PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC.INT

HOST2NDINTHOST PATHOLOGY MOT PHIL Tx

Trichuris trichiura

Whipworm

Barrel-S, 2 plugsunembryo

M – curved 360F – blunt; stichocytes

Embryonated Egg in soil/feces

embryonated in soil

DFS Unembryo eggs in feces

LI, Whipinserted into wall

no migrationphase to lungs

-Prolapse of Anus-IDA, Alb, D-Sometimesappendicitis-symptoms due to unique mode of attachment

F-O-R(fecal-oral route)

Yup

80-90%

warm,tropicalregions

Albendazole

Mebendazole

Oxantel-Pyrantel

EnterobiusVermicularis

SeatWorm

Pinworm

D-shape, football

spindle-S, cephalic ala,corpus, isthmus, bulbM – curved tailF – pointd tail

Embryonated ova Scotch tapeSwab

EmbryonatedEggs

Ileum of SI, Cecum,LI man

Gravid femaleMigrates to Perianal area

1) site - ulceration2) eggs - prupritus3) migration-vulvuvag & salphingitis

H-M(hand-mouth)

inhalation

Retroinfection

Yup (F>M)

Mebendazole

Pyrantel pamoate

TrichinellaSpiralis

larva – w/ spearlikeburrowing tip

thread-like ; F – blunt;M – curved w/ 2 lobular appendages;A-end- non-papillated

Encysted larvae inInad 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 encystedlarvae inpork

yup Thiabendazole

Corticosteroid(for allergic rxn)

Mebendazole?

Ref (5F 20d, 20F10d, 20F 6d)

CapillariaPhilippinensis

peanut shapeembryonated eggs in Ftypical F – 8 in 1 rowatypical F – 40 in 2M – w/ chitin spicule

Larva in raw fish

Eggs embryonate inFresh water

DFS-eggs (E)-larva (L)-adults (A)

SI (jejunum ) of fish, man

larvae in gastric mucosaand intestines

-int mal-ab-Borborygmi-Ab Pain-Diarrhea-Villus flat-Atrophy COL-death

Ingestion Of larvaIn raw fish

Yup (M>F)I. Norte(N.Luzon)

THA,JPN,EGY,TAI,IRAN

Mebendazole

Albendazole

AscarisLumbricoides

Most commonIntestinalnematode

GiantRoundWorm

Decorticated,Unembryo egg

tri-radiate xsF-3 lips; M–2 spicules

Embryonated Egg

larvae, corticated

DFS of eggs

Adults in SIGall bladder,Liver, nares,appendix

SI of man(not attach)

Liver-lung Migration(larv swallowed)

Lung mig –Asthma;Capil penetration–Pneumonia; Ab Pain due to adultMigration; Int Obst; eosin

Ingestion

Burrowing ofSin of foot

Yup

MostCommonIn world

PeperazineCitrate

AlbendazoleMebendzaolePyrantel Pam

AncyclostomaDuodenale

OldWorldHookworm

8-cell stage

teeth

3rd stage filariform

pointed tail, short esophagus

DFSEIA

-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

Oralpercutaneous

Yes

Tropics,subT

PyrantelPamoate

Mebendazole

Iron replacement

NecatorAmericanus

NewWorldHookworm

cuttingplates

DFSEIA

-ELA

SkinPenetration

StrongyloidesStercoralis

ThreadWorm

filariform; no F M

3rd stage filariform Rhab in stool

short buc cav

SI man; Lung Migr aftr skin Penet; reproparthogenesis

Eggs hatch SI

Larval migration – Lobular pneu w/ hem;like PUD, Hyper Infection, Peripheral Eosinophilia, malabsyndrome

- SkinPenetrationof FL- Free-living- autoinfection

Yes

Tropics,SubT

Albendazole

Thiabendazole

Long eso,Prominent Genital primordium, notched tail

PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST2ND INTHOST PATHOLOGY MOT PHIL Tx

Brugia Malayi kinky, overlapping nuclei, nuclei reach tail end (terminal, subterminal n.)

giemsa – sheath unstained

Larvae InArthropodVector

Bites at Night

EntersBitewound

Bioincub- 1 year

Blood smear(thickAnd KnottConc)

MicrofilariaIn blood atNight

CARD Test –Antigen det

DNA probes

LymphaticsBloodstream

Peripheral Blood

mosquitos

W.B. –Culex QuinqueFasciatus

Rural-Anoph;Urban-Fatigans;Pacific-aedes

Acute – Hypersensitizatn

Chronic – (poor prog),elephantiasis(blocks lymphs)

