The document summarizes several intestinal protozoan parasites that can infect humans. It describes the causal agents, life cycles, transmission routes, clinical features, laboratory diagnosis, and treatment for parasites including Entamoeba histolytica, Giardia lamblia, Cryptosporidium parvum, Cyclospora cayetanensis, and Balantidium coli. Key details provided on each parasite include their geographic distribution, sites of infection within the host, symptoms caused, and diagnostic microscopic stages observed in stool samples.
The document discusses three intestinal protozoa:
1. Entamoeba histolytica - Its normal habitat is the large intestine. It causes amebiasis or amebic dysentery. The infective stage is the cyst.
2. Blastocystis hominis - Its normal habitat is the lower large intestine. The trophozoite is the diagnostic stage and cyst is the infective stage.
3. Giardia lamblia - Its normal habitat is the upper small intestine. The trophozoite is the diagnostic stage and cyst is the infective stage. Metronidazole is the drug of choice for treating infections of these protozoa.
This document provides an overview of Entamoeba, including its classification, morphology, life cycle, virulence factors, transmission, clinical features, diagnosis, and treatment. Key points include:
- Entamoeba histolytica is a pathogenic protozoan that can cause intestinal and extra-intestinal infections like amoebic dysentery and liver abscess.
- It has three morphological stages - trophozoite, precystic, and cystic stages. Trophozoites cause tissue invasion and disease.
- The infective transmissive stage is the mature quadrinucleated cyst which is ingested and excysts in the intestine.
- Virulence factors like lect
This document provides a classification and overview of intestinal protozoa including Entamoeba, Giardia, Dientamoeba, Trichomonas, and Balantidium. It describes the morphology, life cycles, pathogenicity and clinical manifestations of Entamoeba histolytica, the causative agent of amebiasis. Laboratory diagnosis and treatment options for intestinal amebiasis and extraintestinal complications like hepatic amebiasis are also summarized. The document briefly mentions other non-pathogenic intestinal amoebae including Entamoeba coli, Entamoeba dispar, Entamoeba hartmanni, Entamoeba gingivalis, Endolimax n
ppt on Entamoeba histolytica INTESTINAL LESIONSSandhya Mishra
This document describes intestinal lesions caused by Entamoeba histolytica, the protozoan parasite that causes amoebiasis. It discusses the life cycle, morphology, and pathogenicity of E. histolytica. Regarding intestinal lesions, it notes that trophozoites penetrate the intestinal epithelium using histolysin, causing coagulative necrosis, abscess formation and ulcers. Acute amoebic dysentery features round or oval ulcers with ragged, undermined margins in the large intestine. Chronic intestinal amoebiasis can cause small mucosal ulcers, extensive superficial ulcers, scarring, thickening and narrowing of the intestinal wall.
This document provides information about parasites and parasitology. It discusses different types of parasites like protozoa, helminthes, and examples. It then focuses on Entamoeba histolytica, describing its life cycle, morphology, geographical distribution, pathogenesis, clinical presentation, diagnosis, treatment and epidemiology. Key points are that E. histolytica is a protozoan parasite that causes amoebic dysentery. It exists in trophozoite and cyst forms and is transmitted when cysts from infected feces contaminate food or water. The parasite infects the large intestine where it can cause intestinal lesions or spread to other organs.
This document summarizes various amoebae including Entamoeba histolytica, Naegleria fowleri, Acanthamoeba, and Balamuthia mandrillaris. It describes their morphology, life cycles, pathogenesis, clinical manifestations, laboratory diagnosis, and treatment. The key points are that these amoebae can cause intestinal and extra-intestinal infections in humans, invading tissues via ingestion or inhalation of cysts/trophozoites from the environment. Clinical symptoms vary depending on the infected site. Laboratory diagnosis involves microscopic examination of samples and molecular methods. Treatment involves antimicrobials targeting the infective stages.
This document discusses medically important protozoa, including their classification, epidemiology, morphology, lifecycles, pathogenesis, clinical manifestations, diagnosis, treatment, and prevention. It focuses on Entamoeba histolytica, providing details on its lifecycle involving the ingestion of cysts, excystation in the intestines, tissue invasion via trophozoites, and formation of cysts that are passed in feces. Symptoms of E. histolytica infection range from asymptomatic carriage to intestinal amebiasis and extraintestinal amebiasis involving the liver and other organs. Diagnosis involves cyst examination in stool and antigen detection, while treatment involves metronidazole and other agents depending on
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 three intestinal protozoa:
1. Entamoeba histolytica - Its normal habitat is the large intestine. It causes amebiasis or amebic dysentery. The infective stage is the cyst.
2. Blastocystis hominis - Its normal habitat is the lower large intestine. The trophozoite is the diagnostic stage and cyst is the infective stage.
3. Giardia lamblia - Its normal habitat is the upper small intestine. The trophozoite is the diagnostic stage and cyst is the infective stage. Metronidazole is the drug of choice for treating infections of these protozoa.
This document provides an overview of Entamoeba, including its classification, morphology, life cycle, virulence factors, transmission, clinical features, diagnosis, and treatment. Key points include:
- Entamoeba histolytica is a pathogenic protozoan that can cause intestinal and extra-intestinal infections like amoebic dysentery and liver abscess.
- It has three morphological stages - trophozoite, precystic, and cystic stages. Trophozoites cause tissue invasion and disease.
- The infective transmissive stage is the mature quadrinucleated cyst which is ingested and excysts in the intestine.
- Virulence factors like lect
This document provides a classification and overview of intestinal protozoa including Entamoeba, Giardia, Dientamoeba, Trichomonas, and Balantidium. It describes the morphology, life cycles, pathogenicity and clinical manifestations of Entamoeba histolytica, the causative agent of amebiasis. Laboratory diagnosis and treatment options for intestinal amebiasis and extraintestinal complications like hepatic amebiasis are also summarized. The document briefly mentions other non-pathogenic intestinal amoebae including Entamoeba coli, Entamoeba dispar, Entamoeba hartmanni, Entamoeba gingivalis, Endolimax n
ppt on Entamoeba histolytica INTESTINAL LESIONSSandhya Mishra
This document describes intestinal lesions caused by Entamoeba histolytica, the protozoan parasite that causes amoebiasis. It discusses the life cycle, morphology, and pathogenicity of E. histolytica. Regarding intestinal lesions, it notes that trophozoites penetrate the intestinal epithelium using histolysin, causing coagulative necrosis, abscess formation and ulcers. Acute amoebic dysentery features round or oval ulcers with ragged, undermined margins in the large intestine. Chronic intestinal amoebiasis can cause small mucosal ulcers, extensive superficial ulcers, scarring, thickening and narrowing of the intestinal wall.
This document provides information about parasites and parasitology. It discusses different types of parasites like protozoa, helminthes, and examples. It then focuses on Entamoeba histolytica, describing its life cycle, morphology, geographical distribution, pathogenesis, clinical presentation, diagnosis, treatment and epidemiology. Key points are that E. histolytica is a protozoan parasite that causes amoebic dysentery. It exists in trophozoite and cyst forms and is transmitted when cysts from infected feces contaminate food or water. The parasite infects the large intestine where it can cause intestinal lesions or spread to other organs.
This document summarizes various amoebae including Entamoeba histolytica, Naegleria fowleri, Acanthamoeba, and Balamuthia mandrillaris. It describes their morphology, life cycles, pathogenesis, clinical manifestations, laboratory diagnosis, and treatment. The key points are that these amoebae can cause intestinal and extra-intestinal infections in humans, invading tissues via ingestion or inhalation of cysts/trophozoites from the environment. Clinical symptoms vary depending on the infected site. Laboratory diagnosis involves microscopic examination of samples and molecular methods. Treatment involves antimicrobials targeting the infective stages.
This document discusses medically important protozoa, including their classification, epidemiology, morphology, lifecycles, pathogenesis, clinical manifestations, diagnosis, treatment, and prevention. It focuses on Entamoeba histolytica, providing details on its lifecycle involving the ingestion of cysts, excystation in the intestines, tissue invasion via trophozoites, and formation of cysts that are passed in feces. Symptoms of E. histolytica infection range from asymptomatic carriage to intestinal amebiasis and extraintestinal amebiasis involving the liver and other organs. Diagnosis involves cyst examination in stool and antigen detection, while treatment involves metronidazole and other agents depending on
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.
