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230 Cards in this Set

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Free living single celled eukaryote with ectoplasm, endoplasm. Reproduces asexually and can create a cyst if challenged.
Protozoa
Motile form
Trophozoite
Four types of malaria
Plasmodium
Falciparum
Vivax
Ovale
Malariae
How many people have malaria worldwide
500 million human cases, 2.7 million deaths. Leading cause of morbidity and mortality in civil war.
Life cycle of malaria
Sporogeny in mosquitos -> pre-erythrocytic schizogeny in liver -> merozoites in blood -> erythrocyte schizonts -> gametocytes -> mostquito
At what stage of malaria do you get symptoms?
Erythrocyte schyzont stage - anemia and fever
Classicaly Fever Paroxysms for each type
Falciparum = sporadic and daily
Ovale = every other day
Vivax = every other day
Malariae = every third day
True relapsing malarias
Vivax and Ovale
Recrudescing malarias
falciparum and malariae (resurface after never really leaving in first place)
What type of sickle cell is protective in malaria?
Heterozygous (A and S)
How is duffy blood group protective against malaria?
Vivax normally binds duffy antigen, but duffy negative people don't allow it to bind and are at an advantage
How do you acquire immunity to malaria?
Type specific (species, strain, stage)
What kind of bug do you get malaria from?
Anapheles female mosquito
How do you diagnose malaria?
Clinical symptoms and thick and thin blood films, serology. Falciparum has banana shaped red cells.
How do you treat malaria?
Blood and tissue schizonticides. Chloroquine, primaquine (but not with G6PD Deficiency)
What is babesiosis?
Tick borne infection similar to malaria found in the United States
African Sleeping Sickness
Trypanosomiasis, from Trypanosoma brucei gambiense or Typanosoma brucei rhodesiense. Rhodesian is more virulent.
What vector does trypanosomiasis have?
Tse Tse fly
Geographic location of trypanosomiasis
Sub-saharan Africa (similar to malaria)
Life cycle of Trypanosoma
Trypomatigoes --> epimastigotes in insect --> tropomastigotes in salivary gland --> tropomastigotes in humans
Forms never become intercellular
Name 3 clinical signs of African Sleeping Sickness
1. Trypanosomal chancre at bite site
2. Lympadenopathy (winterbottoms sign)
3. Perivascular hermorrhage (cuffing)
4. Fever, somnolence, coma, death
Why is African Sleeping sickness hard to treat?
Lots of antigenic variation
How do we treat trypansomiasis?
Suramin, melarsoprol

No prophylaxis
In malaria, what are the clinical signs?
Fever, ANEMIA, cerebral malaria, hepatosplenomegaly, glomerulonephritis, Nephrosis (malariae only), hyperimmunoglobulinemia, immunosupression.
How do you diagnose trypanomoniasis?
Blood film. Has animal reservoirs.
Chagas Disease
American Trypanosomiasis - Trypanosoma cruzi
Cagoma at site of reduviid bite, unilateral periorbital edema
Romana's Sign
Symptoms of acute Chagas
Hepatosplenomegaly, encephalitis, myocarditis
Symptoms of Chronic Chagas
Cardiac disease, GI disease (megacolon or megaesophagus), neruologic disease
What is xenodiagnosis?
Letting sterile vector feed on infected person, and then examining the vector for signs of parasite. Used with Chagas disease.
How do you treat Chagas disease?
Nifurtimox. Must get from CDC.
What is the infective human form of trypanosomas?
Metacyclic trypomastigote.
What is Leishmaniasis?
Promastigotes in sand fly vector that divide in epithelial cells or macrophages of human or animal host.
What are the types of Leishmaniasis?
Visceral, Cutaneous, and Mucocutaneous
What organisms cause Kala Azar?
Visceral leishmaniasis. Caused by L. Donavi and L. Chagasi
What are the highlights of visceral leischmaniasis?
Amastigoes lie in macrophages, get fever parxysms and hepatosplenomegaly resembling malaria.
What are the highlights of cutaneous leischmaniasis?
