PARASITE

A.K.A.

EGG

ADULT

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST

2NDINT HOST

PATHOLOGY

MOT

PHIL

Tx

Trichuris trichiura

Whip worm

Barrel-S, 2 plugs unembryo

M – curved 360 F – blunt; stichocytes

Embryonated Egg in soil/feces

embryonated in soil

DFS Unembryo eggs in feces

LI, Whip inserted into wall no migration phase to lungs

-Prolapse of Anus -IDA, Alb, D -Sometimes appendicitis -symptoms due to unique mode of attachment

F-O-R (fecal- oral route)

Yup 80-90% warm, tropical regions

Albendazole Mebendazole Oxantel- Pyrantel

Enterobius Vermicularis

Seat Worm Pin worm

D-shape, football

spindle-S, cephalic ala, corpus, isthmus, bulb M – curved tail F – pointd tail

Embryonated ova Scotch tape Swab Embryonated Eggs

Ileum of SI, Cecum,LI man Gravid female Migrates to Perianal area

1) site - ulceration 2) eggs - prupritus 3) migration -vulvuvag & salphingitis

H-M (hand-mouth) inhalation Retro infection

Yup (F>M)

Mebendazole Pyrantel pamoate

Trichinella Spiralis

larva – w/ spearlike burrowing tip

thread-like ; F – blunt; M – curved w/ 2 lobular appendages; A-end- non-papillated

Encysted larvae in Inad cooked pork

Tissue biopsy Xenodiagnosis Bachman Intradermal test

Muscle tissue of man, pigs

-Rheumatic pain (intestinal flu) - M eosin -swollen eyelids -3 stages of inf: intest,larval,encap -Stage of conval - death due to Myocard or enceph

Ingestion of encysted larvae in pork

yup Thiabendazole Corticosteroid (for allergic rxn)

Mebendazole? Ref (5F 20d,

20F10d, 20F 6d)

Capillaria Philippinensis

peanut shape

embryonated eggs in F typical F – 8 in 1 row atypical F – 40 in 2 M – w/ chitin spicule

Larva in raw fish Eggs embryonate in Fresh water

DFS -eggs (E) -larva (L) -adults (A)

SI (jejunum ) of fish, man larvae in gastric mucosa and intestines

-int mal-ab -Borborygmi -Ab Pain -Diarrhea -Villus flat -Atrophy COL -death

Ingestion Of larva In raw fish

Yup (M>F) I. Norte (N.Luzon) THA,JPN, EGY,TAI, IRAN

Mebendazole Albendazole

Ascaris Lumbricoides Most common Intestinal nematode

Giant Round Worm

Decorticated, Unembryo egg

tri-radiate xs

F-3 lips; M–2 spicules

Embryonated Egg

larvae, corticated

DFS of eggs Adults in SI Gall bladder, Liver, nares, appendix

SI of man (not attach)

Liver-lung Migration (larv swallowed)

Lung mig –Asthma; Capil penetration –Pneumonia; Ab Pain due to adult Migration; Int Obst; eosin

Ingestion Burrowing of Sin of foot

Yup Most Common In world

Peperazine Citrate Albendazole Mebendzaole Pyrantel Pam

Ancyclostoma Duodenale

Old World Hook worm

8-cell stage

teeth 3rd stage filariform

pointed tail, short esophagus

DFS EIA -ELA

SI Lung migration

Ground itch; <500 eggs in feces = light worm, >500 eggs = heavy worm; Hookworm anemia due to suction of blood/ bleeding Microcytic Hypochromic

Oral percutaneous

Yes Tropics, subT

Pyrantel Pamoate Mebendazole Iron replacement

Necator Americanus

New World Hook worm

cutting plates

DFS EIA -ELA

Skin Penetration

Strongyloides Stercoralis

Thread Worm

filariform; no F M Long eso, Prominent Genital

primordium, notched tail

3rd stage filariform

Rhab in stool

short buc cav

SI man; Lung Migr aftr skin Penet; repro parthogenesis Eggs hatch SI

Larval migration – Lobular pneu w/ hem; like PUD, Hyper Infection, Peripheral Eosinophilia, malab syndrome

- Skin Penetration of FL - Free-living - auto infection

Yes Tropics, SubT

Albendazole Thiabendazole

1

PARASITE

A.K.A.

