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PoD - E4 > Parasites > Flashcards

Parasites Flashcards

1
Q

Ascaris lumbricoides - Epidemiology

A
  • Commonly known as ROUNDWORM
  • NO animal reservoir
  • Throughout world in tropic and termperate climates
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2
Q

Ascaris lumbricoides - Life Cycle

A
  • Children ingest eggs from contaminated soil
  • Contaminated water or green vegetables are consumed
  • Infective larvae hatch from the eggs in the SMALL intestine, the larva penetrate the lining of the small intestine, enter the bloodstream, reach the lung, are carried up the trachea to the larynx and are swallowed and develop into adult worms in the small intesting
  • Live 1-2 years in the small intestine
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3
Q

Ascaris lumbricoides - Clinical manifestations

A
  • LOFFLER’S SYNDROME - pneumonitis-like condition with transient pulmonary infiltrates, cough, occasional fever and peripheral blood eosinophilia
  • Vague abdominal discomfort
  • Passage, usually from rectum
  • DANGER - migration of worms into the appendix, bile duct, liver, pancreatic duct, diverticuli or through some surgical anastomoses
  • High fever from illness or certain drugs used in general anesthesia may provoke the worms to undertake aberrant migration
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4
Q

Ascaris lumbricoides - What may be transmitted in its eggs

A

The flagellate, DIENTAMOEBA FLAGILIS, and PINWORM EGGS

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5
Q

Ascaris lumbricoides - Diagnosis

A
  • Passage of worm
  • Recognize egg by microscopic exam
  • Worms will have smooth borders, even shapes with tapered end and are not pigmented
  • ORDERING STOOL FOR O AND P (OVA AND PARASITES) X 3
  • Won’t find the eggs until 2-3 months after the lung symptoms
  • Increase BLOOD EOSINOPHILS during migration of larvae through lungs
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6
Q

Ascaris lumbricoides - Therapy

A
  • Albendazole (drug of choice)
  • Mebendazole
  • Pyrantel pamoate
  • Ivermectin
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7
Q

Ascaris lumbricoides - Prevention

A

Hand washing

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8
Q

Toxocariasis - Epidemiology and Graphical Distribution

A
  • Also known as Visceral Larva Migrans
  • Dog (canis), cat (cati), raccoon (Baylisascaris procyonis)
  • Small children eating dirt contaminated by dog or cat feces containing the infective eggs
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9
Q

Toxocariasis - Life Cycle

A

Eggs are passed in the feces, embryonate in the soil for 3-4 weeks and are ingested by dirt eating children. The larvae hatch in the SMALL intestine, penetrate the intestine, migrate to the LIVER, then to the LUNGS, where, after the penetration of the pulmonary veins, the larvae are distributed throughout the body to ALL ORGANS. THE LARVAE DO NOT MATURE IN HUMANS (EGGS ARE NOT PRODUCED IN HUMANS) AND MAY CONTINUE MIGRATING UP TO 6 MONTHS.

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10
Q

Toxocariasis - Clinical manifestations

A
  • Asthma-like attacks
  • Fever
  • Abdominal discomfort
  • Nausea and vomiting
  • Utricarial rashes
  • Enlargement of liver
  • Visual loss as a result of larvae entering the eye
  • Retinal lesions resembling RETINOBLASTOMA may be incorrectly diagnosed leading to unnecessary removal of the eye
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11
Q

Toxocariasis - Diagnosis

A
  • ELISA test

- 20-80% or even up to 90% EOSINOPHILIA

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12
Q

Toxocariasis - Treatment

A
  • Albendazole

- Mebendazole

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13
Q

Trichuris trichiura - Epidemiology

A
  • Also known as WHIPWORM
  • Ingesting eggs in soil contaminated by HUMAN feces
  • Take up residence in LARGE intestine
  • NO eosinophilia - does not pass through the lungs
  • Common in WV
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14
Q

