PARASITE
A.K.A.
EGG
ADULT
INFECTIVE
DIAGNOSTIC
Embryonated Egg in soil/feces Trichuris trichiura
Whip worm
DFS Unembryo eggs in feces Barrel-S, Barrel-S, 2 plugs unembryo
M – curved 360 F – blunt; stichocytes
HOST LOC.
LI, Whip inserted into wall no migration phase to lungs
embryonated in soil
INT HOST
2NDINT HOST
PATHOLOGY
-Prolapse of Anus -IDA, Alb, D -Sometimes appendicitis -symptoms due to unique mode of attachment
Embryonated ova
Enterobius vermicularis
Seat Worm Pin worm
D-shape, football
Scotch tape Swab
spindle-S, cephalic ala, corpus, isthmus, bulb M – curved tail F – pointd tail
Embryonated Eggs
Ileum of SI, Cecum,LI man Gravid female Migrates to Perianal area
Encysted larvae in Inad cooked pork Tissue biopsy Trichinella spiralis
larva – w/ spearlike burrowing tip
thread-like ; F – blunt; M – curved w/ 2 lobular appendages; A-end- non-papillated
Xenodiagnosis
Muscle tissue of man, pigs
Bachman Intradermal test
Larva in raw fish Eggs embryonate in Fresh water
Capillaria philippinensis
Ascaris lumbricoides Most common Intestinal nematode Ancyclostoma duodenale
Necator americanus
Strongyloides stercoralis
peanut shape
embryonated eggs in F typical F – 8 in 1 row atypical F – 40 in 2 M – w/ chitin spicule Embryonated Egg
Giant Round Worm
Thread Worm
DFS of eggs
larvae in gastric mucosa and intestines SI of man (not attach)
Decorticated, Unembryo egg
Old World Hook worm New World Hook worm
DFS -eggs (E) -larva (L) -adults (A)
SI (jejunum ) of fish, man
8-cell stage
tri-radiate xs
F-3 lips; M– M –2 spicules teeth
cutting plates
larvae, corticated 3r stage filariform
pointed tail, short esophagus
Adults in SI Gall bladder, Liver, nares, appendix
Liver-lung Migration (larv swallowed)
DFS EIA -ELA
SI
DFS EIA
Lung migration
3r stage filariform
Rhab in stool
short buc cav
-Rheumatic pain (intestinal flu) - M eosin -swollen eyelids -3 stages of inf: intest,larval,encap -Stage of conval - death due to Myocard or enceph -int mal-ab -Borborygmi -Ab Pain -Diarrhea -Villus flat -Atrophy COL -death Lung mig –Asthma; Capil penetration –Pneumonia; Ab Pain due to adult Migration; Int Obst; eosin Ground itch; <500 eggs in feces = light worm, >500 eggs = heavy worm; Hookworm anemia due to suction of blood/ bleeding Microcytic Hypochromic
-ELA filariform; no F M Long eso, Prominent Genital primordium, notched tail
1) site - ulceration 2) eggs - prupritus 3) migration -vulvuvag & salphingitis
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
MOT
PHIL
Yup F-O-R (fecaloral route)
80-90% warm, tropical regions
H-M (hand-mouth) inhalation
Tx
Albendazole Mebendazole OxantelPyrantel
Mebendazole Yup (F>M)
Retro infection
Pyrantel pamoate
Thiabendazol e Ingestion of encysted larvae in pork
Corticosteroid yup
(for allergic rxn)
Mebendazole? Ref (5F 20d, 20F10d, 20F 6d)
Ingestion Of larva In raw fish
Ingestion Burrowing of Sin of foot
Oral percutaneous
Skin Penetration
- Skin Penetration of FL - Free-living - auto infection
Yup (M>F) I. Norte (N.Luzon)
Mebendazole Albendazole
THA,JPN, EGY,TAI, IRAN Yup Most Common In world
Yes Tropics, subT
Peperazine Citrate Albendazole Mebendzaole Pyrantel Pam
Pyrantel Pamoate Mebendazole Iron replacement
Yes
Albendazole
Tropics, SubT
Thiabendazol e
PARASITE
A.K.A.
EGG
ADULT
INFECTIVE
kinky, overlapping nuclei, nuclei reach tail end (terminal, subterminal n.) giemsa – sheath
Brugia malayi
Larvae In Arthropod Vector Bites at Night
unstained smooth, single row of nuclei, no term nuc, >L than BM giemsa – pink stain
Wuchereria bancrofti
Enters Bite wound Bioincub - 1 year Larvae crawl into wound
Loa loa
DIAGNOSTIC
HOST LOC.