This document summarizes information about the amoeba Entamoeba histolytica, including its life cycle, pathogenesis, and methods of diagnosis. It describes two stages - the trophozoite stage, which is invasive and feeds on red blood cells, and the cyst stage, which is the infective form passed in feces. Transmission occurs when mature cysts from contaminated food/water are ingested. In the small intestine, trophozoites are released from cysts and can invade the intestinal mucosa, causing amebic dysentery, or spread to other organs like the liver via the bloodstream. Diagnosis involves microscopy of stool samples to look for trophozoites and cysts or serological tests
Balantidium coli is the largest protozoan parasite that infects humans. It has two stages - the trophozoite stage, which is actively motile, and the cyst stage, which is the infective stage found in feces. B. coli's natural host is pigs, but it can infect humans through ingestion of contaminated food or water containing cysts. In humans, it causes the disease balantidiasis through invasion and ulceration of the large intestine. Symptoms include diarrhea, abdominal pain, and bloody stool. Diagnosis involves microscopic examination of stool samples for trophozoites or cysts. Treatment involves antibiotics like tetracycline or metronidazole.
This document provides information on flagellates, including their classification, morphology, life cycles, pathogenic species, and clinical features. It discusses two pathogenic lumen-dwelling flagellates - Giardia lamblia and Trichomonas vaginalis. G. lamblia causes diarrhea and resides in the duodenum and jejunum. T. vaginalis causes vaginitis and urethritis and is found in the vagina and urethra. The document also briefly mentions other non-pathogenic and less common flagellate species found in the human colon.
This document discusses Balantidium coli, a ciliated protozoan parasite that causes the disease balantidiasis in humans. It has two life stages, a motile trophozoite stage that inhabits the large intestine and reproduces, and an infective cyst stage that is transmitted through fecal contamination. Symptoms include diarrhea, dysentery, abdominal pain and ulceration of the intestinal wall. Diagnosis is made by examining stool samples under a microscope. Treatment involves oral antibiotics such as tetracycline or metronidazole.
This document summarizes several intestinal and urogenital flagellates including Giardia lamblia, Trichomonas vaginalis, Dientamoeba fragilis, Trichomonas tenax, Chilomastix mesnili, Retortamonas intestinalis, and Trichomonas hominis. It describes the morphology, life cycles, transmission routes, clinical manifestations, diagnosis, treatment and prevention of these parasites. Giardia lamblia is a common cause of parasitic diarrhea and is transmitted through ingestion of cysts from contaminated food, water or surfaces. Trichomonas vaginalis causes the sexually transmitted infection trichomoniasis through sexual contact.
This document discusses intestinal protozoa including ameba species. It causes by fecal-oral transmission due to poor hygiene and sanitation. Control involves improving hygiene, treating carriers, and protecting water supply by boiling, iodine or not chlorine. Amoebiasis is caused by Entamoeba histolytica transmitted via cysts in contaminated food/water or direct contact. It causes asymptomatic infection or invasive disease with diarrhea, dysentery, liver abscesses. Diagnosis involves stool exam detecting trophozoites while treatment is metronidazole. Prevention requires improved hygiene and water treatment.
This document describes the characteristics of cysts and trophozoites of several intestinal protozoa:
Entamoeba histolytica cysts are round or oval and contain one to four nuclei and chromatoid bodies. E. histolytica trophozoites are actively motile and feed by ingesting red blood cells in their endoplasm.
Giardia lamblia cysts are oval shaped with four nuclei and axonemes. G. lamblia trophozoites have a tear-drop shape with two nuclei, four pairs of flagella, and two median bodies.
Cryptosporidium parvum oocysts appear red and granular even at high magnification. Is
This document summarizes four intestinal parasites: Entamoeba histolytica, Balantidium coli, Trichomonas vaginalis, and Giardia lamblia. It describes their classification, transmission, sites of infection, clinical manifestations, and laboratory diagnosis. Entamoeba histolytica can cause intestinal or extra-intestinal amoebiasis by forming ulcers in the intestine or other organs. Balantidium coli causes colitis and other infections of the large intestine. Trichomonas vaginalis causes vaginitis or urethritis through sexual contact. Giardia lamblia causes giardiasis through a fecal-oral route and leads to diarrhea and malabsorption.
Entamoeba is a protozoan parasite that causes amoebiasis in humans. It has two stages in its life cycle - the motile trophozoite stage that lives in the intestine, and the infective cyst stage that is passed in feces. Infection occurs when cysts are ingested and excyst in the intestine, releasing trophozoites that multiply and may invade the intestinal wall. Symptoms range from asymptomatic carriage to dysentery. Treatment involves antibiotics like metronidazole that target the trophozoite stage. Prevention focuses on improving sanitation to reduce fecal contamination of food and water.
This document summarizes information about the parasite Entamoeba histolytica:
- E. histolytica lives in the mucous and sub-mucous layers of the large intestine in humans and can occasionally infect the liver, lungs, brain, and spleen, causing ulcers.
- It has no fixed shape and size, with a spherical nucleus and cytoplasm that can be divided into a clear ectoplasm and granular endoplasm containing red blood cells.
- It multiplies by binary fission and has the ability to encyst, developing a protective cyst wall prior to dividing its nucleus.
- E. histolytica commonly exists harmlessly in the intestine but can invade tissues
This document discusses Entamoeba coli, a non-pathogenic intestinal parasite commonly found in humans. It describes E. coli's life cycle between a trophozoite stage inside the intestine and a cyst stage passed in feces. Transmission occurs worldwide via the fecal-oral route through contaminated food or water. While usually harmless, large populations of E. coli can cause minor digestive issues. Diagnosis involves examining stool samples under a microscope for cysts or trophozoites. Treatment is not usually needed, but improved hygiene can reduce transmission.
Topics included :- What are protozoans; list of diseases caused by them (Malaria, amoebiasis, leishmaniasis, trypanosomiasis, balantidiasis, giardiasis, trichomoniasis, toxoplasmosis, pneumocytosis); drugs in treating protozoan diseases
This document summarizes several intestinal and urogenital protozoa that are significant to human health, including Entamoeba histolytica, Giardia lamblia, Cryptosporidium parvum, and Balantidium coli. It describes the morphology, life cycles, transmission, symptoms, pathology, diagnosis and treatment of amebiasis caused by E. histolytica as well as giardiasis caused by G. lamblia. It also briefly discusses cryptosporidiosis caused by C. parvum and balantidiasis caused by B. coli. The document contains several images that illustrate the microscopic appearance of trophozoites and cysts of these protozoan
The document summarizes various ameba species, including the pathogenic Entamoeba histolytica. E. histolytica causes amebic dysentery and can invade the liver, lungs or brain. It has a worldwide distribution but is most common in developing tropical regions. Other non-pathogenic ameba discussed include Entamoeba coli, Endolimax nana, and Iodamoeba bütschlii. Facultative ameba like Naegleria fowleri and Acanthamoeba spp. can cause fatal infections if they enter the brain or eyes from contaminated water.
This document provides a classification and overview of intestinal protozoa including Entamoeba, Giardia, Dientamoeba, Trichomonas, and Balantidium. It describes the morphology, life cycles, pathogenicity and clinical manifestations of Entamoeba histolytica, the causative agent of amebiasis. Laboratory diagnosis and treatment options for intestinal amebiasis and extraintestinal complications like hepatic amebiasis are also summarized. The document briefly mentions other non-pathogenic intestinal amoebae including Entamoeba coli, Entamoeba dispar, Entamoeba hartmanni, Entamoeba gingivalis, Endolimax n
Amoeba are structurally simple protozoans that can invade and damage the intestinal tract. Entamoeba histolytica is an intestinal amoeba that can cause amoebic dysentery or form extra-intestinal abscesses in the liver and lungs. E. histolytica was first discovered in 1875 and exists in trophozoite, precyst, and cyst forms. The cyst form is infectious and can be transmitted through contaminated food or water. In the intestine, trophozoites may invade the colonic mucosa, causing ulcers or abscesses with symptoms of bloody diarrhea. Liver abscesses are a common extraintestinal manifestation and can spread infection to other organs.