Trichuris trichiura - Clinical Manifestations

A
  • Abdominal discomfort
  • Nausea
  • Distention
  • Chronic diarrhea
  • RECTAL PROLAPSE
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15
Q

Trichuris trichiura - Diagnosis

A
  • Barrel shaped eggs
  • Proctoscopy often reveals numerous worms attached to reddened and ulcerated mucosa
  • NO eosinophilia
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16
Q

Trichuris trichuria - Treatment

A
  • Mebendazole
  • Albendazole
  • Albendazole + Ivermectin
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17
Q

Trichuris trichuria - Prevention

A

Hand washing

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18
Q

Capillariasis

A
  • Eggs could be confused with eggs of Trichuris under microscope
  • Only found in certain islands in the northern Philippines
  • Severe diarrhea (due to AUTOINFECTION) with malabsorption and massive PROTEIN LOSS
  • Death from HEART FAILURE if untreated
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19
Q

Angiostrongylus cantonesis

A
  • Rat lungworm
  • Most common cause of HUMAN EOSINOPHILIC MENINGITIS
  • From uncooked snails or slugs or from snail slime containing food
  • Severe headache, neck and back stiffness
  • Blood eosinophils (up to 80%)
  • CSF will have over 20% eosinophils
  • Most patients recover completely
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20
Q

Angiostrongylus costaricensis

A
  • Abdominal/intestinal symptoms
  • Undercooked snails or snail slime containing food
  • Symptoms mimicking ACUTE APPENDICITIS
  • Elevation of blood eosinophils
  • Most patients recover completely
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21
Q

Ancylostoma duodenale and Necator americanus - Epidemiology

A
  • Commonly called HOOKWORM
  • Filariform larvae occupying upper layers of contaminated soil penetrate bare skin, usually of the feet, hands or buttocks
  • Migrate via VENOUS SYSTEM to the RIGHT side of the HEART and then to the LUNGS
  • From the lungs the larvae migrate upward in the trachea and into the ESOPHAGUS and eventually to the stomach and SMALL intestine
  • Worms mature in the small intestine, copulate and the females produce eggs
  • RHABDITIFORM (noninfective) larvae form which after a passage of time are infective to humans as FILARIFORM larvae
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22
Q

Ancylostoma duodenale and Necator americanus - Clinical Manifestations

A
  • Loffler’s syndrome
  • Discomfort in pit of stomach
  • Mental apathy
  • Impaired physical performance
  • Pallor and swelling of the face and feet may occur in heavy infestation with SEVERE CHRONIC BLOOD LOSS (hypochromic anemia) - this is why you would want to add iron to the diet
  • Heart palpitations
  • Major cause anemia in pregnant and lactating women
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23
Q

Ancylostoma duodenale and Necator americanus - Diagnosis

A

Finding eggs by microscopic examination of the stool

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24
Q

Ancylostoma duodenale and Necator americanus - Treatment

A
  • Mebendazole (standard)
  • Albendazole
  • Ivermectin
  • Pyrantel pamoate
  • ORAL IRON TREATMENT with one of agents above
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25
Q

Ancylostoma duodenale and Necator americanus - Prevention

A

Installation of latrines or other sanitary disposal systems for human feces and the wearing of shoes

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26
Q

Ancylostoma braziliense/canium - Epidemiology

A
  • Also known as Cutaneous Larva Migrans or Creeping Eruption
  • CANNOT complete their normal life-cycle in accidental human host but persist for a time under the skin without developing further
  • Damp, sandy soil with dog and cat feces
  • Worldwide
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27
Q

Ancylostoma braziliense/canium - Clinical Manifestations

A
  • Serpiginous, slightly elevated red track develops as the larvae migrate
  • Few millimeters each day
  • ANOTHER FORM: unexplained severe, widespread, itchy eruption of papulo-pustules, especially on their buttocks and back; pustules rich in EOSINOPHILS; called HOOKWORM FOLLICULITIS
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28
Q

