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96 Cards in this Set
- Front
- Back
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Influenza incubation period |
1-4 days |
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Secondary bacterial infections associated with influenza |
Strep pneumoniae, gas, s aureus. Can get TSS |
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Cutoff for influenza PEP |
48 hrs, give for high risk persons or in nursing home outbreak |
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RSV incubation period |
2-8 days |
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Hantavirus incubation period |
4-30 days |
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Most helminths do not multiply within the host except... |
Strongyloides Paracapillaria Hymenolepsis |
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Trematode blood flukes |
Shistosoma mansoni Schistosoma japonicum Schistosoma haemotobium |
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Trematode liver flukes |
Fasciola hepatica Clonorchis sinensis Opisthorchis viverrini |
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Trematode lung flukes |
Paragonimus westermani |
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Trematode intestinal flukes |
Fasciolopsis buski Metagonimus yokagawai |
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Cestodes intestinal tapeworms |
Taenia solium Taenia saginata Diphyllobothrium latum (Hymenolepsis nana) |
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Cestodes larval cysts |
Taenia solium Echinococcus granulosus Echinococcus multilocularis |
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Intestinal nematodes |
Ascaris lumbricoides Ancylostoma duodenale Necator americanus Trichuris trichuria Strongyloides stercoralis Enterobius vermicularis |
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Tissue invasive nematodes |
Wucheria bancrofti Brugia malayi Onchocerca volvulus Loa loa Trichinella spiralis Angiostrongylus cantonensis Anisakis simplex Toxocara canis/cati (Gnathostoma spinigerum) (Dirofilaria repens) (Bayliscaris procyonis) |
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When to consider shistosomiasis |
Fresh water exposure in endemic region. Clinical acute syndrome (katayama fever: fever, abdominal pain, myalgia, eosinophilia), or chronic syndrome (abdominal pain, blood in stool, loose stool, portal htn, hematuria, eosinophilia). |
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Exposure for fasciola hepatica |
Eat encysted larvae on aquatic vegetation. Fluke migrates through liver causing RUQ pain and hepatitis. Mature in biliary ducts, can cause biliary obstruction. |
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How to diagnose fasciola hepatica |
Eggs in stool (low sens) Serology |
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Treatment of fasciola hepatica |
Triclabendazole |
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Exposure to clonorchis sinensis |
Eggs->snails->freshwater fish. Ingest undercooked fish. Flukes develop in duodenum then migrate to liver bile ducts. |
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Clinical syndromes of clonorchis |
Biliary obstruction Cholelithiasis Cholangiocarcinoma |
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Opisthorchis exposure |
Undercooked fish. Develop in duodenum and then migrate to bile ducts. Can cause cholangiocarcinoma |
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Paragonimus exposure |
Eggs->snails->freshwater crabs and crayfish. Ingestion of undercooked seafood. |
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Paragonimus exposure |
Eggs->snails->freshwater crabs and crayfish. Ingestion of undercooked seafood. |
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Symptoms of paragonimus infection |
Fever, cough, diarrhea during acute migration. Later may have chest pain. Can have chronic pulmonary symptoms. |
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Paragonimus exposure |
Eggs->snails->freshwater crabs and crayfish. Ingestion of undercooked seafood. |
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Symptoms of paragonimus infection |
Fever, cough, diarrhea during acute migration. Later may have chest pain. Can have chronic pulmonary symptoms. |
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Diagnosis of paragonimus |
Sputum and/or stool for eggs |
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Paragonimus exposure |
Eggs->snails->freshwater crabs and crayfish. Ingestion of undercooked seafood. |
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Symptoms of paragonimus infection |
Fever, cough, diarrhea during acute migration. Later may have chest pain. Can have chronic pulmonary symptoms. |
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Diagnosis of paragonimus |
Sputum and/or stool for eggs |
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Lung fluke in US acquired my intention of raw crayfish from rivers in Missouri |
Paragonimus kellicotti |
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Paragonimus exposure |
Eggs->snails->freshwater crabs and crayfish. Ingestion of undercooked seafood. |
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Symptoms of paragonimus infection |
Fever, cough, diarrhea during acute migration. Later may have chest pain. Can have chronic pulmonary symptoms. |
