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MMI 426 > African Trypanosomiasis > Flashcards

African Trypanosomiasis Flashcards

1
Q

Trypanosomes order

A

Kinetoplastids

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2
Q

Trypanosomes family

A

Trypanosomatidae

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3
Q

Trypanosomes genus

A

Trypanosoma

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4
Q

African sleeping sickness

A

African trypanosomiasis
2 subspecies
T. brucei rhodesiense and T. brucei gambiense

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5
Q

American trypanosomiasis

A

T. cruzi or Chagas disease

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6
Q

East African Tryp

A

T. brucei rhodesiense = acute

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7
Q

West African Tryp

A

T. brucei gambiense = chronic, slowly progressing

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8
Q

T. brucei brucei

A

infects wild and domestic animals (NOT HUMANS) and causes a disease called nagana

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9
Q

T or F. African tryps are protozoan hemoflagellates

A

T! but do not have intracellular form and multiply as trypomastigotes that circulate in the mammalian bloodstream and other extracell spaces

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10
Q

T or F. 2 subspecies of T. brucei are morphologically distinguishable

A

F! not distinguishable but american and african can be told apart

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11
Q

vector of African sleeping disease

A

tsetse fly
- endemic disease; only in sub-Saharan Africa

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12
Q

T or F. T. brucei rhodesiense is more common

A

F! T. b. gambiense more common = 24 countries in west and central Africa; more than 95% cases

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13
Q

transmission of African sleeping disease

A
  • VECTOR = tsetse flies
  • transfusion
  • mother to child
  • other blood sucking insect
  • lab accidents
  • sexual contact
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14
Q

Glossina flies

A
  • tsetse
  • obligate parasites
  • live on blood of vertebrate animals
  • fold their wings completely so one wing rests directly on top of other over their abdomen
  • long proboscis; attached by distinct bulb of the bottom of their head
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15
Q

T or F. T. b. gambiense infect humans

A

T!
T. b. rhodiense = animals

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16
Q

stage 1 pathogenesis of T. brucei

A
  • bite = chancre
  • hemolypmhatic stage
  • interstitial multiplication of trypanosomes within chancre = intense mononuclear cell rxn to parasites
  • parasites go regional lymph nodes = proliferate = inflammatory response
  • go to lymphatics then to bloodstream = multiplication
17
Q

stage 2 pathogenesis of T. brucei

A
  • reaches brain and meninges = meningoencephalitis = frontal lobe, pons, medulla
  • edema and hemorrhages
  • infiltration of CNS w mononuclear cells (plasma cells, lymphocytes, Mott cells)
  • CSG = increased pressure, total protein, monocytes and eos
18
Q

unique feature of African trypanosomes

A
  • can change surface coat of outer membrane of trypomastigote
    = evades host immune response
  • 1000 different variant surface glycoprotein (VSG)
  • changes about 5-7 days
    = successive waves of parasitemia every 7-14 days
19
Q

how long does T.b. gambiense last

A

months to years
- intermittent fever, posterior cervical lymphadenopathy (Winterbottom sign)

20
Q

how long does T.b. rhodiense last

A

days to weeks
- high fever, thrombocytopenia, hepatitis, myocarditis, cutaneous chancre, anemia

21
Q

Winterbottom’s sign

A

T. b. gambiense

22
Q

primary reservoir of T. b. rhod

A

cattle, antelope, domestic pigs and dogs (accidental)

23
Q

how to diagnose T. b. rhod

A

microscopy
- blood = high parasitemia
- lymph node fluid
- chancre biopsy, aspirate
- CSF (MUST!)

24
Q

how to diagnose T. b. gamb

A
  • multiple lymphadenopathy
    = lymph node aspirate (usually posterior cervical node)
  • blood
  • chancre aspirate
  • CSF (MUST!)
  • serology
  • CATT ( card agglutination test for trypanosomes)
  • ELISA
  • IFA (indirect fluorescent antibody assays)
25
Q

when are trypomastigotes highest in blood?

A

during febrile periods
- best time to take smears

26
Q

T or F. Amastigotes have flagella

A

F! also they have intracellular stage (Leishmania)

27
Q

promastigote

A
  • elongated body form
  • kinetoplast and kinetosome are at anterior end, in front of nucleus
  • Leptomonas stage
  • in sand fly; Leishmaniasis
28
Q

trypomastigote

A
  • bloodstream form
  • has undulating membrane
  • kinetoplast and kinetosome at posterior end, behind nucleus
  • metacyclic tryp isan infect stage for humans
29
Q

epimatigotes

A

nucleus and kinetoplast close to each other
- Crithidia stage

30
Q

T. cruzei vs. T. brucei microscopy differences

A

T. c.
- trypomastigotes larger posterior kinetoplast and undulating membrane with anteriorly-directed flagella
- C-shaped
- no dividing forms

T.b.
- flagella begins as undulating membrane originating from posterior to kinetoplast
- tryps have small kinetoplasts
- dividing forms seen

31
Q

when do we take blood and CSF specimens for African sleeping sickness?

A

during therapy and 1-2 months post-therapy

32
Q

prevention of T. brucei

A
  • eradication of vector
  • sterile insect technique (most environmentally friendly
  • drug treatment of infected humans + animals
  • decrease indiv risk by using insect repellent and wearing clothing that reduces biting of flies
33
Q

oral treatment for gambiense

A

Fexinidazole

MMI 426 (20 decks)

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