Weingarten’sSyndrome –Hyper-eosin ofPeripheral blood

Skin

Larva Enter bitewound

MosquitoBites atnight

Yup

Warm regions

Diethylcarbamazine(not effective onadult worms)

Ivermectin

corticosteroids

supportive – pressure bandaging

surgery

WuchereriaBancrofti

smooth, single row of nuclei, no term nuc,>L than BMgiemsa – pink stain

Loa Loa

shedding of sheath,

Larvae crawl intowound

Thin bloodSmear

biopsy

Subcutaneoustissue

Vector- Dipteran(chrysops)

Calabar swelling

Adult in eye

hypersensitivity

Skin

Larva Enter bitewound

No

Africa

Diethylcarbamazine

Corticosteroids

surgery

DracunculusMedinensis

FierySerpentIsraelites

Guineaworm

larva migrates to lower ext.

Larvae incopepods

Local lesionWorm/Larvae

Calcifiqed Worms byx-ray

Mesenteric Tissues

Larva migrateTo lower ext

CopepodsIngestLarva in water

Blister w/ Serous exudates

Pseudoperitonealsyndromes

IngestionOf Infectivecopepods

NO

MiddleEast,Africa

Metronidazole

Thiabendazole

OncocercaVolvulus

Larvae Crawl intoBite wound

Biopsy

Mazzotti

Slit lamp

Subcutaneoustissue

Vector-Black fly

-River Blindness-Eye lesions- Skin lesions- Scrotum enlargement

Skin

Larva Enter bitewound

NO

AfricaC. and S.America

Diethylcarbamazine

Corticosteriods

SurgeryAngiostrongylusCantonensis

RatLungworm

adult emale “Barber pole” dark red intestinal tract

3rd stage larva in snailsand slugs or rats ingestedby man

snails – paratenichosts

History-eating, travel

leukocytosis& eosinophilia

Skin test needsevaluation

Brain

Spinal cord

Man- Accidentalhosts

Mollusks,Snails:Achantina,Pila

Planaria,Slugs,prawns

Eosinophilic Meningoencephalitis

+ eosins in CSF,CN involve, diplopiaand strabismusCSF >= 500 cells/ml w/ 10-90% eosins

IngestionOf larvaIn snails

NO

TAI, THAI,CAM, VIET,Hawaii, Tahiti

None recommended

Dead parasiteCould exacerbateTissue reaction

Surgical if ncessary

Angiostrongyluscostaricensis

3rd stage larva in snails/ slugsingested by man nd cotton rat (Sigmodon hispidus)

Intestines(gut wall)

Mollusks

Snails,slugs

“acute abdomen”- inflamm of ileocecal region; Ab pain loc toright lower quad +palpable tumor-like m

Anisakis Herringdisease

Terranova sp – juveniles

Pseudoterranova sp – not penetrate

Eustrongylides sp – perforates largebowel

3rd stage larvain flesh of rawfish; larva migrate from viscera to muscle after death of fish

Edoscopy

ImmunologicTests underStudy

MarineCrustaceansAnd fish

Pseudoterranova spp –Not penetr8 stom, Throat irrit, coughed

IngestionOf rawMarine Food w/Alcohol,“green”herring,

NO

JPN,Netherlands

Remove larvaeBy biopsyForceps

Surgical InterventionFor obstruction

Anisakis simplex (USA)Stom, int, inflammRxn surrounding larvaAnisakiasis – local

Tissue response;(Eustrongylides spp)Perforation of L bowel

sashimiManage conservatively

PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST2ND INTHOST PATHOLOGY MOT PHIL Tx

SchistosomaHematobium

Platy-helminthes

terminal spine

S. Japonicum

in copula, males have gynecophoric canals

Free-swimmingCercaria

Eggs, miracidiain urine

Adults - Bladder,liverlarva – Venous Plexuses

Bulinus Snail(Miracidia tocercaria)

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 PenetrationThruInfectedwater

WalaSiguro…

Tropics Subtropics

Praziquantrel

SchistosomaMansoni

Platy-helminthes

lateral spine

Free-swimmingCercaria

Ova in feces (blood,mucus)Rectal biopsy

Liver

Mesentericvenules, SC, lungs

BiomphalariaSnail

Claypipe-stem Fibrosis =Thickening of portal vessels due torxn w/ eggs; Hepatosplenomegaly

