XIV - Parasitology Flashcards Preview

Microbiology > XIV - Parasitology > Flashcards

Flashcards in XIV - Parasitology Deck (382):
1

Process of living together of 2 unlike organisms

Symbiosis

2

One species benefits the other without harming/benefiting the other

Commensalism

3

Both species benefit one another

Mutualism

4

One species benefits while harming the other

Parasitism

5

Parasite lives inside the body of the host

Endoparasite

6

Parasite lives outside the body of the host

Ectoparasite

7

Presence of endoparasite in host connotes

infection

8

Presence of ectoparasite in host connotes

infestation

9

Needs a host at some stage of their life cycle to complete development and propagation

Obligate Parasite

10

May exist in a free-living state but becomes parasitic when the need arises

Facultative Parasite

11

Establishes itself in a host it does not ordinarily live in

Accidental/Incidental Parasite

12

Remains on host for life

Permanent Parasite

13

Lives on host for a short period of time

Temporary Parasite

14

Free-living organism that passes through digestive tract without infecting the host

Spurious Parasite

15

Host where parasite attains sexual maturity

Definitive/Final Host

16

Host that harbors the asexual or larval stage

Intermediate Host

17

Host wherein the parasite does not develop further to later stages

Paratenic Host

18

Host that allows the life cycle to continue and become additional sources of human infection

Reservoir Host

19

Transmits parasite from one host to another

Vector

20

Transmits parasite only after it has completed its development

Biologic Vector

21

Vector that only transports the parasite

Mechanical/Phoretic Vector

22

Process of inoculating an infective agent

Exposure

23

Establishment of infecting agent inside host

Infection

24

Between infection and evidence of symptoms

Incubation Period (Clinical)

25

Between infection and demonstration of infection

Pre-Patent Period (Biological)

26

Infected individual becomes his own direct source of infection

Autoinfection

27

Infected individual is further infected with same species leading to massive infection

Hyperinfection or Superinfection

28

Host Effects: E. histolytica trophozoites secrete cysteine proteases which digest cellular material

Enzymatic Interference

29

Host Effects: Plasmodium invades RBCs and cause rupture

Invasion & Destruction

30

Host Effects: D. latum competes with host for available supply of vitamin B12 (pernicious anemia)

Nutrient Deprivation

31

Immune Invasion: E. histolytica produces suppressor factor that inhibits monocyte movement

Immune Suppression

32

Immune Invasion: Surface protein variation in T. gambiense

Antigenic Variation

33

Immune Invasion: E. granulosus carries blood group antigens

Host Mimicry

34

Immune Invasion: T. gondii multiplies inside macrophages

Intracellular Sequestration

35

Protozoa: Intestinal Tract

Entamoeba histolytica, Giardia lamblia, Cryptosporidium parvum

36

Protozoa: Urogenital Tract

Trichomonas vaginalis

37

Protozoa: Blood & Tissue

Plasmodium, Toxoplasma gondii, Trypanosoma

38

Pseudopod-forming non-flagellated protozoa (Brownian movement), eukaryotic organism that lacks membrane-bound organelles, simple life cycle

Entamoeba histolytica

39

Most invasive parasite among the Entamoeba

Entamoeba histolytica

40

Entamoeba histolytica: Transmission

fecal-oral

41

Entamoeba histolytica: Infective Stage

mature cysts

42

Entamoeba histolytica: Diagnostic Stage

trophozoites (acute diarrhea), mature cysts & immature cysts (hardened stool)

43

Entamoeba histolytica Virulence Factors: Mediates adherence

lectin

44

Entamoeba histolytica Virulence Factors: Penetration

amebapores

45

Entamoeba histolytica Virulence Factors: Cytopathic effect

cysteine proteases

46

Entamoeba histolytica: Diseases

cyst carrier → amebic colitis → ameboma → amebic liver abscess

47

Entamoeba histolytica Diseases: Dysentery without fever, flask-shaped colon ulcers

amebic colitis

48

Entamoeba histolytica Diseases: Mass-like lesion in abdomen, associated with dysentery

ameboma

49

Entamoeba histolytica Diseases: Most common extraintestinal form, anchovy paste-like aspirate

amebic liver abscess

50

Entamoeba histolytica Treatment: Cyst Carrier State (asymptomatic)

Diloxanide furoate

51

Entamoeba histolytica Treatment: Amebic Colitis

Metronidazole

52

Entamoeba histolytica Treatment: Amebic Liver Abscess

Metronidazole, percutaneous drainage for non-responders

53

Entamoeba histolytica Treatment: Mild to Moderate Infection

Metronidazole + luminal agent

54

Entamoeba histolytica Treatment: Severe Infection

Metronidazole/Tinidazole + luminal agent

55

Entamoeba histolytica Treatment: Hepatic Abscess, Extraintestinal Infection

Metronidazole/Tinidazole + luminal agent

56

Flagellate that lives in the duodenum, jejunum and upper ileum, falling leaf motility, simple asexual life cycles, covered with variant surface proteins