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Diagnosis of paragonimus |
Sputum and/or stool for eggs |
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Lung fluke in US acquired my intention of raw crayfish from rivers in Missouri |
Paragonimus kellicotti |
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Acquisition and symptoms of fasciolopsis buski |
Eating encysted larval stage on aquatic vegetation. Usually asymptomatic. Can cause diarrhea, fever, abdominal pain, ulceration and hemorrhage. Diagnose by eggs in stool. |
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Acquisition and symptoms of metagonimus yokagawi |
Eating encysted larvae in undercooked fish. Diarrhea and abdominal pain. |
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Taenia saginatum acquisition, diagnosis and treatment |
Larvae in undercooked beef. See proglottids and eggs in stool. Praziquantel or albendazole. |
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Taenia solium acquisition, diagnosis and treatment |
Pork with larvae. See proglottids and eggs in stool. Rx with praziquantel or albendazole. |
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Diphyllobothrium latum acquisition and symptoms |
Ingesting larvae in fish. B12 deficiency in 40% of patients |
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Treatment of neurocystercircosis |
Decreases risk of future seizures but has immediate risk of increasing seizures/inflammation. - if hydrocephalus or cerebral edema- steroids and/or surgery - if no increased ICP then albendazole. Add praziquantel if >2 viable cysts. And steroids before therapy. |
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Echinococcus granulosus acquisition |
Ingestion of eggs in dog feces. Sheep/goats/swine are intermediate host. |
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Echinococcus granulosus presentation |
Most cysts in liver (65%). 25% in lung. Can occur everywhere in body. - anaphylaxis/allergy due to cyst rupture - cholangitis, biliary obstruction, peritonitis, pneumonia from rupture - rare bone fracture, cardiac rupture, hematuria |
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Diagnosis of echinococcus granulosus |
Imagine, IgG Elisa 85% sensitive for liver cysts. Less sensitive for cyst elsewhere |
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Treatment of echinococcus granulosus cyst |
Do not spill contents. Albendazole for several weeks before surgery or PAIR. If cyst is inactive then don’t treat. |
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Echinococcus multilocularis life cycle |
Fox/ rodent |
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Echinococcus multilocularis imaging characteristics |
Infiltrative, tumor-like growth in liver. Poorly demarcated. Semisolid nature, does not form large cysts. |
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Nematode infection by eating eggs in fecally contaminated food or soil |
Ascaris Trichuris Enterobius Toxocara |
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Nematode infection by direct penetration of larvae through skin |
Strongyloides Hookworm (ancylostoma duodenale and necatur americanus) |
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Nematode infection by eating food containing infectious larvae |
Trichinella, angiostrongylus, anisakis |
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Nematodes acquired through vector transmission |
Wuchereria Brugia Onchocerca Loa loa |
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Nematodes with life cycle of skin->lung->gut |
Strongyloides Hookworm |
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Nematode with life cycle gut-> liver -> lungs-> gut |
Ascaris |
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Loefflers syndrome |
Ascaris lumbricoides causing eosinophilic pneumonitis with transient pulmonary infiltrates |
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Diagnosis and Treatment of ascaris lumbricoides |
Eggs only seen 2-3 months after pulmonary symptoms occur. Rx albendazole or mebendazole |
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Hookworms (names) and symptoms |
Ancylostoma duodenale and necator americanus Anemia, pneumonitis, rash, abdominal pain, cutaneous larvae migrans |
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Trichuris trichiura symptoms and diagnosis |
Loose stools, tenesmus, bloody stools, prolapse. Eggs are football shaped with two polar plugs |
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Strongyloides stercoralis symptoms |
Abdominal pain, wheezing/infiltrated, rash, larva currens, hyperinfection syndrome - often no eosinophilia in hyperinfection |
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Strongyloides stercoralis diagnosis and treatment |
Stool o/p, serology Rx ivermectin Pre-treat if plan immunosuppression in pts from endemic countries |
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Enterobius vermicularis diagnosis and treatment |
See eggs with one flat side. Rx albendazole or mebendazole or pyrantel pamoate x1. Repeat in 2 weeks. Great all members in household. Wash bedding and wash hands. |
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Vector for wuchereria bancrofti and brugia malayi |
Mosquito |
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Vector for loa loa |
Chrysops fly |
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Vector for onchocerciasis |
