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GENERAL PARASITOLOGY > LEC 4 - Larva Migrans > Flashcards

LEC 4 - Larva Migrans Flashcards

1
Q

Denotes that if a person is infected with the larva, the larva will start crawling in the tissues of the infected host, they migrate sa body ng infected host

A

LARVA MIGRANS

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2
Q

skin (epidermis)

A

Cutaneous Larva Migrans

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3
Q

visceral organs (soft internal organs)

A

Visceral Larva Migrans

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4
Q

a type of VLM, another effect of VLM, parasite migrated in the eyes of the host (periorbital region)

A

Ocular Larva Migrans

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5
Q

Site of Infections

A

Site of Infection
* Heart
* Lungs
* Digestive organs
* Reproductive organs
* Circulatory organs
* Excretory organs

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6
Q

not a typical part of the life cycle of the parasite, infected because the host was exposed to the parasite, the larvae will no longer developed to become adult

A

Accidental Host

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7
Q

also known as Toxocariasis, caused by Toxocara spp

A

Visceral Larva Migrans

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8
Q

if the periorbital region is involved

A

Ocular Larva Migrans

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9
Q

also known as creeping eruption or
ground itch

A

Cutaneous Larva Migrans

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10
Q

Etiologic Agent of CLM:

A
  • Anyclostoma braziliense (cat hookworm)
  • Anyclostoma caninum (dog hookworm)
  • Strongyloides stercoralis – Larva Currens/Racing Larva
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11
Q

Rate of migration

A

5-15 cm/hr

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12
Q

associated with S.stercoralis, “Vietnam”

A

Cochin – China Diarrhea

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13
Q

Infective Stage of CLM

A

Filariform Larva

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14
Q

MOT of CLM

A

Skin penetration of larvae from soil

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15
Q

(CLM)
Etiology Most Common na CAT & DOG HOOKWORMS

A

Ancylostoma Braziliense

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16
Q

Etiology Less Common(CLM) - Dog Hookworms

A
  • A.tubaeforme,
  • A. caninum,
  • A. ceylanicum,
  • Uncinaria stenocephala
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17
Q

CLM Treatment

A

Self-limiting (larvae die in weeks to months)
Medication to relieve or alleviate pain and symptoms, dili contagious tho

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18
Q

VLM MOT

A

Ingestion if embryonated eggs from soil; ingestion of encysted larvae from animal organs

Can be harbored by ducks or rabbits (paratenic host)

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19
Q

(CLM)
Etiology Less Common - Animal strongyloidiasis

A
  • S. myopotami
  • S. papillosus
  • S. westeri
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20
Q

(CLM)
Etiology Less Common - Cat, dog, pig roundworms

A
  • Gnasthostoma spp.
  • Gnathostoma spinigerum
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21
Q

(CLM)
Etiology Less Common - Cat, dog, poultry, & rodent whipworms

A

Capillaria spp.

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22
Q

(CLM)
Etiology Less Common - Cattle hookworm

A

Bunostomum phlebotomum

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23
Q

(CLM)
Etiology Less Common - Human hookworms

A

Ancylostoma duodenale
Necator americanus (ground itch)

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24
Q

(CLM)
Etiology Less Common - Human Strongyloidiasis

A

S. stercoralis (larva currens)

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25
Q

Infective Stage of VLM

A

Filariform Larva

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26
Q

VLM
Etiology MOST COMMON - Cat and Dog Nematodes

A

Toxocara canis
Toxocara catis

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27
Q

VLM
Etiology LESS COMMON - Dog/Cat

A
  • Toxoscaris leonine
  • Toxocara vitulorum
  • Toxocara pleropodis
28
Q

VLM
Etiology LESS COMMON - Racoon

A

Baylisascaris procyonis

29
Q

VLM
Etiology LESS COMMON - Pig

A

Ascaris suum

30
Q

VLM
Etiology LESS COMMON - Rare

A
  • Angiostrongylus cantonensis
  • Angiostrongylus costaricensis
  • Anisakis spp.
  • Capillaria hepatica
  • Dirofilaria immitis
  • Gnasthostoma spinigerum
  • Gongylonema spp.
  • Lagochilascaris
  • Pseudoterranova spp.
31
Q

– raw salt water fish, causes anisakiasis
(kapatid ni Anisakis)

A

Pseudoterranova spp.

32
Q

VLM Treatment

A

Need treatment due to the severity of
symptoms

33
Q

According to Panikers,
The larvae produce ____________, which develop into ____________ in the epidermis. With the movements of the larva in the skin, the lesion also shifts, hence the name ‘creeping eruption. Scratching may lead to secondary bacterial infection

A

itching papules; serpiginous tunnels

34
Q

Strongyloides rare sa feces, because it is

A

ovoviviparous Rhabditiform larva

35
Q

To identify hookworm from Strongyloides: (Fecal Cultures)

A

1.Harada Mori
2. Sand & Charcoal/Baermann
3. Koga Agar Plate Culture

36
Q

abnormal tracks below the skin surface in the feet (30%)
o Stinging sensation upon penetration
o Larva starts migrating 1 week to several months after penetration
o Larvae forms tract 1-2 cm. beyond

