Helminths Cards Flashcards
Perianal itch or rash, bedwetting or insomnia in children, superinfection risk
Enterobius vermicularis/pinworm
Dome shaped eggs flat on one side, nematode w/ 1mm worm, no animal reservoir,
Enterobius vermicularis/pinworm
How is enterobius vermicularis treated?
Pyrantel (in gut), albendazole (bloodstream), cessation of scratching of eggs
How is enterobius vermicularis diagnosed?
Morning perirectal cellophate tape test
2cm nemotode worm, eggs released into soil, tropical environment
Trichuris trichiuria / whip worm
What is the transmission of truchuris trichiuria?
Fecal-soil-oral – eggs must exit body and embryonize in soil
Dystentery syndrome, anemia, growth stunting, rectal prolapse
Trichuris trichiuria / whip worm
How is trichuris trichiuria treated?
Albendazole (bloodstram) or malbendazole. Kills the heads buried in intestinal wall.
How is trichuris trichiuria/whip worm diagnosed?
Fecal O&P
Round microscopic eggs, larva in lungs, eggs in soil, giant worm
Ascaris lumbricoides / roundworm
Tropical disease, 25% burden of infection worldwide, poor sanitation
Ascaris lumbricoides / roundworm (very similar to Trichuris trichiuria pattern)
Pneumonitis, Loeffler’s Syndrome, Charcot-Leyden crystals, bowel blockage, peritonitis, biliary sepsis
Ascaris lumbricoides / roundworm
How is ascaris lumbricoides diangosed?
O&P, colonoscopy, ultrasound, GI series
How is ascaris lumbricoides/roundworm treated?
Albendazole/Mebendazole (1st line), Pyrantel (2nd line)
1cm worms, smooth egs with visible round embryo inside
Necator americanus
Invade epidermis, lung migration, embryonization in soil,
Necator americanus / ancylostoma duodenale (hookworms)
Tropical disease, poor sanitation, bare skin, children
Necator americanus / ancylostoma duodenale (hookworms); Resembles pattern of Trichuris or Ascaris
Rash/ground itch, Loeffler’s, pneumonitis, anemia, growth stunting
Necator americanus / ancylostoma duodenale (hookworms)
Cutaneous larva migrans, creeping eruption, severe pruritis
Ancylostoma braziliense (dog hookworm)
How are hookworms treated?
Albendazole or Ivermectin; iron repletion for children; antihistamines for severe itch
How is hookworm diagnosed?
Fecal O&P, or see CLM rash
Roundworm, autoinfection without exiting host
Strongyloides stercoralis
Tropical disease, poor sanitation, warm weather, bare skin
Strongyloides stercoralis (resembles necator americanus / hookworm)
Larva currens, pruritic, Loeffler’s syndrome, hyperinfection and ectopic migration with immunocompromise, sepsis
Strongyloides stercoralis
How is strongyloides stercoralis diagnosed?
Larva currens on exam, ELISA IgG if immunocompetent, eosinophilia, O&P; if hyperinfection, look for systemic infection and larvae in sputum. Cannot use IgG serology for hyperinfection diagnosis.
How is strongyloides stercoralis treated?
Ivermectin > Albendazole, reduce immunosuppression, treat viral infection, pre-emptive rx if intended immunosuppression
Zoonosis in dogs and cats, immature in humans
Toxocara cani or cati
Visceral larvae migrans, ocular larvae migrans, loss of red reflex mimicking retinoblastoma
Toxocara cani or cati
School-age children or preschool age children, Brazil, Indonesia, America
Toxocara cani or cati
Undercooked hog flesh, hunters
Trichinella spiralis
Muscle pain, flue-like illness, fever
Trichinella spiralis
How is toxocara canis/cati treated?
Supportive care if mild VLM; Albendazole and corticosteroids for severe VLM/OLM
How is trichinella spiralis treated?
Supportive care if mild; Albendazole and corticosteroids if severe
How is trichinella spiralis diagnosed?
Eosinophilia, muscle biopsy, serology
How is toxocara canis/cati diagnosed?
Eosinophlia, larvae in tissue biopsy
Meat-human transmission, viviparous in gut, larvae disseminate and encyst
Trichinella spiralis
Tropical disease, mosquito vector, w/ Wolbachia bacteria
Filariasis (Wuchereria bancrofti and Brugia malayi)
Lymphadema, elephantiasis, fistula; tissue migration and tropical pulmonary eosinophilia
Filariasis (Wuchereria bancrofti and Brugia malayi)
How is filiariasis treated?
