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PARASITOLOGY > PREFI THE FILARIAE > Flashcards

PREFI THE FILARIAE Flashcards

1
Q

blood feeding arthropod vector-borne nematodes

A

FILARIAE

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2
Q

LYMPHATIC FILARIAE:

A
  1. Wuchereria bancrofti
  2. Brugia malayi
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3
Q

SUBCUTANEOUS FILARIAE:

A
  1. Loa loa
  2. Onchocerca volvulus
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4
Q

Filariae that causes infection in the
abdomen

A

SEROUS CAVITY

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5
Q

Considered one of the most delabilating
diseases that is known in the man

A

LYMPHATIC FILARIAE

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6
Q

 “BANCROFT’S FILARIAL WORM”
 Causative agent of BANCROFTIAN
FILARIASIS

A

Wuchereria bancrofti

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7
Q

INFECTIVE STAGE OF Wuchereria bancrofti

A

L3 larvae

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8
Q

DIAGNOSTIC STAGE OF Wuchereria bancrofti

A

SHEATHED microfilariae

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9
Q

MOT OF Wuchereria bancrofti

A

vector-borne by a mosquito bite

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10
Q

W. bancrofti DH (DEFINITIVE HOST)

A

HUMAN

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11
Q

W. bancrofti IH (INTERMEDIATE HOST)

A

genus CULEX, Aedes, and Anopheles

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12
Q

B. malayi IH

A

genus Aedes, Anopheles, MANSONIA

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13
Q

Motility: minute snake-like constantly
moving among the RBCs
* Development: 3-9 months

A

MICROFILARIAE

Both W. bancrofti and B. malayi are SHEATHED

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14
Q

W. bancrofti or B. malayi MICROFILARIAE

Mean length (um): 270-290 um
Cephalic space: breadth - 1:1
Tail: Single row of nuclei that DOES NOT REACH the tail’s end
TERMINAL NUCLEI: NONE
Sheath in Giemsa: unstained
- Blunt and round anterior end
Appearance in blood film: Smoothly curved
- Nuclei: conspicuous (dark staining nuclei); REGULARLY SPACED, separately situated
Innenkorper length (um): 34

A

W. bancrofti MICROFILARIAE

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15
Q

W. bancrofti or B. malayi MICROFILARIAE

Mean length (um): 111-222 um
Cephalic space: breadth - 2:1
Tail: Single row of nuclei that REACH the tail’s end
TERMINAL NUCLEI: 2 NUCLEI, which bulge the cuticle, conspicuously placed
Sheath in Giemsa: pink
- Rounded anterior end
Appearance in blood film: Kinky
- Nuclei: indistinct and confluent; IRREGULARLY SPACED, and overlapping
Innenkorper length (um): 30.7

A

B. malayi MICROFILARIAE

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16
Q

 White and threadlike in appearance
 Shape: filiform
 MALE: 20-40 mm in length
 FEMALE: 80-100 mm

A

ADULT WORMS

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17
Q

W. bancrofti PERIODICITY
- can see in peripheral blood during NIGHTTIME

A

NOCTURNAL PERIODICITY

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18
Q

 “MALAYAN FILARIAL WORM”
 Causes MALAYAN FILARIASIS

A

Brugia malayi

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19
Q

DEFINITIVE HOSTS OF Brugia malayi

A

HUMANS

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20
Q

PERIODICITY of Brugia malayi:
(microfilaria present in blood at all time
and the max. level is during afternoon)

A

NOCTURNAL and SUBPERIODIC

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21
Q

Pathogenesis
- lymph nodes of the LOWER extremities

A

W. bancroft

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22
Q

Pathogenesis
- lymph nodes of the UPPER extremities

A

B. malayi

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23
Q

Pathogenesis
- millions of vigorously motile microfilariae in the peripheral blood show no obvious signs
o “endemic normals

a. Asymptomatic microfilaremia
b. Acute dermatolymphangioadenitis
c. Acute filarial lymphangitis
d. Lymphedema and elephantiasis

A

a. Asymptomatic microfilaremia

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24
Q

Pathogenesis
- localized pain, lymphadenitis and/or
lymphangitis and/or cellulitis and local warmth
o Most common acute manifestation

a. Asymptomatic microfilaremia
b. Acute dermatolymphangioadenitis
c. Acute filarial lymphangitis
d. Lymphedema and elephantiasis

