There are nearly 100 viruses of the herpes group that infect many different animal species.
Official name of herpesviruses that commonly infect human is Humans herpesvirus (HHV)
herpes simplex virus types 1 (HHV 1)
Herpes simplex virus type 2 (HHV 2)
Varicella-zoster virus (HHV 3)
Epstein-Barr virus, (HHV 4)
Cytomegalovirus (HHV 5)
Human herpesvirus 6 (HHV 6)
Human herpesvirus 7 (HHV 7)
Human herpesvirus 8 (HHV 8) (Kaposi's sarcoma-associated herpesvirus).
Herpes B virus of monkeys can also infect humans
hELMINTHS#corona virus#Aspergillosis#BUGANDO#CUHAS#CUHAS#CUHAS
The document provides information on tapeworm parasites (order Cestoidea), including their classification, morphology, life cycles, transmission, clinical features, diagnosis and treatment. It discusses several important tapeworm species that can infect humans, including Taenia saginata, Taenia solium, Hymenolepis nana, Echinococcus granulosus, and Diphyllobothrium latum. Key details on the morphology, life cycles, epidemiology and clinical manifestations of each species are provided.
The document discusses various types of symbiotic relationships between organisms, with a focus on parasitism. It defines key terms related to parasites like host, life cycle, and classification. Parasites are divided into protozoans, helminths (worms), and arthropods. Several intestinal protozoan parasites are described in detail, including Entamoeba histolytica, Giardia lamblia, and Trichomonas vaginalis. Blood and tissue protozoans covered include Plasmodium spp. (which cause malaria), Toxoplasma gondii, Leishmania spp., and trypanosomes. Helminths are categorized as cestodes (tapeworms),
Study of parasites Hymenolepis nana, Taenia Echinococcus(), & Pneumocystis carinii
Treatment
Morphology
Life cycle
Pathogenesis
Laboratory diagnosis
Parasites
Hymenolepis nana – Cestode (Dwarf Tapeworm)
Taenia Echinococcus – Cestode (Dog Tapeworm)
Pneumocystis carinii - Sporozoan parasite
Hymenolepis nana
Geographical Distribution
Habitat
Morphology of Hymenolepis nana
Adult Worm
Eggs
Larva
Life cycle of Hymenolepis nana
Direct Cycle
Indirect Cycle
Hymenolepis nana - Life cycle
Life cycle of Hymenolepis nana
Pathogenesis of Hymenolepis nana
Laboratory diagnosis of Hymenolepis nana
Treatment of Hymenolepis nana
Prevention (Prophylaxis) of H. nana
Taenia Echinococcus
Echinococcus Genus: Tapeworm with carnivorous and herbivorous hosts.
Morphology of Taenia Echinococcus
Life Cycle of Taenia Echinococcus
This document summarizes flagellates, including their classification, morphology, and life cycles. It focuses on Giardia intestinalis and Trichomonas vaginalis. G. intestinalis has trophozoite and cyst stages, with the cyst being infective. It causes giardiasis by damaging the intestinal epithelium. T. vaginalis only exists as a trophozoite and causes trichomoniasis through overgrowth in the vagina when pH increases. Both can be diagnosed via microscopy of stool or vaginal samples and treated with metronidazole or tinidazole.
The document discusses diseases of laboratory rats and control measures. It begins by introducing laboratory rats as an animal model and defining disease. It then outlines general preventive measures like procuring pathogen-free animals, using microisolation cages, and maintaining proper temperature, humidity and ventilation. Several common bacterial, fungal, viral and parasitic diseases are described in detail, including their symptoms, transmission, diagnosis and treatment. The document emphasizes preventive measures and controls to maintain healthy colonies and prevent research complications from infectious diseases.
This document provides information on the non-spore-forming gram-positive bacillus Corynebacterium diphtheriae, which causes diphtheria. It discusses the organism's properties, biotypes, modes of transmission, pathogenesis, clinical findings, laboratory diagnosis, treatment and prevention of diphtheria. It also briefly summarizes Listeria monocytogenes and some spore-forming gram-positive bacilli including Bacillus anthracis, Bacillus cereus, Clostridium tetani, Clostridium botulinum, Clostridium perfringens, and Clostridium difficile.
This document provides information on Paragonimus westermani, a species of lung fluke that can cause paragonimiasis in humans. It discusses the life cycle of P. westermani, which involves freshwater snails and crabs or crayfish as intermediate hosts. Humans can be infected by eating raw or undercooked freshwater crustaceans containing the infective metacercariae stage. The worms mature in the lungs, where they can cause symptoms like coughing up blood or chest pain. The document outlines methods for diagnosing and treating paragonimiasis, as well as preventing infection by fully cooking all shellfish.
Gonorrhea is a common sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It can infect the genital tract and other areas like the throat and rectum. Left untreated, it can lead to complications like pelvic inflammatory disease and infertility. While antibiotics can effectively treat gonorrhea, drug resistance has emerged, requiring the use of alternative antibiotic regimens. Preventing the spread of gonorrhea relies on safe sexual practices and promptly diagnosing and treating infected individuals and their partners.
The document provides information on tapeworm parasites (order Cestoidea), including their classification, morphology, life cycles, transmission, clinical features, diagnosis and treatment. It discusses several important tapeworm species that can infect humans, including Taenia saginata, Taenia solium, Hymenolepis nana, Echinococcus granulosus, and Diphyllobothrium latum. Key details on the morphology, life cycles, epidemiology and clinical manifestations of each species are provided.
The document discusses various types of symbiotic relationships between organisms, with a focus on parasitism. It defines key terms related to parasites like host, life cycle, and classification. Parasites are divided into protozoans, helminths (worms), and arthropods. Several intestinal protozoan parasites are described in detail, including Entamoeba histolytica, Giardia lamblia, and Trichomonas vaginalis. Blood and tissue protozoans covered include Plasmodium spp. (which cause malaria), Toxoplasma gondii, Leishmania spp., and trypanosomes. Helminths are categorized as cestodes (tapeworms),
Study of parasites Hymenolepis nana, Taenia Echinococcus(), & Pneumocystis carinii
Treatment
Morphology
Life cycle
Pathogenesis
Laboratory diagnosis
Parasites
Hymenolepis nana – Cestode (Dwarf Tapeworm)
Taenia Echinococcus – Cestode (Dog Tapeworm)
Pneumocystis carinii - Sporozoan parasite
Hymenolepis nana
Geographical Distribution
Habitat
Morphology of Hymenolepis nana
Adult Worm
Eggs
Larva
Life cycle of Hymenolepis nana
Direct Cycle
Indirect Cycle
Hymenolepis nana - Life cycle
Life cycle of Hymenolepis nana
Pathogenesis of Hymenolepis nana
Laboratory diagnosis of Hymenolepis nana
Treatment of Hymenolepis nana
Prevention (Prophylaxis) of H. nana
Taenia Echinococcus
Echinococcus Genus: Tapeworm with carnivorous and herbivorous hosts.
Morphology of Taenia Echinococcus
Life Cycle of Taenia Echinococcus
This document summarizes flagellates, including their classification, morphology, and life cycles. It focuses on Giardia intestinalis and Trichomonas vaginalis. G. intestinalis has trophozoite and cyst stages, with the cyst being infective. It causes giardiasis by damaging the intestinal epithelium. T. vaginalis only exists as a trophozoite and causes trichomoniasis through overgrowth in the vagina when pH increases. Both can be diagnosed via microscopy of stool or vaginal samples and treated with metronidazole or tinidazole.
The document discusses diseases of laboratory rats and control measures. It begins by introducing laboratory rats as an animal model and defining disease. It then outlines general preventive measures like procuring pathogen-free animals, using microisolation cages, and maintaining proper temperature, humidity and ventilation. Several common bacterial, fungal, viral and parasitic diseases are described in detail, including their symptoms, transmission, diagnosis and treatment. The document emphasizes preventive measures and controls to maintain healthy colonies and prevent research complications from infectious diseases.
This document provides information on the non-spore-forming gram-positive bacillus Corynebacterium diphtheriae, which causes diphtheria. It discusses the organism's properties, biotypes, modes of transmission, pathogenesis, clinical findings, laboratory diagnosis, treatment and prevention of diphtheria. It also briefly summarizes Listeria monocytogenes and some spore-forming gram-positive bacilli including Bacillus anthracis, Bacillus cereus, Clostridium tetani, Clostridium botulinum, Clostridium perfringens, and Clostridium difficile.
This document provides information on Paragonimus westermani, a species of lung fluke that can cause paragonimiasis in humans. It discusses the life cycle of P. westermani, which involves freshwater snails and crabs or crayfish as intermediate hosts. Humans can be infected by eating raw or undercooked freshwater crustaceans containing the infective metacercariae stage. The worms mature in the lungs, where they can cause symptoms like coughing up blood or chest pain. The document outlines methods for diagnosing and treating paragonimiasis, as well as preventing infection by fully cooking all shellfish.
Gonorrhea is a common sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. It can infect the genital tract and other areas like the throat and rectum. Left untreated, it can lead to complications like pelvic inflammatory disease and infertility. While antibiotics can effectively treat gonorrhea, drug resistance has emerged, requiring the use of alternative antibiotic regimens. Preventing the spread of gonorrhea relies on safe sexual practices and promptly diagnosing and treating infected individuals and their partners.
1. The document describes the life cycles of several parasitic roundworms (nematodes) that infect humans, including Ascaris lumbricoides, Enterobius vermicularis, Trichuris trichiura, Ancylostoma duodenale, Strongyloides stercoralis, and Trichinella spiralis.
2. It provides details on the morphology, life stages, transmission, localization in the host, and clinical manifestations of each parasite.
3. The life cycles generally involve eggs passing in feces and developing into infective larvae in the soil, which then penetrate the skin or are ingested to develop into adult worms that reproduce sexually and release eggs to complete the
This document provides an overview of infectious diseases and the agents that cause them. It discusses the historical perspective of major infectious diseases like smallpox, plague, and influenza. It describes Robert Koch's pioneering work in the late 19th century that established the germ theory of disease and his criteria (known as Koch's postulates) for identifying disease-causing agents. The document then covers viruses, bacteria, fungi, protozoa, helminths, prions, and ectoparasites as causes of infectious disease, describing their characteristics, life cycles, modes of transmission, and examples of diseases they cause.