L. Tropica, L. Major, L. Mexicana. Clinical manifestations are only dermatologic, get papules, ulcers (crateriform).
How do you diagnose cutaneous leichmaniasis?
Skin test, needle aspiration, biopsy of ulcer for amastigotes. Bone marrow aspirate.
What is an amastigote?
Non-flagellated parasite.
What are some highlights of mucocutaneous leishmaniasis?
Espundia. Found in central and south america. At first indistinguishable from cutaneous form, have tropism for nasopharyngeal region, erodes nares and palate soft tissue.
What type of immunity kills leishmaniasis?
CD4 TH1 cell mediated macrophage activation.
Where do you find chiclet ulcers?
Chiclet ulcers are found with L. mexicana. Usually found on gum farmers.
How do you treat cutaneous leishmaniasis?
You don't, only visceral and mucocutaneous forms need treatment, with pentavalen antimonials.
What are some symptoms of visceral leishmaniasis?
Fever, anemia, hepatosplenomegaly, cratiform ulcer, hyperimmunoglobulinemia, albumin:Ig switch. OFTEN MISTAKEN FOR MALARIA.
How do you treat Chagas disease?
Nifurtimox. Must get from CDC.
What is the infective human form of trypanosomas?
Metacyclic trypomastigote.
What is Leishmaniasis? What is it's vector? What is its reservoir?
Promastigotes in sand fly vector that divide in epithelial cells or macrophages of human or animal host. Its reservoir is canine/rodent.
What are the types of Leishmaniasis?
Visceral, Cutaneous, and Mucocutaneous
What organisms cause Kala Azar?
Visceral leishmaniasis. Caused by L. Donavi and L. Chagasi
What are the highlights of visceral leischmaniasis?
Amastigotes lie in macrophages, get fever parxysms and hepatosplenomegaly resembling malaria.
What are the highlights of cutaneous leischmaniasis?
L. Tropica, L. Major, L. Mexicana. Clinical manifestations are only dermatologic, get papules, ulcers (crateriform).
How do you diagnose cutaneous leichmaniasis?
Skin test, needle aspiration, biopsy of ulcer for amastigotes.
What is an amastigote?
Non-flagellated parasite.
What are some highlights of mucocutaneous leishmaniasis?
Espundia. Found in central and south america. At first indistinguishable from cutaneous form, have tropism for nasopharyngeal region, erodes nares and palate soft tissue. L. Brazilliensis, espundia.
What type of immunity kills leishmaniasis?
CD4 TH1 cell mediated macrophage activation.
Where do you find chiclet ulcers?
Chiclet ulcers are found with L. mexicana. Usually found on gum farmers.
How do you treat cutaneous leishmaniasis?
You don't, only visceral and mucocutaneous forms need treatment, with pentavalen antimonials.
What are some symptoms of visceral leishmaniasis?
Fever, anemia, hepatosplenomegaly, cratiform ulcer, hyperimmunoglobulinemia, albumin:Ig switch. OFTEN MISTAKEN FOR MALARIA.
How does cyst attach to GI tract?
A lectin - NAGA - allows attachment to gut.
How does Amebiasis get energy?
Secretes cytotoxin into gut that kills cells, and then it feeds off of that debris.
What is the life cycle of Amebiasis?
Human ingests cyst -> trophozoites excyst in small intestine -> migrate to colon and attach -> metacyst -> cyst passed in feces.
What is the parasite of amebiasis called?
Entamoeba histolytica
What are the symptoms of amebiasis?
Either asymptomatic, diarrhea, uclerative colitis, flatulence, dysentery, flask shaped ulcers.
Can get extraintesinal - usually to liver (amebic liver abscess), or plerual space causes intrathoracic amebiasis.
What do E. histolytica trophozoites look like?
Big cell with nucleus dead in center.
What do Entamoeba cysts look like?
FOUR NUCLEI with sharp chromatoidal bar. Any more than four and it's entamoeba coli, which is not a pathogen.
How do you diagnose E. Histolytica?
