Viral, Parasites Flashcards
RNA virus
paramyxoviridae
Measles
used for influenza A and B
oseltamivir
use for RSV
aerosolised ribavirin
used to HSV encephalitis
acyclovir
used for CMV
ganciclovir
fusion of infected cells with multinucleated giant cells
warthin finkeldey giant cells
measles
4 phases of measles
incubation, prodromal, exanthematous, recovery
koplik spots appear
1-4 days prior to rash in measles
measles antibody appears after __ and lasts up to __
1-2 days, 1 month
most common cause of death in measles
pneumonia
most common complication of measles
acute otitis media
virus of SSPE missing this protein
M
involved in budding
diagnosis of SSPE at least one
- measles antibody in CSF
- EEG suppression burst episodes
- histologic brain tissue
DOC for SSPE
carbamazepine
vit A in measles
50, 000 <6mo
100, 000 6-12mo
200,000 >12mo
side effect of measles vaccine
thrombocytopenia
single stranded RNA
Togaviridae
rubella
maternal rubella infection most severe when
first 8 weeks of gestation
rose coloured lesions on oropharynx
Forchheimer spots
rubella
most serious complication of postnatal rubella
encephalitis
cns rubella similar to SSPE
PRP
progressive rubella panencephalitis
most common finding in congenital rubella
hearing loss with microcephaly
retinal finding in congenital rubella
salt and pepper retinopathy
most serious eye finding in congenital rubella
cataract
babies with congenital rubella can excrete virus up to
1 year
if preggers had exposure to rubella but with negative antibody
repeat test 2-3 weeks
if (+) in either 2nd or 3rd, infection happened
if (-), repeat 3rd test after 6 weeks, if all are (-) then no infection
single stranded RNA
family paramyxoviridae, genus rubulavirus
mumps
virus in mumps appears
in saliva up to 7 days before symptoms to 7 days after onset of parotid swelling
mumps meningitis manifests __ days after parotitis
5 days
T or F:
false negative PPD result after mumps vaccine
true
T or F:
egg allergy CI to measles vaccination
F
T or F:
egg allergy CI to mumps vaccination
T
positive stranded RNA
picornaviridae
polio
route of transmission polio
fecal oral
polio primarily infects
anterior horn cells (motor) and medulla oblongata (cranial nerve nuclei)
t or f:
polio has sensory deficit
motor and DTRs only
what is VAPP
vaccine associated paralytic polio
some vaccine strains/revertants develop neurovirulent phenotype leading to paralysis
best place to culture polio 1 week after illness
stool
maximum paralysis of polio __ days
2-3 days after onset of paralysis
t or f
breastfeeding reduces chances of enteroviruses
t
hand foot mouth disease frequently caused by
coxsakie a16
fever, soar throat, dysphagia, and lesions in posterior pharynx
dx? cause?
herpangina
enterovirus 71 but can also be coxsakie A
paroxysmal thoracic pain
dx?
cause?