This document provides an introduction to parasitology, defining key terms like host, parasite, vector, and different types of parasite-host relationships. It describes the lifecycles and classifications of major parasite groups like helminths and protozoa. Risk factors, routes of transmission, clinical signs, diagnosis, and control of parasitic diseases are discussed. Parasites can damage hosts through trauma, tissue reactions, and providing access to secondary infections. Diagnosis involves clinical history and laboratory examination of specimens like stool. Treatment requires considering the infection severity and available pharmacological or surgical options.
This document discusses the taxonomy and anatomy of Old World monkeys, specifically macaques. It covers the genus and species of macaques, their characteristics, geographic distributions, and common diseases. Key points include that macaques have the greatest geographic distribution of non-human primates, the most common species is Macaca fascicularis, and common diseases include tuberculosis, pneumonia, parasitic infections like pulmonary acariasis caused by Pneumonyssus simicola mites.
Class Trematoda. Tapeworms as parasites of human beingEneutron
This document provides information on various medically important worms (helminths). It begins by classifying helminths into two phyla - Platyhelminthes and Nemathelminthes. Platyhelminthes includes the classes Trematoda (flukes) and Cestoidea (tapeworms). The document then describes the life cycles and characteristics of various trematode parasites, including Fasciola hepatica, Opisthorchis felineus, Clonorchis sinensis, Dicrocoelium lanceatum, and Paragonimus westermani. It also covers the blood flukes of the genus Schistosoma, which cause schistosomiasis
Nematodes” are Round worms
Most nematodes are free living in fresh water, sea water and soil.
Are elongated bilaterally symmetrical, Non-segmented cylindrical worms, tapering at both the ends.
Sexes are separate (diecious), male is smaller than female & its posterior end is curved ventrally.
Females are either Viviparous (produces larvae/ embryo), Oviparous (lay egg) or ovo-viviparous (lays eggs which hatches immediately)
Lives in intestinal tract or tissues.
Toxoplasmosis is caused by the protozoan parasite Toxoplasma gondii. It can infect all warm-blooded animals. In the US and Pakistan, around 11-30% of the population has been infected. Cats are the definitive host and shed infectious oocysts in their feces. Humans and other animals become infected by ingesting oocysts from the environment or undercooked meat containing tissue cysts. Most infections are asymptomatic, but it can cause abortion, stillbirths, and congenital defects in fetuses. Diagnosis is through blood tests, fecal microscopy, and serological tests. Treatment involves pyrimethamine, sulfadiazine, and cl
Management of Typhoid Intestinal Perforation which is a common and the most dreaded surgical complication of Typhoid fever.
This menace is still on the rise in low and medium income countries where we still battle with lack of potable water and open defecation.
This presentation is especially targeted at trainee surgeons in Nigeria and Medical Students also who may find it worthwhile.
Neglected-tropical-diseasesindia and world.pptxAdhyaDubey1
This document discusses neglected tropical diseases (NTDs), a group of infectious diseases that plague millions worldwide in tropical areas with weak infrastructure. It outlines several specific NTDs, including their causative agents, transmission cycles, geographical distribution, symptoms, impacts on health and socioeconomics, current prevalence figures, and treatment approaches. The WHO's integrated strategy to control NTDs through preventive chemotherapy, vector control, veterinary public health, water and sanitation, and innovative disease management is also summarized.
Neglected-tropical-diseasesindia and world.pptxAdhyaDubey1
This document discusses neglected tropical diseases (NTDs), a group of infectious diseases that plague millions worldwide in tropical areas with weak infrastructure. It outlines several specific NTDs, including their causative agents, transmission cycles, geographical distribution, symptoms, impacts on health and socioeconomics, current prevalence figures, and treatment approaches. The WHO's integrated strategy to control NTDs through preventive chemotherapy, vector control, veterinary public health, water and sanitation, and innovative disease management is also summarized.
This document provides information on various protozoan parasites that can infect humans, including Blastocystis hominis, Cystoisospora spp., Cryptosporidium spp., Cyclospora spp., Microsporidia, Toxoplasma gonii, Balantidium coli, Sarcocystis spp., and Babesia spp. For each organism, it describes characteristics such as morphology, life cycle, transmission, clinical symptoms, diagnosis, and treatment. It also includes images of organisms like oocysts, tissue cysts, and histopathological findings.
Cours de bactériologie sur les Mycoplasme en anglais 30.pdfGedeonNoteNsangou
This document provides an overview of Mycoplasma and Ureaplasma. It begins with objectives to describe Mycoplasma structure, characteristics, distribution, clinical forms, diagnosis, and treatment. The document then covers Mycoplasma's general characteristics including morphology, physiology, human pathogens, pathogenicity, diseases caused, epidemiology, laboratory diagnosis, treatment, and conclusion. Key points include Mycoplasma being the smallest bacteria without a cell wall, causing atypical pneumonia and genital infections, identification through culture and staining techniques, and treatment with tetracyclines or erythromycin.
There are nearly 100 viruses of the herpes group that infect many different animal species.
Official name of herpesviruses that commonly infect human is Humans herpesvirus (HHV)
herpes simplex virus types 1 (HHV 1)
Herpes simplex virus type 2 (HHV 2)
Varicella-zoster virus (HHV 3)
Epstein-Barr virus, (HHV 4)
Cytomegalovirus (HHV 5)
Human herpesvirus 6 (HHV 6)
Human herpesvirus 7 (HHV 7)
Human herpesvirus 8 (HHV 8) (Kaposi's sarcoma-associated herpesvirus).
Herpes B virus of monkeys can also infect humans
hELMINTHS#corona virus#Aspergillosis#BUGANDO#CUHAS#CUHAS#CUHAS
: Parasitic water pollution in the Nile River (Schistosoma & Giardia lamblia)MenrvaSorial
Causative organism.
Geographical distribution.
Epidemiology & Risk factors.
Mode of Transmission.
Vector (if available).
Habitat.
Life cycle (including infective stage, Diagnostic stage, Final host, Intermediate host and Reservoir).
-According to your lab group assignment topic, you must mention at least two examples (Causative organisms) for the required type of parasitic infection and their prevalence in Egypt. -Then discuss briefly the mentioned examples covering all the following points:
As a pharmacist, how could you identify and confirm a patient with such disease?
(NB: Identification and confirmation include the signs and symptoms and the diagnostic tests in details)
What are the therapeutic options available (suggest a line of treatment).
How can we prevent & control such disease?
An infectious disease can be spread from one organism to another through pathogens like bacteria, viruses, fungi and protozoa. An epidemic refers to a sudden increase in a disease in a specific area, an endemic disease is always present in a population, and a pandemic is a global rise in disease incidence. Infectious diseases are combatted through the immune system's non-specific defenses like skin and mucus barriers, and specific defenses like antibodies and lymphocytes that recognize and eliminate pathogens. Vaccines work by exposing the immune system to antigens to produce memory cells that mount a rapid response against the pathogen without causing disease.
1. Trichomonas vaginalis is a protozoan parasite that causes trichomoniasis, a sexually transmitted infection of the urogenital tract.
2. It exists solely as a trophozoite, which is pear-shaped and has an undulating membrane and five flagella.
3. Infection occurs through sexual contact, with the parasite infecting and adhering to the squamous epithelium of the vagina, urethra, or prostate.
4. Symptoms in females include vaginal discharge and irritation, while males may experience urethritis. Diagnosis involves microscopic examination of vaginal or urethral discharge, with culture being the most sensitive test.
This document discusses various infectious agents including prions, viruses, bacteria, fungi, protozoa, helminths and ectoparasites. It describes prion diseases like Creutzfeldt-Jakob disease in humans and bovine spongiform encephalopathy in animals. It also discusses new and emerging infectious diseases, categories of bioterrorism agents, and transmission of microbes via skin, gastrointestinal tract, respiratory tract, urinary tract and other routes. Nosocomial infections, sexually transmitted infections, and host defense mechanisms against infection are also summarized.
Amoebiasis by bhanu chalise, iom maharajgunjaviralchalise
Amebiasis is caused by the protozoan Entamoeba histolytica and is a major public health problem globally. It is commonly found in developing tropical and subtropical countries where poverty, poor sanitation, and malnutrition are prevalent risk factors. E. histolytica infection may be asymptomatic or may cause intestinal disease ranging from mild diarrhea to severe colitis or extraintestinal infections such as amoebic liver abscess. Diagnosis involves identification of trophozoites or cysts in stool samples or detection of antibodies or antigens in blood tests. Treatment involves luminal agents such as metronidazole to eliminate active infections and tissue amoebicides such as diloxanide furoate to clear cyst
Cryptosporidium spp. are microscopic, spore-forming, single-celled protozoans that can infect humans and various animals. They are a common cause of diarrhea, especially in developing areas with poor sanitation. Cryptosporidium parvum and Cryptosporidium hominis are the main species that infect humans. Transmission occurs through ingestion of infective oocysts from contaminated food or water. Infection may cause self-limiting diarrhea but can be life-threatening in immunocompromised individuals. Diagnosis involves microscopic examination of stool samples and treatment is generally supportive due to lack of highly effective drugs.
Electrolyte and fluid balance in elderly.pptxMkindi Mkindi
The body maintains electrolyte and fluid balance through carefully regulated input and output. As people age, the kidneys undergo changes that impair this regulation. There is a 20-25% loss of renal mass and decline in glomerular filtration rate. This impairs the kidneys' ability to concentrate and dilute urine. As a result, elderly people are more prone to fluid and electrolyte disorders like hyponatremia, hypernatremia, and hypertension. Close monitoring of fluid, sodium, and medication intake is needed to prevent issues from imbalances.
Approach to disease in elderly.pptx elderlyMkindi Mkindi
This document provides an overview of the approach to disease in elderly patients. Key points include:
- Elderly patients are defined as those aged 65 and over, and their numbers are growing rapidly worldwide. They experience physiological declines that increase disease susceptibility.
