Malaria And Blood Parasites

Question 1

Three types of flood microbes

Answer 1

Sporozoa (plasmodium and babesia)

Flagellates (trypanosomiasis and leishmania)

Flukes (schistosoma)

Question 2

Main geographical areas for malaria

Answer 2

Africa (specifically west and south)

South America

India

Tropical areas

always transmitted vis mosquitoes (anopheles)

Question 3

Types of malaria species in order of most common to least common

Answer 3

Falciparum (most common and most dangerous)
-10-15 day incubation

Vivax (2nd most common)
- 10-15 day incubation

Malariae
- 28 day incubation

Ovale
- 9-30 day incubation

Knowlesi
- immediate

Question 4

Blood cell stages of malaria

Answer 4

Symptomatic stage
- use symptomatic treatment

Ring stage
- actually reproduce at this stage

Trophozoite stage

Schizont stage

Question 5

Most common symptoms of malaria

Answer 5

Flu like symptoms with undulating fever

Question 6

Why is p. Falciparum most dangerous?

Answer 6

Super high infection rate within all blood cells

Causes neurological damage if allowed to incubate (cerebral malaria)

Can cause Algid malaria (circulatory shock induced by malaria) and black water fever (stupid dark urine due to massive hemolysis and kidney failure)

possess a unique gametocyte stage which allows RBCs to stick to the vessel endothelium

Question 7

Cardinal red flag for malaria clinically

Answer 7

Traveling or is from Africa, South America or India and presents with a high grade fever

Question 8

Malaria paroxysms

Answer 8

Three stages of the fever in malaria infections are recurrent but undulating

1) chills stage (after schizont stage where schizont burst from infected red blood cells to invade new ones)
- 15-60 minutes

2) febrile stage (parasites have invaded and are now incubating in new RBCs)
- several hours

3) sweating stage (time between incubation and bursting)

Question 9

Diagnosis for malaria

Answer 9

Blood smears w/ giemsa stain is the most common and useful

Rapid antigen test, ELISA and PCR can be used but more time consuming

Question 10

Babesiosis (babesia microti)

Answer 10

Tick vector pathogen that is often mistaken for P. Falciparum malaria infections.

• can present with the Maltese cross (100% it) or a ring stage (where it is confused with malaria)*

Also tetras is diagnostic

Question 11

Why are Trypanosomes so difficult to fight normally?

Answer 11

They have a “coat of many colors”

- they have over 1000 different types of glycoprotein coats and have the ability to shape shift their coat

Question 12

Two main types of trypanosome diseases

Answer 12

African sleeping sickness (African type)
- tsetse flies w/ T. Rhodesiense or gambiense

Chagas’ disease (American type)
- kissing bugs w/ T. Cruzi

Question 13

Clinical difference between T. Gambiense and T. Rhodesiense

Answer 13

Gambiense = western type found in wetland biomes and takes longer to kill
- CNS symptoms take 4-6 months to develop

Rhodesiense = eastern type found in savanna biomes and takes less time to kill

• CNS symptoms take 2 weeks to develop
• MUCH WORSE

Question 14

Clinical signs of African sleeping sickness

Answer 14

Induration and swelling at wound site

CNS symptoms causes mass fatigue and malaise

Anorexia, tissue wasting

Eventually coma and death

Question 15

Two cellular stages of Chagas’ disease

Answer 15

Trypomastigotes: extracellular and single
- acute (squiggle appearance)

Amastigotes: intracellular and in colonies
- chronic (dot and a dash appearance )

Question 16

Clinical symptoms of Chagas’ disease

Answer 16

Romana’s sign: conjunctivitis and severe periorbital swelling

Fever, regional lympadenitis

Mega colon/mega esophagus/ myocarditis (only chronic stages)

No treatment however if monitored usually plays itself out

Question 17

Leishmania types

Answer 17

Cutaneous (wet or dry)

• least severe type
• presents with only superficial skin lesions that may be dry or wet

Mucocutaneous (L. Braziliensis)
- grows large slow growing ulcers in the face/nose, will cause fatal respiratory infections if not treated

Visceral (L. Donovani)

• most dangerous type
• presents with fever, hepatosplenomegaly with adenopathy and extreme weight loss
• also presents with pancytopenia

Question 18

Kala-azar (black fever)

Answer 18

Chronic stages of visceral leishmaniasis

Is almost always fatal

• patients who survive will usually present with PKDL nodules and rashes for life*

Symptoms include

• fever
• hepatosplenomegaly
• weight loss
• lymphadenopathy
• anemia
• pancytopenia

Question 19

Schistosoma types
(Valentine disease)
(katakana/snail fever)

Answer 19

All are long worms that live in venous system for up to 10-20 years if not treated.

• species are named for appearance and where they like to incubate in hosts*
• called valentines disease since male and female worms hold each other while incubating

S. Mansoni: large intestine

S. Japonicum: small intestine

S. Haematobium: veins of urinary bladder via UTI

Question 20

Pathological symptoms of schistosoma

Answer 20

Depends where they lodge in the venous system

Liver: causes fibrosis of liver and granuloma presentation

• also portal hypertension and hepatomegaly
• most common location*

Almost always leads to eosinophila

Question 21

Clinical symptoms of schistosoma

Answer 21

Super itchy rash within 1 hr of skin penetration

Fever, headache, chills diarrhea and pathological symptoms within 2 weeks of infection

Question 22

Leishmania braziliensis (espundia)

Answer 22

Agent that causes mucocutaneous leishmaniasis

- comes with sloe growing and large ulcers that eventually causes gastrointestinal issues If not treated