Worms Flashcards
Albendazole- mechanism, diseases
Inhibit glucose uptake
Roundworms (NOT filaria)
echino and cysticer (tape)
clonorchis (fluke)
Angiostrongylus cantonensis- clinical
Most common cause of eosinophilic meningitis
Angiostrongylus cantonensis- host, source, Sx (1), Tx
rat (lungworm)
raw snails, vegetables contaminated by snails
meningitis (most common cause eosinophilic)
surgical removal from CNS
ansiakiasis- geo, source, Sx (2), Tx
Japan but worldwide raw fish
GI, allergy
remove
Ascaris lumbricoides- host, transmission, Sx, Tx, dx, key sx
Human
FO
Loefflers, urticarial, SBO, cough up worm, eos, appy, chole GI -> lung -> gi
ALB
most common helminth
Autoinfective worms (5-SCHET), parasites (2-BC)
strongy, capillaria, H. nana, enterobius, T. solium
Cryptosporidium, Blastocystis hominis
Baliascaris- host, transmission, key sx (2), tx
racoon
FO, dirt, infected rabbit
VLM, neuro
ALB =/- pred
Blastocystis hominus classification, transmission
Stramenopile
Fecal oral transmission, Autoinfective
Capillaria hepatica- geo, source, Sx
worldwide
carnivores, rodents, pigs
hepatic, pulmonary, disseminated
Capillaria phillippensis- class, geo, vector, Sx, Tx
nematode
Asia
raw freshwater fish AND autoinfective
abd pain, diarrhea, malabsorption
ALB
Causes larva currens
srongyloides
causes of VLM (6)- TTG ABC
toxocaria, baliascaris, trichinella, Gnathostoma, angiostrongylus cantonensis, capillaria hepatica
Causes river blindness
onchocerciasis
Causes sowda
Onchocerciasis
Chrysops fly
Loa
Clonorchis- type, geo, source, Tx, complication
hepatic fluke
most common in China
raw fish
PZA
biliary CA
culicoides midge
mansonella
Cysticercosis- agent, Sx (4), Tx
Taenia solium egg
FO (man acts like intermediate)
Sx: neuro, subq, muscle, ocular
pred, surgery, ALB, PZQ
DEC (Diethylcarbamazine)- dz (3L)
LF (no oncho) Loa (no oncho) visceral larva migrans
Diphyllobothrium latum- type, host/source, geo, Sx, Tx
cestode/broad tape
Host dogs and cats (mammals) -> snail -> most fish
Europe, Americas, Former USSR (N hemisphere and SA)
GI obstruction, B12 def
Tx PZQ
Dipylidium caninum- host, intermediate host, Sx, Tx, micro special
dog
dog flea ingested by man
rice in diaper
PZQ
only egg with hooklets
Doxycycline- dz
LF adult, kills Wolbachia bacteria
Echinococcus granulosus (cystic)- host, intermediate host, geo, Sx, Tx
dog
sheep (any herd animal)
worldwide
liver, lung surgery, PAIR, ALB
hydatid cysts with visible protoscolex
Echinococcus multilocularis (alveolar)- host, intermediate host, geo, Sx, Tx
fox
rodent
Northern hemisphere
liver, acts like cancer
surgery, ALB, long term F/U
Echinococcus types, geo
E. granulosis- worldwide
E. multilocularus- northern hemisphere
E. vogeli and E. oligarthrus- Central and South America.
Enterobius- dz, host, transmission, Tx
pinworm
human
FO
ALB
Fasciola hepatica- host, geo, source, characteristic finding, Tx
sheep/cattle
worldwide
water cress
liver rot
triclabendazole
Fasciolopsis buski- type, source, Sx, Tx, associated with..
largest intestinal fluke
pig/human feces
Plants, snail, amphib, reptile, insects
GI
PZA
famines
Gnathostoma spinigerum- family, geo, cycle, Sx (3), Tx
nematode
Asia
cat/dog/pig -> egg -> fresh snail -> larvae -> fish, frog, snake, crabs, retiles
VLM, eos, migratory swelling, OLM, CLM
ALB, IVM
Guinea worm- agent, geo, source, Tx
Dracunculus medinensis
Ethiopia, Ghana, Mali, and Sudan still have
drink water with copepods
removal
Helminth infections causing eosinophilia
Ascaris lumbricoides , Strongyloides stercoralas , Lymphatic filariasis , Schistosoma hematobium , Angiostrongylus species , Necator Americanus
Heterophyes- type, geo, micro, Sx, Tx
intestinal fluke (trematode)
Mid East and Far East
small egg- 30 micron
most GI, possible cardiac (only worm) and brain
Tx: PZQ
Hookworm- agent, host, transmission, key sx, tx
Ancylostoma duodenale, Necator americanus Human
FO
anemia, eos due to pulmonary phase
ALB, MEB
Hymenolepiasis- geo, host, transmission
worldwide
beetle/arthropod
FO, eggs auto infective
most common cestode in man
Hymenolepis diminuta
rat tapeworm,
20-60 µm
rarely seen in humans.