Portal HTN, ascites, eggs sometimesDeposited in SC, lungs

liver enzy,serum alb, glob(prot)

Cercaria PenetrateSkin thruInfectedwater

Nope

AfricaBrazil

Praziquantrel

SchistosomaJaponicum

Platy-helminthes

lateral knob(smallest)

Cercaria Ova in feces,Rectal biopsy,COPT test,ELISA

Liver,MesentericVenules,SI, heart,Spleen, CNS

Oncomelania Quadrasi, Formosa

Katayama rxn/ fever, reaction toEggs in tissue = CNS damage,

Hepatosplenomegaly, Portal HTN,Ascites; mucus/blood in feces,

liver enzy,serum alb, glob(prot)

Cercaria PenetrateSkin thruInfectedwater

Yup

Mindanao,Visayas

Praziquantrel

SchistosomaIntercalatum

Like Schistosoma Mansoni in terms of life cycle, pathology and clinical featuresIntermediate host – Biomphalaria snail

SchistosomaMekongi

Lide Schistosoma Japonicum in terms of life cycle, pathology and clinical featuresIntermediate host – Lithoglyphopsis aperta

FasciolaHepatica

Fasciolidae

SheepLiverFluke

“popping operculum”

leaf S, w/ shoulders cephalic cone, spinous, dendritic testes

MetacercariaEncystedOn aquaticvegetation

Unembryo ova in feces,duodenal aspirates

Bile duct of Sheep

Herbivoreanimals

Snails-Lymnea Philippinensis,Lymnea swinhoe (TAI)(sporocyst-redia-cercaria)

Aquaticvegetation

Halzoun – ingestionRaw sheep, goat livers(dyspnea, deafness,asphyxiation, death)fibrotic vs. traumatic/necrotic lesions; obs;False vs true (no eggs)

Ingestion ofInfectedVegetation;InfectedLiver (false)

Cosmo

In sheepRaisingcountries

Bithionol

FasciolaGigantica

Fasciolidae

GiantLiverFluke

Larger thanF. hepatica

no shoulders

MetacercariaEncystedOn aquaticvegetation

Unembryo ova

Giant Animals- CattleBiliary tract (BT)

Snail Aquaticvegetation

Ingestion ofInfectedVegetation

MostProbably

Africa,Asia

Bithionol

ClonorchisSinensis

Opistorchidae

ChineseLiverFluke

branchedtestes;spatulate

MetacercariaEncystedOn FreshWater fish

Embryo ovaIn fecesor BiliaryduodenalaspiratesBDA

Man

BT

OperculateSnails(Alocinma, Parafossarulus,Bithynia)

Fresh water Fish (FWF) :Cyprinidae,Ctenopha-ryngodon

Cholangiocarcinoma ofliver, liver function Impaired but SGPT andSGOT are normal

Ingestion ofUncooked fish

Rare

CHI, JPN,SK, Vietnam

ChloroquineDiphosphate

Praziquantel

OpistorchisFelineus

Opistorchidae

CatLiverFluke

lancet Sreddish-bilecolor

MetacercariaEncystedOn freshWater fish

Embryo ovaIn fecesor BDA

Small Animals-Cats, dogs, etc (BT SI)

Snails - Bithynia Funiculate

FWFCyprinusCarpio (Taiwan)

Periportal fibrosis,Invasion of pancreas, Form bile stones

Ingestion ofInfectivefish

Nope

USSR,poland

Praziquantel

OpistorchisViverrini

Opistorchidae knob at lobed testes like O. felineus

Metacercaria

Embryo ovaIn fecesOr BDA

Civet cat,Dog, fish-eating

Snails - BithyniaGoniomphalus,Funiculate,

FWFPunteus Orphoides,Hampala

Hyperplastic biliaryEpithelium (Stim byNitrosamines); assos.w/ cholangiocarcinoma

Ingestion ofInfective fish

Nope

ThailandUdorn

Praziquantel

abopercular end laevis disparDicrocoeliumDendriticum

Dicrocoellidae

Lancetfluke

deepgolden-brown

2 large testeslancet, flat,transparent,aspiny

Metacercaria

Embryo ova

w/ fully devmiracidium

sheep Snails- Abida, Cochilcopa,Helicella, Zeb

FormicaFusca (ants)