Must be considered in any patient with dysentery. Find characteristic trophozoites and cysts in stool. OFten confused with other commensals.
How do you treat E. Histolytica?
Diloxanide (cysticidal) or iodoquinol, may have to aspirate liver abscesses
What is the most common intestinal protozoan parasite in the US?
Giardiasis - Giardia Lamlia (intestinalis)
What is Giardias geographic distribution?
Cosmopolitain - has many animal reservoir hosts
What is the life cycle of G. Lamlia?
Cyst -> ingested -> flagellated trophozoite -> attaches to mucosa with sucking disks -> reproduce by binary fission -> cysts -> passed in feces
What are the clinical signs of giardia?
Diarrhea, fulminant and water, flatulence, steatorrhea, malabsorption, weight loss, fatigue, epigastric pain.
Where do you find giardia in the body?
SMALL INTESTINE. Can literally cover it. Sticks to brush border. Looks like a little flat disk with owls eyes.
How do you diagnose giardia?
Identify cyst in fecal sample or duodenal aspriate (string test). Can do immunoflourescense, ELISA
How do you treat giardia?
Metronidazole, furazolidone, TINIDAZOLE (a single dose drug)
What protozoan is sexually transmitted?
Trichmonas vaginalis. Makes trichomoniasis.
What is the prevalence of trichomoniasis?
7.5 million cases/ year in US. Distributed cosmopolitain
What is the life cycle of Trichomonas Vaginalis?
flagellated trophozoites -> vagina, prostate, urethra -> NO CYST STAGE
What percent of sexually active females will get trichomonas?
25%. Causes proliferation of bacterial flora and change in pH of vagina.
What are the clinical symptoms of trichomoniasis?
Females - can be asymptomatic but usually vaginal discomfort, itching, burning, thick yellow blood tinged discharge, burning on urination, increased risk of pre-term births and HIV. Men usually asymptomatic but can involve prostate.
How do you treat trichomoniasis?
Metronidazole
80% of us have this, and with a normal immune system it is fine.
Penumocytis carinii. Shares many characteristics with a fungus.
What is pneumocytosis' life cycle?
Cyst with 8 sporozoites -> trophozoites -> precyst -> cyst. Attach to and enter alveolar macrophages via mannose receptor. Macrophages destroy parasites via toxic oxygen radicals, which fails in immunocompromised patients.
What is the clinical course of Pneumocytsis carinii?
An opportunistic pathogen. Alveoli fill with honecomb material, get plasma cell pneumonia (PCP), non productive cough, tachypnea, hypoxia, dypnea, bilateral infiltrates. Can be disseminated.
What percentage of people with HIV will develop plasma cell pneumonia?
85%. A leading cause of death in AIDS.
How do you diagnose Pneumocystosis?
See cysts in bronchoalveolar lavage, transbronchal biopsy with silver or giemsa stains.
How do you treat pneumocystosis?
Trimethoprim and corticosteroids.
Cryptosporidiosis has what kind of distribution?
Cosmopolitain (zoonotic!)
What is the life cycle of cryptosporidium parvum?
Occyst ingested -> sporozoites released in small intestine and attach to columnar epithelial cells -> trophozoites -> merozoites -> gametocytes -> oocyst. VERY SIMILAR to malaria.
How do you treat giardia?
Metronidazole, furazolidone, TINIDAZOLE (a single dose drug)
What protozoan is sexually transmitted?
Trichmonas vaginalis. Makes trichomoniasis.
What is the prevalence of trchomoniasis?
7.5 million cases/ year in US. Distributed cosmopolitain
What is the life cycle of Trichomonas Vaginalis?
flagellated trophozoites -> vagina, prostate, urethra -> NO CYST STAGE
What percent of sexually active females with get trichomonas?
25%. Causes proliferation of bacterial flora and change in pH of vagina.
What are the clinical symptoms of trichomoniasis?
Females - can be asymptomatic but usually vaginal discomfort, itching, burning, thick yellow blood tinged discharge, burning on urination, increased risk of pre-term births and HIV. Men usually asymptomatic but can involve prostate.