EGG

ADULT

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST 2ND INT HOST

PATHOLOGY

MOT

PHIL

Tx

Brugia Malayi

kinky, overlapping nuclei, nuclei reach tail end (terminal, subterminal n.) giemsa – sheath

unstained

Larvae In Arthropod Vector Bites at Night Enters Bite wound Bioincub - 1 year

Blood smear (thick And Knott Conc) Microfilaria In blood at Night CARD Test – Antigen det DNA probes

Lymphatics Bloodstream Peripheral Blood

mosquitos W.B. – Culex Quinque Fasciatus Rural- Anoph; Urban- Fatigans; Pacific- aedes

Acute – Hypersensitizatn Chronic – (poor prog), elephantiasis (blocks lymphs) Weingarten’s Syndrome – Hyper-eosin of Peripheral blood

Skin Larva Enter bite wound Mosquito Bites at night

Yup Warm regions

Diethylcarbamazine (not effective on adult worms) Ivermectin corticosteroids supportive – pressure bandaging surgery

Wuchereria Bancrofti

smooth, single row of nuclei, no term nuc, >L than BM giemsa – pink stain

Loa Loa

shedding of sheath,

Larvae crawl into wound

Thin blood Smear biopsy

Subcutaneous tissue

Vector- Dipteran (chrysops)

Calabar swelling Adult in eye hypersensitivity

Skin Larva Enter bite wound

No Africa

Diethylcarbamazine Corticosteroids surgery

Dracunculus Medinensis

Fiery Serpent Israelites Guinea worm

larva migrates to lower ext.

Larvae in copepods

Local lesion Worm/Larvae Calcifiqed Worms by x-ray

Mesenteric Tissues Larva migrate To lower ext

Copepods Ingest Larva in water

Blister w/ Serous exudates Pseudoperitoneal syndromes

Ingestion Of Infective copepods

NO Middle East, Africa

Metronidazole Thiabendazole

Oncocerca Volvulus

Larvae Crawl into Bite wound

Biopsy Mazzotti Slit lamp

Subcutaneous tissue

Vector- Black fly

-River Blindness -Eye lesions - Skin lesions - Scrotum enlargement

Skin Larva Enter bite wound

NO Africa C. and S. America

Diethylcarbamazine Corticosteriods Surgery

Angiostrongylus Cantonensis

Rat Lung worm

adult emale “Barber pole” dark red intestinal tract

3rd stage larva in snails and slugs or rats ingested by man snails – paratenic hosts

History -eating, travel leukocytosis & eosinophilia Skin test needs evaluation

Brain Spinal cord Man- Accidental hosts

Mollusks, Snails: Achantina, Pila Planaria, Slugs, prawns

Eosinophilic Meningoencephalitis + eosins in CSF, CN involve, diplopia and strabismus CSF >= 500 cells/ml w/ 10-90% eosins

Ingestion Of larva In snails

NO TAI, THAI, CAM, VIET, Hawaii, Tahiti

None recommended Dead parasite Could exacerbate Tissue reaction Surgical if ncessary

Angiostrongylus costaricensis

3rd stage larva in snails/ slugs ingested by man nd cotton rat (Sigmodon hispidus)

Intestines (gut wall)

Mollusks Snails, slugs

“acute abdomen” - inflamm of ileocecal region; Ab pain loc to right lower quad + palpable tumor-like m

Anisakis Herring disease

Terranova sp – juveniles Pseudoterranova sp – not penetrate Eustrongylides sp – perforates large bowel

3rd stage larva in flesh of raw fish; larva migrate from viscera to muscle after death of fish

Edoscopy Immunologic Tests under Study

Marine Crustaceans And fish

Pseudoterranova spp – Not penetr8 stom, Throat irrit, coughed

Ingestion Of raw Marine Food w/ Alcohol, “green” herring, sashimi

NO JPN, Netherlands

Remove larvae By biopsy Forceps Surgical Intervention For obstruction Manage conservatively

Anisakis simplex (USA) Stom, int, inflamm Rxn surrounding larva

Anisakiasis – local Tissue response; (Eustrongylides spp) Perforation of L bowel

2

PARASITE

A.K.A.