Blood smear (thick And Knott Conc) Microfilaria In blood at Night
mosquitos
Lymphatics Bloodstream Peripheral Blood
CARD Test – Antigen det DNA probes Thin blood Smear
INT HOST
W.B. – Culex Quinque Fasciatus RuralAnoph; UrbanFatigans; Pacificaedes VectorDipteran (chrysops)
Dracunculus medinensis
Guinea worm
Larvae in copepods larva migrates to lower ext. Larvae Crawl into Bite wound
Oncocerca volvulus
Calcifiqed Worms by x-ray Biopsy Mazzotti
Mesenteric Tissues Larva migrate To lower ext
Subcutaneous tissue
Copepods Ingest Larva in water
VectorBlack fly
Slit lamp
Angiostrongylus cantonensis
Rat Lung worm
3rd stage larva in snails and slugs or rats ingested by man adult emale “Barber pole” dark red intestinal tract
snails – paratenic hosts 3rd stage larva in snails/ slugs ingested by man nd cotton rat
Angiostrongylus costaricensis
Brain History -eating, travel
Spinal cord
leukocytosis & eosinophilia
ManAccidental hosts
Skin test needs evaluation
Mollusks, Snails: Achantina, Pila Planaria, Slugs, prawns Mollusks
Intestines (gut wall)
Snails, slugs
(Sigmodon hispidus)
Edoscopy Terranova sp – juveniles Anisakis
Herring disease
Pseudoterranova sp – not penetrate Eustrongylides sp – perforates large bowel
rd
3 stage larva in flesh of raw fish; larva migrate from viscera to muscle after death of fish
Immunologic Tests under Study
Marine Crustaceans And fish
MOT
PHIL
Weingarten’s Syndrome – Hyper-eosin of Peripheral blood
Larva Enter bite wound Mosquito Bites at night
Tx
Diethylcarbamazine (not effective on adult worms)
Skin Chronic – (poor prog), elephantiasis (blocks lymphs)
Yup
Ivermectin
Warm regions
corticosteroids supportive – pressure bandaging surgery
Adult in eye hypersensitivity
shedding of sheath, Local lesion Worm/Larvae
PATHOLOGY
Acute – Hypersensitizatn
Calabar swelling Subcutaneous tissue
biopsy Fiery Serpent Israelites
2ND INT HOST
Blister w/ Serous exudates Pseudoperitoneal syndromes -River Blindness -Eye lesions - Skin lesions - Scrotum enlargement
Skin Larva Enter bite wound
Ingestion Of Infective copepods
Diethylcarbamazine No Corticosteroids Africa surgery NO Metronidazole Middle East, Africa
Thiabendazole
Skin
NO
Diethylcarbamazine
Larva Enter bite wound
Africa C. and S. America
Corticosteriods
NO
None recommended
TAI, THAI, CAM, VIET, Hawaii, Tahiti
Dead parasite Could exacerbate Tissue reaction
Surgery
Eosinophilic Meningoencephalitis + eosins in CSF, CN involve, diplopia and strabismus CSF >= 500 cells/ml w/ 10-90% eosins “acute abdomen” - inflamm of ileocecal region; Ab pain loc to right lower quad + palpable tumor-like m Pseudoterranova spp – Not penetr8 stom, Throat irrit, coughed Anisakis simplex (USA) Stom, int, inflamm Rxn surrounding larva Anisakiasis – local Tissue response; (Eustrongylides spp) Perforation of L bowel
Ingestion Of larva In snails
Surgical if ncessary
Ingestion Of raw Marine Food w/ Alcohol, “green” herring, sashimi
NO JPN, Netherland s
Remove larvae By biopsy Forceps Surgical Intervention For obstruction Manage conservatively
PARASITE
A.K.A.