How do you treat trichomoniasis?
Metronidazole
80% of us have this, and with a normal immune system it is fine.
Penumocytis carinii. Shares many characteristics with a fungus.
What is pneumocytosis' life cycle?
Cyst with 8 sporozoites -> trophozoites -> precyst -> cyst. Attach to and enter alveolar macrophages via mannose receptor. Macrophages destroy parasites via toxic oxygen radicals, which fails in immunocompromised patients.
What is the clinical course of Pneumocytsis carinii?
An opportunistic pathogen. Alveoli fill with honecomb material, get plasma cell pneumonia (PCP), non productive cough, tachypnea, hypoxia, dypnea, bilateral infiltrates. Can be disseminated.
What percentage of people with HIV will develop plasma cell pneumonia?
85%. A leading cause of death in AIDS.
How do you diagnose Pneumocystosis?
See cysts in bronchoalveolar lavage, transbronchal biopsy with silver or giemsa stains.

Sputum exam, biopsy
How do you treat pneumocystosis?
Trimethoprim and corticosteroids.
Cryptosporidiosis has what kind of distribution?
Cosmopolitain (zoonotic!)
What is the life cycle of cryptosporidium parvum?
Occyst ingested -> sporozoites released in small intestine and attach to columnar epithelial cells -> trophozoites -> merozoites -> gametocytes -> oocyst. VERY SIMILAR to malaria.
What percentage of AIDS patients have cryptosporidium?
10%
What type of disease is crytosporidium?
A cosmopolitan zoonotic disease
What type of people get cryptosporidium?
Kids, immunocompromised, AIDS patients, medical personnel.
Histologically, what does cryptosporidium parvum do?
Villous atrophy, crypt enlargement, minimal mononuclear cell infiltrate of the lamina propria.
What is the case fatality rate of cryptosporidium for someone with HIV?
50% of AIDS patients die, daily fluid losses up to 17 liters. Sporozoites can auto-infect.
How do you treat cryptosporidium?
Paromomycin, rehydration
How do you diagnose cryptosporidium?
Identify oocysts in stool - the look kind of like pollen, hard for non-microbiologist to identify.
What is the infective form of cryptosporidium?
Sporulated oocyst
What similarity do Giardia and cryptosporidia share?
They both live in the small intestine.
40% of AIDS patients have this disease, which is an obligate intracellular parasite found in feline feces or undercooked meat
Toxoplasmosis - Toxoplasma gondii

Can also get it transplacentally or via transfusion/transplantation
Describe the life cycle of toxoplasmosis gondii
Sexual in felines, asexual in rodents and humans.
ingest oocyst -> sporozoite -> tachyzoite in tissue -> (bradyzoites in cysts in brain, heart, skeletal muscle)
In what cells is t. gondii located?
Macrophages - survive in phagosomes by preventing phagosome/lysosome fusion
What three types of infection can Toxoplasmosis cause?
Acute, Chronic, or congenital.
Acute = subclinical or like mono, encephalitis in AIDS patients
Chronic = asymptomatic usually, pseudocyst rupture can lead to systemic infection. ALSO CHORIORETINITIS in kids and adults in US.
Congenital = maternal infection of FIRST trimester, neurological sequellae, chorioretinitis, mental retardation, often fatal. 70% asymptomatic.
How does the immune system deal with Toxoplasmosis?
Antibody against extracellular tachyzoites, and CD4 TH1 cell induced macrophage activation
How do you treat T. Gondii?
Pyrimethamine, sulfadiazine. Prevent by cooking meats and avoiding cats during pregnancy.
What are the two ways you can get T. Gondii environmentally?
Oocysts from felines, pseudocyst in meat

Tachyzoite non-environmentally
What is the best way to diagnose toxoplasmosis?
serological tests. High levels of IgM will show acute infection.
What are the helminth parasites?
Nematode (roundworms), cestodes (tapeworms), Trematodes (flukes)
What type of helminth is Enterobius vermicularis?
