18c Treatment for Parasitic Infection (Protozoa) Goad Flashcards
What is Toxoplasmosis?
Toxoplasma gondii. 3rd leading cause of death d/t foodborne illness (primarily in immunocompromised and newborns). Can also be transmitted from “cat box disease” or Mother-fetus –> stillborn, miscarriage
What is the treatment for Toxoplasmosis?
Pyrimethamine and Sulfadiazine. Clindamycin is alternative. Treat for up to 4 weeks. Treat infants instead of mothers
What is Giardia intestinalis?
Giardia lamblia. Backpackers disease. Contaminated ground water. Zoonotic and person to person. MSM transmission
What is Giardiasis?
1-2 week incubation. Stool: foul smelling, loose or watery, fatty stools. Stomach cramps, flatulence and upset stomach
What is the treatment for Giardia?
Tinidazole (Tindamax): 2nd gen nitromidazole, 2g PO x1 dose w/ food. Metronidazole 2g PO x3d or 250mg TID 5-7 days (not FDA indicated). Nitazoxanide (Alinia): 500mg PO Q12h x3 days. Paromomycin (Humatin): Aminoglycoside; not systemically absorbed, 30mg/kg/day PO for at least 5 days
What is the advantage of Metronidazole vs. Tinidazole for Giardiasis?
Metronidazole can be used for infants, while Tinidazole is > 3 years old. Tinidazole is a single PO dose though, while Metronidazole is 3 day or 5-7 day
What is Cryptosporidiosis?
Cryptosporidium parvum. Contaminated water. Watery diarrhea, vomiting, abdominal pain. Self-limiting in immunocompetent. More severe disease in AIDS and elderly
What is used to treat Cryptosporidium parvum?
Nitazoxanide 500mg PO BID x3 days
What is Entamoeba histolytic?
Amoebiasis (Amoebic dysentery). Contaminated hands, food, water. Mild to intestinal perforation
What is looked at in a stool sample for Entamoeba histolytic?
Frequency. Form. Color. Ova and Parasites (O&P)
What is the spectrum of disease caused by Entamoeba?
Asymptomatic disease (cyst passers). Intestinal Amebiasis. Extraintestinal Amebiasis
What is done for Asymptomatic disease (cyst passers) caused by Entamoeba?
Vague GI symptoms, if E. dispar no treatment, if E. histolytica use a luminal agent alone
What is done for Intestinal Amebiasis caused by Entamoeba?
Dysentary (diarrhea w/ blood). Metronidazole then a Luminal agent. May need antibacterials for gut perforation
What is done for Extraintestinal Amebiasis caused by Entamoeba?
Liver abscess. Same as intestinal plus surgical intervention
What is treatment for Entamoeba histolytica?
Broad spectrum (Metronidazole 750mg TID x10 days) PLUS a luminal agent (with cysts): Iodoquinol, Paromomycin, Diloxanide
What is American Trypanosomiasis?
Chagas disease. Fecal contamination of bite
What is African Trypanosomiasis?
Sleeping sickness. Transmitted by tsetse flies
What is Leishmaniasis?
Cause 3 forms: cutaneous, mucosal, and visceral (kala azar). Transmitted by sandfly
What is treatment like for Leishmaniasis?
Toxic treatments: Na stibogluconate, Liposomal AMB for visceral
What is Hookworm?
Nematode. Ancylostoma duodenale. Necator americanus. Ancylostoma caninum
What are the clinical aspects of Hookworm?
“Ground itch” - Nector americanus. Cutaneous “creeping” larvae migrans - A. braziliense. Lung findings: mild to moderate cough, eosinophilic pneumonia. Intestinal disease (blood loss, abdominal pain, diarrhea, weight loss). Chronic disease - anemia (children, pregnant women)
What is the treatment for Hookworm?
Albendazole 400mg once (DOC). Mebendazole 100mg BID x3d or 500mg once. Pyrantel pamoate 11mg/kg (max 1g) x3d
What is the DOC for Hookworm?
Albendazole 400mg once
What is Baylisascaris procyonis
Transmitted by ingesting eggs in raccoon latrines. Neural and ocular larvae migrans (Neural ALWAYS fatal, no effective treatment)