pleurodynia or Bornholm disease
coxsakie B and echovirus
acute haemorrhagic conjunctivitis
enterovirus 70 and coxsakie a24
commonly implicated in myocarditis
coxsakie b
secondmost cause of orchitis (after mumps)
coxsakie
implicated in cases of nephritis and IgA nephropathy
enteroviruses
most common cause of viral meningitis in mumps immunised population
enteroviruses
css findings in enterovirus meningitis
slight pleocytosis, predominantly PMS in first 48 hours, normal or slightly low glucose, normal or slightly high protein
bacterial and viral ddx
Nonspecific febrile illness
BACTERIAL
Streptococcus pneumoniae, Haemophilus in uenzae type b, Neisseria meningitides
VIRAL
In uenza viruses, human herpesviruses 6 and 7, human parechoviruses
bacterial and viral ddx
Exanthems/enanthems
BACTERIAL
Group A streptococcus, Staphylococcus aureus, N. meningitides
VIRAL
Herpes simplex virus, adenoviruses, varicella-zoster virus, Epstein-Barr virus, measles virus, rubella virus, human herpesviruses 6 and 7, human parechoviruses
bacterial and viral ddx
Respiratory illness/conjunctivitis
BACTERIAL
S. pneumoniae, H. in uenzae (nontypeable and type b), N. meningitidis, Mycoplasma pneumoniae, Chlamydia pneumonia
VIRAL
Adenoviruses, in uenza viruses, respiratory syncytial virus, parain uenza viruses, rhinoviruses, human metapneumovirus, coronaviruses
bacterial and viral ddx
Myocarditis/pericarditis
BACTERIAL
S. aureus, H. in uenzae type b, M. pneumonia
VIRAL
coxsakie Adenoviruses, in uenza virus, parvovirus, cytomegalovirus
bacterial and viral ddx
Meningitis/encephalitis
BACTERIAL
S. pneumoniae, H. in uenzae type b,
N. meningitidis, Mycobacterium tuberculosis, Borrelia burgdorferi, M. pneumoniae, Bartonella henselae, Listeria monocytogenes
VIRAL
Herpes simplex virus, West Nile virus, in uenza viruses, adenoviruses, Epstein-Barr virus, mumps virus, lymphocytic choriomeningitis virus, arboviruses, human parechoviruses
bacterial and viral ddx
Neonatal infections
BACTERIAL
Group B streptococcus, Gram-negative enteric bacilli, L. monocytogenes, Enterococcus
VIRAL
Herpes simplex virus, adenoviruses, cytomegalovirus, rubella virus, human parechoviruses
erythema infectiosum or fifth disease
aplastic crisis
parvovirus b19
target cells of parvovirus
erythroid
most sensitive trimester to parvovirus b19
2nd trimester
fever, pruritus, painful edema, erythema localised to distal extremities “gloves and socks”
dx? cause?
PPGSS papular purpuric gloves and socks syndrome
parvovirus b19
leading cause of fatal encephalitic in children and adults
HSV encephalitis
most common manifestation of HSV1
fever blisters or cold sores or herpes labialis
local burning and tenderness over genitals before vesicle formation
vesicles then become ulcers
HSV2
area of brain affected by HSV
frontal or temporal and limbic system
fever, nuchal rigidity, anosmia, memory loss, peculiar behaviour, expressive aphasia, hallucination, focal seizure
HSV enchephalitis
most common cause of recurrent aseptic meningitis
Mollaret meningitis - caused by HSV
newborn presents at 8-17 days old of life with vesicles, irritability, lethargy, poor feeding poor tone, seizures
neonatal HSV
gold standard for diagnosing HSV
viral culture
treatment of HSV encephalitis
acyclovir 10mkdose q8 x 14-21 days
treatment of neonatal HSV
acyclovir 60mkday TID x 14 (skin), 21 days (disseminated)
t or f
male circumcision is associated with reduced risk go acquiring genital HSV
true
what is breakthrough varicella
rash that appears after being vaccinated 42days prior
breakthrough varicella caused by
wild type virus
infants born to mothers with varicella present high risk if
with rash 5 days prior to delivery or 2 days after delivery
varicella igG able to cross placenta after _ weeks aog
30 wks
t or f
all preterms should receive ivig if mom develops varicella even if >1wk
true
cicatricial skin scarring, limb hypoplasia, microcephaly, chorioretinits, cataracts, hydronephrosis, iugr
congenital varicella
secondary bacterial infections associated with varicella
strep
staph
neurologic complications of varicella
encephalitis and cerebellar ataxia
csf findings varicella
mild lymphocytic pleocytosis, slight increase protein, normal glucose
findings on tzanck smear for varicella
multinucleated giant cells
triad of fatigue, pharyngitis, generalised lymphadenopathy
EBV
mononucleosis
first human virus to be associated with malignancy
EBV
EBV associated in HIV adults benign
oral hairy leukoplakia
EBV associated in HIV kids
lymphoid interstitial pneumonitis
malignant EBV associated
CLAD, eustachian tube blockage, nasal obstruction with epistaxis
NPCA
most common childhood cancer in east africa
endemic african burkitt lymphoma
protooncogene in burkitt
c-myc
hodgkin disease associated with
EBV
morbilliform vasculitic rash seen after giving beta lactam antibiotic to patient with mononucleosis
ampicillin rash
symmetric rash on cheeks that coalesce into plaques
lasts 15-50 days
dx? associated with?