- A comprehensive geriatric assessment evaluates physical and mental health, functional status, social circumstances, and screens for issues like elder abuse. This helps develop individualized care plans.
- Common geriatric syndromes like frailty, falls, and delirium are assessed. Polypharmacy is a major risk, so medication reviews are important. Nutritional status also declines with age and disease.
- Discharge planning must consider living situation and need for home care assistance after leaving hospital
1. The document describes the life cycles of several parasitic roundworms (nematodes) that infect humans, including Ascaris lumbricoides, Enterobius vermicularis, Trichuris trichiura, Ancylostoma duodenale, Strongyloides stercoralis, and Trichinella spiralis.
2. It provides details on the morphology, life stages, transmission, localization in the host, and clinical manifestations of each parasite.
3. The life cycles generally involve eggs passing in feces and developing into infective larvae in the soil, which then penetrate the skin or are ingested to develop into adult worms that reproduce sexually and release eggs to complete the
This document provides an overview of infectious diseases and the agents that cause them. It discusses the historical perspective of major infectious diseases like smallpox, plague, and influenza. It describes Robert Koch's pioneering work in the late 19th century that established the germ theory of disease and his criteria (known as Koch's postulates) for identifying disease-causing agents. The document then covers viruses, bacteria, fungi, protozoa, helminths, prions, and ectoparasites as causes of infectious disease, describing their characteristics, life cycles, modes of transmission, and examples of diseases they cause.
This document provides an introduction to parasitology, defining key terms like host, parasite, vector, and different types of parasite-host relationships. It describes the lifecycles and classifications of major parasite groups like helminths and protozoa. Risk factors, routes of transmission, clinical signs, diagnosis, and control of parasitic diseases are discussed. Parasites can damage hosts through trauma, tissue reactions, and providing access to secondary infections. Diagnosis involves clinical history and laboratory examination of specimens like stool. Treatment requires considering the infection severity and available pharmacological or surgical options.
This document discusses the taxonomy and anatomy of Old World monkeys, specifically macaques. It covers the genus and species of macaques, their characteristics, geographic distributions, and common diseases. Key points include that macaques have the greatest geographic distribution of non-human primates, the most common species is Macaca fascicularis, and common diseases include tuberculosis, pneumonia, parasitic infections like pulmonary acariasis caused by Pneumonyssus simicola mites.
Class Trematoda. Tapeworms as parasites of human beingEneutron
This document provides information on various medically important worms (helminths). It begins by classifying helminths into two phyla - Platyhelminthes and Nemathelminthes. Platyhelminthes includes the classes Trematoda (flukes) and Cestoidea (tapeworms). The document then describes the life cycles and characteristics of various trematode parasites, including Fasciola hepatica, Opisthorchis felineus, Clonorchis sinensis, Dicrocoelium lanceatum, and Paragonimus westermani. It also covers the blood flukes of the genus Schistosoma, which cause schistosomiasis
Nematodes” are Round worms
Most nematodes are free living in fresh water, sea water and soil.
Are elongated bilaterally symmetrical, Non-segmented cylindrical worms, tapering at both the ends.
Sexes are separate (diecious), male is smaller than female & its posterior end is curved ventrally.
Females are either Viviparous (produces larvae/ embryo), Oviparous (lay egg) or ovo-viviparous (lays eggs which hatches immediately)
Lives in intestinal tract or tissues.
Toxoplasmosis is caused by the protozoan parasite Toxoplasma gondii. It can infect all warm-blooded animals. In the US and Pakistan, around 11-30% of the population has been infected. Cats are the definitive host and shed infectious oocysts in their feces. Humans and other animals become infected by ingesting oocysts from the environment or undercooked meat containing tissue cysts. Most infections are asymptomatic, but it can cause abortion, stillbirths, and congenital defects in fetuses. Diagnosis is through blood tests, fecal microscopy, and serological tests. Treatment involves pyrimethamine, sulfadiazine, and cl
Management of Typhoid Intestinal Perforation which is a common and the most dreaded surgical complication of Typhoid fever.
This menace is still on the rise in low and medium income countries where we still battle with lack of potable water and open defecation.
This presentation is especially targeted at trainee surgeons in Nigeria and Medical Students also who may find it worthwhile.
Neglected-tropical-diseasesindia and world.pptxAdhyaDubey1
This document discusses neglected tropical diseases (NTDs), a group of infectious diseases that plague millions worldwide in tropical areas with weak infrastructure. It outlines several specific NTDs, including their causative agents, transmission cycles, geographical distribution, symptoms, impacts on health and socioeconomics, current prevalence figures, and treatment approaches. The WHO's integrated strategy to control NTDs through preventive chemotherapy, vector control, veterinary public health, water and sanitation, and innovative disease management is also summarized.
Neglected-tropical-diseasesindia and world.pptxAdhyaDubey1
This document discusses neglected tropical diseases (NTDs), a group of infectious diseases that plague millions worldwide in tropical areas with weak infrastructure. It outlines several specific NTDs, including their causative agents, transmission cycles, geographical distribution, symptoms, impacts on health and socioeconomics, current prevalence figures, and treatment approaches. The WHO's integrated strategy to control NTDs through preventive chemotherapy, vector control, veterinary public health, water and sanitation, and innovative disease management is also summarized.
This document provides information on various protozoan parasites that can infect humans, including Blastocystis hominis, Cystoisospora spp., Cryptosporidium spp., Cyclospora spp., Microsporidia, Toxoplasma gonii, Balantidium coli, Sarcocystis spp., and Babesia spp. For each organism, it describes characteristics such as morphology, life cycle, transmission, clinical symptoms, diagnosis, and treatment. It also includes images of organisms like oocysts, tissue cysts, and histopathological findings.
Cours de bactériologie sur les Mycoplasme en anglais 30.pdfGedeonNoteNsangou
This document provides an overview of Mycoplasma and Ureaplasma. It begins with objectives to describe Mycoplasma structure, characteristics, distribution, clinical forms, diagnosis, and treatment. The document then covers Mycoplasma's general characteristics including morphology, physiology, human pathogens, pathogenicity, diseases caused, epidemiology, laboratory diagnosis, treatment, and conclusion. Key points include Mycoplasma being the smallest bacteria without a cell wall, causing atypical pneumonia and genital infections, identification through culture and staining techniques, and treatment with tetracyclines or erythromycin.
There are nearly 100 viruses of the herpes group that infect many different animal species.
Official name of herpesviruses that commonly infect human is Humans herpesvirus (HHV)
herpes simplex virus types 1 (HHV 1)
Herpes simplex virus type 2 (HHV 2)
Varicella-zoster virus (HHV 3)
Epstein-Barr virus, (HHV 4)
Cytomegalovirus (HHV 5)
Human herpesvirus 6 (HHV 6)
Human herpesvirus 7 (HHV 7)
Human herpesvirus 8 (HHV 8) (Kaposi's sarcoma-associated herpesvirus).
Herpes B virus of monkeys can also infect humans
hELMINTHS#corona virus#Aspergillosis#BUGANDO#CUHAS#CUHAS#CUHAS
: Parasitic water pollution in the Nile River (Schistosoma & Giardia lamblia)MenrvaSorial
Causative organism.
Geographical distribution.
Epidemiology & Risk factors.
Mode of Transmission.
Vector (if available).
Habitat.
Life cycle (including infective stage, Diagnostic stage, Final host, Intermediate host and Reservoir).
-According to your lab group assignment topic, you must mention at least two examples (Causative organisms) for the required type of parasitic infection and their prevalence in Egypt. -Then discuss briefly the mentioned examples covering all the following points:
As a pharmacist, how could you identify and confirm a patient with such disease?
(NB: Identification and confirmation include the signs and symptoms and the diagnostic tests in details)
What are the therapeutic options available (suggest a line of treatment).
How can we prevent & control such disease?
An infectious disease can be spread from one organism to another through pathogens like bacteria, viruses, fungi and protozoa. An epidemic refers to a sudden increase in a disease in a specific area, an endemic disease is always present in a population, and a pandemic is a global rise in disease incidence. Infectious diseases are combatted through the immune system's non-specific defenses like skin and mucus barriers, and specific defenses like antibodies and lymphocytes that recognize and eliminate pathogens. Vaccines work by exposing the immune system to antigens to produce memory cells that mount a rapid response against the pathogen without causing disease.
1. Trichomonas vaginalis is a protozoan parasite that causes trichomoniasis, a sexually transmitted infection of the urogenital tract.
2. It exists solely as a trophozoite, which is pear-shaped and has an undulating membrane and five flagella.
3. Infection occurs through sexual contact, with the parasite infecting and adhering to the squamous epithelium of the vagina, urethra, or prostate.
4. Symptoms in females include vaginal discharge and irritation, while males may experience urethritis. Diagnosis involves microscopic examination of vaginal or urethral discharge, with culture being the most sensitive test.
This document discusses various infectious agents including prions, viruses, bacteria, fungi, protozoa, helminths and ectoparasites. It describes prion diseases like Creutzfeldt-Jakob disease in humans and bovine spongiform encephalopathy in animals. It also discusses new and emerging infectious diseases, categories of bioterrorism agents, and transmission of microbes via skin, gastrointestinal tract, respiratory tract, urinary tract and other routes. Nosocomial infections, sexually transmitted infections, and host defense mechanisms against infection are also summarized.
Amoebiasis by bhanu chalise, iom maharajgunjaviralchalise
Amebiasis is caused by the protozoan Entamoeba histolytica and is a major public health problem globally. It is commonly found in developing tropical and subtropical countries where poverty, poor sanitation, and malnutrition are prevalent risk factors. E. histolytica infection may be asymptomatic or may cause intestinal disease ranging from mild diarrhea to severe colitis or extraintestinal infections such as amoebic liver abscess. Diagnosis involves identification of trophozoites or cysts in stool samples or detection of antibodies or antigens in blood tests. Treatment involves luminal agents such as metronidazole to eliminate active infections and tissue amoebicides such as diloxanide furoate to clear cyst
Cryptosporidium spp. are microscopic, spore-forming, single-celled protozoans that can infect humans and various animals. They are a common cause of diarrhea, especially in developing areas with poor sanitation. Cryptosporidium parvum and Cryptosporidium hominis are the main species that infect humans. Transmission occurs through ingestion of infective oocysts from contaminated food or water. Infection may cause self-limiting diarrhea but can be life-threatening in immunocompromised individuals. Diagnosis involves microscopic examination of stool samples and treatment is generally supportive due to lack of highly effective drugs.
