PARASITE Trichuris trichiura A.K.A. EGG ADULT Whip worm Embryonated Egg in soil/feces Barrel-S, 2 plugs unembryo Enterobius Vermicularis INFECTIVE M – curved 360 F – blunt; stichocytes Seat Worm Dshape, football spindle-S, cephalic ala, corpus, isthmus, bulb M – curved tail F – pointd tail Encysted larvae in Inad cooked pork Trichinella Spiralis Larva in raw fish embryonated eggs in F typical F – 8 in 1 row atypical F – 40 in 2 M – w/ chitin spicule peanut shape Most common Intestinal nematode Ancyclostoma Duodenale Necator Americanus Giant Round Worm LI, Whip inserted into wall Scotch tape Swab Ileum of SI, Cecum,LI man Embryonated Eggs Gravid female Migrates to Perianal area Tissue biopsy Muscle tissue of man, pigs Bachman Intradermal test threadlike ; F – blunt; M – curved w/ 2 lobular appendages; A-end- non-papillated Capillaria Philippinensis HOST LOC. no migration phase to lungs Xenodiagnosis larva – w/ spearlike burrowing tip Ascaris Lumbricoides DFS Unembryo eggs in feces embryonated in soil Embryonated ova Pin worm DIAGNOSTIC Eggs embryonate in Fresh water Embryonated Egg DFS -eggs (E) -larva (L) -adults (A) DFS of eggs SI (jejunum ) of fish, man larvae in gastric mucosa and intestines SI of man (not attach) Decorticated, Unembryo egg tri-radiate xs F-3 lips; M–2 spicules Old World Hook worm teeth cutting plates New World Hook worm 8cell stage larvae, corticated 3rd stage filariform Adults in SI Gall bladder, Liver, nares, appendix DFS EIA -ELA pointed tail, short esophagus DFS EIA -ELA Liver-lung Migration (larv swallowed) SI Lung migration INT HOST 2NDINT HOST PATHOLOGY MOT PHIL -Prolapse of Anus -IDA, Alb, D Sometimes appendicitis symptoms due to unique mode of attachment 1) site ulceration 2) eggs prupritus 3) migrationvulvuvag & salphingitis F-O-R (fecaloral route) -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 Ingestion of encysted larvae in pork Lung mig –Asthma; Capil penetration –Pneumonia; Ab Pain due to adult Migration; Int Obst; eosin Ingestion Yup Burrowing of Sin of foot Most Common In world Ground itch; <500 eggs in feces = light worm, >500 eggs = heavy worm; Hookworm anemia due to suction of blood/ bleeding Oral percutaneous Yes Microcytic Hypochromic H-M (handmouth) Tx Yup 80- Albendazole 90% Mebendazole warm, tropical regions OxantelPyrantel Yup (F>M) Mebendazole yup Thiabendazole inhalation Pyrantel pamoate Retro infection Corticosteroid (for allergic rxn) Mebendazole? Ref (5F 20d, 20F10d, 20F 6d) Ingestion Of larva In raw fish Yup (M>F) I. Norte (N.Luzon) Mebendazole Albendazole THA,JPN, EGY,TAI, IRAN Skin Penetration Tropics, subT Peperazine Citrate Albendazole Mebendzaole Pyrantel Pam Pyrantel Pamoate Mebendazole Iron replacement Strongyloides Stercoralis Thread Worm 3rd stage filariform Rhab in stool filariform; no F M Long eso, Prominent Genital primordium, notched tail PARASITE A.K.A. EGG ADULT Brugia Malayi giemsa – sheath unstained Wuchereria Bancrofti short buc cav INFECTIVE kinky, overlapping nuclei, nuclei reach tail end (terminal, subterminal n.) smooth, single row of nuclei, no term nuc, >L than BM giemsa – SI man; Lung Migr aftr skin Penet; repro parthogenesis Eggs hatch SI Larvae In Arthropod Vector Bites at Night Enters Bite wound Bioincub - 1 year DIAGNOSTIC Blood smear (thick And Knott Conc) Microfilaria In blood at Night HOST LOC. Lymphatics Bloodstream Peripheral Blood INT HOST mosquitos W.B. – Culex Quinque Fasciatus