1

PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST LOC. INT HOST 2NDINT HOST PATHOLOGY MOT PHIL Tx

Trichuris trichiura

Whip worm

Embryonated Egg in soil/feces

DFS Unembryo eggs in feces

LI, Whip inserted into wall no migration phase to lungs

Barrel-S, 2 plugs unembryo Enterobius Vermicularis Seat Worm Pin worm

M curved 360 F blunt; stichocytes

embryonated in soil Embryonated ova Scotch tape Swab Embryonated Eggs

Ileum of SI, Cecum,LI man Gravid female Migrates to Perianal area Muscle tissue of man, pigs

D-shape, football

spindle-S, cephalic ala, corpus, isthmus, bulb M curved tail F pointd tail Encysted larvae in Inad cooked pork thread-like ; F blunt; M curved w/ 2 lobular appendages; A-end- non-papillated Larva in raw fish Eggs embryonate in Fresh water

-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

F-O-R (fecaloral route)

Yup 80-90% warm, tropical regions Yup (F>M)

Albendazole Mebendazole OxantelPyrantel Mebendazole Pyrantel pamoate

H-M (handmouth) inhalation Retro infection Ingestion of encysted larvae in pork

Trichinella Spiralis

Tissue biopsy Xenodiagnosis

larva w/ spearlike burrowing tip

Bachman Intradermal test

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

DFS -eggs (E) -larva (L) -adults (A)

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

(not attach)

peanut shape

-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

Thiabendazole Corticosteroid
(for allergic rxn)

Mebendazole? Ref (5F 20d,

20F10d, 20F 6d)

Ingestion Of larva In raw fish

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

Mebendazole Albendazole

Ascaris Lumbricoides Most common Intestinal nematode Ancyclostoma Duodenale

Giant Round Worm Decorticated, Unembryo egg Old World Hook worm New World Hook worm Thread Worm
tri-radiate xs

Embryonated Egg

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

Liver-lung Migration
(larv swallowed)

F-3 lips; M2 spicules teeth

larvae, corticated 3rd stage filariform

SI Lung migration

Oral percutaneous

Necator Americanus

8-cell stage

cutting plates

pointed tail, short esophagus 3rd stage filariform

DFS EIA -ELA Rhab in stool SI man; Lung Migr aftr skin Penet; repro parthogenesis Eggs hatch SI

Skin Penetration

Strongyloides Stercoralis

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

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 Thiabendazole

2
2ND INT HOST

PARASITE

A.K.A.

EGG

ADULT

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST

PATHOLOGY

MOT

PHIL

Tx

Brugia Malayi

kinky, overlapping nuclei, nuclei reach tail end (terminal, subterminal n.) giemsa sheath unstained 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

Lymphatics Bloodstream Peripheral Blood

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

Acute Hypersensitizatn Chronic (poor prog), elephantiasis (blocks lymphs) Weingartens Syndrome Hyper-eosin of Peripheral blood Calabar swelling Adult in eye hypersensitivity

Skin Larva Enter bite wound Mosquito Bites at night

Yup Warm regions

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

Wuchereria Bancrofti

Loa Loa

Subcutaneous tissue

Skin Larva Enter bite wound Ingestion Of Infective copepods

No Africa

Diethylcarbamazine Corticosteroids surgery

shedding of sheath, Dracunculus Medinensis Fiery Serpent Israelites Guinea worm Oncocerca Volvulus Larvae in copepods Local lesion Worm/Larvae Calcifiqed Worms by x-ray Biopsy Mazzotti Slit lamp History -eating, travel leukocytosis & eosinophilia Skin test needs evaluation Brain Spinal cord ManAccidental hosts Intestines (gut wall) Mollusks, Snails: Achantina, Pila Planaria, Slugs, prawns Mollusks Snails, slugs Edoscopy Immunologic Tests under Study Marine Crustaceans And fish 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 NO Middle East, Africa NO Africa C. and S. America NO TAI, THAI, CAM, VIET, Hawaii, Tahiti Metronidazole Thiabendazole

larva migrates to lower ext. Larvae Crawl into Bite wound

VectorBlack fly

Skin Larva Enter bite wound Ingestion Of larva In snails

Diethylcarbamazine Corticosteriods Surgery None recommended Dead parasite Could exacerbate Tissue reaction Surgical if ncessary

Angiostrongylus Cantonensis

Rat Lung worm

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)

Angiostrongylus costaricensis

Anisakis

Herring disease

Terranova sp juveniles 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

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

NO JPN, Netherlands

Remove larvae By biopsy Forceps Surgical Intervention For obstruction Manage conservatively

3
2ND INT HOST

PARASITE

A.K.A.

