Genus Species

Infective stage Pathogenic stage Definitive host Intermediate host MOT

Vector Disease Signs and Symptoms

Trypanosoma Gambiense/Brucei Rhodiense Cruzi Trypomastigote- motile (flagellated) extracellular Trypomastigote- motile (flagellated) form extracellular form Trypomastigote and epimastigote present in tsetse Amastigote- intracellular & fly nonmotile, present in macrophages, lymph nodes and organs (brain, heart) trypomastigote & epimastigotekissing bug Trypomastigote Trypomastigote Trypomastigote Trypomastigote Tsetse fly Kissing bug/Ruduviid bug Humans Humans bite; contaminated blood, transfusion Tunneling of the trypomastigotes into the skin (ie. bug defecates after feeding, trypanosomes present in feces); contaminated blood, transfusion Tsetse fly Tsetse fly( ie.Glossina Kissing bug/Ruduviid bug
pallipedes, Morcidas spp.?)

West African Sleeping Sickness: Slowly progressing fever, wasting, late neurologic symptoms

East African Sleeping Sickness More severe with rapid cycling of fevers, leading to neurologic symptoms and death in weeks to months

Chagas Disease
1. Chagoma- hardened area at the site of parasite entry 2. Acute- Chagas disease: fever, malaise, swollen lymph nodes Meningoencephalitis Acute myocarditis with tachycardia and EKG changes 3. Intermediate- low levels of parasite in blood, (+) Abs against T. cruzi, (-) signs and symptoms, most people remain in this phase for life 4. Chronic-some progress to this stage Cardiomyopathy: heart dilation, heart failure, arrhythmia Megadisease: large dilated, poorly functioning hollow organs, lead to: -Megacolon: constipation, abd. pain -Megaesophagus: dysphagia, vomitting

African Sleeping Sickness: 1. Hard, painful skin ulcer at the site of tsetse fly bite, heals
in 2 weeks( chancre- 1 sign), chagoma 2. fever, headache, lymph node swelling 3. fevers subside then relapses can occur (lasts for months) 4. CNS symptoms: daytime drowsiness, behavioral changes, difficulty waking, slurred speech, coma, death
st

Pathognomonic sign Cause of death Diagnosis

Wintterbottom sign: posterior cervical lymph nodes are enlarged, non-tender, and are like ripe plums renal/cardiac complications; results in coma death usually
after coinfection with malaria and agents causing pneumonia 1. Visualize trypamostigote in blood, spinal, fluid, lymph nodes 2. Serology: high IgM titers 1. Visualize trypomastigote in blood, spinal, fluid, lymph nodes 2. Xenodiagnosis: 40 lab bugs are allowed to feed on pt., after 1 mo bugs are examined

Treatment

1. Suramin- does not penetrate CNS 2. Melarsoprol- with CNS involvement 3. Alternatives: Pentamidine, Eflomithine

1. Nitrofurtimox- acute 2. Benznidazole 3. No antibiotic for chronic

Genus Species

Leishmania Tropica, Braziliensis, Donovani Promastigotes- flagellated (inside the sandlfy) Amastigote: intracellular & nonflagellated, inside the cells of RES

Infective stage Pathogenic stage Definitive host Intermediate host MOT Vector Disease

Humans Sandlfy bite; Contaminated blood, transfusion; Zoonotic (carried by: rodents, foxes) Sandfly Leishmaniasis: Cutaneous-tropica Mucocutaneous-Brazilienses Diffuse/Visceral-Donovani
1. Cutaneous-single ulcer at the site of bite( Oriental bite); heals in 1 yr, leaves a depigmented scar 2. Diffuse-nodules at the bite site (ie. does not ulcerate) and over the body (esp. near the nose; treatment lasts 20 years 3. Mucocutaneous- ulcers appear on mucus membranes at bite site heals; ulcers erode the nasal septum, soft palate, lips; lasts 20-40 years 4. Visceral- (Kala-azar), common in young, malnourished: fever, anorexia, weight loss, abd. swelling (hepatosplenomegaly); often fatal

Signs and Symptoms

Pathognomonic sign Cause of death Diagnosis

1. Demonstration of protozoa -blood smear -biopsy of skin lesions, spleen or liver 2. leishmanin skin test- negative in patients with low cell mediated immunity -diffuse cutaneous leishmaniasis -active visceral leishmaniasis

Treatment

Stibogluconate- arsenical compound

Genus Species

Acanthamoeba 1. Amoeba stage 2. Cyst stage in the brain

Naegleria fowleri Amoeba

Infective stage Pathogenic stage Definitive host Intermediate host MOT

-Lives in freshwater lakes -eye infections from infected contact lens, solution Granulomatous Amebic Encephalitis (GEA) 1. Chronic, ganulomatous brain infection, fatal in 1 year 2. Corneal infection

-Lives in freshwater lakes, warm

Vector Disease

Signs and Symptoms

Primary Amebic Meningoencephalitis (PAM) Acute meningitis, fatal in 1 week

Pathognomonic sign Cause of death Diagnosis Treatment

CSF exam