gianotti crosti syndrome
diseases associated with atypical lymphocytosis
EBV, CMV, toxoplasmosis, rubella, viral hepatitis, roseola, mumps, tb, typhoid, mycoplasma, malaria, drug reaction
heterophiles antibody test
EBV
paul bunnell antibodies
blunt ab trauma in patients with EBV
splenic rupture (due to splenomegaly)
prednisone in ebv indicated in
airway obstruction, thrombocytopenia,
autoimmune haemolytic anemia, seizure, meningitis
most feared complication in ebv
sub scapular splenic hemorrhage
splenic rupture
perceptual distortions in sizes, shapes and spatial relations associated with EBV
alice in wonderland syndrome
metamorphsia
immunodeficiency with high mortality to EBV
duncan syndrome
x linked lymphoproliferative syndrome
most common opportunistic infection in HIV prior to antiretroviral
CMV
largest human herpesvirus
cmv
rate of transmission in breast milk CMV
60-70%
clinical findings congenital cmv
hepatosplenomegaly, petechial rash, jaundice, microcephaly, iugr, hearing loss
lab findings congenital cmv
hyperbilirunemia, elevated transaminase, thrombocytopenia, anemia, abnormal cuts/ct
lab diagnosis of CMV
recovery of virus within first 3 weeks of life
histopath finding of CMV
owl eye inclusion
nuclear and cytoplasmic inclusions
treatment of congenital cmv
6wk ganciclovir
roseola infantum
exanthem subitum
sixth disease
human herpesvirus 6
high fever which resolves after 72 hours followed by blanching evanescent rash (trunk) 1-3 days
roseola infantum
exanthem subitum
sixth disease
human herpesvirus 6
ulcer at uvulopalatoglossal junction
nagayama spot roseola infantum exanthem subitum sixth disease human herpesvirus 6
mir findings of HHV6
areas of hyper intense T2 and fluid attenuation inversion on hippocampus, uncut, amygdala
gold standard for diagnosing HHV6
viral culture
most common complication of roseola
seizures
kaposi sarcoma
hhv 8
anemia, thrombocytopenia, lad
hhv8
multi centric castleman disease
primary diagnostic in hhv8
elisa
hhv 8
lymphomatous invasion of the pleura, pericardium
primary effusion based lymphoma
treatment hhv8
rapamycin
rna
orthomyxoviridae
influenza
primary human pathogens influenza
a and b
minor changes within serotype
antigenic drift
major changes within serotype
antigenic shift
pathogenesis of influenza
infect respiratory epithelium
loss of ciliary function
decreased mucus production
common complications of influenza
otitis media
penumonia
secondmost common cause of viral pneumonia
parainfluenza
croup
barking cough
parainfluenza
narrowing of subglottic region
steeple sign
croup
emergency treatment of croup
dexamethasone 0.6mg/kg single dose
aerosolised epinephrine
major cause of bronchiolitis
RSV
respiratory syncytial virus
one of the most contagious viruses to affect humans
rsv
t or f
bronchiolitis is more common in boys
true
1.5:1 ratio
first sign of infection RSV
rhinorrhea
car findings rsv
hyper expansion
peribronchial thickening
interstitial infiltrates
definitive diagnosis of RSV
viral culture
treatment for rsv
ribavirin
passive immunoprophylaxis in rsv
palizumab
one of the most common causes of serious lower respiratory tract infections
human metapnuemovirus
most sensitive test for human metapnuemovirus
reverse transcriptase PCR
most common manifestation of adenovirus
respiratory tract infection
cornea and conjunctiva involved by adenovirus
epidemic keratoconjunctivitis
most frequent cause of common cold
rhinovirus
important cause of exacerbation of asthma or COPD in adults
rhinovirus
t or f
rhinovirus associated wheezing is an important risk factor for developing asthma
true
cause of SARS
coronaviruses
in early childhood, single most important casuse of severe dehydrating diarrhea
rotavirus
pathogenesis of viral diarrhea
destroy villi
most common finding in viral enteritis