This document provides an overview of Entamoeba histolytica, including its history, structure, transmission, pathology, diagnosis, and treatment. E. histolytica is a parasitic protozoan that infects the human colon and causes acute diarrhea and dysentery. It has two stages - the active trophozoite stage that causes infection, and the transmissive cyst stage. The cysts are ingested and excyst in the gut, releasing trophozoites that colonize the colon and cause tissue destruction through enzymatic lysis of epithelial cells. Diagnosis involves microscopic examination of stool samples for trophozoites or cysts. Treatment depends on the site of infection but generally involves nitroimidazole derivatives for intestinal
Giardia lamblia is a protozoan parasite that infects the small intestine. It has two stages - the trophozoite stage, which actively multiplies in the small intestine, and the cyst stage, which is passed in feces and can survive outside the body. Infection occurs when cysts are ingested and excyst in the small intestine, releasing trophozoites. Trophozoites attach to the intestine and cause symptoms like diarrhea and abdominal cramps. Cysts form when trophozoites reach the colon and are passed in stool, allowing transmission to new hosts. Diagnosis involves examining stool samples microscopically for cysts or trophozoites. Treatment involves antibiotics like metronidaz
The document summarizes information about three parasites: Entamoeba coli, Entamoeba gingivalis, and Giardia lamblia. It describes their life cycles, characteristics of their trophozoite and cyst forms, sizes, distinguishing features, and clinical symptoms. For E. coli infections are usually asymptomatic. E. gingivalis typically produces no symptoms but has been associated with pyorrhea alveolaris. G. lamblia causes mild diarrhea, anorexia, abdominal cramps, and malabsorption syndrome.
This document provides 15 common interview questions and answers, with examples of both good and bad responses. Some key tips highlighted include focusing on specific accomplishments and examples rather than generic statements, staying positive about previous employers, and relating experiences back to the role. The questions cover topics like industry interests, work history, management styles, goals, weaknesses, salaries, and personality. Overall, the document advises tailoring answers around strengths and qualifications rather than weaknesses for the role.
This document summarizes information about the amoeba Entamoeba histolytica, including its life cycle, pathogenesis, and methods of diagnosis. It describes two stages - the trophozoite stage, which is invasive and feeds on red blood cells, and the cyst stage, which is the infective form passed in feces. Transmission occurs when mature cysts from contaminated food/water are ingested. In the small intestine, trophozoites are released from cysts and can invade the intestinal mucosa, causing amebic dysentery, or spread to other organs like the liver via the bloodstream. Diagnosis involves microscopy of stool samples to look for trophozoites and cysts or serological tests
Balantidium coli is the largest protozoan parasite that infects humans. It has two stages - the trophozoite stage, which is actively motile, and the cyst stage, which is the infective stage found in feces. B. coli's natural host is pigs, but it can infect humans through ingestion of contaminated food or water containing cysts. In humans, it causes the disease balantidiasis through invasion and ulceration of the large intestine. Symptoms include diarrhea, abdominal pain, and bloody stool. Diagnosis involves microscopic examination of stool samples for trophozoites or cysts. Treatment involves antibiotics like tetracycline or metronidazole.
This document provides information on flagellates, including their classification, morphology, life cycles, pathogenic species, and clinical features. It discusses two pathogenic lumen-dwelling flagellates - Giardia lamblia and Trichomonas vaginalis. G. lamblia causes diarrhea and resides in the duodenum and jejunum. T. vaginalis causes vaginitis and urethritis and is found in the vagina and urethra. The document also briefly mentions other non-pathogenic and less common flagellate species found in the human colon.
This document discusses Balantidium coli, a ciliated protozoan parasite that causes the disease balantidiasis in humans. It has two life stages, a motile trophozoite stage that inhabits the large intestine and reproduces, and an infective cyst stage that is transmitted through fecal contamination. Symptoms include diarrhea, dysentery, abdominal pain and ulceration of the intestinal wall. Diagnosis is made by examining stool samples under a microscope. Treatment involves oral antibiotics such as tetracycline or metronidazole.
This document summarizes several intestinal and urogenital flagellates including Giardia lamblia, Trichomonas vaginalis, Dientamoeba fragilis, Trichomonas tenax, Chilomastix mesnili, Retortamonas intestinalis, and Trichomonas hominis. It describes the morphology, life cycles, transmission routes, clinical manifestations, diagnosis, treatment and prevention of these parasites. Giardia lamblia is a common cause of parasitic diarrhea and is transmitted through ingestion of cysts from contaminated food, water or surfaces. Trichomonas vaginalis causes the sexually transmitted infection trichomoniasis through sexual contact.
This document discusses intestinal protozoa including ameba species. It causes by fecal-oral transmission due to poor hygiene and sanitation. Control involves improving hygiene, treating carriers, and protecting water supply by boiling, iodine or not chlorine. Amoebiasis is caused by Entamoeba histolytica transmitted via cysts in contaminated food/water or direct contact. It causes asymptomatic infection or invasive disease with diarrhea, dysentery, liver abscesses. Diagnosis involves stool exam detecting trophozoites while treatment is metronidazole. Prevention requires improved hygiene and water treatment.
This document describes the characteristics of cysts and trophozoites of several intestinal protozoa:
Entamoeba histolytica cysts are round or oval and contain one to four nuclei and chromatoid bodies. E. histolytica trophozoites are actively motile and feed by ingesting red blood cells in their endoplasm.
Giardia lamblia cysts are oval shaped with four nuclei and axonemes. G. lamblia trophozoites have a tear-drop shape with two nuclei, four pairs of flagella, and two median bodies.
Cryptosporidium parvum oocysts appear red and granular even at high magnification. Is
This document summarizes four intestinal parasites: Entamoeba histolytica, Balantidium coli, Trichomonas vaginalis, and Giardia lamblia. It describes their classification, transmission, sites of infection, clinical manifestations, and laboratory diagnosis. Entamoeba histolytica can cause intestinal or extra-intestinal amoebiasis by forming ulcers in the intestine or other organs. Balantidium coli causes colitis and other infections of the large intestine. Trichomonas vaginalis causes vaginitis or urethritis through sexual contact. Giardia lamblia causes giardiasis through a fecal-oral route and leads to diarrhea and malabsorption.
Entamoeba is a protozoan parasite that causes amoebiasis in humans. It has two stages in its life cycle - the motile trophozoite stage that lives in the intestine, and the infective cyst stage that is passed in feces. Infection occurs when cysts are ingested and excyst in the intestine, releasing trophozoites that multiply and may invade the intestinal wall. Symptoms range from asymptomatic carriage to dysentery. Treatment involves antibiotics like metronidazole that target the trophozoite stage. Prevention focuses on improving sanitation to reduce fecal contamination of food and water.
This document summarizes information about the parasite Entamoeba histolytica:
- E. histolytica lives in the mucous and sub-mucous layers of the large intestine in humans and can occasionally infect the liver, lungs, brain, and spleen, causing ulcers.
- It has no fixed shape and size, with a spherical nucleus and cytoplasm that can be divided into a clear ectoplasm and granular endoplasm containing red blood cells.
- It multiplies by binary fission and has the ability to encyst, developing a protective cyst wall prior to dividing its nucleus.
- E. histolytica commonly exists harmlessly in the intestine but can invade tissues
This document discusses Entamoeba coli, a non-pathogenic intestinal parasite commonly found in humans. It describes E. coli's life cycle between a trophozoite stage inside the intestine and a cyst stage passed in feces. Transmission occurs worldwide via the fecal-oral route through contaminated food or water. While usually harmless, large populations of E. coli can cause minor digestive issues. Diagnosis involves examining stool samples under a microscope for cysts or trophozoites. Treatment is not usually needed, but improved hygiene can reduce transmission.
Topics included :- What are protozoans; list of diseases caused by them (Malaria, amoebiasis, leishmaniasis, trypanosomiasis, balantidiasis, giardiasis, trichomoniasis, toxoplasmosis, pneumocytosis); drugs in treating protozoan diseases
This document summarizes several intestinal and urogenital protozoa that are significant to human health, including Entamoeba histolytica, Giardia lamblia, Cryptosporidium parvum, and Balantidium coli. It describes the morphology, life cycles, transmission, symptoms, pathology, diagnosis and treatment of amebiasis caused by E. histolytica as well as giardiasis caused by G. lamblia. It also briefly discusses cryptosporidiosis caused by C. parvum and balantidiasis caused by B. coli. The document contains several images that illustrate the microscopic appearance of trophozoites and cysts of these protozoan
The document summarizes various ameba species, including the pathogenic Entamoeba histolytica. E. histolytica causes amebic dysentery and can invade the liver, lungs or brain. It has a worldwide distribution but is most common in developing tropical regions. Other non-pathogenic ameba discussed include Entamoeba coli, Endolimax nana, and Iodamoeba bütschlii. Facultative ameba like Naegleria fowleri and Acanthamoeba spp. can cause fatal infections if they enter the brain or eyes from contaminated water.
