PARASITE

A.K.A.

EGG

ADULT

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST

2NDINT HOST

PATHOLOGY

MOT

PHIL

Tx

Embryonated Egg in soil/feces Trichuris trichiura Whip worm Barrel-S, 2 plugs unembryo Seat Worm Pin worm M curved 360 F blunt; stichocytes embryonated in soil Embryonated ova Scotch tape Swab Embryonated Eggs Encysted larvae in Inad cooked pork Trichinella spiralis thread-like ; F blunt; M curved w/ 2 lobular appendages; A-end- non-papillated Larva in raw fish Capillaria philippinensis Eggs embryonate in Fresh water DFS -eggs (E) -larva (L) -adults (A) DFS Unembryo eggs in feces

LI, Whip inserted into wall no migration phase to lungs Ileum of SI, Cecum,LI man Gravid female Migrates to Perianal area

-Prolapse of Anus -IDA, Alb, D -Sometimes appendicitis -symptoms due to unique mode of attachment 1) site - ulceration 2) eggs - prupritus 3) migration -vulvuvag & salphingitis -Rheumatic pain (intestinal flu) - M eosin -swollen eyelids -3 stages of inf: intest,larval,encap -Stage of conval - death due to Myocard or enceph -int mal-ab -Borborygmi -Ab Pain -Diarrhea -Villus flat -Atrophy COL -death Lung mig Asthma; Capil penetration Pneumonia; Ab Pain due to adult Migration; Int Obst; eosin Ground itch; <500 eggs in feces = light worm, >500 eggs = heavy worm; Hookworm anemia due to suction of blood/ bleeding Microcytic Hypochromic

Yup F-O-R (fecaloral route) 80-90% warm, tropical regions

Albendazole Mebendazole OxantelPyrantel

H-M (hand-mouth) inhalation Retro infection Yup (F>M)

Mebendazole Pyrantel pamoate

Enterobius vermicularis

D-shape, football

spindle-S, cephalic ala, corpus, isthmus, bulb M curved tail F pointd tail

Tissue biopsy Xenodiagnosis Bachman Intradermal test Muscle tissue of man, pigs

Thiabendazol e Ingestion of encysted larvae in pork Corticosteroid yup

larva w/ spearlike burrowing tip

Mebendazole? Ref (5F 20d,

SI (jejunum ) of fish, man larvae in gastric mucosa and intestines SI of man

peanut shape

embryonated eggs in F typical F 8 in 1 row atypical F 40 in 2 M w/ chitin spicule

Ingestion Of larva In raw fish

Yup (M>F) I. Norte (N.Luzon) THA,JPN, EGY,TAI, IRAN Yup Most Common In world

Mebendazole Albendazole

Ascaris lumbricoides Most common Intestinal nematode Ancyclostoma duodenale

Embryonated Egg Giant Round Worm

DFS of eggs Adults in SI Gall bladder, Liver, nares, appendix DFS EIA -ELA

Ingestion Burrowing of Sin of foot

Peperazine Citrate Albendazole Mebendzaole Pyrantel Pam Pyrantel Pamoate Mebendazole Iron replacement

Decorticated, Unembryo egg

tri-radiate xs

Liver-lung Migration
(larv swallowed)

Old World Hook worm New World Hook worm 8-cell stage

F-3 lips; M2 spicules teeth

larvae, corticated 3rd stage filariform

SI Lung migration

Oral percutaneous

Yes Tropics, subT

Necator americanus

cutting plates

pointed tail, short esophagus 3 stage filariform

DFS EIA -ELA

Skin Penetration

Strongyloides stercoralis

Thread Worm

filariform; no F M Long eso, Prominent Genital primordium, notched tail

Rhab in stool

SI man; Lung Migr aftr skin Penet; repro parthogenesis Eggs hatch SI

short buc cav

Larval migration Lobular pneu w/ hem; like PUD, Hyper Infection, Peripheral Eosinophilia, malab syndrome

- Skin Penetration of FL - Free-living - auto infection

Yes Tropics, SubT

Albendazole Thiabendazol e

PARASITE

A.K.A.