Same as F. hepatica

Portal cirrhosis,Periductal fibrosis

Ingestion ofants

Wala siguro

Praziquantel

PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST2ND INTHOST PATHOLOGY MOT PHIL Tx

ParagonimusWestermani

OrientalLung Fluke

operculum atbroad end,thick aboper

branchedtestes side by side;coffee bean;

integument w/ spines

MetacercariaIn crustacean

Cercaria w/spines

Unembryoeggs in fecesor sputum

complementfixation

Encapsulated inParenchyma of lung; in fibrotic capsules

Reservoir –Cats & dogs

Snail -Miracidia (M)Cercaria (C)AntemelaniaAsperta;Antemelania Dactylus

Crabs –

SundathelphusaPhilippina

C meta-C

Granulomatous rxn in lungs; rust-colored sputum, w/ Foul fish Odor

MisdiagnosedFor PTB

IngestionOf Infectedcrustaceans

Yes

Asia

Praziquantel

Bithionol

Triclabendazole

FasciolopsisBuski

indistinguishfrom F. hep,F. gigantica

2 dendritic testes in tandem

Metacercaria In water Plants

MC are Sensitive to Dryness

UnmebryoEggs in feces

Duodenum of Man or pigs

Snails –M C

Segmentina,Hippeutis

Aquatic VegetationC meta-CWater caltrop,Water chestnut,Water morningGlory, lotus

Worms causeTraumatic,Obstructiveand toxic effects;ulceration and mucus prod.

IngestionOf InfectedWater Plants

Nope

SEA,CHN,India,indonesia

Praziquantel

HeterophyesHeterophyes

H.

M.eggs no aboperprotub; same

hard to distinguish adults;scale-like spines, w/genital sucker, globulartestes

MetacercariaIn fish

Miracidiumpresent inThe egg onceDeposited byadult

Unembryo Eggs in stoolUsing Kato-Katz method

Small Intestines

Reservoir – Fish eatingmammals

Snails :Freshwater,Brackish orMarine

M C

Many fish in the Phil. (30 Species); in muscles at base of the fin

C meta-C

Inflamm, Sloughing offOf layers, xsMucus prod

MisdiagnosedFor acid Peptic ds (APD), consistentw/ PUD

Ingestionof MCEncysted infish

Yes

EGY,Greece, CHN, JPN,KOR, TWN,Phil

Praziquantel

Metagonimusyokogawai

EchinostomaIlocanum

indisting.fromfasciolas

oral sucker with collar ofspines; 2 lobed testes intandem, reddish-grey

Metacercaria

No sporocyststage

Unembryo Eggs in feces

SmallIntestines

Reservoir-rats

Snails:-GyralusConvexlusculus-Hippeutis UmbilicalisM C

Snails:-Pila luzonica“kuhol” and-Vivipara Angularis“suso”C meta-C

Inflamm, Ulceration,Diarrhea,intoxiacation

IngestionOf encystedMC in snails

Of course

N. Luzon,Samar,Leyte,Mindanao

Praziquantel

TaeniaSolium

PorkTapeworm

indistinguishfrom each other and fromE. granulosus;hexacanth (6hooklets); radially striated shell

rostellum w/ hooks4 suckers; ripe proglottid<13 lateral branches; 3m

CysticercousCellulosae

eggs – causecysticercosis

Ripe or gravidProglottid

formaldehydesoln

Scolex aftertherapy

Small intestinesof man

cysticercosisin muscles

Hogs, wildBoars, sheep,Deer, dogs,Monkeys, rats,cats

eggs cysticercouscellulosae

Inflamm,Eosinophilia,leukopenia

Dev Cisticercosis(ingestion of eggs), larva inbrain, muscle,eye

IngestestionOf inadeq.Cooked Pork

AccidentalIngestion ofeggs

yes

cosmo

Praziquantel

TaeniaSaginata

Longest Tapeworm

Beeftapeworm

no rostellum, hookletsripe >15 branches; 5m;tree-like dicho branching

Cysticercousbovis

Ripe or gravidProglottid

Scolex aftertherapy

Man SI(accidental)

Cattle, llama,Giraffe, Carabao

eggs cysticercousbovis

Epigastric Pain, vertigo,Nervousness, eosinophilia

IngestionOf cysts in beef

Niclosamide-damage to point of dissolution

EchinococcusGranulosussmallestTapewormIn man

ParasiteOf dog

one long gravid proglottid

Eggs – manHydatid sand

dogs

x-ray to detect hydatid ds;immunologictests

SI of Dog-Cysts Ingested and Release scolices

Sheep, man(accidental,intermediate–in liver andlungs)

