Protozoa--CNS infections

Question 1

Toxoplasma gondii–disease

Answer 1

• congenital toxoplasmosis
  
  • classic triad of chorioretinitis, hydrocephalus, intracranial calcifications
• reactivation in AIDS –> brain abscess seen in ring enhancing lesions on MRI

Question 2

Toxoplasma gondii–transmission

Answer 2

• cysts in meat–most common
• oocysts in cat feces
• crosses placenta–pregnant women should avoid cats

Question 3

Toxoplasma gondii–diagnosis

Answer 3

• serology
• biopsy (tachyzoite)

Question 4

Toxoplasma gondii–treatment

Answer 4

• sulfadiazine + pyrimethamine

Question 5

Naegleria fowleri–disease

Answer 5

• rapidly fatal meningoencephalitis

Question 6

Naegleria fowleri–tranmission

Answer 6

• swimming in freshwater lakes
  
  • “think Nalgene bottle filled with fresh water contain Naegleria”
• enter vira cribriform plate

Question 7

Naegleria fowleri–diagnosis

Answer 7

• amoebas in spinal fluid

Question 8

Naegleria fowleri–treatment

Answer 8

• amphotericin B has been effective for a few survivors

Question 9

Trypanosoma brucei–disease

Answer 9

• African Sleeping Sickness
  
  • enlarged lymph nodes
  • recurring fever (due to antigenic variation)
  • somnolence
  • coma
• 2 subspecies:
  
  • Trypanosoma brucei rhodesiense
  • Trypanosoma bruci gambiense

Question 10

Trypanosoma brucei–transmission

Answer 10

• Tsetse fly–a painful bite

Question 11

Trypanosoma brucei–diagnosis

Answer 11

• Trypomastigote in blood smear

Question 12

Trypanosoma brucei–treatment

Answer 12

• Suramin for blood borne disease
• Melarsoprol for CNS penetration
  
  • “it sure is nice to go to sleep, melatonin helps with sleep”