EGG

ADULT

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST

2ND INT HOST

PATHOLOGY

MOT

PHIL

Tx

Brugia malayi unstained Wuchereria bancrofti

kinky, overlapping nuclei, nuclei reach tail end (terminal, subterminal n.) giemsa sheath smooth, single row of nuclei, no term nuc, >L than BM giemsa pink stain

Larvae In Arthropod Vector Bites at Night Enters Bite wound Bioincub - 1 year Larvae crawl into wound

Blood smear (thick And Knott Conc) Microfilaria In blood at Night CARD Test Antigen det DNA probes Thin blood Smear biopsy Subcutaneous tissue Lymphatics Bloodstream Peripheral Blood

mosquitos W.B. Culex Quinque Fasciatus RuralAnoph; UrbanFatigans; Pacificaedes VectorDipteran (chrysops)

Acute Hypersensitizatn Skin Chronic (poor prog), elephantiasis (blocks lymphs) Weingartens Syndrome Hyper-eosin of Peripheral blood Larva Enter bite wound Mosquito Bites at night Skin Larva Enter bite wound No Yup Warm regions

Diethylcarbamazine (not effective on adult worms) Ivermectin corticosteroids supportive pressure bandaging surgery

Calabar swelling Adult in eye hypersensitivity Mesenteric Tissues Larva migrate To lower ext Subcutaneous tissue Copepods Ingest Larva in water Blister w/ Serous exudates Pseudoperitoneal syndromes -River Blindness -Eye lesions - Skin lesions - Scrotum enlargement Eosinophilic Meningoencephalitis + eosins in CSF, CN involve, diplopia and strabismus CSF >= 500 cells/ml w/ 10-90% eosins acute abdomen - inflamm of ileocecal region; Ab pain loc to right lower quad + palpable tumor-like m Pseudoterranova spp Not penetr8 stom, Throat irrit, coughed Anisakis simplex (USA) Stom, int, inflamm Rxn surrounding larva Anisakiasis local Tissue response; (Eustrongylides spp) Perforation of L bowel

Diethylcarbamazine Corticosteroids Africa surgery NO Metronidazole Middle East, Africa NO Africa C. and S. America Thiabendazole Diethylcarbamazine Corticosteriods Surgery

Loa loa shedding of sheath, Dracunculus medinensis Fiery Serpent Israelites Guinea worm Oncocerca volvulus larva migrates to lower ext.

Local lesion Worm/Larvae Larvae in copepods Calcifiqed Worms by x-ray Biopsy Mazzotti Slit lamp 3rd stage larva in snails and slugs or rats ingested by man adult emale Barber pole dark red intestinal tract snails paratenic hosts 3rd stage larva in snails/ slugs ingested by man nd cotton rat
(Sigmodon hispidus)

Ingestion Of Infective copepods Skin Larva Enter bite wound

Larvae Crawl into Bite wound

VectorBlack fly Mollusks, Snails: Achantina, Pila Planaria, Slugs, prawns Mollusks Snails, slugs

Brain History -eating, travel leukocytosis & eosinophilia Skin test needs evaluation Spinal cord ManAccidental hosts

Angiostrongylus cantonensis

Rat Lung worm

NO Ingestion Of larva In snails TAI, THAI, CAM, VIET, Hawaii, Tahiti

None recommended Dead parasite Could exacerbate Tissue reaction Surgical if ncessary

Angiostrongylus costaricensis

Intestines (gut wall)

Terranova sp juveniles Anisakis Herring disease Pseudoterranova sp not penetrate Eustrongylides sp perforates large bowel

3rd stage larva in flesh of raw fish; larva migrate from viscera to muscle after death of fish

Edoscopy Immunologic Tests under Study Marine Crustaceans And fish

Ingestion Of raw Marine Food w/ Alcohol, green herring, sashimi

NO JPN, Netherland s

Remove larvae By biopsy Forceps Surgical Intervention For obstruction Manage conservatively

PARASITE

A.K.A.

