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17 Cards in this Set
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- Back
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E. histolytica
Transmission? 1 Morph? 4 Dz? 3 Dx? 4 Tx? 2 |
Fecal-oral
Oocyst Trophozoite: motile; bulls eye shaped nuc; RBC in cytoplasm Asymptomatic 90% Bloody diarrhea: trophozoites invade Reddish brown abscess in liver Histo show flask-shaped ulcer Fecal exam: cysts & trophozoites w/ RBC Serology Abd CT: liver abscesses Metronidazole (1st line) Tinidazole |
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Giardia lamblia
Transmission? 1 Morph? 2 Dz? 2 Dx? 2 Tx? 3 |
Fecal-oral
Oocyst Flagellated trophozoite looks like Chinese grandpa Foul smelling, greasy diarrhea (high fat content) Abd gassy distension Fecal exam: cysts, trophozoites Commercial immunoassay kit: test stool Metronidazole (1st line) Tinidazole Nitazoxanide |
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Cyclospora cayetanesis
Transmission? 1 Morph? 1 Dz? 2 Dx? 2 Tx? 1 |
Fruits & veggies contain oocysts, esp strawberries & raspberries
Oocysts Watery diarrhea N/V Stool exam of oocysts: UV fluorescence, acid fast TMP/sulfa |
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Cryptosporidium
Transmission? Morph? 2 Dz? 1 Dx? 2 Tx? 1 |
Fecal-oral
Oocysts is infective (4 sporozoites) Life cycle w/in inf epi cells (obligate intracellular) Water D/V/abd pain Fecal exam: acid-fast oocysts Bx of SI Immunocompetent: no Tx needed Persistant/immunocompromised: nitazoxanide or paromomycin +/- azithromycin |
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Isospora spp
Transmission? Morph? 2 Dz? 1 Dx? 3 Tx? 1 |
Fecal-oral
Oocysts infective (8 sporozoites) Obligate intracellular Severe diarrhea & malabsorption in AIDS pt Fecal exam: oocysts req acid fast stain & fluorescence Bx Eosinophilia TMP/sulfa |
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Trichomonas vaginalis
Transmission? 1 Morph? 2 Dz? 3 Dx? 2 Tx? 2 |
STD
No cyst stage Flagellated trophozoite Painful vaginal itching Burning on urination Yellow-green malodorous, frothy vaginal d/c Vaginal d/c shows highly motile protozoa Examine urine for protozoa Metronidazole to pt & partner |
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Naegleria fowleri
Transmission? 1 Morph? 1 Dz? 2 Dx? 1 Tx? 1 |
Freshwater lakes (like in a Nalgene)
Amoeba Acute meningitis Fatal in 1 wk CSF exam: motile amoeba w/ WBC Amph B |
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Acanthamoeba spp
Transmission? 2 Morph? 2 Dz? 2 Dx? 2 Tx? 4 |
Fresh water alkes
Eye inf from dirty contact lenses Amoeba stage Cyst stage in brain Chronic, granulomatous brain inf -> fatal in 1 yr Corneal inf from non-sterile soln CSF & brain Bx: cysts, mature trophozoites Examine corneal scrapings Chronic meningoencephalitis: multiple antifungal Rx + pentamidine Topical antimicrobial agents for cornea Corneal transplant |
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Balamuthia mandrillaris
Transmission? 2 Morph? 2 Dz? 2 Dx? 3 Tx? 3 |
Fresh water, soil
Amoeba stage Cyst stage in brain Chronic, granulomatous brain inf -> poor prog Granulomatous skin inf Brain or skin bx: cysts, trophozoites Immunoflourescent staining Fluconazole Azithromycin Pentamidine |
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Toxoplasma gondii
Transmission? 3 Morph? 3 Dz? 4 Triad? Dx? 3 Tx? 4 |
Oocysts in raw pork
Inhale oocyst from cat feces Congenital if preg expo for first time Oocyst infectious Trophozoites Obligate intracellular parasite Congenital: still birth, chorioretinitis, blindness, MR, microcephaly Immunocomp: encephalitis, chorioretinits, LN, PA Triad: chorioretinits, hydrocephalus, intracranial calcifications Serology: high IgM & IgG CT show enhancing mass Retinal exam Sulfadiazine + pyrimethamine Clindamycin if allergic to sulfa Folonic acid w/ pyrimethamine to lower risk of marrow depression Pregnant avoid cats |
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Pneumocystis carinii
Transmission? 2 Morph? 1 Dz? 2 Dx? 4 Tx? 5 |
