Protozoa: Malarea, Babesia, Free-living Amoeba

Question 1

The 3 stages of naegleria are:

Answer 1

• Trophozoite.
  
  • Reproductive stage.
• Flagellates
• Cysts

Question 2

Naegleria causes:

Answer 2

Primary amebic meningoencephalitis (PAM)

Question 3

Naegleria enters CNS via:

Answer 3

Nasal inoculation by disruption of olfactory mucosa.

Penetrates cribriform plate and enters CNS.

Question 4

Naegleria s/s (8):

Answer 4

• Intense headache.
• Sore throat.
• Fever.
• Stiff neck.
• Kernig sign.
  Brain:
• Hemorrhage.
• Edema.
• Tissue necrosis.

Question 5

Naegleria diagnosis (4):

Answer 5

• Purulent CSF with erythrocytes and amebae.
• Motile trophozoites on CSF wet mount.
• Hemorrhagic CSF.
• CSF PCR.

Question 6

Naegleria treatment:

Answer 6

IV +/- intrathecal amphoteracin B.

Question 7

Balamuthia is caused by:

Answer 7

Balamuthia mandrillaris.

Question 8

Balamuthia is transferred by:

Answer 8

Inhalation of cysts or direct skin contact with open wound.

Question 9

Balamuthia causes:

Answer 9

Granulomatous amebic encephalitis.

Question 10

Balamuthia signs and symptoms (7):

Answer 10

• Dermatologic/nasal lesion.
• Fever.
• Headache.
• Nausea.
• Vomiting.
• Seizure.
• Edema of brain tissue.

Question 11

Acanthamoeba causes (2):

Answer 11

• Granulomatous Amebic Encephalitis (GAE).

- Acanthameoba Keratitis (AK).

Question 12

Acanthamoeba Keratitis (5):

Answer 12

• Corneal trauma with exposure to acanthamoeba.
• Contact lenses.
• Corneal ulceration and severe ocular pain.
• Sight threatening.
• Misdiagnosed as HSV.

Question 13

Acanthamoeba diagnosis (3):

Answer 13

• Brain biopsy (GAE).
• Neuroimaging.
  
  • Space occupying lesions.
• Corneal scrapings (AK).

Question 14

Babesiosis is caused by:

Answer 14

Babesia macroti.

Question 15

Babesiosis vector:

Answer 15

Ixodes tick.

Question 16

Babesiosis host:

Answer 16

Deer, Cattle and rodents.

Question 17

Babesiosis s/s (4):

Answer 17

• Flu-like symptoms.
• Hemolytic anemia.
  
  • Renal failure.
  • Hepatomegaly, splenomegaly.

Question 18

Babesiosis diagnosis:

Answer 18

Blood smear.

Question 19

Babesiosis treatment (3):

Answer 19

• Asymptomatic = no treatment.
• Atovaquone + azithromycin.
  Severe illness:
• Clindamycin + quinine.

Question 20

Malaria hosts (2):

Answer 20

• Human

- Female anopheles mosquito

Question 21

Malaria is caused by (4):

Answer 21

• P. falciparum
• P. vivax
• P. ovale
• P. malariae

Question 22

Malaria hypnozoite:

Answer 22

Dormant in liver in P. vivax and P. ovale. Weeks to months after infection.

Question 23

Cerebral Malaria is caused by:

Answer 23

P. falciparum

Question 24

Cerebral Malaria s/s (7):

Answer 24

• Prostration
• Impaired consciousness
• Respiratory distress
• Convulsions
• Jaundice
• Pulmonary edema
• Hypotension

Question 25

Malaria diagnosis (3):

Answer 25

• Thick/thin smears.
• Rapid diagnostic antigen tests.
• Molecular PCR.

Question 26

Malaria treatment (4):

Answer 26

• Chloroquine (if not resistant).
• Atovaquone/proguanil
• Artemether-lumefanteine (LA)
  
  • IV for cerebral malaria
• Mefloquine

Question 27

Malaria prophylaxis (4):

Answer 27

• Malarone
• Mefloquine
• Doxycycline
• Primaquine

Question 28

Malaria protective factors (3):

Answer 28

• Sickle cell trait.
• Duffy-negative blood type.
• Immunity.