EGG

ADULT

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST

2ND INT HOST

PATHOLOGY

MOT

PHIL

Tx

S. Japonicum Schistosoma hematobium Platyhelminthes Schistosoma mansoni Platyhelminthes Schistosoma japonicum Platyhelminthes Schistosoma intercalatum Schistosoma mekongi Fasciola hepatica Fasciolidae Fasciola gigantica Fasciolidae Clonorchis sinensis Opistorchidae Opistorchis felineus Opistorchidae Opistorchis viverrini Opistorchidae Dicrocoelium dendriticum Dicrocoellidae Lancet fluke knob at abopercular end lobed testes like O. felineus 2 large testes lancet, flat, transparent, aspiny in copula, males have gynecophoric canals lateral spine Cercaria terminal spine Freeswimming Cercaria Eggs, miracidia in urine

Adults Bladder, liver larva Venous Plexuses Liver Mesenteric venules, SC, lungs Liver, Mesenteric Venules, SI, heart, Spleen, CNS

Bulinus Snail
(Miracidia to cercaria)

Calcified Bladder (dead eggs= sandy patches); Painful urination; Kala-azar; adults coated w/ RBC An and not detected; trapped egg cause clinical symptoms; Terminal Hematuria; infection linked To S. typhi and paratyphi carriers Claypipe-stem Fibrosis = Thickening of portal vessels due to rxn w/ eggs; Hepatosplenomegaly Portal HTN, ascites, eggs sometimes Deposited in SC, lungs liver enzy,serum alb, glob(prot) Katayama rxn/ fever, reaction to Eggs in tissue = CNS damage, Hepatosplenomegaly, Portal HTN, Ascites; mucus/blood in feces, liver enzy,serum alb, glob(prot)

Skin Penetration Thru Infected water Cercaria Penetrate Skin thru Infected water Cercaria Penetrate Skin thru Infected water

Wala Siguro Tropics Subtropics Praziquantrel

Freeswimming Cercaria

Ova in feces (blood, mucus) Rectal biopsy Ova in feces, Rectal biopsy, COPT test, ELISA

Nope Africa Brazil Yup Mindanao, Visayas Praziquantrel Praziquantrel

Biomphalaria Snail

lateral knob (smallest) Like Schistosoma mansoni in terms of life cycle, pathology and clinical features Intermediate host Biomphalaria snail Lide Schistosoma japonicum in terms of life cycle, pathology and clinical features Intermediate host Lithoglyphopsis aperta Sheep Liver Fluke Metacercaria Encysted On aquatic vegetation Metacercaria Encysted On aquatic vegetation branched testes; spatulate lancet S reddishbile color Metacercaria Encysted On Fresh Water fish Metacercaria Encysted On fresh Water fish

Oncomelania Quadrasi, Formosa

popping operculum Larger than F. hepatica

leaf S, w/ shoulders cephalic cone, spinous, dendritic testes

Unembryo ova in feces, duodenal aspirates

Bile duct of Sheep Herbivore animals Giant AnimalsCattle Biliary tract (BT) Man BT Small AnimalsCats, dogs, etc (BT SI) Civet cat, Dog, fisheating

SnailsLymnea Philippinensis, Lymnea swinhoe (TAI) (sporocystredia-cercaria) Snail Operculate Snails (Alocinma, Parafossarulus, Bithynia) Snails Bithynia Funiculate Snails Bithynia Goniomphalus, Funiculate, laevis Snails- Abida, Cochilcopa, Helicella, Zeb

Aquatic vegetation

Halzoun ingestion Raw sheep, goat livers (dyspnea, deafness, asphyxiation, death) fibrotic vs. traumatic/ necrotic lesions; obs; False vs true (no eggs)

Ingestion of Infected Vegetation; Infected Liver (false) Ingestion of Infected Vegetation

Cosmo In sheep Raising countries Most Probably Bithionol Africa, Asia Rare Bithionol

Giant Liver Fluke Chinese Liver Fluke Cat Liver Fluke

Unembryo ova Embryo ova In feces or Biliary duodenal aspiratesBDA Embryo ova In feces or BDA Embryo ova In feces Or BDA Embryo ova