Ancylostoma braziliense/canium - Diagnosis

A

Slowly advancing serpentine tunnel in the skin associated with intense itching and lesions that persist for months

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29
Q

Ancylostoma braziliense/ canium - Therapy

A
  • Albendazole
  • Ivermectin
  • 10% suspension of thiabendazole applied 4x daily to rash
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30
Q

Strongyloides stercoralis - Epidemiology

A
  • Also known as THREADWORM
  • Tropics, subtropics and in many temperate climate such as WV
  • Skin contact with the infective larvae in the soil
  • Fecally contaminated food or water in feces transmitted by sexual activity involving the anal canal
  • Through breast milk
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31
Q

Strongyloides stercoralis - Immunosuppressant

A

Patients who have been on high dose corticosteroids, leukemia or lymphoma patients on immunosuppressive therapy and patients with prior gastric surgery or organ transplant ARE AT A HIGHER RISK FOR STRONGYLOIDIASIS
- Question: A patient, usually a child, is on steroids for asthma and suddenly goes downhill. The CBC will show an eosinophil count of 30-70%.

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32
Q

Strongyloides stercoralis - Life Cycle

A
  • Complicated
  • Entry of parasite through the skin, usually the feet, with further development within the patient in a cycle similar to that of hookworm (passage of larvae via the venous system to the right side of the heart, then the lungs, migration up the trachea, over the glottis and eventual residence in the DUODENUM and the SMALL intestine
  • AUTOINFECTION
  • Hyperinfection in immunosuppressed patients
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33
Q

4 parasites with capacity for autoinfections

A
  1. Pinworm
  2. Strongyloides
  3. Capillaria
  4. Hymenolepsis nana (dwarf tapeworm)
34
Q

Strongyloides stercoralis - Clinical Manifestastions

A
  • Majority of infections are ASYMPTOMATIC
  • Loffler’s syndrome
  • Pain in pit of stomach
  • Utricarial rash
  • LARVA CURRENS - racing larva; pathognomonic for strongyloidiasis; rash that MOVES 1-2 cm per hour
  • Hyperinfection with dissemination (disseminated strongyloidiasis) - particularly in immunosuppressed patients
  • Hyperinfection syndrome and disseminated strongyloidiasis may be accompanied by a LIFE THREATENING BLOOD BORNE BACTERIAL INFECTION AND LIFE THREATENING GRAM NEGATIVE SEPSIS
35
Q

Strongyloides stercoralis - Diagnosis

A
  • Blood EOSINOPHIL count is often the 1st clue
  • Life-threatening, overwhelming disease the eosinophil count may PLUMMET TO A VERY LOW COUNT or even be absent just before the patient dies
  • Larva (NOT EGGS) are found in the stool
  • String test
  • PCR
  • Enzyme immunoassay (EIA) test (good but doesn’t differentiate new from old infection)
36
Q

Strongyloides stercoralis - Treatment

A
  • Ivermectin (drug of choice)
  • Albendazole
  • Nearly 100% mortality in untreated patients
37
Q

Strongyloides stercoralis - Prevention

A

Wear shoes and cover skin

38
Q

Enterobius vermicularis - Epidemiology

A
  • Also known as PINWORM
  • Temperate climates
  • Prevalent in general childhood population
  • HUMANS ARE THE ONLY HOST
39
Q

Enterobius vermicularis - Clinical Manifestations

A
  • Itching around the anus (esp at night)
  • Adolescent females seem prone to occasionally developing vaginal itch and even UTI from wandering worms
  • Insomnia, restlessness, irritability and bed wetting
  • Appendicitis
40
Q

Enterobius vermicularis - What is transmitted in their eggs

A

Dientamoeba fragilis

41
Q

Enterobius vermicularis - Diagnosis

A
  • Scotch tape test
  • Gloved little finger, without lubricant, inserted just inside the anal opening and material from the glove is transferred to a slide and examined under the microscope
42
Q