This document provides a classification and overview of intestinal protozoa including Entamoeba, Giardia, Dientamoeba, Trichomonas, and Balantidium. It describes the morphology, life cycles, pathogenicity and clinical manifestations of Entamoeba histolytica, the causative agent of amebiasis. Laboratory diagnosis and treatment options for intestinal amebiasis and extraintestinal complications like hepatic amebiasis are also summarized. The document briefly mentions other non-pathogenic intestinal amoebae including Entamoeba coli, Entamoeba dispar, Entamoeba hartmanni, Entamoeba gingivalis, Endolimax n
Amoeba are structurally simple protozoans that can invade and damage the intestinal tract. Entamoeba histolytica is an intestinal amoeba that can cause amoebic dysentery or form extra-intestinal abscesses in the liver and lungs. E. histolytica was first discovered in 1875 and exists in trophozoite, precyst, and cyst forms. The cyst form is infectious and can be transmitted through contaminated food or water. In the intestine, trophozoites may invade the colonic mucosa, causing ulcers or abscesses with symptoms of bloody diarrhea. Liver abscesses are a common extraintestinal manifestation and can spread infection to other organs.
This document provides an overview of Entamoeba histolytica, including its history, structure, transmission, pathology, diagnosis, and treatment. E. histolytica is a parasitic protozoan that infects the human colon and causes acute diarrhea and dysentery. It has two stages - the active trophozoite stage that causes infection, and the transmissive cyst stage. The cysts are ingested and excyst in the gut, releasing trophozoites that colonize the colon and cause tissue destruction through enzymatic lysis of epithelial cells. Diagnosis involves microscopic examination of stool samples for trophozoites or cysts. Treatment depends on the site of infection but generally involves nitroimidazole derivatives for intestinal
Giardia lamblia is a protozoan parasite that infects the small intestine. It has two stages - the trophozoite stage, which actively multiplies in the small intestine, and the cyst stage, which is passed in feces and can survive outside the body. Infection occurs when cysts are ingested and excyst in the small intestine, releasing trophozoites. Trophozoites attach to the intestine and cause symptoms like diarrhea and abdominal cramps. Cysts form when trophozoites reach the colon and are passed in stool, allowing transmission to new hosts. Diagnosis involves examining stool samples microscopically for cysts or trophozoites. Treatment involves antibiotics like metronidaz
The document summarizes information about three parasites: Entamoeba coli, Entamoeba gingivalis, and Giardia lamblia. It describes their life cycles, characteristics of their trophozoite and cyst forms, sizes, distinguishing features, and clinical symptoms. For E. coli infections are usually asymptomatic. E. gingivalis typically produces no symptoms but has been associated with pyorrhea alveolaris. G. lamblia causes mild diarrhea, anorexia, abdominal cramps, and malabsorption syndrome.
This document provides 15 common interview questions and answers, with examples of both good and bad responses. Some key tips highlighted include focusing on specific accomplishments and examples rather than generic statements, staying positive about previous employers, and relating experiences back to the role. The questions cover topics like industry interests, work history, management styles, goals, weaknesses, salaries, and personality. Overall, the document advises tailoring answers around strengths and qualifications rather than weaknesses for the role.
The letter is from Burmese dissident groups to the Prime Minister of Norway. It thanks Norway for its past support of democracy in Burma but expresses concern that the Norwegian Government Pension Fund has invested in companies operating in Burma that are accused of human rights abuses. The letter requests that Norway intervene to prevent further damage to its reputation and sort out any complications between business interests and human rights principles.
This document provides an overview of Medusa Scientific, a company that innovates and develops exotic technologies. It discusses the company's intellectual property, areas of focus including communication, ultrasound, sensing, energy sources, imaging and electronics. It then provides recommendations and solutions for human resources, marketing and risk management to support the company's growth and expansion. The recommendations include strategies for hiring, developing an online presence, and establishing a risk register and business continuity plan. An implementation timeline and potential financial and organizational impacts are also summarized.
12Mass helps brands talk on social networks with large audiences significantly faster (by 100X) than any other method on the market. Using 12Mass, a brand creates dialog decision trees and optimizes its content using A/B testing.
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This portfolio summarizes Amanda Tietjen's educational experience and philosophy. It includes her autobiography describing growing up in a small rural town and being influenced by hard work and strong community relationships. It also outlines her experience attending small local public schools where teachers knew students and families personally. The portfolio demonstrates Amanda's ability to apply child development knowledge, create effective learning environments, use appropriate assessment techniques, and understand the importance of family and community relationships, in line with early childhood professional standards. It expresses her goal of continuing her education to help children in her community.
China's emergence as an economic powerhouse poses both threats and opportunities for Central
Massachusetts manufacturers. Some companies have lost manufacturing jobs to cheaper Chinese labor, while
others do business in China. Critics argue that the US trade deficit with China is unfair due to differences in
wages, regulations, and China's currency valuation. Supporters counter that coping with China means doing
business there to access its large market. The impact of trade with China on US jobs and the economy is
debated.
8010161310@ ILD Arete is coming up with its new affordable luxury homes in Sector 33, Sohna, Greater Gurgaon. Arete by ILD project is just 10 minutes away from Golf Course Extn. Road and Sohna Road, Gurgaon.
Presentation to the Valdosta-Lowndes County Chamber of Commerce on the Common Community Vision for Greater Lowndes County. A full version of the report can be found at www.bit.ly/LowndesCCV
Anti Counterfeit System using QR codes and Various other applicationsKrishna Sangeeth KS
This document discusses a counterfeit detection system using QR codes. It proposes encoding biometric fingerprint data as QR codes to enhance authentication. The system would implement QR code preprocessing techniques like image localization, rotation correction and perspective transformation. It then suggests applications like bus commuter passes, patient identification, and jewelry certification where encoding fingerprints in QR codes could enable real-time verification and counterfeit detection.
Aplikasi teori.model konsepsual kep di yankeszulham efendi
This document discusses nursing epistemology and conceptual models in nursing. It covers several key topics:
1) Nursing epistemology is the study of nursing knowledge and patterns of knowing, including empirical, esthetic, personal, and ethical knowledge.
2) Conceptual models in nursing are developed based on nursing theorists' views and include models like Henderson's complementary-supplementary model, Orem's self-care model, and Peplau's interpersonal process model.
3) Conceptual models describe central concepts, seven core elements of nursing care, and nursing processes to guide nursing practice, education, and research.
VTax is a tax preparation firm that offers partnerships and referral programs for existing businesses. Through these programs, partner businesses can offer tax preparation services to their existing customers and attract new customers, generating additional revenue. Partners earn a percentage of tax preparation fees for each referral without having to operate a tax business themselves. The VTax mobile app and online tools make it easy for partners and customers to connect with VTax tax professionals remotely for convenient tax filing.
This document summarizes laboratory diagnosis of parasites. Common specimen types for diagnosis include stool, sputum, urine and tissue. Diagnostic methods include microscopic examination, serology, fluorescent stains and molecular assays. Common parasites that can be diagnosed include protozoa (Entamoeba histolytica, Giardia lamblia, Cryptosporidium), helminths (Ascaris lumbricoides, Strongyloides stercoralis), and intestinal pathogens (Blastocystis hominis, Microsporidia). Symptoms, morphology of parasites and life cycles are described to aid in diagnosis.
Parasitology 2024 | Microbes with MorganMargie Morgan
This document provides an overview of laboratory diagnosis of parasites. It discusses microscopic examination of various specimen types and additional testing methods like serology, fluorescent stains, and molecular assays. Key points about parasitic diarrheal disease and the two-vial stool collection kit are summarized. Numerous protozoan, helminthic, and other parasites are then described in detail, including their life cycles, symptoms of infection, and microscopic appearance of diagnostic stages.