Aquatic vegetation Fresh water Fish (FWF) : Cyprinidae, Ctenopharyngodon FWF Cyprinus Carpio (Taiwan) FWF Punteus Orphoides, Hampala dispar Formica Fusca (ants) Cholangiocarcinoma of liver, liver function Impaired but SGPT and SGOT are normal Periportal fibrosis, Invasion of pancreas, Form bile stones Hyperplastic biliary Epithelium (Stim by Nitrosamines); assos. w/ cholangiocarcinoma Same as F. hepatica Portal cirrhosis, Periductal fibrosis

no shoulders

Ingestion of Uncooked fish Ingestion of Infective fish Ingestion of Infective fish

CHI, JPN, SK, Vietnam Nope USSR, poland Nope Thailand Udorn Wala siguro

Chloroquine Diphosphate Praziquantel Praziquantel

Metacercaria

Praziquantel

deep golden-brown

Metacercaria

w/ fully dev miracidium

sheep

Ingestion of ants

Praziquantel

PARASITE

A.K.A.

EGG

ADULT

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST

2ND INT HOST

PATHOLOGY

MOT

PHIL

Tx

Paragonimus westermani

Oriental Lung Fluke

operculum at broad end, thick aboper

branched testes side by side; coffee bean; integument w/ spines

Metacercaria In crustacean Cercaria w/ spines Metacercaria In water Plants

Unembryo eggs in feces or sputum complement fixation

Encapsulated in Parenchyma of lung; in fibrotic capsules Reservoir Cats & dogs

Snail Miracidia (M) Cercaria (C) Antemelania Asperta; Antemelania Dactylus Snails MC

Crabs Sundathelphusa Philippina C meta-C Aquatic Vegetation C meta-C Water caltrop, Water chestnut, Water morning Glory, lotus Many fish in the Phil. (30 Species); in muscles at base of the fin C meta-C

Granulomatous rxn in lungs; rustcolored sputum, w/ Foul fish Odor Misdiagnosed For PTB Worms cause Traumatic, Obstructive and toxic effects; ulceration and mucus prod. Inflamm, Sloughing off Of layers, xs Mucus prod Misdiagnosed For acid Peptic ds (APD), consistent w/ PUD Inflamm, Ulceration, Diarrhea, intoxiacation Inflamm, Eosinophilia, leukopenia Dev Cisticercosis (ingestion of eggs), larva in brain, muscle, eye

Praziquantel Ingestion Of Infected crustaceans Yes Bithionol Asia Triclabendazole Nope Ingestion Of Infected Water Plants SEA, CHN, India, indonesia Praziquantel

Fasciolopsis buski

indistinguish from F. hep, F. gigantica

2 dendritic testes in tandem

MC are Sensitive to Dryness Metacercaria In fish

Unmebryo Eggs in feces

Duodenum of Man or pigs

Segmentina, Hippeutis

Heterophyes heterophyes H. hard to distinguish adults; scale-like spines, w/ genital sucker, globular testes

Metagonimus yokogawai

M. eggs no aboper protub; same

Miracidium present in The egg once Deposited by adult

Unembryo Eggs in stool Using Kato-Katz method

Small Intestines Reservoir Fish eating mammals

Snails : Freshwater, Brackish or Marine MC

Yes Ingestion of MC Encysted in fish EGY, Greece, CHN, JPN, KOR, TWN, Phil Of course Ingestion Of encysted MC in snails Ingestestion Of inadeq. Cooked Pork Accidental Ingestion of eggs N. Luzon, Samar, Leyte, Mindanao Praziquantel Praziquantel

Metacercaria Echinostoma ilocanum indisting.from fasciolas oral sucker with collar of spines; 2 lobed testes in tandem, reddish-grey No sporocyst stage Cysticercous Cellulosae Taenia solium Pork Tapeworm rostellum w/ hooks 4 suckers; ripe proglottid <13 lateral branches; 3m indistinguish from each other and from E. granulosus; hexacanth (6 hooklets); radially striated shell eggs cause cysticercosis