EGG

ADULT

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST 2ND INT HOST

PATHOLOGY

MOT

PHIL

Tx

Schistosoma Hematobium Platy- helminthes

terminal spine

S. Japonicum

in copula, males have gynecophoric canals

Free- swimming Cercaria

Eggs, miracidia in urine

Adults - Bladder, liver larva – Venous Plexuses

Bulinus Snail (Miracidia to cercaria)

Calcified Bladder (dead eggs= “sandy patches”); Painful urination;

Kala-azar; adults coated w/ RBC An and not detected; trapped

egg cause clinical symptoms; Terminal Hematuria; infection linked

To S. typhi and paratyphi carriers

Skin Penetration Thru Infected water

Wala Siguro… Tropics Subtropics

Praziquantrel

Schistosoma Mansoni Platy- helminthes

lateral spine

Free- swimming Cercaria

Ova in feces (blood, mucus) Rectal biopsy

Liver Mesenteric venules, SC, lungs

Biomphalaria Snail

Claypipe-stem Fibrosis = Thickening of portal vessels due to rxn w/ eggs; Hepatosplenomegaly

Portal HTN, ascites, eggs sometimes Deposited in SC, lungs

liver enzy,serum alb, glob(prot)

Cercaria Penetrate Skin thru Infected water

Nope Africa Brazil

Praziquantrel

Schistosoma Japonicum Platy- helminthes

lateral knob (smallest)

Cercaria

Ova in feces, Rectal biopsy, COPT test, ELISA

Liver, Mesenteric Venules, SI, heart, Spleen, CNS

Oncomelania Quadrasi, Formosa

Katayama rxn/ fever, reaction to Eggs in tissue = CNS damage,

Hepatosplenomegaly, Portal HTN, Ascites; mucus/blood in feces,

liver enzy,serum alb, glob(prot)

Cercaria Penetrate Skin thru Infected water

Yup Mindanao, Visayas

Praziquantrel

Schistosoma Intercalatum

Like Schistosoma Mansoni in terms of life cycle, pathology and clinical features Intermediate host – Biomphalaria snail

Schistosoma Mekongi

Lide Schistosoma Japonicum in terms of life cycle, pathology and clinical features Intermediate host – Lithoglyphopsis aperta

Fasciola Hepatica Fasciolidae

Sheep Liver Fluke

“popping operculum”

leaf S, w/ shoulders cephalic cone, spinous, dendritic testes

Metacercaria Encysted On aquatic vegetation

Unembryo ova in feces, duodenal aspirates

Bile duct of Sheep Herbivore animals

Snails- Lymnea Philippinensis, Lymnea swinhoe (TAI) (sporocyst- redia-cercaria)

Aquatic vegetation

Halzoun – ingestion Raw sheep, goat livers (dyspnea, deafness, asphyxiation, death) fibrotic vs. traumatic/ necrotic lesions; obs; False vs true (no eggs)

Ingestion of Infected Vegetation; Infected Liver (false)

Cosmo In sheep Raising countries

Bithionol

Fasciola Gigantica Fasciolidae

Giant Liver Fluke

Larger than F. hepatica

no shoulders

Metacercaria Encysted On aquatic vegetation

Unembryo ova

Giant Animals- Cattle Biliary tract (BT)

Snail Aquatic vegetation

Ingestion of Infected Vegetation

Most Probably Africa, Asia

Bithionol

Clonorchis Sinensis Opistorchidae

Chinese Liver Fluke

branched testes; spatulate

Metacercaria Encysted On Fresh Water fish

Embryo ova In feces or Biliary duodenal aspiratesBDA

Man BT

Operculate Snails (Alocinma, Parafossarulus, Bithynia)

Fresh water Fish (FWF) : Cyprinidae, Ctenopha- ryngodon

Cholangiocarcinoma of liver, liver function Impaired but SGPT and SGOT are normal

Ingestion of Uncooked fish

Rare CHI, JPN, SK, Vietnam

Chloroquine Diphosphate Praziquantel

Opistorchis Felineus Opistorchidae

Cat Liver Fluke

lancet S reddish- bile color

Metacercaria Encysted On fresh Water fish

Embryo ova In feces or BDA

Small Animals- Cats, dogs, etc (BT SI)