A nematode. Also called pinworm. Seen a lot in children.
What nematode infection causes Enterobiasis?
Enterobius vemincularis. The most common nematode infection in temperate zones.
What is the life cycle of enterobiasis?
Lavae in small intestine -> colon -> reproduce -> perinanal region -> eggs embryonate on perianum. Autoinfection can occur if egg hatches and it migrates back to colon.
What is the pathology of enterobiasis?
Adult pinworms in colon cause no pathology. Eggs cause pruritis ani, scratching may lead to cellulitis.
How do you diagnose pinworm?
Enterobiasis can be diagnosed via the scotch-tape or pinworm paddle method. Oval eggs classically flat on one side.
How do you treat pinworm?
Mebendazole, pyrantel, re-treat to kill new worms
What type of helminth is Trichuris trichuria?
Nematode. A whipworm.
Whipworm disease is also known as what?
Trichuriasis. Cosmopolitain distribution, over one billion cases worldwide.
What is the clinical disease of trichuriasis?
Light infections are asymtpomatic, but heavy infections are acute dysentery or chronic colitis that resembles inflammatory bowel diesase. Malnutrition, anemia, short stature, finger clubbing. Seen usually in kids.

Hemorrhagic colitis and rectal prolapse.
In trichuriasis, protracted tenesmus of the rectum causes what?
Rectal prolapse.
How do you diagnose whipworm?
Chracteristic bipolar eggs in stool, lab sees eosinophila (as with many worms). Also can see with colonoscopy.
How do you treat trichuriasis?
Mebendazole, albendazole. Surgically correct rectal prolapse.
What is the infective human form of trichuriasis?
embryonated egg (same as Enterobious vermicularis and ascaris lumbricoides)
This helminthic parasite infects over 1 billion people worldwide and can cause pneumonitis, hepatomegaly, and toxicity
Ascaris lumbricoides "ascariasis". Eggs are very resistant to environment and can last for years. Giant roundworm disease.
What is the infectious human form of ascariasis?
Embryonated egg. This hatches in small intesting, penetrates mucosa nad migrates to liver -> migrates to lung and molts twice -> breaks out into alveolar spaces -> migrate up bronchi to trachea -> larvae are swallowed -> in small intestine larvae become adults -> reproduce and lay eggs which pass in feces.
It is estimated that 25,000 tons of this species eggs are passed each year
Ascaris lumbricoides, a nematode,
What are the clinical symptoms of ascaris lumbricoides?
Pneumonitis, hepatosplenomegaly, obstruction, malabsorbtion. See eosinophilia and hypergammaglobulinemia G.
How do you diagnosis ascariasis?
Identify characteristic eggs in stool, xray for intestinal obstruction.
How do you treat ascariasis?
Mebendazole, pyrantel. Surgery for obstruction.
What drug is used to treat most nematode infections?
Mebendazole
Ancylostoma duodenale and necator americanus cuase this diesase, which may cause significant blood loss.
Hookworm disease. One billion cases worldwide.
What is the geographic distribution of Ancylostoma duodenale?
This hookworm nematode is found in Mediterranean, Asia, S. America. It is the most virulent form of hookworm.
What is the geographic distribution of Necator americanus?
This hookworm nematode is found in the western hemisphere, but some in Africa, Asia, and Pacific. It is the lesser virulent hookworm.
What is the infective human form of hookworm?
3rd stage filariform larva.
This is found on grass, it penetrates skin or infects orally (can get stuck in muscles), migrates to lung, enters alveoli, migrates up trachea, gets swallowed, and molts in adult intestine.
What is the clinical pathology of hookworm?
Skin penetration causes dermatitis, lung migration may cause pneumonia, epigastric pain, vomiting, mucosal damage with severe blood loss, up to 200ml per day. See iron deficiency anemia, edema, ascites from malnutrition, physical/mental retardation if severe.
What nematode causes 7 million liters of blood lost per day in all infected people?
HOOKWORM. Ancyclostoma duodenale.
