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132 Cards in this Set
- Front
- Back
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Characteristics of cestodes?
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Tapeworms
Segmented Do not have digestive tract |
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Scolex?
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Scolex (head) composed of suckers, hooks, or sucking grooves
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Taeniasis
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Infection with T. solium and saginata larvae
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Cysticercosis
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occurs when infected with T. solium
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id cestodes based on?
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Identification based upon symptoms, eggs, scolices, and proglottids (reproductive organs)
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T solium=
T saginata= |
solim=pork
saginata=beef |
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Find Taenia where?
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worldwide but endemic to E. Europe, Asia, and S. America
Found where pigs and cattle have access to human feces |
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How do you get taenia?
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Eating undercooked meat that contain larvae
Ingesting eggs from contaminated food/water |
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Taeniasis symptoms? size? (2x)
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Asymptomatic but can be 4-6 m (solium) or 6-10 m (saginata) in length
T. saginata proglottids are motile and can migrate out of the anus. They are large enough to be seen and this will alarm the patient Eosinophilia |
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Cysticercosis symptoms?(6x)
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Any tissue but mostly brain
Headache, vomiting, and seizures Other neurological defects Inflammation and calcification when larvae die CT scan shows large calcified often multiple lesions Eosinophilia |
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Diagnose Taenia pt history? Taeniasis? cysticercosis? how many proglottiods for beef and pork?
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Patient history for eating undercooked meat such as steak tartarre or “measly” meat (contains cysts)
Taeniasis is diagnosed by finding eggs or proglottids in stool T. solium proglottids 5-10 branches T. saginata proglottids 15-20 branches Cysticercosis is diagnosed by X-ray or CT scan |
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Taenia treatment?
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Adult worms should be treated immediately with either niclosamide or praziquantel
Tissue infections Non CNS - surgical removal of cysts CNS - surgery or chemotherapy but not very effective |
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prevent taenisis by?
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cooking of meat and increased sanitation
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Diphyllobothriasis dz caused by?
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Diphyllobothrium latum (Broadfish tapeworm
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Diphyloobotharis dz found where?
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Worldwide, endemic where raw fish are eaten
Common in cold clear lakes in Scandanvia, Russia, Japan, Canada, North Central US |
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how do you get diphyllobothriasis?
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Ingestion of larvae in undercooked fish.
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symptoms of diphyllobathriasis?
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Infection is normally asymptomatic but some may complain of weakness, nausea, diarrhea, salt craving, and abdominal cramps.
Prolonged or heavy infection may lead to megablastic anemia b/c of B12 deficiency due to parasite scavenging the vitamin |
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diphyllobathriasis diagnosis?
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Patient history
Identification of eggs in stool. Proglottids can also sometime be found in stool. |
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Diphyllobathriasis treatment?
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Praziquantel is the drug of choice. Preventive measures include properly cooking fish and disposing of human feces
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Hydatid or unilocular hydatid disease caused by?
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Echinococcus granulosus (dog tapeworm)
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granulosus disease is found where?
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Granulosus endemic in cattle and sheep-raising districts includes Western US, Mediterranean, Middle East, and Australia
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granulosus disease is spread by?
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Granulosis - ingesting eggs from soil, water, or dog fur
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how does the lifecycle of E multilocularis differ from granulosus?
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The life cycle for E. multilocularis is the same except that foxes are the definitive host and rodents are the intermediate hosts.
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what are symptoms of granulosus?
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Fluid filled cysts found mostly in brain, lungs, and liver
Can be asymptomatic for several years Cysts can lead to bloody sputum and cause neurologic or hepatic disorders Cysts rupture can cause fever, eosinophilia, and anaphylaxis |
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Granulosus how do you diagnosis? trt? and prevent?
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Imaging and serology. Also can identify parasites in aspirates from cysts.
Surgery followed by albendazole treatment Prevent dogs from eating sheep entrails |
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Alveolar cyst disease is caused by?
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Echinococcus multiloculari (fox tapeworm)
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alveolar cyst disease is associoted with people?
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Endemic to fox hunters
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how does alveolar cyst disease spread?
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Digestion of eggs in fox feces
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what is the differnce between granulosus and alveolar cyst disease in the life cycles?