EGG

ADULT

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST

PATHOLOGY

MOT

PHIL

Tx

Schistosoma Hematobium Platyhelminthes Schistosoma Mansoni Platyhelminthes Schistosoma Japonicum Platyhelminthes Schistosoma Intercalatum Schistosoma Mekongi Fasciola Hepatica Fasciolidae terminal spine

S. Japonicum

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)

Freeswimming Cercaria lateral spine Cercaria

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

Biomphalaria Snail

in copula, males have lateral knob gynecophoric canals (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 Metacercaria Unembryo Sheep Encysted ova in feces, Liver On aquatic duodenal Fluke vegetation aspirates leaf S, w/ shoulders cephalic popping cone, spinous, dendritic testes operculum Giant Liver Fluke Chinese Liver Fluke Cat Liver Fluke Larger than F. hepatica no shoulders branched testes; spatulate lancet S reddishbile color Metacercaria Encysted On aquatic vegetation Metacercaria Encysted On Fresh Water fish Metacercaria Encysted On fresh Water fish Metacercaria Unembryo ova

Oncomelania Quadrasi, Formosa

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 Nope Africa Brazil Yup Mindanao, Visayas

Praziquantrel

Praziquantrel

Praziquantrel

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

Fasciola Gigantica Fasciolidae Clonorchis Sinensis Opistorchidae Opistorchis Felineus Opistorchidae Opistorchis Viverrini Opistorchidae Dicrocoelium Dendriticum Dicrocoellidae

SnailsLymnea Philippinensis, Lymnea swinhoe (TAI) (sporocystredia-cercaria) Snail

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

Bithionol

Aquatic vegetation

Bithionol

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

Operculate Snails (Alocinma, Parafossarulus, Bithynia) Snails Bithynia Funiculate Snails Bithynia Goniomphalus, Funiculate, laevis Snails- Abida, Cochilcopa, Helicella, Zeb

knob at abopercular end Lancet fluke deep golden-brown

lobed testes like O. felineus 2 large testes lancet, flat, transparent, aspiny Metacercaria Embryo ova w/ fully dev miracidium sheep

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

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

Chloroquine Diphosphate Praziquantel Praziquantel

Praziquantel

Ingestion of ants

Praziquantel

4
2ND INT HOST

PARASITE

A.K.A.

EGG

ADULT

INFECTIVE

DIAGNOSTIC

HOST LOC.

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 Unmebryo Eggs in feces

Encapsulated in Parenchyma of lung; in fibrotic capsules Reservoir Cats & dogs Duodenum of Man or pigs

Fasciolopsis Buski 2 dendritic testes in tandem

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

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

Ingestion Of Infected crustaceans

Yes Asia

Praziquantel Bithionol Triclabendazole

Ingestion Of Infected Water Plants

Nope SEA, CHN, India, indonesia Yes EGY, Greece, CHN, JPN, KOR, TWN, Phil

Praziquantel

indistinguish from F. hep, F. gigantica Heterophyes Heterophyes H. Metagonimus yokogawai

MC are Sensitive to Dryness Metacercaria In fish Unembryo Eggs in stool Using Kato-Katz method Small Intestines Reservoir Fish eating mammals

M. eggs no aboper protub; same

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

Miracidium present in The egg once Deposited by adult Metacercaria No sporocyst stage

Snails : Freshwater, Brackish or Marine MC

Ingestion of MC Encysted in fish

Praziquantel

Echinostoma Ilocanum oral sucker with collar of spines; 2 lobed testes in tandem, reddish-grey

Unembryo Eggs in feces

Small Intestines Reservoirrats

indisting.from fasciolas Taenia Solium Pork Tapeworm

Snails: -Gyralus Convexlusculus -Hippeutis Umbilicalis MC Hogs, wild Boars, sheep, Deer, dogs, Monkeys, rats, cats eggs cysticercous cellulosae

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

Ingestion Of encysted MC in snails

Of course N. Luzon, Samar, Leyte, Mindanao yes cosmo

Praziquantel

Cysticercous Cellulosae

Ripe or gravid Proglottid formaldehyde soln

Small intestines of man cysticercosis in muscles

Inflamm, Eosinophilia, leukopenia Dev Cisticercosis (ingestion of eggs), larva in brain, muscle, eye Epigastric Pain, vertigo, Nervousness, eosinophilia

Ingestestion Of inadeq. Cooked Pork Accidental Ingestion of eggs Ingestion Of cysts in beef