isotonic dehydration with acidosis
complication of rotavirus vaccine
intussusception
most prevalent viral STI in usa
human papillomavirus
most common clinically detected cervical lesion hpv
LSIL
low grade squamous epithelial lesion
infants acquire hpv by passage to infected birth canal leading to recurrent _
respiratory papillomatosis
hpv related malignant potential
epidermodysplasia veruciformis
low risk malignant hpv types
6 and 11
genital warts
high risk malignant hpv types
16 and 18
repeat cytology for LSIL
every 12 months
removal of warts
topical podofilox salicylic acid cryotherapy laser electrosurgery
principal vector of japanese encephalitis
culex tritaeniorhynchus summarosus
4 stages of japanese encephalitis
prodromal 2-3 days
acute 3-4 days
subacute 7-10 days
convalescence 4-7 weeks
characteristic of jap enceph
rapidly changing nervous system signs
in dengue severe back pain precedes fever
back break fever
temperature pattern in dengue
biphasic
saddleback
dengue hemorrhagic fever
fever (2-7 days in duration or biphasic), minor or major hemorrhagic manifestations, thrombocytopenia (≤100,000/μL), and objective evidence of increased capillary permeability (hematocrit increased by ≥20%), pleural e usion or ascites (by chest radiography or ultrasonography), or hypoalbuminemia
dengue shock syndrome
dengue hemorrhagic fever as well as hypoten- sion, tachycardia, narrow pulse pressure (≤20 mm Hg), and signs of poor perfusion (cold extremities)
dengue IgM disappear after
6-12 weeks
most common cbc finding in dengue
hemoconcentration
most common complication of dengue in infants and young kids
fluid and electrolyte losses, hyperexia, and febrile seizure
what receptor does rabies virus utilize
nicotinic acetylcholine receptor
pathologic hallmark of rabies
negri body
clumped viral nucleocapsids that create inclusion bodies
most common cause of death in rabies
arrhythmia
2 clinical forms of rabies
encephalitic or furious rabies
paralytic or dumb rabies
cardinal signs of rabies
hydrophobia
aerophobia
most sensitive test for rabies
RT PCR
prophylaxis of cerebrovascular spasm in rabies
nimodipine
t or f
bites of rats/mice can cause rabies
false
t or f
cat bite can cause rabies
true
HIV envelope protein used in detection assays
gp41
binding site to CD4 T
gp120
enzyme critical for HIV assembly
protease
all kids < 13 years old have HIV via
vertical transmission
highest percentage of infants with HIV obtained
intrapartum
exposure to blood/ cervicovaginal secretions
risk of transmission of HIV through breastfeeding
9-16%
elective cesearen section plus zidovudine decrease HIV transmission by
87%
reservoirs of HIV in body
monocytes
first cell to be infected by HIV
dendritic cells
increased inflammatory response of a subclinical infection in a HIV kid that just started antiretroviral
immune reconstitution inflammatory syndrome
due to recovered immune system
most common opportunistic infection in children with hiv
pneumocystis jirovecii
most common fungal infection in hiv kids
oral candidiasis
neuroimaging in hiv encephalitis
cerebral atrophy (85%), ventriculomegaly, basal ganglia calcification, leukomalacia
most common GI disease in HIV
chronic or recurrent diarrhea with malabsorption, ab pain, dysphagia, failure to thrive
infants born to HIV mothers lose maternal antibody at 6-12mo
seroreverters
to make diagnosis of HIV in infants
igM, igA, anti HIV, igG
HIV viral diagnostic assay useful in <18m
HIV DNA PCR
HIV viral testing in newborns should be done
1-2 days old
if negative HIV viral testing for newborns negative initially, when to repeat
1-2months of age
HIV can be excluded for infant if
2 tests negative with at least 1 test >4mo age
for adolescents with HIV, what should we follow? adult or pedia dosing?