Ivermectin- mechanism, diseases (Main 3 SOL) contraindication
Bind chloride channels
Oncho, strongy, LF
Also gnathostomiasis, ascaris, trichuris, enterobius, CLM, lice, scabies
Avoid Loa
Katayama fever- agent, etiology
schisto serum sickness
Katayama syndrome- agent, Sx, source, CXR, dx, tx
Schistosomiasis hypersenitivity
fresh water
fever, hives, cough lower lobe infiltrates and nodules
urine/stool/serology may take months to turn pos
delay Tx until eggs (adult worms), then PZQ
LF + Loa Tx
doxy
LF + oncho Tx
IVM
LF lone infection tx
DEC +/- ALB
Loa + oncho Tx
low Loa MF: IVM -> DEC (Tx oncho 1st)
high Loa MF -> apheresis/albendazole -> IVM -> DEC
Loa alone tx
DEC
LoaLoa- geo, host, vector, dz, Tx, Dx
West central Africa
Human only
Chrysops fly
Calabar, urticarial, eye
DEC- monoinfection (if oncho with low Loa MF: IVM -> DEC if oncho with high Loa MF -> aphoresis or albendazole -> IVM -> DEC)
Noon smear
location of adult worms of schisto
mansoni- sup mes v lg intestine
hematobium- venous plexus bladder/rectum
Japonicum- sup mes v small intestine
Loeffler’s syndrome-agent, cause
Ascaris pulmonary allergy
longest tapeworm
Diphyllobothrium latum
Lymphatic filariasis - species, host, vector, dz (3), Tx (3), Dx
Wucheria bancrofi (worldwide tropical) + Brugia sp (B. malayi- Asia, B. timori- Indonesia)
Human (B. malayi has monkey/cat)
any mosquito
LAD, skin, edema, hydroceles, Tropical Pulmonary Eosinophilia
DEC and alb (doxy with Loa, IVM with oncho)
Midnight smear, may filter
Wucheria emty tail, Brugia 2 nuclei
Mansonella Sx
CLM, HA, aches, VLM, Hepatomegaly, LAD
Mansonella- vector (2), micro, 4 types, geo, Tx, Dx
Culicoides (midges) AND Simulium (black fly)
small filaria, no sheath
strepto- Africa ozzardi- Americas perstans- both M. perstans with Wolbachia (Mali) -> 6 wks of doxy without Wolbachia -> DEC + MEB x 21 d. M. streptocerca or M. ozzardi- IVM x 1
smear or snip
Mebendazole- dz
Roundworms- Ascaris, hookworm, enterobia, trichuris
Metagonimus- fame, geo
smallest human fluke Asia
Micro Loa vs Wucheria
both sheath
Loa 200 microns, W 300 microns
Loa dense nuclei, W loose Loa tail full to tip, W tip empty
most common cestode in man
Hymenolepiasis nana
most common helminth to man? in US
Ascaris, pinworm
most common method diagnose cholera
clinical other test for confirming outbreaks- selective media culture, darkfield, rapid
Myiasis
Tumbu (clothing) or botfly (hitchhike egg on mosquito)-> eggs hatch in skin
niclosamide treats
taenia
Oesophagostomum- family, Sx
nematode
GI, obstruction, acute abdomen, perforation
Onchocerca alone Tx
IVM
Onchocerciasis volvulus- host, vector, Sx(3), Tx, Dx
Human Simulium (black fly)- fast moving rivers
River blindness (all but lens affected)
subq nodules where worms replicate (Sowda), itchy skin atrophy (leapoard, lizard), hanging scrotum
Skin snip, Mazzoti rxn to DEC
IVM kills MF (no Loa), doxy adult Wolbachia.
Only worm cyst with with protoscolex
Echinococcus granulosus
Only worm egg with hooklets
Dipylidium caninum
Opisthorchis- geo, source, organ, PZA
O. felinius (Eurasia), O. vivrrini (Asia) raw fish biliary PZA
PAIR
PAIR (Percutaneous aspiration injection re-aspiration) Asp > 30% Replace with scolicidal agent (hyper saline or ethanol) Wait 30 min then reaspirate 95% cure rate
Paragonimus- geo, source, Sx, Tx, DDx, egg
P. westermani (Far East). Other species worldwide
Fresh water crab
GI, fever RARE lung cysts, thick red-brown sputum
PZA
looks like TB
70-90 microns, oval, thick shell. Operculum flattened
Praziquantil- dz
Flukes (include schisto) tapeworm (EXCEPT alb for larval cysti and echino)
Pregnancy safe anti-parasitic (9)
praziquantil, pyrantel, nitazoxamide, DEC, flagyl, Chlroquine, quinine, mefloquine, artemisinin (not 1st)
Pyrantel pamoate- dz
roundworms- ascaris, enterobiasis, trichuriasis, strongy
Scabies Tx
IVM
Schisto source, 3 syndromes, Tx, Dx
swimmers itch, Katayama fever, chronic including Symmer’s pred then PZQ (fails ALB x1) rectal/bladder snip
Schisto- 3 types and geo
mansoni- AF, SA, Med, ME japonicum- AS hematobium- AF, ME
Schistosoma in Asia
S. japonicum , S. mekongi
Schistosomas (2) presenting with transverse myelitis with flaccid paralysis.