Electrolyte and fluid balance in elderly.pptxMkindi Mkindi
The body maintains electrolyte and fluid balance through carefully regulated input and output. As people age, the kidneys undergo changes that impair this regulation. There is a 20-25% loss of renal mass and decline in glomerular filtration rate. This impairs the kidneys' ability to concentrate and dilute urine. As a result, elderly people are more prone to fluid and electrolyte disorders like hyponatremia, hypernatremia, and hypertension. Close monitoring of fluid, sodium, and medication intake is needed to prevent issues from imbalances.
Approach to disease in elderly.pptx elderlyMkindi Mkindi
This document provides an overview of the approach to disease in elderly patients. Key points include:
- Elderly patients are defined as those aged 65 and over, and their numbers are growing rapidly worldwide. They experience physiological declines that increase disease susceptibility.
- A comprehensive geriatric assessment evaluates physical and mental health, functional status, social circumstances, and screens for issues like elder abuse. This helps develop individualized care plans.
- Common geriatric syndromes like frailty, falls, and delirium are assessed. Polypharmacy is a major risk, so medication reviews are important. Nutritional status also declines with age and disease.
- Discharge planning must consider living situation and need for home care assistance after leaving hospital
Approach to disease in elderly.pptx bwire bwireMkindi Mkindi
This document provides an overview of the approach to disease in elderly patients. Key points include:
- Elderly patients are defined as those aged 65 and over, and their numbers are increasing globally. They experience physiological declines that increase disease susceptibility.
- A comprehensive geriatric assessment evaluates physical and mental health, functional status, social circumstances, and screens for issues like elder abuse. This helps develop individualized care plans.
- Common geriatric syndromes like frailty, falls, and delirium are assessed. Polypharmacy is a major risk, so medication reviews are important. Nutritional status also declines with age and disease.
- Discharge planning must consider living situation and need for home care assistance after leaving hospital.
01-INVESTIGATIONS IN KDInvesting ckd bugando cuhasMkindi Mkindi
This document discusses investigations used in kidney disease. It begins with an introduction to kidney anatomy and physiology. Laboratory tests discussed include urine analysis, renal function tests measuring creatinine and GFR, electrolytes, and blood work including markers for glomerular diseases. Imaging options like ultrasound, CT, MRI, and angiography are outlined. Kidney biopsy procedures and their utility are also summarized.
Arterial thrombi in details#MkindiArterial thrombi#Mkindi Arterial thrombi#M...Mkindi Mkindi
Unexplained arterial thrombosis can occur due to underlying hypercoagulable states or prothrombotic conditions. The authors provide an approach to diagnosis of unexplained arterial thrombosis that involves obtaining a thorough medical history, performing laboratory tests to identify underlying hypercoagulable states or prothrombotic conditions, and long-term anticoagulation therapy for identified conditions while further evaluating those without an identified cause.
This document outlines the components and utility of urinalysis. It discusses the importance of urinalysis as a non-invasive diagnostic tool that can provide information about renal and systemic health issues. The key components of urinalysis covered are physical examination of attributes like color and specific gravity, microscopic examination of sediment and crystals, and chemical analysis to detect substances like glucose, proteins, ketones and others. Together, urinalysis provides valuable insights into conditions affecting the kidneys, urinary tract, and other body systems.
This document discusses selective toxicity and the mechanisms of action of antiparasitic drugs. It begins by defining three types of human parasitism and noting that antiparasitic agents are cytotoxic, exhibiting cytocidal or cytostatic effects. It then explores various ways drugs can selectively target parasites over human cells, including qualitative, quantitative, and distributional selectivity. The rest of the document delves into specific mechanisms of selective toxicity, such as inhibiting cell wall synthesis, nucleic acid synthesis, mitosis, protein synthesis, and energy metabolism in parasites. It provides examples of drugs that act through each of these mechanisms.
A case-control study compares individuals with a disease or condition (cases) to individuals without that disease or condition (controls) to determine whether exposure to a particular agent is associated with the disease. It begins with identifying cases who have the disease and controls who do not, then measuring and comparing past exposure to potential risk factors between the two groups. Case-control studies are useful for rare diseases, identifying new risk factors, and when prospective cohort studies are not possible due to time or cost constraints. However, they are prone to biases like recall and selection bias.
Gout and pseudogout are crystal-induced arthropathies caused by the deposition of urate crystals or calcium pyrophosphate dihydrate crystals in the joints respectively. Gout results in painful flares typically affecting the big toe and is characterized by periods of acute inflammation. Pseudogout causes intermittent arthritis that may be asymptomatic and is detected by chondrocalcinosis on x-rays. Both can be diagnosed by identifying the characteristic crystals in synovial fluid under polarized microscopy. Treatment involves management of symptoms during acute flares and reducing crystal deposition long-term.
1. Malabsorption syndromes can involve defects in digestion or absorption of nutrients and present with symptoms of nutrient deficiencies.
2. Celiac disease is an immune-mediated disorder triggered by ingestion of gluten that results in damage to the small intestine and malabsorption. It is diagnosed through small bowel biopsy and treatment is a lifelong gluten-free diet.
3. Tropical sprue is a malabsorption syndrome of the small intestine seen in tropical regions, whose cause is thought to be an infectious agent. It resembles celiac disease and improves with antibiotic treatment.
This document provides an overview of viral hepatitis, focusing on hepatitis B. It discusses the epidemiology, virology, transmission, natural history, diagnosis, and treatment of hepatitis B. Key points include that hepatitis B virus is estimated to cause nearly 900,000 deaths annually worldwide, has several genotypes that impact treatment and disease progression, and follows a natural history over decades from initial infection to potential chronic infection, liver damage, and liver cancer. Non-invasive blood tests and transient elastography can assess liver fibrosis without a biopsy.
3. Ananthakrishnan - Management of Severe UC and Pouch-Related Complications....Mkindi Mkindi
1. The document outlines a 5-step management approach for acute severe ulcerative colitis: identifying precipitants, intravenous steroids, assessing steroid response, initiating rescue therapy for non-responders, and determining need for salvage therapy or surgery.
2. Key rescue therapies discussed are cyclosporine and infliximab, which clinical trials have found to be similarly effective. Newer approaches like tofacitinib are also mentioned.
3. The document also reviews pouch-related complications after surgery for ulcerative colitis and their treatment approaches.
This document provides an overview of upper gastrointestinal bleeding (UGIB), including its definition, classification, epidemiology, clinical features, diagnostic evaluation, and management. Some key points:
1. UGIB is more common than lower GI bleeding, with a reported incidence of 170 patients per 100,000 population per year. The most common cause is peptic ulcer disease (40% of cases).
2. Risk of rebleeding is higher in patients on antiplatelet therapy and those with recurrent bleeding within 48-72 hours. Mortality is 5-10% for severe UGIB.
3. Diagnostic evaluation includes endoscopy within 24 hours to identify the source of bleeding, as well as
HEPATOCELLULAR AND GALL BLADDER CARCINOMA.pptxMkindi Mkindi
Hepatocellular carcinoma (HCC) is the most common type of liver cancer and the third leading cause of cancer deaths worldwide. Risk factors include hepatitis B and C infections, aflatoxin exposure, and alcohol use. Screening with ultrasound and alpha-fetoprotein (AFP) levels can detect HCC early in high-risk patients with cirrhosis. Treatment depends on tumor stage but may include surgical resection, liver transplantation, radiofrequency ablation, chemoembolization, or the drug sorafenib for advanced disease. Prognosis is generally poor due to late stage at presentation, with a 5-year survival rate of less than 10% for untreated HCC.
1. Toxoplasmosis is caused by the protozoan Toxoplasma gondii and presents a high risk for fetuses, newborns, and immunocompromised individuals. Congenital toxoplasmosis results from maternal infection during pregnancy.
2. In immunocompromised patients, toxoplasmosis often occurs in those with impaired T cell-mediated immunity and presents as toxoplasmic encephalitis, pneumonia, or organ involvement.
3. Diagnosis involves antibody testing, parasite detection, imaging, and histology. Treatment consists of pyrimethamine and sulfadiazine with folate for acute infections or prophylaxis in high-risk groups.
The document outlines the three stage process for a clinical neurological examination: 1) Taking a careful history to determine the underlying pathology, 2) Conducting a physical examination to localize any lesions by assessing relevant nervous system functions, and 3) Formulating a diagnosis of the nature of the pathology. The examination involves assessing higher cognitive functions, the 12 cranial nerves, signs of meningeal irritation, motor strength and reflexes, sensation, coordination, and gait. The goal is to localize any lesions in the central or peripheral nervous system.
Disorders of lipid metabolism are inborn errors that cause the body to improperly metabolize lipid components from food. They result from genetic defects in the enzymes or transport proteins involved in breaking down lipids. There are three main types: fatty acid oxidation disorders which impair the breakdown of fats; lipid storage disorders where fats accumulate in tissues; and lipoprotein metabolism disorders affecting cholesterol and triglyceride transport. Specific disorders discussed include carnitine deficiency, Gaucher disease, Niemann-Pick disease, Tay-Sachs disease, and Fabry disease. Treatment options are limited and aim to manage symptoms, though enzyme replacement therapy can help some conditions.
Adult malnutrition can be diagnosed using criteria that evaluate insufficient energy intake, weight loss, loss of muscle mass, fluid accumulation, and diminished handgrip strength. New criteria also consider acute and chronic inflammation. Common causes of malnutrition include medical issues like inflammatory bowel disease, celiac disease, short bowel syndrome, and liver disease. Age-related physiological changes can also increase risk by impairing digestion and absorption of nutrients. Proper nutrition management depends on the condition and may involve dietary modifications, oral supplements, tube feeding, or parenteral nutrition.