based on tanner stage
stage 1-3 use pedia dosing
stage 4-5 use adult dosing
initial virologic response to ARVs for HIV
decrease in load 5 fold after 4-8 weeks
maximum response to HIV therapy at
12-16week
hiv viral load should be measured every
3-6 mo
potential toxicity of drugs
hema- tologic complications (e.g., ZDV); hypersensitivity rash (e.g., efavi- ranz); lipodystrophy (e.g., redistribution of body fat seen with NRTIs, protease inhibitors); hyperlipidemia (elevation of cholesterol and tri- glyceride concentrations); hyperglycemia, and insulin resistance (e.g., protease inhibitors); mitochondrial toxicity leading to severe lactic acidosis (e.g., stavudine, didanosine); electrocardiogram abnormalities (e.g., atazanavir, lopinavir); abnormal bone mineral metabolism (e.g., tenofovir); and hepatic toxicity, including severe hepatomegaly with steatosis.
MAC prophylaxis in HIV
azithromycin or clarithromycin
AFASS
acceptable feasible affordable sustainable safe
2 kinds of parasites
protozoan (unicellular)
helminths (multicellular)
fever, jaundice, proteinura and hemorrhage
yellow fever
eosinophilic degradation of hepatocytes
councilman bodies
yellow fever
nitazoxanide used for
cryptosporidium
giargia
atovaquone/proguanil use
pnemocystis in aids
inhibit liver stage of plasmodium (malaria)
artemisinin used for
plasmodium vivax
drug of choice for asymptomatic amebiasis
paromomycin
alternatives: iodoquinol, diloxanide
drug of choice amebic menigoencephalitis
amphotericin b
drug of choice for symptomatic amebiasis
metronidazole
drug of choice for Ancylostoma caninum (eosinophilic enterocolitis)
albendazole
drug of choice for ascariasis
albendazole
drug of choice for Babesiosis
atovaquone plus azithromycin
drug of choice for Balantidiasis
tetracycline
drug of choice blastocystis hominis
metronidazole
drug of choice for Cryptosporidiosis
nitazoxanide
drug of choice for Cutaneous larva migrans (creeping eruption, dog and cat hookworm)
albendazole
drug of choice Enterobius vermicularis (pinworm)
albendazole
drug of choice for
Filariasis (Wuchereria bancrofti, Brugia malayi, Brugia timori)
Diethylcarbamazine
drug of choice for Loa loa
Diethylcarbamazine
drug of choice for Tropical pulmonary eosinophilia (TPE)
Diethylcarbamazine
drug of choice for Onchocerca volvulus
river blindness
Invermectin
drug of choice for Fasciola hepatica (sheep liver fluke)
Triclabendazole
drug of choice for Paragonimus westermani (lung fluke)
Praziquantel
drug of choice for Giardiasis (Giardia duodenalis)
metronidazole
drug of choice for Hookworm infection (Ancylostoma duodenale, Necator americanus)
albendazole
drug of choice for Leishmania infection
Sodium stibogluconate
drug of choice for Lice infestation (Pediculus humanus, Pediculus capitis, Phthirus pubis)50
0.5% Malathion
drug of choice for P. falciparum acquired in areas of chloroquine resistance
Atovaquone/ proguanil
drug of choice for P. vivax acquired in areas of chloroquine resistance
Quinine sulfate plus doxycycline plus primaquine
drug of choice
All Plasmodium except chloroquine-resistant P. falciparum and chloroquine-resistant P. vivax (areas without chloroquine resistance)
Chloroquine phosphate
drug of choice for All Plasmodium
Parenteral (severe infection; chloroquine-sensitive and resistant)
Quinidine gluconate (IV)
drug of choice for Microsporidiosis
albendazole plus fumagillin (if eye)
Scabies (Sarcoptes scabiei)
Drug of choice
5% Permethrin
drug of choice for Schistosomiasis
praziquantel
drug of choice for Strongyloidiasis (Strongyloides stercoralis)
ivermectin