S. haematobium and S.mansoni due to shape and spine get stuck in spinal arteries
Schistosomiasis- source, host, reproduction
Intermediate host needed skin penetration Sexual reproduction
Simulin black fly
oncho, mansonella
Sparganosis- agent, geo, life cycle, Sx, Tx
Spirometra cestode/tapeworm
worldwide
host dogs and cats -> snail -> fish/reptile/amphibian
Sx from All LM
Tx surgical (drug resistant)
Swimmer’s itch- agent, source, Tx timing
Schistosomiasis fresh water delay PZQ 6 weeks until adult worm
Symmer’s
pipestem hepatic dx due to schisto
Taenia saginata- host, source, Tx, micro
man raw beef cysts PZQ, niclosamide suckers only
Taenia solium- host, source, Tx, micro
man (pig intermediate) raw pork cysts PZQ, niclosamide crown and suckers
Thread worm- agent, host (3), transmission, key sx, dx, tx
Strongyloides primate, cats, dogs FO, autoinfect larva currens on buttox; pulmonary super infection with steroids larvae in stool, Cx showing bacterial tracts, ELISA IVM (fails sgl dose ALB)
Toxocaria- host, transmission, key sx (2), tx
dog, cat feces
FO
VLM, ocular DDX retinoblastoma
ALB +/- pred
Toxoplasma gondii- maternal, neonatal tests, risks
IgM pos up to a year (may be false pos so confirm with IgG later; IgG pos after couple weeks with rising titer)
infant- check IgA and IgM
severity worse 1st tri, higher transmission 3rd trimester
treatment for strongy
IVM
Trematode blood (1) hepatic (3) GI (1) pulm (1)
Schistosoma Clonorchis Fasciola Opisthorchis Fasciolopsis Paragonimus
Trichinella- class, host, source, Sx (2), Tx
round
pig wild game/bears, pork
VLM, acute GI, edema, eosinophilia, diarrhea, myalgia
ALB
Trichostrongylus- type, host
nematode
herbivores
Trichuris trichuria- mode, mature in, reporduction, Sx, Tx
Fecal-oral
Matures in the environment (not in a host)
Sexual reproduction
Limited to intestinal infection
ALB, IVM alt
Triclabendazole- dz
Fasciola hepatica
Tropical pulmonary eosinophilia caused by
LF
Whipworm- agent, host, transmission, key sx, tx, egg
Trichuris trichiuria human FO rectal prolapse (only colon) MEB, ALB bipolar barrel
worm cause SBO
Ascaris lumbricoides
worm causing anemia due blood loss
hookworm (Ancylostoma and Necator Americanus)
worm causing B12 deficiency
Diphyllobothrium latum
worm causing larva currens
strongyloides
worm causing Loeffler’s syndrome
Ascaris lumbricoides
worm causing rectal prolapse
trichuris tricuria
worm causing SBO
Ascaris
worm causing TPE
LF (Wucheria bancrofi + Brugia sp)
Worm that has a free-living form
strongy
worms affecting the eyes (4)
oncho, Loa, toxocaria, cysticercosis (T. solium)
Worms causing creeping eruptions (5)
hookworm, strongy, gnathstoma, Fasciola, migratory myiasis
worms in raw fish (4 round GAAC + 1 tape +2 fluke)
round- Capillaria phillippensis, ansiakiasis, Gnathostoma spinigerum, Angiostrongylus cantonensis tape- Diphyllobothrium latum fluke- Clonorchis, opisthorchis
Worms penetrating skin
Hookworm, schisto, strongyloides
Worms with pulmonary phase- ASH
strongy, ascaris, hookworm (Ancyclostma duodenal is, Necator americanus)
top 2 causes of blindness
1- chlamydia trachomatis- 41 mill infected
2- oncho- 17 mill infected, 500K impaired, 270K blind
Oroyo fever- agent, Sx, Dx, Tx
B. bacilliformis
fever, hemolytic anemia, jaundice, CHF, neuro
verruga peruana in some 1-2 mos later
smear- intracellulaer coccobacilli
Cipro +/- rocephin
Tungiasis- agent, Sx, Tx
Chigoe flea
in skin, releasing eggs
removal