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Life cycle similar to E. granulosus except definitive hosts are foxes and intermediate hosts are rodents
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alveolar cyst disease is trted how? diagnosed how?
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Diagnosis is same as for E. granulosis
Albendazole is drug of choice Surgery to remove cysts |
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Hymenolepiasis caused by?
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Hymenolepis nana (dwarf tapeworm)
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Hymenolepiasis is found?
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Worldwide but mostly southeastern US
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Hymenolepiasis is spread by?
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ingesting eggs?
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Hymenolepiasis symptoms are ?
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Largely asymptomatic but heavy infection will cause weakness and diarrhea
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Hymenolepiasis is diagnosed how?
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Diagnosis is made by finding the eggs in the stool.
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Hymenolepiasis trt?
prevent? |
Praziquantel is the drug of choice and prevention consists of good personal hygiene.
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Dipylidium caninum (dog tapeworm) causes?
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Common tapeworm in pets that can be passed to humans
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Dipylidium caninum (dog tapeworm) found where?
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This organism if found worldwide and is transmitted to humans by ingesting fleas containing the cysticerci. This most often occurs with children and their pets.
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Dipylidium caninum (dog tapeworm) spread?
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Ingesting fleas containing cysticerci which develop into adult worms in the hosts intestine
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Dipylidium caninum (dog tapeworm) symptoms.
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Most are asymptomatic but diarrhea and pruritus ani can occur.
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Dipylidium caninum (dog tapeworm) diagnosis?
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Diagnosis is made by finding the proglottids in the feces.
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Dipylidium caninum (dog tapeworm) trtment?
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Niclosamide is the drug of choice.
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Trematodes (flukes)general characteristics? 5x
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Bilaterally symmetrical and flat worms.
Attach to host using ventral suckers and acquire nutrients with oral suckers Have digestive and excretory tracts All use snails as intermediate hosts (limits geographic distribution not found in US) Human infections are incidental |
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Schistosomiasis (swimmer’s itch) caused by 3x?
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Schistosoma mansoni, S. japonicum, and S. haematobium (blood flukes)
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what is the epidimiology of schistosmoiasis?
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Africa/Latin America for mansoni
Africa/Middle East for haematobium Asia for japonicum 200 million infected people, ~ 400,000 deaths/yr |
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Schistosoma is spread?
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Free-swimming cercariae (larval stage) penetrate the skin
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acute symptoms of schistosoma? 8x
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Acute Phase
Dermatitis, swimmer’s itch (cercariae) Fever, cough, abdominal pain, diarrhea, hepatosplenomegaly, and eosinophilia (mature worms) |
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chronic symotoms of schistosoma?
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chronic phase
Tissue biopsies show large granulomas surrounding eggs (all) Inflammation in infected tissues due to soluble egg proteins (All) Mansoni GI Tract and Liver Japonicum GI Tract and Liver Haemotobium Urinary Tract Portal hypertension (All) Colonic polyposis with bloody diarrhea (mansoni) Bloody urine, urinary tract infection, cystitis, and bladder neoplasms (haemotobium) |
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How do you diagnose schistosoma?
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Identification of eggs in stool or urine. Order test based upon suspected organism.
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How do you trt and diagnose schistosoma?
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Praziquantal is drug of choice
Avoid swimming in endemic areas and proper disposal of human waste |
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Clonorchiasis is caused by?
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Clonorchis sinensis (liver fluke)
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where is Clonorchiasis found?
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Endemic in China, Taiwan, Vietnam, Korea, Japan, and Indochina
Over 30,000,000 people infected |
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Clonorchiasis is transmitted how?
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Ingestion of cercariae from raw or undercooked fish
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Clonorchiasis symptoms are?
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Most infections are asymptomatic
Heavy infection can lead to: Abdominal pains Bile duct obstruction leads to cholangitis and cholangiohepatitis Rare incidence of cholangiocarcinomas |
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Clonorchiasis diagnose?
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Identification of eggs in stool
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how is Clonorchis sinensis (liver fluke) treated? prevented?
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Prazinquantal is drug of choice
Prevent by eating properly cooked fish and proper disposal of human waste |
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Paragonimiasis or lung fluke disease caused by?
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Paragonimus westermani (lung fluke)
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Paragonimiasis is found where?
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Endemic in Asia and India
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Paragonimiasis is spread how?