Snails - Bithynia Funiculate

FWF Cyprinus Carpio (Taiwan)

Periportal fibrosis, Invasion of pancreas, Form bile stones

Ingestion of Infective fish

Nope USSR, poland

Praziquantel

Opistorchis Viverrini Opistorchidae

knob at abopercular end

lobed testes like O. felineus

Metacercaria Embryo ova In feces Or BDA

Civet cat, Dog, fish- eating

Snails - Bithynia Goniomphalus, Funiculate, laevis

FWF Punteus Orphoides, Hampala dispar

Hyperplastic biliary Epithelium (Stim by Nitrosamines); assos. w/ cholangiocarcinoma

Ingestion of Infective fish

Nope Thailand Udorn

Praziquantel

Dicrocoelium Dendriticum Dicrocoellidae

Lancet fluke

deep golden-brown

2 large testes lancet, flat, transparent, aspiny

Metacercaria Embryo ova w/ fully dev miracidium

sheep Snails- Abida, Cochilcopa, Helicella, Zeb

Formica Fusca (ants)

Same as F. hepatica Portal cirrhosis, Periductal fibrosis

Ingestion of ants

Wala siguro

Praziquantel

3

PARASITE

A.K.A.

EGG

ADULT

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST 2ND INT HOST

PATHOLOGY

MOT

PHIL

Tx

Paragonimus Westermani

Oriental Lung Fluke

operculum at broad end, thick aboper

branched testes side by side; coffee

bean; integument w/ spines

Metacercaria In crustacean Cercaria w/ spines

Unembryo eggs in feces or sputum complement fixation

Encapsulated in Parenchyma of lung; in fibrotic capsules Reservoir – Cats & dogs

Snail - Miracidia (M) Cercaria (C) Antemelania Asperta; Antemelania Dactylus

Crabs – Sundathelphusa Philippina C meta-C

Granulomatous rxn in lungs; rust- colored sputum, w/ Foul fish Odor Misdiagnosed For PTB

Ingestion Of Infected crustaceans

Yes Asia

Praziquantel Bithionol Triclabendazole

Fasciolopsis Buski

indistinguish from F. hep, F. gigantica

2 dendritic testes in tandem

Metacercaria In water Plants MC are Sensitive to Dryness

Unmebryo Eggs in feces

Duodenum of Man or pigs

Snails – M C Segmentina, Hippeutis

Aquatic Vegetation C meta-C Water caltrop, Water chestnut, Water morning Glory, lotus

Worms cause Traumatic, Obstructive and toxic effects; ulceration and mucus prod.

Ingestion Of Infected Water Plants

Nope SEA, CHN, India, indonesia

Praziquantel

Heterophyes Heterophyes

H.

M. eggs no aboper protub; same

hard to distinguish adults; scale-like spines, w/ genital sucker, globular testes

Metacercaria In fish Miracidium present in The egg once Deposited by adult

Unembryo Eggs in stool Using Kato-Katz method

Small Intestines Reservoir – Fish eating mammals

Snails : Freshwater, Brackish or Marine M C

Many fish in the Phil. (30 Species); in muscles at base of the fin C meta-C

Inflamm, Sloughing off Of layers, xs Mucus prod Misdiagnosed For acid Peptic ds (APD), consistent w/ PUD

Ingestion of MC Encysted in fish

Yes EGY, Greece, CHN, JPN, KOR, TWN, Phil

Praziquantel

Metagonimus yokogawai

Echinostoma Ilocanum

indisting.from fasciolas

oral sucker with collar of spines; 2 lobed testes in tandem, reddish-grey

Metacercaria No sporocyst stage

Unembryo Eggs in feces

Small Intestines Reservoir- rats

Snails: -Gyralus Convexlusculus -Hippeutis Umbilicalis M C

Snails: -Pila luzonica “kuhol” and -Vivipara Angularis“suso” C meta-C

Inflamm, Ulceration, Diarrhea, intoxiacation

Ingestion Of encysted MC in snails

Of course N. Luzon, Samar, Leyte, Mindanao

Praziquantel

Taenia Solium

Pork Tapeworm

indistinguish from each other and from E. granulosus; hexacanth (6 hooklets); radially striated shell

rostellum w/ hooks 4 suckers; ripe proglottid <13 lateral branches; 3m

Cysticercous Cellulosae

eggs – cause cysticercosis

Ripe or gravid Proglottid formaldehyde soln Scolex after therapy

Small intestines of man cysticercosis in muscles

Hogs, wild Boars, sheep, Deer, dogs, Monkeys, rats, cats eggs cysticercous cellulosae

