Helminths

Question 1

Ancylostoma duodenale and Necator americanus are the most common types of this helminth and are most commonly found in tropical and subtropical regions.

Answer 1

Hookworms

Question 2

How do most cases of Hookworm present?

Answer 2

Asymptomatically

Question 3

Hookworm infections may present with what type of rash?

Answer 3

Pruritic maculopapular rash
- sometimes with serpiginous tracks of larval migration

Question 4

Hookworm infection causes: dry cough, wheezing, and low fever. What are the larvae of the Hookworm doing during this phase?

Answer 4

Migrating to the Lungs

Question 5

One month after the hookworms migrate through the lungs, where do they go to next?

Answer 5

Gastrointestinal Tract
- pain
- diarrhea
- anorexia

Question 6

Large infestations of Hookworm can lead to what?

Answer 6

Iron-deficiency Anemia
Protein Malnutrition

Question 7

How is Hookworm diagnosed?

Answer 7

Eggs in Feces - Ova & Parasite Test
CBC - Microcytic Anemia + Eosinophilia

Question 8

What is the primary treatment for Hookworm?

Answer 8

Albendazole (single dose)
Mebendazole (2x a day for 3 days)

Question 9

What are the four major non-invasie Tapeworms?

Answer 9

Beef Tapeworm - Taenia saginata
Pork Tapeworm - Taenia solium
Fish Tapeworm- Diphyllobothrium latum
Dwarf Tapeworm - Hymenolepis nana

Question 10

How do most Taenia Tapeworms present?

Answer 10

Asymptomatically

Question 11

What is the classical manifestation of Diphyllobothriasis infection?

Answer 11

Megaloblastic anemia (Vitamin B12 deficiency)

Question 12

Hymenolepiasis is most common in what age population?

Answer 12

Children

Question 13

How do most cases of Hymenolepiasis present?

Answer 13

Asymptomatically
- symptoms are more common as burden increases
- 1000+ worms or 500+ eggs per gram/stool

Question 14

How is Tapeworm diagnosed?

Answer 14

Eggs or Proglottids in Stool - Ova & Parasite

Question 15

How are most tapeworms treated?

Answer 15

Praziquantel (PO)
5 - 10mg/kg

Question 16

How is dwarf tape worm treated?

Answer 16

Praziquantel (PO)
25mg/kg
Repeat dose after 1 week

Question 17

Invasive Tapeworm infection that occurs through direct human fecal contamination of food leading to the ingestions of eggs of T. Solium. Leads to tissue infection with cysts.

Answer 17

Cystericercosis

Question 18

Cystericercosis infection that can cause seizures, focal neurological deficits, altered cognition, and psychiatric disease. Intracerebral, subarachnoid, spinal cord lesions, or intraventricular cysts may be present.

Answer 18

Neurocystericercosis

Question 19

Cystericercosis infection that involves muscle or subcutaneous tissue and may present with asymptomatic nodules that can cause discomfort when inflamed.

Answer 19

Extraneural Cystericercosis

Question 20

How is Cystericercosis diagnosed.

Answer 20

Neuroimaging + ELISA
- CT and MRI

Question 21

What is a caveat to treating Cystericercosis?

Answer 21

Medical management is controversial
- use adjunct steroid therapy if you do intend to treat it
- Anti-seizure medications

Question 22

How should you treat Cystericercosis?

Answer 22

Albendazole (10-14 days)
- use adjunct steroid therapy

Question 23

In a patient with Cystericercosis, what warrants anti-parasitic therapy?

Answer 23

Viable or Degenerating Cysts

Question 24

Invasive tapeworm contracted through ingesting food contaminated with canine feces containing parasite eggs from E. granulosis and E. multiocularis

Answer 24

Echinococcosis

Question 25

What is a hallmark sign of Echinococcosis?

Answer 25

Large Cystic Lesions
- usually Liver or Lungs

Question 26

What happens if a cyst caused by Echinococcosis ruptures?

Answer 26

Severe Allergic Reaction
- fever and hypotension

Question 27

Where at in the United States can Echinococcosis occur but is rarely seen?

Answer 27

Southwest

Question 28

How is Echinococcosis diagnosed?

Answer 28

Ultrasound or CT
IgG ELISA (confirmation)

Question 29

How is Echinococcosis treated?

Answer 29

Albendazole
1 - 6 months

Question 30

Infection caused by Enterobius vermicularis eggs.

Answer 30

Pinworm

Question 31

What is the most common symptoms of Pinworms?

Answer 31

Nighttime Perianal Pruritus

Question 32

How are Pinworms diagnosed?

Answer 32

Tape Test
- found on skin

Question 33

How are Pinworms treated?

Answer 33

Albendazole
- repeat in 2 weeks