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Heme/Lymph 1 > Vector Borne Helminth Infections and Schistosomiasis > Flashcards

Vector Borne Helminth Infections and Schistosomiasis Flashcards

1
Q

Nematoda, Cestoda, and trematoda

A

Roundworms, tapeworms, flukes

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2
Q

Themes in helminth infections

A

Long ter mand chronic
ANy type of host
All life cycle stages can cause symptoms
Host response is responsble for symtoms

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3
Q

Host responses to helminths

A

Lots of morbidity but little mortality
Th2 like response
IgE with eosinophilia and mast cell responses

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4
Q

Wuchereria bancrofti and brugia malayi vector and dz

A

mosquito and lymphatic filariasis

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5
Q

Loa loa
Onchocerca volvulus
Dirofilaria immitis

Vectors and dz

A

Crysops fly - loasis
Simulium fly - river blindness
Mosquito - canine heartworm

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6
Q

Lymphatic filariasis transmission

A

Any kind of mosquito…anopheles, culex, aedes

Anopheles and culex bite at night while aedes bites in day

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7
Q

Lymphatic filariasis infeciton process

A

MF (microfilariae) develop in the mosquito and migrate outside of the surface of the proboscis…migrate in from the skin to the blood to the lymph tissue

Live 5-10 years and are viviparous (no egges)

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8
Q

Timing and release of MF

A

Synchronized with biting habits…anopheles and culex in lymph nodes release MF at night

Some people develop elephantitis, most do not

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9
Q

Pregression of lymphatic filariasis

A

Larvae mature in lymph nodes for 6 months to a year…migrate to lymph nodes in lower extremities like legs, groin, genitalia…can remain paired for 5-40 years…fever may be present and then recurrent lymphedema due to worms lodged in lymphatic system

If adult worms die, huge immune response that results in formation of granulomas that become fibrotic, blocking vessels and causing localized damage

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10
Q

Elephantiasis

A

Giant swelling of organs or tissues triggered by lymph entering the tissue causing prolif of tissue and skin in localized manner

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11
Q

Men can get ____ with lymphatic filariasis

A

Orchitis with hydrocele (enlargement of the scrotum)

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12
Q

Tx of lymphatic filariasis

A 
Focus on controlling MF grwoth 
Piperizine derivatives (diethylcarbamazine DEC) is a prophlyactic for mass tx...paralyzes MF and then cleared by liver...potential allergic side effects cause anaphylaxis in some cases

Ivermectin/mebendazole can work
Surgical

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13
Q

Strategies to control filarial dz

A

Control of contact with vectors
Detect with periodic blood smears
Periodic admin of DEC to both symptomatic and asymptomatic patients

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14
Q

Loa loa

A

Transmitted by chrysops biting fly

Slow developing dz

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15
Q

Loa loa life cycle

A

MF enter fly bite during blood meal…develop into adults (1-4 years)…migrate through tissue and release MF…live worms and MF do NOT elicit a significant immune response of cause severe pathology in loa loa

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16
Q

Migration of loa loa

A

Occurs subcutaneously
Generally painless but can be felt on bridge of nose, conjunctiva and eyelid
Calabar swelling can occur - severe angioedema
Liver worms elicit minor pathology than dead
Dead elicit huge eosinophilic response

17
Q

Ocular involvement of loa loa

A

Cause ocular filariasis - release MF which interfere with cornea and retina

Must be removed surgically

18
Q

Detection, tx, and periods of loa loa

A

Detect MF, highest levels are midday…can detect ocular with slit lamp

DEC kills MF and immature stages but not adults (be careful with dose)…ivermectin and mebendazole can also be used

Adult worms must be removed during transit through eye

Incubation - 2-12 months
Prepatent - 6 mos -4 years
Patent - 4-17 years

19
Q

Onchocerca volvulus

A

Transmitted by simulium of black flies
Only females
Transmit 3rd stage larvae (L3) or MF
Repeated infections can cause progressive blindness

20
Q

Progression of onchocerca volvulus

A

MF migrate through skin maturing for about a year…slow migration results in nodules…worms mate and produce MF which migrate to skin and eye…MF taken back up by simulium flies

21
Q

Symptoms of onchocerca volvulus

A

Cutaneous - papular dermatitis (craw craw), thickening of skin (sowda), changes in pigmentation…also elephantiasis

Ocular - mostly from dead MF…keratitis…chroioretian ldamage in anterior chamber of the eye…inflam damage to optic nerve and retina

22
Q

Diagnosis and tx of onchocerca

A

Skin snips from nodules
Slit lamp of anterior chamber
Sclerocorneal punch biopsy
Rarely detectable in blood

DEC (could worsen cutaneous symptoms), Ivermectin, surgery

23
Q

Treamtodes

A 
Leaf or oval shaped
Blind alimentary canal 
Locomotion by muscle movement 
Adults pair for life
Use snails as IM hosts
24
Q

Schistosomiasis stages

A

Eggs are released in partially matured state…mature in bodies of water and release miracidia…miracidia infect snail and form sporocyst within which thousands of cercariae are formed…cercariae are released from snail to water and infect the human…mature in humans to adults and form mating pairs

25
Q

Schistosomiasis structure and cause of pathology

A

Female in the gynocophorous canal of the male

Eggs responsbile for pathology caused by worms

26
Q

Life cycle of schistosomiais in humans

A

Cercariae burrow in skin or swallowed…intesstinal migrate to mesenteric veins…urinary migrate to pelvic veins…eggs are shed

27
Q

At site of infection

A

Maculopapular rash in hours-week

28
Q

Intestinal schistosomiasis

A

Acute - takes 14-84 days
Fever, headache, hepatomegaly, bloody diarrhea, S mansoni can have resp syndromes
Eosinophilia
Symptoms coincide with depositon of eggs

29
Q

Chronic intestinal schistosomiasis

A

Immune response to eggs and granuloma formation
Force eggs into the lumen of the boewel
Maximal granuloma at intestine and following portal circulation, the liver
Hypogastric pain with blood in the stool, diarrhea and constipation…colon cancer symptoms
Liver fibrosis promoting hepatomegaly…postal hypertension, anemia, and ascites due to liver damage

30
Q

Urogenital schistosomiasis

A 
Initial symptom in hematouria 
Increased proteourea
Granulomas in the bladder
Obstruction of ureters
Renal colic and failure 
Women can get female genital schistosomiasis as ulcertive, hypertrophic lesions on the vulva and perineum (also from intestinal)
31
Q

Pulmonary schisto

A

Escape of eggs to lungs leads to pulmonary hypertension and cardiac hypertrophy

32
Q

CNS shisto

A

S japaniocum can impair blood flow

33
Q

Childhood schisto

A

Anemia, growth and reatardation

34
Q

Intestinal schisto vs. urinary times

A

Intestinal has patent period of 25 years, uro only 25 weeks

35
Q

Tx of schisto

A

Praziquantel and tetrahydroquinolones

36
Q

Microbilharzaria variglandis

A

Cercarial dermatitis caused by schisto in lakes and ponds
Dead end host
Rash, itching, localized edema
Topical corticosteroids and antihistamines

37
Q

other flukes

A

Liver
Lung
Intestinal

Heme/Lymph 1 (14 decks)

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