This document provides an overview of parasitology and summarizes key information about parasitic protozoans. It describes the life cycles of various protozoans including their modes of reproduction (e.g. fission, budding), hosts, and transmission. Representative parasitic protozoans are grouped by their structures and include flagellates like Giardia lamblia and Trichomonas vaginalis, amoeboid forms like Entamoeba histolytica, ciliates like Balantidium coli, and sporozoans like Plasmodium species which cause malaria. Details are provided on the life cycles and pathogenesis of several important protozoan parasites.
This document summarizes parasitic infections that can cause diarrheal disease. It discusses the most common protozoan parasites found in stool, including amebae like Entamoeba histolytica and flagellates like Giardia lamblia. It also reviews laboratory diagnosis of parasitic infections through microscopic examination of various specimens and alternative testing methods. The major blood-borne protozoa are described, including their transmission, clinical manifestations, and diagnostic approaches.
Strategies Novartis can use to GROW from a Billion Dollar Company to a Trillion Dollar Company like Alphabet Inc
Novartis is a leading healthcare company which is situated in Switzerland and uses digital technologies and innovative science to come up with transformative ways of treatment in areas of great medicinal needs. This article explains what Novartis strategies and what they should employ so that they can rise from a billion dollar company to a trillion dollar company like the Google Alphabet Inc.
Novartis was formed in March 1996 by the merging of pharmaceutical and agrochemical divisions of Ciba-Geigy and Sandoz companies. Thanks to the merging of the two companies, Novartis is one of the biggest pharmaceutical companies in the world. Novartis is one of the largest companies which achieved a great milestone within a few decades. Novartis as a whole is divided into three major divisions: Sandoz (generics), Innovative Medicines and Alcon (eyecare). Novartis is also involved in collaborative research projects that are publicly funded.
Below are some of Novartis best selling drugs and their revenue
1.Cosenty – This is the top selling drug with a revenue of 4.788 billion dollars
2.Enfresto – This has a revenue of 4.644 billions dollars
3.Promacta – This has a revenue 0f 2.088 billion dollars
Medicine manufactured by Novartis and their uses
Medicine Medicine use
Cosentyx Used to treat psoriatic arthritis
Entresto Used to treat heart failure
Lucentis Used to block abnormal vessel growth in the back of the eye
Tasigna Used to treat chronic myelogenous leukemia which has the Philadelphia chromosome
Jakavi Used to treat myelofibrosis, polycythemia vera and graft-versus-host disease
Promacta Used to treat patients with abnormal low platelet count
Sandostatin Used to treat patients with tumor experiencing symptoms like flushing and diarrhea
Xolair Used to treat moderate and severe asthma
Gilenya Used to treat multiple sclerosis
How Novartis became one of the biggest pharmaceutical companies in the world
1.Market control through partnership
Geigy, Sandoz and Ciba combined their power so that they can compete with strong foreign firms and formed a cartel called the Basal Syndicate or Basal IG. Basal IG secured most of the manufacturing facilities all over the US and across Europe. It later joined with IG Farben and other chemical companies to form a big cartel called the Quadrapartite Cartel which dominated all of the European market and enjoyed the profits made from the joint manufacturing.
2.Growth acceleration through mergers
Since competition was very rampant in the pharmaceutical industry, Ciba and Geigy decided to merge with Sandoz AG to form Novartis. With this merge, Novartis became one of the growing giants in the pharmaceutical industry. This made Novartis gain a lot of fame and build a strong reputation over other companies. Novartis majored on agrochemical and pharmaceutical industries which made it easy to focus on a specific mar
This document provides an overview of parasitic infections and their diagnosis. It discusses the most common intestinal protozoa and helminths seen in stool, including Entamoeba histolytica, Giardia lamblia, Cryptosporidium, and hookworm. It also covers blood-borne protozoa like Plasmodium, Babesia, Trypanosomes, and Leishmania. Diagnosis is based on microscopic examination of stool, tissue, or blood samples, as well as molecular testing. Symptoms vary by parasite but often include abdominal pain, diarrhea, and fatigue. Travel history and immune status factor into risk of infection.
This document discusses parasitic infections that can cause diarrhea. It focuses on the laboratory diagnosis of parasitic infections through microscopic examination of stool and other specimens. The most common protozoan parasites found in stool are described in detail, including Entamoeba histolytica, Giardia lamblia, Cryptosporidium species, and others. Diagnostic methods for specific parasites are also outlined.
Amebiasis is an intestinal infection caused by the protozoan Entamoeba histolytica. It is transmitted through the fecal-oral route and infects 50 million people annually. Symptoms range from mild diarrhea to severe dysentery. Rarely, the infection may spread to other organs and cause liver abscesses. Diagnosis involves microscopy of stool or biopsy samples to identify the protozoan trophozoites. Treatment consists of metronidazole or tinidazole to eliminate the intestinal infection, followed by other drugs like paromomycin or diloxanide furoate to clear cysts from the gut and prevent recurrence.
This document discusses intestinal protozoa, specifically focusing on intestinal amoebae. It outlines the life cycles and pathogenic effects of Entamoeba histolytica and Balantidium coli. It describes the mechanisms of pathogenesis of E. histolytica including adhesion molecules and cytolytic factors. The clinical manifestations of intestinal and extraintestinal amoebiasis are described. Methods for diagnosis including microscopy, antigen detection, and molecular tests are also summarized.
This document provides an overview of intestinal parasites and their diagnosis. It discusses protozoa like Entamoeba histolytica and helminths that can infect the human gastrointestinal tract. Entamoeba histolytica is highlighted as it is the only protozoan species known to cause disease. It has two forms - an invasive, pathogenic form that can lead to amebiasis, and a non-invasive, commensal form. The life cycle and morphology of Entamoeba histolytica trophozoites and cysts are described. Symptoms of intestinal and extra-intestinal amebiasis are also outlined.
E. histolytica causes a range of diseases in humans. It can cause asymptomatic intestinal infection or symptomatic amebic colitis characterized by diarrhea, abdominal cramps and pain. Rarely, it can cause a severe, fulminant colitis with toxic megacolon. It is also known to cause amebic liver abscess when trophozoites spread from the intestine to the liver via the portal vein. E. histolytica exhibits a complex life cycle alternating between the infective cyst form and the invasive trophozoite form.
This document provides information about various protozoan parasites classified as amoebas. It describes the morphology, life cycles, and pathogenic characteristics of several intestinal amoebas that can infect humans, including Entamoeba histolytica, Entamoeba coli, Endolimax nana, Entamoeba gingivalis, Dientamoeba fragilis, and Iodamoeba butschlii. For each parasite, it details their trophozoite and cyst stages, structures, sites of infection, and methods of diagnosis and treatment. The document aims to educate on the classification, identification, and clinical significance of different amoeba species.
This document describes several non-pathogenic and pathogenic amoeba species. It discusses their characteristics such as habitat, morphology of trophozoite and cyst stages, transmission methods, and prevalence in humans. Some notable amoeba discussed are Entamoeba coli and Entamoeba histolytica which are common gut commensals, as well as Naegleria fowleri and Acanthamoeba species which can cause infections in humans and are typically found in soil and water environments. The document provides detailed information on the life cycles, symptoms, and diagnosis of diseases caused by these pathogenic free-living amoeba.
This document summarizes various intestinal protozoa including their trophozoite and cyst stages. It describes:
1) Entamoeba histolytica, the causative agent of amebiasis, whose trophozoites have a single nucleus and may contain ingested red blood cells. Its cysts are spherical with 1-4 nuclei.
2) Entamoeba coli, a non-pathogenic species found in the large intestine. Its trophozoites are larger than E. histolytica and its cysts contain 8 nuclei.
3) Giardia lamblia, a flagellate protozoan that causes giardiasis. Its trophozoites have a tear-drop
Giardia lamblia is a protozoan parasite that causes giardiasis. It inhabits the duodenum and upper small intestine where it attaches to the mucosa as trophozoites. The infective stage is the cyst, which can be transmitted through contaminated food or water or via person-to-person contact. Symptoms range from asymptomatic carriage to acute diarrhea.
This document provides information about amoebiasis caused by Entamoeba histolytica. It discusses the life cycle, symptoms, diagnosis and treatment. Regarding life cycle, E. histolytica has stages of cysts which are ingested and release trophozoites in the intestines. Trophozoites colonize the intestines and form cysts which are released causing further infections. Symptoms range from asymptomatic to dysentery and liver abscesses. Diagnosis involves examining stool for cysts/trophozoites and imaging abscesses. Treatment includes metronidazole or tinidazole antibiotics. Prevention relies on proper sanitation and water treatment to avoid fecal-oral transmission.