Enterobius vermicularis - Treatment

A
  • Treat EVERYONE in household
  • Mebendazole
  • Albendazole
  • Pyrantel pamoate
  • Ivermectin
  • Retreatment may be required
  • Has nothing to do with lack of cleanliness in the home
43
Q

Trichinella spiralis/nativa/nelsoni - Epidemiology

A

Undercooked muscles of domestic pigs, bear, boar, walruses… wild animals

44
Q

Trichinella spiralis/nativa/nelsoni - Life Cycle

A
  • Eating raw or inadequately cooked meat
  • Larvae ENCYSTED in striated skeletal m.
  • Larvae are liberated by gastric juices and are transported by peristalsis to the SMALL intestine; after mating the females begin to discharge larvae which then enter the MESENTERIC lymphatics or the BLOODSTEAM are distributed throughout the body
  • Larvae that eneter tissue other than striated m. die
45
Q

Trichinella spiralis/nativa/nelsoni - Pathology

A
  • DEGREE OF ILLNESS reflects the number of larvae ingested
  • INTESTINAL and MUSCLE INVASION phase
  • INTESTINAL: mucosal irritation
  • MUSCLE INVASION: invasion of larvae into muscle cells, particularly masseters, extraocular muscles, the tongue, diaphragm, intercostals, gluteus, biceps, and gastrocnemius
  • Myocardial involvement: acute congestive heart failure may result from myocarditis
  • Neurologic involvement: although larvae are unable to successfully encyst in the nervous system, PETECHIAL hemorrhages within the brain may occur accompanied by marked meningeal irritation
46
Q

Trichinella spiralis/nativa/nelsoni - Clinical Manifestations

A

Intestinal Stage:

  • 1st 1-7 days of infection
  • Diarrhea
  • N/V
  • Headache

Muscle Invasion Stage:

  • 1-8 weeks after infection
  • Muscle pain
  • FACIAL and BILATERAL PERIORBITAL EDEMA
  • SPLINTER HEMORRHAGES involving nailbeds
  • Maculopapular rash

Chronic Stage:

  • Vague muscle pains
  • General malaise
47
Q

Trichnella spiralis/nativa/nelsoni - Diagnosis

A
  • History of eating poorly cooked pork, wild pig or bear meat
  • EOSINOPHILIA
  • ELISA test
  • MUSCLE BIOPSY IS THE DEFINITIVE TEST - biopsy at gastrocnemius or pectoralis muscles at sites of swelling; biopsy material should be compressed between glass slides for microscopic examination
48
Q

Trichinella spiralis/nativa/nelsoni - Treatment

A
  • SEVERE: steroids + mebendazole

- Otherwise, analgesic and antipyretic treatment

49
Q

Trichinella spiralis/nativa/nelsoni - Prevention and Control

A
  • Animal inspection
  • Cook pork at 77 C (171 F) or until meat is gray; microwaving and smoking meat does not always kill the larvae
  • Freezing meat less than 15 cm thick at -15 C (5 F) for at least 30 days
  • Trichinella parasites in meat from artic animals may be resistant to freezing and should be cook thoroughly
50
Q

Scabies - Epidemiology

A
  • Worldwide and affects people of all races and socioeconomic level
  • Direct skin-to-skin contact although infective mites may be transferred from undergarment and bedclothes
  • Transmission often occurs during sexual intercourse
  • Severe form, SCABIES CRUSTOSA, occurs in immunodeficient, debilitate and senile individuals living in nursing homes or institutions
51
Q

Scabies - Life Cycle and Pathology

A
  • HUMANS ARE RESERVOIR
  • Female mite burrows into skin and deposits fertile eggs as she tunnels through the upper layers of the epidermis
  • Intense itching
52
Q

Scabies - Clinical Manifestations

A
  • Intense itching (esp at night)
  • 2 or more individuals in the same household will present with complaints of nocturnal itching
  • Finger webs, flexor surfaces of the wrist, women’s breast, penis - noted
  • SCABIES CRUSTOSA - hyperinfection in immunodeficient individuals
53
Q