Black flies |
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Sites of organisms: wuchereria bancrofti and brugia malayi |
Adults: lymphatics Microfilariae: blood (night) |
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Site of loa loa |
Adults: sub q tissues (moving) Microfilariae: blood (day) |
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Site of onchocerciasis (river blindness) |
Adults: sub q tissues (nodules) Microfilariae: skin |
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Treatment of lymphatic filariasis (wuchereria and brugia) |
DEC |
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Treatment of loa loa |
DEC Use caution with treatment if high microfilaremia - can lead to encephalopathy and death |
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Treatment of onchocerciasis |
Ivermectin. Avoid DEC Can have severe skin inflammation and blindness |
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Pulmonary infiltrates with eosinophilia. Elevated IgE. Paroxysmal nocturnal asthma. |
Tropical pulmonary eosinophilia. Rapid response to anti-filarial therapy. Likely due to excessive immune response to microfilariae in the lung vasculature |
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Treatment of onchocerciasis |
Ivermectin, but does not kill adult worms. Treat 1-3x/year for up to 10 years. Alternative is doxy for 6 weeks to kill endosymbiotic wolbachia bacteria that kills adult worms. |
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Trichinellosis acquisition and symptoms |
Eat meat with cysts (pork, boar, horse, wild game). Abdominal cramps, diarrhea. Larvae migrate to striated muscle- sever muscle pain, periorbital edema, eosinophilia. +\- fever and urticaria |
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Trichinellosis diagnosis and treatment |
Serology supportive, biopsy definitive. Rx albendazole and steroids. |
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Angiostrongylus cantonensis acquisition |
Ingestion of parasite in snails or slugs, or hosts (prawns, shrimps, crabs) SE Asia, pacific basin, Jamaica |
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Angiostrongylus symptoms and treatment |
Eosinophilic meningitis. Supportive care. Anti-helminth therapy can worsen meningitis symptoms |
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Anisakis acquisition and symptoms |
Raw or undercooked seafood. Abdominal pain, vomiting, allergic reaction (urticaria, itchy throat, anaphylaxis) |
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Treatment of anisakis |
Endoscopic removal |
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Visceral larva migrans |
Toxocara Usually 2-5 years old. Fever, eosinophilia, hepatomegaly, wheezing/pneumonia, splenomegaly |
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Ocular larva migrana |
Toxocara Usually 10-15 years old. Retinal lesions that appear as solid tumors |
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Diagnosis and treatment of toxocara |
Clinical picture plus antibody (serum and intraocular fluid ELISA) Usually self limited. Can rx albendazole and steroids. |
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Toxocara or baylisascaris acquisition |
Ingest feces Toxocara ca is or cati Baylisascaris procyonis from raccoon. |
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Gnathostoma spinigerum and hispidum acquisition |
Undercooked freshwater fish, frogs, birds and remotes in Asia (esp Thailand) central/South America and Africa |
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Gnathostoma symptoms |
Migratory painful subcutaneous swellings that recur every few weeks. Creeping eruption/ cutaneous larva migrans. Can also cause visceral larva migrans, eosinophilic meningitis, radiculomyelitis and uveitis |
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Diagnosis and treatment of Gnathostoma |
Empiric or biopsy. No antibody tear. Rx albendazole up to 3 weeks |
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Freshwater exposure plus eosinophilia |
Schistosomiasis |
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Crab/ crayfish plus pulmonary symptoms plus eosinophilia |
Paragonimus |
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Allergic symptoms after trauma |
Echinococcus |
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Itchy feet after return from the tropics |
Hookworm |
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Subcutaneous nodules |
Onchocerca volvulus |
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Muscle pain plus eosinophilia |
Trichinellosis |
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Abdominal pain after sushi |
Anisakis |
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Eosinophilia plus fever plus elevated AST/ALT in child |
Visceral larva migrans (toxocara) |
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Drugs that cause pneumonitis |
INH PAS sulfasalazine Nitrofurantoin Daptomycin Amiodarone, flecainide Bleomycin |
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Time to onset from exposure to legionella for legionnaires disease |
2-10 days |
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Symptoms of mycoplasma pneumoniae |
Walking pneumonia, hemolytic anemia, hepatitis, meningitis/encephalitis |
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Gram negative bacilli intrinsically resistant to colistin |
Back (Definition) |