A

b. Acute dermatolymphangioadenitis

25
Q

Pathogenesis
- lymphangitis progressing distally along
the lymphatic vessel = palpable “cord”
o Caused by spontaneous death of adult worms
o Symptoms: self-limiting

a. Asymptomatic microfilaremia
b. Acute dermatolymphangioadenitis
c. Acute filarial lymphangitis
d. Lymphedema and elephantiasis

A

c. Acute filarial lymphangitis

26
Q

Pathogenesis
- most common chronic manifestation
o Stage 1: SWELLING INCREASES during the day but is REVERSIBLE once patient lies flat in bed
o Stage 2: SWELLING IS NOT REVERSIBLE overnight but experiences acute attacks
o Stage 3: presence of SHALLOW SKIN FOLDS; legs “open up”
o Stage 4: KNOBS ARE PRESENT in the
affected area
o Stage 5: DEEP SKIN FOLDS
o Stage 6: presence of MOSSY LESIONS
that leak translucent fluid
o Stage 7: patient is PROSTATE

a. Asymptomatic microfilaremia
b. Acute dermatolymphangioadenitis
c. Acute filarial lymphangitis
d. Lymphedema and elephantiasis

A

d. Lymphedema and elephantiasis

27
Q

production of hydrocele or chylocele
o Chylocele: accumulation of milky
hydrocele fluid in the closed sac of the
testis due to the presence of lymph
o Hydrocele: common chronic
manifestation of Bancroftian filariasis

A

Genito-urinary lesions

28
Q

classic example of occult filariasis
o Hypereosinophilia: 3,000-5,000 cells per mm3 of blood
o Elevated erythrocyte sedimentation
rate
o Extremely high titers of filarial
antibody (IgE)

A

Tropical pulmonary eosinophilia

29
Q

CLINICAL MANIFESTATION OF LYMPHATIC FILARIAE
* One of the most debilitating diseases
* Second leading cause of permanent and long-term disability
* Acquired from childhood
* Expatriate Syndrome: infection of people from outside regions after migration to the endemic area
o Symptoms: hives, rashes, and blood eosinophilia

A

Lymphatic filariasis

30
Q

CLINICAL MANIFESTATION OF LYMPHATIC FILARIAE
 Most common chronic manifestation of LF
 Most common affected: LOWER LIMBS
(but upper limb and male genitalia can be affected also)
 Progression to ELEPHANTIASIS
 Formation of HYDROCELE (CHYLOCELE) – obstructions of the lymphatic in the tunica vaginalis

A

LYMPHEDEMA

31
Q

CARDINAL SIGNS OF Lymphatic filariasis
- lymph dilatation due to the tight coiling of adult worms in nodular dilated nests in lymph vessels and sinuses of lymph glands
▪ Common feature of patent
infection

A. Lymphangiectasia
B. Lymphangiogenesis
C. Chronic LF infection

A

A. Lymphangiectasia

32
Q

CARDINAL SIGNS OF Lymphatic filariasis
- live filarial parasites or antigens induce
lymphatic endothelial cell proliferation and differentiation = collaterization
▪ Results to secondary bacterial infections and trigger inflammatory reactions in the skin and subcutaneous tissue
▪ Leads to lymphedema and elephantiasis

A. Lymphangiectasia
B. Lymphangiogenesis
C. Chronic LF infection

A

B. Lymphangiogenesis

33
Q

CARDINAL SIGNS OF Lymphatic filariasis
- fibrosis and cellular hyperplasia in and around the lymphatic walls
o Dead and calcifying adult worms = lymphangitis and lymphadenitis with localized pain and swelling

A. Lymphangiectasia
B. Lymphangiogenesis
C. Chronic LF infection

A

C. Chronic LF infection

34
Q

DIAGNOSIS OF LYMPHATIC FILARIAE

A

Microscopy using Giemsa-stained (wet) thick blood films
o W. bancrofti: nocturnal
o B. malayi: nocturnal & subperiodic
* Knott’s technique: for low intensity infections
* Immunochromatographic card test: detect circulating filarial antigens
* Xenomonitoring