drug of choice for tapeworm Diphyllobothrium latum ( sh), Taenia saginata (beef), Taenia solium (pork), Dipylidium caninum (dog)
praziquantel
drug of choice for Toxoplasmosis (Toxoplasma gondii)
Pyrimethamine
plus
sulfadiazine
drug of choice for Trichinellosis (Trichinella spiralis)
steroids plus albendazole
drug of choice for Trypanosoma cruzi
American trypanosomiasis, Chagas disease
Benznidazole
drug of choice for Visceral larva migrans (Toxocariasis)
albendazole
mebendazole
drug of choice for Trypanosoma brucei gambiense (West African trypanosomiasis, sleeping sickness)
hemolytic: Pentamidine isethionate or suramin
late CNS: Melarsoprol
albendazole absorption from the gastrointestinal tract is poor but improved with a concomitant
high fat meal
serious adverse effect of ivermection
Mazzotti reaction
fever, urticaria, swollen and tender lymph nodes, tachycardia, hypotension, arthralgias, oedema, and abdominal pain that occur within seven days of treatment
common forms of entamoeba in humans
amebic colitis
amebic liver abscess
3rd leading cause of parasitic death worldwide
amebiasis
flasked shaped ulcers in intestinal epithelium
amebiasis
most common imaging finding in amebic liver abscess
single abscess in right hepatic lobe
diagnosis of amebiasis
presence of e. histolytica in stool exam
most common intestinal parasite seen in usa
giardia
which immunodeficiencie predispose to Giardia infection
humoral immunodeficiencies
common variable hypoglammaglobulinemia
x-linked agammaglobulinemia
foul smelling greasy stools with no blood, mucus, or leukocytes
giardia lamblia
test of choice for iardia
stool enzyzme immunoassay
largest protozoan that infects humans?
vector?
balantidium coli
pigs
leading protozoal cause of diarrhea in kids
common cause of outbreak in day care centers
cryptosporidium
cryptosporidiosis in ICC associated with
biliary tract disease, pancreatitis, respiratory tract disease
diagnostic of choice for cryptosporidiosis
enzyme immuoassay
most common nonviral STI
trichomonas vaginalis
frothy discharge with vaginal erythema and cervical hemorrhage
strawberry cervix
trichomoniasis
leishmaniasis transmitted by
phlebotomine sandflies
abudant histiocytes and kupffer cells
specialized stellate macrophages located in the liver
amastigotes
leishmaniasis
positive delayedtype hypersensitivity skin response to leishmanial antigens
Montenegro skin test
visceral leishmaniasis
kala azar
high fever, marked splenomegaly, hepatomegaly and cachexia
definitive diagnosis of leishmaniasis
amastigotes seen on tissue specimens
trypanosomiasis transmitted by
tsetsefly
glossina
large strawberry like cells supposedly derived from plasma cells in brain
morular cells
trypanosomiasis
site of bite of tsetse fly
hard painful nodule
trypanosomai chancre
drowsiness, uncontrollable urge to sleep, ataxia, tremor, rigidity
sleeping sickness
trypanosomiasis
definitive diagnosis of trypanosomiasis in early stage
blood smear
arthropod vectors of chagas t. cruzi
reduviid inset
wild bedbugs, assassin bugs, kissing bugs
local tissue reaction in which trypanosmona lyse the microphages, at site of entry
chagoma
unilateral painless swelling of eye
Romana sign
chagas disease
most common presentation of chronic T. Cruzi infection
cardiomyopathy
fever, chills, sweats, fatigue, anemia, and splenomegaly
malaria
2 phases of plasmodium
human (asexual)
mosquito (sexual)
human liver phase of malaria
exoerythrocytic phase
sporozoites enter the hepatocytes of the liver, where they develop and multiply asexually as a schizont. After 1-2 wk, the hepatocytes rupture and release thousands of merozoites into the circulation.
