I Got Worms - Michigan College of Emergency PhysiciansEnterobiasis (Enterobius vermicularis) Most...
9
7/1/2019 1 I Got Worms… ADAM C. HUNT, DO, MHS COVENANT EMERGENCY CARE CENTER, SAGINAW, MI Disclosures This is gonna make you cringe… No financial disclosures 1 2
Transcript of I Got Worms - Michigan College of Emergency PhysiciansEnterobiasis (Enterobius vermicularis) Most...
7/1/2019
1
I Got Worms…ADAM C. HUNT, DO, MHS
COVENANT EMERGENCY CARE CENTER, SAGINAW, MI
Disclosures
This is gonna make you cringe…
No financial disclosures
1
2
7/1/2019
2
Tapeworm (Cestoda) Taenia sp (Saginata, Solium)
Beef and Pork
Diphyllobothrium latum
Bear/Fish Tapeworm
Cysticercosis v. Adult Tapeworm
https://www.cdc.gov/parasites/taeniasis/biology.html
Tapeworm
Presentation:
Dizziness, Abd Pain, diarrhea, headache, localized pain
Treatment
Praziquantel & albendazole
3
4
7/1/2019
3
Sushi worm Anisakis simplex (Anisakiasis)
Preparation/Cooking/Freezing
Japan (2K-3K), ↑ in US
Treatment
EGD & Albendazole
https://www.cdc.gov/parasites/anisakiasis/biology.html
Hookwork
Ancylostoma duodenale & Necator americanus
Barefoot (skin) contact with larvae hatched from human
feces
Anemia from blood loss in GI tract
5
6
7/1/2019
4
Hookworm
Life Cycle
Phases
Cutaneous, Pulmonary, Intestinal
Symptoms
Cutaneous Larval Migrans
Cough, hemoptysis
Abd Pain, Diarrhea, Anemia
Treatment
Albendazole, Mebendazole
Schistosomiasis
Schistosoma mansoni, haematobium,
japonicum
CDC: “In terms of impact this disease is
second only to malaria as the most
devastating parasitic disease.
Schistosomiasis is considered one of
the neglected tropical diseases
(NTDs).”
7
8
7/1/2019
5
Schistosomiasis
Life Cycle
Migratory, Acute and Chronic Phases
Treatment
Praziquantel
Long term effects
Bladder CA
Ascites
Adults live in vascular system and soft tissue
Prevention
Roundworm
Ascaris lumbricoides (Human Roundworm)
Soil transmitted helminths (STH) along with hookworm
and whipworm
9
10
7/1/2019
6
Roundworm
Fecal-Oral
Ingest eggs from contaminated soil or
vegetables
Symptoms
Very mild, abdominal discomfort, cough,
progresses to bowel obstruction
Treatment
Albendazole and Mebendazole
Filarial Worm
Wuchereria bancrofti, Brugia malayi and Brugia timori
Lymphatic filiariasis, Lymphedema, Elephantiasis
Arthropod Born Disease (Anopheles, Aedes, Culex
quinquefasciatus, Mansoni)
11
12
7/1/2019
7
Filarial Worm
No animal intermediate host
Adult worms live in lymphatic vessels
Treatment
Diethylcarbamazine (DEC)… funny story
Ivermectin, if co-infected with Onchocerciasis or
Loa Loa
Doxycycline???
Whipworm
Trichuriasis (Trichuris trichiura)
Fecal-Oral (Contaminated soil or veggies)
Symptoms
Depends on worm burden, can be painful stools
with mucus, water and blood
Children can have anemia, growth retardation,
impaired cognitive development
Rectal Prolapse
Treatment
Albendazole or Mebendazole
13
14
7/1/2019
8
Pinworm
Enterobiasis (Enterobius vermicularis)
Most common worm infection in the US
Mostly affects children, people who are
institutionalized and those who care for
these populations
Gravid females migrate to perianal
region and lay eggs at night
Scotch tape test
Treatment
Mebendazole, pyrantel pamoate, or
albendazole
Fun Book
15
16
7/1/2019
9
Resources
Atlas of Tropical Medicine. 6th Ed. Wallace Peters & Geoffrey Pasvol.
2008.
Foundations of Parasitology. 6th Ed. Gerald Schmidt, Larry Roberts &
John Janovy. McGraw-Hill. 2000.
CDC website
17