Scabies - Diagnosis

A
  • History of several family members complaining of an itchy rash at the same time
  • Application of black ink from a fountain pen or moist felt-tipped pen to the skin over a suspected burrow; after a few minutes the surface ink is wiped off with an alcohol soaked pad and the ink remaining in the burrow will easily be visible thus confirming the diagnosis
54
Q

Scabies - Therapy

A
  • Simultaneous treatment of all family members
  • Ivermectin
  • 5% permethrin
  • Lindane (adverse: seizures)
  • 10% crotamiton
  • Thorough washing of clothing and bed linens in hot water following treatment
55
Q

Scabies - Prevention

A

Hot cycle and machine dry on hot cycle

56
Q

Pediculus humanus capitis

A
  • HEAD LOUSE
  • Physical contact or through the sharing of hats, combs and brushes
  • Itchy scalp
  • Cemented on the hair shaft at a slight angle of about 30 degrees
  • Permethrin (drug of choice)
  • Ivermectin, benzyl alcohol lotion, malathion (flammable), pyrethrins, spinosad (expensive)
  • Nits are difficult to dislodge, even after using fine toothed comb
57
Q

Pediculus humanus corpus

A
  • BODY LOUSE
  • VECTORS of louse-borne TYPHUS, trench fever, louse-bourne relapsing fever
  • Lice and their nits are more likely to be found in seams of garments rather than on body
  • 1% permethrin
  • 0.5% malathione
58
Q

Phthirus pubis

A
  • CRAB LOUSE
  • Sexual contact
  • “Moving freckles” - upon closer examination looks like little crabs
  • Can be found in pubic region, eyebrows, eyelashes and axillary hair
  • 1% permethrin
  • 0.5% malathion
  • Lindane (adverse: seizures)
  • Pyrethrins
59
Q

Tungiasis

A
  • JIGGER FLEA, CHIGOE FLEA, NIGUA
  • Originally native only to Central and South America, jigger flea infestation is now encountered as well in Africa and India
  • Soles of feet or around the toenails
  • Swelling reaches the size of a small pea - white papule with a central black dot
  • Natives are often quite expert at plucking out the distended mature female jigger intact so that rupture and subsequent severe secondary infection does not occur
  • Best way to treat is to carefully remove the flea with a scalpel as early as possible or with a sterile needle and treat the would with a local antibiotic or hydrogen peroxide to prevent secondary infection
  • Prevention may be accomplished by wearing shoes
60
Q

American trypanosomiasis - Epidemiology

A
  • Also known as CHAGAS disease
  • Only occurs in the New World
  • Transmitted by various species of TRIATOMID (reduvid) bugs, commonly called KISSING bugs
  • Bug bites man, defecates, and man rubs the bug feces containing the infective parasite into the bite - man is thus infected by contamination
  • Opportunistic infection in HIV/AIDS
  • Kissing bugs tend to live in thatch-roofed huts with adobe/plaster wall in areas of endemicity
  • Disease of poverty
61
Q

American trypanosomiasis - Clinical Manifestations

A
  • ROMANA’S SIGN - unilateral swelling of the eyelids
  • UNILATERAL periorbital edema and swelling of the face
  • CHAGOMA - SWOLLEN NODULE of skin at the site of inoculation
  • Intermittent fever
  • Enlargement of LIVER and SPLEEN
  • Serious heart complications, including rapid heart rate and various arrhythmias (RIGHT BUNDLE BRANCH BLOCK), enlargement of the heart (CONGESTIVE HEART FAILURE), and apical heart aneurysms
  • # 1 cause of sudden cardiac arrest in young athletes from certain parts of S. America
  • Most common cause of cardiomyopathy in South and Central America
  • Massive enlargement of the esophagus (MEGAESOPHAGUS)
  • Massive enlargement of the colon (MEGACOLON)
  • Patients with HIV infection or patients on chemotherapy who develop symptoms of Chagas disease (oven a reactivation of chronic disease) commonly develop severe MENINGOENCEPHALITIS
62
Q

