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13 Cards in this Set
- Front
- Back
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Giardiasis - Epidemiology, Clinical Manifestations
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Most common cause of diarrhea outbreaks associated w/ daycares
Can get from beavers Half of kids are asymptomatic Acute Giardiasis (half) - fat malabsorption - fatty stool (steatorrhea) - diarrhea - bloated - weight loss - no dysentery Chronic Giardiasis (significant subset) - prolonged fat malabsorption (steatorrhea) - “failure to thrive” (growth retardation) - decreased serum carotene - abnormal xylose absorption |
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Giardiasis - Diagnosis
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Fecal exam looking for cysts
Fecal ELISA – measure fecal Ag in stool Entero-test Duodenal aspiration biopsy Serum Antibody PCR |
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Cryptosporidiosis - Epidemiology, Clinical Manifestations
(Cryptosporidium parvum) |
Daycares, public drinking water, pools
- Villous blunting - Mild inflammation - Prolonged diarrhea (dehydration) - Malnutrition, “failure to thrive” Immunocompromised patients: - Fulminant diarrhea - Wasting |
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Cryptosporidiosis - Diagnosis
(Cryptosporidium parvum) |
Acid Fast
Immunofluorescence Staining (Mab –monoclonal antibody based) Look for oocytes |
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Cyclosporiasis
(what is is, symptoms, how do you get it) |
- Resembles cryptosoridiosis
- Watery diarrhea and fatigue - Outbreaks from imported foods (i.e. raspberries) |
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Dientamoeba fragilis - Clinical Manifestations
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(Resembles Trichomonas which causes vaginitis, cervicitis)
Asymptomatic Symptomatic - Gastroenteritis - Chronic abdominal pain - Diarrhea (If you have a child with pinworm with abdominal pain, think about co-treating for dientamoeba) |
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Dientamoeba fragilis - Diagnosis
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?? Didn't cover this
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Blastocystis hominis - Clinical Manifestations
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- Irritable Bowel Syndrome (?)
- Know very little about it…weird morphology - Pathogenicity is controversial |
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Blastocystis hominis - Diagnosis
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?? Didn't cover this
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Enteamoeba histolytica - Epidemiology, Clinical Manifestations
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Tropical areas w/ overcrowded/unsanitary living conditions
US - hispanic males 20-40 - Asymptomatic colonization (may be E. dispar which is non-pathogenic, but morphologically identical) - Amebic Dysentery - Amebic Colitis (colonizes and invades large intestine) - Flask-shape colonic ulcers (digs through mucosa) - Liver Abscess (via migration into portal circulation) *can even cause Brain abscess if it enters efferent circulation |
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Enteamoeba histolytica - Signs and Symptoms of Amebic Colitis
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- Gradual onset
- History of symptoms >1 wk - Diarrhea - Dysentery - Abdominal pain - Weight loss - Fever - Heme+stools - Immigrant/traveler from endemic area |
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Enteamoeba histolytica - Signs and Symptoms of Amebic Liver Abscess
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- History of symptoms >4 wk,
- Fever - Abdominal tenderness (RUQ) - Hepatomegaly - Jaundice - Diarrhea - Weight loss - Male:female ratio 9:1 - Cough - Immigrant/traveler from endemic area |
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Enteamoeba histolytica - Diagnosis
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Microscopic examination (cannot distinguish from non-pathogenic E. dispar)
- Single/multiple stool exams - Look for erythrophagocytosis - Liver abscess aspirate (anchovy paste) PCR and Fecal antigen (can distinguish from E. dispar) Serology antibody difficult to interpret (pretty sensitive for Liver Abscess, and Amebic Colitis) Colonoscopy Radiographic Imaging |