Praziquantel

rostellum w/ hooks 4 suckers; ripe proglottid <13 lateral branches; 3m Taenia Saginata
Longest Tapeworm

Beef tapeworm

indistinguish from each other and from E. granulosus; hexacanth (6 hooklets); radially striated shell

eggs cause cysticercosis Cysticercous bovis

Scolex after therapy Ripe or gravid Proglottid Scolex after therapy Man SI (accidental)

Cattle, llama, Giraffe, Carabao eggs cysticercous bovis

Niclosamide -damage to point of dissolution

no rostellum, hooklets ripe >15 branches; 5m; tree-like dicho branching Eggs man Hydatid sand dogs x-ray to detect hydatid ds; immunologic tests SI of Dog -Cysts Ingested and Release scolices

Echinococcus Granulosus
smallest Tapeworm In man

Parasite Of dog

one long gravid proglottid

Sheep, man (accidental, intermediate in liver and lungs)

Obstruction Growing cysts; Anaphylactic Shock when Cyst ruptures

FOR Ingestion Of eggs in feces

rare

Sugery Prev spillage of eggs) Albendazole

5
2ND INT HOST (fish) perch, trout, salmon, pike ProC PleroC Coracidia (CO) Procercoid (ProC) Ctenocephalides canis (dog flea) Ctenocephalides felis (cat flea) Pulex irritans (human flea) Trichodectes canis (dog louse) Insects, rice And flour beetles

PARASITE Diphyllobothrium Latum

A.K.A. Fish/ Broad t-worm

EGG

ADULT

yellow-brown knob like thickening Dipylidium Caninum Dog T-worm Double Pored T-worm

INFECTIVE Plerocercoid Larva Encyted In fish

DIAGNOSTIC Operculated Eggs; Proglottids Kato tech

HOST LOC. SI in man Reservoir Host: Dogs, cats,Bears Paratenic host: Carnivore fish

INT HOST copepods (Cyclops & Diaptomus)

spatulate, rosette uterus 2 bothria = sucking grooves Cysticercoid Larva in Arthropod Host when ingested retractile, conical scolex; rose-thorn shape hooklets mature proglottid with 2 lateral genital pores Embryo Eggs in Contam food and Water 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

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

MOT Ingestion

PHIL Rare Only 7 cases temperate zone

Tx Praziquantel

SI of dog or cat

Ingestion

yup

Praziquantel

egg packets (8-15 eggs) oncosphere w/ 6 hooklets

Hymenolepsis Nana

Dwarf t-worm

SI of man

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

FOR Auto Infection

yup

Praziquantel

with filaments like D. caninum scolex but with less hooklets; ripe segment Hymenolepsis Diminuta Rat T-worm

Cyticerci Can complete Cycle in single Host (autoinf) Cysticercoid Larvae in insects

w/o filaments bile-stained; fan-like Sparganosis Mansoni, Erinacei, Ranarum Spirometra

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

gravid segment; rudimentary, unarmed rostellum Plerocercoid In toads, frogs, snakes, paratenic hosts - pigs mistaken for D. latum; pseudosegmentation w/ slit-like invagination White larvae In lesion Adult Intestines of Cat/man 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

Entamoeba Histolytica

Ameba

Qudri cysts

-Trophozoites In liquid stools -Cysts in Formed stools Culture, serology to detect invasive Amebiasis (IHAT) ELISA most Sensitive indicator Trophozoites In CSF and tissue Flagellate form in CSF

Naegleria fowleri

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 Trophozoite

Large Intestines (cecal and sigmoidorectal) liver in extraint amebiasis Brain

Flasklike Primary ulcer; 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) Amebic Keratitis (assoc w/ use of contam contact lenses)

Ingestion Of Infective cysts

Yes Most Common Are Asympto carriers

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

EntersThru Nose Penetrate Cribriform Plate Multiply in brain Thru Lower respi Tract or Thru ulcerated, Broken skin

rare all types of soil

Large, usually Central K Acanthamoeba

slug-like; PSD: blunt; trophozoite

Cysts and Trophs inTissue Giemsa or PAS of Scrapings or Cornial biopsy

CNS cornea

Rare All types Of soil

Propamidine, Miconazole, neomycin Corneal grafting

large central K; double cell wall Entamoeba coli

sluggish; PSD: spine-like No peripheral chrom

yellow-brown; 1-8 nuclei, K eccentric; CB : splinter-like Entamoeba Gingivalis Endolimax nana pale green; 1-4 nuc; K irreg CB : bacilliform Iodamoeba butschlii 1 nuc yellow green; K surr w/ granules; endosome Entamoeba hartmanii 1-4 nuc; K small/Central; Diffuse glyco mass

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

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

slug, prog; PSD : Blunt/Hyaline

non prog; PSD : fingerlike

7
2ND INT HOST

PARASITE

A.K.A.