Inflamm, Eosinophilia, leukopenia Dev Cisticercosis (ingestion of eggs), larva in brain, muscle, eye

Ingestestion Of inadeq. Cooked Pork Accidental Ingestion of eggs

yes cosmo

Praziquantel

Taenia Saginata Longest Tapeworm

Beef tapeworm

no rostellum, hooklets ripe >15 branches; 5m; tree-like dicho branching

Cysticercous bovis

Ripe or gravid Proglottid Scolex after therapy

Man SI (accidental)

Cattle, llama, Giraffe, Carabao eggs cysticercous bovis

Epigastric Pain, vertigo, Nervousness, eosinophilia

Ingestion Of cysts in beef

Niclosamide -damage to point of dissolution

Echinococcus Granulosus smallest Tapeworm In man

Parasite Of dog

one long gravid proglottid

Eggs – man Hydatid sand

dogs

x-ray to detect hydatid ds; immunologic tests

SI of Dog -Cysts Ingested and Release scolices

Sheep, man (accidental, intermediate– in liver and lungs)

Obstruction – Growing cysts; Anaphylactic Shock when Cyst ruptures

FOR Ingestion Of eggs in feces

rare Sugery Prev spillage of eggs) Albendazole

4

PARASITE

A.K.A.

EGG

ADULT

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST

2ND INT HOST

PATHOLOGY

MOT

PHIL

Tx

Diphyllobothrium Latum

Fish/ Broad t-worm

yellow-brown knob like thickening

spatulate, rosette uterus 2 bothria = sucking grooves

Plerocercoid Larva Encyted In fish

Operculated Eggs; Proglottids Kato tech

SI in man Reservoir Host: Dogs, cats,Bears Paratenic host: Carnivore fish

copepods (Cyclops & Diaptomus)

Coracidia (CO) Procercoid (ProC)

(fish) perch, trout, salmon, pike ProC PleroC

Anemia (misdiag for pernicious type Vit B12 def); hyperchromic megaloblastic; examine for HCl in gastric juice (+ infection)

Ingestion Rare Only 7 cases temperate zone

Praziquantel

Dipylidium Caninum

Dog T-worm Double Pored T-worm

egg packets (8-15 eggs) oncosphere w/ 6 hooklets

retractile, conical scolex; rose-thorn shape hooklets mature proglottid – with 2 lateral genital pores

Cysticercoid Larva in Arthropod Host when ingested

Gravid Proglottids That are passed out/ Crawl out, Egg packets, Melon-shaped Proglottids in Chains (Not stool bec proGlot disint in environment

SI of dog or cat Ctenocephalides canis (dog flea) Ctenocephalides felis (cat flea) Pulex irritans (human flea) Trichodectes canis (dog louse)

Minimal symptoms

Ingestion yup Praziquantel

Hymenolepsis Nana

Dwarf t-worm

with filaments

like D. caninum scolex but with less hooklets; ripe segment

Embryo Eggs in Contam food and Water Cyticerci - Can complete Cycle in single Host (autoinf)

Embryo Eggs in feces Proglottids not Recovered bec They degenerate

SI of man Insects, rice And flour beetles

Enteritis due to Necrosis and Desquamation Of intestinal Epithelial cells Direct/indirect pathways

FOR Auto Infection

yup Praziquantel

Hymenolepsis Diminuta

Rat T-worm

w/o filaments bile-stained; fan-like

gravid segment; rudimentary, unarmed rostellum

Cysticercoid Larvae in insects

Eggs in stool (more circular, larger, lack bipolar thickening vs H. nana

SI of man Fleas, beetles, cockroaches, mealworms & earwigs

Minimal and Non-specific

Ingestion Of Infected insects

yes In rats <8%

Praziquantel

Sparganosis Mansoni, Erinacei, Ranarum

Spirometra

mistaken for D. latum; pseudosegmentation w/ slit-like invagination

Plerocercoid In toads, frogs, snakes, paratenic hosts - pigs

White larvae In lesion

Adult – Intestines of Cat/man Larvae – any part, eye, subQT, muscles

Cyclops, copepods

Frogs, Snakes, Toads, rats

Painful edema Due to migrating Larvae Eosinophilia, Edema and erythema

Ingestion Of Infected interM hosts

Not sure

surgical

- COPYRIGHT © 2005 -

- AUDS MARTINEZ – - USTMED SEC C ’07 -

5

PARASITE

A.K.A.