RuralAnoph; UrbanFatigans; Pacificaedes CARD Test – Antigen det Larval migration – Lobular pneu w/ hem; like PUD, Hyper Infection, Peripheral Eosinophilia, malab syndrome 2ND INT HOST PATHOLOGY Acute – Hypersensitizatn Chronic – (poor prog), elephantiasis (blocks lymphs) Weingarten’s Syndrome – Hyper-eosin of Peripheral blood Skin Penetration of FL Freeliving- auto infection MOT Yes Albendazole Tropics, SubT Thiabendazole PHIL Skin Yup Larva Enter bite wound Warm regions Tx Diethylcarbamazine (not effective on adult worms) Ivermectin corticosteroids Mosquito Bites at night supportive – pressure bandaging surgery DNA probes pink stain Loa Loa Larvae crawl into wound Thin blood Smear biopsy Subcutaneous tissue VectorDipteran (chrysops) Calabar swelling Adult in eye hypersensitivity Skin No Larva Enter bite wound Africa Diethylcarbamazine Corticosteroids surgery Larvae in copepods Local lesion Worm/Larvae Mesenteric Tissues Blister w/ Serous exudates Metronidazole Larva migrate To lower ext Ingestion Of Infective copepods NO Middle East, Africa Thiabendazole Calcifiqed Worms by xray Copepods Ingest Larva in water Biopsy Subcutaneous tissue VectorBlack fly Skin NO Diethylcarbamazine Larva Enter bite wound Africa C. and S. America Corticosteriods Brain Mollusks, Snails: Achantina, Pila -River Blindness -Eye lesions - Skin lesions - Scrotum enlargement Eosinophilic Meningoencephalitis Ingestion Of larva In snails NO None recommended TAI, THAI, CAM, VIET, Hawaii, Tahiti Dead parasite Could exacerbate Tissue reaction shedding of sheath, Dracunculus Medinensis Fiery Serpent Israelites Guinea worm larva migrates to lower ext. Oncocerca Volvulus Larvae Crawl into Bite wound Mazzotti Slit lamp 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 Spinal cord ManAccidental hosts Planaria, Slugs, prawns Pseudoperitoneal syndromes + eosins in CSF, CN involve, diplopia and strabismus CSF >= 500 cells/ml w/ 10-90% eosins Surgery Surgical if ncessary Angiostrongylu s costaricensis 3rd stage larva in snails/ slugs ingested by man nd cotton rat Skin test needs evaluation Intestines (gut wall) Mollusks Snails, slugs (Sigmodon hispidus) Anisakis Herring disease Terranova sp – juveniles Pseudoterranova sp – not penetrate Eustrongylides sp – perforates large bowel PARASITE A.K.A. EGG Schistosoma Hematobium 3rd stage larva in flesh of raw fish; larva migrate from viscera to muscle after death of fish ADULT S. Japonicum INFECTIVE Freeswimming Cercaria Platyhelminthes Edoscopy Marine Crustaceans And fish Immunologic Tests under Study DIAGNOSTIC Eggs, miracidia in urine HOST LOC. Adults Bladder, liver larva – Venous Plexuses terminal spine Freeswimming Cercaria Schistosoma Mansoni Platyhelminthes Ova in feces (blood, mucus) Rectal biopsy Platyhelminthes Schistosoma Intercalatum Schistosoma Mekongi Fasciola Hepatica Fasciolidae Cercaria Ova in feces, Rectal biopsy, COPT test, ELISA 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 Sheep Metacercaria Unembryo Liver Encysted On ova in feces, Fluke aquatic duodenal vegetation aspirates “popping operculum” leaf S, w/ shoulders cephalic cone, spinous, dendritic testes Bulinus Snail (Miracidia to cercaria) Liver Mesenteric venules, SC, lungs lateral spine Schistosoma Japonicum INT HOST Liver, Mesenteric Venules, SI, heart, Spleen, CNS Bile duct of Sheep Herbivore animals Biomphalaria Snail Oncomelania Quadrasi, Formosa SnailsLymnea Philippinensis, Lymnea swinhoe (TAI) (sporocystrediacercaria) “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 2ND INT HOST Ingestion Of raw Marine Food w/ Alcohol, “green” herring, sashimi PATHOLOGY NO Remove larvae By biopsy Forceps JPN, Netherlands Surgical Intervention For obstruction Manage conservatively MOT PHIL 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 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) Katayama rxn/ fever, reaction to Eggs in tissue = CNS damage, Hepatosplenomegaly, Portal HTN, Ascites; mucus/blood in feces, liver enzy, serum alb, glob(prot) Skin Penetration Thru Infected water Wala Siguro… Cercaria Penetrate Skin thru Infected water Nope Cercaria Penetrate Skin thru Infected water Yup Aquatic vegetation Ingestion of Infected Vegetation; Infected Liver (false) Cosmo Halzoun – ingestion Raw sheep, goat livers (dyspnea, deafness, asphyxiation, death) fibrotic vs. traumatic/ necrotic lesions; obs; False vs true (no eggs) Tx Praziquantrel Tropics Subtropics Praziquantrel Africa Brazil Praziquantrel Mindanao, Visayas In sheep Raising countries Bithionol e Fasciola Gigantica Giant Liver Fluke Larger than F. hepatica Fasciolidae no Metacercaria Encysted On aquatic vegetation Unembryo ova Metacercaria Encysted On Fresh Water fish Embryo ova In feces or Biliary duodenal aspiratesBDA Metacercaria Encysted On fresh Water fish Embryo ova In feces or BDA Metacercaria shoulders Clonorchis Sinensis Opistorchidae Opistorchis Felineus Opistorchidae Chinese Liver Fluke branched testes; spatulate Cat Liver Fluke lancet S reddishbile color Opistorchis Viverrini knob at abopercular end Opistorchidae Dicrocoelium Dendriticum Lancet fluke deep golden-brown Dicrocoellida PARASITE Paragonimus Westermani A.K.A. EGG testes like O. felineus 2 large testes lancet, flat, transparent, aspiny branched testes side by side; coffee operculum at broad end, thick aboper bean; integument w/ spines Fasciolopsis Buski Metacercaria indistinguish from F. hep, F. gigantica 2 dendritic testes in tandem H. Most Probably Cholangiocarcinoma of liver, liver function Impaired but SGPT and SGOT are normal Periportal fibrosis, Invasion of pancreas, Form bile stones Ingestion of Uncooked fish Rare Ingestion of Infective fish Nope FWF Cyprinus Carpio (Taiwan) Embryo ova In feces Or BDA Civet cat, Dog, fisheating Snails - Bithynia Goniomphalus, Funiculate, laevis FWF Punteus Orphoides, Hampala dispar Hyperplastic biliary Epithelium (Stim by Nitrosamines); assos. w/ cholangiocarcinoma Ingestion of Infective fish Nope Embryo ova sheep Snails- Abida, Cochilcopa, Helicella, Zeb Formica Fusca (ants) Same as F. hepatica Ingestion of ants Wala siguro HOST LOC. Metacercaria In crustacean Unembryo eggs in feces or sputum Encapsulated in Parenchyma of lung; in fibrotic capsules complement fixation Unmebryo Eggs in feces Reservoir – Cats & dogs Duodenum of Man or pigs Snail Miracidia (M) Cercaria (C) Antemelania Asperta; Antemelania Dactylus Crabs – Snails – M C Aquatic Vegetation C meta-C Water caltrop, Water chestnut, Water morning Glory, lotus Many fish in the Phil. (30 Species); in Segmentina, Hippeutis MC are Sensitive to Dryness Unembryo Eggs in stool Using KatoKatz method Small Intestines 2ND INT HOST INT HOST Snails : Freshwater, Brackish or Sundathelphusa Philippina C meta-C Portal cirrhosis, Periductal fibrosis PATHOLOGY MOT Granulomatous rxn in lungs; rustcolored sputum, w/ Foul fish Odor Ingestion Of Infected crustaceans