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69 Cards in this Set

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Malassezia furfur
Nonsystemic Fungal Infection
Superficial Keratinized Infection

Normal Flora, Lipophilic Yeast

Pityriasis or Tinea versicolor
Hypopigmented Spots (Chest/Back)
KOH Skin scrapings= Spaghetti/meatballs
Coppery-Orange fluorsence under wood lamp

Tx: Topical Selenium Sulfide
Dermatophytes
Cutaneous Fungal Infections (Nonsystemic)

Filamentous, Monomorphic
Skin, Hair, Nails
Tineas
Ringworms
Dermatophytes
Cutaneous Fungal Infections

Tinea barbae, Corporis, cruris, pedis, unnguium
(beard, glabrous skin, jock, athletes foot, Nails)

KOH arthroconidia and Hyphae

TX: Topical imidazoles or tolnaftate
Oral imidazoles griseofulvin
Sporothrix schenckii
Subcutaneous Mycoses
Traumatic Implantation

(Subcutaneous) Gardner/Florist
lesions

(Pulmonary) Urban alcoholics
Rose garden sleeper sickness

TX: Itraconazole or KI in Milk

Dimorphic
environmental- hyphae with rosettes
Tissue- Cigar shaped yeast in pus
Histoplasma capsulatum
Deep Fungal Infection
Caves, bird feces, soil/dust, Chicken coops

Fungus Flu (Pneumonia) AIDS
Acute, Hepatosplenomegaly, Calcified healing lesions,

Enviroment- Hyphae with microconidia and tuberculate macroconidia
Tissue- Sm Intracell yeast in RES cells. (Mold outside Macs)

TX: Ketonazole, Ampho B
Coccidioides immitis
Deep Fungal Infection
Inhaled arthroconidia from SW Desert

Valley Fever
Desert bumps- erythema nodosum and Arthritis
Pulmonary lesions--> Calcify. Sputum=spherules with endospores
Systemic infections- Meningitis ImmunoComp AIDS
Cocci disseminate in 3rd trymester

Enviroment- Hyphae breaks into arthroconidia
Tissue- Spherules with endospores

TX: Ampho B
Blastomyces dermatitidis
Blastomycosis
Acute/Chronic pulmonary disease
Unlikely to self resolve
disseminate in Immunocomp

Enviromental- Hyphae with Nondescript conidia
Tissue- Sm Budding yeasts (2-4um), no capsule
Vs. Coccidioides (20-60um) and Histoplasma (3-5um in Macs)

Mississippi River Beds, Ohio, Canada, Great lakes, N/S Carolinas

Sputum=Budding yeasts with double cell walls

TX: Ampho B
Aspergillus fumigatus
Opportunistic Fungi
Chronic Granulomatous Disease (Neutropenic)

Monomorphic Filamentous, Dichotomously Branched, Acute angles

Compost Pits, Moldy Marijuana

Allergic BronchoPlumonary Aspergillus
Asthma/Allergies grow in MucousPlugs in Lungs
Fungus Ball- Free in lung. Surgical removal
Invasive Aspergillus
Neutropenia,CGD,CF,Burns
Invades tissue-->Infarcts/Hemorrhages
Nasal Colonization--> Pneumonia, Meningitis
Cellulitis in Burns

TX: Amp B, Itraconazole
Candida albicans
Opportunistic Fungi

Yeast (Normal Flora), Pseudo-True Hyphae
**Mold at 37 Yeast at cooler temps

Perleche- dry corner of mouth
Oral Thrush- Antibiotics/IC/AIDS
Esophagitis-Antibiotics/IC/AIDS
Gastritis- Antibiotics/IC/AIDS
Septicemia- with skin lesions and endophthalmitis
Endocarditis- IV Drug users
Cutaneous Infections- Obese, Infants
Vaginitis- Diabetic women

TX: Topical- Imidazoles
Oral- Nystatin
Disseminated form- Ampho B Fluconazole
Cryptococcus neoformans
Opportunistic Fungi
Monomorphic Encapsulated Yeasts
Soil/Pigeon Droppings

