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64 Cards in this Set
- Front
- Back
Giardia lamblia
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- Giardiasis, bloating, farting, foul smelling fatty diarrhea, seen in camper and hikers
- Cysts in water transmission - Seen trophozoites or cysts in stool |
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Entamoeba histolytica
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- Amebiasis, bloody diarrhea (dysentary), liver abcess, RUQ pain, flask-shaped ulcer
- Cysts in water - Serology/trophozoites (RBC's in cytoplasm) or multinucleated cysts in stool treat w/ metronidazole and iodoquinol |
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Cryptosporidium
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- Severe diarrhea in AIDS, mild disease (watery diarrhea) in normal people
- Cysts in water transmission - See cysts on acid fast stain - Treat w/nitozoxanide, or clean water |
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GI Protozoa
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Giardia lamblia, Entamoeba histolytica, Cryptosporidium
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CNS protozoa
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Toxoplasma gondii, Naegleria fowleri, Trypanosoma brucei/gambiense/rhodesiense
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Toxoplasma gondii
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- Brain abcess in HIV (ring enhancing brain lesions on CT)
- Congenital toxo = classic triad (chorioretinitis, hydrocephalus, and intracranial calcifications) - Transmission from cysts in meat or CAT LITTER, crosses placenta - Treat - sulfadiazine and pyrimethamine |
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Naegleri fowleri
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- Rapidly fatal meningoencephalitis
from swimming in fresh water lakes, enter via cribiform plate "think NALGENE bottle / fresh water containing NAEGLERIA" - Amoebas in spinal fluid - Treat - amphotercin |
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Trypanosoma brucei/gambiense/rhodesiense
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African sleeping sickness, enlarged lymph nodes, recurring fever (antigenic variation), somnolence, coma
from Tse Tse fly, painful blood smear treat w/ Suramin (blood borne) or Melarsoprol (CNS) "it SURe is nice to go to sleep: MELAtonin helps with sleep" |
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Hematologic Protozoan Infections
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Plasmodium falciparum, vivax, ovale, malariae, and babesia
Malaria causes - fever, headache, anemia, splenomegaly from mosquitos (anopheles) see on blood smear, trophozoites, merozoites (RBC) treat - choloroquine to start (blocks plasmodium heme polymerase), add mefloquine if resistant ***for Vivax/Ovale use PRIMAQUINE for dormaint liver form hypnozoite**** |
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P. vivax, P. ovale
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48 hr cycle
Dormant hypnozoite form (in liver) = Primaquine |
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P. falciparum
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severe, irregular fever patterns, parasitized RBC's, occlude brain capillaries, kidneys, lung
Tx - choloroquine |
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P. malariae
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72 hr cycle
Tx - choloroquine |
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Babesia
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Babesiosis: fever and hemolytic anemia, in NE USA, asplenia = increased risk for severe dx***
from Ixodes tick, often w/lyme dx coinfection see "maltese cross" on blood smear, or ring form Tx - quinine, clindamycin |
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Visceral protozoal infections
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Trypanosoma cruzi, Leishmania donovani
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Trypanosoma cruzi
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Chagas disease, dilated cardiomyopathy, megacolon, megaesophagus
from Reduviid bug (Kissing Bug) Seen on blood smear Tx - Benznidazole and/or Nifurtimox |
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Leishmania donovani
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visceral leishmaniasis, Kala azar, spiking fevers, hepatosplenomegally, pancytopenia
from Sandfly see macrophages containing 'amastigotes' Tx - sodium stibogluconate |
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Trichomonas vaginalis
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vaginitis, foul smelling greenish discharge, itching and burning
Parasitic STD see trophozoites on wet mount (MOTILE*) Tx - Metronidazole (patient & partner) |
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Nematodes
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round worms
Intestinal - Enterobius vermicularis (pinworm), Ascaris lumbricoides (giant roundworm), Trichinella spiralis, Strongyloids stercoralis, Ancylostoma duodenale, Necator americans (hookworms) Tissue - Dracunculus medinensis, Onchocerca volvulus, Loa Loa, Wuchereria bancrofti, Toxocara canis |
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Enterobius vermicularis
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pinworm, from food contaminated w/eggs, intestinal infection, causes anal pruritus (scotch tape test)
Tx - "Worms are bendy, treat with mebendazole" |
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Ascaris lumbricoides
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giant roundworm, ingest, can see eggs in stool
#1 cause of Loeffler's syndrome --> eosinophilic pneumonitis Tx - bendazoles |
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Trichinella spiralis
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from undercooked meat (pork), inflammation of muscle (larvae encyst in muscle), periorbital edema
Tx - Bendazoles |
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Strongyloides stercoralis
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larvae in soil penetrate skin, intestinal infection, causes vomitting, diarrhea, and anemia
Tx - bendazoles or ivermectin |
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Ancylostoma duodenale, Nectator americanus
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hookworms, larvae penetrate skin of feet, intestinal infection, cutaneous larvae migrans, can cause anemia
Tx - bendazoles or pyrantel pamoate |
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Dracunculus medinensis
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in drinking water, skin infalmmation & ulceration
Tx - Niridazole, prolonged extraction |
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Onchocerca volvulus
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from female Blackfly, causes hyperpigmented skin and RIVER BLINDNESS, "BLACK flies, BLACK skin, BLACK sight"
Tx - IVERmectin (rIVER blindness) |
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Loa Loa
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from deerfly/horsefly/mango fly, causes swelling in skin (can see worm crawling in conjunctiva during the DAY)
Tx - diethylcarbamazine |
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Wuchereria bancrofti
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female mosquito, cause blockage of lymphatic vessels (ELEPHANTIASIS), takes 9 months to 1 year after bite to develop elephantisis symptoms
Must get blood culture AT NIGHT Tx - diethylcarbamzine |
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Toxocara canis
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food contaminated w/ eggs, causes granulomas (if in retina = blindness), and visceral larval migrans (worm moves around body, 'creeping lesion')
Tx - diethylcarbamzine |
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Cestode
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Tapeworms
Taenia solium, Diphyllobothrium latum, Echonococcus granulosis |