EGG
ADULT
INFECTIVE
DIAGNOSTIC
S. Japonicum Schistosoma hematobium
Freeswimming Cercaria
Platyhelminthes
terminal spine
Schistosoma mansoni
Freeswimming Cercaria
Platyhelminthes
lateral spine Cercaria
Schistosoma japonicum Platyhelminthes Schistosoma intercalatum Schistosoma mekongi Fasciola hepatica Fasciolidae
Fasciola gigantica Fasciolidae Clonorchis sinensis Opistorchidae Opistorchis felineus Opistorchidae
Sheep Liver Fluke
Giant Liver Fluke
popping operculum” “
Bile duct of Sheep
Unembryo ova
no shoulders
Metacercaria Encysted On Fresh Water fish
Embryo ova In feces or Biliary duodenal aspiratesBDA
lancet S reddishbile color
Cat Liver Fluke
knob at abopercular end Lancet fluke
deep golden-brown
Metacercaria Encysted On fresh Water fish
Embryo ova In feces or BDA
Metacercaria
Embryo ova In feces Or BDA
lobed testes like O. felineus 2 large testes lancet, flat, transparent, aspiny
Mesenteric venules, SC, lungs
Unembryo ova in feces, duodenal aspirates
Metacercaria Encysted On aquatic vegetation
Herbivore animals Giant AnimalsCattle Biliary tract (BT) Man BT Small AnimalsCats, dogs, etc (BT SI) Civet cat, Dog, fisheating
Embryo ova Metacercaria
w/ fully dev miracidium
INT HOST
Bulinus Snail (Miracidia to cercaria)
Liver
Liver, Mesenteric Venules, SI, heart, Spleen, CNS
leaf S, w/ shoulders cephalic cone, spinous, dendritic testes
branched testes; spatulate
Adults Bladder, liver larva – Venous Plexuses
Ova in feces, Rectal biopsy, COPT test, ELISA
Metacercaria Encysted On aquatic vegetation
Larger than F. hepatica
Chinese Liver Fluke
Opistorchidae
Dicrocoellidae
Ova in feces (blood, mucus) Rectal biopsy
in copula, males have lateral knob gynecophoric canals (smallest) Like Schistosoma mansoni in terms of life cycle, pathology and clinical features Intermediate host – Biomphalaria snail Lide Schistosoma japonicum in terms of life cycle, pathology and clinical features Intermediate host – Lithoglyphopsis aperta
Opistorchis viverrini
Dicrocoelium dendriticum
Eggs, miracidia in urine
HOST LOC.
sheep
Biomphalaria Snail
Oncomelania Quadrasi, Formosa
2ND INT HOST
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
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
Aquatic vegetation
Snail
Aquatic vegetation
Snails Bithynia Goniomphalus, Funiculate, laevis
Fresh water Fish (FWF) : Cyprinidae, Ctenopharyngodon FWF Cyprinus Carpio (Taiwan) FWF Punteus Orphoides, Hampala dispar
Snails- Abida, Cochilcopa, Helicella, Zeb
Formica Fusca (ants)
Snails Bithynia Funiculate
MOT
Skin Penetration Thru Infected water
SnailsLymnea Philippinensis, Lymnea swinhoe (TAI) (sporocystredia-cercaria)
Operculate Snails (Alocinma, Parafossarulus, Bithynia)
PATHOLOGY
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
Halzoun – ingestion Raw 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) Ingestion of Infected Vegetation
PHIL
Tropics Subtropics
Ingestion of Uncooked fish
Periportal fibrosis, Invasion of pancreas, Form bile stones
Ingestion of Infective fish
Hyperplastic biliary Epithelium (Stim by Nitrosamines); assos. w/ cholangiocarcinoma
Ingestion of Infective fish
Praziquantrel
Nope Africa Brazil
Praziquantrel
Yup Mindanao, Visayas
Praziquantrel
Cosmo In sheep Raising countries
Bithionol
Most Probably Bithionol Africa, Asia Rare
Cholangiocarcinoma of liver, liver function Impaired but SGPT and SGOT are normal
Tx
Wala Siguro…
CHI, JPN, SK, Vietnam Nope USSR, poland
Chloroquine Diphosphate Praziquantel
Praziquantel
Nope Thailand Udorn
Praziquantel
Same as F. hepatica Portal cirrhosis, Periductal fibrosis
Ingestion of ants
Wala siguro
Praziquantel
PARASITE
Paragonimus westermani
A.K.A.
Oriental Lung Fluke
EGG
ADULT
operculum at broad end, thick aboper
branched testes side by side; coffee bean; integument w/ spines
INFECTIVE
Metacercaria In crustacean Cercaria w/ spines Metacercaria In water Plants
Fasciolopsis buski
2 dendritic testes in tandem
indistinguish from F. hep, F. gigantica
Heterophyes heterophyes
MC are Sensitive to Dryness Metacercaria In fish
H.