How do you treat hookworm?
Mebendazole, pyrantel, iron supplementation.
With 200million cases worldwide, this nematode causes serpingous creeping urticarial eruptions in skin
Strongyloides stercoralis, causing "strongyloidiasis". Located tropical, subtropical, and temperate.
What is the infectious human form of strongyloidiasis?
3rd stage filariform larvae. Right after its FREE LIVING CYCLE - the 3rd stage larvae penetrate the skin, go to lungs, get swallowed, mult in intestin to PARTHOGENETIC adults that reside within columnar epithelium in small intestine.
How do you get strongyloidiasis?
Thru the skin
Who are the reservoir hosts of strongyloidiaisis?
Dogs and non-human primates
When do you see hyperinfection of filariform larvae in strongyloidiasis?
Immunocompromised hosts - develops in colon
What are the clinical aspects of strongyloidiasis?
Pneumonia, diarrhea, disseminated disease, and LARVA CURRENS - as serpinginous urticarial eruption
How do you diagnose strongyloidiasis?
Can't really do stool sample for rhabditiform larvae, have to sediment and concentrate - ELISA is not widely available. Do see eosinophilia.

"stool exam for larvae"
How do you treat strongyloidiasis?
Thiabendazole, ivermectin, antibiotics for secondary bacterial infections, fluid management.
What is the best prevention for helminthic infection?
Sanitary disposal of feces, etc
This nematode infection is often found in meat, but is rare in US due to proper handling.
Tricheinellosis, from Trichinella spiralis. A cosmopolitain disease.
What is the infectious human form of trichinellosis?
Infected "nurse" cells in muscle with larvae inside. Larvae then get eaten and live/penetrate columnar epithelial cells. Become adult worms.
How do humans normally acquire trichinellosis?
Consuming undercooked pork. Usually humans are dead end hosts (nurse cells calcify). Eating embryonated egg (?)
What are the clinical symptoms of trichinellosis?
Gastroenteritis, myocarditis, encephatlitis, myositis (fever, myalgia, periorbital edema), paralysis of diaphragm. Get eosinophilia and elevated muscle enzymes.
How do you diagnose trichinella spiralis?
Hx of pork consumption, gastroenteritis, ELISA and CIE. Definitive = muscle biopsy, squash prep.
How do you prevent trichinellosis?
Cook/Freeze pork, prevent pigs from eating meat scraps
What disease is brought on by Wucheria bancrofti?
Filariasis, found in tropics and subtropics (pacific islands), causes Elephantiasis
What is the human infectious form of filariasis?
3rd stage filariform larva, deposited by mosquito onto skin - enters bite wound and goes to lymphatics, microfilariae circulate in bloodstream
What are the lab findings for Wucheria bancroft?
Elevated IgE, eosinophila
What are the clinical manifestations of Filariasis?
Many are asymptomatic. Microfilaremia causes fever, lymphangitis, lymphadenitis, cellulitis, dermatitis. Chronic worms lead to lymphedema and ELEPHANTIASIS in late stage.
What is tropical Pulmonary Eosinophila, and what is it caused by?
Hypersensitivity syndrome with elevated IgE, nocturnal asthma, fatigue, weight loss caused by Wuchereria bancrofti.
How do you diagnose Filariasis?
Microfilaria on Geimsa stained blood film, but consider that it may come periodically (nocturnal). Serology is not useful.
How do you treat filariasis?
You cannot treat adult worms. Surgery may be required for lympedema. Diethylcarbamazine/ivermectin to kill microfilariae.
What disease, caused by onchocerca volvulus, causes blindness?
Onchocerciasis, River Blindness
Where is onchocerca volvulus located?
Subsaharan Africa and Latin America
What vector is used with River BLindness?
Blackfly vector (Similium), deposits 3rd stage filariform larvae on skin while biting in onchoceriasis.
What is the life cycle of onchercerca volvulus?
It enters fly bite and produces microfilaria, which goes into blood and tissues (eyes).