Classification of medical parasitology Lec.2.pptxnedalalazzwy
Parasitology is the scientific discipline concerned with the study of the biology of parasites and parasitic diseases, including the distribution, biochemistry, physiology, molecular biology, ecology, evolution and clinical aspects of parasites, including the host response to these agents.
This document provides an overview of various protozoan parasites that can infect humans. It discusses the life cycles, infective and pathogenic stages, epidemiology and pathogenesis of intestinal protozoa (Entamoeba histolytica, Giardia lamblia, Balantidium coli, Trichomonas vaginalis), tissue protozoa (Acanthamoeba, Naegleria), and the blood protozoan Leishmania. Key points covered include the clinical manifestations of disease, laboratory diagnosis, treatment and prevention/control measures for these important protozoan infections.
The document discusses the importance of nursing informatics. It notes that informatics can help nursing practice become more visible through healthcare data, empowering nurses to influence policy. It also emphasizes that information is critical for effective decision-making and high-quality nursing care. The document recommends that nurses strive for an "innovator" level of technical competency in nursing informatics.
This document provides an overview of the gastrointestinal system, including:
- A review of gastrointestinal anatomy and physiology with emphasis on the sympathetic and parasympathetic nervous systems.
- A discussion of common gastrointestinal disorders like GERD, hiatal hernia, and esophageal cancer.
- Details on laboratory procedures used to evaluate gastrointestinal issues such as occult blood, C/S stool, and stool exams.
- Information on gastrointestinal surgical procedures including Nissen fundoplication.
The document is authored by Colleen C. Flores, RN and focuses on providing nurses with knowledge to care for patients with gastrointestinal conditions.
The document discusses various types of acute inflammatory disorders including hepatitis, appendicitis, pancreatitis, and cholecystitis. It provides details on:
1) The causes, symptoms, transmission, and prognosis of different types of hepatitis (A, B, C, D, E).
2) The pathophysiology of appendicitis as obstruction in the appendix lumen leads to inflammation, restricted blood flow, and potential perforation.
3) The pathophysiology of acute pancreatitis as spasm, edema or blockage in the ampulla of Vater causes reflux of enzymes and autodigestion of the pancreas.
4) Nursing management focuses on isolation, nutrition,
This document provides a summary of disturbances in oxygenation carrying mechanisms and transportation facilities. Specifically, it discusses issues related to disruptions in blood circulation and oxygen delivery. Key points include that disturbances can occur in the blood itself as well as the vessels and mechanisms that transport blood and oxygen throughout the body. Maintaining proper functioning of these critical systems is essential for health.
This document discusses several cardiovascular disorders related to disturbances in oxygen transport, including structural heart valve disorders like mitral valve prolapse, mitral regurgitation, and mitral stenosis. It also covers infective endocarditis, rheumatic heart disease, myocarditis, pericarditis, aortic aneurysm, and vascular disorders like Buerger's disease, Raynaud's disease, and venous thrombosis. For each condition, it provides information on clinical manifestations, diagnosis, and treatment approaches.
The document discusses proper patient positioning and equipment used for various surgical procedures, including safety belts, armboards, wrist straps, and other attachments that help expose the operative site and support the body. It also covers preoperative skin preparation and draping techniques to prevent infection and maintain a sterile field during surgery. Specific positioning and draping methods are recommended for different types of operations involving the abdomen, pelvis, spine, and other body areas.
The document defines pain and its terminology, describes the pathophysiology and perception of pain, different types of pain syndromes and management approaches, including pharmacological treatments like analgesics and non-pharmacological options like cognitive behavioral therapy and various physical therapies. Pain is a complex, subjective experience influenced by physiological, psychological, social, and cultural factors.
1. The document outlines a post-anesthesia care unit (PACU) scoring system to assess patient recovery and determine readiness for discharge. It assesses 5 areas: activity, respiration, circulation, consciousness, and color.
2. A sample patient in the document scores a 2 for each category, indicating full recovery in each area assessed.
3. A discharge score of 7-8 points is required. The scoring system provides a standardized way to evaluate patient recovery and determine appropriate timing of discharge from the PACU.
This document discusses patient safety considerations for surgery. It emphasizes providing safe patient care by ensuring the correct patient, site, and procedure. It also stresses providing a safe environment by adhering to asepsis and promoting effective communication. The document outlines steps to take in the preoperative phase like addressing nutritional deficiencies, conducting exams, and administering pre-op medications to reduce anxiety and nausea. Informed consent and surgical checklists are also addressed.
Introduction to surgery with his 1st sem 2011Bea Galang
This document discusses the history and evolution of surgery from ancient times to modern times. It covers important developments like the first surgeries performed in ancient Egypt and India, advances during the Middle Ages by surgeons like Guy de Chauliac, and seminal discoveries and techniques from the 16th century onward by figures like Ambroise Pare, William Harvey, Joseph Lister, and later pioneers of techniques like anesthesia, antisepsis, and organ transplantation. It outlines milestones from trepanation to the first heart transplant that have helped establish surgery as a major field of medicine.
This document discusses surgical instrumentation including sutures, needles, and hemostasis. It provides definitions and classifications for cutting instruments, grasping instruments, retractor instruments, and sutures/needles. Specific types of instruments are listed such as scalpels, scissors, forceps, and needle holders. Characteristics and proper use of different suture needles are also outlined.
1. Surgical drains are used to collapse surgical dead space, drain abscesses, provide early warning of leaks, and control established fistula leaks.
2. Post-operative care objectives include re-establishing physiological equilibrium, preventing pain and complications, and promoting functions like respiration, circulation, nutrition, and wound healing.
3. Common post-operative complications involve respiratory, cardiovascular, gastrointestinal, urinary, wound, and integumentary systems. Close monitoring is needed to detect and manage complications early.
This document discusses proper surgical scrub techniques and protocols. It covers:
- Proper handwashing and scrubbing methods, including the brush stroke technique of scrubbing nails, fingers, hands, and arms for the required duration.
- Gowning and gloving procedures to maintain sterility after scrubbing.
- Types of surgical scrubs including full, short, and indications for each.
- Operating room attire and restrictions for different zones to maintain asepsis.
1. The document discusses different types of anesthesia including general anesthesia which causes loss of consciousness and regional anesthesia which causes loss of sensation in one area while maintaining consciousness.
2. It describes various agents that can be used for anesthesia like opioids, barbiturates, benzodiazepines and different techniques for their administration including topical application, local infiltration, nerve blocks and spinal or epidural anesthesia.
3. The advantages of regional anesthesia are discussed versus general anesthesia.
This document lists complications that can occur from various drugs and anesthetics. It discusses potential side effects such as cardiac arrest, respiratory depression, hypotension, loss of protective pain response, vomiting, and malignant hyperthermia that require establishing an open airway, oxygen administration, and notifying the surgeon. It also covers prevention and intervention steps for issues like anaphylaxis, hypotension, nausea and vomiting, headaches, overdosage, and respiratory and neurological complications. Local and systemic side effects of local anesthetics are also outlined.
The document discusses various issues that may arise in labor and birth and their management, including:
1) Trial labor is used to determine if normal labor can progress with conditions like borderline pelvis, induction and augmentation are used to artificially start or assist stalled labor, and instrumental deliveries like forceps and vacuum can be used when pushing is ineffective.
2) Cesarean delivery is performed by making an abdominal and uterine incision when vaginal birth poses risks, and complications include infections, hemorrhage, and injury to mother or baby.
3) Postpartum complications are also reviewed like hematoma, infection, mastitis, thrombosis, and postpartum depression or psychosis.
Infertility is the inability to conceive a child or sustain a pregnancy, affecting 14% of couples. It can be primary (never conceived) or secondary (unable to conceive again). Male infertility can be caused by low sperm count, mobility issues, or ejaculation problems from infections, obesity, or medications. Female infertility can be due to cervical, vaginal, or ovulation issues from conditions like PCOS or thyroid problems. Diagnosis involves semen analysis, ovulation monitoring, and tests of fallopian tube patency. Treatment may include lifestyle changes, medication, surgery, assisted reproduction techniques like IVF, or alternatives like adoption.