Metagonimus yokogawai
M. eggs no aboper protub; same
hard to distinguish adults; scale-like spines, w/ genital sucker, globular testes
Miracidium present in The egg once Deposited by adult
Metacercaria Echinostoma ilocanum indisting.from fasciolas
oral sucker with collar of spines; 2 lobed testes in tandem, reddish-grey
No sporocyst stage Cysticercous Cellulosae
Taenia solium
Longest Tapeworm
Echinococcus granulosus smallest Tapeworm In man
Beef tapeworm
Unembryo eggs in feces or sputum complement fixation
indistinguish from each other and from E. granulosus; hexacanth (6 hooklets); radially striated shell
HOST LOC.
INT HOST
Encapsulated in Parenchyma of lung; in fibrotic capsules
Snail Miracidia (M) Cercaria (C) Antemelania Asperta; Antemelania Dactylus
Reservoir – Cats & dogs
Snails – MC Unmebryo Eggs in feces
Unembryo Eggs in stool Using Kato-Katz method
Unembryo Eggs in feces
Duodenum of Man or pigs
Small Intestines Reservoir – Fish eating mammals
Small Intestines Reservoirrats
Ripe or gravid Proglottid formaldehyde soln
Pork Tapeworm rostellum w/ hooks 4 suckers; ripe proglottid <13 lateral branches; 3m
Taenia saginata
DIAGNOSTIC
Small intestines of man cysticercosis in muscles
eggs – cause cysticercosis
Segmentina, Hippeutis
Snails : Freshwater, Brackish or Marine M
C
Snails: -Gyralus Convexlusculus -Hippeutis Umbilicalis MC Hogs, wild Boars, sheep, Deer, dogs, Monkeys, rats, cats
Scolex after therapy
eggs cysticercous cellulosae
Ripe or gravid Proglottid
Cattle, llama, Giraffe, Carabao
2ND INT HOST
Crabs – Sundathelphusa Philippina C
meta-C
Aquatic Vegetation C meta-C Water caltrop, Water chestnut, Water morning Glory, lotus Many fish in the Phil. (30 Species); in muscles at base of the fin C
meta-C
Snails: -Pila luzonica “kuhol” and -Vivipara Angularis“suso” C meta-C
PATHOLOGY
Granulomatous rxn in lungs; rustcolored sputum, w/ Foul fish Odor
MOT
PHIL
Ingestion Of Infected crustaceans
Yes Bithionol Asia
Misdiagnosed For PTB Worms cause Traumatic, Obstructive and toxic effects; ulceration and mucus prod. Inflamm, Sloughing off Of layers, xs Mucus prod Misdiagnosed For acid Peptic ds (APD), consistent w/ PUD Inflamm, Ulceration, Diarrhea, intoxiacation
Inflamm, Eosinophilia, leukopenia Dev Cisticercosis (ingestion of eggs), larva in brain, muscle, eye
Tx
Praziquantel
Triclabendazole Nope Ingestion Of Infected Water Plants
SEA, CHN, India, indonesia
Praziquantel
Yes Ingestion of MC Encysted in fish
EGY, Greece, CHN, JPN, KOR, TWN, Phil
Praziquantel
Of course Ingestion Of encysted MC in snails
N. Luzon, Samar, Leyte, Mindanao
Ingestestion Of inadeq. Cooked Pork Accidental Ingestion of eggs
Praziquantel
Praziquantel
yes cosmo
Cysticercous bovis no rostellum, hooklets ripe >15 branches; 5m; tree-like dicho branching Eggs – man Hydatid sand
Parasite Of dog one long gravid proglottid
dogs
Scolex after therapy
x-ray to detect hydatid ds; immunologic tests
Man SI (accidental)
SI of Dog -Cysts Ingested and Release scolices
eggs cysticercous bovis Sheep, man (accidental, intermediate– in liver and lungs)
Epigastric Pain, vertigo, Nervousness, eosinophilia
Obstruction – Growing cysts; Anaphylactic Shock when Cyst ruptures
Niclosamide -damage to point of dissolution
Ingestion Of cysts in beef
FOR Ingestion Of eggs in feces
rare
Sugery Prev spillage of eggs) Albendazole
PARASITE
A.K.A.
EGG
ADULT
INFECTIVE
DIAGNOSTIC
HOST LOC.