Misdiagnosed For PTB Worms cause Traumatic, Obstructive and toxic effects; ulceration and mucus prod. Inflamm, Sloughing off Bithionol Africa, Asia Snails - Bithynia Funiculate DIAGNOSTIC Metacercaria In fish Heterophyes Heterophyes Ingestion of Infected Vegetation Small AnimalsCats, dogs, etc (BT SI) BT INFECTIVE Metacercaria In water Plants Aquatic vegetation Fresh water Fish (FWF) : Cyprinidae, Ctenopharyngodon w/ fully dev miracidium Cercaria w/ spines Snail Operculate Snails (Alocinma, Parafossarulus, Bithynia) lobed ADULT Oriental Lung Fluke Giant AnimalsCattle Biliary tract (BT) Man CHI, JPN, SK, Vietnam Chloroquine Diphosphate Praziquantel Praziquantel USSR, poland Praziquantel Thailand Udorn PHIL Praziquantel Tx Yes Praziquantel Asia Bithionol Triclabendazole Ingestion Of Infected Water Plants Nope Ingestion of MC Encysted in fish Yes Praziquantel SEA, CHN, India, indonesia EGY, Greece, Praziquantel Metagonimus yokogawai M. eggs no aboper protub; same hard to distinguish adults; scale-like spines, w/ genital sucker, globular testes Echinostoma Ilocanum Metacercaria indisting.from fasciolas Taenia Solium oral sucker with collar of spines; 2 lobed testes in tandem, reddish-grey rostellum w/ hooks 4 suckers; ripe proglottid <13 lateral branches; 3m Taenia Saginata Beef tapeworm Longest Tapeworm No sporocyst stage Cysticercous Cellulosae Pork Tapeworm indistinguish from each other and from E. granulosus; hexacanth (6 hooklets); radially striated shell Reservoir – Fish eating mammals Miracidium present in The egg once Deposited by adult eggs – cause cysticercosis Cysticercous bovis Unembryo Eggs in feces Small Intestines Reservoirrats Ripe or gravid Proglottid Small intestines of man formaldehyde soln cysticercosis in muscles M C Snails: -Gyralus Convexlusculus -Hippeutis Umbilicalis M C muscles at base of the fin Of layers, Mucus prod C Misdiagnosed For acid Peptic ds (APD), consistent w/ PUD meta-C Snails: -Pila luzonica “kuhol” and -Vivipara Angularis“suso” C meta-C Hogs, wild Boars, sheep, Deer, dogs, Monkeys, rats, cats Man SI (accidental) Scolex after therapy xs Cattle, llama, Giraffe, Carabao eggs cysticercous bovis CHN, JPN, KOR, TWN, Phil Inflamm, Ulceration, Diarrhea, intoxiacation Ingestion Of encysted MC in snails Of course Inflamm, Eosinophilia, leukopenia Ingestestion Of inadeq. Cooked Pork yes cosmo Dev Cisticercosis (ingestion of eggs), larva in brain, muscle, eye eggs cysticercous cellulosae Scolex after therapy Ripe or gravid Proglottid Marine Praziquantel N. Luzon, Samar, Leyte, Mindanao Praziquantel Accidental Ingestion of eggs Epigastric Pain, vertigo, Nervousness, eosinophilia Ingestion Of cysts in beef Obstruction – Growing cysts; Anaphylactic Shock when Cyst ruptures FOR Niclosamide damage to point of dissolution no rostellum, hooklets ripe >15 branches; 5m; tree-like dicho branching Echinococcus Granulosus smallest Tapeworm In man PARASITE Parasite Of dog Eggs – man Hydatid sand one long gravid proglottid A.K.A. EGG ADULT dogs INFECTIVE x-ray to detect hydatid ds; immunologic tests SI of Dog -Cysts Ingested and Release scolices DIAGNOSTIC HOST LOC. Sheep, man (accidental, intermediate– in liver and lungs) INT HOST 2ND INT HOST PATHOLOGY rare Ingestion Of eggs in feces MOT Sugery Prev spillage of eggs) Albendazole PHIL Tx Diphyllobothrium Latum Fish/ Broad tworm Plerocercoid Larva Encyted In fish yellow-brown knob like thickening Operculated Eggs; Proglottids Kato tech SI in man Reservoir Host: Dogs, cats,Bears Paratenic host: Carnivore fish copepods (Cyclops & Diaptomus) (fish) perch, trout, salmon, pike Ingestion Coracidia (CO) Procercoid (ProC) Anemia (misdiag for pernicious type Vit B12 def); hyperchromic megaloblastic; examine for HCl in gastric juice (+ infection) Ctenocephalides canis (dog flea) Minimal symptoms Ingestion yup Praziquantel Enteritis due to Necrosis and Desquamation Of intestinal Epithelial cells FOR yup Praziquantel Praziquantel ProC PleroC Rare Praziquantel Only 7 cases temperat e zone spatulate, rosette uterus 2 bothria = sucking grooves Dipylidium Caninum Dog T-worm Cysticercoid Larva in Arthropod Host when ingested Double Pored T-worm egg packets (815 eggs) oncosphere w/ 6 hooklets Hymenolepsis Nana Dwarf tworm Embryo Eggs in Contam food and Water with filaments Hymenolepsis Diminuta like D. caninum scolex but with less hooklets; ripe segment Rat T-worm w/o filaments bile-stained; fan-like Sparganosis retractile, conical scolex; rose-thorn shape hooklets mature proglottid – with 2 lateral genital pores Cyticerci Can complete Cycle in single Host (autoinf) Mansoni, Erinacei, Ranarum Embryo Eggs in feces SI of man Ctenocephalides felis (cat flea) Pulex irritans (human flea) Trichodectes canis (dog louse) Insects, rice And flour beetles Proglottids not Recovered bec They degenerate Auto Infection Direct/indirect pathways Eggs in stool (more circular, larger, lack bipolar thickening vs H. nana SI of man Plerocercoid In toads, frogs, snakes, White larvae In lesion Adult – Intestines of Cat/man paratenic hosts - pigs mistaken for D. latum; pseudosegmentation w/ slit-like invagination SI of dog or cat Cysticercoid Larvae in insects gravid segment; rudimentary, unarmed rostellum Spirometra Gravid Proglottids That are passed out/ Crawl out, Egg packets, Melon-shaped Proglottids in Chains (Not stool bec proGlot disint in environment Larvae – any part, eye, subQT, muscles Fleas, beetles, cockroaches, mealworms & earwigs Cyclops, copepods Frogs, Snakes, Toads, rats Minimal and Nonspecific Ingestion Of Infected insects yes Painful edema Due to migrating Larvae Ingestion Of Infected interM hosts Not sure Eosinophilia, Edema and erythema In rats <8% surgical INT HOST PARASITE Entamoeba Histolytica Naegleria fowleri A.K.A. CYST TROPHOZOITE Ameba greenish-yellow quadrinucleate, thick, rodlike chromatoidal bodies CB, central karyosome (K), w/ chromatin dots No cyst only Flagellated form INFECTIVE DIAGNOSTIC Qudri cysts -Trophozoites In liquid stools -Cysts in Formed stools Large Intestines (cecal and sigmoidorectal) Culture, serology to detect invasive Amebiasis (IHAT) liver in extraint amebiasis active, progressive, directional; pseudopod PSD: finger-shape, hyaline; w/ ingested RBC Trophozoite ELISA most Sensitive indicator Trophozoites In CSF and tissue HOST LOC. Brain Flagellate form in CSF Large, usually Central K trophozoite large central K; double cell wall sluggish; PSD: spinelike No peripheral chrom yellowbrown; 1-8 nuclei, K eccentric; CB : splinter-like sluggish, rarely prog and dir; PSD: short, blunt; Bacteria/ debris Inclusions Mod active, prog PSD : blunt, hyalin Entamoeba coli Entamoeba Gingivalis Endolimax nana pale green; 1-4 nuc; K irreg CB : bacilliform sluggish prog; PSD:blunt /hyaline; K – L, cent Cysts and Trophs inTissue Giemsa or PAS of Scrapings or Cornial biopsy PATHOLOGY CNS cornea MOT Flasklike Primary ulcer; Histo changes: Histolysis, Thrombosis, Petechiae, Round Cell Infiltration, Necrosis Ingestion Of Infective cysts Bacilliary vs Amebic dysentery glu Amebic Encephalitis (immunocompromised) Amebic Keratitis (assoc w/ use of contam contact lenses) PHIL Yes Most Common Are Asympto carriers Tx Supportive, Chemotherapy Asympto – Diiodohydroxyquin Mod severe Metronidazole Severe – D + M Hepatic – M + emetine Meningoencephalitis Severe frontal Headache,Blocked nose, Altered taste and smell Kernig’s sign; Leukocytosis w/ neuts, prot, slug-like; PSD: blunt; Acanthamoeba 2ND INT HOST EntersThru Nose Penetrate Cribriform Plate Multiply in brain 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 Iodamoeba butschlii 1 nuc yellow green; K surr w/ granules; endosome slug, prog; PSD : Blunt/Hyaline 1-4 nuc; K small/Central; Diffuse glyco mass prog; PSD : fingerlike Entamoeba hartmanii PARASITE A.K.A. CYST non TROPHOZOITE Balantidium Coli Largest prot parasite Only ciliate Giardia Lamblia INFECTIVE cyst bean-shaped nuc cytostome; cytopyge; “gay bowel syn” Quadri cysts young – 2 nuc; mature – 4 nuc; flagella retracted into axonemes No cyst stage Trichomonas vaginalis pyriform/tear-drop; bisymm; erratic tumbling motion; 8 flag Troph No known cystic stage DFS of Troph and Cysts in Feces Sigmoidoscopy DFS Cysts and Trophs Biopsy, Entero-test, IF and antigen detection pyriform; jerky movements; 4 free flag +1 undulating; axos Dientamoeba Frgilis DIAGNOSTIC Troph HOST LOC. INT HOST SI Cysts Troph Diarrhea and Dysenter (indisting. from Amebic) 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 -Vaginal discharge – Liquid, green to yellow, Irritating -Speculum – Strawberry Cervix (diagnostic) -Vaginitis; urethritis SI Duo, jeju, upper il Attaches To int villi Via adhes Disc on ven Female – Vaginal epi Binucleate Trophs in fresh Stool samples In lumen Of LI Male – Urethra, Epididymis, Prostate g -Increase excess mucus -Hypermotility of the bowel -Colicky ab pain; anal Pruritis; Peripheral eosinophilia rosetteshaped nuclei; no peri chromatin; K w/ 4-6 granules; no flag Leishmania Tropica Old World Cut Leish w/ ovoid or rounded bodies MOT in skin tissue biopsy Lives Intracellular In Macrophages Sand fly Pheobotomus Spp Cutaneous leishmaniasis Lesions resembling Lepromatous leprosy PHIL Tx FOR Siguro Tetracycline Ingestion of Contam Food And water Uncommon In Temperate; Assoc w/ Pigs in tropics siguro Metronidazole FOR Outbreaks Are waterborne Sexual intercourse Passed thru Birth canal Co-infection With E. vermicularis -Mimics IBS (irrit bow syn) Pro M promastigote PATHOLOGY Ulcer w/ rounded Base and wide Neck (vs flask shape) LI (cecal area) troph Trophozoites In urine, Urethral sec, Vaginal sec, Cervical sec, Semen, Prostatic sec 2ND INT HOST Bite of Sandly vector Yes Hostpitality Girls – 24% Iodoquinol Oral Metronidazole Tinidazole Furozolidone Quinacrine paromomycin Oral Metronidazole Acid douches Other groups - 3-8% Siguro Iodoquinol …as long as may infection w/ E. vermic in pre-schools in Germany, Israel, Holland Wala Tetracycline Africa, India South amercia Metronidazole Antimony Compounds Leishmania Donovani 1 free flagella arising from kinetoplast Bone marrow, Spleen or Lymph nodes Pro M Mast amastigote Leishmania Braziliensis PMS and Endothelial Cells New World Cut Leish amastigote Trichomonas Tenax Smaller and longer than T. vaginalis Chilomastix Mesnili Troph cysts knob- like prod, LemonS Serology – For supportive diagnosis swabbing Cysts in Semi-formed Stools; Trophs in Liquid stools Visceral Leishmaniasis or Kala-azar A-Mast Pro M in gut of fly Splenomegaly, presence of Parasites in RE cells; Mucocutaneous or American Leishmaniasis A- Tapir nose Erosion of pinna of forest workers Oral cavity tartar Droplets, kissing yes Cecal region Of LI FOR Rare <1% spiral forW; 3 ant flag + 1 INT HOST PARASITE Trypanosoma Gambiense Trypanosoma Rhodesiense Trypanosoma Cruzi A.K.A. CYST West African Sleepng Sicknes TROPHOZOITE Trypomastigote INFECTIVE T-mastigote DIAGNOSTIC Parasite in Blood tissues Or CSF HOST LOC. In blood, Lymph and CSF Serology for Large scale Screening East African Sleepng Sicknes Chaga’s Disease Trypomastigote T-mastigote Blood smear Serology –CF Xenodiag biopsy Tsetse Fly Reservor Host: Domestic Animals Tsetse Fly Reservor Host: Game animals ELISA, IF Epimastigote Second line Drugs: Amp B, Pentamidine (Kala-azar), Metronidazole Nifurtimox Histiocytes RE cells (adipose, myocardial, RE, Neuroglial) Reduviids, Triatomid Bugs Reservoir: Wild mammals 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 MOT Bite of Vector Congenital Transmission possible PHIL Tx NO Supportive West and Central Africa Pentamidine Suramin Melarsopenol Tryparsamide Melarsen NO Uh..east Africa? J -Bite of Vector -feces -transplacental -accidental ingestion blood trans No 8-amino quinolones Income Groups In Suburban rural Primaquine, Nifurtomax (Bayer 2502) Toxoplasma gondii (cat?) pseudocyst and oocyst w/ Sporozoites -Oocyst prod By sexual Cycle in cat; Pseudocystsasexual (man) bradyzoite, cyst male and female gametocytes Schizont, gametes Inside host Isospora Belli Mature oocyst w/ sporozoites 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 Immature Cysts in feces -Oocysts/ Sprorcysts in dudenum SI of man Mouse or Rat Man, pigs, Sheep, Accidental Intermediate hosts Definitive – CAT Definitive – MAN GAMETE Plasmodium Falciparum Plasmodium Vivax Plasmodium Malariae Plasmodium Ovale cysts SCHIZONT Surgical open Lung biopsy; BronchoAlLav; Bronchoscopy; Methenamine Silver stain Ingestion, Transplacenetal Yes Cosmo Many are Chronic Ill but are asympto 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 immature cyst Pneumocystis Carinii Brain lesions; hepatitis; Chorioretinitis; Lymphadenitis FOR interstitial pneumonia; fatal pneumonia in infants; hypogammaglobulinemia, leukemia, Hodgkin’s, etc lungs are gray and airless; death due to asphyxia Not sure Pyrimethamine (Daraprim), TrisulfapyriMidines; Preg – spiramycin, Clinamycin; AIDS – Atovaquone Pyrimethamine Sulfadiazide or Trimetroprim Droplets, Close contact Yes cosmo Bactrim Bite of female Mosquito Yes Vivax and Ova –Chloroquine + Primaquine TROPHOZOITE Mosquito – Gametocytes; Man – Sporozoites Peripheral Blood smears -thick thin RBC (Man) Vivax – young Malariae – old Falciparum –all Anopheles Flavirostris Minimus Hypnoxoite – Latent stage, Cause relapse QBC, Para sight F test (dipstick test), IFA Mosquito : 1)Stomach – Gamete form, 2)Stomach wall – oocyst and sporozoite release 3)salivary glands - sporo Anopheles -litoralis -balabacensis -mangyanus -maculates Sporogany – Mosquito LC; Schizogony – Human LC - exoerythro (merozoites) - erythro (gametocytes) -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 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. Falci and Mal Chloroquine Chloroquine Resistant – Falc