What pathology does onchercerca volvulus cause?
microfilariae = little to none, dead ones cause intense inflammatory response. Adult worms are in subcutaneous nodules - cause edema, elephantiasis. Dead microfilariae in eye cause sclerosisng keratitis, blindness.
How do you diagnose onchoceriasis?
Giemsa stained blood film, identify adults with skin snip near nodule
How do you treat the nematode onchercerca volvulus?
Ivermectin, nodulectomy. Drugs are fairly cheap and are donated to Africa by pharmaceutical companies.
Guinea Worm Disease is also known as what?
Dracunculiasis from Dracunculus medinensis
Where is Dracunculiasis found?
Africa, Yemen, Pakistan, India, Latin America
What is the infective human form of Dracunculiasis?
Copepods with 3rd stage larvae consumed, migrates to connective tissues, copulates, migrates to skin of lower extremities. forms vesicle, bursts upon contact with water
What is the clinical pathology of Dracunculaisis?
No host response to initial worm migration, female worm secretes toxin that induces vesicle with ulceration, can get secondary bacterial infections and allergies to worm products
How do you diagnose dracunculiasis?
Find head of FEMALE worm in skin lesion, larvae
How do you treat dracunculiasis?
Slowly twist adult worm onto thin stick, surgery, metronidazole with corticosteroids. Need to boil water to eliminate copepods.
What are the three types of human schistosomes?
Schistosoma mansoni, schistosoma japonicum, shistosoma hematobium
Name the 3 major types of trematode infections
Schistosomiasis, Clonorchis Sinensis, Paragonimus Westermanni
What is the geographic distribution of schistosomiasis?
Tropics and subtropics. Each schistosome form has it's own type of snail host.
What's the life cycle of schisosoma? What is the infectious human particle?
Cercariae penetrate skin -> schistosomules -> lungs -> portal veins -> mesenteric vessels or venous plexus of bladder -> copulate -> eggs to colon/bladder -> passed in feces or urine -> snail -> sporocyst -> redia -> cercariae exit snail and find human
What are the clinical symptoms of schistosomiasis?
Dermatitis from cercarial penetration. Pneumonitis from migration thru lungs, onset of egg production causes Katayama fever, intestinal or urinary bladder symptoms, granulomas in liver, blockage of sinusoids, pipestem fibrosis, protal hypertension. Granulomas in lungs. Hepatosplenomegaly, eosinophilia, hyperimmunoglobulinemia.
What are the clinical manifestations of schistomiasis primarily caused by?
T cell mediated, delayed hpyersensitivity reaction to eggs
Diagnosis of schistomiaisis is based on what?
Eggs in feces or urine. HUGE. Lateral spined = mansoni, lateral blebbed = japonicum, terminal spined = hematobium.
How do you treat schistomiasis?
Praziquantel or oxamniquine, fatal if untreated. Snail control.
What is schistomiasis also known as?
Blood flukes. A waterborne snail using granuloma producing liver and bladder destroying blood fluke.
What types of snail are found in schistosomiasis?
Biomphalaria = masoni
Oncomelania = japonicum
Bulinus - hematobium
What type of helminth is clonorchiasis?
A chinese liver fluke, a trematode.
Clonorchiasis is from what species?
Clonorchis sinensis, 80 million cases worldwide, found in tropics and subtropics.
What is the human infective form of clonorchiasis?
metacercaria.

Uncooked fish contain encysted metacercariae -> small intestine -> larvae -> bile duct -> liver -> monoecious adult -> produces eggs -> snail, find and encyst on fish.
What's the disease caused by clonorchiasis?
Adult worms in gall bladder, bile ducts, liver -can also penetrate pancreatic duct, causing sequelae. Liver destruction can occur.
How do you dignose clonorchiasis?
Operculated egg in fecal sample.
How do you treat chinese liver fluke?
Praziquentel
What is the most common type of treatment for flukes?
Praziquantel
What is the disease caused by lung flukes?
Paragonimiasis from paragonimus westermanni. Found particularly in orient. Has many host reservoirs.