This document provides an overview of chronic myelogenous leukemia (CML) for primary care physicians. It discusses the epidemiology, clinical manifestations, molecular pathophysiology, natural history, diagnosis, and treatment of CML. Key points include: CML represents 15-20% of adult leukemias, with the median age of onset being 45-55 years. The Philadelphia chromosome, resulting from a translocation, produces a Bcr-abl fusion gene that drives uncontrolled proliferation. CML progresses through chronic, accelerated, and blast phases if left untreated. Tyrosine kinase inhibitors like imatinib revolutionized treatment by targeting the Bcr-abl protein. Imatinib induces high rates of remission but side effects can include
61.Cerebral blood flow, the cerebrospinal fluid and brain me.pptMkindi Mkindi
The document summarizes key aspects of cerebral blood flow, cerebrospinal fluid, and brain metabolism from Chapter 61 of Guyton & Hall's Textbook of Medical Physiology. It notes that the brain receives 15% of cardiac output, and cessation of blood flow for 5-10 seconds can cause loss of consciousness. Cerebral blood flow is regulated by factors like CO2, H+, and O2 levels and is autoregulated to remain constant over a blood pressure range of 60-140 mmHg. The cerebrospinal fluid acts as a cushion and about 500 ml are produced daily to be reabsorbed through arachnoid villi. The brain has a high metabolism despite being only 2% of body
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
1. Worms and More Worms:
The World of Helminths
Dr.Hamisi Mkindi
2. What are helminths?
• Complex and fascinating organisms
• Infect about 1.5 billion people, or 24% of the world’s population
• Belong to 4 phyla:
• Nematoda (roundworms)
• Platyhelminthes (flatworms)
• Acanthocephala (spiny-headed worms)
• Nematophora (hairworms)
1. World Health Organization. Soil-transmitted
helminth infections [Internet]. 2022
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
4. Major helminths around the world
Trematodes
Blood flukes
S. haematobium
S. japonicum
S. mansoni
Liver flukes
Clonorchis sinensis
Fasciola hepatica
Opisthorchis viverrini
Lung flukes
Paragonimus westermani
Intestinal flukes
Fasciolopsis buski
Metagonimus yokogawai
Cestodes
Intestinal tapeworms
Diphyllobothrium latum
Hymenolepis nana
Taenia saginata
Taenia solium
Larval cysts
Echinococcus granulosus
Echinococcus multilocularis
Taenia solium
Nematodes
Intestinal
Ancylostoma duodenale
Ascaris lumbricoides
Capillaria philippinensis
Enterobius vermicularis
Necator americanus
Strongyloides stercoralis
Trichuris trichiura
Tissue invasive
Angiostrongylus cantonensis
Anisakis simplex
Baylisascaris procyonis
Brugia malayi
Gnathostoma spinigerum
Loa loa
Onchocerca volvulus
Toxocara canis
Trichinella spiralis
Wuchereria bancrofti
1. Despommier et al. Parasitic Diseases. Seventh
Edition.
2. Hotez et al, J Clin Invest 2008
5. How helminths differ from other pathogens
• Lifespan—up to years
• Eukaryotic, multicellular
• Sometimes have complex lifecycles
• Immune dysregulation--shifting host immune system away from Th1
and inducing Th2 responses (eosinophilia and IgE)
• Do not multiply within host (exceptions: Strongyloides, Capillaria,
Hymenolepis)
1. Despommier et al. Parasitic Diseases. Seventh
Edition.
7. Question # 1:
A 37 year-old woman originally from rural Tanzania undergoes a speculum exam
during routine screening. She has also been complaining of recurrent crampy lower
abdominal and suprapubic pain for the past 3 months. On exam, there are “sandy
patches” and papules at the cervix. Biopsy of these areas reveal an egg with
surrounding granulomatous inflammation.
8.
9.
10.
11.
12.
13.
14. Major helminths around the world
Trematodes
Blood flukes
S. haematobium
S. japonicum
S. mansoni
Liver flukes
Clonorchis sinensis
Opisthorchis viverrini
Fasciola hepatica
Lung flukes
Paragonimus westermani
Intestinal flukes
Fasciolopsis buski
Metagonimus yokogawai
Cestodes
Intestinal tapeworms
Diphyllobothrium latum
Hymenolepis nana
Taenia saginata
Taenia solium
Larval cysts
Echinococcus granulosus
Echinococcus multilocularis
Taenia solium
Nematodes
Intestinal
Ancylostoma duodenale
Ascaris lumbricoides
Capillaria philippinensis
Enterobius vermicularis
Necator americanus
Strongyloides stercoralis
Trichuris trichiura
Tissue invasive
Angiostrongylus cantonensis
Anisakis simplex
Baylisascaris procyonis
Brugia malayi
Gnathostoma spinigerum
Loa loa
Onchocerca volvulus
Toxocara canis
Trichinella spiralis
Wuchereria bancrofti
1. Despommier et al. Parasitic Diseases. Seventh
Edition.
2. Hotez et al, J Clin Invest 2008
15. History of schistosomes (1 of 2)
• Dr. Bilharz described S.
haematobium serving in the
German army and stationed in
Egypt
• Made the connection between
hematuria and S. haematobium
• Before this—paleoparasitologists
have found S. haematobium
eggs in Egyptian mummies from
1250 BCE.
• Advent of “manhood” or “rite of
passage” for young Egyptian boys
to have bloody urine as they
became men, similar to female
menstruation
Theodor Maximilian Bilharz, M.D. (1825–1862) 1. Despommier et al. Parasitic
Diseases. Seventh Edition.
16. History of schistosomes (2 or 2)
• Scottish physician who discovered S.
mansoni (+ other parasites, including
extensive work on lymphatic filariasis)
while stationed on the island of
Formosa (modern-day Taiwan)
Patrick Manson, M.D. (1844–1922)
1. Despommier et al. Parasitic
Diseases. Seventh Edition.
17. Global distribution of Schistosoma species
1. Weerakoon et al. Clinical Microbiology
Reviews, 2015.
18. Life cycle of
schistosomes
Intermediate snail hosts
(genera):
Biomphalaria--S. mansoni
Oncomelania--S. japonicum
Bulinus--S. haematobium, S.
intercalatum, S. guineensis
Neotricula aperta—S. mekongi
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
19. Acute schistosomiasis
• Cercarial dermatitis or
swimmer’s itch
• Urticarial skin plaques or papules
that occur in response to re-
exposure to cercariae in a person
previously sensitized
• Can be seen with exposure to both
human and avian schistosomes
• Katayama fever or snail fever
(described in 1847 in the
Katayama district of Japan)
• Occurs in previously unexposed
hosts and at onset of egg-laying
phase (3-8 weeks)
• Fevers, myalgias, abd pain,
diarrhea, headache, urticaria
• May see eosinophilia, increased
AST, alkaline phosphatase
1. Despommier et al. Parasitic Diseases. Seventh Edition.
2. https://stacks.cdc.gov/view/cdc/18143
20. Chronic schistosomiasis
S. mansoni, S. japonicum
• Intestinal and hepatosplenic
disease
• Chronic abd pain, blood in stools,
colitis, hepatosplenomegaly, portal
hypertension, periportal liver fibrosis,
hematemesis
S. haematobium
• Granulomatous cystitis, bladder
fibrosis/cancer, obstructive
uropathy
• Chronic genital disease—female
genital schistosomiasis (women—
pelvic pain, post-coital bleeding,
dysmenorrhea)
• Increased risk of HIV acquisition
1. Top left photo: Neglected Tropical
Diseases Study Group, University of the
Philippines Manila--Dr Vicente Y.
Belizario, Jr., Convenor
2. Top right photo: Masong et al. PLOS GPH,
2021.
3. Norseth et al. PLOS NTD, 2014.
21. Schistosomiasis—Diagnosis and Treatment
• Dx:
• Examination of stool and urine for eggs (acute schisto—usually clinical diagnosis)
• Serology--useful in travelers or immigrants from endemic areas who have not been
treated in the past
• For new infections—collect serum sample 6-8 weeks after likely infection
• Not appropriate test for those repeated infected and treated—cannot distinguish resolved vs.
active infection
• Antigen test—can detect new infections, but not widely available in clinical setting
(U.S.)
• Eggs in urine/stool Kato katz thick smear/pcr assays
• Rx: praziquantel 40mg/kg stat or in 2 divided doses
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
22. Question # 3:
A 67 year-old woman from China presents with chronic RUQ pain and significant
weight loss. On MRCP, there is marked biliary ductal dilatation with a papillary mass
concerning for cholangiocarcinoma.
23.
24.
25.
26. Clonorchis sinensis (“Chinese Liver Fluke”)
• Earliest record of clonorchiasis dates
back to an ancient corpse in the Han
Dynasty in 278 B.C.
• James McConnell was first to report it
in the English literature in 1874 while
a resident in Calcutta
• Eggssnailsfreshwater fish--
>humans ingest metacercariae in raw
or undercooked fish
• Larvae develop in duodenumbile
ducts and can live up to 50
yearscholangitis,
cholangiocarcinoma
• Dx: stool eggs (can also see flukes on
imaging, ERCP); Rx: praziquantel
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
27. Opisthorchis viverrini (“Southeast Asian Liver
Fluke”)
• Endemic to northern Thailand,
Vietnam, Cambodia, Laos
• Opisthorchis felineus—Russia,
Belarus, Ukraine, Italy, Germany,
Kazakhstan
• Similar life cycle to Clonorchis—
acquired from eating raw or
undercooked fish
• Can also cause pancreatitis,
cholangitis, cholangiocarcinoma
• Similar Dx and Rx to Clonorchis
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
28. Fasciola hepatica (“sheep liver fluke”)
• Acquired by eating encysted larvae
on aquatic vegetation
• Adult flukes migrate through liver:
RUQ pain, hepatitis
• Takes residence in biliary ducts and
matures over 4 months, can induce
biliary obstruction
• Dx: stool eggs (low sensitivity
during acute stage), serology,
circulating antigen
• Rx: triclabendazole (FDA approved
in 2019)
• Note: only trematode that does not
respond well to praziquantel
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
29. Question # 4:
• A 55 year-old man from Thailand presents for evaluation of a chronic cough of 6
months associated with occasional blood-tinged sputum. ROS is positive for
intermittent fevers and chest pain. On CT imaging of the lungs, there are
subpleural linear opacities and pleural thickening. Further history reveals that the
patient regularly eats som tam, a Thai green papaya salad typically served with
pickled crabs.
