Helminths Flashcards
What is the difference between Helminths and Protozoa
Helminths: DO NOT multiply in the host; DO cause eosinophilia
Protozoa: MULTIPLY in the host! ONLY Cystoisosopora causes eosinophilia
Which filaria most commonly causes hydrocele
Wucheria Bancrofti
Big differences between brugia malayi and wucheria
Brugia: Cold filarial abscess and elephantiasis is usually the LOWER legs
Tropical Pulmonary Eosinophilia
Wucheria Bancrofti: Mostly males, paroxysmal nocturnal asthma, massive peripheral eoiphilia
DEC
Diethylcarbamazine : has aggressive macrofilaricidal (adult) regimen; single dose is microfilaricidal (microfil in the blood)
Ivermectin
Only Microfilaricidal, NOT macrofilaricidal
Albendazole
Single dose is micro and macrofilaricidal
infective stages of filaria:
L3, Hosts are generally flies or mosquitos; the MICROfilariae are released in humans (usually blood)
Vector of onchocerca volvulus
similium flies
punctate keratitis and snowflake opacities
Onocherca volvulus
What is Sowda
Hyper reactive onchodermatitis: Localized hyperimmune reaction to microfilariae
Treatment of onchocerva volvulus monoinfection
Ivermectin, Doxycycline, Ivermectin ; then ivermectin repeated q3-6 months
Anytime >2500 microfilaria/mL loa loa
ALWAYS consider apharesis first.
Dual Loa and Oncho infection
treat oncho FIRST with ivermectin, wait 6-12 months, then LOA with DEC., BUt if >2500 Loa, caution because ivermectin can facilitate loa entry into the CNS with severe encephalopathy and even death
dual LF and Loa OR Oncho infection
First treat oncho with ivermectin, wait ONE month then DEC for lymphatic filariasis// If loa + LF, need to know how much Loa Loa there is. If <2500, DEC x 3 doses; if >2500, apharesis first OR ivermectin first then DEC.
What can cause tubo-ovarian localization
enterobius vermicularis
rectal prolapse and appendicitis
trichuris trichuria
largest, obstructive helminth
ascaris lumbricoides
anemia in helminths
hook worm, the adult worms ingest the blood
Treatment of ascaris
albendazole
Hookworm treatmetn
albendazole, 3 days
trichuris tx
mebendazole
helminths that PENETRATE the skin
ancylostoma duodenale, necator americanus, strongyloides stercoralis (ONLY ONE that causes larva currens)
periorbital edema after eating bear, boar, horse meat
trichinella spiralis
perianal pruritis in children worldwide
Enterobius vermicularis
Vulvovaginitis
enterobius vermicularis
D shape
Enerobius vermicularis
Which helminths cause eosinophilia
trichuris trichiura, strongyloides stercoralis , ancylostoma duodenale/necator americanus , ascaris lumbricoides
rectal prolapse, appendicitis
trichuris
what causes visceral larva migrans
toxocara canis or cati
clinical manifestations of toxocariasis; Tx?
asymptomatic usually with eosinophilia-abdominal pain, respiratory symptoms, hepatomegaly; can have ocular manifestations uveitis and retinitis// Steroids for ocular disease, DEC and albendazole
Visceral larva migrans caused by racoon
baylisascaris procyonis
clinical manifestations of baylisascaris
migration of larvae into tissues mostly CNS resulting in eosinophilic meningoencephalitis
A gorgas course graduate goes to a sushi bar and then 4 hours later has horrible abdominal pain
anisakis larva in the gastric mucosa
A business executive has an insidious onset of an intractable bitemporal headache. 6th nerve palsy. CSF shows 235 WBC and 55% eosinophils . Was at a dinner in seafood market in Bangkok
Agniostrongyliasis (eosinophilic meningitis): caused by angiostrongyliasis (rat lungworm)
eosinophilic meningitis, SE asia
angiostrongylus cantonensis, tx with steroids
Subcutaneous migratory swellings, creeping eruption; can hace cerebtal bleeding and conjunctival edema
Gnathostoma spinigerum (gnathstomiasis)
An open lung resection of a solitary pulmonary nodule from a 35year old non-smoker from NY, a worm is discovered in the necrotic tissue that is removed ; coin lesion
Dirofilariasis : dirofilaria immitis
42year old hunter who has never left the US complains of migratory transient swellings on his face for several months. feels like a worm is under his skin
Dirofilariasis tenuis
profuse watery diarrhea with massive malabsorption, abdominal pain, eosinophilia, from philipines and thailand ; raw fish
capillaria philippinesis
ingestion of water containging infected copepods with a painful lister on your leg. if you go into freshwater, it releases
dracunculus medinensis -guine worm
5 causes of destructive facial lesions
Balamuthia
Mucormycosis
Rhinosclera
TB
Burkitts lymhoma
Leish
Paracocci
Swimming, chronic nasal lesion, brain leions
Balamuthia Mandrillaris
Treatment: Amph B/Miltefosine/albendazole/flucanazole
7 warning signs of dengue
abdominal pain
persistent vomiting
thrombocytopenia with high hct
hepatomegaly >2cm
mucosal bleeding
edema
lethargy
failed leish and TB treatment for 6 months
chromoblastomycosis
tx: itraconazole
Pathology: copper bodies
