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55 Cards in this Set
- Front
- Back
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Entamoeba histolytica
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Motile feeding form = trophozite
Causes intestinal erosions Liver & pulmonary abscess Stool rbc's = active dx None = asymptotic carrier |
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Metronizadole
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METRO runs over GET out of the way - kills:
Giardia lamblia Entomoeba histolytica Trichomonas Aka flagyl = kills flagellated Protozoa Giardia, Trich |
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Giardia
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Cyst form ingested
Trophozoite adheres to small GI Interferes with fat absorption = smelly, frothy diarrhea, no bld Tx metronidazole (flagyl) |
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Cryptosporidium
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Severe diarrhea in immunocompromised pts
Diarrhea outbreak in daycare, infants Oocyst = 4 sporozoites motile |
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Trichomonas vaginalis
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Sexual transmission
Pruritus, copious vagl secrtns, burng urin'n, malodorous Wet mount prep Tx = metronidazole |
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Naegleria fowleri
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FOWL play
95% pts die in 1 week Acute meningoencephalitis Normal host hx swimming Mature amoeba only in brain Nose, cribiform plate, brain |
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AIDS
4 major infections Most common CNS infection |
Cryptosporidium, isospora
=diarrhea Pneumocystis carnii (jiroveci) Toxoplasma gondii (most common CNS infectn in AIDS) |
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Toxoplasma gondii
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Raw pork, cat feces
Infectious cyst, latent infection Most common parasitic infection in US Immunocompromised pt, reactivn infecn AIDS CNS infcn, chorioretinitis = fluffy patches in red retina Transplacentl infctn if first infection on mother Severe if early gestatn If infant normal can reactivate in later life --> retinal infcn |
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Pneumocystis carinii (jiroveci)
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Flying saucer shape fungus
Immunocomp --> interstitial pneum most common opportun infcn AIDS Perihilar interstitial streakg CD4 <200 Silver staining Tx TMP/SMX or pentamidine |
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Malaria
Tertian Quartan Irregular period |
Tertian rbc's burst q48h
Plasmodium vivax P. Ovale Quartan. P malariae burst q72h Irregular P falciparum burst q36-48h |
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Plasmodium
Exo-erythrocytic cycle |
Liver
Plasmodium Vivax & Ovale Latent form in liver with relapses |
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Plasmodium trophozoite
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Merozoite --> trophozoite
RBC form Looks like diamond ring Division --> schizont mult-nuc --> merozoite --> rbc lysis --> immune response |
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Diagnosis malaria
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Smears -->Trophozoite, schizont
Rapid antigen test |
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Chloroquine
Resistant Susceptible |
Resistant P falciparum - Africa, India, SE Asia, S of Panama Canal
Susceptible- P. malaria, ovale, vivax, falciparum N of Panama Canal Vivax, ovale - Exo-erythrocytic cycle protects in liver |
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Babesiosis
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Tick bites
NE US Lyme dx Inside RBC, not liver Sporozoite in tick salivary gland Bld --> rbc --> trophozoite --> bud --> 4 merozoites x-tetrad |
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Blood borne flagellates
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Leishmania
Trypanosoma |
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Leishmaniasis
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Sandfly bite
Macrophage = amastigote 3 forms Cutaneous - simple & diffuse Mucocutaneous Visceral |
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Cutaneous
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Simple - N cell med immy - Delayed hypersensy
Ulcer formation Skin test like PPD Chronic - Venezuela, Ethiopia Defect cell med immy Nodular lesions diffuse, not ulcer |
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Mucocutaneous
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Dermal ulcer initially
Reappear mucous membranes mouth, nose |
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Visceral Leishmaniasis
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Invades reticuloendothelial cells
Spleno- & hepatomegaly Severe anemia, low WBC -ve leishmannin skin test with def cell med immy |
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Trypanosoma brucei
Rhodesiense Gambiense |
Tsetse fly African sleeping sickness
Recurrent fevers due to variable surface glycoproteins Wn = gambiense, slow fevers En = Rhodesiense, rapid fevers, severe |
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Chagas' dx
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Trypanosome cruzi
Vector reduviid bug when pt slpg South Am to Sn Texas (Tom Cruz Amn actor) Trypomastigotes tunnel into skin Lose flagelm --> amastigote --> skin, lymph nodes |
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Acute Chagas'
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Chagoma - skin pnt of entry hard, red --> systematic spread
--> lymph nodes Intermed phase --> low levels parasite Can progress to chronic |
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Chronic Chagas'
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Heart - dilation, arrhythmia
Dilation esophagus Megacolon - constipation, weeks btw BMs |
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Intestinal nematodes
acquired by eating eggs |
ATE
Ascaris lumbricoides Trichuris trichuria (whipworm) Enterobius vermicularis (pinworm) |
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Intestinal nematodes
acquired by skin penetration of larvae |
SkiN
Strongyloides stercoralis Necator americanus (hookworm) |
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Intestinal nematodes
Stay in GI vs invade other tissues |
Stay in GI (T, E of ATE)
Trichuris Enterobius Invade other tissues (to lungs) Ascaris Necator Strongyloides |
