Zoonotic helminths + extras Flashcards
What is meant by zoonotic helminth
Humans are dead end hosts
What causes visceral larva migrans? What human helminth is it the same as? Life cycle ? Sx
Toxocara canis/cati [or Baylisascariasis]
-type of Ascaris
Dogs pass eggs in faeces
Human ingests - > larva hatch in bowel
Migrate mostly to LIVER then die
-Occasionally to eye / spleen / other places
Get Hepatosplenomegaly (tiny granuloma where ascaris dies) and Eosinophilia
+/- Retinal granuloma [ocularlarva migrans]
Toxocara canis/cati rx? Prevent ?
Larvae will die over a few weeks
[Maybe DEC]
Steroids for ocular disease
Lids on sandboxes
Deworm puppies - can be infected by mother though placenta
Ix Toxocara canis/cati
NO eggs in stool as worms in the wrong host and die - likey clinical with eosinophilia and hepatomegaly
Baylisascaris procynois from? Features? Dx?
Racoons
Larvae migrate though CNS -> eosinophilic meningitis and common ocular involvement
[REALLY BAD - basically eat through brain]
Brain imaging often lags clinical disease
Basically everyone who gets this dies
[Baylifts take bins where racoons live]
Baylisascariasis procynois from? Features? Dx?
Racoons
Larvae migrate though CNS -> eosinophilic meningitis and common ocular involvement
[REALLY BAD - basically eat through brain]
Brain imaging often lags clinical disease
[Can get serology in some labs]
Basically, everyone who gets this dies
No proven Rx - people give albendazole
[BUT albendazole does not really work against Larva of any helminth]
Cutaneous lava migrans caused by? Main issue? Rx?
Dog/cat ancylostoma
Eg Ancylostoma Braziliense
Bacterial superinfection
Single dose Albendazole / ivermectin
goes to dinner at a well-known sushi bar. 4 hrs later develops the worst abdominal pain ever experienced
Anisakis larva
‘Ani sak that’s sore’
[Pseudoterranova decipiens]
Anisakis from? Rx? prevent?
Raw seafood
Endoscope removal of nematode or may need surgical resection of eosinophilic granuloma
Need to freeze for 4 hours
Experienced chefs can identify larva
insidious onset of an intractable bitemporal headache
Development of meningismus and a 6th nerve palsy
CSF eosinophilic meningitis
Seafood Market=
Angiostrongyliasis (eosinophilic
meningitis)
Angiostrongylus cantonensis
Angiostrongyliasis from ? Features? Imaging? Dx? Species?
Rat lungworm lays eggs -> faeces
[then the number of intermediate hosts including slugs/snails which can contaminate greens]
Eosinophilic meningitis
MRI - generalised meningeal thickening
PCR for Dx
Angiostrongylus cantonensis
Angiostrongyliasis classic vector
Giant African land snails
Angiostrongyliasis Rx?
CSF taps
Steroids
[Antihelminths mostly contraindicarted as if larva die in brain -> inflammation (some use with high dose steroids)]
Gnathostomiasis from? Intermediate host?
Cats [garfield]
Fish intermediate host (sushi)
Gnathostomiasis features? Main complication? Rx?
Woms have spines on -> when migrating cause haemorrhagic tracts [creeping eruption]
-Track like necrosis with haemorrhage along nematode tract
Key issue is cerebral haemorrhage if migrates through CNS
Cook food
Ivermectin / albendazole
Cerebral haemorrhage which worm?
Gnathostomiasis
gnathostomiasis spinigerum
Open lung resection of pulmonary nodule - worm discovered = ? From?
Dirofilariasis
Dogs - lives in R ventricle of heart
- This is what dogs get de wormed for “heartworm’
[Causes necrotic lesion in lungs]
dirofilaria immitis
42 hunter from US. complaining of
migratory transient swellings on his face and has one which crawls through eye ?
Rx?
Dirofilaria
Surgical
[occasionally DEC/Albendazole]
Which Dirofilaria in lungs
dirofilaria immitis
(It ‘imitates’ TB symptoms)
Capillariasis From? resevoir ? Key issue? rx?
Raw fish
Birds
Capillaria philippinensis
Profuse watery diarrhoea + eosinophilia
Massive malabsorbtion
Albendazole - at least 3 weeks
Raw fish in Hx then profuse watery diarrhoea Egg
Capillaria philippinensis
Where is most guinea worm now
Dogs - remain a reservoir especially in Chad
Chad, Ethiopia, Mali, South Sudan and Angola, with most cases in Chad and Ethiopia
Trichinella spiralis where do larvae migrate to? clinical features? Name a complication? Dx? Rx?
Muscles - form cysts + inflammation
Then infects the next host that eats the dead host
[Usually pig]
Affects many animals eg horse, bear, hunted animals
Eosinophilia - usually very high
Can get myocarditis - the heart is a muscle dumb ass
Periorbital oedema
Serology for Dx
Albendazole
Which zoonic helminth from muscle meat
Trichinella spiralis
Cause of guinnae worm infection? geography
Dracunculus medinensis.
Ingesting contaminated water. Copepods in the water. Blisters on legs.
Now confined to africa and thought to become the second disease eradicated after small pox
Guinae worm life cycle? Vector?
Limb exposed to freshwater containing their host - cyclops (copepod “water flea”)
Human consumes flea
Penetrate gut wall and develop in sub cut tissue
-Grow 50-100cm over 3 months and have millions of larvae
After approx 1 year secrete enzymes which allow worm to leave via the skin and release ‘white cloud of larvae’ when in water and re infect flea
Guinae worm presentation? dx?
-Get burning pain from worm trying to emerge from skin -> makes people put affected area in water to cool
-May also get allergic Sx due to worm emerging and also forms a blister
-Common to get an abscess where this happens
Dx usually clinical - especially if see white cloud of larvae released from female worm in water
Guinae worm (Dracunculiasis) rx?
Medical therapy usually doesn’t work
-surgical and delicate removal of the worm
[sometimes gently pulled out over several days]
What causes the main disability in Dracunculiasis?
Ulceration / abscess formation / secondary infection
Dracunculiasis control?
Safe drinking water protected from people bathing
Guinea worm host cyclops flea can be filtered out even by just straining drinking water through a cloth
[now eliminated from Asia - down from 50M infections to only 150 annually worldwide]
5F travelled to SE Asia for 2 mo
3 wk after return, onset of fever, abdominal pain, diarrhoea, and an urticarial rash.
Toxocara - visceral larva migrans
Sparganosis life cycle and eg species
Spirometra mansoni
