platyheminth flatworm cases Flashcards
Patient presents after a trip to South Korea. He says he experienced what felt like the stomach flu with a fever while in Korea, having eaten primarily fish with his host family. Now, several weeks later, he is losing weight and his liver is enlarged. What parasite should you be worried about, how do you test it, and what is the long term danger if this bug?
Chinese liver fluke: clonorchis sinensis
Mostly found in Korea, the acute phase causes fever, abdominal pain, a tender liver and eosinophilia. The Chronic phase results in weight loss, hepatomegaly, and may lead to CholangioCarcinoma– cancer of the bile duct.
Check feces for eggs.
“the only shisto. infection endemic to the Americas”
S. Mansoni
A patient presents in the united states with flu like symptoms as well as lymphadenopathy, hepatosplenolomegaly. She was on a canoe trip with friends two months ago, frequently swimming in fresh water. What could be causing her symptoms, and how do you test for it?
S. Mansoni: Katayama fever
This Shisto. bug is the only one endemic to the Americas. It travels from fresh water through the skin to the intestine and bile ducts, causing major inflammation wherever the eggs are laid. Unlike its Asian cousin, Mansoni is considered to be less pathogenic but can still inflame the spinal cord (transverse myelitis) and chronically cause liver granulomas/ portal HTN.
Test by doing a Rectal Biopsy for eggs
A foreign exchange student from southeast asia presents to your clinic with fatigue, bloody diarrhea, hepatomegaly, and possible esophageal varices. He says he has had ongoing issues like this for months, but that they are getting worse and more frequent. What possible bugs are responsible?
S. Mekongi/ Japanicum: Katayama fever
These forms of Shisto are endemic to southeast asia (Mekongi) and the Phillipines/china (Japanicum). After an acute phase which mimics the flu, the body reacts to the eggs in the liver by forming granulomas and causing serious portal HTN. These bugs can also cause right sided heart failure, and enflame the brain.
Test with a rectal biopsy for eggs
A female HIV patient in sub-Saharan Africa presents with dysuria and haematuria. She admits that she has also had pelvic pain recently. A urine culture shows no sign of bacterial infection. What bug should you be worried about, and what are the risks for this unique patient?
S. Haematobium : genitourinary shisto.
Haema. causes fibrosis in the urinary tract, bladder, and can travel to the kidneys. In female patients, it can also infect the vagina and cervix. This is of particular import because this bug is endemic to Africa, and women who have cervical infection may spread HIV much easier due to inflammation and bleeding. It can also cause bladder cancer.
Requires a microscopic urinalysis, and pelvic exam required
A woman visits your clinic in northern Michigan feeling weak and tired. Blood tests reveal she is anemic and lacking B12. After weeks of treatment with iron and b12 supplements, she’s still not better. Now, she feels a “vague” abdominal pain, like something is moving. What type of parasite could be causing this issue?
Adult freshwater fish Tapeworm: Diphylobothrium Latum
Commonly found in great lakes region, Alaska, Scandinavia- anywhere with fresh water fish. Adult tapeworms tend to be asymptomatic in patients, but this type harvests B12 and causes anemia.
Patient presents in New Mexico with sudden onset seizures. CT/MRI show unusual cysts and surrounding inflammation in his brain. What bug could be the cause, and what did he eat?
Pork Tapeworm: T. Soleus
Common in latin America/ Mexico and bordering US states, usually asymptomatic unless bug forms cysts in brain. When these cysts die, inflammation occurs and may cause seizures. Pork tapeworm.
A dog handler in the western united states has a cough that has lasted several weeks, and an enlarged liver. On a chest xray, you see a golf ball sized mass in his lung, but an ultrasound shows another on his liver. If this is not cancer, what kind of parasite causes it?
Echinococcosis : dog tapeworm
These bugs normally live in dogs but can be accidentally ingested by humans. They tend to travel to the liver and lungs where they form large cysts, they are usually otherwise asymptomatic. It’s usually an accidental finding on autopsy.