SI in man Diphyllobothrium Latum
Dipylidium Caninum
Fish/ Broad t-worm
spatulate, rosette uterus 2 bothria = sucking grooves
Dog T-worm Double Pored T-worm
Hymenolepsis Nana
yellow-brown knob like thickening
Dwarf 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
Embryo Eggs in Contam food and Water with filaments like D. caninum scolex but with less hooklets; ripe segment
Hymenolepsis Diminuta
Plerocercoid Larva Encyted In fish
Cysticercoid Larvae in insects
Rat T-worm w/o filaments bile-stained; fan-like
Cyticerci Can complete Cycle in single Host (autoinf)
gravid segment; rudimentary, unarmed rostellum
Operculated Eggs; Proglottids Kato tech Gravid Proglottids That are passed out/ Crawl out, Egg packets, Melon-shaped Proglottids in Chains (Not stool bec proGlot disint in environment
Plerocercoid In toads, frogs, snakes, Spirometra mistaken for D. latum; pseudosegmentation w/ slit-like invagination
paratenic hosts - pigs
Paratenic host: Carnivore fish
copepods (Cyclops & Diaptomus)
Coracidia (CO) Procercoid (ProC) Ctenocephalides canis (dog flea)
2ND INT HOST
(fish) perch, trout, salmon, pike ProC PleroC
Ctenocephalides felis (cat flea) SI of dog or cat Pulex irritans (human flea)
Proglottids not Recovered bec They degenerate
Eggs in stool (more circular, larger, lack bipolar thickening vs H. nana
MOT
Ingestion
Minimal symptoms
Ingestion
Enteritis due to Necrosis and Desquamation Of intestinal Epithelial cells
SI of man
Insects, rice And flour beetles
PHIL
Tx
Rare Only 7 cases
Praziquantel
temperate zone
yup
Praziquantel
Auto Infection
yup
Praziquantel
Ingestion Of Infected insects
yes
FOR
Direct/indirect pathways
SI of man
Fleas, beetles, cockroaches, mealworms & earwigs
Adult – Intestines of Cat/man White larvae In lesion
PATHOLOGY
Anemia (misdiag for pernicious type Vit B12 def); hyperchromic megaloblastic; examine for HCl in gastric juice (+ infection)
Trichodectes canis (dog louse)
Embryo Eggs in feces
Sparganosis Mansoni, Erinacei, Ranarum
Reservoir Host: Dogs, cats,Bears
INT HOST
Larvae – any part, eye, subQT, muscles
- COPYRIGHT © 2005 - AUDS MARTINEZ – - USTMED SEC C ’07 -
Cyclops, copepods
Minimal and Non-specific
Frogs, Snakes, Toads, rats
Painful edema Due to migrating Larvae Eosinophilia, Edema and erythema
Ingestion Of Infected interM hosts
In rats <8%
Not sure
Praziquantel
surgical
PARASITE
A.K.A.
CYST
TROPHOZOITE
INFECTIVE
DIAGNOSTIC
-Trophozoites In liquid stools -Cysts in Formed stools Entamoeba histolytica
Ameba
greenish-yellow quadrinucleate, thick, rodlike chromatoidal bodies CB, central karyosome (K), w/ chromatin dots No cyst only Flagellated form
active, progressive, directional; pseudopod PSD: finger-shape, hyaline; w/ ingested RBC
Quadri cysts
Culture, serology to detect invasive Amebiasis (IHAT) ELISA most Sensitive indicator
Large Intestines (cecal and sigmoidorectal)
Trophozoite
trophozoite large central K; double cell wall
Entamoeba coli
yellow-brown; 1-8 nuclei, K eccentric; CB : splinter-like
Entamoeba gingivalis
Endolimax nana
Iodamoeba butschlii
Entamoeba hartmanii
sluggish; PSD: spine-like No peripheral chrom
sluggish, rarely prog and dir; PSD: short, blunt; Bacteria/ debris Inclusions Mod active, prog PSD : blunt, hyalin
pale green; 1-4 nuc; K irreg CB : bacilliform
sluggish prog; PSD:blunt /hyaline; K – L, cent
1 nuc yellow green; K surr w/ granules; endosome
slug, prog; PSD : Blunt/Hyaline
1-4 nuc; K small/Central; Diffuse glyco mass
non prog; PSD : fingerlike
Giemsa or PAS of Scrapings or Cornial biopsy
PATHOLOGY
MOT
Flasklike Primary ulcer;
Tx
Yes Histo changes: Histolysis, Thrombosis, Petechiae, Round Cell Infiltration, Necrosis
Ingestion Of Infective cysts
EntersThru Nose
Brain
Kernig’s sign; Leukocytosis w/ neuts, prot, glu Amebic Encephalitis (immunocompromised)
Multiply in brain
CNS cornea
PHIL
Supportive, Chemotherapy
Meningoencephalitis Severe frontal Headache,Blocked nose, Altered taste and smell
Cysts and Trophs inTissue Acanthamoeba
2ND INT HOST
Bacilliary vs Amebic dysentery
Flagellate form in CSF
slug-like; PSD: blunt;
INT HOST
liver in extraint amebiasis
Trophozoites In CSF and tissue
Naegleria fowleri Large, usually Central K
HOST LOC.
