Parasites

Balantidium coli

the only ciliate that parasitizes humans and causes dysentery. It is common in pigs and the cysts can be found in feces of affected humans

Symptoms of Trichomoniasis

* male - slight itching; moisture on top of penis; slight, early morning urethral discharge; many males asymptomatic * female - itching and redness of vulva and skin inside thighs; copious watery, frothy vaginal discharge

symptoms of chagas disease

- Megacolon w/ extreme constipation - Dilated Cardiomyopathy - Megaesophagus (mega snake)

Leishmania Baziliensis (classification)

-Host = vertebrates, esp humans -Vector = sandflys -Sandfly carries promastigote (infective form) -In host, becomes amastigote inside macropahge - visible in aspirate from lesions -Consumes flesh

A patient who recently visited Maine for a hiking trip comes in complaining of an irregular fever. They had a splenectomy several years ago. The patient is jaundice and is sweating profusely. 1. What is a ddx? 2. Vector? 3. What would be seen on a blood smear? 4. Treatment

1. Baesia microti 2. Ixodes Tick 3. thick blood smear in Babesia spp. infection will show intracellular and extracellular ring forms and classic tetrad "Maltese Cross" forms inside RBCs 4. Atovaquone and azithromycin

Characteristics of Entamoeba histolytica include:

1. Bloody Diarrhea 2. Cysts in fece 3. RUQ- right lobe of liver is involved in amoebic liver abscess 4. outpouching of haustra- Anchovy paste consistency 5. Ulcerations along the colon, that are flask shaped ELISA antigen test for Oocysts and Protozoa

___________ leishmaniosis is caused by ________ form. Vertebrates are hosts and sand flys are the vectors Once it is transmitted it end up in the macrophage, and can cause skin lesions. Amastigotes infect the spleen

1. Cutaneous 2. Leshmania Braziliensis

A young male patient comes into your office complaining of foul smelling stool, flatulence and abdominal bloating. He states he just returned from a camping trip to the national parks and had gotten his water supply from springs 1. Possible diagnosis 2. Detect by? 3. Treatment

1. Giardia Lambia 2. Detect by looking for trophozoite/ cysts in feces 3. Metronidazole

Black fever is caused by 1. _________. It causes 2.________ of the skin. It causes 3.______ of all RBCs. Treat with 4._________

1. Lishmania Donovani 2. Hyperpigmentation of skin 3. Pancytopenia 4. Amphotericin B

Classification of protozoans

1. Motility 2. 4-phylum -Amoeboza -Ciliates -Flagellates -Apicomplexia

A 1._______ can be used to diagnose a Trypanosoma cruzi infection. The 2. _____ will be observable in the sample 3. _____ can be used to treat it

1. Peripheral Blood Smear 2. Trypomastigotes 3. Nifurtimox

*Typanosoma cruzi (Chagas disease) causes:

1. Toxic Megacolon 2. Dilated cardiomyopathy 3. Megesophagus can be diagnosed by blood spear

A patient who recently traveled to Africa is in the ICU in a coma. They present with enlarged cervical and axillary lymph nodes. They have recurrent fevers. The suspected pathogen supports antigenic variation. 1. What is a potential diagnosis and what is the vector 2. What would a peripheral blood smear show 3. What is the treatment

1. Trypansoma brucei gambiense and rhodesiens, vector= tseste fly 2. Trypanosoma brucei trypomastigotes (mature form) can be seen on peripheral blood smear 3. Treat with Melarsoprol (CNS) , Suramin (blood)

Cryptosporidium parvum is a protozoa that causes profound 1._____ diarrhea. It is incredibly dangerous to the HIV population. To test we will use 2. ____stain on the oocytes. It is a self limiting infection and attaches to the 3. ________ to cause cellular damage. To treat we use 4.___________.

1. Watery Diarrhea 2. Acid Fast 3. Intestinal Lumen/walls 4. Nitazoxanide

Plasmodium malariae

ANOPHELES mosquitos final host causes hemoglobinemia and hemoglobinuria QUARTAN fever cycle Dx: thick and thin blood smears. has hemozoin pigment Tx: chloroquine

Leshmania Braziliensis is diagnosed by

Amastigotes in macrophages=> Cutaneous lesions

Leshmania Donovani is diagnosed by

Amastigotes in macrophages=> bone marrow, liver and spleen

Naegleria fowleri life cycle

An amoeboflagellate that has three distinct stages in its life cycle: cyst, amoeba and the flagellated swarming form, it is typically found in warm bodies of fresh water, such as ponds, lakes, rivers, and hot springs, the trophozoite (amoeba) form is the reproductive stage of the protozoan organism which reproduces by binary fission when the temperature is above 25°C, it grows fastest at around 42°C, encystment occurs due to unfavorable conditions including temperatures below 10oC, most human infections involve swimmers and begin in the sinuses, if the infection spreads to the brain it can cause severe meningitis and encephalitis, such infections are rare but nearly always results in the death of the victim, both the trophozoite and swarming stages are thought to be infectious

Naegleria fowleri

Associated with fresh water, they have a high mortality rate because they enter the brain via cribriform plate - causes primary amoebic meningoencephalitisTrap

_____ can be used to treat a Babesia microti.

Atovaquone and azithromycin

Maltese cross is a characteristic of what parasite. The patter

Babesia microti

_____ is a parasite that moves with cilia

Balantidium coli

Clinical features of Giardia lamblia

Bloating. flatulence and foul smelling diarrhea. Steatorrhea (fatty diarrhea) this is caused by excess mucus production, fat-soluble vitamin deficient Diagnosis: Cysts in stool, ELISA to detect antigens

A stool sample is in the path lab. The sample contains trophozoites that contain endocytosed RBCs. Upon further examination the patient is found to have pain in his RUQ, the abscess in that area has an anchovy paste consistency and are flask shaped. What is your differential diagnosis and treatment?

