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Tropical Diseases (part 2 - 12/09) > Soil-transmitted Helminths > Flashcards

Soil-transmitted Helminths Flashcards

1
Q

Pathogenic Agent:

Pinworm

A

Enterobius Vermicularis

  • Small threadlike white worms
  • Females migrate at NIGHT to lay eggs
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2
Q

Population most affected by pinworms?

A
  • Children under 18

- Those taking care of them

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3
Q

Person to person:

Pinworm

A

Yes.
Person-to-person

(Hands, toys, bedding)

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4
Q

Transmission Mechanism:

Pinworm

A
  1. Eggs ingested
  2. Larvae hatch in intestines and migrate to colon to mature
  3. Adults pooped out and lay eggs on perianus
  4. Anus is scratched
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5
Q

Clinical Finding:

Pinworms

A

Perianal itching

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6
Q

Diagnosis:

Pinworms

A

Scotch tape swab (3 mornings after they wake before washing)

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7
Q

Treatment (Drugs):

Pinworms

A
  • Mebendazole/Albendazole
  • Pyrantel
  • Ivermectin
  • Levamisole
  • Piperazine
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8
Q

What is the most common worm in the United States?

A

Pinworms

Common intestinal infection of the cecum - large intestine

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9
Q

Pathogenic Agent:

Ascaris

A

Ascaris limbricoides

  • Long white yellow worms
  • Liv in jejunum or ileum (small intestine not colon)
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10
Q

Where does ascaris live in the body?

A

Jejunum or ileum (small intestine)

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11
Q

Distribution:

Ascaris

A

Tropics, part of Europe, warm, humid areas in warmer months

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12
Q

Person-to-person:

Ascaris

A

No direct person-to-person transmission

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13
Q

Clinical Findings:

Ascaris

A
  • Asymptomatic but mild abdonimal discomfort
  • Children with heavy burden are obstructed and can’t digest protein

(Spaghetti noodles)

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14
Q

Ascaris in children leads to malabsorption of what?

A
  • Fat, lactose, vitamin A

Due to impaired digestion of protein

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15
Q

What is the most common worm infection in the world?

A

Ascaris (most asymptomatic)

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16
Q

Pathogenic Agent:

Whipworm

A

Trichuris trichiura

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17
Q

Distribution (general):

Whipworms

A
  • Areas where human feces used as fertilizer
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18
Q

Person-to-person:

Whipworms

A

No person-to-person transmission

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19
Q

Clinical Findings:

Whipeworm

A
  • Asymptomatic

- Intestinal - diarrhea, nutritional deficiencies, rectal prolapse, painful stools?

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20
Q

Rectal prolapse is seen with which worm?

A
  • Whipworm
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21
Q

Diagnosis:

Whipworm

A
  • Eggs in stool

- Adult worms on prolapsed rectum or colonoscopy

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22
Q

Clubbing of nails from anemia is common with which worm?

A

Whipworm

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23
Q

Treatment (drugs):

Whipworm

A

Albendazole

Ivermectin

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24
Q

Pathogenic Agent:

Hookworm

A
  • Necator Americanus
  • Ancylostoma duodenale
  • Small white worms that live in intestines for 5 years and lay 7000 eggs daily ( caan drain 0.03ml of blood a day per worm so high burden means a lot of blood loss)
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25
Q

Transmission Mechanism:

Hookworm

A
  1. Eggs pooped in stool to soil and larvae hatch
  2. Larvae penetrate skin in contact with soil
  3. Circulate to lungs
  4. Penetrate alveolar wall and climb trachea
  5. Swallowed to intestines
26
Q

Clinical Findings:

Hookworms

A
  • Asymptomatic
  • “Ground itch”
  • Loeffler syndrome - cough after the hookworms reach the lungs
  • Yellow disease
27
Q

“Ground itch” is associated with which worm?

A

Hookworm

28
Q

Loeffler syndrome? What is it and it’s association?

A

Cough. Associated with hookworms reaching the lungs

29
Q

Diagnosis:

Hookworms

A

Stool examination

30
Q

Treatment (drugs):

Hookworms

A
  • Albendazole
  • Levamisole
  • Pyrantel
31
Q

Prevention:

Hookworms

A

Walking with shoes

32
Q

What worm is the major cause of iron deficiency?

A

Hookworms

33
Q

Pathogenic Agent:

Strongyloides

A

S. stercoralis

Rhabditiform larvae

34
Q

Distribution:

Strongyloides

A

Tropical and subtropical regions

- Kentucky most common parasitic infection

35
Q

Most common parasitic infection in Kentucky?