Image from:
http://www.chefseng.com/weekend-
special-spicy-papaya-salad-wblue-crab-
khaonom-koke/
30.
31.
32.
33. Paragonimus westermani (“lung fluke”)
• Eggsmiracidium penetrates
snailsfreshwater
crabs/crustaceans-->humans
• Adult worms hatch in small intestine
and migrate to lungs to mature
• Signs + Symptoms:
• Eosinophilia, fever, cough, diarrhea
during acute migration
• Chest pain, chronic pulmonary
hemoptysis, lung infiltrates
• Dx: sputum or stool eggs
• Rx: praziquantel
1. Despommier et al. Parasitic Diseases. Seventh
Edition.
34. Intestinal flukes
Fasciolopsis buski (“Giant intestinal
fluke”– 2 cm x 8 cm)
• Lifecycle: eggssnailsmetacercariae
on aquatic vegetation-->humans
infected after eating veggiesadult
fluke lives in small intestine
• Symptoms: usually asymptomatic; can
cause abd pain, diarrhea, fever,
ulceration, hemorrhage
• Dx: stool eggs; Rx: praziquantel
Metagonimus yokagawi (”Minute
intestinal fluke”–2.5 mm x 0.75 mm)
• Lifecycle: eggssnailscercariae
penetrate fresh/brackish water fish
tissuehumans (+fish-eating
mammals and birds) get
infectedadults live in small
intestine
• Symptoms: abd pain, diarrhea, weight
loss
• Dx: stool eggs; Rx: praziquantel
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
35. Trematodes (flukes): Summary
• Flat, fleshy, leaf-shaped worms
• Parasites of mollusks (typically snails are the intermediate hosts)
• Usually hermaphroditic (except schistosomes, the blood flukes, which
has male and female worms)
• Praziquantel treats all, except Fasciola hepatica which requires
triclabendazole
36. Question # 5:
A 26-year-old woman from Mexico is passing thin, flat, white tissue fragments in
her stools over the past month. She is otherwise healthy and does not report any
symptoms. Your micro lab confirms that these tissue fragments are indeed parts of
a helminth.
37.
38.
39.
40. Major helminths around the world
Trematodes
Blood flukes
S. haematobium
S. japonicum
S. mansoni
Liver flukes
Clonorchis sinensis
Fasciola hepatica
Opisthorchis viverrini
Lung flukes
Paragonimus westermani
Intestinal flukes
Fasciolopsis buski
Metagonimus yokogawai
Cestodes
Intestinal tapeworms
Diphyllobothrium latum
Hymenolepis nana
Taenia saginata
Taenia solium
Larval cysts
Echinococcus granulosus
Echinococcus multilocularis
Taenia solium
Nematodes
Intestinal
Ancylostoma duodenale
Ascaris lumbricoides
Capillaria philippinensis
Enterobius vermicularis
Necator americanus
Strongyloides stercoralis
Trichuris trichiura
Tissue invasive
Angiostrongylus cantonensis
Anisakis simplex
Baylisascaris procyonis
Brugia malayi
Gnathostoma spinigerum
Loa loa
Onchocerca volvulus
Toxocara canis
Trichinella spiralis
Wuchereria bancrofti
1. Despommier et al. Parasitic Diseases. Seventh
Edition.
2. Hotez et al, J Clin Invest 2008
41. Taenia species
Taenia solium (“Pork tapeworm”)
• Acquired by eating larvae in pork—most
people are asymptomatic and may pass
proglottids (gravid parts of the worm) in stools
• Cysticercosis, including neurocysticercosis
(most common cause of seizures worldwide), is
acquired from eating food contaminated with
feces containing eggs
Taenia saginata (“Beef tapeworm”)
• Acquired by eating larvae in undercooked
beef (relatively asymptomatic, but can have
more GI symptoms—longer than T. solium)
• No risk of invasive disease (unlike above)—T.
saginata eggs only hatch in cow stomachs
• Dx: stool proglottids or eggs (not
frequently passed, plus eggs are
indistinguishable between species)
• Rx: Praziquantel for intestinal tapeworm
infection (but not for neurocysticercosis-–
different guidelines)
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
43. Neurocysticercosis Dx and Rx Guidelines
• Diagnosis:
• Definitive = tissue biopsy, multiple cystic lesions each with scolex on imaging, or retinal
cysticercus seen on fundoscopic exam
• Presumptive: suggestive lesions on imaging
• Cysticercus serology is supportive
• Treatment: (medical therapy decreases risk of future seizures, but has immediate risk of increasing brain
inflammation/seizures)
• If hydrocephalus or diffuse cerebral edema, treat with steroids and/or surgery (not with anti-parasitics)
• If no increased ICP: 1-2 viable cysts albendazole + steroids before anti-parasitic
>2 viable cysts albendazole + praziquantel + steroids before anti-parasitics
+ retreatment for any lesions persisting for 6 months after the end of the initial
course of therapy
• Antiepileptics for all NCC patients with seizures
1. Diagnosis and Treatment of Neurocysticercosis:
2017 Clinical Practice Guidelines by IDSA and
ASTMH
44. Diphyllobothrium latum (“broad fish
tapeworm”)
• Can grow to >10m (record is
25m, making it the longest
human parasite)
• Wide distribution—North
America, Scandinavia, Russia,
Baltics, etc.
• Acquired by eating raw or
undercooked fish
• Symptoms of B12 deficiency in
40% of patients
• Dx: stool proglottids or eggs; Rx:
praziquantel
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
45. Hymenolepis nana (“dwarf tapeworm”)
• Small intestinal tapeworm (34-45mm),
mostly infects children, worldwide
prevalence of ~4% (other species—H.
diminuta; rare)
• Humans infected when they ingest eggs
from contaminated food, water, or
hands
vs. eating cysticercoid-infected insects
• Autoinfection can occur (like in
Strongyloidiasis)
• Dx: stool eggs
• Rx: praziquantel (active against adults +
cysticercoid in villus tissue)
vs. alternatives: niclosamide (only active
against adults) and nitazoxanide
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
46. Echinococcus granulosus
• Cestode helminth that forms hydatid
cysts (“watery vessel” containing internal
cystic fluid and daughter cysts) in humans
• Most in liver (65%), 25% in lungs (RLL), rest
can occur anywhere in body
• Distribution of disease coincides with
sheep husbandry (ingestion of eggs)
• Presentations: (60% asymptomatic, but..)
• Allergic symptoms/anaphylaxis due to cyst
rupture after trauma
• Peritonitis, cholangitis, biliary obstruction,
pneumonia due to cyst rupture in those
spaces
• Bone fracture due to bone cysts, mechanical
rupture of heart with pericardial tamponade,
hematuria/flank pain due to renal cysts
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
47. E. granulosus - diagnosis
1. Mehta et al. Trop Parasitol, 2016.
2. CDC-–DPDx
3. Despommier et al. Parasitic Diseases. Seventh
Edition.
Radiology
(Multiloculated cyst appearing as well-defined fluid
attenuation lesion with multiple septae or daughter cysts
in a honeycomb pattern)
Microscopy
(Cyst with multiple daughter cysts)
Serology
Of patients with
hepatic cystic
echinococcosis, 30-
40% have negative
serologies
• Ability of
parasite antigens
to inhibit B cell
activity
• Those with intact
cysts may not
experience
sufficient antigen
challenge
48. E. granulosus - treatment
• Need to be careful to not spill cyst contents
• Anaphylaxis
• Spilled protoscoleces (larval component of hydatid cyst) can re-establish infection
• Typically treat with albendazole first (x several days) before surgery or
PAIR (Puncture, Aspiration, Injection, Re-aspiration) vs. “watchful waiting”
(e.g., single cyst without daughter cyst and pt asymptomatic)
• Surgery remains most effective treatment and can lead to complete cure
1. https://www.cdc.gov/parasites/echinococcosis/treatment.html
2. https://www.who.int/news-room/fact-sheets/detail/echinococcosis
49. Echinococcus multilocularis
• Fox/rodent lifecycle—disease
distribution coincides with fur
trappers
• Appearance of infiltrative, tumor-
like growth that is poorly
demarcated
• Has a semi-solid nature
• does not form large cyst or produce
protoscoleces
• grows by external budding/mets
• Similar diagnosis, typically treat
with albendazole and surgery
1. CDC-–DPDx
2. Chouhan et al. Clinical Radiology, 2019.
3. Despommier et al. Parasitic Diseases. Seventh
Edition.
50. Cestodes (tapeworms) Summary
• Have flat, ribbon-like bodies consisting of proglottid segments which
contain reproductive organs
• Have no digestive systems (absorb food through soft body wall)
• All except D. latum have suckers with hooklets on the scolex
• Humans acquire through oral route (fecal-oral or eating cyst-laden
food)
• Adult tapeworms do not cause significant pathology in the human
intestines (unlike adult trematode or nematode worms)
• But significant global morbidity when humans serve as intermediate hosts
(e.g., neurocysticercosis and echinococcosis)
1. Despommier et al. Parasitic Diseases. Seventh
Edition.
51. Question # 6:
A 40-year old woman who is originally from Kenya and worked on a farm presents
for her annual physical. She states she has been doing well except that she recently
passed a large, round, whitish worm in her stools. She denies any symptoms. She
brings the worm to your office in plastic container.
1. CDC-–DPDx
52.
53.
54.