Resp route in early age
Latent in norm hosts Flying-saucer FUNGUS Interstitial PA: fever, dry, nonproductive cough Most common pathogen in AIDS pt Silver stain for flying saucer in: saline-induced sputum, BAL, bronchial wall Bx X-ray: interstitial PA TMP/sulfa Pentamidien Atovaquone Dapsone Clindamycin |
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MALARIA
Spp? 4 Transmission? 1 Morph/life cycle? Dz? 6 Dx? 3 Tx? 4 |
P. falciparum (most common, most deadly), vivax, ovale, malariae
Anopheles mosquito Mosquito (at night) -> sporozoite -> Liver -> schizont -> merozoite -> rupture -> RBC -> trophozoite (ring) -> schizont -> merozoite -> gametocyte -> mosquito Dormant stage in liver for vivax, ovale Periodic fever & shaking chills f/u profuse sweating -> release of merozoites Tertian: vivax/ovale -> q 48 hr Quartan: malariae -> q 72 hr Anemia HSM Brain, lung, kidney damage Exam blood smear: ring-shape trophozoites, schizonts, gametocytes Rapid Ag Dx P. ovale/vivax: chloroquine + primaquine P. malariae: chloroquine P. falciparum: quinine, atavaquone-proguanil, mefloquine (resistant), artemesin compounds Prophylaxis: atavaquone-proguanil, mefloquin, doxycycline |
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Babesia microti
Transmission? 1 Morph? 2 Dz? 2 Dx? 1 Tx? 1 Co-inf w/? |
Ixodes scapularis tick
Sporozoites from tick Trophozoites = mature form; invade RBC Asymptomatic in immunocompetent Anemia from hemolysis, fatigue, protracted Blood smear: MALTESE CROSS Quinine + clindamycin Lyme dz |
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Leishmania
Spp? 5 Transmission? 3 Morph? 2 Dz? 4 Dx? 3 Tx? 3 |
Leishmania tropica, chagasi, major, brazillensis, donovani
Sandfly bite Contaminated blood transfusion Zoonotic: dogs, fox, rodent Promastigote: flagellated; in sandfly Amastigote: intracelluar, nonflagellated in RES Cutaneous: single ulcer at site (oriental sore); heal in year w/ scar Diffuse: non-ulcerating nodules at bite site & over body; lasts <20 yrs Mucocutaneous: ulcer on mucosa after 1st ulcer at bite heals; erods nasal septum, soft palate, lips; 20-40 yrs Visceral: Kala-azar; massive splenomegaly; often fatal Demonstrate protozoa on blood smear, Bx Leishmanin skin test neg in pt w/ cell-med immunity Elevated IgG Stibugluconate Amph B Miltefosine |
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Trypanosoma
Spp? 2 Transmission? 2 Morph? 2 Dz? 5 Dx?3 Tx? 3 |
Rhodesience (E) Gambiense (W)
Tsetse fly Contaminated blood transfusion Trypmastigote: flagellated extracellular form in blood, LN, CNS Trypmastigote & epimastigote in tsetse fly Hard, red painful ulcer at site of bite; heals 2 wks Fever, HA, LAD Relasping fevers x m CNS: West African: slowly progressing, wasting, late neuro Sx East African: Rapid cycling fevers, neuro Sx; death in wk-m Trypomastigotes in blood, spinal fluid, LN Serology Ab agglutination test for T. gamiense Suramin (doesn't penetrate CNS) Melarsoprol (CNS inv) Alt: pentamidine, eflornithine |
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Trypanosome cruzi
Transmission? 2 Morph? 3 Dz? 4 Dx? 2 Tx? 2 |
Kissing bug (reduviid): defecate -> trypomastigotes tunnel into skin
Contaminated blood transfusion Trypmastigote = motile, flagellated extracellular form livign in blood Amastigote: intracellular & non-motile: macrophages, LN, organs Trypomastigote & epimastigote in kissing bug CHAGAS Chagoma: hardened red area at site of parasite entry Acute Chagas' dz: fever, malaise, swollen LN, meningoencephalitis, acute myocarditis w/ tachcardia, EKG Intermediate phase: low parasite in blood, + Ab against T. cruzi, asymptomatic Chronic: cardiomyopathy, megadisease Visualize trypomastigotes in blood Xenodiagnosis Nitrofurtimox (acute) Benznidazole |
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Protozoa that cause GI inf? 3
CNS inf? 4 Visceral inf? 2 Hematologic inf? 2 STDs? |
Giardia, entamoeba, cryptosporidium
Toxoplasma, naegleria, Trypanosoma gambience/rhodesiense Trypanosoma cruzi, Leishmania donovani Malaria, Babesia Trichomonas |