American trypanosomiasis - Diagnosis

A
  • Parasites can be identified in FRESH BLOOD FILMS, in THICK and THIN blood films, and in the “BUFFY COAT” after centrifugation of heparinized blood
  • Need to distinguish from T. rangeli (non-pathogenic)
  • Culture on NNN MEDIA
  • Inoculation into white rats
  • Indirect immunofluorescent antibody (IFAT)
  • ELISA
  • PCR
  • XENO-DIAGNOSIS - allows unifected, lab-bred kissing bugs to feed on the patient and later examining the contents of the hind gut of the bug for the presence of the parasite
63
Q

American trypanosomiasis - Treatment

A
  • Nifurtimox

- Benznidazole

64
Q

American trypanosomiasis - Prevention

A
  • Avoid sleeping in thatch-roofed huts which have adobe/plaster walls
  • Pyrethoid-impregnanted bed netting
  • Insect repellant
65
Q

African trypanosomiasis - Epidemiology

A
  • Also known as AFRICAN SLEEPING SICKNESS
  • Only occurs on African continent
  • TSETSE FLY (Glossina species)
  • 2 types of sleeping sickness: GAMBIAN and RHODESIAN
  • GAMBIAN: wet tropical regions of west and central Africa with man serving as a “reservoir” host (man-fly-man)
  • RHODESIAN: drier, savannah regions of east and southern Africa as a “zoonosis” of game like bushbuck and cattle
  • GENERATE CONSECUTIVE WAVES OF PARASITEMIA BY CHANGING THEIR ANTIGENIC COAT AND ARE ABLE TO STAY IN THE BLOODSTREAM FOR MONTHS OR YEARS BY REGULARLY ACQUIRING NEW IDENTITIES, THEREBY AVOIDING RECOGNITION AND TOTAL ELIMINATION BY THE IMMUNE SYSTEM
66
Q

African trypanosomiasis - Clinical Manifestations

A
  • Bite reaction which resembles a boil (red, plainful, hard nodule) - TRYPANOSOMAL CHANCRE
  • TRYPANOSOMAL RASH
  • Intense headache and severe itching of the skin
  • KERANDEL SIGN - delayed sensation to pain
  • WINTERBOTTOM’S SIGN - POSTERIOR CERVICAL LYMPH NODE ENLARGEMENT - GAMBIAN, not Rhodesian
  • Early stage - insomnia
  • Headaches, personality changes and eventual madness, lethargy, body wasting and death
  • GAMBIAN - slow progression, 6 months - years
  • RHODESIAN - weeks-months; more rapid deterioration
67
Q

African trypanosomiasis - Diagnosis

A
  • Wet films and after Giemsa or Wright staining
  • Parasite may be found in blood or lymph from aspirated gland juice
  • Advanced stage - parasite found in CSF
  • EOSINOPHILIC PLASMA CELLS KNOWN AS MOTT CELLS IF FOUND IN CSF ARE PATHOGNOMONIC
  • XENO-DIAGNOSIS with tsetse fly
68
Q

African trypanosomiasis - Treatment

A
  • IV suramin (early stage)

- IV melarsoprol (CSF involvement)

69
Q

African trypanosomiasis - Prevention

A
  • Wear long sleeved shirt and long pants
  • Permethrin impregnanted mosquito nets
  • Vaccine development has been hindered by ANTIGENIC VARIATION
70
Q

Leishmaniasis

A
  • 3 types: cutaneous, mucocutaneous, visceral

- All transmitted by the bite of the SAND fly (PHLEBOTOMUS or LUTZOMYIA)