55. Major helminths around the world
Trematodes
Blood flukes
S. haematobium
S. japonicum
S. mansoni
Liver flukes
Clonorchis sinensis
Fasciola hepatica
Opisthorchis viverrini
Lung flukes
Paragonimus westermani
Intestinal flukes
Fasciolopsis buski
Metagonimus yokogawai
Cestodes
Intestinal tapeworms
Diphyllobothrium latum
Hymenolepis nana
Taenia saginata
Taenia solium
Larval cysts
Echinococcus granulosus
Echinococcus multilocularis
Taenia solium
Nematodes
Intestinal
Ancylostoma duodenale
Ascaris lumbricoides
Capillaria philippinensis
Enterobius vermicularis
Necator americanus
Strongyloides stercoralis
Trichuris trichiura
Tissue invasive
Angiostrongylus cantonensis
Anisakis simplex
Baylisascaris procyonis
Brugia malayi
Gnathostoma spinigerum
Loa loa
Onchocerca volvulus
Toxocara canis
Trichinella spiralis
Wuchereria bancrofti
1. Despommier et al. Parasitic Diseases. Seventh
Edition.
2. Hotez et al, J Clin Invest 2008
56. Ascaris lumbricoides
• One of the largest nematodes/soil-
transmitted helminths (STH)
• Eggs in soilingestlarvae hatch in
intestinesmigrate to liver then
lungslarvae coughed up and swallowed
into GI tractworm matures
• Symptoms
• Loeffler’s syndrome—eosinophilic pneumonitis
with transient lung infiltrates
• Abd pain, distention, or intestinal obstruction
with large worm burden
• Aberrant worm migrationcholangitis,
pancreatitis
• Asymptomatic—passing eggs or large worm in
stools
• Dx: typically stool eggs (or worm); Rx:
albendazole or mebendazole; alternative--
pyrantel pamoate 1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
57. Hookworms—Ancylostoma and Necator species
• Filariform larva penetrates
skingoes to lungs, then coughed up
and swallowed—worm matures in
intestines
• Major cause of iron-deficiency
anemia and protein loss
• Symptoms:
• urticarial rash (papulovesicular
dermatitis) vs. cutaneous larva migrans
(serpiginous lesions if worms migrate
laterally)
• transient pneumonitis
• Abd pain
• Signs + symptoms related to anemia and
protein loss, particularly in children
• Dx: stool eggs, consider clinical if CLM;
Rx: Albendazole or mebendazole
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
58. Question # 7:
A 45-year-old American man with no known medical history presents with nearly 4 months of
profound daily diarrhea and weight loss of 35 pounds after spending 1 month in the Philippines.
Towards the end of his backpacking trip, he decided to try a “jumping salad” prepared by a street
food stall—symptoms started shortly after. Review of systems is negative for cough and other
respiratory symptoms.
On exam, the patient appears pale and nearly cachectic. His labs reveal electrolyte derangements,
anemia, low albumin, and is notable for a negative HIV 4th generation screen.
1. https://www.overseaspinoycoo
king.net/2008/06/jumping-
salad-fresh-water-shrimp-
salad.html
59.
60.
61.
62. Capillaria philippinensis
• Acquired by eating
raw/undercooked crustaceans and
minnows
• Intestinal capillariasis—manifests
as abdominal/GI disease
• Can become serious due to
autoinfection (embryonated eggs
hatch inside host’s intestine and
released larvae can re-invade)
• Protein-losing enteropathy may
occurcardiomyopathy, emaciation,
cachexia, death.
• Dx: stool microscopy; Rx:
Albendazole or mebendazole
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
63. Enterobius vermicularis (pinworm)
• Ubiquitous; fecal/oral transmission;
typically present in children with peri-
anal itching (rarely appendicitis)—
humans are only host
• Dx: stool O+P not helpful—usually
employ scotch tape test—tape applied
to perianal region in early morning
and then removed for examination
under microscopy to detect eggs or
worms
• Rx: pyrantel pamoate, albendazole, or
mebendazole single dose
• Treat all family members
• Retreat in 2 weeks
• Trim fingernails, wash bedsheets,
practice good hand hygiene 1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
64. Strongyloides stercoralis
• Penetrate skin-->enter lungsmature in
intestines
• Usual manifestations: mild abd pain,
wheezing/transient infiltrates, urticarial
rash/cutaneous larva migrans
• Risk of autoinfection, hyperinfection,
disseminated strongyloidiasis
• Immunocompromised state (steroids, TNF-
inhibitors, HTLV-1, malignancy, malnutrition)
• Disseminated disease characterized by
multisystem involvement (GI—abd pain,
diarrhea; pulm—cough with lung infiltrates;
systemic—fever and hypotension due to shock
2/2 gram-negative sepsis)
• Can have bacteremia, pneumonia, meningitis,
particularly with gram-negative organisms
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
65. Strongyloides diagnosis and treatment
• Dx:
• Stool O&P and/or serology
• In disseminated infections, can check sputum or bronchoalveolar lavage fluid
for O&P—may see larvae migrating/moving across sample
• Rx:
• ivermectin
• For at-risk groups, ideally would check serology and/or give prophylactic ivermectin if
pt’s background or clinical history (e.g., from endemic region and has unexplained
peripheral eosinophilia) fits before starting immunosuppressive drugs, such as steroids
• For disseminated infection—prolonged ivermectin (until stool/sputum
negative x 2 weeks) with abx for gram-negative infection + supportive care if
warranted
1. https://www.cdc.gov/parasites/strongyloides/h
ealth_professionals/index.html
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
66. Trichuris trichiura (whipworm)
• 4 cm long nematode, frequently
coincident with other STH
infections (Ascaris and hookworms)
• Fecal/oral transmission
• Heavy infection may lead to loose,
frequent stools, tenesmus, blood in
stools, and rectal prolapse in
children
• Dx: stool eggs (football-shaped
with two polar plugs)
• Rx: albendazole or mebendazole
1. Despommier et al. Parasitic
Diseases. Seventh Edition.
67. Major helminths around the world
Trematodes
Blood flukes
S. haematobium
S. japonicum
S. mansoni
Liver flukes
Clonorchis sinensis
Fasciola hepatica
Opisthorchis viverrini
Lung flukes
Paragonimus westermani
Intestinal flukes
Fasciolopsis buski
Metagonimus yokogawai
Cestodes
Intestinal tapeworms
Diphyllobothrium latum
Hymenolepis nana
Taenia saginata
Taenia solium
Larval cysts
Echinococcus granulosus
Echinococcus multilocularis
Taenia solium
Nematodes
Intestinal
Ancylostoma duodenale
Ascaris lumbricoides
Capillaria philippinensis
Enterobius vermicularis
Necator americanus
Strongyloides stercoralis
Trichuris trichiura
Tissue invasive
Angiostrongylus cantonensis
Anisakis simplex
Baylisascaris procyonis
Gnathostoma spinigerum
Loa loa
Onchocerca volvulus
Toxocara canis
Trichinella spiralis
Wuchereria bancrofti
1. Despommier et al. Parasitic Diseases. Seventh
Edition.
2. Hotez et al, J Clin Invest 2008
68. Eosinophilic meningitis
• Angiostrongylus cantonensis (”rat lungworm”)
• Most common parasitic cause of eosinophilic meningitis worldwide (SE Asia, Pacific
basin, Caribbean)
• Typically acquired by ingestion of parasite in snails/slugs or raw vegetables vs.
contaminated water source
• Dx: CSF PCR (not widely available); Rx: supportive with steroids—unclear benefit;
anthelmintic therapy controversial
• Others:
• Baylisascaris procyonis—acquired by ingestion of eggs shed in raccoon feces (can
cause visceral/neural larva migrans, eosinophilic meningitis)
• Gnathostoma spinigerum—acquired by ingesting infective larvae in freshwater fish
(ceviche), snakes, birds (can cause VLM, subcutaneous swellings, eosinophilic
meningitis, ocular disease)
• Caveat—very simplistic way of approaching this (probably most useful for test
questions).
• Keep in mind that other nematodes can also cause eosinophilic meningitis, as well as some
species from trematodes and cestodes 1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
69. Toxocariasis
• Acquired by ingestion of eggs in animal feces (Toxocara canis—dog;
Toxocara cati—cat)—larvae hatch in intestines then migrate to liver, spleen,
lungs, brain, and/or eye
• Symptoms
• Visceral larva migrans: usually children (<5yo); fever, eosinophilia,
hepatosplenomegaly, wheezing, pneumonia
• Ocular larva migrans: often older children (5-10yo); retinal lesions appear as solid
tumor-like unilateral vision loss
• Dx: clinical + Toxocara antibody testing (serum + intraocular ELISA)
• Rx: can be self-limiting disease; acute VLM or OLM—albendazole and
steroids
1. Despommier et al. Parasitic Diseases. Seventh
Edition.
70. Anisakis simplex
• Acquired by ingesting larvae in raw
or undercooked seafood
(worldwide)
• Acute abdominal symptoms of pain
and vomiting (hours), mimicking
food poisoning, gastric ulcer,
appendicitis, or IBD if larvae
penetrate gastric mucosa or pass
into small bowel
• Allergic reaction to worm
• Dx and Rx: usually endoscopic
removal of worm, but sometimes
self-resolves
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
3. Madi et al. Can J Gastroenterol, 2013
71. Trichinella spiralis
• Acquired from eating meat
containing cysts (pork/boar, bear,
horse, wild game)
• Larvae released from cysts by
gastric acid, invade small bowel,
then migrate to striated muscle
• Symptoms: acute abd pain and
diarrhea, later with severe muscle
pain, periorbital edema,
eosinophilia
• Dx: serologies supportive, biopsy
definitive; Rx: albendazole +
steroids
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
72. Filariasis
• Filariae—threadlike, tissue-
invasive roundworms that are
transmitted by insect vectors
• Caused by
• Wuchereria bancrofti
• Brugia malayi
• Loa loa
• Onchocerca volvulus Microfilaria of W. bancrofti in a thick blood smear,
stained Giemsa
1. CDC-–DPDx
2. Despommier et al. Parasitic Diseases. Seventh
Edition.
73. Body location of filarial infections
Wuchereria bancrofti
Brugia malayi
(lymphatic filariasis—mosquitos)
Loa loa
(Loasis--deer fly (Chrysops flies))
Onchocerca volvulus
(river blindness—black flies)
Adults
lymphatics
Subcutaneous tissues (moving)
Subcutaneous tissues (nodules)
Microfilariae
blood (night)
blood (day)
skin
1. Despommier et al. Parasitic Diseases.
Seventh Edition.
