Strongyloidiasis Flashcards
Strongyloidiasis is a zoonotic disease. True or false?
True, but it is also a human parasitic disease.
Strongyloidiasis is caused by
nematode, S. Stercoralis.
Strongloides has one life cycle. True or false?
False. It has two unique ones.
In which condition would you see a life cycle similar in Strongyloidiasis
Larva migrans
How do people contact Strongyloidiasis?
By by direct contact with contaminated soil and recreational activities.
Strongyloides is an intestinal worm. True or false?
True
Strongyloides larva are coughed up from the lungs and swallowed. Which other organism reaches the GIT this way?
Hookworm (Ancylostoma and Necator)
Clinical presentation of acute Strongyloidiasis
Lower extremity itching (mild erythematous maculopapular rash at the site of skin penetration)
Cough, dyspnea, wheezing
Low-grade fevers
Epigastric discomfort, n/v/d
Clinical features of severe strongyloidiasis
Can be abrupt or insidious in onset
N/v/d, severe abdominal pain, distention
Cough, hemoptysis, dyspnea, wheezing, crackles
Stiff neck, headache, MS changes
If CNS involved
Fever/chills
Hematemesis, hematochezia
Rash (petechiae, purpura) over the trunk and proximal extremities
Risk factors for severe strongyloidiasis infection
Immunosuppressant meds (steroids, chemo, TNF modulators, tacro, etc – all BUT cyclosporine)
Malignancy
Malabsorptive state
ESRD
DM
Advanced age
HIV
HTLV1
Etoh
The strongyloidiasis rash is caused by
Caused by dermal blood vessel disruption brought on by massive migration of larvae within the skin
Features of Hyperinfection Syndrome
- Acceleration of the normal life cycle, causing excessive worm burden
- Autoinfection (turn into infective filariform larva within the lumen
- Spread of larvae outside the usual migration pattern of GI tract and lungs
Features of Disseminated strongyloidiasis
- Widespread dissemination of larvae to extraintestinal organs: CNS (meningitis), heart, urinary tract, bacteremia, etc
- Can be complicated by translocation of enteric bacteria which travel on the larvae themselves or via intestinal ulcers
- Due to delayed diagnosis, immunocompromised state of the host at this point
Strongyloidiasis diagnosis
Stool exam
ELISA
Strongyloidiasis treatment
Antihelminitic therapy:
Ivermectin
Albendazole
Thiabendazole
Other names for Yaws
Bouba
frambosie
Frambesia tropica
parangi
pian
polypapilloma tropicum
thymosis
Yaws is caused by
The spirochete bacterium, Treponema pallidum pertenue.
Other related treponemal diseases are
bejel (Treponema pallidum endemicum)
pinta (Treponema pallidum carateum)
syphilis (Treponema pallidum pallidum)
Early Yaws symptoms (3-6months)
- Hard swelling of the skin which may break open and form an ulcer
- Yaw nodules (mother yaws) which may enlarge and become warty in appearance
- This initial skin lesion typically heals after three to six months.
Late Yaws symptoms (6 months - 5 years)
- Painful joints/bones
- Fatigue
- New skin lesions (crab yaws)
- Deformed bone and cartilage of the nose (rhinopharyngitis mutilans or “gangosa”)
- Formation of large thick areas of skin death with subsequent scarring.
Yaws transmission
Skin-to-skin lesion
Yaws treatment
Azithromycin
Penicillin
Azithromycin MOA
It interferes with bacterial protein synthesis by binding to 50S subunit of bacterial ribosome and inhibiting translation of mRNA.
Adverse effects effects of Azithromycin
Nausea and vomiting
Abdominal pain
Clostridium difficile associated diarrhoea
Hepatic failure
Cholestatic jaundice.
Benzathine Penicillin MOA
Penicillins interfere with bacteria cell wall synthesis by attaching to the penicillins-binding-proteins and inhibiting the transpeptidation enzyme (transpeptidase) that crosslinks the peptide chains attached to the backbone of the peptidoglycan
Common Penicillin adverse effects
Common => hypersensitivity reactions characterized by skin rashes
Fever
Angioedema
Serum sickness
Anaphylaxis.
Rare penicillin adverse effects
Convulsions