Obstruction – Growing cysts;AnaphylacticShock when Cyst ruptures

FOR

IngestionOf eggs in feces

rare SugeryPrev spillage of eggs)

Albendazole

PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST2ND INT HOST PATHOLOGY MOT PHIL Tx

DiphyllobothriumLatum

Fish/Broadt-worm

yellow-brownknob likethickening spatulate, rosette uterus

2 bothria = suckinggrooves

PlerocercoidLarva EncytedIn fish

OperculatedEggs;Proglottids

Kato tech

SI in man

ReservoirHost: Dogs, cats,Bears

Paratenic host:Carnivore fish

copepods (Cyclops & Diaptomus)

Coracidia (CO) Procercoid (ProC)

(fish) perch, trout, salmon, pike

ProC PleroC

Anemia (misdiag for pernicioustype Vit B12 def);hyperchromicmegaloblastic;examine for HCl in gastric juice (+ infection)

Ingestion Rare

Only7 cases

temperatezone

Praziquantel

DipylidiumCaninum

DogT-worm

DoublePoredT-worm

egg packets(8-15 eggs)oncosphere w/6 hooklets

retractile, conical scolex; rose-thorn shape hookletsmature proglottid – with 2 lateral genital pores

CysticercoidLarva inArthropodHost wheningested

GravidProglottidsThat are passed out/ Crawl out,Egg packets,Melon-shapedProglottids in Chains(Not stool becproGlot disintin 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

HymenolepsisNana

Dwarft-worm

with filaments like D. caninum scolex butwith less hooklets; ripesegment

EmbryoEggs in Contam food and Water

Cyticerci -Can completeCycle in singleHost (autoinf)

EmbryoEggs in feces

Proglottids notRecovered becTheydegenerate

SI of man Insects, riceAnd flour beetles

Enteritis due to Necrosis and DesquamationOf intestinalEpithelial cells

Direct/indirectpathways

FOR

AutoInfection

yup Praziquantel

HymenolepsisDiminuta

Rat T-worm

w/o filamentsbile-stained;fan-like

gravid segment;rudimentary, unarmedrostellum

CysticercoidLarvae ininsects

Eggs in stool(more circular,larger, lackbipolar thickening vsH. nana

SI of man Fleas, beetles, cockroaches, mealworms & earwigs

Minimal andNon-specific

IngestionOf Infectedinsects

yes

In rats<8%

Praziquantel

Sparganosis

Mansoni,Erinacei,Ranarum

Spirometra

mistaken for D. latum;pseudosegmentation w/slit-like invagination

PlerocercoidIn toads, frogs, snakes,

paratenichosts - pigs

White larvaeIn lesion

Adult – Intestines ofCat/man

Larvae – any part, eye,subQT, muscles

Cyclops, copepods

Frogs, Snakes,Toads, rats

Painful edemaDue to migratingLarvae

Eosinophilia, Edema anderythema

IngestionOf InfectedinterMhosts

Not sure surgical

PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC HOST LOC.INT

HOST2ND INTHOST PATHOLOGY MOT PHIL Tx

EntamoebaHistolytica

Ameba

greenish-yellowquadrinucleate,thick, rodlikechromatoidal 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 invasiveAmebiasis (IHAT)

ELISA most Sensitive indicator

Large Intestines(cecal andsigmoido-rectal)

liver inextraintamebiasis

Flasklike Primary ulcer;

Histo changes:Histolysis, Thrombosis,Petechiae, Round Cell Infiltration, Necrosis

Bacilliary vsAmebic dysentery

IngestionOf Infectivecysts

Yes

Most CommonAre Asymptocarriers

Supportive,Chemotherapy

Asympto – Diiodohydroxyquin

Mod severeMetronidazole

Severe – D + MHepatic – M + emetine

Naegleriafowleri

No cyst only Flagellated form

Large, usually Central Kslug-like;PSD: blunt;

Trophozoite TrophozoitesIn CSF and tissue Flagellate form inCSF

Brain MeningoencephalitisSevere frontalHeadache,Blocked nose, Altered taste and smell

