Blood and Tissue nematodes Flashcards
2nd cause of permanent and long-term disability after psychological problems
Lymphatic filariasis
Presence of larva in the lymphatics causes it to be blocked, impairing
drainage of excess fluids in the body causing ________ and ________ of tissues
edema and swelling
Lower lymphatics (Elephantiasis; Hydrocele)
W. bancrofti
Upper lymphatics
B. malayi
Worldwide
W. bancrofti
Southeast Asia
B. malayi
Enclosed in a hyaline sheath
W. bancrofti and B. malayi
Head space – extension beyond the head; as wide as it is long
W. bancrofti
Head space – longer than it is wide
B. malayi
Nuclei – evenly spaced
W. bancrofti
Tip of tail – with 2 nuclei
B. malayi
Tip of tail have NO NUCLEUS
W. bancrofti
Kinky
B. malayi
Sheath is faintly stained or unstained
W. bancrofti
Sheath – dark pink, highly stained
B. malayi
Dilates lymphatics
Lymphangiectasis
Proliferation of lumen
Lymphangiogenesis
Common among those who grew up outside endemic regions
Expatriate syndrome
Expatriate syndrome manifests __________ reaction.
Type I hypersensitivity
Endemic normals
Asymptomatic
(+) microfilaria (thousands to millions) in the blood but does not
manifest symptoms
Asymptomatic
Worm has the ability to inhibit _____ - no immune response - no
progress to elephantiasis
CD4
Most common manifestation of acute form
Acute Dermatolymphangioadenitis
Localized pain, lymphadenitis, lymphangitis, cellulitis, localized
warmth
Acute Dermatolymphangioadenitis
Acute Dermatolymphangioadenitis is recurrent every ______ days.
1 to 16 days
Acute Dermatolymphangioadenitis may be mistaken an _______ and _______ which are cause by Group A streptococcus.
Erysipelas and cellulitis
Recent studies show that these manifestations of filariasis is due to ______________ as secondary bacterial infection
Streptococcus pyogenes
Directly caused by adult worms that died spontaneously or following
treatment
Acute Filarial Lymphangitis
Characterized by lymphangitis that progresses distally along the
vessel producing a palpable cord
Acute Filarial Lymphangitis
May indicate death of worms after treatment
Acute Filarial Lymphangitis
Self-limiting
Acute Filarial Lymphangitis
Chronic form
Lymphedema and elephantiasis
most common manifestation of chronic lymphatic filariasis
Lymphedema
A bacteria that infects the filarial worms can also contribute to the chronicity of filariasis
Wolbachia
Results in the obstruction of lymphatics of the tunica vaginalis of the
testis
Hydrocele
_____________ hydrocele fluid accumulate in the closed sac of
testis
Clear or straw-colored
In some cases, microfilaria will hide in the tissue - trigger allergic
manifestations - skin manifestations and allergic cough
Tropical pulmonary eosinophilia
Sometimes misdiagnosed as asthma or TB
Tropical pulmonary eosinophilia
best time to collect; microfilaria stay in the blood (nocturnal periodicity)
8 pm to 4 am
In daytime, the microfilaria stay in the __________.
Pulmonary vessels
If beyond 4am, administer __________ to trigger the microfilaria to come out from the pulmonary vessels
DIETHYLCARBAMAZINE (Diethylcarbamazine provocative test)
Preferred method
Circulating filarial antigens detection
Can detect latent infections
Circulating filarial antigens detection
Can be used to diagnose a case with no microfilaria present in the blood
Circulating filarial antigens detection
If low intensity infection
Knott concentration method
May cause fever, myalgia, headache, fever, myalgia, and sorethroat
Diethylcarbamazine
Same adverse effect of DEC but milder
Ivermectin
If target area is endemic for soil-transmitted helminths
Albendazole
For Wolbachia
Doxycycline
Treat the side effects accordingly (e.g. headache - pain reliever)
Diethylcarbamazine
Not effective against adult worms
Ivermectin
Albendazole must be maintained for _______.
6-12 months
Effective against adult and micrfilaria
Diethylcarbamazine
Given for 1 year
Ivermectin
Give for 12 days
Diethylcarbamazine
For prevention and control, annual _____ plus _______ or _______ in endemic areas.
DEC
Albendazole
Ivermectin