Giardia lamblia

57

Giardia lamblia: Transmission

fecal-oral

58

Giardia lamblia: Infective Stage

cysts

59

Giardia lamblia: Diagnostic Stage

trophozoites (binucleated, "old man"), cysts

60

Adhesive disc and lectin facilitate attachment to avoid peristalsis, villous flattening, crypt hypertrophy, disruption of cytoskeleton, ultimately leads to enterocyte apoptosis

Giardia lamblia

61

Abdominal pain, "Backpacker's Diarrhea", excessive flatus (rotten eggs)

Acute Giardia lamblia Infection

62

Giardia lamblia: Chronic Infection

constipation, weight loss, steatorrhea

63

Giardia lamblia: Treatment

Metronidazole

64

Opportunistic intestinal protozoa, undergoes schizogony and gametogony, autoinfection in immunocompromised patients, acid-fast organism, simple life cycle

Cryptosporidium parvum

65

Cryptosporidium parvum: Transmission

fecal-oral

66

Cryptosporidium parvum: Infective Stage

thick-walled oocysts

67

Cryptosporidium parvum: Diagnostic Stage

thick-walled oocysts

68

Self-limited non-bloody diarrhea, severe life-threatening diarrhea if CD4 < 200 due to autoinfection

Cryptosporidium parvum

69

Cryptosporidium parvum: Treatment

Nitazoxanide

70

Urogenital protozoan, exists only as a trophozoite, pear-shaped, flagellated trophozoites, simple life cycle

Trichomonas vaginalis

71

Trichomonas vaginalis: Transmission

sexual intercourse, "Ping-Pong" transmission

72

Trichomonas vaginalis: Infective Stage

trophozoites

73

Trichomonas vaginalis: Diagnostic Stage

trophozoites

74

Watery, foul-smelling, greenish vaginal discharge accompanied by itching and burning, strawberry cervix (punctate hemorrhages on ectocervix)

Trichomonas vaginalis

75

Trichomonas vaginalis: Treatment

single oral dose of 2g (4 x 500mg tabs) of Metronidazole

76

Blood and tissue sporozoa, non-motile, asexual life cycle consists of shizogony & gametogony, sexual life cycle involves sporogeny, complex life cycle

Plasmodium

77

Most important parasitic disease in man

Plasmodium

78

Plasmodium: Transmission

bite of infected female mosquito (Anopheles filariasis minimus)

79

Plasmodium Life Cycle: Shizogony, Gemetogony

asexual

80

Plasmodium Life Cycle: Sporogony

sexual

81

Plasmodium: Asexual Host

man, intermediate

82

Plasmodium: Sexual Host

mosquito, definitive

83

Plasmodium: Infective Stage

sporozoites

84

Plasmodium: Diagnostic Stage

trophozoites (ring forms)

85

Pathologic findings from the destruction of RBCs, release of merozoites and splenic sequestration of infected cells, people with RBC defects (G6PD, sickle cell) are immune, partial immunity (premonition) seen in individuals who completely recover initial infection

Malaria (Plasmodium)

86

Plasmodium: 48 hour asexual cycle, malignant tertian, all aged RBCs, highest parasitemia, 0 merozoites, banana-shapes gametocytes, cerebral malaria, recrudescence, drug resistance

P. falciparum

87

Plasmodium: 48 hour asexual cycle, benign tertian, young RBCs, low parasitemia, 12-24 merozoites, large round gametocytes, relapse

P. vivax

88

Plasmodium: 72 hour asexual cycle, benign quartan, old RBCs, lowest parasitemia, 6-12 merozoites, compact gametocytes, recrudescence

P. malariae

89

Plasmodium: 48 hour asexual cycle, benign tertian, young RBCs, low parasitemia, 8 merozoites, small round gametocytes, relapse

P. ovale

90

Plasmodium: Recurrence of symptoms after a temporary abatement (2-4 weeks), seen in P. falciparum and P. malariae

Recrudescence

91

Plasmodium: Return of disease after its apparent cessation (1-6 months) due to reactivation of hypnozoites, seen in P. ovale and P. vivax

Relapse

92

Plasmodium: Diagnosis

thin & thick smears on Giemsa (thick - presence of organism, thin - species), higest yield when blood samples are taken during fever or 2-3 hours after peak

93

Malarial Dots: Punctate granulations present in RBCs invaded by P. ovale and P. vivax

Schuffner Dots

94

Malarial Dots: Coarse granulations present in RBCs invaded by P. falciparum, comma-shaped

Maurer Dots

95

Malarial Dots: Fine dots present in RBCs invaded by P. malariae

Ziemann Dots

96

Paroxysmal fever with malaise and bone pains, hemolytic anemia, jaundice, splenomegaly, parasitic pneumonitis, acute renal failure (blackwater fever), septic shock

Malaria (Plasmodium)

97

Plasmodium Findings: Malarial or Dürck's granulomas

Cerebral Malaria

98

Plasmodium Findings: Acute renal failure, severe complication of P. falciparum, intravascular hemolysis, massive hemoglobinuria, acute renal failure, rare and sometimes fatal complication of quinine-sensitized persons

Blackwater Fever

99

Plasmodium Findings: Septic Shock

Algid Malaria

100

Plasmodium: High Endemicity

Palawan, Kalinga-Apayao, Ifugao, Agusan del Sur

101

Plasmodium: Chloroquine Resistance

Palawan, Davao del Norte, Compostela Valley

102

Plasmodium Treatment: Tissue Schizonticides

Primaquine - kill schizonts in the liver

103

Plasmodium Treatment: Blood Schizonticides

Chloroquine, Quinine - kill parasitic forms only in the erythrocyte

104

Plasmodium Treatment: Gametocides

Primaquine - kills gametocytes in blood

105

Plasmodium Treatment: Sporontocides

Proguanil, Pyrimethamine - prevent sporogony and multiplication in the mosquito

106

Plasmodium Treatment: Chloroquine-sensitive P. falciparum, P. malaria

Chloroquine

107

Plasmodium Treatment: P. vivax, P. ovale

Chloroquine + Primaquine

108

Plasmodium Treatment: Uncomplicated infections with Chloroquine-resistant P. falciparum

Quinine + Doxycycline/Clindamycin

109

Plasmodium Treatment: Severe or complicated infections with P. falciparum

Artesunate + Doxycycline/Clindamycin or Mefloquine/Malarone OR Quinidine gluconate

110

Plasmodium Treatment: Chloroquine-resistance

Mefloquine + Doxycycline

111

Plasmodium Treatment: Eradication of Hypnozoites

Primaquine

112

Plasmodium Treatment: Severe Cases/Pregnant

Quinidine, Quinine

113

Plasmodium Prophylaxis: Without resistant P. falciparum

Chloroquine

114

Plasmodium Prophylaxis: Chloroquine-resistant P. falciparum

Malarone, Mefloquine

115

Plasmodium Prophylaxis: Multidrug-resistant P. falciparum

Doxycycline

116

Plasmodium Prophylaxis: Terminal prophylaxis of P. vivax and P. ovale infection, alternative for primary prevention

Primaquine

117

Plasmodium Prophylaxis: Chloroquine-Sensitive Areas

Chloroquine 500mg/tab, 1 tab weekly

118

Plasmodium Prophylaxis: Chloroquine-Resistant Areas

Mefloquine 250mg/tab, 1 tab weekly, Malarone (Atovaquone 250mg/Proguanil 100mg)/ tab, 1 tab daily

119

Plasmodium Prophylaxis: Multidrug-Resistant Areas

Doxycycline 100mg/tab, 1 tab daily

120

Plasmodium: Prevention

chemoprophylaxis, insecticide-treated nets, insect repellant with DEET, biologic modification (cultivation of snails that eat mosquito larvae)

121

Tissue protozoan, definitive host - domestic cat, intermediate hosts - humans & other mammals, complex life cycle

Toxoplasma gondii

122

Toxoplasma gondii: Transmission

ingestion of cysts in raw meat and contaminated food, transplacentally

123

Toxoplasma gondii: Infective Stage

fecal oocysts

124

Toxoplasma gondii: Diagnostic Stage

trophozoites (bradyzoites)

125

Toxoplasma gondii Trophozoites: Rapidly multiplying, CMI limits spread

tachyzoites

126

Toxoplasma gondii Trophozoites: Slowly multiplying, important in tissue diagnosis

bradyzoites

127

Toxoplasma gondii: Diagnostic Test

IgM antibody

128

Toxoplasma gondii Disease: Heterophil-negative mononucleosis

immunocompetent

129

Toxoplasma gondii Disease: Encephalitis, ring-enhancing lesions

immunocompromised

130

Abortion, stillbirth, neonatal disease with hydrocephalus, encephalitis, chorioretinitis, hepatosplenomegaly, intracranial calcifications

Congenital Toxoplasma gondii Disease

131

Toxoplasma gondii: Treatment

Sulfadiazine + Pyrimethamine

132

Blood and tissue protozoan, 4 forms (amastigote, promastigote, epimastigote, trypomastigote), complex life cycle

Trypanosoma cruzi

133

Trypanosoma cruzi: Transmission

reduviid bug (Triatoma)

134

Trypanosoma cruzi: Infective Stage

metacyclic trypomastigotes

135

Trypanosoma cruzi: Diagnostic Stage

trypomastigotes in blood

136

Myocardial, glial, reticuloendothelial cells are frequent sites, cardiac muscle is the most frequently and severely affected tissue

Trypanosoma cruzi

137

Trypanosoma cruzi: Diagnosis

stained BMA or muscle biopsy, culture in special medium, xenodiagnosis - allowing an uninfected, laboratory-raised reduviid bug to feed on patient

138

Trypanosoma cruzi: Unilateral periorbital edema (Romaña's sign), nodule near bite (chagoma), fever, LAD, hepatosplenomegaly

Acute Chagas' Disease

139

Trypanosoma cruzi: Myocarditis, megacolon, megaesophagus (achalasia)

Chronic Chagas' Disease

140

Trypanosoma cruzi: Treatment

Nifurtimox

141

Blood and tissue protozoan, 2 forms (epimastigote, trypomastigote), complex life cycle, remarkable antigenic variation

Trypanosoma brucei

142

Trypanosoma brucei: Types

gambiense, rhodesiense

143

Trypanosoma brucei: Transmission

tsetse fly (Glossina)

144

Trypanosoma brucei: Infective Stage

metacyclic trypomastigotes

145

Trypanosoma brucei: Diagnostic Stage

trypomastigotes in blood

146

Spread from the skin through the blood to the lymph nodes and the brain, somnolence (sleeping sickness) progresses to coma due to demyelinating encephalitis (ARAS, brainstem), cyclical fever spike (every 2 weeks) due to antigenic variation

Trypanosoma brucei

147

Trypanosoma brucei rhodesiense is _____ rapid and fatal than Trypanosoma brucei gambiense.

rhodesian is more rapid and fatal

148

Trypanosoma brucei: West

gambiense

149

Trypanosoma brucei: East

rhodesiense

150

Indurated skin ulcer (trypanosomal chancre), intermittent weekly fever and LAD, enlargement of the posterior cervical LN (Winterbottom's sign), excessive somnolence, hyperesthesia (Kerandel's sign), encephalitis, plasma cells with cytoplasmic Ig globules (Mott cells)

Trypanosoma brucei

151

Trypanosoma brucei Treatment: Blood-Borne

Suramin

152

Trypanosoma brucei Treatment: CNS Penetration

Melarsoprol

153

Trypanosoma brucei Treatment: West African, early

Pentamidine

154

Trypanosoma brucei Treatment: West African, CNS

Eflornithine

155

Trypanosoma brucei Treatment: East African, early

Suramin

156

Trypanosoma brucei Treatment: East African, CNS

Melarsoprol

157

Flagellated marine protists, algal blooms cause red tide

Dinoflagellates

158

Most common cause of red tide in the Philippines

Pyrodinium bahamense var. compressum

159

Most common cause of red tide in the US

Alexandrium

160

Dinoflagellates: Transmission

eating bivalve mollusks, fish obtained from red tide

161

Red Tide Season

May-August

162

Filter feeders accumulate toxins produced by

dinoflagellates

163

Shellfish Poisoning Syndromes: Saxitoxin

Paralytic

164

Shellfish Poisoning Syndromes: 15 min incubation period, facial paresthesia, total paralysis, respiratory failure

Paralytic

165

Shellfish Poisoning Syndromes: Brevetoxin

Neurotoxic

166

Shellfish Poisoning Syndromes: 15 min incubation period, facial paresthesis, slurred speech, ataxia, diarrhea, stroke-like symptoms

Neurotoxic

167

Shellfish Poisoning Syndromes: Okadaic Acid

Diarrheic

168

Shellfish Poisoning Syndromes: 30 min incubation period, diarrhea, nausea, vomiting, abdominal pain

Diarrheic

169

Shellfish Poisoning Syndromes: Domoic Acid

Amnesic

170

Shellfish Poisoning Syndromes: 30 min incubation period, diarrhea, short-term memory loss, seizures

Amnesic

171

Dinoflagellates: Treatment

gastric lavage with activated charcoal, supportive fluid resuscitation, endotracheal intubation for respiratory failure, Neostigmine and Edrophonium for muscle weakness

172

Free-living ameba, infected contact lenses, granulomatous amebic encephalitis

Acanthamoeba castellani

173

Free-living ameba, swimming in contaminated pools, primary amebic meningoencehalitis

Naegleria fowleri

174

Only ciliated protozoan to cause human disease

Balantidium coli

175

Round-based, wide-necked intestinal ulcers, dysentery, pigs

Balantidium coli

176

Ixodes tick, intraerythrocytic ring-shaped trophozoites in tetrads in the form of a Maltese cross

Babesia microti

177

Phlebotomus sandfly, infective promastigotes

Leishmania

178

Leishmania: Cutaneous

Leishmania tropica

179

Leishmania: Visceral / Kala-azar

Leishmania donovani

180

Leishmania: Mucocutaneous

Leishmania brasiliensis

181

Leishmania: Treatment

Sodium stibogluconate (Antimony compound)

182

Coccidial sporozoa, diarrhea in immunocompromised patients

Cyclospora cayetanensis, Isospora belli

183

Cestodes: Eggs/larvae in undercooked pork, pigs, in intestines

T. solium

184

Cestodes: Larvae in undercooked beef, cattle, in intestines

T. saginata

185

Cestodes: Larvae in undercooked fish, in intestines

D. latum

186

Cestodes: Eggs in food contaminated by dog feces, sheep, in liver

E. granulosus

187

Intestinal cestodes, differentiated based on scolex and gravid proglottids

Taenia

188

Taenia: 4 suckers, rostellum, 5-10 primary uterine branches in gravid proglottids, pork

T. solium

189

Taenia: 4 suckers, 15-25 primary uterine branches in gravid proglottids, beef

T. saginata

190

Taenia: Transmission

undercooked pork/beef

191

Taenia: Infective Stage

cysticerci, eggs (T.solium)

