Parasite Fast Facts Flashcards
Giardia
Bloating, fatty diarrhea, foul smell
Transmission - cysts in water (jungle ride)
Trophozoites or cysts in stool (O&P)
Tx - metro (metro in amusement park)
Entamoeba histolytica
Bloody diarrhea, liver abscess w/ anchovy paste pus and RUQ pain
Histo - flask shaped ulcers
“Entamoeba eats RBCs” - see trophozoites w/ engulfed RBCs
Tx - metro (train near underground historical site)
Cryptosporidium
Severe diarrhea in AIDS pt or mild diarrhea in normal pt
Transmission by oocysts in water (can detect by acid-fast stain)
Prevent by filtration NOT Cl-
Toxoplasma gondii
Congenital = chorioretinitis + hydrocephalus + intracranial calcifications (crosses placenta)
React in AIDS –> ring enhancing lesions
Meat or cat feces (litter box)
Tachyzoite on biopsy (sickle shaped)
Tx - sulfadiazine + pyrimethamine (easter eggs w/ pyramids painted on)
Naegleria fowleri
Rapid, fatal, meningioencephalitis
Fresh water –> cribiform plate –> brain
See amoebas in spinal fluid
Amphotercin (frog in lake)
Trypanosoma brucei
African sleeping sickness
Prince bruce to rescue sleeping beauty
Recurring fever (hills - due to antigenic variation)
Tsetse fly (tea kettle)
Trypomastigote (goat stuffed animal) on blood smear
Tx = suramine for blood (sounds like serum) & melarsoprol for CNS (like melatonin - sleep)
Plasmodium (4)
Malaria - anemia, fever, headache, splenomegaly
Anopheles mosquito
1/2- Vivax/ovale - tertiary fevers and hyponozoites dormant in liver; add primaquine (primal queen) for hypozoites
3- Malariae - quart fever
4- Falciparum - severe, irregular fever cycles, inc RBCs and occlude capillaries of brain, kidney, lungs (see rings in RBCs or Schuffner stippling)
Use chloroquine for all unless resistant (endemic Africa) - then use IV quinidine, artesunate (artist), mefloquine, atovaquone, proguanil (iguana)
Babesia
Fever, hemolytic anemia, inc severity if asplenic
NE USA
Ixodes tick (common co-infection w/ borrelia)
Maltese cross on smear
Tx = atovaquone and macrolide (vampire queen w/ crow on shoulder)
Trypanosoma cruzi
Chagas disease
Dilated cardiomyopathy, megacolon (gas pump) or megaesophagus (snake)
Romano sign - unilateral peri-orbital swelling
Kissing bug (painless bite) then defecate in wound –> human scratches
Tx = benznidazole & nifurtimox (in benz w/ fur boots)
Leishmania donovani
Sandfly of mid-east and africa
Cutaneous = skin ulcers Visceral = fevers, hepatosplenomegaly and pancytopenia
Macrophages containing amastagotes (goats in cages) on BM aspirate
Tx = stibogluconate (t bone steak) or amphotercin B if bad (frogs of plague)
Trichomonas vaginalis
Foul, green d/c
Motile trophozoites on wet mount
Strawberry cervix
Tx = metro (for partner too)
Enterobius vermicularis
VERMIN LADY
AKA pinworm
Anal itch
Dx - tape at anus for eggs
Tx - pyrantel pamoate or bendazoles (PAM - action words)
Ascaris lumbricoides
TREE MAN (lumber)
AKA giant roundworm
Ingest eggs that hatch in intestine –> blood –> lungs –> cough and swallow –> GI to mature
Intestine obstruction / perforation, malnutrition, resp prob (bronchial tree) and biliary obstruction (biliary tree)
Knobby-coated oval eggs in feces
Tx - abendazoles
Strongyloides stercoralis
STRONG GUY
AKA threadworm
In boots (larvae in soil penetrate skin –> blood –> lungs –> cough and swallow –> GI)
Larvae in feces, eggs in intestine
Tx - abendazole or ivermectin (allen iverson is strong)
Ancylostoma duodenale & Nectar Americanus
AMERICA MAN
Hookworms in rural southern US
Cowboy boots (larvae penetrate skin); walking on beach barefoot
Anemia b/c suck intestine blood
Cutaneous serpiginous rash
Tx = abendazole or pyrantel pamoate
Trichinella spiralis
SPIRAL PIG VILLAIN
In undercooked pork
fever, vomit, nausea, periorbital edema (glasses)
Larvae in blood –> striated muscle (inflammation)
Tx = abendazole
Trichuris trichiura
Often asymp or loose stools, anemia, rectal prolapse in kids
Tx = abendazoles
Toxocara canis
Food w/ dog or cat feces –> larvae –> blood –> heart, liver, eyes, CNS
“visceral larva migrans”
“ocular larva migrans” if eyes involved
Tx = bendazoles
Onchocerca volvulus
Black fly (near rivers) bites host –> deposit larva in skin –> mature and migrate thru body
Skin changes and “river blindness”
Ivermectin (river)
Loa Loa
Deer fly, horse fly, mango fly
Local Calabar swelling as migrates thru subQ tissue and worm in eye
Tx = diethylcarbamazine (diet and carb magazine)
Wuchereris bancrofti
Elephantitis (elephant pants - esp legs)
Mosquito bite –> larvae –> worms invade nodes –> inflammation –> lymphedema
Takes 9 mo - 1 yr for onset
Tx = diethylcarbamazine (diet and carb magazine)
Taenia solium
Intestinal tapeworm from pork (pig) if ingest larvae
Neurocysticerosis if ingest eggs (sz and swiss chz on MRI)
Tx - praziquantel (pretzels at carnival)
Diphyllobothrium latum
bothrium think bathroom (run to bathroom after ingest undercooked fish)
Competes for B12 –> B12 def –> megaloblastic anemia
Tx - praziquantel (pretzels at carnival)
Echinococcus granulosus
Dogs = definitive host (eggs in dog feces)
Sheep = intermediate host
Sheep dog at carnival (cocker - coccus)
Hydatid cysts w/ eggshell calcification in liver
Cyst rupture –> anaphylaxis
Tx - praziquantel (pretzels at carnival)
Schistoma (3)
SNAIL host - penetrate skin in water (swimmers at risk)
Swimmer’s itch
All move against portal flow (salmon against stream)
Mansoni - merman w/ lateral spine (like fin); portal HTN
Japonicum - smooth small spine like smooth circle of japanese flag; also portal HTN
Haematobium - large TERMINAL spine (like sword fish); in bladder veins so hematuria and squamous cell carcinoma of bladder
Tx - praziquantel (pretzels at aquarium)
Chonorchis sinensis
Orca
Snail –> fish –> humans eat undercooked fish
Sea gull - gall problems (biliary tract inflammation, pigmented gallstones, cholangiocarcinoma)
Tx - praziquantel (pretzels at carnival)
Sarcoptes scabiei
Scabies
Burrow in stratum corneum - serpiginous
Itching worse at night
Think crowds (jails, nursing homes)
Transmit skin to skin or by fomites
Tx - permethrin + change sheets/clothes + close contacts
Pediculus humanis / Phthirus pubis
Blood-sucking lice –> itch –> excoriations
Scalp and axilla
Can transmit borrelia prowazekii, Borrelia recurrentis, Bartonella quintana (trench fever)
Tx - pyrethroids, malathion, ivermectin lotions and nit combing
