Helminths Cards Flashcards by Robyn Shaffer

Perianal itch or rash, bedwetting or insomnia in children, superinfection risk

Enterobius vermicularis/pinworm

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Dome shaped eggs flat on one side, nematode w/ 1mm worm, no animal reservoir,

Enterobius vermicularis/pinworm

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How is enterobius vermicularis treated?

Pyrantel (in gut), albendazole (bloodstream), cessation of scratching of eggs

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How is enterobius vermicularis diagnosed?

Morning perirectal cellophate tape test

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2cm nemotode worm, eggs released into soil, tropical environment

Trichuris trichiuria / whip worm

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What is the transmission of truchuris trichiuria?

Fecal-soil-oral – eggs must exit body and embryonize in soil

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Dystentery syndrome, anemia, growth stunting, rectal prolapse

Trichuris trichiuria / whip worm

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How is trichuris trichiuria treated?

Albendazole (bloodstram) or malbendazole. Kills the heads buried in intestinal wall.

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How is trichuris trichiuria/whip worm diagnosed?

Fecal O&P

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Round microscopic eggs, larva in lungs, eggs in soil, giant worm

Ascaris lumbricoides / roundworm

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Tropical disease, 25% burden of infection worldwide, poor sanitation

Ascaris lumbricoides / roundworm (very similar to Trichuris trichiuria pattern)

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Pneumonitis, Loeffler’s Syndrome, Charcot-Leyden crystals, bowel blockage, peritonitis, biliary sepsis

Ascaris lumbricoides / roundworm

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How is ascaris lumbricoides diangosed?

O&P, colonoscopy, ultrasound, GI series

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How is ascaris lumbricoides/roundworm treated?

Albendazole/Mebendazole (1st line), Pyrantel (2nd line)

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1cm worms, smooth egs with visible round embryo inside

Necator americanus

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Invade epidermis, lung migration, embryonization in soil,

Necator americanus / ancylostoma duodenale (hookworms)

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Tropical disease, poor sanitation, bare skin, children

Necator americanus / ancylostoma duodenale (hookworms); Resembles pattern of Trichuris or Ascaris

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Rash/ground itch, Loeffler’s, pneumonitis, anemia, growth stunting

Necator americanus / ancylostoma duodenale (hookworms)

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Cutaneous larva migrans, creeping eruption, severe pruritis

Ancylostoma braziliense (dog hookworm)

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How are hookworms treated?

Albendazole or Ivermectin; iron repletion for children; antihistamines for severe itch

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How is hookworm diagnosed?

Fecal O&P, or see CLM rash

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Roundworm, autoinfection without exiting host

Strongyloides stercoralis

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Tropical disease, poor sanitation, warm weather, bare skin

Strongyloides stercoralis (resembles necator americanus / hookworm)

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Larva currens, pruritic, Loeffler’s syndrome, hyperinfection and ectopic migration with immunocompromise, sepsis

Strongyloides stercoralis

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How is strongyloides stercoralis diagnosed?

Larva currens on exam, ELISA IgG if immunocompetent, eosinophilia, O&P; if hyperinfection, look for systemic infection and larvae in sputum. Cannot use IgG serology for hyperinfection diagnosis.

How is strongyloides stercoralis treated?

Ivermectin > Albendazole, reduce immunosuppression, treat viral infection, pre-emptive rx if intended immunosuppression

Zoonosis in dogs and cats, immature in humans

Toxocara cani or cati

Visceral larvae migrans, ocular larvae migrans, loss of red reflex mimicking retinoblastoma

Toxocara cani or cati

School-age children or preschool age children, Brazil, Indonesia, America

Toxocara cani or cati

Undercooked hog flesh, hunters

Trichinella spiralis

Muscle pain, flue-like illness, fever

Trichinella spiralis

How is toxocara canis/cati treated?

Supportive care if mild VLM; Albendazole and corticosteroids for severe VLM/OLM

How is trichinella spiralis treated?

Supportive care if mild; Albendazole and corticosteroids if severe

How is trichinella spiralis diagnosed?

Eosinophilia, muscle biopsy, serology

How is toxocara canis/cati diagnosed?

Eosinophlia, larvae in tissue biopsy

Meat-human transmission, viviparous in gut, larvae disseminate and encyst

Trichinella spiralis

Tropical disease, mosquito vector, w/ Wolbachia bacteria

Filariasis (Wuchereria bancrofti and Brugia malayi)

Lymphadema, elephantiasis, fistula; tissue migration and tropical pulmonary eosinophilia

Filariasis (Wuchereria bancrofti and Brugia malayi)

How is filiariasis treated?