CYST

TROPHOZOITE

INFECTIVE

DIAGNOSTIC

HOST LOC. INT

HOST 2ND INT HOST

PATHOLOGY

MOT

PHIL

Tx

Entamoeba Histolytica

Ameba

greenish-yellow quadrinucleate, thick, rodlike chromatoidal bodies CB, central karyosome (K), w/ chromatin dots

active, progressive, directional; pseudopod PSD: finger-shape, hyaline; w/ ingested RBC

Qudri cysts

-Trophozoites In liquid stools -Cysts in Formed stools Culture, serology to detect invasive Amebiasis (IHAT) ELISA most Sensitive indicator

Large Intestines (cecal and sigmoido- rectal) liver in extraint amebiasis

Flasklike Primary ulcer; Histo changes: Histolysis, Thrombosis, Petechiae, Round Cell Infiltration, Necrosis Bacilliary vs Amebic dysentery

Ingestion Of Infective cysts

Yes Most Common Are Asympto carriers

Supportive, Chemotherapy Asympto – Diiodohydroxyquin Mod severe Metronidazole Severe – D + M Hepatic – M + emetine

Naegleria fowleri

No cyst only Flagellated form

Large, usually Central K

slug-like; PSD: blunt;

Trophozoite Trophozoites In CSF and tissue Flagellate form in CSF

Brain Meningoencephalitis Severe frontal Headache,Blocked nose, Altered taste and smell Kernig’s sign; Leukocytosis w/ neuts, prot, glu

EntersThru Nose Penetrate Cribriform Plate Multiply in brain

rare all types of soil

Amphotericin Amp + miconazole and rifampicin

Acanthamoeba

large central K; double cell wall

sluggish; PSD: spine-like No peripheral chrom

trophozoite Cysts and Trophs inTissue Giemsa or PAS of Scrapings or Cornial biopsy

CNS cornea

Amebic Encephalitis (immunocompromised) Amebic Keratitis (assoc w/ use of contam contact lenses)

Thru Lower respi Tract or Thru ulcerated, Broken skin

Rare All types Of soil

Propamidine, Miconazole, neomycin Corneal grafting

Entamoeba coli

yellow-brown; 1-8 nuclei, K eccentric; CB : splinter-like

sluggish, rarely prog and dir; PSD: short, blunt; Bacteria/ debris Inclusions

Entamoeba Gingivalis

Mod active, prog PSD : blunt, hyalin

Endolimax nana

pale green; 1-4 nuc; K irreg CB : bacilliform

sluggish prog; PSD:blunt /hyaline; K – L, cent

Iodamoeba butschlii

1 nuc yellow green; K surr w/ granules; endosome

slug, prog; PSD : Blunt/Hyaline

Entamoeba hartmanii

1-4 nuc; K small/Central; Diffuse glyco mass

non prog; PSD : fingerlike

6

PARASITE

A.K.A.

CYST

TROPHOZOITE

INFECTIVE

DIAGNOSTIC

HOST LOC. INT

HOST 2ND INT HOST

PATHOLOGY

MOT

PHIL

Tx

Balantidium Coli Largest prot parasite Only ciliate

bean-shaped nuc

cytostome; cytopyge;

cyst DFS of Troph and Cysts in Feces Sigmoidoscopy

SI Cysts Troph LI (cecal area) troph

Ulcer w/ rounded Base and wide Neck (vs flask shape) Diarrhea and Dysenter (indisting. from Amebic)