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Intestinal nematodes
Treatment Mode of action |
BEND worm to kill
Mebendazole Albendazole Thiabendazole Paralyze worm --> pass in stool |
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Strogyloides
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Pruritic rash, bloating, cough/ wheeze, eosinophilia
Endemic areas pt on immunosuppresants/ steroids --> severe autoinfection |
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Trichinella spiralis
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Encrypted larvae in raw pork
Infectn--> muscle invasion --> ^ CPK, ^ eosinophilia |
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Enterobius vermicularis
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Fmale lays eggs at night on perianal area
Diagnosis - scotch tape |
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Filariae
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Blood & tissue nematodes
Transmitted by bite of arthropod Onchocerca, Wuchereria, Brugia, Dracunculus Live in lymphatic tissue, organs Allergic rxn to microfilariae, dead adult worms |
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Onchocerca volvulus
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Africa, S & Ctl Am - river blindness
Bite of black flies Migrate thru dermis, conn tissue Pruritis, pigmentation Intraepithelial granulomas 'lizard skin' Eye --> blindness Tx - ivermectin |
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Wuchereria bancrofti
Brugia malayi |
Lymphatic infection --> elephantiasis
Wuchereria - Africa, Pac Islands Brugia - Malay Pennins, SE Asia Mosquito bite Nocturnal periodicity - more org circulate at night |
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Dracunculus medinensis
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Guinea worm
Eradication by public health Release progeny near water Larvae --> intestine Female adult --> skin--> loop of body pokes out Stick wrapped around then twisted to pull out worm |
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Schistosoma
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Water snail species int host
Mature worms - molecular mimicry--> evade immune system Larvae, eggs --> immune response Dermatitis Katayama fever - eggs release Chronic fibrosis - deposited eggs --> inflammation, fibrosis, portal system blocked Tx- praziquantel |
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Cestodes
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Tapeworm - long, flat segments = proglottids
No digestive syst - nutrients diffuse Hermaphrodite Tx- praziquantel |
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Taenia solium (pork)
Taenia saginata (beef) |
Tapeworm
Cysticerci- eggs--> larvae--> cysticercus (sac with larvae) --> migrate thru tissue --> brain Most common cause seizures endemic areas Mexico, C & S America, SE Asia |
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Diphyllobothrium latum
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Fish tapeworm
Larvae in raw freshwater fish Absorb vit B12 --> anemia |
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Echinococcus
granulosus & multilocularis |
Hydatid dx
Dogs and sheep GI -->> liver + lungs, kidney, brain Cysts --> burst --> allergic rxn Granulosus --> grow larger Multilocularis --> lateral bud /spread |
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Yeast
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Unicellular growth form of fungi
Budding reproduction Pseudohyphae - long chains of yeast cells |
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Mold
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Clumps of intertwined branching hyphae
Spores = Reproducing bodies of molds |
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Dimorphic fungi
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Grow as yeasts or molds
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Ergosterol
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Essential sterol of fungi
Antifungals disrupt ergosterol |
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1) Amphotericin B, Nystatin
2) azoles, echinocandins |
1) bind ergosterol --> cell wall holes
2) interfere with ergosterol synthesis |
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Superficial fungal infections
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Pityriasis versicolor (hypo- or hyper pigmented skin, Malassezia furfur)
Tinea nigra - black pigment on soles, palms, Exophilia werneckii diagnosis slide + KOH --> hyphae |
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Dermatophytoses
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Tinea
Corporis - ringworm, red, raised border Cruris - jock itch, Pedis - athlete's foot, Capitis - scalp, children Unguium - onychomycosis = nails |
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Dermatophytoses
Diagnose Tx |
1) Dissolve skin KOH--> see branched hyphae
2) wood's light = UV--> fluoresce green Tx imidazoles Terbinafine, azoles (fluconazole) |
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Sporotrichosis
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Sporothrix schenckii
Soil, rose thorns Hazard for gardeners Subq nodule --> necrotic, ulcer Spread along lymphatic tract Tx- itraconazole, fluconazole, potassium I |
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Chromoblastomycosis
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subq infection, soil saprophytes on rotting wood --> puncture
Phialophora, Cladosporium Violet warty lesion - clusters like cauliflower KOH--> copper-colored sclerotic bodies Tx - itraconkazole |
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Systemic Fungal infections
(3) |
Histoplasma capsulatum
Blastumyces dermatitidis (Missip Rvr) Coccidioides immitis (SWn US) Dimorphic - spore in soil, yeast in body |
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Systemic fungal infections, Tx
Histoplasmosis Blastomyces Coccidiosis |
Inhaled as spore --> bloodstream
Pneumonia --> lung granulomas, cavitations Disseminated in immunocompromised pt Skin test like PPD Amphoterican B, itraconazole |
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Coccidiosis
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SWn US
Pneumonia Opportunistic in AIDS |
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Histoplasmosis Capsulatum
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Nonencapsulated
Bird, bat droppings |
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Blastomycosis
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Soil, rotten wood
Rare but --> chronic dx Wt loss, lungs, skin ulcers |