CYST

TROPHOZOITE

INFECTIVE

DIAGNOSTIC

HOST LOC.

INT HOST

PATHOLOGY

MOT

PHIL

Tx

Balantidium Coli Largest prot parasite Only ciliate Giardia Lamblia

cyst

DFS of Troph and Cysts in Feces Sigmoidoscopy DFS Cysts and Trophs Biopsy, Entero-test, IF and antigen detection

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 In lumen Of LI

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 -Colicky ab pain; anal Pruritis; Peripheral eosinophilia

FOR Ingestion of Contam Food And water FOR

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

Tetracycline Metronidazole Iodoquinol Oral Metronidazole Tinidazole Furozolidone Quinacrine paromomycin Oral Metronidazole Acid douches

bean-shaped nuc gay bowel syn young 2 nuc; mature 4 nuc; flagella retracted into axonemes No cyst stage

cytostome; cytopyge; Quadri cysts

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

Trichomonas vaginalis

pyriform; jerky movements; 4 free flag +1 undulating; axos Dientamoeba Frgilis No known cystic stage Troph

Trophozoites In urine, Urethral sec, Vaginal sec, Cervical sec, Semen, Prostatic sec Binucleate Trophs in fresh Stool samples

Sexual intercourse Passed thru Birth canal

Yes Hostpitality Girls 24% Other groups - 3-8%

Co-infection With E. vermicularis

Siguro as long as may infection w/ E. vermic -in pre-schools in Germany, Israel, Holland Wala Africa, India South amercia

Iodoquinol Tetracycline Metronidazole

rosette-shaped nuclei; no peri chromatin; K w/ 4-6 granules; no flag Leishmania Tropica Old World Cut Leish w/ ovoid or rounded bodies promastigote 1 free flagella arising from kinetoplast Pro M 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

-Mimics IBS (irrit bow syn) Cutaneous leishmaniasis Lesions resembling Lepromatous leprosy Visceral Leishmaniasis or Kala-azar Splenomegaly, presence of Parasites in RE cells; Mucocutaneous or American Leishmaniasis

Bite of Sandly vector

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

Leishmania Donovani

Bone marrow, Spleen or Lymph nodes

amastigote Leishmania Braziliensis New World Cut Leish amastigote Trichomonas Tenax Chilomastix Mesnili knoblike prod, LemonS Smaller and longer than T. vaginalis spiral forW; 3 ant flag + 1 Troph cysts Serology For supportive diagnosis swabbing Cysts in Semi-formed Stools; Trophs in Liquid stools

Tapir nose Erosion of pinna of forest workers Oral cavity -tartar Cecal region Of LI Droplets, kissing FOR yes Rare <1%

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 Chagas Disease

Trypomastigote

T-mastigote

Parasite in Blood tissues Or CSF 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

Bite of Vector Congenital Transmission possible

NO West and Central Africa NO Uh..east Africa? No Income Groups In Suburban rural Yes Cosmo Many are Chronic Ill but are asympto Not sure

Supportive Pentamidine Suramin Melarsopenol Tryparsamide Melarsen

Trypanosoma Rhodesiense

Trypanosoma Cruzi

Epimastigote

Trypomastigote

T-mastigote

Blood smear Serology CF Xenodiag biopsy

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 Schizont, gametes Inside host

Isospora Belli

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

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

-Bite of Vector -feces -transplacental -accidental ingestion -blood trans Ingestion, Transplacenetal

8-amino quinolones Primaquine, Nifurtomax (Bayer 2502) Pyrimethamine (Daraprim), TrisulfapyriMidines; Preg spiramycin, Clinamycin; AIDS Atovaquone Pyrimethamine Sulfadiazide or Trimetroprim

FOR

immature cyst Pneumocystis Carinii

Droplets, Close contact

Yes cosmo

Bactrim

cysts GAMETE Plasmodium Falciparum SCHIZONT 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

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

Plasmodium Vivax Plasmodium Malariae

-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

Bite of female Mosquito Passage of Blood w/ Erythrocytic Parasite by: -blood trans -contam syringe -neonatal -congenital

Yes Malaria Free areas -manila -aklan -capiz -guimara -siquijor -biliran -iloilo -leyte N -leyte S -N Samar -Camiquin -Cebu -Catand.

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

Plasmodium Ovale