FOR Ingestion of Contam Food And water

Siguro Uncommon In Temperate; Assoc w/ Pigs in tropics

Tetracycline Metronidazole Iodoquinol

Giardia Lamblia

“gay bowel syn”

young – 2 nuc; mature – 4 nuc; flagella retracted into axonemes

pyriform/tear-drop; bi-symm; erratic tumbling motion; 8 flag

Quadri cysts

DFS Cysts and Trophs Biopsy, Entero-test, IF and antigen detection

SI Duo, jeju, upper il Attaches To int villi Via adhes Disc on ven

Villus flat and crypt Hypertrophy;electrolytes, glu, fluid abs, disacchs; diarrhea most common symptom (89%); spont recovery in 6 wks; chronic – steato, diarr altern w/ constip

FOR siguro Outbreaks Are water- borne

Oral Metronidazole Tinidazole Furozolidone Quinacrine paromomycin

Trichomonas vaginalis

No cyst stage

pyriform; jerky movements; 4 free flag +1 undulating; axos

Troph Trophozoites In urine, Urethral sec, Vaginal sec, Cervical sec, Semen, Prostatic sec

Female – Vaginal epi Male – Urethra, Epididymis, Prostate g

-Vaginal discharge – Liquid, green to yellow, Irritating -Speculum – Strawberry Cervix (diagnostic) -Vaginitis; urethritis

Sexual intercourse Passed thru Birth canal

Yes Hostpitality Girls – 24% Other groups - 3-8%

Oral Metronidazole Acid douches

Dientamoeba Frgilis

No known cystic stage

rosette-shaped nuclei; no peri chromatin; K w/ 4-6 granules; no flag

Troph

Binucleate Trophs in fresh Stool samples

In lumen Of LI

-Increase excess mucus -Hypermotility of the bowel -Colicky ab pain; anal Pruritis; Peripheral eosinophilia -Mimics IBS (irrit bow syn)

Co-infection With E. vermicularis

Siguro …as long as may infection w/ E. vermic -in pre-schools in Germany, Israel, Holland

Iodoquinol Tetracycline Metronidazole

Leishmania Tropica

Old World Cut Leish

w/ ovoid or rounded bodies

promastigote

Pro M

in skin tissue biopsy

Lives Intracellular In Macrophages PMS and Endothelial Cells Pro M A-Mast

Sand fly Pheobotomus Spp A-Mast Pro M in gut of fly

Cutaneous leishmaniasis Lesions resembling Lepromatous leprosy

Bite of Sandly vector

Wala Africa, India South amercia

Antimony Compounds Second line Drugs: Amp B, Pentamidine (Kala-azar), Metronidazole Nifurtimox

Leishmania Donovani

amastigote

1 free flagella arising from kinetoplast

Bone marrow, Spleen or Lymph nodes

Visceral Leishmaniasis or Kala-azar Splenomegaly, presence of Parasites in RE cells;

Leishmania Braziliensis

New World Cut Leish

amastigote

Serology – For supportive diagnosis

Mucocutaneous or American Leishmaniasis Tapir nose Erosion of pinna of forest workers

Trichomonas Tenax

Smaller and longer than T. vaginalis

Troph swabbing Oral cavity -tartar

Droplets, kissing

yes

Chilomastix Mesnili

knob- like prod, LemonS

spiral forW; 3 ant flag + 1

cysts Cysts in Semi-formed Stools; Trophs in Liquid stools

Cecal region Of LI

FOR Rare <1%

7

PARASITE

A.K.A.

CYST

TROPHOZOITE

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST

2ND INT HOST

PATHOLOGY

MOT

PHIL

Tx

Trypanosoma Gambiense

West African Sleepng Sicknes

Trypomastigote

T-mastigote Parasite in Blood tissues Or CSF Serology for Large scale Screening ELISA, IF

In blood, Lymph and CSF

Tsetse Fly Reservor Host: Domestic Animals

Local Infiltration from bite area to lymph and CNS -Chronic inflammation Of lymphatics -Atrophy of dendrons Of ganglion cells -Winterbottom’s sign, Kerandels sign

Bite of Vector Congenital Transmission possible

NO West and Central Africa

Supportive Pentamidine Suramin Melarsopenol Tryparsamide Melarsen

Trypanosoma Rhodesiense

East African Sleepng Sicknes

Tsetse Fly Reservor Host: Game animals

NO Uh..east Africa?