Amebic Keratitis (assoc w/ use of contam contact lenses)
Most Common Are Asympto carriers
Asympto – Diiodohydroxyquin Mod severe Metronidazole Severe – D + M Hepatic – M + emetine
Penetrate Cribriform Plate
Thru Lower respi Tract or Thru ulcerated, Broken skin
rare
Amphotericin
all types of soil
Amp + miconazole and rifampicin
Rare
Propamidine, Miconazole, neomycin
All types Of soil
Corneal grafting
PARASITE
A.K.A.
CYST
TROPHOZOITE
INFECTIVE
Balantidium coli cyst
Largest prot parasite Only ciliate
bean-shaped nuc
cytostome; cytopyge;
DIAGNOSTIC
DFS of Troph and Cysts in Feces Sigmoidoscopy DFS Cysts and Trophs
Giardia kamblia
“gay bowel syn”
Trichomonas vaginalis
young – 2 nuc; mature – 4 nuc; flagella retracted into axonemes
Quadri cysts pyriform/tear-drop; bi-symm; erratic tumbling motion; 8 flag
No cyst stage
Troph pyriform; jerky movements; 4 free flag +1 undulating; axos
Biopsy, Entero-test, IF and antigen detection Trophozoites In urine, Urethral sec, Vaginal sec, Cervical sec, Semen, Prostatic sec
HOST LOC.
INT HOST
2ND INT HOST
PATHOLOGY
SI Cysts Troph
Ulcer w/ rounded Base and wide Neck (vs flask shape)
LI (cecal area) troph
Diarrhea and Dysenter (indisting. from Amebic)
SI Duo, jeju, upper il
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
Attaches To int villi Via adhes Disc on ven Female – Vaginal epi
-Vaginal discharge – Liquid, green to yellow, Irritating -Speculum – Strawberry Cervix (diagnostic) -Vaginitis; urethritis
Male – Urethra, Epididymis, Prostate g
MOT
FOR Ingestion of Contam Food And water
Troph
No known cystic stage rosette-shaped nuclei; no peri chromatin; K w/ 4-6 granules; no flag
Leishmania tropica
Old World Cut Leish
Binucleate Trophs in fresh Stool samples
FOR
Metronidazole Iodoquinol Oral Metronidazole Tinidazole Furozolidone Quinacrine paromomycin
Passed thru Birth canal
Co-infection With E. vermicularis
Hostpitality Girls – 24% Other groups - 3-8% Siguro …as long as may infection w/ E. vermic -in pre-schools in Germany, Israel, Holland
Oral Metronidazole Acid douches
Iodoquinol Tetracycline Metronidazole
Cutaneous leishmaniasis in skin tissue biopsy promastigote 1 free flagella arising from kinetoplast Pro M
Bone marrow, Spleen or Lymph nodes
amastigote
Lives Intracellular In Macrophages PMS and Endothelial Cells Pro M A-Mast
New World Cut Leish
Serology – For supportive diagnosis
amastigote Trichomonas tenax Chilomastix mesnili
-Colicky ab pain; anal Pruritis; Peripheral eosinophilia
Outbreaks Are waterborne
Tx
Tetracycline
Yes Sexual intercourse
-Mimics IBS (irrit bow syn)
w/ ovoid or rounded bodies
Leishmania donovani
Leishmania braziliensis
In lumen Of LI
Uncommon In Temperate; Assoc w/ Pigs in tropics siguro
-Increase excess mucus -Hypermotility of the bowel Dientamoeba fragilis
PHIL
Siguro
knoblike prod, LemonS
Smaller and longer than T. vaginalis spiral forW; 3 ant flag + 1
Lesions resembling Lepromatous leprosy Sand fly Pheobotomus Spp
A-Mast Pro M in gut of fly
Antimony Compounds
Visceral Leishmaniasis or Kala-azar Splenomegaly, presence of Parasites in RE cells;
Wala Bite of Sandly vector
Africa, India South amercia
Mucocutaneous or American Leishmaniasis Tapir nose Erosion of pinna of forest workers
Troph
swabbing
Oral cavity -tartar
Droplets, kissing
cysts
Cysts in Semi-formed Stools; Trophs in Liquid stools
Cecal region Of LI
FOR
yes Rare <1%
Second line Drugs: Amp B, Pentamidine (Kala-azar), Metronidazole Nifurtimox
PARASITE
A.K.A.