Meningitis- Hodgkin, AIDS
Acute Pulmonary Disease-

DX: Detect Capsule Ag latex agglut
India Ink
Urease+ cultures

TX: AMB+5FC flucytosine until negative culture then Fluconazole
Mucor, Rhizopus, Absidia
Opportunistic Fungi
Nonseptate Filamentous

Sporangiospores are inhaled

Rhinocerebral infection- Paranasal swelling, Necrotic, Hemorrhagic exudates from nose eyes, Mental lethargy

Ketoacidotic Diabetic and Leukemic Patients

KOH- Nonseptate Ribbon-like hyphae branch at 90 angles

TX: Ampho B
Pneumocystis jiroveci
Opportunistic Fungi
Silver stained Cysts, Obligate Extra Cellular

Pneumonia in AIDS, Malnourished/premature Infants/IC
Fever, Cough, Short Breath, Nonproductive (exp smokers)

Biospy Lung Tissue- H&E Honeycomb
X-Ray- Patchy infiltrative (Ground Glass)

TX: Trimethoprim/Sulfamethoxazole, (Severe) Dapsone
Amebae
Protozoans

Entamoeba
Naegleria
Acanthamoeba
Flagellates
Protozoans

(Luminal)
Trichomonas
Giardia

(Hemoflagellates)
Leishmania
Trypanosoma
Ciliates
Protozoans

Blantidium
Apicomplexa
Protozoans

(Blood/Tissue)
Plasmodium
Toxoplasma
Babesia

(Intestinal)
Isospora
Protozoans
(4 genera)
Amebae
Flagellates
Ciliates
Apicomplexa
Metazoans
(3 genera)
Trematodes (flukes)
Cestodes (tapeworms)
Nematodes (roundworms)
Trematodes
(Flukes)
Schistosoma
Clonorchis
Fasciola
Fasciolopsis
Paragonimus
Cestodes
(Tapeworms)
Diphyllobothrium
Hymenolepis
Taenia
Echinococcus
Nematodes
(Roundworms)
Necator
Enterobius
Wuchereria/Brugia
Ascaris/Ancylostoma
Toxocara, Tricuris, Trichinella
Onchocerca
Dracunculus
Eye Worm Loa Loa
Strongyloides
Entamoeba histolytica
Amebiasis= dysentery
Inflamm blood/pus in stools, (Trophos ingest RBCs)

Inverted Flask-Shaped Lesions--> Lg Intestines Necrosis-->
Possible LIVER Abscesses (RUQ Pain) Hepatomegaly

Rarely spread to lungs, brain, heart

Transmission- Cysts- Fecal Oral
Water, Fruits, Veggies
DX: Trophozoites/Cysts(4nuclei) in stool
TX: Metronidazole followed by Iodoquinol
Giardia lamblia
Giardiasis= Fatty Foul smelling Noninflamm Diarrhea

Transmission- cysts, Fecal Oral(Human/beaver), Water,Food, Daycare
Survives Cl
Sucking Disks attach to duodenal wall --> Malabsorption

DX: Trophs(2nuclei)/cysts(4nuclei) in stool Fecal Ag test
TX:Metronidazole
Cryptosporidium parvum
Cryptosporidiosis
Transient (Healthy) to Severe (IC) Diarrhea

Transmission- MC water borne parasite, Cysts in food, Water, Swimming pools

DX: ACID FAST oocysts in stool.
Biopsy- oocysts in intestinal glands
TX: Nothing 100% Nitrazoxanide, Puromycin, AAzithromycin
Isospora belli
Transient diarrhea in AIDS (mimics Giardiasis)

Transmission- oocysts Fecal Oral

DX: ACID FAST Elliptical oocyst in stool
TX: TMP-SMX or Pyrimethamine/Sulfadiazine
Cyclospora cayetanensis
Self limiting Diarrhea in IC (Severe in AIDS)

Transmission- oocysts in water

DX: Acid Fast Spherical oocysts in stool. UV Fluorescence
TX: TMS
Microsporidia
Microsporidiosis= Debilitating Diarrhea in AIDS
Spread to Neurological and Hepatitis