Unembryo Eggs in feces Ripe or gravid Proglottid formaldehyde soln Scolex after therapy

Small Intestines Reservoirrats

Snails: -Gyralus Convexlusculus -Hippeutis Umbilicalis MC Hogs, wild Boars, sheep, Deer, dogs, Monkeys, rats, cats eggs cysticercous cellulosae Cattle, llama, Giraffe, Carabao eggs cysticercous bovis Sheep, man (accidental, intermediate in liver and lungs)

Snails: -Pila luzonica kuhol and -Vivipara Angularissuso C meta-C

Small intestines of man cysticercosis in muscles

Praziquantel

yes cosmo

Taenia saginata
Longest Tapeworm

Beef tapeworm

Cysticercous bovis no rostellum, hooklets ripe >15 branches; 5m; tree-like dicho branching Eggs man Hydatid sand one long gravid proglottid dogs

Ripe or gravid Proglottid Scolex after therapy x-ray to detect hydatid ds; immunologic tests

Man SI (accidental)

Epigastric Pain, vertigo, Nervousness, eosinophilia

Ingestion Of cysts in beef

Niclosamide -damage to point of dissolution

Echinococcus granulosus
smallest Tapeworm In man

Parasite Of dog

SI of Dog -Cysts Ingested and Release scolices

Obstruction Growing cysts; Anaphylactic Shock when Cyst ruptures

FOR Ingestion Of eggs in feces rare

Sugery Prev spillage of eggs) Albendazole

PARASITE

A.K.A.

EGG

ADULT

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST

2ND INT HOST

PATHOLOGY

MOT

PHIL

Tx

SI in man Diphyllobothrium Latum Fish/ Broad t-worm Plerocercoid Larva Encyted In fish Operculated Eggs; Proglottids Kato tech Gravid Proglottids That are passed out/ Crawl out, Egg packets, Melon-shaped Proglottids in Chains (Not stool bec proGlot disint in environment Embryo Eggs in feces Proglottids not Recovered bec They degenerate SI of man Reservoir Host: Dogs, cats,Bears Paratenic host: Carnivore fish

copepods (Cyclops & Diaptomus)

yellow-brown knob like thickening

(fish) perch, trout, salmon, pike ProC PleroC

spatulate, rosette uterus 2 bothria = sucking grooves

Coracidia (CO) Procercoid (ProC) Ctenocephalides canis (dog flea) Ctenocephalides felis (cat flea)

Anemia (misdiag for pernicious type Vit B12 def); hyperchromic megaloblastic; examine for HCl in gastric juice (+ infection)

Rare Ingestion Only 7 cases temperate zone Praziquantel

Dipylidium Caninum

Dog T-worm Double Pored T-worm egg packets (8-15 eggs) oncosphere w/ 6 hooklets

retractile, conical scolex; rose-thorn shape hooklets mature proglottid with 2 lateral genital pores

Cysticercoid Larva in Arthropod Host when ingested

SI of dog or cat Pulex irritans (human flea) Trichodectes canis (dog louse)

Minimal symptoms

Ingestion

yup

Praziquantel

Hymenolepsis Nana

Dwarf t-worm

Embryo Eggs in Contam food and Water with filaments like D. caninum scolex but with less hooklets; ripe segment Cyticerci Can complete Cycle in single Host (autoinf)

Insects, rice And flour beetles

Enteritis due to Necrosis and Desquamation Of intestinal Epithelial cells Direct/indirect pathways

FOR Auto Infection yup Praziquantel

Hymenolepsis Diminuta

Rat T-worm w/o filaments bile-stained; fan-like gravid segment; rudimentary, unarmed rostellum

Cysticercoid Larvae in insects

Eggs in stool (more circular, larger, lack bipolar thickening vs H. nana

SI of man

Fleas, beetles, cockroaches, mealworms & earwigs

Minimal and Non-specific

Ingestion Of Infected insects

yes In rats <8% Praziquantel

Sparganosis Mansoni, Erinacei, Ranarum Plerocercoid In toads, frogs, snakes, Spirometra mistaken for D. latum; pseudosegmentation w/ slit-like invagination paratenic hosts - pigs

Adult Intestines of Cat/man White larvae In lesion Larvae any part, eye, subQT, muscles Cyclops, copepods

Frogs, Snakes, Toads, rats

Painful edema Due to migrating Larvae Eosinophilia, Edema and erythema

Ingestion Of Infected interM hosts

Not sure

surgical

- COPYRIGHT 2005 - AUDS MARTINEZ - USTMED SEC C 07 -

PARASITE

A.K.A.