2. CDC-–DPDx
74. Lymphatic filariasis
• W. bancrofti and B. malayi (vector—mosquito bite)
• W. bancrofti—Sub-Saharan Africa (not southern portion),
some western Pacific Island nations, part of the Caribbean,
South America, India, Southeast Asia
• B. malayi—Southeast Asia
• Clinical disease:
• Asymptomatic
• Acute lymphadenitis—painful swelling of lymph nodes,
fever, secondary bacterial infections
• Elephantiasis—lymphedema of arms, legs, etc.
• Tropical pulmonary eosinophilia—paroxysmal
nocturnal asthma with dyspnea, fatigue, weight loss,
eosinophilia (>3,000/mm3)
• likely due to excessive immune response to
microfilariae in lung
• Dx:
• Microscopy—ID of microfilariae on blood smears at night
• Serology—ELISA with Western blot
• Antigen testing—circulating filarial antigen assay (only
Wb)
• Identification of adult worm (tissue biopsy or ultrasound
“filarial dance sign”)
• Rx:
• R/o co-infection with Loa loa first due to risk of severe
treatment adverse effects (avoid DEC in high load of Loa
loa on blood smears)
• DEC (diethylcarbamazine) or doxycycline
• Triple-drug therapy (DEC/albendazole/ivermectin) now
recommended by WHO in areas not co-endemic for Loa
loa or Onchocerca volvulus
• Lymphatic surgery, hydrocele drainage
• Lymphedema care, treatment of wounds/secondary
bacterial infections
1. Despommier et al. Parasitic Diseases. Seventh Edition.
2. CDC-–DPDx
76. Onchocerca volvulus
• Bite from black fly (vector)—causes
“river blindness”
• Found mainly in West and Central
Africa; foci in Yemen and Brazil-
Venezuela border
• Clinical disease:
• Dermatitis, lymphadenopathy
(inguinal, head/neck), ocular
(keratitis, iritis, optic neuritis,
cataracts, blindness, etc.)
• Nodding syndrome—presents with
seizures, head nodding, periods of
unresponsiveness
• Dx:
• Serology—ELISA with Western blot
• Microscopy—skin snips, nodulectomy
• Rx:
• ivermectin—make sure no co-infection
with Loa loa (high microfilarial levels)
• moxidectin (FDA approved in 2018)
• Both are microfilaricidal, need repeated
treatments
• Alternative: doxycycline for 6 weeks
1. Despommier et al. Parasitic Diseases. Seventh Edition.
2. https://aho.org/fact-sheets/onchocerciasis-fact-sheet/
3. https://www.thenewhumanitarian.org/ar/node/246506
4. CDC-–DPDx
77. Loa loa (“African eye worm”)
• Bite from deer fly (Chrysops spp—
vector)
• West and Central Africa
• Clinical disease:
• Asymptomatic
• Calabar swellings (allergic rxn to
worms/dead worms)--moves
• Worm migration across eye
• Endomyocardial fibrosis, renal disease
• Encephalitis, lymphadenitis
• Serious adverse reactions when
treated with agents for other
parasitic infections
• Dx:
• Adult worm in subconjunctiva
• Microscopy—blood smears during middle
of day
• Serology—ELISA with Western blot
• Rx:
• Microfilarial level <8000 MF/ml—DEC
(diethylcarbamazine)
• >8000 MF/ml—apheresis or albendazole
first prior to treatment with DEC
• Do not use DEC with O. volvulus co-
infection--risk of blindness and/or
worsening of skin disease
1. Despommier et al. Parasitic Diseases. Seventh Edition.
2. CDC-–DPDx
3. Bowler et al. Eye, 2011.
78. General treatment summary of filariasis
Wuchereria bancrofti
Brugia malayi
(lymphatic filariasis)
Loa loa
(Loasis)
Onchocerca volvulus
(river blindness)
Treatment
DEC
DEC
ivermectin
Avoid
-------
DEC and ivermectin if high microfilarial
level
DEC
Adverse effects (due to immune response and effects from dying worms)
Loa loa with high microfilarial levelsencephalopathy and death
Onchocerciasis-->blindness and severe skin inflammation
1. Despommier et al. Parasitic Diseases. Seventh Edition.
2. CDC-–DPDx
79. Nematodes (roundworms) summary
• Nonsegmented, round
• Has nervous, digestive, renal, and reproductive organs
• Has flexible outer coating (cuticle) with muscular layer underneath
• People get infected in a variety of ways:
• Eating eggs in fecally contaminated food/soil (Ascaris, Trichuris, Enterobius,
Toxocara, Baylisascaris)
• Direct penetration of larvae through skin (Strongyloides, hookworms)
• Eating food with infectious larvae (Angiostrongylus, Gnathostoma, Anisakis,
Capillaria, Trichinella)
• Vector (filarial nematodes)
1. Despommier et al. Parasitic Diseases. Seventh Edition.
2. CDC-–DPDx
80. Some key associations (simplified)
• Freshwater exposure + hematuria or hepatosplenomegalyschistosomiasis
• crab/crayfish consumption + pulm sxsParagonimus
• Seizures with calcified brain lesionsTaenia solium (egg exposure), NCC
• Chinese pt with cholangiocarcinomaClonorchis sinensis (vs. O. viverrini in Southeast Asia though less
commonly associated with cancer)
• Megaloblastic anemiaD. latum (B12 deficiency)
• Allergic reaction after abd/lung traumaEchinococcus
• Itchy feet after returning from tropicsdermatitis/ground itch from hookworm
• Gram-negative sepsis in setting of steroidsdisseminated strongyloidiasis
• Elevated CK, periorbital edema, profound peripheral eosinophiliaTrichinella
• Eosinophilic meningitis, drinking from garden house with slugs/snails around-->Angiostrongylus
• SQ nodulesO. volvulus
• Nighttime blood microfilariaelymphatic filariasis (vs. daytime blood-Loa loa and skin-O. volvulus)
• Eosinophilia, increased AST/ALT, dog exposurevisceral larva migrans from Toxocara canis
• Abdominal pain after eating sushiAnisakis
81. Concluding Thoughts
• Helminths are diverse and quite prevalent around the world—affecting ¼
of the world’s population
• High morbidity (e.g., developmental delays in children, loss of employment in adults,
etc.) and mortality
• Methods for eradicating helminths
• Annual (or more frequent) mass drug administration targeted towards country (i.e.,
annual praziquantel + albendazole in Tanzania), vaccine development?
• Education (hand hygiene, wash/cook food, wear protective clothing such as boots or
long sleeves)
• Water/food sanitation
• Vector/intermediate host control (e.g., snail eradication in Japan)
• WHO’s goal is to achieve and maintain elimination of STH morbidity in pre-
SAC and SAC by 2030
82. Thank you for the opportunity to present!
Questions/comments?
Editor's Notes
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Jibu ni A eating underecooked fish
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MSC-Miracidia sporocyst cercaria
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A potential long-term complication that can occur as a result of infection with a certain species of this type of helminth is:
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A potential long-term complication that can occur as a result of infection with a certain species of this type of helminth is:
https://www.polleverywhere.com/multiple_choice_polls/gQ8oG6MARD2YLuOuknum8?display_state=chart&activity_state=closed&state=closed&flow=Instructor&onscreen=persist
Do not modify the notes in this section to avoid tampering with the Poll Everywhere activity.
More info at polleverywhere.com/support
A potential long-term complication that can occur as a result of infection with a certain species of this type of helminth is:
https://www.polleverywhere.com/multiple_choice_polls/gQ8oG6MARD2YLuOuknum8?display_state=chart&activity_state=closed&display=correctness&state=closed&flow=Instructor&onscreen=persist
Do not modify the notes in this section to avoid tampering with the Poll Everywhere activity.
More info at polleverywhere.com/support
What is the likely helminth?
https://www.polleverywhere.com/multiple_choice_polls/RbfcNFeCLaJZvSezkqNzp?display_state=instructions&activity_state=opened&state=opened&flow=Engagement&onscreen=persist
Do not modify the notes in this section to avoid tampering with the Poll Everywhere activity.
More info at polleverywhere.com/support
What is the likely helminth?
https://www.polleverywhere.com/multiple_choice_polls/RbfcNFeCLaJZvSezkqNzp?display_state=chart&activity_state=opened&state=opened&flow=Engagement&onscreen=persist
Do not modify the notes in this section to avoid tampering with the Poll Everywhere activity.
More info at polleverywhere.com/support
What is the likely helminth?
https://www.polleverywhere.com/multiple_choice_polls/RbfcNFeCLaJZvSezkqNzp?display_state=chart&activity_state=closed&state=closed&flow=Engagement&onscreen=persist
Do not modify the notes in this section to avoid tampering with the Poll Everywhere activity.
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What is the likely causative agent?
https://www.polleverywhere.com/multiple_choice_polls/XVr3KFOfOf7EO1zmAVusq?display_state=instructions&activity_state=opened&state=opened&flow=Engagement&onscreen=persist
Do not modify the notes in this section to avoid tampering with the Poll Everywhere activity.
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What is the likely causative agent?
https://www.polleverywhere.com/multiple_choice_polls/XVr3KFOfOf7EO1zmAVusq?display_state=chart&activity_state=opened&state=opened&flow=Engagement&onscreen=persist
Do not modify the notes in this section to avoid tampering with the Poll Everywhere activity.
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What is the likely causative agent?
https://www.polleverywhere.com/multiple_choice_polls/XVr3KFOfOf7EO1zmAVusq?display_state=chart&activity_state=closed&state=closed&flow=Engagement&onscreen=persist
Do not modify the notes in this section to avoid tampering with the Poll Everywhere activity.
More info at polleverywhere.com/support
What is the likely causative agent?
https://www.polleverywhere.com/multiple_choice_polls/b4vcabWTGsyI8OBwqdAOw?display_state=instructions&activity_state=opened&state=opened&flow=Engagement&onscreen=persist