Ddx: Entamoeba Histolytica Treatment: Metronidazole

Symptoms of babesiosis caused by the ixodes tick include

Fever, irregular cycling fevers, hemolytic anemia, jaundice, thick blood smear with maltese cross

Toxoplasma gondii characteristics

Is a sporozoan, non motile parasite. -Its definitive host is cats, but it can also be passed from raw meat (pig is number one in the US), water can also be contaminated. - Oocytes is the main form of transmission Serology will show an increased IgM or rising IgM

Giardia lamblia

Is common among travelers or campers. It can be caused by drinking unfiltered/ unpurified water that contains cysts of giardia from feces. It is transmitted fecal-orally Causes bloating, flatulence and foul smelling diarrhea. It is flagellated only affects intestines

babesiosis is a tick-borne illness caused by ________

Ixodes tick

What is the most server form of leishmania?

Leishmania Donovanii

_____ is used to treat giardia lambia and entamoeba histolytica. . Its function is to inhibit nucleic acid synthesis. It functions to reduce the nitro group of metronidazole within the microorganism forms a highly reactive nitro radical anion which breaks DNA strands

Metronidazole

Trypansoma brucei gambiense and rhodesiense

Motile w/ single flagella, parasite Caused by the Tsetse fly (vector) - Biting causing the infection to move from blood to lymph causing posterior cervical and axially lympaenopathy - recurrent fevers - CNS Main virulence factor is antigenic variation Diagnosis with blood smear Can cause coma and death if left untraeted

Primary Amoebic Meningoencephalopathy is caused by ___________. Symptoms include high fever. It gets into the CNS via the ________. It is is associated with people who play water sports, swim in lakes are rarely those who wear contacts. Treat with ______

Naegleria Fowleri Cribiform PLate Amphotericin to treat

_______ is used to treat Cryptosporidium.

Nitazoxanide

Plasmodium falciparum

No persistent liver stage or relapse; blood smear shows multiple ring forms and crescent-shaped gametes; irregular febrile pattern; associated with cerebral malaria

_______ is associated with neurological symptoms. They look banana-shaped under microscopes. It causes irregular fever spikes and cerebral malaria. Treat with ______

Plasmodium Falciparum Treat with Chloroquine

What type of Plasmodium affects • Only mature RBCs? What is seen on the blood smear>

Plasmodium malariae Bar and band forms; rosette schizonts

Trypanosome cruzi is transmitted by

Reduvid bug (vector) , the kissing bug. Found in south and central America. It gets in when the victim scratches the infected area. Patients can be asymptomatic for 10-20 years before Chags sets in The Reduvid burrows into the endocardium

Cyptosporidium

Severe diarrhea in AIDS Mild disease (watery diarrhea) in immunocompetent Transmission = Cysts in water -> Cysts contain 4 motile sporozoites which attach to the intestinal wall and cause damage Diagnosis = cysts on acid fast stain Tx = prevention by filtering city water supplies; nitazoxanide in immunocompetent hosts

______ and _____ is a treatment for Toxoplasma gondii. If the patient is immuno compromised and has a CD4 count of <100 they should also be treated with________

Sulfadiazine and Pyramethamine If immunocompromised treat with Prophylaxis

An immuno compromised patient infected with toxoplasma gondii could present with toxoplasma ______. This can be diagnosed with a biopsy and patients with HIV area at risk.

Toxoplasma Encephalitis, ring lesions on MRI

Which parasitic organism, when it crosses the placenta, results in intracerebral calcifications, chorioretinitis, microcephaly, hydrocephaly, and convulsions?

Toxoplasma gondii

A pregnant woman contracts toxoplasma gondii, a torch infection, meaning it can cross the placental barrier, from cleaning her cats liter box. Her child is born with a triad of symptoms that includes: 1. 2. 3. The child is also suffering from 4. _______

Triad includes: 1. Brain calcifications/ cranial calcifications 2. Hydrocephalous 3. Chorioretinitis 4. Deafness

African sleeping sickness is caused by

Trypanosoma brucei

Chagas disease is caused by

Trypanosoma cruzi

_____ causes Chegas disease. It is a parasite transmitted by a kissing bug's feces. It tunnels through tissue and feeds on blood and lymph. It is a hemoflagellate

Trypanosoma cruzi

to diagnosis trichomoniasis use a _________ this is going to show motile _______ if positive

Wet Mount Trophozoits, there are no cysts

Flagellates

a group of protozoans that move using a whip-like organelle called a flagellum Include Trichomonas, Giardia, Leishmania, Typanosoma

Entamoeba histolytica

amoebic dysentery (blood and pus due to colonic damage); extraintestinal (liver abscess most common) Cysts form ingested from contaminated water-pooly sanitized Out pouching of haustra Trophozoites contain endocytose RBCs

Plasmodium vivax/ovale

are the hyypnozoites that can stay in the liver and can be resistant to chloroquine. Primaquine for these guys

Leishmania donovani

causes visceral leishmaniasis transmitted by bite of sandfly parasite travels to internal organs damage to liver, spleen, and bone marrow If untreated, visceral disease is fatal. Treatment includes antimony, compounds, bed rest, and blood transfusions.

pancytopenia

deficiency of all types of blood cells

Trichomonas vaginalis

is an anaerobic, flagellated protozoan parasite and the causative agent of trichomoniasis. It is an STI

Babesia spp. is transmitted

is transmitted via the bite of a ixodes tick and can cause severe disease in patients who have been splenectomised or who are immunocompromised. To diagnose accurately these patients populations, the specimen of choice is

Amebae (protozoa)

move with pseudopods - Include Entamoeba and Naegleria