CYST

TROPHOZOITE

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST

2ND INT HOST

PATHOLOGY

MOT

PHIL

Tx

-Trophozoites In liquid stools -Cysts in Formed stools Entamoeba histolytica Ameba greenish-yellow quadrinucleate, thick, rodlike chromatoidal bodies CB, central karyosome (K), w/ chromatin dots No cyst only Flagellated form active, progressive, directional; pseudopod PSD: finger-shape, hyaline; w/ ingested RBC Quadri cysts Culture, serology to detect invasive Amebiasis (IHAT) ELISA most Sensitive indicator Trophozoites In CSF and tissue Trophozoite Large, usually Central K slug-like; PSD: blunt; Flagellate form in CSF Cysts and Trophs inTissue Acanthamoeba large central K; double cell wall sluggish; PSD: spine-like No peripheral chrom trophozoite Giemsa or PAS of Scrapings or Cornial biopsy

Large Intestines (cecal and sigmoidorectal) liver in extraint amebiasis

Flasklike Primary ulcer; Yes Histo changes: Histolysis, Thrombosis, Petechiae, Round Cell Infiltration, Necrosis Bacilliary vs Amebic dysentery Meningoencephalitis Severe frontal Headache,Blocked nose, Altered taste and smell Kernigs sign; Leukocytosis w/ neuts, prot, glu Amebic Encephalitis (immunocompromised) EntersThru Nose Penetrate Cribriform Plate Multiply in brain Thru Lower respi Tract or Thru ulcerated, Broken skin rare all types of soil Ingestion Of Infective cysts Most Common Are Asympto carriers

Supportive, Chemotherapy Asympto Diiodohydroxyquin Mod severe Metronidazole Severe D + M Hepatic M + emetine Amphotericin Amp + miconazole and rifampicin

Naegleria fowleri

Brain

Rare All types Of soil

CNS cornea

Propamidine, Miconazole, neomycin Corneal grafting

Amebic Keratitis (assoc w/ use of contam contact lenses)

Entamoeba coli

yellow-brown; 1-8 nuclei, K eccentric; CB : splinter-like

Entamoeba gingivalis Endolimax nana

sluggish, rarely prog and dir; PSD: short, blunt; Bacteria/ debris Inclusions Mod active, prog PSD : blunt, hyalin

pale green; 1-4 nuc; K irreg CB : bacilliform

sluggish prog; PSD:blunt /hyaline; K L, cent

Iodamoeba butschlii

1 nuc yellow green; K surr w/ granules; endosome

slug, prog; PSD : Blunt/Hyaline

Entamoeba hartmanii

1-4 nuc; K small/Central; Diffuse glyco mass

non prog; PSD : fingerlike

PARASITE

A.K.A.

CYST

TROPHOZOITE

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST

2ND INT HOST

PATHOLOGY

MOT

PHIL

Tx

Balantidium coli Largest prot parasite Only ciliate cyst bean-shaped nuc cytostome; cytopyge;

DFS of Troph and Cysts in Feces Sigmoidoscopy DFS Cysts and Trophs

SI Cysts Troph LI (cecal area) troph SI Duo, jeju, upper il Attaches To int villi Via adhes Disc on ven Female Vaginal epi Male Urethra, Epididymis, Prostate g