Doxycycline kills endosymbiotic Wolbachia bacteria + Albendazole to kill adult worms; Diethylcarbamazine reduces tropical eosinophilia (kills microfiliariae)

How is filiariasis diagnosed?

Adults visualized via untrasound, microfiliariae seen in blood films

How is filiariasis prevented?

Vector control of mosquitoes, mass administration of DEC (added to cooking salt)

Freshwater fish, fish-oral transmission (raw fish)

Diphyllobothrium latum / fish tapeworm

Double-grooved head, scolex, hoolets, proglottides, strobilia

Cestodes (tapeworm) e.g. diphyllobothrium latum

Proglottid passage, anorexia, megaloblastic anemia, B12 deficiency

Diphyllobothrium latum / fish tapeworm

How is diphyllobothrium latum treated?

Oral praziquantel, B12 injections, fish inspection

How is diphyllobothrium latum diagnosed?

Identification of proglottides or eggs in stool, low B12, megaloblastic anemia

Beef-oral transmission, uncooked beef

Taenia Sagninata / beef tapeworm

Four suckers at scolex, cestodes

Taenia Sagninata / beef tapeworm

Proglottid passage, GI upset

Taenia Sagninata / beef tapeworm

How is taenia sagninata diagnosed?

Fecal O&P for egg, strobilia on enteroscopy, rarely eosinophilia

How is taenia sagninata treated?

Oral praziquantel, meat inspection

Cestode, 4 suckers, ring of hooklets

Taenia solium / pork tapeworm

Pork-oral transmission (taeniasis) or fecal-oral (cysticerosis)

Taenia solium / pork tapeworm

Asymptomatic, proglottid passage, new onset seizures, blindness, muscle tenderness

Taenia solium / pork tapeworm

How is taena solium diagnosed?

Fecal O&P, enteroscopy, brain MRI (cysticcerosis), skeletal survey

How is taena solium treated?

Anti-epileptic drugs for seizures, corticosteroids + albendazole/praziquantel

Fecal-oral, sheep entrails, dog feces

Echinococcus granulosis / dog tapeworms

Central Asia, Alaska

Echinococcus granulosis / dog tapeworms

Hydatid disease, encysted liver, biliary dysfunction, blindness, anaphylaxis, cyst seeding

Echinococcus granulosis / dog tapeworms

How is echinococcus granulosis diagnosed?

CXR to show calcified cysts in lung; abdominal CT; eosinophilia and serology may be helpful if cysts "leak"

How is echinococcus granulosis treated?

PAIR: puncture, aspirate hydatid juice, inject albendazole, reaspirate out of cyst. Or surgical removal (careful not to spill hydatid sand and cause anaphylaxis)

Northern hemosphere, foxes, voles

Echinococcus multilocaris

Gradual liver destruction, alveolar pattern

Echinococcus multilocaris

Trematode, fluke, grooved (male)

Schistosomiasis (shistosoma mansoni, hematobium, or japonicum)

Snail, cercaria, portal system

Schistosomiasis (shistosoma mansoni, hematobium, or japonicum)

Cercarial dermatitis, pruritis, swimmer's itch

Acute Schistosomiasis (shistosoma mansoni, hematobium, or japonicum)

Subacute Katayama syndrome, fever, chills, hepatomegaly

Schistosomiasis (shistosoma mansoni, hematobium, or japonicum)

Chronic hematuria, squamous cell carcinoma, hematochezia, chronic diarrhea, ascites, hemorrhage

Chronic Schistosomiasis (shistosoma mansoni/japonicum cause hematochezia/colon disease from mesenteric venous plexis, hematobium, causes hematuria/squamous carcinoma from veins draining bladder)

How is schistosomiasis diagnosed?

Acute rash, eosinophilia, serology, fecal/urine O&P

How is schistosomiasis treated?

Praziquantel, snail control, manage liver care

Anaplasma, erlichia, Lyma, rickettsiae

Ticks (ixodes or ornithodoros)

Epidemic typhus, trench fever (bartonella), borrelia recurrentis

Body louse

Rickettsialpox, scrub typhus,

Mite-born infection (sarcoptes scabiei)

Yersinia pestis, tularemia, murine endemic typhus

Flea-borne infection (xenopsylla cheopis)

Malaria

Anopheles mosquito

Yellow fever, dengue fever, chikungunya fever

Aedes mosquito

Filariasis, West Nile

Culex mosquito

How is arthropod disease treated?

Symptomatic treatment, risk factor treatment (clothing/blankets)

Multi-legged, exoskeleton

Arthropods / ectoparasites

Helminths Cards Flashcards

(79 cards)