What is the infective human form of paragonimiasis?
Metacercaria from uncooked crab or crab juice. Thses go to small intestine, larvae migrate to lungs, eggs go to alveoli, pass in sputum or feces. Eggs hatch and release miracidia which get consumed by snail -> sporocysts -> redia -> motile cercariae -> crabs -> humans
What types of disease does paragonimiasis cause?
Inflammatory lesions - like cerebral paragonimiasis with siezures. Also secondary bacterial infections, chronic cough with blood, plerual pain, dyspnea, clubbing of fingers and toes.
How do you diagnose lung flukes?
Operculated eggs in SPUTUM.
Paragonimiasis is treated with praziquantel. Boil crab meat products.
What type of helminth is a tapeworm?
Cestode.
Broad fish tapeworm is also known as what?
Diphyllobothrium latum. Found in tropics, subtropics, nordic countries, great lakes.
Diphllobothriasis comes from eating what?
Uncooked fish. The embryonated egg ->pleurocercoid larva matures to adult tapeworm in small intestine. Eggs are produced and hatch in water releasing coracidium, which is eaten by a crustacean, the procercoid larva develops in crustacean which is eaten by a fish and the larva develop in its muscles.
What kind of diseases does broad fish tapeworm cause?
Adult tapeworm can grow to 60ft, causing diarrhea, B12 deficiency, and pernicious anemia. Diphyllobothrium latum
How do you diagnose diphyllobothriasis?
Characteristic operculated (shell like) egg in fecal sample/ paraglottid
How can you tell differences between fluke eggs?
SIZE.
How do you treat diphyllobothriasis?
Niclosamide. Cook FISH! Give psychological support when removing tapeworm.
How do you treat most Cestodes?
Niclosamine or praziquantel
What tapeworm is also known as Taeniarhynchus sagniatus, causing taeniasis?
The Cattle and Pork tapeworms
What is the human infectious particle of T. Solium?
CYSTICERCUS larva from uncooked beef or pork product.
Tapeworm in small intestine produces egg which embryonates in soil, cow or pig consumes it, egg hatches abd cysticercus larva develop in muscle.
Tapeworms attach to small intestine via what?
Scolex - suckers and hooks
What is the clinical pathology caused by Taeniasis?
usually asymptomatic, but may get abdominal discomfort and diarrhea.
How do you diagnose taeniasis?
Eggs or proglottids in feces
How do you treat taeniasis?
Niclosamide and psychological support. Cook beef and pork, or freeze.
What is cysticercosis related to?
Taeniasis. Same animal - T. Solium Larvae
Where is cysticercosis most prominent?
Cosmopolitain, especially where you raise pigs
What is the infectious particle of cysticercosis?
Embryonated egg -> hatches in small intestine -> oncosphere -> blood -> cysticercus (bladder worm).
What is the clinical pathology of Cysticercosis?
Painless subcutaneous nodules, depending on location of cysts get neruocysticercosis (brain tumor, epilepsy), retinitis, uveitis, etc.
How do you diagnose cysticercosis?
x-ray, MRI, CT, serology, eosinophilia.
How do you treat cysticercosis?
Praiquantel, corticosteroids, surgical removal

If you see speckled regions in muscle on x-ray, it is fatal
What is Hydatid Disease?
Caused by echinococcus granulosus, it is anywhere where sheep are raised.
Echinococcosis causes what kind of pathology?
NOT ADULT TAPEWORMS. Larval tapeworms - form umilocular hdydtid cyst usually in liver or other ograns. Rupture can lead to anaphylactic shock and death.
What is the infectious human form of hydatid disease?
Embronated egg which becomes oncosphere, goes to blood, develops into hydatid cyst, something comsumes sheep and gets worms.
This disease is commonly seen with a sheep --> dog --> sheep cycle
Echinococcosis.
How do you treat echinococcosis?
Albendazole, surgery
Prevent by avoiding contact with dogs and prevent them from consuming offal
How do you diagnose echinococcosis?
Serology, radiography