Transmission- oocyst in water

DX: Gram+, AcidFast Spores in stools
TX: None
Trichomonas vaginalis
Asym or Frothy Yellow/Green Vaginal Discharge
Strawberry cervix

Transmission- Trophozoites during sex
Only Trophozoite existance

DX: Motile (Tear-drop) Trophozoites, Meth Blue, Corkscrew Motility
TX: Metronidazole
Naegleria
Free living Amebia
Primary Amebic MeningoEncephalitis (PAM)

Severe Prefrontal Headache, Fever, Nausea, Alt. Smell

Transmission- Free living amebae invades nasal mucosa in polluted Warm Fresh Water

DX: Motile Tropho in CSF
Culture- Amebae leave trails in plate lined with gram- bacteria
TX: Ampho B
Acanthamoeba
Free living Amebia with "teeth"
Keratitis
Granulomatous Amebic Encephalitis (GAE) in IC

Transmission- Amebae or Airborne cysts in Contact Solution or polluted water

DX:
TX:
Keratitis- topical Miconazole and Propamidine Isothionate
GAE- Ketoconazole Sulfamethazine
Plasmodium vivax
Malaria with Relapse (Hypozoites in Hepatocytes)
Infects Reticulocytes ONLY

Disease effects metabolism, Hg, RBC lysis--> Anemia and Agglutination
Symptoms- Paroxysms, Chills, Fever Spike, Malarial Rigors(during RBC lysis)

Host
Humans- Asex, Schizogony takes place in liver
Anopheles/Mosquitos- Gametogony, Sex and sporogony takes place. Sporozoites injected

Benign Tertian
48hr Fever Spikes
Blood smears- Enlarge host cells(Ameboid Tropho)

DX: Large Irreg Rings in RBCs
TX: Chloroquine PO4, Then primaquine
Plasmodium ovale
Malaria with Relapse (Hypozoites in Hepatocytes)
Infects Reticulocytes ONLY

Disease effects metabolism, Hg, RBC lysis--> Anemia and Agglutination
Symptoms- Paroxysms, Chills, Fever Spike, Malarial Rigors(during RBC lysis)

Host
Humans- Asex, Schizogony takes place in liver
Anopheles/Mosquitos- Gametogony, Sex and sporogony takes place

Benign Tertian
48hr Fever Spikes
Oval, Jagged, infeected RBCs

DX: Large Irreg Rings in RBC
TX: Chloroquine PO4, Then primaquine
Plasmodium malariae
Malaria infects Mature RBCs ONLY

Disease effects metabolism, Hg, RBC lysis--> Anemia and Agglutination
Symptoms- Paroxysms, Chills, Fever Spike, Malarial Rigors(during RBC lysis)
Vascular Occlusion/Hemorrhage/Necrosis (Cerebral/Renal Fail/Lungs)

Host
Humans- Asex, Schizogony takes place in liver
Anopheles/Mosquitos- Gametogony, Sex and sporogony takes place

Quartan or Malarial
72hr Fever Spikes (Recrudescence)
Blood smears- Bar and Band forms; Fosette schizonts
NO persistent stage

DX: Band/Rectangle in RBCs
TX: Chloroquine PO4, Then primaquine
Plasmodium falciparum
Malaria Infects both RBCs and Reticulocytes
End organ damage. Vascular occulusion hemorrage Necrosis

Disease effects metabolism, Hg, RBC lysis--> Anemia and Agglutination
Symptoms- Paroxysms, Chills, Fever Spike, Malarial Rigors(during RBC lysis)

Host
Humans- Asex, Schizogony takes place in liver
Anopheles/Mosquitos- Gametogony, Sex and sporogony takes place

Malignant Tertian
Irreg Fever Spikes (Cerebral Malaria)
Blood smears- Multi ring forms crescent-shaped gametes

DX: Small Rings in RBCs
TX: Chloroquine PO4
Trypanosoma cruzi
Protozoa Hemoflagellates (Lives in Most Cells)