Kernig’s sign; Leukocytosis w/ neuts, prot, glu

EntersThru Nose

PenetrateCribriform Plate

Multiply inbrain

rare

all typesof soil

Amphotericin

Amp + miconazole andrifampicin

Acanthamoeba

large central K; double cell wall

sluggish; PSD: spine-likeNo peripheral chrom

trophozoite Cysts and TrophsinTissue

Giemsa or PAS ofScrapings orCornial biopsy

CNScornea

Amebic Encephalitis(immunocompromised)

Amebic Keratitis (assoc w/ use of contam contact lenses)

Thru Lower respiTract orThru ulcerated,Broken skin

Rare

All typesOf soil

Propamidine,Miconazole, neomycin

Corneal grafting

Entamoebacoli

yellow-brown; 1-8nuclei, 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 sluggish prog;

CB : bacilliform PSD:blunt/hyaline; K – L, cent

Iodamoebabutschlii

1 nucyellow green; K surr w/ granules; endosome

slug, prog;PSD : Blunt/Hyaline

Entamoebahartmanii

1-4 nuc;K small/Central;Diffuse glyco mass

non prog;PSD : fingerlike

PARASITEA.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC HOST LOC.

INT HOST

2ND INTHOST PATHOLOGY MOT PHIL Tx

Balantidium Coli

Largest prot parasiteOnly ciliate bean-shaped nuc cytostome; cytopyge;

cyst DFS ofTroph andCysts inFeces

Sigmoidoscopy

SICysts Troph

LI (cecal area) troph

Ulcer w/ roundedBase and wide Neck (vs flask shape)

Diarrhea and Dysenter (indisting. from Amebic)

FOR

Ingestion of Contam Food And water

Siguro

UncommonIn Temperate;Assoc w/Pigs in tropics

Tetracycline

Metronidazole

Iodoquinol

GiardiaLamblia

“gaybowelsyn”

young – 2 nuc;mature – 4 nuc;flagella retractedinto axonemes

pyriform/tear-drop; bi-symm; erratic tumbling motion; 8 flag

Quadricysts

DFS Cysts andTrophs

Biopsy,Entero-test,IF and antigendetection

SIDuo, jeju,upper il

AttachesTo int villiVia adhesDisc on ven

Villus flat and cryptHypertrophy;electrolytes, glu, fluid abs, disacchs; diarrhea most common symptom (89%); spont recovery in 6 wks; chronic – steato, diarr altern w/ constip

FOR siguro

OutbreaksAre water-borne

Oral Metronidazole

TinidazoleFurozolidoneQuinacrineparomomycin

Trichomonasvaginalis

No cyst stage

pyriform; jerkymovements; 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 – StrawberryCervix (diagnostic)-Vaginitis; urethritis

Sexualintercourse

Passed thruBirth canal

Yes

HostpitalityGirls – 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 freshStool samples

In lumenOf LI

-Increase excess mucus-Hypermotility of the bowel

-Colicky ab pain; analPruritis; Peripheral eosinophilia

-Mimics IBS (irrit bow syn)

Co-infectionWith E. vermicularis

Siguro

…as long asmay infectionw/ E. vermic-in pre-schoolsin Germany,Israel, Holland

Iodoquinol

Tetracycline

Metronidazole

LeishmaniaTropica

Old WorldCutLeish

w/ ovoid or rounded bodies

promastigote

Pro M in skin tissuebiopsy

LivesIntracellularIn MacrophagesPMS andEndothelial Cells

Pro M A-Mast

Sand flyPheobotomusSpp

A-Mast Pro M in gut of fly

Cutaneous leishmaniasis

Lesions resemblingLepromatous leprosy

Bite ofSandly vector

Wala

Africa, IndiaSouth amercia

AntimonyCompounds

Second lineDrugs:Amp B,Pentamidine(Kala-azar),Metronidazole

LeishmaniaDonovani

amastigote

1 free flagellaarising from kinetoplast

Bone marrow,Spleen orLymph nodes

Visceral Leishmaniasis orKala-azar

Splenomegaly, presence ofParasites in RE cells;