Ulcer w/ rounded Base and wide Neck (vs flask shape) Diarrhea and Dysenter (indisting. from Amebic) Villus flat and crypt Hypertrophy;electrolytes, glu, fluid abs, disacchs; diarrhea most common symptom (89%); spont recovery in 6 wks; chronic steato, diarr altern w/ constip -Vaginal discharge Liquid, green to yellow, Irritating -Speculum Strawberry Cervix (diagnostic) -Vaginitis; urethritis -Increase excess mucus -Hypermotility of the bowel

FOR Ingestion of Contam Food And water

Siguro Uncommon In Temperate; Assoc w/ Pigs in tropics siguro

Tetracycline Metronidazole Iodoquinol Oral Metronidazole Tinidazole Furozolidone Quinacrine paromomycin

Giardia kamblia

gay bowel syn

young 2 nuc; mature 4 nuc; flagella retracted into axonemes

pyriform/tear-drop; bi-symm; erratic tumbling motion; 8 flag

Quadri cysts

Biopsy, Entero-test, IF and antigen detection Trophozoites In urine, Urethral sec, Vaginal sec, Cervical sec, Semen, Prostatic sec

FOR

Outbreaks Are waterborne Yes

Trichomonas vaginalis

Sexual intercourse Passed thru Birth canal

No cyst stage pyriform; jerky movements; 4 free flag +1 undulating; axos

Troph

Hostpitality Girls 24% Other groups - 3-8% Siguro as long as may infection w/ E. vermic -in pre-schools in Germany, Israel, Holland

Oral Metronidazole Acid douches

Iodoquinol Tetracycline Metronidazole

Dientamoeba fragilis

No known cystic stage

Troph rosette-shaped nuclei; no peri chromatin; K w/ 4-6 granules; no flag

Binucleate Trophs in fresh Stool samples

In lumen Of LI

-Colicky ab pain; anal Pruritis; Peripheral eosinophilia -Mimics IBS (irrit bow syn) Cutaneous leishmaniasis

Co-infection With E. vermicularis

Leishmania tropica

Old World Cut Leish

w/ ovoid or rounded bodies promastigote 1 free flagella arising from kinetoplast

in skin tissue biopsy Lives Intracellular In Macrophages PMS and Endothelial Cells Pro M A-Mast Sand fly Pheobotomus Spp A-Mast Pro M in gut of fly

Lesions resembling Lepromatous leprosy Visceral Leishmaniasis or Kala-azar Splenomegaly, presence of Parasites in RE cells; Mucocutaneous or American Leishmaniasis Tapir nose Erosion of pinna of forest workers Bite of Sandly vector Wala Africa, India South amercia

Antimony Compounds Second line Drugs: Amp B, Pentamidine (Kala-azar), Metronidazole Nifurtimox

Leishmania donovani amastigote Leishmania braziliensis Trichomonas tenax Chilomastix mesnili New World Cut Leish

Pro M

Bone marrow, Spleen or Lymph nodes

amastigote Smaller and longer than T. vaginalis spiral forW; 3 ant flag + 1 Troph

Serology For supportive diagnosis swabbing Cysts in Semi-formed Stools; Trophs in Liquid stools

Oral cavity -tartar Cecal region Of LI

Droplets, kissing

yes Rare

cysts

FOR <1%

knoblike prod, LemonS

PARASITE

A.K.A.

CYST

TROPHOZOITE

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST

2ND INT HOST

PATHOLOGY

MOT

PHIL

Tx

Trypanosoma gambiense

West African Sleepng Sicknes East African Sleepng Sicknes Epimastigote

Trypomastigote

Parasite in Blood tissues Or CSF T-mastigote Serology for Large scale Screening ELISA, IF In blood, Lymph and CSF

Tsetse Fly Reservor Host: Domestic Animals Tsetse Fly Reservor Host: Game animals Reduviids, Triatomid Bugs Reservoir: Wild mammals Mouse or Rat Man, pigs, Sheep, Accidental Intermediate hosts