Chagas Disease (American Trypan)
Early- (Trophos in blood) Romana Sign, Fever, Fatigue, Body aches, Vom/diarrhea
Later- (Amastagotes with Cells)
Cardiac Muscle (CHF),
Megaesophagus, Megacolon
Liver, Brain

Transmission- Reduviid Bug (Kissing/Cone bug) Feces
Scratching transplants flagellated Trypomastigotes

Reservoirs- cats, dogs, armadillos, opossums

DX: Bloody films motile trypomastigotes
TX: Benzimidazole
Trypanosoma brucei gambiense/rhodesiense
Protozoa Hemoflagellates (Always Extracellular)

African Sleeping Sickness *Antigenic Variation*
1st- Fever, Headaches, JointPain, Itching, Back/Neck lymph
2nd- Neurologic confusion, coordination, Day slumber, Insomnia
Anemia, endocrine, Cardiac, Kidney

Transmission- Tsetse fly Saliva containing Trypomastigotes

Reservoirs- Human/Wild Animals

DX: Trypos in blood/CSF. High Ig levels in CSF
TX: Acute- Suramin Chronic- Melarsoprol
Leishmania donovani
Viseral Leishmania
Promastigotes phago--> Amastigotes

Protozoa, Hemoflagellates
Visceral Leish (Kala Azar)
Malaria-like, Fever, Pancytopenia, Splenomegaly, Hepatomegaly

Transmission- Sandfly Bite

Reservoir- (Urban) Humans, (Rural) Rodents/Wild animals

DX: Amastigotes in Macs. BM/Liver/Spleen
TX: Stibogluconate Na
Leishmania Mexicania
Cutaneous Leishmania

Oriental Sore
Disfiguring Face lesions (buttons/boils)

Transmission- Sandfly Bite

Reservoir- Humans/Rodents/wild animals
DX: Amastigotes in Macs. cutaneous lesions
TX: Stibogluconate
Leishmania brazilanse
Mucocutaneous leishmania

Mucosal + Cartilage
Babesia microti
Apicomplexa

Babesiosis- Hemolytic, Malaria-like

Transmission- Ixodes Tick throughout the US
Co-infections with Borrelia

DX: Giemsa Stain blood smear= Tetradin RBCs
Maltese Cross, Hamster inoculation
TX: Clindamycin+Quinine
Toxoplasma gondii
Apicomplexa
Healthy- Mild Flu-like, Lymphadenopathy, fever, Bradyzoites encysts
Pregos- Flu-like
Early Fetus- Severe Congenital infections. Intracerebral calcifications, chorioretinitis, Hydromicroencephaly
Later Fetus- Asym, Lead to Blindness in teens
AIDS- Leading cause of focal CNS disease. Ring Enhancing lesions

Transmission- Cat (essential host), Animals (intermed host)
Tachyzoites/Bradyzoites
1) Ingestion of Raw Meat
2) Cat feces

DX: Serology High or High IgM, X-ray/CT Muscle/brain Ca cyst
TX: Pyrimethamine+Sulfadiazine
Schistosoma mansoni
Schistosoma japonicum
Intestinal Schisto
Asym, ill feeling, Rash at entrance, Katayma Fever
Eggs lodged in intestine wall--> obst Colon
Eggs in Liver--> increase in BP
Enlarged spleen, Fluid in Ab

Aquired- Contact with Water, Skin penetration
Progression- Skin penetration (itching)-->Mature in veins of mesentery-->eggs in liver

DX: Eggs with Beaks in Stool
TX: Praziquantel
Schistosoma haematobium
Vesicular/Urinary Schisto
Egypt Africa
Hematuria, Calc bladder, Hydronephrosis

Aquire- Water
Progression- Skin penetration-->mature in bladder veins--> Eggs in bladder wall-->bladder carcinoma

DX: Eggs with Beaks in stool
TX: Praziquantel
Schistosoma (nonhuman)
Swimmers Itch
Dermatitis at Penetration (2-3 days later)
Raised Papules

