Protozoa Flashcards
Giardia
trophozoite or cysts in stool
metronidazole
entamoeba histolytica
amebiasis: bloody diarrhea, liver abscess (anchovy paste exudate). RUQ pain.
Flask shaped ulcer if submucosal abscess of colon ruptures.
Cysts in water
Serology: trophozoite (with RBCs in the cytoplasm) or cysts (with multiple nuclei) in stool
Metronidazole .
Lodoquinol for asympatomatic cyst passers
Cryptosporidium, not same as cryptococcus
Severe diarrhea in AIDS, mild disease (watery diarrhea) in normal.
Cyst in water.
Cyst on acid fast stain
Prevention (by filtering water supplies), nitrazoxanide in immuno compromised.
“Crypto is not bad, so ni-trazo-xanide”
Toxoplasma gondii
Brain abscess in HIV, congenital toxoplasmosis,
Classic triad of chorioeretinitis, hydrocephalus, and intracranial calcification.
Cysts in meat or cat feces, process placenta
Treat with pyrimethamine + sulfadiazine
“PS, treat your toxo”
Naegleria fowleri
Rapidly fatal
Swimming in freshwater lakes, enters via cribriform plate
Amoebas in spinal fluid
Amphotericin has been effective for few survivors
Trypanosoma brucei
T. gambiense
T rhodesiense
African sleeping sickness
Enlarged LN, recurring fever (due to antigenic variation), somnolence, coma
Tsetse fly, a painful bite
Blood spear
Suramin for blood-borne disease or
Melarsoprol for CNA penetration
“it sure is nice is go to sleep; melatonin helps with sleep”
Plasmodium
Malaria: fever, headache, anemia, and splenomegaly, transmitted by mosquito, dx by blood smear shoing trophzoite ring from, RBC schizont with merezoites.
P vivax/ovale: 48 hrs cycle, fever on 1st day, and 3rd day, 48 hrs apart. Dormant form (hypnozoite) in the liver
P falciparum: severe: irregular fever pattern, parasitized RBC occludes capillaries in the brain (cerebral malaria), kidneys, lungs
P palariae: 72 hr cycle (quartan)
Treatment: begin with
Chloroquinie (blocks plasmodium heme polymerase)
If resistant, mefloquinoe
If lift threatening, use IV quinidine (test for G6PD)
For vivax/ovale, add primaquine for hypnozoites (also test for G6PD)
Babesia
Babesiosis: fever with hemolytic anemia, prodominantly in northeastern US, asplenia increased risk of severe disease
Ixodes tick: same as borrelia burdorferi of Lyme, may often coinfect humans
Blood smear, ring forms, Maltese cross
Treat with atovaquone + azithromycin.
“treat B with two As”
Trypanosoma cruzi
Chaga’s; dilated card, megacolon, megaesophagus, predominantly in south aferica
Reduviid bud: kissing bug, a painless bite much like a kiss
Treat with nifurtimox
“Chaga is such a NI-FUCK”
Leshmania donovani
Visceral leishmanias: spiking fevers, hepatosplenomegaly, pancytonia
Sandfly
Marophages containing amastigotes
Treat with sodium stibogluconate
“Treat Leishman (ERIC) whos got everything low (pancytopenia) stuck in MP(contains amastigotes) from drinking (HSM) with STIBO(Steve-O)”
Trichomonas vaginalis
Foul smelling, greenish discharg, itching and burning
Trophozoites motile on wet mount
Metronidazole for patient and partner prophylaxis.