This document provides an introduction to philosophy. It discusses how Pythagoras coined the term "philosophy" to describe those who seek wisdom rather than fame or wealth. Philosophy is defined as the love of wisdom and involves reflecting on topics like knowledge, God, life, death, human nature, ethics, and society through reason alone. The major branches of philosophy explore questions regarding the existence of God, the nature of knowledge, what it means to be human, free will, ethics, beauty, the meaning of life, and attainment of happiness.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
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8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
3. Eukaryotic Unicellular Chemoheterotrophs Vegetative form is a trophozoite. Asexual reproduction is by fission,budding, or schizogony. Sexual reproduction by conjugation. Some produce cysts. Protozoa Figure 12.16
4. No mitochondria Multiple flagella Giardia lamblia Trichomonas vaginalis (no cyst stage) Archaezoa Figure 12.17b–d
10. Move by cilia Complex cells Balantidium coli is the only human parasite. Figure 12.20 Ciliophora (Ciliates)
11. Move by flagella Photoautotrophs Euglenoids Chemoheterotrophs Naegleria: Flagellated and amoeboid forms; causes meningoencephalitis. Trypanosoma: Undulating membrane, transmitted by vectors. Leishmania: Flagellated form in sand fly vector, ovoid form in vertebrate host. Euglenozoa
22. Cysts and trophozoites are passed in feces . ingestion of mature cysts in fecally contaminated food, water, or hands. Excystation occurs in the small intestine - trophozoitesare released, which migrate to the large intestine. The trophozoites multiply by binary fission - produce cysts , and both stages are passed in the feces . Pathogenecity
23. Cysts and trophozoites are passed in feces . ingestion of mature cysts in fecally contaminated food, water, or hands. Excystation occurs in the small intestine and trophozoites are released, which migrate to the large intestine. The trophozoites multiply by binary fission and produce cysts , and both stages are passed in the feces . protection by their walls, the cysts can survive days to weeks in the external environment Pathogenecity
24. trophozoitesremain confined to the intestinal lumen ( noninvasive infection) individuals who are asymptomatic carriers, passing cysts in their stool. trophozoitesinvade the intestinal mucosa (intestinal disease) through the bloodstream, extraintestinal sites such as the liver, brain, and lungs (extraintestinal disease), Pathogenecity
25. E. histolytica morphologically ingested red blood cells (erythrophagocystosis) Transmission can also occur through exposure to fecal matter during sexual contact (in which case not only cysts, but also trophozoites could prove infective). Pathogenecity
26. Worldwide, with higher incidence of amebiasis in developing countries. In industrialized countries, risk groups include male homosexuals, travelers and recent immigrants, and institutionalized populations. Geographic Distribution:
28. Fresh stool: wet mounts and permanently stained preparations (e.g., trichrome) Concentrates from fresh stool: wet mounts, with or without iodine stain, and permanently stained preparations E. histolyticatrophozoites can also be identified in aspirates or biopsy samples obtained during colonoscopy or surgery. Laboratory Diagnosis:
29. Microscopy Immunodiagnosis Molecular methods for discriminating between E. histolytica and E. dispar Morphologic comparison with other intestinal parasites Bench aid for E. histolytica Diagnostic findings:
42. Endolimax nana Trophozoites:1 nucleus w/ large, irregularly shaped, blot-like karyosome; has no peripheral chromatin; cytoplasm is granular and vacuolated
43. Cyst: mature cyst w/ 4 nuclei with large, blot-like karyosomes; no have chromatoid bodies
44. Iodamoeba butschlii Trophozoite: 1 nucleus w/ large, usually central karyosome surr by refractile, achromatic granules; cytoplasm coarsely granular, vacuolated & can contain bacteria, yeasts
45. Cyst: one nucleus with a large, usually eccentric karyosome; no chromatoid bodies but have a compact, well defined glycogen mass; shape varies from ovoidal to rounded.
46. For asymptomatic infections, iodoquinol, paromomycin, or diloxanidefuroate are the drugs of choice. For symptomatic intestinal disease, or extraintestinal, infections (e.g., hepatic abscess) the drugs of choice are metronidazole or tinidazole, immediately followed by treatment with iodoquinol, paromomycin, or diloxanidefuroate. Treatment:
53. Causal Agent Balantidium coli, a large ciliated protozoan parasite. Geographic Distribution: Worldwide. Because pigs are an animal reservoir. Other reservoirs include rodents and nonhuman primates. Balantidiasis
54. cysts – infective stage ingestion of contaminated food or water Life cycle
55. excystation occurs in the small intestine- trophozoitescolonize the large intestine Trophozoites undergo encystation to produce infective cysts . Some trophozoites invade the wall of the colon and multiply. Mature cysts are passed with feces . Life cycle
56. Most cases are asymptomatic. Clinical manifestations, when present, include persistent diarrhea occasionally dysentery abdominal pain weight loss. Symptoms can be severe in debilitated persons. Clinical Features:
57. trophozoites - stool specimens or in tissue Cysts are less frequently encountered. Laboratory Diagnosis:
58. Trophozoites: large size (50-70 µm); rows of cilia on the cell surface; a cytostome; a bean shaped macronucleus and a smaller, less conspicuous micronucleus
59. Cyst: spherical to oval; cilia present in the young cyst but are absent in older forms; large, kidney-shaped macronucleus & contractile vacuoles in cytoplasm
60. The drug of choice is tetracycline*, with metronidazole* and iodoquinol* as alternatives. Tetracycline is contraindicated in pregnancy and in children less than 8 years old. Treatment:
64. thick-walled cyst present in the stools (fecal-oral route) cysts infect epithelial cells of the digestive tract and multiply asexually Vacuolar forms - give origin to multi vacuolar and ameboidforms multi-vacuolar -- pre-cyst -- thin-walled cyst (autoinfection) ameboid-- pre-cyst --thick-walled cyst Life Cycle:
65.
66. can cause both asymptomatic and symptomatic symptoms of illness including watery diarrhea, abdominal pain, perianalpruritus, and excessive flatulence. Clinical Features:
67. Cyst-like forms appear round with large, central vacuole-like body. The nuclei in the peripheral cytoplasmic rim are clearly visible, staining purple.
76. Causal Agent: Giardiaintestinalis Giardialamblia Geographic Distribution:Worldwide, more prevalent in warm climates, and in children. Giardisis
77.
78. Cysts for transmission Both cysts and trophozoites can be found in the feces (diagnostic stages) . Infection occurs by the ingestion of cysts in contaminated water, food, or by the fecal-oral route (hands or fomites) . Life Cycle:
79. (small intestine) excystation Trophozoites multiply (lumen of the proximal small bowel )-- free or attached to the mucosa by a ventral sucking disk . Encystation(colon). cyst (nondiarrhealfeces ) Life Cycle:
80. The spectrum varies from asymptomatic carriage to severe diarrhea and malabsorption Acute giardiasis develops after an incubation period of 1 to 14 days (average of 7 days) and usually lasts 1 to 3 weeks Symptoms include diarrhea, abdominal pain, bloating, nausea, and vomiting. In chronic giardiasis the symptoms are recurrent and malabsorption and debilitation may occur. Clinical Features:
81. Trophozoite: pyriform shape w/ 2 nuclei & a large, central karyosome; large ventral sucking disc, 4 pairs of flagella, 2 curved median bodies
82. Cysts: ellipsoid shape w/ 2 nuclei each (more mature ones will have four); lengthwise running central fibrils; short fibers laterally or obliquely across fibrils in lower half of cyst
88. Causal Agent:Cryptosporidium parvum and Cryptosporidium hominisare (most prevalent species) Geographic Distribution:first reports of human cases in 1976, worldwide. Waterborne outbreak in Milwaukee (Wisconsin) in 1993, that affected more than 400,000 people. Crytosporidiosis
89.
90. Sporulatedoocysts, containing 4 sporozoites-- excreted by the infected host through feces and possibly other routes such as respiratory secretions . Transmission occurs mainly through contact with contaminated water (e.g., drinking or recreational water). food sources outbreaks U S -- waterparks, community swimming pools, and day care centers. Zoonotic and anthroponotictransmission Life cycle
91. Life cycle Following ingestion (and possibly inhalation) Excystation-- sporozoitesare released --parasitize gastrointestinal AND respiratory tract. asexual multiplication (schizogony or merogony) -- sexual multiplication (gametogony) -- producing microgamonts (male) and macrogamonts (female)
92. Life cycle Upon fertilization -- oocysts that sporulate in the infected host Two different types of oocysts are produced thick-walled, which is commonly excreted from the host thin-walled oocyst , which is primarily involved in autoinfection.