Reservoir/Host- birds

DX:
TX: Trimeprazine, Calamine, Sedatives
Trematodes
Flukes

Fat Fleshy leaf-shaped Worms
Hermaphroditic except Schisto
Complicated Life cycles 2+Hosts
Operculated eggs (except schisto) which contaminate water
1st intermediate hosts are Snails
Clonorchis sinensis
Trematodes (Starts in Snails)

Chinese Liver Fluke
Ingestion of fish with cysts--> Billary Ducts-->
Liver Enlargment (eggs laid in bile ducts)-->
Pigmented Gall Stones, Cancer

Jaundice, Diarrhea, Vomit, Nausea

Reservoir Host- Dog/Cat/Human
Aquire- Raw fish ingestion

DX:
TX:Praziquantel
Fasciola Hepatica
Sheep Liver Fluke
Anemia, Weight Loss, Diarrhea, Fever, Night sweats

Reservoir Host- Sheep/Cattle/Human
Aquire- Ingestion of Water-cress

TX: Praziquantel
Fasiolopsis buski
Giant Intestinal Fluke
Asym, Diarrhea, Ab Pain, Fever, acites, anasarca

Reservoir Host- Pig/Dog/Rabbit/Human
Aquire- ingestion water chestnuts, Aquatic Veg

DX: eggs in stool
TX: Praziquantel
Paragonimus westermani
Lung Fluke
Acute-Diarrhea, ab pain, Fever Cough, Hepatosplenomegaly
Later- Mimics T.B. Cough, chest pain, dyspnea, Rash, Cough up eggs

Reservoir Host- Humans/Dogs/Cats/Pigs
Aquire- Ingestion of Raw Crabs, Crayfish

TX: Praziquantel
Cestodes
Tapeworms
Scolex, Neck, Proglottids
Hermaphroditic, Proglottids= M/F organs
No GI tract
DX: eggs/prglottids in feces
Complex life- extraintestinal larvae
Infections more serious in Intermediate Hosts
Taenia Saginata
Beef Tapeworm
IH- Cattle DH- Humans

Asymp or Vague Ab pains, Malnutrition
Attach in sm Intestine

Scolex- No Hooks
Proglottids- 12-25

Transmission- Rare Beef with cysticerci
DX: eggs/proglttids in feces
TX: Praziquentel
Taenia solium
Pork Tapeworm Slavic Countries
IH-Pigs/Rare Human DH Humans

Scolex- Hooks
Proglottids- 5-10

IH- Cysticercosis(eggs)--> Larvae develop in Brain, Eye, Lung, Heart
Seizures/Blindness/Neurologic
DX: Xray, CT (Ca cysts), Biopsy
TX: Prazi

DH- Intestinal tapeworm (Larvae). Ingestion of Raw Pork with Cysticeri
Asymp to Vague pain, Malnutrition
DX: Eggs/Proglottids in stool
TX: Prazi
Diphyllobothrium latum
Fish Tapeworm (Largest Parasite)
IH(2)-Crustaceans,Fish/rare human
DH- Humans/Mammals

IH Sparganosis-larvae penetrate intestinal wall & encyst
Drinking Pond Water with Copepods
DX: Biopsy
TX: Prazi

DH- Intestinal Worm, Megaloblastic anemia (Vit B12 Def)
Eating raw Fish with sparganum
DX: eggs/proglott in stool
TX: Praz
Echinococcus Granulosus
Hydatid Tapeworm (Dog/Sheep Cycle)

IH- Herbivores (rare human)
DH- Carnivors in sheep rasing areas

Hydatid Cyst Disease
Cyst develop in Liver or Lung. (Eosinophil) Rupture cause anaphalaxis

Transmission- ingestion of eggs-->Blood-->Liver/Lung
DX: Imaging, serology
TX: Surgery, Albendazole
Echinococcus multilocularis
IH-Rodents DH-Dogs/Cats