Doxycycline kills endosymbiotic Wolbachia bacteria + Albendazole to kill adult worms; Diethylcarbamazine reduces tropical eosinophilia (kills microfiliariae)
How is filiariasis diagnosed?
Adults visualized via untrasound, microfiliariae seen in blood films
How is filiariasis prevented?
Vector control of mosquitoes, mass administration of DEC (added to cooking salt)
Freshwater fish, fish-oral transmission (raw fish)
Diphyllobothrium latum / fish tapeworm
Double-grooved head, scolex, hoolets, proglottides, strobilia
Cestodes (tapeworm) e.g. diphyllobothrium latum
Proglottid passage, anorexia, megaloblastic anemia, B12 deficiency
Diphyllobothrium latum / fish tapeworm
How is diphyllobothrium latum treated?
Oral praziquantel, B12 injections, fish inspection
How is diphyllobothrium latum diagnosed?
Identification of proglottides or eggs in stool, low B12, megaloblastic anemia
Beef-oral transmission, uncooked beef
Taenia Sagninata / beef tapeworm
Four suckers at scolex, cestodes
Taenia Sagninata / beef tapeworm
Proglottid passage, GI upset
Taenia Sagninata / beef tapeworm
How is taenia sagninata diagnosed?
Fecal O&P for egg, strobilia on enteroscopy, rarely eosinophilia
How is taenia sagninata treated?
Oral praziquantel, meat inspection
Cestode, 4 suckers, ring of hooklets
Taenia solium / pork tapeworm
Pork-oral transmission (taeniasis) or fecal-oral (cysticerosis)
Taenia solium / pork tapeworm
Asymptomatic, proglottid passage, new onset seizures, blindness, muscle tenderness
Taenia solium / pork tapeworm
How is taena solium diagnosed?
Fecal O&P, enteroscopy, brain MRI (cysticcerosis), skeletal survey
How is taena solium treated?
Anti-epileptic drugs for seizures, corticosteroids + albendazole/praziquantel
Fecal-oral, sheep entrails, dog feces
Echinococcus granulosis / dog tapeworms
Central Asia, Alaska
Echinococcus granulosis / dog tapeworms
Hydatid disease, encysted liver, biliary dysfunction, blindness, anaphylaxis, cyst seeding
Echinococcus granulosis / dog tapeworms
How is echinococcus granulosis diagnosed?
CXR to show calcified cysts in lung; abdominal CT; eosinophilia and serology may be helpful if cysts “leak”
How is echinococcus granulosis treated?
PAIR: puncture, aspirate hydatid juice, inject albendazole, reaspirate out of cyst. Or surgical removal (careful not to spill hydatid sand and cause anaphylaxis)
Northern hemosphere, foxes, voles
Echinococcus multilocaris
Gradual liver destruction, alveolar pattern
Echinococcus multilocaris
Trematode, fluke, grooved (male)
Schistosomiasis (shistosoma mansoni, hematobium, or japonicum)
Snail, cercaria, portal system
Schistosomiasis (shistosoma mansoni, hematobium, or japonicum)
Cercarial dermatitis, pruritis, swimmer’s itch
Acute Schistosomiasis (shistosoma mansoni, hematobium, or japonicum)
Subacute Katayama syndrome, fever, chills, hepatomegaly
Schistosomiasis (shistosoma mansoni, hematobium, or japonicum)
Chronic hematuria, squamous cell carcinoma, hematochezia, chronic diarrhea, ascites, hemorrhage
Chronic Schistosomiasis (shistosoma mansoni/japonicum cause hematochezia/colon disease from mesenteric venous plexis, hematobium, causes hematuria/squamous carcinoma from veins draining bladder)
How is schistosomiasis diagnosed?
Acute rash, eosinophilia, serology, fecal/urine O&P
How is schistosomiasis treated?
Praziquantel, snail control, manage liver care
Anaplasma, erlichia, Lyma, rickettsiae
Ticks (ixodes or ornithodoros)
Epidemic typhus, trench fever (bartonella), borrelia recurrentis
Body louse
Rickettsialpox, scrub typhus,
Mite-born infection (sarcoptes scabiei)
Yersinia pestis, tularemia, murine endemic typhus
Flea-borne infection (xenopsylla cheopis)
Malaria
Anopheles mosquito
Yellow fever, dengue fever, chikungunya fever
Aedes mosquito
Filariasis, West Nile
Culex mosquito
How is arthropod disease treated?
Symptomatic treatment, risk factor treatment (clothing/blankets)
Multi-legged, exoskeleton
Arthropods / ectoparasites
