Fungus and Parasites Why me? Systemic Fungi Dimorphic Histoplasmosis Mold in soil, yeast in tissue Cold=mold; Heat=yeast Bird or Bat droppings Mississippi and Ohio River Blastomycosis Mississippi River Big, Broad-Based Budding HIsToplasmosis & BLASTomycosis Coccidiomycosis Southwest US San Joaquin “valley fever” Skin Fungus Tinea – all skin fungi Tinea versicolor Odd Color Caused by Malassezia furfur Skin fungus Tinea nigra Brown/black Cladosporium werneckii Skin fungus Others are by location: Tinea pedis – Athlete’s foot Tinea cruris – Jock itch Tinea corporis – Body (ringworm) Tinea capitis - Head Opportunistic fungi Candida Normal • Thrush • Vaginitis – “yeast infection” • Diaper rash or under breasts Immunocompromised • Esophagitis • Disseminated infection Opportunistic fungi Aspergillus – Aspirate – Asthma(?) A for Acute Angle branching Opportunistic Fungi Cryptococcus Neoformans Opportunistic Fungi Mucor and Rhizopus >90° branching mold Ketoacidosis and leukemia Pneumocystis carinii Pneumonia Cyst – circle – yeast (not mold) Opportunistic Fungi Sporothrix schenckii Dimorphic fungus “Rose gardener’s” disease Protozoa Having fun yet? Entamoeba Histolytica Things to remember: Inflammatory Diarrhea Liver – “anchovy paste” Flask-shaped ulcer Cysts Tx with Metronidazole Anchovy Paste Giardia lamblia From drinking untreated water (cysts) Flatulence, foul-smelling diarrhea Cryptosporidium Starts w/ Crypto, so think AIDS Spore, so think cysts Causes diarrhea (surprise) The 1994 Milwaukee outbreak from water treatment problem Toxoplasma Cat feces to pregnant moms Hydrocephalus / birth defects Plasmodium Malaria Diagnosed w/ blood smear Tx w/ mosquito (female) Plasmodium Plasmodium Plasmodium Trichimonas vaginalis STD Trichimonas vaginalis Trypanosoma cruzi American Things to remember: Chagas’ (heart) disease Reduviid bug Trypanosoma cruzi Chagas problems of the heart Reduviid - The Kissing Bug Don’t let the kissing bug poop on you! Trypanosoma gambiense Trypanosoma rhodesiense African (Gambia, Rhodesia) Things to remember African Tsetse fly sleeping sickness • Tutsi’s are in Africa • (Rwanda) Leishmania Things to remember: Cutaneous Visceral (kala-azar) Sandfly Leishmania Babesia microti Ixodes tick “Maltese cross” on blood smear Naegleria Fowleri Things to remember Fowl play – 95% die in a week Meningitis Swimming Naegleria Fowleri Metronidazole Worms It’ll be over soon Tapeworms Treat tapeworms with niclosamide Taenium solium Pork tapeworm Causes mass lesions in the brain Echinococcus granulosus Hydatid tapeworms Granulosus – think of these big cysts – mostly liver and lung Schistosoma Snails, Swimmer’s itch, Skin, Spleen Clonorchis sinensis Undercooked fish Inflamed biliary tract Paragonimus westermani Lung fluke Western man – Marlboro man – lung problems Ancyclostoma duodenale Hookworm Can penetrate feet Can cause anemia Remember An=not cyclo=round Stoma=mouth Ascaris lumbricoides Scariest intestinal worm Wandering behavior Enterobius vermicularis Pinworm (vermin) Most common parasite in US Scotch tape test Strongyloides stercoralis Threadworm Tx with Ivermectin Trichinella spiralis Worm in undercooked prok Causes muscle inflammation & periorbital edema Dracunculus medinensis In untreated water Loa Loa Transmitted by deer fly See worm crawling on conjunctiva Onchocerca volvulus From blackflies River blindness Onco-tumor Cerca-circle (eye)? Toxocara canis From dogs -cara rhymes with sclera Wuchereria bancrofti Elephantiasis – lymph blockage Thank you!