Local Infiltration from bite area to lymph and CNS -Chronic inflammation Of lymphatics -Atrophy of dendrons Of ganglion cells -Winterbottoms sign, Kerandels sign -Engulfed by histocytes and invade adipose tissue -inflamm response w/ fibrotic encapsulation = chagoma; Romanas sign Brain lesions; hepatitis; Chorioretinitis; Lymphadenitis 2 types of postnatal ds 1) mild lymphatic (lide infectious Mononucleosis) 2) acute fulminating Malabsorption syndrome; Shortened villi, hyperTrophied crypts, infilt Of lamina propria, w/ Eosins, polys, rounded cells interstitial pneumonia; fatal pneumonia in infants; hypogammaglobulinemia, leukemia, Hodgkins, etc -lungs are gray and airless; death due to asphyxia -Tissue anoxia basic pathophysio change in malaria -4 mechanisms leading to tissue anox: 1. anemia-hemolysis 2. changes in blood flow 3. changes in capillary endothelium 4. histotoxic shock -parasite virulence factors: 1. multiplication capacity 2. red cell selectivity 3. cytoadherence and resetting ability 4. potential to induce cytokine release 5. antigenicity 6. antimalarial drug resistance Blackwater fever, liver dys, hypogly, Acidosis, GI dys, placenta dys, pulmo edema, renal failure, coagulo and thrombocyto, coma

NO Bite of Vector Congenital Transmission possible -Bite of Vector -feces -transplacental -accidental ingestion -blood trans West and Central Africa NO Uh..east Africa? No Income Groups In Suburban rural Yes Cosmo Many are Chronic Ill but are asympto

Supportive Pentamidine Suramin Melarsopenol Tryparsamide Melarsen 8-amino quinolones Primaquine, Nifurtomax (Bayer 2502) Pyrimethamine (Daraprim), TrisulfapyriMidines; Preg spiramycin, Clinamycin; AIDS Atovaquone Pyrimethamine

Trypanosoma rhodesiense

Trypomastigote T-mastigote

Blood smear Serology CF Xenodiag biopsy Serology IgM detection By ELISA; IFA for IgG And IgM; PCR Of Toxo DNA Immature Cysts in feces -Oocysts/ Sprorcysts in dudenum Surgical open Lung biopsy; BronchoAlLav; Bronchoscopy; Methenamine Silver stain

Trypanosoma cruzi

Chagas Disease

Histiocytes RE cells (adipose, myocardial, RE, Neuroglial) In SI of Cat (sexual And asexual Cycle); in Tissues in Asexual cycle Definitive CAT SI of man Definitive MAN

Toxoplasma gondii

(man) bradyzoite, cyst

(cat?) male and female gametocytes

pseudocyst and oocyst w/ Sporozoites -Oocyst prod By sexual Cycle in cat; Pseudocystsasexual Mature oocyst w/ sporozoites

Ingestion, Transplacenetal

Isospora belli immature cyst Pneumocystis carinii cysts GAMETE Plasmodium falciparum SCHIZONT

Schizont, gametes Inside host

FOR

Not sure

Sulfadiazide or Trimetroprim

Droplets, Close contact

Yes Bactrim cosmo

TROPHOZOITE Mosquito Gametocytes; Man Sporozoites Hypnoxoite Latent stage, Cause relapse Sporogany Mosquito LC; Schizogony Human LC - exoerythro (merozoites) - erythro (gametocytes) Peripheral Blood smears -thick -thin QBC, Para sight F test (dipstick test), IFA RBC (Man) Vivax young Malariae old Falciparum all Mosquito : 1)Stomach Gamete form, 2)Stomach wall oocyst and sporozoite release 3)salivary glands - sporo Yes Bite of female Mosquito Passage of Blood w/ Erythrocytic Parasite by: -blood trans -contam syringe -neonatal -congenital Malaria Free areas -manila -aklan -capiz -guimara -siquijor -biliran -iloilo -leyte N -leyte S -N Samar -Camiquin -Cebu -Catand.

Plasmodium vivax Plasmodium malariae

Anopheles Flavirostris Minimus Anopheles -litoralis -balabacensis -mangyanus -maculates

Vivax and Ova Chloroquine + Primaquine Falci and Mal -Chloroquine Chloroquine Resistant Falc

Plasmodium ovale