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Ingesting the encysted stage in undercooked freshwater crabs (intermediate hosts).
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Paragonimiasis symptoms acute phase 5x and chronic phase 6x?
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Acute Phase
Abdominal pain, diarrhea, fever, hepatosplenomegaly, eosinophilia Chronic Phase Pulmonary Coughing Discolored sputum Hemoptysis Abnormal chest x-rays Rare extrapulmonary complications include CNS |
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paragonismus diagnosis?
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Diagnosis depends on finding the egg in sputum or feces. May need to concentrate feces.
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paragonismus trtment and prevention?
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Praziquantel is the drug of choice and prevention is by means of eating properly cooked crabs and properly disposing of feces.
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Fasciola hepatica (liver fluke) causes what disease?
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Fascioliosis “Sheep liver fluke disease”
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Fasciola hepatica is found where?
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Found where sheep and man are closely associated
Asia, Europe, Africa, Australia, Latin America |
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Fasciola hepatica is tranmitted how?
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Ingestion of metacercariae larva encysted in aquatic plants
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Fasciola hepatica symtoms acute and chronic?
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Acute Phase (hepatic migratory stage)
Right upper quadrant abdominal pain, heptamegaly, fever, eosinophilia Chronic Phase (flukes in biliary tract) Jaundice Biliary tract obstruction and inflammation |
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Fasciola hepatica diagnosis trt and prevention?
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Identification of eggs in stool.
Praziquantal is drug of choice Prevent by not eating aquatic vegetable or raw sheep liver |
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Fasciolopsiasis is caused by?
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Fasciolopsis buski (largest intestinal fluke)
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Fasciolopsis buski is found?
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Asia and Indian subcontinent particularly in areas where pigs are raised closely to aquatic vegetation
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Fasciolopsis buski is spread?
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Digestion of contaminated aquatic vegetables that contain cysts
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Fasciolopsis buski symptoms
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Heavy infection symptoms include diarrhea, abdominal pain, fever, ascites, and intestinal obstruction
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Fasciolopsis buski diagnosis?
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Diagnosis is made by finding the egg in the feces. F. buski eggs are indistinguishable from F. hepatica eggs
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Fasciolopsis buski trtment and prevention?
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Praziquantel is the drug of choice. Prevention consists of proper disposal of human waste.
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Nematodes (roundworms)
General characteristics? 3x life stages? tansmitted? |
Cylindrical, non-segmented
Microscopic to 5 cm in length Light creamy to white in color Egg-rhabditiform-filariform-adult stages Transmitted by ingestion of egg, larval penetration of skin, insect vector or ingestion of raw food |
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Enterobius vermicularis causes diseases?
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Pinworm, seatworm, enterobiasis
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Enterobius vermicularis found where?
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Worldwide
Most common helminth infection in US (4 million/yr) |
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Enterobius vermicularis is spread how? 2x
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Ingestion of eggs
Retroinfection occurs when eggs hatch and juvenile worms crawl back into anus |
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Enterobius vermicularis symptoms
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Children are most often infected but infection is typically asymptomatic
Perianal pruritis (nightime) leading to excoriations and bacterial infections In rare cases causes peritoneal granulomas and vulvovaginitis |
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Enterobius vermicularis diagnosis?
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Eggs are detected in perianal region by using Scotch Tape to make impression. Must be performed in morning before defecation and washing
Cannot detect eggs in feces |
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Enterobius vermicularis trtment and prevemtion?
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Pyrantel pamoate is drug of choice.
Because infection easily spreads all family must be treated whether or not they appear to be infected Increase personal hygiene and wash all bedding and clothes |
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Whipworm or Trichuriasis is caused by?
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Trichuris trichuria (whipworm)
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whipworm is found where?
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Worldwide but predominantly in tropics
2.2 million cases/yr in US |
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how is whipworm spread?
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Digestion of eggs from contaminated soil or food/water.
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whipworm symptoms are?
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Most infections are asymptomatic
Heavy infections in children can lead to abdominal pain, diarrhea, and rectal prolapse |
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whipworm diagnosis trt and prevent?
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Identification of eggs in stool
a typical barrel shape two polar plugs, that are unstained size: 50 to 54 µm by 22 to 23 µm Adult worms can sometimes be identified in rectal mucosa by proctoscopy Mebendazole is drug of choice Prevent by proper disposal of feces |
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Ascariasis is caused by?
