Micro Set 3 Parysytology

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Cause/Epidemiology of African trypanosomiasis

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Trypanosoma brucei gambiense in SW Africa

Trypanosoma brucei rhodesiense in Southeast Africa

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Tsetse fly

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African trypanosomiasis

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Life cycle: African trypanosomiasis

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1) Uninfected Tsetse flies have blood meal- trypomastigotes, 2) metacyclic trypomastigotes develop and migrate to salivary glands,
3) fly injects trypomastigotes into human

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Pathogenesis: African trypanosomiasis

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Trypomastigotes produce chancre which spreads to lymph and blood circulation

Trypanosome genes capable of making surface glycoproteins

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Symptoms: African trypanosomiasis

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Winterbottoms sign: swollen lymph nodes, chancres, sleeping sickness

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Tx: African trypanosomiasis

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Suramin for T.b. rhodesiense and
Melarsoprol for T.b. gambiense

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Cause: mesocercarial visceral migrans

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Alaria americana,

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Epidemiology Mesocercarial visceral migrans

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Alaria americana: found in North America NOT WORLDWIDE!!

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Life cycle: Mesocercarial visceral migrans

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adult worms live in small intestine of carnivorous mammals

1) Miracidia hatch from eggs and penetrate snails
2) cercariae develop in snails and penetrate tadpoles
3) mesocercariae develop in adult frogs

but if tadpoles eaten then eater becomes intermediate (paratenic hosts)

Animals eat infected frogs- adult worms in SI repeat

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How do humans become infected with Mesocercarial visceral migrans? What kind of hosts are humans

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eating undercooked frogs/deadend hosts

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Pathogenesis: Mesocercarial visceral migrans

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mesocercarial larvae tunnel into tissues causing inflammatory response,

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Symptoms: Mesocercarial visceral migrans

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whatever organs are tunneled

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tx: Mesocercarial visceral migrans

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steroids

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cause: fasciolasis

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fasciola hepatica (sheep liver fluke)
fasciola gigantica: giant liver trematode

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epidemiology: fasciolasis

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fasciola gigantica is in Africa Asia and Hawaii NOT WORLDWIDE
fasciola hepatica: worldwide

humans and herbavores as reservoirs

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life cycle: fasciolasis

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1) adult worms in human livers and bile ducts where eggs are released

2) miracidia hatch and penetrate snails and turn into cercariae

3) miracidia hatch get into snails and form cercariae

4) cercariae leave snails and form metacercariae on vegetation which humans eat and metecercariae form adult worms in liver

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pathogenesis: fasciolasis

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adult worms and eggs destroy human liver tissue, cause mechanical and toxic irritation and enlarged liver**

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symptoms of fasciolasis

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malaise, eosinophilia

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diagnosis: fasciolasis

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operculated eggs in feces

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Tx: fasciolasis

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Tricalbendazole

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Cause: Paragonimiasis

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This species are Lung flukes

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Epidemiology: Paragonimiasis

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Asia, Africa and Americas NOT WORLDWIDE

reservoir: crab, crayfish-eating non-human mammals, humans

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Life cycle: Paragonimiasis

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1) Adult worms live in lungs eggs are released passed out with feces
2) Miracidia hatch, develop into cercaria in snails and released
3) penetrate crabs/crayfish where they turn into metacercaria

Humans ingest metacercaria in undercooked crabs crayfish and larvae excyst in duodenum and find their way to lungs where adult worms are

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pathogensis: Paragonimiasis

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lung tissue damage, thin walled cysts around parasite producing a cystic cavity and pleural adhesion

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symptoms: Paragonimiasis

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infection produces pleurisy, dyspnea, hemoptysis,

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Tx: Paragonimias

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praziquantel

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cause: Clonorchiasis

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Clonorchis and Opisthorchis species are human liver trematodes

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Epidemiology: Clonorchiasis

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Clonorchis sinensis is found in Asia,
ClonorchisOpisthorchis in Europe and Asia,

FISH EATING MAMMLS as reservoirs

Prevalence in 40 yrs of age and over

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Life cycle: Clonorchiasis

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1) adult worms live in bile duct and liver releasing eggs
2) eggs containing miracidia are ingested by snails and develop into cercaria
3) cercaria leave snails and penetrate fish where they turn into metacercariae
4) humans and mammals ingest infected fish and cercaria excyst and adult worms are in liver and bile ducts

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pathogenesis: Clonorchiasis

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adult worms tunnel in liver and produce hyperplasia of epithelium

biliary tract carcinomas are caused

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symptoms: Clonorchiasis

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Jaundice, ascites

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Tx: Clonorchiasis

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Praziquantel

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cause: Schistosomiasis

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Shistosoma species are trematodes living in human blood vessels

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epidemiology: Schistosomiasis

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Africa Asia Phillippines and Caribbean islands

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Life cycle: Schistosomiasis

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1) adult worms live in blood vessels of humans around large intestine and urinary bladder
2) eggs are released into bloodstream pass out with feces
3) miracidia hatch from eggs and penetrate snails and turn into cercaria
4) cercariae (infectious) are releasted into water and penetrate skin of humans, and develop into schistoluma that turn into adults in blood vessles of LI or bladder

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Symptoms: Schistosomiasis

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enlarged liver, hematuria, ascites, other symptoms related to location of eggs

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Dx: Schistosomiasis

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operculated eggs recovered from feces/ worst bladder infection ever had

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Tx: Schistosomiasis

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Praziquantel

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Cause: Shistosome dermatitis

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These Shisosoma species are trematodes non-human animals or birds** in US

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Epidemiology: Shistosome dermatitis

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fresh or salt water, in birds**

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Life cycle: Shistosome dermatitis

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1) adult worms live in blood vessels of birds and release eggs which pass out with feces
2) Miracidia hatch, penetrate snails and turn into cercaria
3) in fresh or salt water cercaria can accidently penetrate humans (dead end) will not become adults in humans but will in DUCKS

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Pathogenesis: Shistosome dermatitis

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Cercaria migrate under skin of humans but do not enter lood vessels or become adults

produce serpinginous tunnels where they will die

delayed hypersensitivity can develop

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Symptoms: Shistosome dermatitis

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rash, itching, secondary bacterial infections in humans

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Dx: Shistosome dermatitis

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history of exposure, nickname is swimmers itch bc need to get it from fresh or salt water

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Tx: Shistosome dermatitis

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Antihistamines (for assoc. rash)