A

CREEPING ERUPTIONS

37
Q

o 2-4mm wide
o Erythematous (reddish), elevated, vesicular, itchy :
o Erratic Pattern (snake-line/serpiginous means wavy)
o Progresses 2mm to 2cm/day

A

MIGRATORY TRACT/ TRAIL

38
Q

Anyone in contact with sand/soil in warm, moist, shady
areas:
o Sunbathers
o Fishermen
o Hunters
o Gardeners
o Constriction workers
o Children plating in sandboxes, beach

A

AT RISK GROUPS

39
Q

Resolve with/without treatment, no long-term
complications Pruritic lesions → scratching → skin blisters wound open to secondary bacterial infection

A

Morbidity (self-limiting)

40
Q

Mortality of Cutaneous Larva Currens

A

None

41
Q

Diagnosis of CLM

A

o Physical examination & medical history
o Skin biopsy not necessary
o Peripheral eosinophilia
o Coherence tomography (imaging test to view larvae & remove them)

42
Q

REMEMBER CLASS!!!

A

Eosinophilia – for parasitic infection
Basophilia – viral infections
Neutrophil – bacterial infections

43
Q

TREATMENT of CLM - Without drugs

A

Self-heal

44
Q

TREATMENT of CLM - With anti-helminthic drugs

A
  • Albendazole (oral)
  • Mebendazole (oral)
  • Thiabendazole (topical)
  • Ivermectin (oral)
45
Q

TREATMENT of CLM - Supportive Therapy

A
  • Antihistamines (relieve itching)
  • topical corticosteroids (relieve inflammation)
  • antibiotics (secondary infections)
46
Q

TREATMENT of CLM - Surgical care

A
  • cryosurgery (painful, requires multiple treatment)
  • liquid nitrogen
  • ethyl chloride spray
  • carbon dioxide slush
47
Q

CLM PREVENTION

A

o Avoid direct contact with contaminated soil: wear shoes on the beach, lay towels behind your backs on the sand, garden gloves
o Prohibit dogs & cats on beaches
o Deworm pets regularly
o Cover sandboxes when not in use to avoid animals defecating

48
Q
  • Disease affecting younger children (<5 years old)
  • Symptoms due to antigens secreted by the migrating larvae
A

Visceral Larva Migrans

49
Q
  • Larvae migrate to lungs, liver, eyes, brain, muscles (visceral organs)
  • Majority asymptomatic to gradual symptoms
A

Visceral Larva Migrans

50
Q
  • Symptoms of allergy & inflammatory response:
A
  • Wheezing
  • Breathlessness
  • asthma-like
  • cough
  • itchy skin
  • fever
  • headache
  • generalized weakness
  • tiredness
  • muscle pain
  • seizures
51
Q

Cardinal Signs of Inflammation
Rubor

A

Redness

52
Q

Cardinal Signs of Inflammation
Calor

A

Heat

53
Q

Cardinal Signs of Inflammation
Tumor

A

Swelling

54
Q

Cardinal Signs of Inflammation
Dolor

A

Pain

55
Q

Cardinal Signs of Inflammation
Funtio laesa

A

loss of function

56
Q

*When migrating larval nematode invade the eye of the host
* More often in older children (5-10 y/0) & young adults compared to VLM (more often in young children 4-5 y/o)
* Symptoms of VLM may or may not be present

A

OCULAR LARVA MIGRANS

57
Q

Eye involvement often leads to unilateral vision loss, cross eye called

A

strabismus

58
Q

Etiologic agents of OLM

A
  • Toxocara canis & T. cati (most common) → ocular Toxocariasis
  • Baylisascaris procyonis – racoon
  • Ancylostoma spp.
  • Gnasthostoma spinigerum – swine
59
Q

DIAGNOSIS OF OLM - Serology

A

ELISA (Enzyme Link Immunosorbent Assay)
using Toxocara excretory-secretory antigens
- Study of antigen and antibody
- Antibodies against Toxocara spp. (+ na-exposed ka sa Toxocara)

60
Q

DIAGNOSIS OF OLM - Peripheral blood count

A

High eosinophilia (may be
absent on OLM)
- CBC count – not definitive, clue lang
- High eosinophil count – helminthiasis

61
Q

DIAGNOSIS OF OLM - imaging

A

chest X-ray

62
Q

DIAGNOSIS OF OLM - Histology

A

Encysted larvae in liver, lungs, brain, eyes

63
Q

TREATMENT AND PREVENTION OF OLM - * Anti-helminthic drugs:

A
  • Albendazole
  • Mebendazole
  • Diethylcarbamazine (DEC)
64
Q

TREATMENT AND PREVENTION OF OLM - Supportive Therapy

A

Steroids during wheezing, inflamed tissues
- Removal of granulomas in the eyes

65
Q

TREATMENT AND PREVENTION OF OLM - Prevention

A
  • Careful child supervision
  • Wash hands before eating
  • Wash hands after playing with pets
  • Cover sandboxes
  • Regular deworming of pets
  • Cook liver & other organ meats well before eating
66
Q

calcification or scarring that can lead to blindness

A

granulomas

GENERAL PARASITOLOGY (7 decks)

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