RBC phase of malaria
erythrocytic phase
when they invade RBC, turn into ring form then enlarges to become a trophozoite
in malaria fever occurs when
erythrocytes rupture and release merozoites into the circulation
in malaria fever occurs when
erythrocytes rupture and release merozoites/schizont into the circulation
t or f
erythrocytes lacking duffy blood group resistant to P vivax
true
paroxyms of fever in P vivax and ovale
48 hours
paroxyms of fever P malariae
72 hours
most severe form of malaria
p falciparum
complications of p. falciparum
cerebral malaria, acute renal failure, respiratory distress from metabolic acidosis, algid malaria and bleeding diatheses
congenital malaria
fever, restlessness, drowsiness, pallor, jaundice, poor feeding, vomiting, diarrhea, cyanosis, and hepatosplenomegaly
diagnosis of malaria
blood smear with giema stain
thick smear blood malaria
to scan
thin smear blood malaria
to identify species
treatment for p. knowlesi
chloroquine plus sulfadoxine pyrimethamin
used to eradicate hypnozoites in liver
primaquine
primaquine causes hemolytic anemia in
g6pd deficiency
most common severe complication of malaria
severe malarial anemia
first line therapy seizures in malaria
benzodiazepines
complication in malaria in kids taking quinine
hypoglycemia
what symptom in malaria is associated with worse outcome
jaundice
mefloquinone, a prohyacti drug for malaria, should not be given to
those with hypersensitivity to the drug,
receiving cardiotropic drugs,
psych disorders, epilepsy, or area with resistance
most common latent infection in humans
toxoplasma gondii
toxoplasmosis acquired by
ingesting raw or undercooked food with oocytes
from cats
statistics in congenital toxoplasmosis
if 1st trimester 17% infected but severe
if 3rd trimester 65% infected but mild
toxoplasmic encephalitis with AIDs
fever, headache, altered mental status, psychosis, cognitive impairment, seizures, and focal neurologic defects, including hemiparesis, aphasia, ataxia, visual eld loss, cranial nerve palsies, and dysmetria or movement disorders
chorioretinitis, hydrocephalus, and cerebral calcifications
congenital toxoplasmosis
brain calcifications in toxoplasmosis seen in
caudate nucleaus
basal ganglia
choroid plexus
subependymal
pyrimethamine contraindicated
during 1st trimester
side effect of pyrimethamine
neutropenia
what can be concomittantly given to pyrimethamine to prevent bone marriow suppression
folinic acid or leukovorin
treatment for pregnant women that acquire toxoplasmosis during pregnancy
spiramycin
causes of lymphatic filariasis
brugia malayi, brugia timori, and wuchereria bancrofti
recurrent lymphangitis fever headache then eventually obstruction of lymph flow leading to edema
filariasis
causes chronic scrotal edema
wuchereria bancrofti
migration worms thru skin lead to transient episodes of pruritus and edema
ca;abar swellings
muscle fiber after ingestion of this worm contains cyst wall especially from uncooked pork
trichinella spiralis
snail fever
katayama syndrome
acute schistosomiasis
cercarial penetration in skin by schistosoma
swimmers itch
schitosomal dermatitis
fever chills sweating LAD hepatosplenomegaly eosinophilia
katayama syndrome
beef tapeworm
taenia saginata
pork tapeworm
taenia solium
most anterior end of tapeworm anchors to intestine
scolex
longest human tapeworm
diphyllobotrium latum
fish tapeworm
>10m
taperworm that causes megaloblastic anemia (low b12 or folate)
diphyllobotrium latum
fish tapeworm
disease in which pork taperworm taenia solium invade CNS
neurocysticercosis
presenting finding in neurocysticercosis
seizure
drug of choice for neurocysticercosis
albendazole
+- prednisolone
most widespread nematode infection in the world
hydatid disease or hydatidosis
Echinococcosis
common site Echinococcosis in kids
lung
preferred therapy in Echinococcosis or hydatid disease
CT PAIR
CT guided percutaneous aspiration instillation and reaspiration
drug of choice for hydatid disease or Echinococcosis
albendazole
leading cause of death worlwide
tb