192

Taenia: Diagnostic Stage

gravid proglottids

193

Minor intestinal damage from adult tapeworms, cystecerci can become SOLs in the brain, living cystecerci do not cause inflammation

Taenia

194

Taenia: Abdominal pain, weight loss, pruritus ani, intestinal obstruction

T. saginata

195

Taenia: Mild intestinal symptoms, small infective eggs cross the BBB causing seizures (neurocysticercosis), worms in vitreous humor

T. solium

196

Taenia: Treatment

Praziquantel

197

Has 2 elongated sucking grooves for attachment, operculated eggs

Diphyllobothrium latum

198

Diphyllobothrium latum: Intermediate Hosts

fish, copepods

199

Diphyllobothrium latum: Transmission

undercooked fish

200

Diphyllobothrium latum: Infective Stage

plerocercoid larvae (fish muscle)

201

Diphyllobothrium latum: Diagnostic Stage

unembryonated egg

202

Abdominal pain, diarrhea, megaloblastic anemia due to vitamin B12 deficiency

Diphyllobothrium latum

203

Diphyllobothrium latum: Treatment

Praziquantel

204

Composed of scolex and only 3 proglottids, one of the smallest tapeworms

Echinococcus granulosus

205

Echinococcus granulosus: Intermediate Hosts

sheep, humans

206

Echinococcus granulosus: Definitive Host

dog

207

Echinococcus granulosus: Transmission

ingestion of eggs

208

Echinococcus granulosus: Infective Stage

embryonated eggs

209

Echinococcus granulosus: Diagnostic Stage

hydatid cysts

210

Cysts act as SOLs, if cyst ruptures, life-threatening anaphylaxis can occur

Echinococcus granulosus

211

Echinococcus granulosus: Cysts

hydatid cysts (liver), pulmonary cysts, cerebral cysts

212

Echinococcus granulosus: Treatment

surgical resection, Albendazole, PAIR procedure (Puncture, Aspiration, Injection, Reaspiration) - uses 95% Ethanol (helminthicidal, scolicidal)

213

Echinococcus multilocularis: Definitive Host

fox

214

Echinococcus multilocularis: Intermediate Host

rodents

215

Multiloculated cysts (honeycomb vesicles)

Echinococcus multilocularis

216

Dwarf tapeworm, most common tapeworm in developed countries, eggs are directly infectious, polar filaments, six-hooked larvae

Hymenolepsis nana

217

Rat tapeworm, accidental parasite

Hymenolepsis diminuta

218

Hymenolepsis diminuta: Transmission

ingestion of insects harboring eggs

219

Most common tapeworm of dogs and cats, barrel-shaped proglottids

Dipylidium caninum

220

Trematodes: Penetrate skin, in liver, snails

S. japonicum

221

Trematodes: Ingested with raw crab, in lungs, snails

P. westermani

222

Trematodes: Ingested with raw fish, in liver, snails

C. sinensis

223

Oriental blood fluke, adults exist as separate sexes, reside in mesenteric and portal veins

Schistosoma japonicum

224

Schistosoma japonicum: Intermediate Host

snail (Oncomelania hupensis quadrasi)

225

Schistosoma japonicum: Transmission

cercariae penetrate skin

226

Schistosoma japonicum: Infective Stage

cercariae

227

Schistosoma japonicum: Diagnostic Stage

eggs in feces

228

Schistosoma haematobium: Diagnostic Stage

eggs in urine

229

Schistosoma japonicum: Diagnosis

Kato-Katz technique, Circumoval Precipitin Test (COPT) - ovoid egg with small hook

230

Presence of eggs cause granuloma formation, liver granulomas lead to pre-sinusoidal obstruction, hepatomegaly and portal hypertension, evade host defenses by coating themselves with host antigens

Schistosoma japonicum

231

Itching and dermatitis (swimmer's itch), systemic hypersensitivity resembling serum sickness (Katayama fever)

Acute Schistosoma japonicum Infection

232

Chronic liver disease, portal hypertension, colonic, pulmonary and cerebral involvement, Jacksonian/focal seizures

Chronic Schistosoma japonicum Infection

233

Schistosoma japonicum: Endemic Areas

Sorsogon, Samar, Leyte, Oriental Mindoro, Bohol, all of Mindanao except Misamis Oriental

234

Schistosoma japonicum: Treatment

Praziquantel

235

Lung fluke, hermaphrodite

Paragonimus westermanii

236

Paragonimus westermanii: Intermediate Hosts

snail (Antemelania asperata), mountain crab (Sundathelphusa philippina)

237

Paragonimus westermanii: Transmission

undercooked/raw fish

238

Paragonimus westermanii: Infective Stage

metacercariae

239

Paragonimus westermanii: Diagnostic Stage

unembryonated egg

240

Paragonimus westermanii: Diagnosis

3% NaOH preparation

241

Paragonimus westermanii: Eggs

ovoid, thin opercular end, thick abopercular end

242

Develops a fibrous wall that provokes a granulomatous reaction, secondary bacterial infection frequently occurs

Paragonimus westermanii

243

Chronic cough with bloody sputum, endemic hemoptysis, ring-shadow opacity on CXR, closely resembles TB

Paragonimiasis

244

Paragonimus westermanii: Treatment

Praziquantel

245

Asian liver flukes, hermaphrodite, inflammatory response can cause hyperplasia and fibrosis of biliary tract

Clornichis sinensis

246

Asian Liver Flukes

Clornichis sinensis, Opistorchis viverrini

247

Clornichis sinensis: Intermediate Hosts

snail (Parafossarulus), fish (Cyprinidae)

248

Clornichis sinensis: Transmission

uncooked/raw fish

249

Clornichis sinensis: Infective Stage

metacercariae

250

Clornichis sinensis: Diagnostic Stage

embryonated eggs

251

Clornichis sinensis: Diagnosis

direct fecal smear, potassium permanganate stain (melon-like ridges)

252

Fever, eosinophilia, LAD, tender hepatomegaly, embryonated eggs in direct fecal smear

Acute Clornichis sinensis Infection

253

Hepatobiliary disease, pancreatitis, cholangiocarcinoma (Klatskin tumor), neurocirculatory dystonia

Clornichis sinensis

254

Clornichis sinensis: Treatment

Praziquantel

255

Sheep liver fluke, watercress (aquatic plants), obstructive jaundice and painful pharyngitis (Halzoun)

Fasciola hepatica

256

Intestinal fluke, aquatic vegetation, gland abscesses, anasarca and coma from accumulation of toxins (worm intoxication)

Fasciolopsis buski

257

Intestinal fluke, raw fish containing cysts, mimics peptic ulcer disease

Heterophyes heterophyes

258

Nematodes: Intestines, ascariasis, ingestion of eggs

Ascaris

259

Nematodes: Intestines, hookworm, larval penetration of skin

Ancylostoma, Necator

260

Nematodes: Intestines, whipworm, ingestion of eggs

Trichuris

261

Nematodes: Intestines, pinworm, ingestion of eggs

Enterobius

262

Nematodes: Intestines, strongyloidiasis, larval penetration of skin

Strongyloides

263

Nematodes: Intestines, capillariasis, eggs in undercooked fish

Capillaria

264

Nematodes: Tissue, filariasis, mosquito bite

Wuchereria, Brugia

265

Nematodes: Tissue, trichinosis, larvae in uncooked meat

Trichinella

266

Most common and largest nematode, giant roundworm, soil-transmitted helminth

Ascaris lumbricoides

267

Ascaris lumbricoides: Transmission

ingestion of eggs

268

Ascaris lumbricoides: Infective Stage

embryonated eggs

269

Asian liver flukes, hermaphtodite, inflammatory response can cause hyperplasia and fibrosis of biliary tract

Clornichis sinensis

270

Ascaris lumbricoides: Diagnosis

direct fecal smear, Kato-Katz technique

271

Clornichis sinensis: Intermediate Hosts

snail (Parafossarulus), fish (Cyprinidae)

272

Clornichis sinensis: Transmission

uncooked/raw fish

273

Clornichis sinensis: Infective Stage

metacercariae

274

Clornichis sinensis: Diagnostic Stage

embryonated eggs

275

Clornichis sinensis: Diagnosis

direct fecal smear, potassium permanganate stain (melon-like ridges)

276

Fever, eosinophilia, LAD, tender hepatomegaly, embryonated eggs in direct fecal smear

Acute Clornichis sinensis Infection

277

Hepatobiliary disease, pancreatitis, cholangiocarcinoma (Klatskin tumor), neurocirculatory dystonia

Clornichis sinensis

278

Clornichis sinensis: Treatment

Praziquantel

279

Necator & Ancylostoma: Diagnosis

direct fecal smear, Kato-Katz technique

280

Intestinal fluke, aquatic vegetation, gland abscesses, anasarca and coma from accumulation of toxins (worm intoxication)

Fasciolopsis buski

281

Intestinal fluke, raw fish containing cysts, mimics peptic ulcer disease

Heterophyes heterophyes

282

Nematodes: Intestines, ascariasis, ingestion of eggs

Ascaris

283

Nematodes: Intestines, hookworm, larval penetration of skin

Ancylostoma, Necator

284

Nematodes: Intestines, whipworm, ingestion of eggs

Trichuris

285

Nematodes: Intestines, pinworm, ingestion of eggs

Enterobius

286

Trichuris trichiuria: Infective Stage

embryonated eggs

287

Nematodes: Intestines, capillariasis, eggs in undercooked fish

Capillaria

288

Nematodes: Tissue, filariasis, mosquito bite

Wuchereria, Brugia

289

Nematodes: Tissue, trichinosis, larvae in uncooked meat

Trichinella

290

Most common and largest nematode, giant roundworm, soil-transmitted helminth

Ascaris lumbricoides

291

Ascaris lumbricoides: Transmission

ingestion of eggs

292

Ascaris lumbricoides: Infective Stage

embryonated eggs

293

Ascaris lumbricoides: Diagnostic Stage

fertilized egg (unembryonated)

294

Ascaris lumbricoides: Diagnosis

direct fecal smear, Kato-Katz technique

295

Major damage occurs during larval migration, principal site of tissue reaction is in the lungs where inflammation with an eosinophilic exudate occurs, heavy worm burden may contribute to malnutrition

Ascaris lumbricoides

296

Ascaris lumbricoides: Diseases

hypersensitivity pneumonitis (Loeffler's Syndrome), acute intestinal obstruction, hepatobiliary ascariasis, pancreatitis, malabsorption syndromes, nutrient deficiencies

297

Ascaris lumbricoides: Treatment

Albendazole (greater larvicidal activity than Mebendazole)

298

Parasites with Transpulmonary Phase

Ascaris, Necator, Ancylostoma, Strongyloides

299

Soil-transmitted helminth, blood-sucking nematodes, hookworms, differentiated based on the character of buccal spears of filariform larvae

Necator americanus, Ancylostoma duodenale

300

Necator & Ancylostoma: Transmission

larvae penetrate skin

301

Necator & Ancylostoma: Infective Stage

filariform larvae

302

Necator & Ancylostoma: Diagnostic Stage

eggs in feces

303

Necator & Ancylostoma: Diagnosis

direct fecal smear, Kato-Katz technique

304

Major damage due to blood loss (0.25mL blood/worm/day) at site of attachment, blood consumed oozes in response to an anticoagulant made by the worm, microcytic anemia caused by blood loss

Necator americanus, Ancylostoma duodenale

305

Ground itch at site of entry, serpiginous tracks (cutaneous larva migrans), eosinophilic pneumonia during transpulmonary stage, mild GIT syndromes

Acute Necator/Ancylostoma Infection

306

Microcytic anemia from blood-sucking nematodes, hypoalbuminemia

Chronic Necator/Ancylostoma Infection

307

Necator & Ancylostoma: Treatment

Albendazole

308

Whipworm, soil-transmitted helminth

Trichuris trichiuria

309

Strongyloides stercoralis: Treatment

Ivermectin

310

Trichuris trichiuria: Diagnostic Stage

unembryonated eggs

311

Trichuris trichiuria: Diagnosis

direct fecal smear, Kato-Katz technique

312

Trichuris trichiuria: Eggs

barrel-shaped eggs with bipolar plugs (Chinese lantern)

313

Burrow their hair-like anterior ends into the intestinal mucosa, do not cause significant anemia

Trichuris trichiuria

314

Diarrhea, rectal prolapse from increased peristalsis to expel the worms

Trichuris trichiuria

315

Trichuris trichiuria: Treatment

Mebendazole

316

Pinworm, seatworm, soil-transmitted helminth, life cycle is confined to humans, most common sexually transmitted helminths in developed countries (cosmopolitan worm)

Enterobius vermicularis

317

Enterobius vermicularis: Transmission

ingestion/inhalation of eggs

318

Enterobius vermicularis: Infective Stage

embryonated eggs

319

Capillaria philippinensis: Treatment

Albendazole

320

Enterobius vermicularis: Diagnosis

Graham's scotch tape technique (D-shaped eggs)

321

Female releases thousands of fertilized eggs on perianal skin, eggs develop into larvae causing perianal pruritus, autoinfection can occur

Enterobius vermicularis

322

Pruritus ani, eosinophilic enterocolitis, vulvovaginitis, appendicitis (oxyuriasis)

Enterobius vermicularis

323

Enterobius vermicularis: Treatment

Pyrantel pamoate

324

Soil-transmitted helminth, facultative parasites

Strongyloides stercoralis

325

Strongyloides stercoralis: Transmission

larvae penetrate skin

326

Strongyloides stercoralis: Infective Stage

filariform larvae

327

Strongyloides stercoralis: Diagnostic Stage

rhabditiform larvae

328

Strongyloides stercoralis: Diagnosis

Harada-Mori culture

329

Larvae penetrate intestinal wall directly without leaving host and migrate to the lungs (autoinfection), hyperinfection in immunocompromised patients

Strongyloides stercoralis

330

Ground itch at site of entry, eosinophilic pneumonia, mild watery diarrhea, facultative parasite

Acute Strongyloides stercoralis Infection

331

Serpiginous track (larva currens), duodenitis, paradoxical asthma, hyperinfection syndrome

Chronic Strongyloides stercoralis Infection

332

Strongyloides stercoralis: Treatment

Ivermectin

333

Intestinal nematode, pudoc worm, only nematode whose life cycle involves a migratory bird

Capillaria philippinensis

334

Wuchereria & Brugia: Treatment

Diethylcarbamazine (DEC)

335

Capillaria philippinensis: Infective Stage

infective larvae

336

Capillaria philippinensis: Diagnostic Stage

unembryonated eggs

337

Capillaria philippinensis: Diagnosis

direct fecal smear, Kato-Katz technique

338

Capillaria philippinensis: Eggs

peanut-shaped eggs with flattened bipolar plugs

339

Embryonated eggs can cause autoinfection and hyperinfection, leads to ulcerative and compressive degeneration of enterocytes resulting in severe malabsorption