93. asymptomatic infections severe, life-threatening illness incubation period is an average of 7 days (2 to 10 days). Watery diarrhea is the most frequent symptom accompanied by dehydration, wt loss, abd. pain, fever, n/v immunocompetent persons, symptoms are usually short lived (1 to 2 weeks-- can be chronic and more severe in immunocompromised patients, especially those with CD4 counts <200/µl. Clinical Features:
94. asymptomatic infections severe, life-threatening illness incubation period is an average of 7 days (but can range from 2 to 10 days). Watery diarrhea is the most frequent symptom, and can be accompanied by dehydration, weight loss, abdominal pain, fever, nausea and vomiting. Clinical Features:
95. Clinical Features: In immunocompetent persons, symptoms are usually short lived (1 to 2 weeks); they can be chronic more severe in immunocompromised patients, especially those with CD4 counts <200/µl. also found in other digestive tract, lungs, and conjunctiva.
96. Treatment: Rapid loss of fluids -- fluid and electrolyte replacement. healthy, immunocompetent persons (self-limited)-- Nitazoxanide Immunocompromisedand high risk pt.-- nitazoxanide is unclear. For persons with AIDS, anti-retroviral therapyis encourage
97. Laboratory Diagnosis: Acid-fast staining methods immunofluorescencemicroscopy method of choice (followed closely by enzyme immunoassays)
98. Oocysts are rounded, 4.2 µm - 5.4 µm in diameter. Sporozoites are visible inside the oocysts, indicating that sporulation has occurred.
99. Oocysts stained by the modified acid-fast method: against a blue-green background, the oocysts stand out in a bright red stain. Sporozoites are visible inside the two oocysts to the right.
100. Oocysts of C. parvum (upper left) and cysts of Giardia intestinalis (lower right) labeled with immunofluorescent antibodies.
104. Sporulation of Cyclospora oocysts. The sequence shows, as observed by DIC microscopy of wet mounts: an oocyst passed in fresh stool (Day 0); sporulated oocysts at days 5 (Day 5) and 10 (Day 10), which both contain 2 sporocysts; and a ruptured oocyst (Rupture), with a sporocyst still inside the oocyst and the other sporocyst just outside the coiled sporozoites are barely visible inside the sporocysts.
105.
106. Causal Agent:unicellular coccidian parasite- Cyclosporacayetanensis Geographic Distribution: most common in tropical and subtropical areas 1990, foodborneoutbreaks of cyclosporiasis, 3600 persons, in the United States and Canada.
107.
108. sporulation -- sporont -- two sporocysts (contains 2 sporozoites) sporulatedoocysts are ingested (in contaminated food or water) oocystsexcyst in the gastrointestinal tract-- sporozoites invade the small intestine asexual multiplication and sexual development -- oocysts Life Cycle:
109. Clinical Features: incubation period of 1 week—severe watery diarrhea s/sx- anorexia, wt loss, abd. pain, N/V, myalgias, low-grade fever, and fatigue. Untreated infections typically last for 10-12 weeks -- follow a relapsing course. In disease-endemic settings -- asymptomatic.
111. combination of two antibiotics, trimethoprim-sulfamethoxazole*, also known as Bactrim, Septra, or Cotrim. Supportive measures include management of fluid and electrolyte balance, and rest. Treatment:
115. Causal Agent:coccidian parasite, Cystoisospora belli, is the least common of the three intestinal coccidia Geographic Distribution:Worldwide, especially in tropical and subtropical areas. Infection occurs in immunodepressedpt. and outbreaks in institutionalized groups in US
116.
117. infection occurs by ingestion of sporocysts-containing oocysts sporocystsexcyst in the small intestine -- release their sporozoites, which invade the epithelial cells -- initiate schizogony . Life Cycle:
126. Causal Agent:Dientamoebafragilis is not an ameba but a flagellate. parasite produces trophozoites; cysts have not been identified. Geographic Distribution:Worldwide.
127. the trophozoite is the only stage in stools Trophozoites have characteristically one or two nuclei Life Cycle:
130. detection of trophozoites in permanently stained fecal smears (e.g., trichrome). Laboratory Diagnosis:
131. Nucleus: cluster of granules, with no peripheral chromatin; size range 5-15 µm.
132.
133. The drug of choice is iodoquinol Paromomycin*, tetracycline*, (contraindicated in children under age 8, pregnant and lactating women) or metronidazole can also be used. Treatment:
134.
135.
136. Genera found in humans:Enterocytozoon, Encephalitozoon, Pleistophora, Nosema, & Microsporidium
141. Stool smear stained with Chromotrope 2R containing Enterocytozoon bieneusi spores. Black arrows indicate E. bieneusi spores with their belt-like stripe visible. Red arrow indicates an unidentified yeast. The yellow arrow indicates a vacuolated spore.
142. Stool smear stained with Quick-Hot Gram Chromotrope stain containing Enterocytozoon bieneusi spores. Black arrows indicate E. bieneusi spores with their belt-like stripe visible. The red arrow indicates an unidentified yeast. The yellow arrow indicates a vacuolated spore.
144. OTHER PROTOZOA BLOOD and TISSUE PROTOZOA Plasmodium Babesia Trypanosomabrucei Trypanosomacruzi Toxoplasmagondii Leishmania
145. PROTOZOA FROM OTHER BODY SITES Free-living Amebae Naegleria Acanthamoeba Trichomonasvaginalis
146. PLASMODIUM Disease: Malaria P. vivax: Benign tertian malaria P. malariae: Quartan malaria P. falciparum: Malignant tertian malaria P. ovale: Ovale tertian malaria Lab Dx: Giemsa stained thick and thin blood smears; IFA; PCR
147. Infected RBC: P. vivax and P. ovale: reticulocytes P. malariae: senescent erythrocytes P. falciparum: erythrocytes of all ages Cyclic paroxysm of fever: P. vivax and P. ovale: every 48 hours P. malariae: every 72 hours P. falciparum: every 36-48 hours
148.
149. P. falciparum: Blood Stage Parasites Thin Blood Smears Fig. 1: Normal red cell; Figs. 2-18: Trophozoites (among these, Figs. 2-10 correspond to ring-stage trophozoites); Figs. 19-26:Schizonts (Fig. 26 is a ruptured schizont); Figs. 27, 28: Mature macrogametocytes (female); Figs. 29, 30: Mature microgametocytes (male).
150. Gametocytes of P. falciparum in thin blood smears. Note the presence of a “Laveran’s bib”, which is not always visible.
151. P. falciparum rings have delicate cytoplasm and 1 or 2 small chromatin dots. Red blood cells (RBCs) that are infected are not enlarged; multiple infection of RBCs more common in P. falciparum than in other species. Occasional appliqué forms (rings appearing on the periphery of the RBC) can be present.
152. P. falciparum schizonts: seldom seen in peripheral blood. Mature schizonts have 8 to 24 small merozoites; dark pigment, clumped in one mass.
153. P. malariae schizonts: have 6 to 12 merozoites with large nuclei, clustered around a mass of coarse, dark-brown pigment. Merozoites can occasionally be arranged as a rosette pattern.
154. P. malariae trophozoites: have compact cytoplasm and a large chromatin dot. Occasional band forms and/or "basket" forms with coarse, dark-brown pigment can be seen.
155. P. vivax gametocytes: round to oval with scattered brown pigment and may almost fill the red blood cell (RBC). RBCs are enlarged 1 1/2 to 2 × and may be distorted. Under optimal conditions, Schüffner's dots may appear more fine than those seen in P. ovale.
156. Rex Karl S. Teoxon, R.N, M.D 133 Vector: (night biting) anopheles mosquito minimus flavire
157. 134 SIGNS AND SYMPTOMS Fever, chills, profuse sweating, convulsion, Anemia and fluid and electrolytes imbalance, hepatomegaly, splenomegaly Dx: blood extraction (extract blood at the height of fever) thin and thick smear. Fluorescently labeled Ab
162. 137 MANAGEMENT P. Vivax and P. Ovale – Primaquine (relapse) P. falciparum - Chloroquine For chloroquine resistant plasmodium – quinine * