippeutis Umbilicalis M C Snails: -Pila luzonica “kuhol” and -Vivipara Angularis“suso” C meta-C Inflamm, Ulceration, Diarrhea, intoxiacation Ingestion Of encysted MC in snails Of course N. Luzon, Samar, Leyte, Mindanao Praziquantel Taenia
Solium PorkTapeworm
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 Cysticercous Cellulosae eggs – cause cysticercosis Ripe or gravid Proglottid formaldehyde 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 Ingestestion Of inadeq. Cooked Pork Accidental Ingestion of eggs yes cosmo Praziquantel Taenia Saginata Longest Tapeworm Beef tapeworm no rostellum, hooklets ripe >15 branches; 5m; Cysticercous
bovis Ripe or gravidProglottid 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 Echinococcus Granulosus smallest Tapeworm In man Parasite Of dog
one long gravid proglottid
Eggs – man Hydatid sand dogs x-ray to detect hydatid ds; immunologic tests SI of Dog -Cysts Ingested and Release scolices Sheep, man (accidental, intermediate– 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
Diphyllobothrium Latum Fish/Broad
t-worm
yellow-brown knob like thickening
spatulate, rosette uterus 2 bothria = sucking grooves Plerocercoid 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) Ingestion Rare Only 7 cases temperat e zone Praziquantel 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
Cysticercoid 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) Ctenocephalides 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 (autoinf) Embryo Eggs in feces Proglottids not Recovered bec They degenerate
SI of man Insects, rice
And flour beetles Enteritis due to Necrosis and Desquamation Of intestinal Epithelial cells Direct/indirect pathways FOR Auto Infection yup Praziquantel Hymenolepsis
Diminuta Rat T-worm
w/o filaments bile-stained; fan-like gravid segment; rudimentary, unarmed rostellum Cysticercoid 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 IngestionOf Infected insects yes In rats <8% Praziquantel
Sparganosis Mansoni, Erinacei, Ranarum
Spirometra
mistaken for D. latum; pseudosegmentation w/ slit-like invagination Plerocercoid 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 Ingestion Of Infected interM hosts
Not sure surgical
COPYRIGHT © 2005 -- AUDS MARTINEZ – USTMED SEC C ’07
-PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC HOST LOC. HOSTINT 2
ND 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 -Trophozoites In liquid stools -Cysts in Formed stools Culture, serology to detect invasive Amebiasis (IHAT) ELISA most Sensitive indicator Large Intestines (cecal and sigmoido-rectal) liver in extraint amebiasis
Flasklike Primary ulcer; Histo changes: Histolysis, Thrombosis, Petechiae, Round Cell Infiltration, Necrosis Bacilliary vs Amebic dysentery Ingestion Of Infective cysts Yes Most Common Are Asympto carriers Supportive, Chemotherapy Asympto – Diiodohydroxyquin Mod severe Metronidazole Severe – D + M Hepatic – M + emetine Naegleria
fowleri No cyst only Flagellated form
Large, usually Central K slug-like;PSD: blunt;
Trophozoite Trophozoites In 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
Acanthamoeba
large central K; double cell wall
sluggish; PSD: spine-like
No peripheral chrom
trophozoite Cysts and Trophs inTissue Giemsa or PAS of Scrapings or Cornial biopsy
CNS
cornea Amebic Encephalitis(immunocompromised) Amebic Keratitis (assoc w/ use of contam contact lenses)
Thru Lower respi Tract or Thru ulcerated, Broken skin Rare All types Of soil Propamidine, Miconazole, neomycin Corneal grafting Entamoeba coli yellow-brown; 1-8 nuclei, K eccentric; CB : splinter-like
sluggish, rarely prog and dir; PSD: short, blunt; Bacteria/ debris Inclusions Entamoeba
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. HOSTINT 2
ND INT
HOST PATHOLOGY MOT PHIL Tx
Balantidium Coli Largest prot parasite
Only ciliate bean-shaped nuc cytostome; cytopyge;
cyst DFS of Troph and Cysts in Feces Sigmoidoscopy 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 Tetracycline Metronidazole Iodoquinol Giardia
Lamblia “gaybowel 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 andTrophs 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;electrolytes, 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 Metronidazole Tinidazole Furozolidone Quinacrine paromomycin Trichomonas
vaginalis No cyst stage
pyriform; jerky movements; 4 free flag +1 undulating; axos
Troph Trophozoites 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 Metronidazole Acid douches Dientamoeba
Frgilis No known cysticstage
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. vermicularis Siguro …as long as may infection w/ E. vermic -in pre-schools in Germany, Israel, Holland Iodoquinol Tetracycline Metronidazole Leishmania
Tropica Old World Cut Leish
w/ ovoid or rounded bodies
promastigote
Pro M in skin tissue
biopsy LivesIntracellular In Macrophages Sand fly Pheobotomus Spp Cutaneous leishmaniasis Lesions resembling Lepromatous leprosy Bite of
Sandly vector Wala Africa, India South amercia
Antimony Compounds
PMS and Endothelial Cells Pro M A-Mast A-Mast Pro M in gut of fly Second line Drugs: Amp B, Pentamidine (Kala-azar), Metronidazole Nifurtimox Leishmania 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; Leishmania
Braziliensis NewWorld Cut Leish amastigote Serology – For supportive diagnosis Mucocutaneous or American Leishmaniasis Tapir nose
Erosion of pinna of forest workers
Trichomonas
Tenax Smaller and longer thanT. vaginalis Troph swabbing Oral cavity-tartar Droplets, kissing yes
Chilomastix
Mesnili
knob-like prod, LemonS
spiral forW; 3 ant flag + 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
Trypanosoma
Gambiense WestAfrican Sleepng Sicknes
Trypomastigote T-mastigote Parasite in Blood tissues Or CSF Serology for Large scale Screening ELISA, IF In blood, Lymph and CSF Tsetse Fly Reservor Host: Domestic Animals
Local Infiltration from bite area to lymph and CNS -Chronic inflammation Of lymphatics -Atrophy of dendrons Of ganglion cells -Winterbottom’s sign, Kerandels sign Bite of Vector Congenital Transmission possible NO West and Central Africa Supportive Pentamidine Suramin Melarsopenol Tryparsamide Melarsen Trypanosoma
Rhodesiense EastAfrican Sleepng Sicknes Tsetse Fly Reservor Host: Game animals NO Uh..east Africa? Trypanosoma
Cruzi Chaga’sDisease 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 -transplacental -accidental ingestion -blood trans No Income Groups In Suburban rural 8-amino quinolones Primaquine, Nifurtomax (Bayer 2502) Toxoplasma gondii (man) bradyzoite, cyst (cat?)
male and female gametocytes pseudocyst and oocyst w/ Sporozoites -Oocyst prod By sexual Cycle in cat; Pseudocysts-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 Intermediate hosts
Brain lesions; hepatitis; Chorioretinitis; Lymphadenitis 2 types of postnatal ds 1) mild lymphatic (lide infectious Mononucleosis) 2) acute fulminating Ingestion, Transplacenetal Yes Cosmo Many are Chronic Ill but are asympto Pyrimethamine (Daraprim), Trisulfapyri-Midines; Preg – spiramycin, Clinamycin; AIDS – Atovaquone Isospora Belli immature cyst Schizont, gametes
Inside host Mature oocystw/ sporozoites ImmatureCysts 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
Pneumocystis Carinii cysts Surgical open Lung biopsy; BronchoAlLav; Bronchoscopy; Methenamine Silver stain interstitial pneumonia; fatal pneumonia in infants; hypogammaglobulinemia, leukemia, Hodgkin’s, etc -lungs are gray and airless; death due to asphyxia
Droplets,
Close contact Yes cosmo
Bactrim
GAMETE SCHIZONT TROPHOZOITE
Plasmodium
Falciparum Mosquito – Gametocytes;
Man – Sporozoites Hypnoxoite – Latent stage, Cause relapse Sporogany – Mosquito LC; Schizogony – Human LC - exoerythro (merozoites) - erythro (gametocytes) 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 form, 2)Stomach wall – oocyst and sporozoite release 3)salivary glands - sporo Anopheles Flavirostris Minimus Anopheles -litoralis -balabacensis -mangyanus -maculates
-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:
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 Bite of female Mosquito Passage of Blood w/ Erythrocytic Parasite by: -blood trans -contam syringe -neonatal -congenital Yes Malaria Free areas -manila -aklan -capiz -guimara -siquijor -biliran -iloilo -leyte N -leyte S -N Samar -Camiquin -Cebu -Catand.
Vivax and Ova –Chloroquine + Primaquine Falci and Mal -Chloroquine Chloroquine Resistant – Falc Plasmodium Vivax Plasmodium Malariae Plasmodium Ovale
