Protazoal and Helminth Diseases Flashcards by Elizabeth Neuhardt

where is malaria an endemic (6)

(mostly tropical places)
South and Central America
Africa
Middle East
Indian subcontinents
Oceania

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In which place is the mortality and morbidity the greatest?

Africa

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What are the four Plasmodium species that cause malaria?

P. falciprum
P. vivax
P. ovale
P. malariae

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which species causes nearly all the severe cases of malaria in Africa?

P. falciprum

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how is malaria transmitted?

bite from infected female anopheline mosquito

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Deaths caused by P. falciprum in the US are typically d/t:

not taking prophylaxis correctly or at all (incorrect drug or regimen)

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What are the clinical findings of Malaria? (non-severe dz) (4)

(shaking chills
fever
diaphoresis) -every other day
splenohepatomegaly

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What are the clinical findings of malaria (in severe dz) (4)

bleeding
mental disturbances
Acute tubular necrosis (black water fever)
hemolytic anemia

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What is the prophylatic tx for malaria?

Chloroquine prophylaxis 1 dose q week starting 1-2 weeks prior to entering endemic area and 4 weeks after departure
-If going to chloroquine resistant area – Atovaquone w/ progquanil 1 qd beginning day before entering endemic area and daily for one week after departure

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tx for falciparum Malaria

Artemether and Lumefantrine

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what is the definative host for toxoplasmosis

kitties

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where are the toxoplasmosis oocysts found?

cat feces

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how do humans get infected with toxoplasmosis

ingestion of raw or under cooked meat
contaminated food or water
careless handling of cat litter
transplacental transmittal

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what are the four different syndromes of toxoplasmosis

primary infection in ImmunoComp host
congenital infection
retinochoroiditis
reactivated dz in the immunocomp pt

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how does a primary infection of toxoplasmosis present in the immunocomp pt (7)

-acute, mild multi-system illness (mono-like)
-lymphadenopathy of the head and neck** (MC finding)
-malaise
myalgia
headache
sore throat
maculopapular rash

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Three fun facts about congenital toxoplasmosis infection

more severe when in 1st trimester**
if contracted in 3rd Tri may be born with subclinical dz
85% will develop overt dz later

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What is chorioretinitis and when does it happen?

develops weeks to years after congenital toxoplasmosis infection
necrotic retinal lesions

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what is the clinical presentation of chorioretinitis? (1 sign, 4 sx)

yellow/white patches w/ blurred margins on retina

- visual defects: scotoma, central defects, pain and photophobia

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What are the MC sites for reactive dz of toxoplasmosis in the immunocomp pt?

brain
lungs
eyes

lab tests for toxoplasmosis

serologic and histopathologic

DOC for toxoplasmosis

pyrimethamin + sulfadiazine for 3-4 weeks (may casue BM supression) (bactrim)

when treating a patient for toxoplasmosis w/ pyrimethamin + sulfadiazine what lab values are important to follow?

make sure pt has good urine output

* platelet and WBC counts twice weekly (BM suppression)

what the most common nematode infection in the US

Enterobius vermicularis (pin worms!!) ~~~~~~

what is the cycle of a pin worm? (where do adults live/eggs etc.)

the adult pin worms live in the cecum, females migrate tot he anus to lay eggs on the perianal skin. Cycle continues when eggs are transmitted to the mouth

clinical findings of pin worm infestation

asymptomatic | perianal itching- particularly in the PM

Lab finding for pin worms

scotch tape test- collect eggs for microscopic ID | - do 3 successive tests before you call it negative (only need one positive, no need to repeat)

Tx for pin worms

Albendazole | 1 round of tx, repeat in 2 weeks

What are the hosts for hookworms?

humans, dogs and cats

where is hookworm most prevalent?

moist tropical/sub tropical areas

what is the path of migration of hookworms in the body?

worms enter the skin, usually through foot, migrate to lungs.; cilliary action moves them to the oropharynx where they are swallowed

how long does it take hookworms to mature and where do they suck your blood?

4-6 weeks, at site of attachment (usu upper small bowel)

clinical findings of hookworms (8)

``` pruitits at site of infection dry cough wheezing blood tinged sputum low grade fever vague abd cramps anorexia nausea ```

Tx for hookworms

``` Fe supplementation Albendazole (1 dose) pyrantel pamoate (1 dose) ```

What is Entamoeba histolytica and what is it's only host

parasite | humans

how do you contract Entamoeba histolytica?

contaminated food or water (usu in overcrowded areas w/ poor sanitation and nutrition)

clinical findings of Entamoeba histolytica (amebiasis) (3 types w/ sx)

- mild to mod: colitis w/ cramps, usu blood in stool - severe colitis: liquid, bloody, mucus stools, fever, colic, prostration, ileus perf/ hemorrhage may occur - hepatic amebiasis: fever, hepatomegaly, pain and localized tenderness

lab findings of amebiasis

amebas in stool antigens in stool + serologic tests US or CT showing hepatic abcess

tx for an asymptomatic carrier of amebiasis (3)

luminal agents: diloxanide furate (10days) lodoquinol (21 days) paramomycin (7 days)

Tx for mild and severe intestinal Amebiasis (2)

metronidazole (10 days) | Tinidizole + luminal agent

what is the causative organism for Giardiasis?

Giardia lamblia (it's a flagellate!)~~~~

what are 4 fun facts about Giardiasis?

- humans are only reservoirs - only cyst form is inactive - infectious dose is low** - incubation period is 1-3 weeks**

what is the incubation period of Giardiasis?

1-3 weeks

clinical findings of Giardiasis (4 different states/syndromes)

- carriers may be asymptomatic - acute diarrhea - chronic diarrhea - malabsorption

lab tests of Giardiasis (4)

- stool sample for ova and parasites - duodenal string test - endoscopy - CBC (it's normal)

Tx for Giardiasis

Tinidazole (2 g single dose, has a 90-100% cure rate) Metronidazole (flagyl) 250mg TID X 5-7 days (**neither can be taken w/ alcohol)