Helminths

Question 1

What is Enterobius vermicularis (pinworm)? Know Pictures

Answer 1

• causes anal itching particularly at night when the female worm migrates through the anal canal to deposit her eggs.
• can cause appendicitis symptoms (RLQ pain, nausea, and vomiting) when living in lumen of appendix.
• worms live primarily in the cecum.

Question 2

How is Enterobius vermicularis (pinworm) transmitted?

Answer 2

• contamination of soiled nightclothes
• exposure to viable eggs on soiled linen
• contaminated fomites
• can be found under fingernails

Question 3

What is anisakiasis (sushi worm)?

Answer 3

• parasitic disease caused by nematodes (worms) that attach to the wall of the esophagus, stomach (epigastric pain), or intestine (abdominal distention and pain).
• The best ways to prevent this disease is to avoid eating raw or undercooked fish or squid.

Question 4

How do you treat anisakiasis?

Answer 4

endoscopic removal or surgical removal of worm

Question 5

What is Trichinella spiralis?

Answer 5

• nematode parasite, occurring in RODENTS, PIGS, horses, bears, and humans, and is responsible for the disease trichinosis.
• will see larvae in skeletal muscle
• transmitted via ingestion of wild game

Question 6

What symptoms will you see with Trichinosis?

Answer 6

• peri-orbital edema and swelling of conjuntiva

- eosinophilia

Question 7

What is Strongyloidiasis stercoralis?

Answer 7

• presents as urticaria (moving larva under the skin; racing larva or larva currens).
• can develop Loffler’s syndrome= pulmonary eosinophilia.
• can develop hyperinfection syndrome= bronchopneumonia, enteritis, gram-negative sepsis, or meningitis in immunocompromised individuals.
• can cause gram-negative sepsis.
• “winding trails” on culture

Question 8

How do you treat Strongyloides stercoralis?

Answer 8

albendazole or ivermectin

Question 9

What is Trichuris trichiura “whipworm”?

Answer 9

• lemon or barrel shaped egg

- can cause rectal prolapse or dysentery (bloody diarrhea).

Question 10

What is Ascaris lumbricoides?

Answer 10

• small intestinal roundworms that can cause pallor, urticarial rash, and epigastric tenderness

Question 11

What is Necator americanus and Ancylostoma duodenale (hookworm)?

Answer 11

• larva penetrates the skin “ground itch”

- causes iron-deficiency anemia, edema, and dyspnea

Question 12

How do you treat Necator americanus and Ancylostoma duodenale (hookworm)?

Answer 12

mebendazole, albendazole, ferrous sulfate

Question 13

What are the cestodes (tapeworms)?

Answer 13

• Taenia solium (pork)
• Taenia sagginata (beef)
• Diphyllobathrum latum (fish)
• Echinococcus granulosus

Question 14

What is neurocysticercosis?

Answer 14

• patients present with a new-onset epilepsy due to Taenia solium from eating pork.
• generalized tonic clonic seizures
• headache and fever

Question 15

How do you treat neurocysticercosis?

Answer 15

• Praziquantel and niclosamide

- steroids are given concurrently to decrease the inflammatory response and risk of seizures as the parasite degenerates

Question 16

What is Dracunculus medinensis (Guinea worm)?

Answer 16

• nematode that causes dracunculiasis “fiery serpent”= painful burning feeling as the female worm forms a blister in the skin, usually on the lower limb. The worm then comes out of the skin over the course of a few weeks
• can cause pernicious (megaloblastic) anemia