71
Q

Cutaneous Leischmaniasis

A
  • SLOWLY growing skin ulcers of the leg, arm or face
  • Tropical and sub-tropical zones
  • DRY LESION - old world
  • WET LESION - new world
  • New world (L. Mexicana) responsible for destructive ear lesions (chiclero ulcer)
  • Consider NON-HEALING ULCERS
  • DIAGNOSIS: scrapings of a needle aspiration under the margin of the ulcer (NOT FROM THE CENTER OF THE LESION) and culture on suitable media or by microscopic identification; SEROLOGICAL TEST; DNA probes
72
Q

Mucocutaneous Leischmaniasis

A
  • Often due to the L. braziliensis strain
  • Found in jungle regions of Central and South America (doesn’t occur in any part of the world)
  • Initial lesion which ulcerates, appears to be identical to cutaneous form and heals with scarring
  • Months or years later, ulcerative lesions appear on/in the nose or mouth
  • Subsequent destruction of the nose (TAPIR NOSE) and mouth can be horrendous
  • DIAGNOSIS: biopsy, culture, skin test, serological test
73
Q

Visceral Leischmaniasis

A
  • Also known as KALA-AZAR or BLACK FEVER
  • FEVER, chills and vomiting
  • SPLEEN and LIVER enlarge
  • SKIN develops GRAYISH color
  • Sores develop on the gums and in the mouth
  • Without treatment, usually fatal
  • LOWER THAN NORMAL WHITE CELL COUNT
  • DIAGNOSIS: blood smears of the bone marrow, spleen and from lymph gland juice; parasite may be isolate by culture from biopsy or aspirated material
74
Q

Leischmaniasis - Treatment

A
  • Injections of pentavalent antimonials (stibogluconate sodium or meglumine antimoniate)
  • Amphoterecin B (esp mucotaneous and visceral)
  • Paramomycin topical ointment (cutaneous
75
Q

Leischmaniasis - Prevention

A
  • Insect repellent

- Protective (permethrin treated) clothing

76
Q

Babesiosis - Epidemiology

A
  • Bite of TICKS
  • Blood transfusion
  • Severe SPLENECTOMIZED patients
  • Occurs worldwide
  • Human cases of B. microti are reported most frequently in North America, particularly in the coastal islands off of NEW ENGLAND and the state of WISCONSIN
  • In Europe, due to B. divergens
  • LYME DISEASE, BABESIA, AND HUMAN ANAPLASMOSIS OFTEN OCCUR AS CO-INFECTIONS AS THEY HAVE: 1. Same geographic distribution 2. Same tick vector 3. Same white-footed mouse vector
77
Q

Babesiosis - Life Cycle and Pathology

A
  • Humans usually become infected by the bite of nymphal lxodes TICKS carrying the infective organisms
  • Transmission via blood transfusion
  • Parasites INVADE RBCs where it multiplies asexually
  • HEMOGLOBINEMIA, HEMOGLOBINURIA, JAUNDICE, RENAL FAILURE
  • Asplenic individuals are especially at risk of having symptomatic infections
78
Q

Babesiosis - Clinical Manifestations

A
  • Malaria-like illness characterized by FEVER, CHILLS, HEADACHE, FATIGUE, MYALGIA, AND HEMOLYTIC ANEMIA
  • Moderate hemolytic anemia and HEPATOSPLENOMEGALY
  • Splenectomized patients have more severe form of hemolytic anemia
  • B. divergens ONLY OCCURS IN SPLENECTOMIZED PATIENTS
79
Q

Babesiosis - Diagnosis

A
  • Giemsa-stained THIN and THICK blood smears which reveal INTRAERYTHROCYTIC parasites (parasites in the RBC) under the microscope
  • Small ring forms of B. microti may be difficult to differentiate from the ring forms of MALARIA due to P. falciparum
  • Serological tests
  • PCR
80
Q

Babesiosis - Treatment

A
  • Clindamycin + quinine/atovaquone + azithromycin

- SPLENECTOMIZED PATIENTS: Exchange transfusion with antibiotics

81
Q

Babesiosis - Prevention

A
  • Prompt removal of ticks
  • Deet or Picardin
  • Permethrin treated clothing

PoD - E4 (5 decks)

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