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Ascaris lumbricoides
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Ascariasis is found where?
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Worldwide; most common human helminthic infection
1 billion cases/yr with 60,000 deaths/yr 2 million cases/yr in US |
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Ascariasis is spread how?
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Digestion of eggs from contaminated soil, food, or water
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ascaris symptoms?
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Acute infections are asymptomatic
Moderate to heavy infections can cause abdominal pain and intestinal obstruction Adult worms may cause bile tract obstruction Migrating worms can cause pulmonary problems including eosinophilia, pneumonia, and cough MALNUTRITION in children in developing countries |
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ascaris diagnosis trt and prevention?
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Identification of eggs in stool
Occasionally, worms can migrate out of the body via the rectum or mouth Mebendazole is drug choice Proper disposal of feces |
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Hookworm Disease is caused by 2x?
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Ancylostoma duodenale and Necator americanus (Hookworms)
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A duodenale is found where?
N. Americanus? |
A. duodenale – Africa, Asia, and Americas (tropics)
N. americanus – Americas and Australia |
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Hookworm Disease is spread how?
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Filariform (larva) penetrate skin
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hookwork symptoms are?
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Skin penetration may cause a pruritic papular erythematous rash (“ground itch”)
Iron deficiency anemia and other nutritional disorders caused worm attachment to intestine Abdominal pain, diarrhea, weight loss Pulmonary eosinophilia during lung migration (Loffler’s Syndrome) |
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hookwork diagnosis and trt and prevention?
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Detection of eggs in fecal smear
Mebendazole is drug of choice. Also may need to treat severe anemia with ferrous sulfate Wear shoes and proper disposal of feces |
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Strongyloidiasis is caused by?
found where? |
Strongyloides stercoralis
Worldwide, primarily in tropics and temperate regions including Southern US |
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strongyloidiasis is spread how?
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Filariform larvae in contaminated soil can penetrate skin
Autoinfection |
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strongyloidiasis symptoms?
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1/3 of cases are asymptomatic
Skin penetration may cause a pruritic papular erythematous rash (“ground itch”) Pulmonary complications during lung migration (Loffler’s Syndrome) Burning or colicky abdominal pain, diarrhea with passage of mucus. Nausea, vomitting and weight loss are often seen. Immunocompromised (HIV, leukemia, lymphomas, etc…) patients are more likely to suffer from autoinfection. Presents with abdominal pain, distension, shock, pulmonary and neurologic complications and septicemia (gram negative bacilli). Can be fatal. |
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strongyloidiasis diagnose?trt? prevent?
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Identification of larvae in stool or duodenal fluid
Larvae may be detected in sputum from patients with disseminated strongyloidiasis Ivermectin or thiabendazole are drugs of choice Wear shoes and proper disposal of feces. |
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Trichinosis caused by
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Trichinella spiralis
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Trichinosis found?
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worldwide
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Trichinosis spread?
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Ingestion of larvae from undercooked meat (most often pork but other meats as well
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Trichinosis symptoms?
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Light infections are asymptomatic
Intestinal obstruction accompanied by abdominal pain, diarrhea, and nausea Larval migration into muscle tissue characterized by facial and periorbital edema, conjuctavitis, fever, myalgias, rashes, and blood eosinophilia Some patients may develop potentially fatal myocarditis, encephalitis, or pneumonitis |
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Trichinosis diagnose?
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History of eating undercooked meat
Identification of larvae in tissue biopsies Bentonite flocculation exam ELISA |
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Trichinosis trt and prevent?
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If infection was within 7 days treat with thiabendazole
Mebendazole and corticosteroids can be used later Avoid eating undercooked meat |
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what causes Lymphatic filariasis or elephantitis?
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Wuchereria bancrofti and Brugia malayi (filariasis)
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Lymphatic filariasis or elephantitis found where?
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Endemic in tropics of Central Africa, India, Southeast Asia
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Lymphatic filariasis or elephantitis transmitted?
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Mosquito bite
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Lymphatic filariasis or elephantitis symptoms?
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Most often asymptomatic microfilaremia
Early stages Headache and nausea Local lymphadentitis, orchitis, and hydrocele Late stages Lymphatic obstruction b/c of worms resulting in lymphadema Thickening of skin and verrucous growth resulting in elephantiasis Lymphangitis and cellulitis resulting in secondary bacterial or fungal infections |
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Lymphatic filariasis or elephantitis diagnose, trt, prevent?
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Identification of microfilaria in blood smears.
To increase chances of detecting parasites blood should be drawn late at night (to identify Wucheria) or in morning (to detect Brugia) Antigen detection and PCR assays are also available Diethylcarbamazine is drug of choice for microfilariae. But may worsen symptoms b/c killed worms may activate acute immune responses Prevent by mosquito control and wearing protective clothing |
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Loaisis caused by?
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Loa loa
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Loaisis found where?
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tropical africa
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Loaisis transmitted how?
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Bite of the horse or deer fly (Chrysops)
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loa loa symptoms are?
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Microfilariae induce a hypersensitivity reaction that results in subcutaneous edema or Calabar swelling
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how do you diagnose loa loa?
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Identification of microfilariae in blood smears
Diethylcarbmazine is drug of choice Surgical removal of worms |
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what causes Onchoceriasis or “River Blindness”?
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Onchocerca volvulus
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Onchoceriasis is found where?
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Endemic in Central Africa and Central/South America
18 million people infected annually with 400,000 blinded |
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how is Onchoceriasis transmitted?
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Bite of Blackfly
Vector lives near oxygen-rich fresh water |
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Onchoceriasis is symptoms?
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Pruritus, dermatitis, onchocercomata (subcutaneous nodules), and lymphadenopathies
Rashes can ulcerate leading to “Craw Craw” Firm, nontender, freely mobile fibrous nodules that may contain worms Loss of vision leading to blindness Wrinkled skin due to loss of subcutaneous fibers |
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Onchoceriasis is diagnosed, trt, and prevented how?
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Identification of microfilariae in skin snips, nodules, cornea, or anterior chamber.
Diethylcarbamazine and ivermectin are drugs of choice to kill microfilariae Anti-bacterial creams to prevent secondary bacterial infections of skin lesions Protective clothing Blackfly control programs |
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Dracunculiasis or Guinea worm disease is caused by?
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Dracunculus medinensis
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Dracunculiasis is found where?
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Found where drinking water was drawn from primitive wells
Was found Africa, Middle East, and Asia Now, almost fully erradicated. Only second pathogen |
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Dracunculiasis is transmitted how?
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Digestion of infected water fleas (copepads)
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Dracunculiasis symptoms are?
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Skin ulcers present on lower extremities that are painful, burn, and itch.
Worm is often visible in ulcer Secondary bacterial infections are common |
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Dracunculiasis diagnosis, trtment, prevention?
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The ulcers and worms are so typical that their presence is all that’s needed for diagnosis
Cleansing of ulcer and topical antibiotics to treat secondary infections Thiabendazole and metronidazole are drugs of choice. The drugs don’t kill the worm but reduce the inflammation and permit easy extraction of the worm Proper water treatment |
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Visceral larva migrans
Ocular larva migrans are caused by what? |
Toxocara canis
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Toxocara canis is found where?
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Worldwide in children
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Toxocara canis transmission?
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Ingestion of eggs. Eggs hatch in intestine and worms migrate to viscera. However, worms are unable to reproduce in humans.
Eggs can survive in very stressed conditions and it’s therefore difficult to sanitize infected areas. |
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toxocara canis life cycle describe it!
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The adult worm resides in the intestine of the dog and passes eggs in the feces. When humans ingest the egg, the larvae hatches in the small intestine and migrate to many organs, including the liver, brain, and eyes. The larvae become encapsulated and die.
Does not complete its life cycle in humans. |
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toxocara symptoms?
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Most infections are asymptomatic with only eosinophilia
Primarily schoolchildren who present with fever, anorexia, weight loss, cough, wheezing, rashes, hepatosplenomegaly, and hypereosinophilia. May cause blindness |
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diagnosis of toxocara?
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History of exposure to puppies
Laboratory findings (including eosinophilia) Detection of antibodies to Toxocara Will not detect eggs in stool because life cycle can’t be completed in humans |
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trtmnt and prevention for toxocara?
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The drug of choice is diethylcarbamazine.
Preventive measures include keeping the pet dog wormed. |
