11- vector borne disease 2

Question 1

east african trypanosomiasis is caused by

Answer 1

trypanosoma brucei rhodesiense

Question 2

west african trypanosomiasis is caused by

Answer 2

aka gambian sleeping sicknessl T. brucei gambiense

Question 3

Trypanosoma are carried by

Answer 3

tsetse fly (both male and female)

Question 4

stages of african trypanosomiasis

Answer 4

first stage: parasite found in peripheral circulation, not in CNS
second stage: parasite in CNS

Question 5

dx of african trypanosomiasis

Answer 5

• T.B rhodiense parasite are easily found in blood, lymph node fluid or fluid or biopsy of a chancre
• T.B. gambiense: microscopic examination of lymph node aspirate (posterior cervical node)

Question 6

mx of african trypanosomiasis

Answer 6

based on stage of disease, all mys undergo lumbar puncture for examination of CSF

Question 7

TX of african trypanosomiasis

Answer 7

suramin: T. Rhodiense hemolymphatic stage
melarsoprol: T. Rhodiense CNS stage
pentamidine: T. Gambiense hemolymphatic stage
eflornithine: T. Gambiense CNS stage

Question 8

american trypanosomiasis aka

Answer 8

chagas disease via trypanosoma cruzi which is transmitted by triatomine bugs (kissing bugs)

Question 9

acute phase of chagas dx

Answer 9

• acute: occurs immediatly after infection, lasts weeks to months (4-8 weeks), is asymptomatic in most cases
• signs: fever, inflammation of inoculation site, unilateral palpebal edema (romana sign), lymphadenopathy, hepatosplenomegaly
• severe acute: acute myocarditis, pericardial effusion, meningeencephalitis

Question 10

chronic phase of chagas dx

Answer 10

no parasites in blood, asymptomatic

Question 11

chagas disease causes what clinical condition most often

Answer 11

cardiac disease (cardiomyopathy)

Question 12

dx of chagas dx

Answer 12

in acute phase: observation of parasite in blood smear by microscope; thick and thin smear for visualisation of parasites
- chronic: note pts clinic findings, country, parasite specific antibodies

Question 13

tx of chagas dx

Answer 13

benznidazole and nifurtimox

Question 14

rickettsial dx are transmitted via

Answer 14

ticks, lice, mites, fleas (BACTERIA)

Question 15

main groups of rickettsia spps are

Answer 15

spotted fever group, typhus group, (orientia spp make scrub typhic group)

Question 16

tx for rickkettsia

Answer 16

doxycyline

Question 17

reservoir differences in west vs east sleeping sickness

Answer 17

east: reservoir is animals
west: reservoir is humans

Question 18

T/F african sleeping sickness in the second stage (affecting CNS) is much more severe than stage 1

Answer 18

F

Both stages lead to coma and death if not treated

Question 19

T rhodiense pathogenesis

Answer 19

progresses rapidly, Pts have CNS involvement after a few weeks (mental deterioration, neurological) Death within months

Question 20

T gambiense pathogenesis

Answer 20

progresses slowly, After 1-2 years CNS involvement occurs, with personality changes, daytime sleepiness, progressive confusion, partial paralysis and hormonal balances. The course of untreated infection lasts 6-7 years but it usually kills in 3 years

Question 21

T/F rickettsia can have maculopapular rash, eschars, vesicular or petechial rash

Answer 21

T