35
Q

specimen collection for Microscopy of lymphatic filariae

A

between 8 pm to 4 am

36
Q

Treatment for W. bancrofti:

A
  • diethylcarbamazine
  • ivermectin with albendazole
37
Q

Treatment for B. malayi:

A
  • diethylcarbamazine
38
Q

Subcutaneous Filariae
“African eye worm”

39
Q

Subcutaneous Filariae
“blinding filaria”

A

Onchocerca volvulus

40
Q

Subcutaneous Filariae Infective Stage:

41
Q

Subcutaneous Filariae Diagnostic Stage

A

MICROFILARIAE

42
Q

Subcutaneous Filariae MOT

A

vector-borne by a fly bite

43
Q

L. loa IH:

A

deerflies under genus Chrysops (DAY BITING FLY)

44
Q

O. volvulus IH:

A

blackflies under genus Simulium

45
Q

L. loa PERIODICITY
- (they can be found during the
day)

46
Q

MICROFILARIAE
- 248-300 um
- Has continuous row of nuclei EXTENDING TO THE TIP of the tail
- Pointed tail
- Sheathed
Circulation: peripheral blood

L. loa OR O. volvulus?

A

L. loa MICROFILARIAE

47
Q

MICROFILARIAE
- 150-355 um
- Nuclei DOES NOT EXTEND to the tip of the tail
- Somewhat pointed tail
- Unsheathed
Circulation:
subcutaneous tissue
L. loa OR O. volvulus?

A

O. volvulus MICROFILARIAE

48
Q

L. loa OR O. volvulus ADULT WORMS?
- White cylindrical threadlike
 MALE: 28-35 mm
 FEMALE: 38-72 mm

A

L. loa ADULT WORMS

49
Q

L. loa OR O. volvulus ADULT WORMS?
- Thin and wirelike
- Coil up in knots inside skin nodules
 MALE: 25-50 mm
 FEMALE: up to 500 mm

A

O. volvulus ADULT WORMS

50
Q

CM OF L.loa
* Initial bite = pruritus and localized pain
followed by Calabar swellings

51
Q

Loiasis most common form of manifestation?

A
  • CALABAR SWELLINGS
  • EYE WORM
52
Q

: localized, nontender swellings on the arms and legs near the joint
▪ Occur anywhere on the body due
to the migration and death of the
microfilariae

A

CALABAR/FUGITIVE SWELLINGS

53
Q

In loiasis adult worms may migrate into?

A

o CONJUNCTIVA
o UNDER THE SKIN
o BRIDGE OF THE NOSE

54
Q

DIAGNOSIS OF L.loa?

A

BLOOD
- MICROFILARIAE IN GIEMSA STAINED IN
BLOOD (10:15 AM – 2:15 PM)
 Extraction of adult worms on body
locations
 Serologic testing

55
Q

TREATMENT FOR L.loa

A

 DEC (DIETHYLCARBAMAZINE)
 SURGICAL REMOVAL/EXTRACTION

56
Q

PERIODICITY of O. volvulus:
(microfilaria circulate in the blood throughout 24 hour period)

A

NONPERIODIC

57
Q
  • Infection usually results in a chronic and non-fatal condition
  • Development of infected nodules causes localized symptoms
  • RIVER BLINDNESS: Development of lesions in the eye
  • Symptoms: loss of elasticity, location of nodules on the body, where the patient contracted the parasite (Eastern or Western Hemisphere)
A

Onchocerciasis

58
Q

DIAGNOSIS OF O. volvulus:

A

 SKIN SNIPS
- MICROFILARIAE IN GIEMSA STAINED
TISSUE
- Tissue biopsy in the infected area –
SPECIMEN OF CHOICE
- Obtained with little blood (to avoid
contamination sample)
 Extraction of adult worms on infected
nodules
 OPHTHALMOLOGIC EXAM
- Uses SLIT LAMP
 PCR AND SEROLOGIC METHODS

59
Q

TREATMENT FOR O. volvulus:

A

 IVERMECTIN
 THERAPY CAN BE LONG BECAUSE OF THE ADULT WORM LIFESPAN (15 YEARS

PARASITOLOGY (23 decks)

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