Alveolar Hydatid Cyst Disease

Transmission- Ingestion of eggs
DX: Imaging
TX: Surgical Resectioning
Nematodes
Roundworms
Round unsegmented bodies
Transmitted by...
ingestion of eggs (Enterobius, Ascaris, Trichuris)
Larval Invasion of Skin (Necator, Ancylostoma, Strongyloides)
Ingestion of larvae in meat (Trichinella)
Larvae in Insects(Wuchereria, Loa Loa, Mansonella, Onchocerca, Dracunculus)
Enterobius vermicularis
Pinworm (1st helminth in US)
Asymp, Perianal itching (Worm in lg intestine)

Transmission- Eggs, Autoinfect, Person-Person
Hatch in Sm Intestines--> Live in Colon-->Lay eggs outside anus

Eggs= **NO Eggs in Stool** ova with flat side
DX: Sticky swab perianal
TX: Pyrantel, Mebendazole
Trichuris trichiura
Whipworm
Asymp-->bloody diarrhea, Anemia, Prolapse, decrease in Vit A, Appendicitis, PROLAPSE

Transmission- eggs ingested
DX: Barrel shaped eggs in stool (bipolar plugs)
TX:Albendazole
Acaris lumbricoides
1st World Wide & Largest Roundworm

Ascariasis- Asymp--> Peritonitis, hepatosplenomegaly, Pneumonia(Dyspnea)
Bowl Billiary obstruction (W/out Anemia)

Transmission- Eggs ingested, Hatch in sm Intestines, Migrate blood vessels, larvae migrate thru lungs (cough) and mature in lg intestine.
DX: Eggs in stool (Bile stained, Knoby, Circular)
TX: mebendazole, Surgery, Pneumonia Therapy
Toxocara canis & cati
Dog&Cat roundworm

Asymptom until worms migrate throughout body.
Blindness Eye migration
Larvae cant mature in human

Transmission- Ingested eggs, Handeling puppies, eating dirt

TX: Mebendazole
Necator americanus
Hookworm

"Ground itch" at penetration site
Coughing, Chest pain Wheezing with Anemia
Nausea, Vomit, Constipation/diarrhea

Transmission- Filariform larva penetrates skin (bare feet)-->Migrates to heart and lung--> up Respiratory tract-->Stomach

DX: Fecal larvae and Ova (Thin Wall) in Stool
TX: Mebendazole, Fe tharapy
Ancylostama braziliense & caninum
Dog & Cat Hookworm

Cutaneous Larva Migrans- Intense Skin Itch
Filariform Larva Penetrates skin but does not mature

TX: Thiabendazole
Strongyloides stercoralis
Threadworm

Early: Pneumonitis, ab pain, Diarrhea
Late: Malabsorbtion, Ulcers, Bloody Stools

Transmission- Filariform penetrates skin and Autoinfection. Migrates to lungs--> Small Intestine (Larvae mature Diarrhea)

DX: Larvae in stool
TX: Thiabendazole
Trichinella spiralis
Trichinosis
Gastroenteritis, Muscle Pain, Fever Facial edema, Myalgia
Eosinophilia, Hemorrhages

Transmission- Ingestion of encysted larvae in wild game meat
DX: Steroids+Mebendazole
TX: Muscle biopsy
Brugia malayi
Elephantiasis

Transmission- mosquito bite

TX: Surgery, Ivermectin+ diethylcarbamazine (DEC)
Wucheria bancrofti
Elephantiasis

Transmission- mosquito bite

TX: Surgery, Ivermectin+ diethylcarbamazine (DEC)
Loa Loa
African Eye Worm
Pruritus Calabar Swellings (Ams/legs)
Subconjunctival migration

Transmission- Chrysops (Mango fly)

TX: Surgical Removal of worms + DEC
DX: Microfilariae in blood, Eosino
Onchocera volvulua
River Blindness
Leopard Rash(scattered papules)--> edema, lymph, 2nd Bacterial Infections--> loss of elastic
Microfilariae migrate through eye.

Transmission- Black Fly

DX: Skin snips from calabar swellings
TX: Removal of worms, DEC or Ivermectin
Dracunculus medinensis
Guiea Worm, Fire Serpent

Creeping eruptions, Ulcerations, Rash

Transmission- Drinking water with copepods

DX: Increased IgG
TX: Worm removal+Metronidazole