20- Parasitic Infections Flashcards
May be the sole manifestation of early amebiasis
Chronic urticaria
Treatment of choice for amebiasis cutis
Metronidazole 750mg TID x 10 days
Common cause of vaginal pruritus with burning and frothy leukorrhea
Vaginal mucosa is bright red with pseudomembranous patches
Trichomoniasis
Treatment of trichomoniasis
Metronidazole 2g single dose
Or 500mg BID x 7 days
Treatment for trichomoniasis in pregnant women
Clotrimazole 100mg intravaginally per night x 2 weeks
Treatment for cutaneous leishmaniasis
Spontaneous healing in 12-18 months
Topical: paromomycin sulfate 15% + methylbenzethonium chloride 12%
Ketoconazole cream
Cryotherapy, photodynamic therapy, laser
Systemic: immunosuppressed
Sodium antimony gluconate IM/IV 20mg/kg/day in 2 doses x 28 days
Cutaneous ulcer
Transmitted by sandfly
Endemic in Asia minor and Mediterranean
Cutaneous leishmaniasis
Mucocutaneous leishmaniasis has an initial cutaneous ulcer and develops a secondary mucosal lesions after how much time?
Within 5 years
Earliest mucosal lesion in mucocutaneous leishmaniasis
Hyperemia of nasal septum with subsequent ulceration
Antimony resistance is common in this type of leishmaniasis
Mucocutaneous
Treatment for mucocutaneous leishmaniasis
Combination therapy:
Antimonials with rifampin/azithromycin
Amphotericin B
Primary target site of leishmanial parasites in visceral leishmaniasis is
Reticuloendothelial system
-spleen, liver, bone marrow and lymph nodes
Treatment for visceral leishmaniasis
Pentavalent antimony
Amphotericin B- resistant cases
Evanescent erythema, erythema multiforme and edema (angioedema) are the early skin manifestations observed in
Trypanosomiasis
Treatment of East African (Rhodesian) trypanosomiasis
No CNS involvement:
With CNS involvement:
No CNS involvement: suramin
With CNS involvement: melasoprol
Treatment for West African (Gambian) trypanosomiasis
Pentamidine isethionate
Treatment for American trypanosomiasis (Chagas disease)
Nifurtimox
Benznidazole
Treatment of toxoplasmosis
Pyrimethamine and sulfadiazine
Organisms enter a snail
Swimming
Attack by burrowing into skin
Transient erythematous reaction then recur after 10-15 hrs
Swimmers itch Cercarial dermatitis (schistosome)
Mild itching and papular dermatitis of feet
Urinary bladder/ intestinal inhabitation of the organisms
Fever, chills, pneumonitis, eosinophilia, petechiae, malaise, abdominal crsmps, arthritis, liver spleen involvement
Visceral schistosomiasis
Treatment of schistosomiasis
Praziquantel 40mg/kg/day in 2 doses for 1 day
S. japonicum- 60mg/kg in 3 doses for 1 day
Painless nodules in subcutaneous tissues
Organisms may enter general circulation and form cysts in striated muscles
Cysticercosis ( T.solium)
Treatment for cysticercosis
Albendazole
Praziquantel
Also known as hydatid disease
From ova-contaminated feces from an infected dog
Infestation of liver and lungs
Eosinophilia, intractable urticaria and pruritus
Echinococcosis
Treatment of echinococcosis
Echinococcus granulosus- albendazole + percutaneous drainage
Hymenolepis nana- praziquantel
Chief symptom of pinworm infestation
Nocturnal pruritus ani
Treatment of enterobiasis
Albendazole 400mg
Mebendazole 100mg
Pyrantel pamoate 11mg/kg (max 1g)
Given once and repeated in 2 weeks
Erythematous macules and papules that turn into vesicles
Occurs in toe webs, soles and ankles
Iron deficiency anemia, skin becomes dry and pale or yellowish
Carried into circulation to the lungs—pharynx—swallowed into the small intenstine
Hookworm (ancylostoma, necator)
Treatment for hookworm disease
Albendazole 400mg single dose
Mebendazole 100mg BID x 3 days or 500mg single dose
Pyrantel pamoate 11mg/kg (max 1g) OD x 3 days
Prevention of contamination of soil
Term applied to twisting linear skin lesions produced by the burrowing of larvae
Creeping eruption (larva migrans)
Treatment for larva migrans
Ivermectin single 12mg dose and repeated the next day
Albendazole 400mg/day x 3 days
Also called perianal larva migrans syndrome
Caused by stongyloides stercoralis
Larva currens
Treatment for larva currens
Ivermectin
Thiabendazole
Lymphedema, hypertrophy of skin and subcutaneous tissues
Enlargement and deformity of affected parts
Recurrent attacks of acute lymphangitis with chills and fever
Elephantiasis (filariasis)
Treatment for filariasis
Diethylcarbamazine x 14 days
Usually asymptomatic, appearance of symptoms may be after 1 year
Transmitted by mango fly
Worm under conjunctiva, calabar swelling, eosinophilia and microfilariae in peripheral blood
Loiasis (loa loa)
This sign in loiasis is usually the first one observed
Painful localized subcutaneous nonpitting edema
Calabar swelling
Treatment for loiasis
Diethylcarbamazine
Itchy papular dermatitis localized to one extremity, may become chronic
Transmitted by black fly
After a time, subcutaneous nodules develop that are painful
Onchocerciasis
Treatment for onchocerciasis
Ivermectin
Inflict series of bites in a row
“Breakfast, lunch and dinner “
Cimicosis (bed bug bites)
Treatment for cimicosis (bed bug bites)
Permethrin impregnated bednets
Ivermectin 200ug/kg
Treatment for pediculosis
Permethrin
Nit combing
Launder clothing 65C for 30 mins drying
Pruritic papular lesions, excoriations and burrows
Favors finger webs wrists axillar umbilicus lowe abdomen genitals buttockss
Dull red nodules may appear during active period in scrotum penis or vulva
Scabies
Axillae, elbow, flexures, wrists and hands and crotch are mostly affected in scabies and is collectively called
Circle of Hebra
Treatment for scabies
Permethrin 5% cream
Benzyl benzoate and 10% precipitated sulfur in white petrolatum
Thoroughly rubbed and washed off 8-10h later