Capillaria philippinensis

340

Borborygmus, fever, abdominal pain, eosinophilia

Acute Capillaria philippinensis Infection

341

Chronic watery diarrhea, edema, wasting, protein-losing enteropathy, anasarca, hypogammaglobulinemia

Chronic Capillaria philippinensis Infection

342

Capillaria philippinensis: Treatment

Albendazole

343

Blood and tissue nematode, most debilitating nematode infection, farmer from abaca plantation

Wuchereria bancrofti, Brugia malayi

344

Filariasis: Smoothly curved, widespread prevalance, scrotal lymphatics, hydrocoele, more severe

Wuchereria bancrofti

345

Filariasis: Kinky, terminal nuclei, SEA prevalence only, limb lymphatics, elephantiasis, less severe

Brugia malayi

346

Wuchereria bancrofti: Vectors

Culex, Aedes, Anopheles

347

Brugia malayi: Vector

Mansonia

348

Wuchereria & Brugia: Transmission

mosquito bite

349

Wuchereria & Brugia: Infective Stage

3rd stage larvae

350

Wuchereria & Brugia: Diagnostic Stage

microfilariae

351

Wuchereria & Brugia: Diagnosis

thick blood smear (curved or kinky microfilariae), specimen collection best done at night (8pm-4am) - nocturnal periodicity, diethylcarbamazine (DEC) provocation test

352

Adult worms in lymph nodes cause inflammation that obstructs lymphatic vessels causing lymphedema, microfilariae do not cause symptoms

Wuchereria & Brugia

353

Acute adenolymphangitis, filarial fever, nocturnal wheezing (tropical pulmonary eosinophilia), small epithelioid granulomas (Meyers-Kouvenaar bodies), expatriate syndrome

Acute Wuchereria/Brugia Infection

354

Hydrocoele, elephantiasis, milky urine (chyluria)

Chronic Wuchereria/Brugia Infection

355

Bancroftian Filariasis: Endemic Areas

Sorsogon, Samar, Leyte, Palawan, Camarines, Albay, Mindoro, Marinduque, Romblon, all of Mindanao

356

Malayan Filariasis: Endemic Areas

Eastern Samar, Agusan del Sur, Palawan, Sulu

357

Wuchereria & Brugia: Treatment

Diethylcarbamazine (DEC)

358

Tissue nematode from pigs

Trichinella spiralis

359

Trichinella spiralis: Intermediate Host

pigs

360

Trichinella spiralis: Transmission

undercooked pork

361

Trichinella spiralis: Infective Stage

encysted larvae

362

Trichinella spiralis: Diagnostic Stage

encysted larvae

363

Trichinella spiralis: Diagnosis

muscle biopsy, larvae within striated muscle, elevated CPKs, xenodiagnosis

364

Trichinella spiralis Stage: Liberated from pork by gastric juices

Intestinal Stage

365

Trichinella spiralis Stage: Disseminate hematogenously to streaked skeletal muscle, encysted within a host-derived cell (nurse cell)

Muscle Stage

366

Fever, muscle, pain, periorbital edema, eosinophilia, hemorrhagic phenomena (subconjunctival, splinter)

Mild Trichinella spiralis Infection

367

Myocarditis, encephalitis, pneumonia, respiratory myositis

Severe Trichinella spiralis Infection

368

Trichinella spiralis: Treatment

Thiabendazole

369

Transmitted by the female blackfly (Simulium), dermal nodules, hanging groin, lizard skin, river blindness, lysis of worm leads to Mazzotti reaction

Onchocerca volvulus

370

Onchocerca volvulus: Treatment

Ivermectin (Mazzotti Reaction)

371

Transmitted by the deer fly or mango fly (Chrysops), subcutaneous edema (Calabar swellings), worm crawling across conjunctiva

Loa loa

372

Guinea fire worm, serpents of Israelites, transmitted when copepods are swallowed in water, pruritic painful papule, live worm in skin ulcer

Dracunculus medinensis

373

Dracunculus medinensis: Treatment

mechanical removal daily

374

Dog ascaris, visceral larva migrans, ocular toxocariasis, ocular larva migrans, uveitis, endophthalmitis

Toxocara canis

375

Transmitted in undercooked seafood, eosinophilic meningitis, most common cause of parasitic meningitis

Ancylostoma caninum / brasiliense

376

Zoonotic roundworms, ingested in raw seafood, eosinophilic gastroenteritis

Anisakis simplex

377

Arthropods: Pruritus of scalp, trunk, nits on hair shaft

Pediculus humanus (lice)

378

Arthropods: Pruritus in pubic area, nits on hair shaft

Phthirus pubis (lice)

379

Arthropods: Pruritic, painful and erythematous nodule, larva may be seen emerging from nodule

Dermatobia hominis (flies)

380

Arthropods: Pruritic, erythematous wheal

Cimex lectularius (bedbugs)

381

Arthropods: Pruritic, erythematous papules, linear tracks

Sarcoptes scabei (mites)

382

Arthropods: Ascending paralysis

Dermacentor (ticks)