CYST
TROPHOZOITE
INFECTIVE
Trypomastigote Trypanosoma gambiense
West African Sleepng Sicknes
Trypanosoma rhodesiense
East African Sleepng Sicknes
Trypanosoma cruzi
Chaga’s Disease
Trypomastigote
Blood smear T-mastigote
Isospora belli
(cat?) male and female gametocytes
Schizont, gametes Inside host
Serology – IgM detection By ELISA; IFA for IgG And IgM; PCR Of Toxo DNA
Mature oocyst w/ sporozoites
Immature Cysts in feces -Oocysts/ Sprorcysts in dudenum
cysts
Plasmodium vivax
Plasmodium malariae
Plasmodium ovale
In blood, Lymph and CSF
Histiocytes RE cells (adipose, myocardial, RE, Neuroglial) In SI of Cat (sexual And asexual Cycle); in Tissues in Asexual cycle Definitive –CAT
INT HOST
Tsetse Fly Reservor Host: Domestic Animals Tsetse Fly Reservor Host: Game animals Reduviids, Triatomid Bugs Reservoir: Wild mammals Mouse or Rat Man, pigs, Sheep, Accidental Intermediate hosts
2ND INT HOST
PATHOLOGY
Local Infiltration from bite area to lymph and CNS -Chronic inflammation Of lymphatics -Atrophy of dendrons Of ganglion cells -Winterbottom’s sign, Kerandels sign -Engulfed by histocytes and invade adipose tissue -inflamm response w/ fibrotic encapsulation = chagoma; Romana’s sign Brain lesions; hepatitis; Chorioretinitis; Lymphadenitis 2 types of postnatal ds 1) mild lymphatic (lide infectious Mononucleosis) 2) acute fulminating Malabsorption syndrome; Shortened villi, hyperTrophied crypts, infilt Of lamina propria, w/ Eosins, polys, rounded cells
SI of man Definitive – MAN
Surgical open Lung biopsy; BronchoAlLav; Bronchoscopy; Methenamine Silver stain
Pneumocystis carinii
SCHIZONT
Serology –CF Xenodiag biopsy
pseudocyst and oocyst w/ Sporozoites -Oocyst prod By sexual Cycle in cat; Pseudocystsasexual
immature cyst
Plasmodium falciparum
Serology for Large scale Screening ELISA, IF
(man) bradyzoite, cyst
GAMETE
HOST LOC.
Parasite in Blood tissues Or CSF T-mastigote
Epimastigote
Toxoplasma gondii
DIAGNOSTIC
interstitial pneumonia; fatal pneumonia in infants; hypogammaglobulinemia, leukemia, Hodgkin’s, etc -lungs are gray and airless; death due to asphyxia
MOT
PHIL
NO Bite of Vector Congenital Transmission possible
-Bite of Vector -feces -transplacental -accidental ingestion -blood trans
Ingestion, Transplacenetal
West and Central Africa NO Uh..east Africa? No Income Groups In Suburban rural Yes
Tx
Supportive Pentamidine Suramin Melarsopenol Tryparsamide Melarsen
8-amino quinolones
Cosmo Many are Chronic Ill but are asympto
Primaquine, Nifurtomax (Bayer 2502) Pyrimethamine (Daraprim), TrisulfapyriMidines; Preg – spiramycin, Clinamycin; AIDS – Atovaquone Pyrimethamine
FOR
Not sure
Droplets, Close contact
Yes
Sulfadiazide or Trimetroprim
Bactrim cosmo
TROPHOZOITE 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
Yes
Bite of female Mosquito Passage of Blood w/ Erythrocytic Parasite by: -blood trans -contam syringe -neonatal -congenital
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