Trypanosoma Cruzi

Chaga’s Disease

Epimastigote

Trypomastigote

T-mastigote Blood smear Serology –CF Xenodiag biopsy

Histiocytes RE cells (adipose, myocardial, RE, Neuroglial)

Reduviids, Triatomid Bugs Reservoir: Wild mammals

-Engulfed by histocytes and invade adipose tissue -inflamm response w/ fibrotic encapsulation = chagoma; Romana’s sign

-Bite of Vector -feces -transplacental -accidental ingestion -blood trans

No Income Groups In Suburban rural

8-amino quinolones Primaquine, Nifurtomax (Bayer 2502)

Toxoplasma gondii

(man) bradyzoite, cyst

(cat?) male and female gametocytes

pseudocyst and oocyst w/ Sporozoites -Oocyst prod By sexual Cycle in cat; Pseudocysts- asexual

Serology – IgM detection By ELISA; IFA for IgG And IgM; PCR Of Toxo DNA

In SI of Cat (sexual And asexual Cycle); in Tissues in Asexual cycle Definitive –CAT

Mouse or Rat Man, pigs, Sheep, Accidental Intermediate hosts

Brain lesions; hepatitis; Chorioretinitis; Lymphadenitis 2 types of postnatal ds 1) mild lymphatic (lide infectious Mononucleosis) 2) acute fulminating

Ingestion, Transplacenetal

Yes Cosmo Many are Chronic Ill but are asympto

Pyrimethamine (Daraprim), Trisulfapyri- Midines; Preg – spiramycin, Clinamycin; AIDS – Atovaquone

Isospora Belli

immature cyst

Schizont, gametes Inside host

Mature oocyst w/ sporozoites

Immature Cysts in feces -Oocysts/ Sprorcysts in dudenum

SI of man Definitive – MAN

Malabsorption syndrome; Shortened villi, hyper- Trophied crypts, infilt Of lamina propria, w/ Eosins, polys, rounded cells

FOR Not sure Pyrimethamine Sulfadiazide or Trimetroprim

Pneumocystis Carinii

cysts

Surgical open Lung biopsy; BronchoAlLav; Bronchoscopy; Methenamine Silver stain

interstitial pneumonia; fatal pneumonia in infants; hypogammaglobulinemia, leukemia, Hodgkin’s, etc -lungs are gray and airless; death due to asphyxia

Droplets, Close contact

Yes cosmo

Bactrim

GAMETE SCHIZONT TROPHOZOITE

Plasmodium Falciparum

Mosquito – Gametocytes; Man – Sporozoites Hypnoxoite – Latent stage, Cause relapse Sporogany – Mosquito LC; Schizogony – Human LC - exoerythro (merozoites) - erythro (gametocytes)

Peripheral Blood smears -thick -thin QBC, Para sight F test (dipstick test), IFA

RBC (Man) Vivax – young Malariae – old Falciparum –all Mosquito : 1)Stomach – Gamete form, 2)Stomach wall – oocyst and sporozoite release 3)salivary glands - sporo

Anopheles Flavirostris Minimus Anopheles -litoralis -balabacensis -mangyanus -maculates

-Tissue anoxia – basic pathophysio change in malaria -4 mechanisms leading to tissue anox: 1. anemia-hemolysis 2. changes in blood flow 3. changes in capillary endothelium 4. histotoxic shock -parasite virulence factors: 1. multiplication capacity 2. red cell selectivity 3. cytoadherence and resetting ability 4. potential to induce cytokine release 5. antigenicity 6. antimalarial drug resistance Blackwater fever, liver dys, hypogly, Acidosis, GI dys, placenta dys, pulmo edema, renal failure, coagulo and thrombocyto, coma

Bite of female Mosquito Passage of Blood w/ Erythrocytic Parasite by: -blood trans -contam syringe -neonatal -congenital

Yes Malaria Free areas -manila -aklan -capiz -guimara -siquijor -biliran -iloilo -leyte N -leyte S -N Samar -Camiquin -Cebu -Catand.

Vivax and Ova –Chloroquine + Primaquine Falci and Mal -Chloroquine Chloroquine Resistant – Falc

Plasmodium Vivax

Plasmodium Malariae

Plasmodium Ovale

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