A

Strongyloides

36
Q

Transmission (general):

Strongyloides

A

Direct cutaneous or musosal penetration

37
Q

Can strongyloides be passed in breastfeeding?

A

Yes

38
Q

Clinical Findings:

Strongyloides

A

Immunocompetent person - Asymptomatic

Immunocompromised perosn - severe disease

Organs: GI tract, lung, skin, pulmonary

Bacteremia or gram negative sepsis (after they invade blood stream

39
Q

Diagnosis:

Strongyloides

A

Detection of rhabditiform larvae in stool

Detection of filariform larvae in stool or sputum

Sputum stronger evidence for hyper infection

Small bowel biopsy less useful

Molecular methods like ELISA (IgG) does not distinguish old vs new infection

40
Q

True or False

Molecular methods like ELISA (IgG) does not distinguis old vs new infection

A

True

41
Q

Treatment (drug):

Strongyloides

A
  • Ivermectin (drug of choice)
  • Thiabendazole (high failure)
  • Albendazole (poor absorption)
42
Q

Prevention:

Strongyloides

A

Hygiene

Shoes

43
Q

Duration of infection with strongyloides

A

Lifetime

44
Q

Pathogenic Agent:

Neurocysticercosis/Tapeworms

A

Taenia solium (

45
Q

Vector:

Neurocysticercosis/Tapeworms

A

Infected pork

Humans obligate host

46
Q

Distribution (general):

Neurocysticercosis/Tapeworms

A

Areas where pigs are raised close to humans

Eastern Europe, Latin America, India, Sub-saharan Africa

47
Q

Clinical Findings:

Neurocysticercosis/Tapeworms

A
  • Few symptoms but two options

Parenchymal (brain)
Extraparenchymal (outside of brain)

48
Q

Clinical Findings:

Parenchymal Neurocysticercosis/Tapeworms

A
  • Seizure and headache
  • Cysticeral encephalitis
  • Favorable prognosiss
  • When inactive we see Ca+ spots in image
49
Q

Clinical Findings:

Extraparenchymal Neurocysticercosis/Tapeworms

A
  • Ventricles and CSF and can cause increased cranial pressure, heart attacks, dizziness, visual changes
  • Ventricular - needs MRI
  • Active subarachnoid space - similar to active parenchymal
  • Spinal - radicular parasthesia
50
Q

Which is worse parenchymal or extraparenchymal Neurocysticercosis/Tapeworms

A

Extraparenchymal - more fatal

51
Q

Diagnosis:

Parenchymal Neurocysticercosis/Tapeworms

A
  • Neuroimaging is the definitive test

- Serodiagnostics is poor because it crosses reactions with other parasites

52
Q

Treatments (drugs):

Parenchymal Neurocysticercosis/Tapeworms

A
  • Antiepileptics
  • Praziquantel - treatment of choice
  • Albendazole
  • Niclosamide
  • Ventricular - open craniotomy or endoscopic surgery
  • Subarachnoid - no treatment
  • Spinal - surgery
  • Ocular - surgical resection
53
Q

Prevention:

Parenchymal Neurocysticercosis/Tapeworms

A

Sanitation, less pig contact + vaccines

54
Q

Pathogenic Agent:

Echinococcus

A

Echinococcus granulosus

- small

55
Q

Vector:

Echinococcus

A
  • Dogs (definitive host)

- Sheeps, cattle

56
Q

Distribution:

Echinococcus

A

Everywhere

- Most common in people raising sheeps (which eat plants contaminated by dogs)

57
Q

Phase:

Echinococcus

A
  1. Eggs travel to lungs and liver to make fluid filled cyst
  2. When large enough they cause discomfort and vomiting (can get big enough to cause physical destruction of affected organs)
58
Q

Clinical Findings:

Echinococcus

A
  • Asymptomatic
  • Slow growing cyst in liver, lungs, and other organs
  • Alveolar echinococcusis- most sever form with high mortality because of metastatic cyst (treated with “Find and watch” method
59
Q

Diagnosis:

Echinococcus

A
  • Imaging techniques (CT, ultrasound, MRI)

- Serology to confirm

60
Q

Treatment:

Echinococcus

A
  • “Watch and wait” - conservative approach
  • Surgery - remove
  • PAIR (percutaneous aspiratin injection of chemicals and reaspiration)
  • Chemotherapy with albendazole
61
Q

Prevention:

Echinococcus

A
  • Stop dogs from eating infected sheep carcasses
  • Control stray dog population
  • Washing hands

Tropical Diseases (part 2 - 12/09) (5 decks)

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