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Taenia solium
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ingestion of undercooked pork = intestinal tapeworms
ingestion of undercooked eggs = cystercercosis/neurocystercercosis, mass lesions in brain "swiss cheese" Tx - praziquantel, bendazoles (if neuro) |
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Diphyllobothrium latum
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ingestion of larvae in raw freshwater fish, causes vit. B12 deficiency and anemia
Tx - praziquantel |
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Echinococcus granulosus
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eggs in dog feces/wolves when ingested causes cysts in liver, can cause anaphylaxis if echinococcal antigens are released from cysts
Surgeons inject ethanol or hypertonic saline to kill daughter cyst before removal Tx - bendazoles |
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Trematodes
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Flukes - treat w/praziquantel
Schistomas, Clonorchis sinensis, Paragonimus westermani |
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Schistosoma
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snails are host, cercariae penetrate skin of humans, causes granulomas/fibrosis/inflammation of spleen and liver, can lead to SCC of bladder
Tx - praziquantel |
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Clonorchis sinensis
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undercooked fish, causes inflammation of the biliary tract - pigmented gallstones also associated with cholangiocarcinoma
Tx - praziquantel |
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Paragonimus westermani
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undercooked crab meat, causes inflammation and 2* bacterial infection of lung, causing hemoptysis
Tx - praziquantel |
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Nematodes routes of infection - ingested or cutaneous
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Ingested = Enterobius, Ascaris, Trichinella
"You'll get sick if you EAT these" Cutaneous = Strongyloides, Ancylostoma, Necator "These get into your feet from the SANd" |
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Giardia lamblia Tx
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metronidazole
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Entamoeba histolytica Tx
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metronidazole and iodoquinol
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Cryptosporidium Tx
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Water tx
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Choloroquine MOA
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blocks plasmodium heme polymerase
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Brain Cysts, Seizures
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cystercercosis
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Liver Cysts
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echinococcus granulosus
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B12 Deficiency
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Diphyllobothrium latum
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Biliary Tract Disease
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Clonorchis sinensis
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Hemoptysis
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Paragonimus westermani
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Portal HTN
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Schistosoma mansoni
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Hematuria, Bladder Cancer
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Schistosoma haematobium
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Microcytic Anemia
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Ancylostoma, Necator
Perianal pruritis = enterobius |
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Histoplasmosis
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Systemic Mycosis - PNA
Mississippi & Ohio River Valleys macrophage filled with histoplasma bird/bat droppings Chest X-ray shows a widen mediastinum Tx - amphotericin B |
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Blastomycosis
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Systemic mycosis
Cold = Mold; Heat = Yeast East of Mississippi Inflammatory lung disease w skin & bone nodules broad based buds (same size as RBCs) Tx - amphotericin B |
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Paracoccidioidomycosis
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Latin America (rarest, most severe)
Budding yeast with "Captain's Wheel" Tx - amphotericin B |
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Coccidioides immitis
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SW & Mexico
PNA in immunocompetent disseminated disease to bone & skin in immunocompromised & meningitis Spherules filled with endospores larger than RBCs see in 10% KOH prep or Silver stain Culture on Sabouraud's Agar Tx - amphotericin B |
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Valley Fever
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Acute Coccidioidomycosis
self-limited flulike illness with fever, cough, chest pain, and weight loss Erythema nodosum |
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Cryptococcus neoformans
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Heavily encapsulated yeast, polysaccharide
Not dimorphic Found in soil, pigeon droppings Inhalation with hematogenous spread Major virulence factor Inhibits phagocytosis and downregulates Th1 responses "Soap Bubble" lesions in brain |
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Aspergillus fumigatus
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Seen in AIDS & post-TB, CGD and CF
Not dimorphic branches arise at acute (∼45°) angles |
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Candida albicans
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oral and esophageal thrush
dimorphic Tx - oral fluconazole |
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Pneumocystosis
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Interstitial pneumonitis with a mononuclear infiltrate composed predominantly of plasma cells
Yeast, Inhaled Diagnosis on biopsy or lavage Pathology shows disc shaped yeast on methenamine silver stain of lung tissue **PPX with bactrim when CD4 under 200** |
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Tinea Versicolor
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Caused by malasezia furfur
Hot, humid weather causing hypopigmented patches "Spaghetti & Meatball" on KOH Tx - topical miconazol, selenium sulfide |
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Tinea Misc.
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Pruritic lesions with central clearing resembling a ring caused by dermatophytes
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Dermatophytes (3)
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1. Microsporum
2. Tricophyton 3. Epidermophyton |
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Mucormycosis
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DKA & Leukemia
Cribiform plate Rhinocerebral, frontal lobe abscesses Necrotic eschar on face |
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Sporotrichosis
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Dimorphic cigar shaped budding yeast
"Rose Gardener's Disease" (thorn prick) Ascending lymphangitis with pustules Tx - itraconazole or KI |
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Systemic Mycosis
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1. Histoplasmosis (bird/bat droppings) 2. Blastomycosis (Broad-base budding/Saboraud's agar)
3. Coccidiodomycosis (inflammatory lung disease) 4. Paracoccidioidomycosis (captain's wheel appearance) All except for COCCIDIOIDOMYCOSIS are found in the dimorphic form (cold = mold, heat = yeast) and can cause pneumonia when disseminated Tx: Fluconazole or ketoconazole for local disease; Amphotericin B for systemic infection |