NifurtimoxLeishmaniaBraziliensis

NewWorldCutLeish

amastigote

Serology –For supportivediagnosis

Mucocutaneous orAmerican Leishmaniasis

Tapir noseErosion of pinna of forestworkers

TrichomonasTenax

Smaller and longer than T. vaginalis

Troph swabbing Oral cavity-tartar

Droplets, kissing

yes

Chilomastix Mesnili

knob-like prod, LemonS

spiral forW;3 antflag + 1

cysts Cysts in Semi-formedStools;Trophs in Liquid stools

Cecal regionOf LI

FOR Rare

<1%

PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC HOST LOC.INT

HOST2ND INTHOST PATHOLOGY MOT PHIL Tx

TrypanosomaGambiense

WestAfricanSleepngSicknes

Trypomastigote T-mastigote Parasite inBlood tissuesOr CSF

Serology forLarge scaleScreening

ELISA, IF

In blood,Lymph andCSF

Tsetse FlyReservorHost:DomesticAnimals

Local Infiltration from bite area to lymph and CNS

-Chronic inflammationOf lymphatics-Atrophy of dendronsOf ganglion cells-Winterbottom’s sign,Kerandels sign

Bite ofVector

CongenitalTransmissionpossible

NO

West and CentralAfrica

Supportive

PentamidineSuraminMelarsopenolTryparsamideMelarsenTrypanosoma

RhodesienseEastAfricanSleepngSicknes

Tsetse FlyReservorHost: Gameanimals

NO

Uh..eastAfrica?

TrypanosomaCruzi

Chaga’sDisease

Epimastigote Trypomastigote T-mastigote Blood smear

Serology –CFXenodiagbiopsy

HistiocytesRE cells(adipose,myocardial, RE, Neuroglial)

Reduviids,TriatomidBugsReservoir:Wild mammals

-Engulfed by histocytesand invade adipose tissue-inflamm response w/ fibrotic encapsulation= chagoma; Romana’s sign

-Bite of Vector-feces-transplacental-accidentalingestion-blood trans

No

Income Groups In Suburbanrural

8-aminoquinolones

Primaquine,Nifurtomax(Bayer 2502)

Toxoplasmagondii

(man)bradyzoite, cyst (cat?)

male and femalegametocytes

pseudocyst and oocyst w/Sporozoites-Oocyst prodBy sexual Cycle in cat;Pseudocysts-asexual

Serology – IgM detectionBy ELISA;IFA for IgGAnd IgM; PCROf Toxo DNA

In SI of Cat (sexualAnd asexualCycle); in Tissues in Asexual cycle

Definitive –CAT

Mouse or Rat

Man, pigs,Sheep,AccidentalIntermediatehosts

Brain lesions; hepatitis;Chorioretinitis; Lymphadenitis

2 types of postnatal ds1) mild lymphatic (lideinfectious Mononucleosis)2) acute fulminating

Ingestion,Transplacenetal

Yes

Cosmo

Many areChronicIll but areasympto

Pyrimethamine(Daraprim),Trisulfapyri-Midines; Preg – spiramycin, Clinamycin;AIDS –Atovaquone

IsosporaBelli

immature cyst

Schizont, gametesInside host

Mature oocystw/ sporozoites

ImmatureCysts in feces-Oocysts/Sprorcysts in dudenum

SI of man

Definitive –MAN

Malabsorption syndrome;Shortened villi, hyper-Trophied crypts, infiltOf lamina propria, w/Eosins, polys, rounded cells

FOR Not sure Pyrimethamine

Sulfadiazide orTrimetroprim

PneumocystisCarinii

cysts

Surgical openLung 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

PlasmodiumFalciparum

Mosquito – Gametocytes;Man – Sporozoites

Hypnoxoite –Latent stage,Cause relapse

Sporogany –Mosquito LC;Schizogony –Human LC- exoerythro(merozoites)- erythro(gametocytes)

PeripheralBlood smears-thick -thin

QBC, Para sight F test (dipstick test),IFA

RBC (Man)Vivax – youngMalariae – oldFalciparum –all

Mosquito :1)Stomach –Gamete form,2)Stomach wall – oocystand sporozoiterelease3)salivaryglands - sporo

AnophelesFlavirostrisMinimus

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 capillaryendothelium 4. histotoxic shock-parasite virulence factors:1. multiplication capacity 2. red cellselectivity 3. cytoadherence and resetting ability 4. potential to induce cytokine release 5. antigenicity6. antimalarial drug resistance

Blackwater fever, liver dys, hypogly,Acidosis, GI dys, placenta dys, pulmoedema, renal failure, coagulo andthrombocyto, coma

Bite of femaleMosquito

Passage ofBlood w/ ErythrocyticParasite by:-blood trans-contam syringe-neonatal-congenital

Yes

MalariaFree 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

ChloroquineResistant –Falc

PlasmodiumVivax

PlasmodiumMalariae

PlasmodiumOvale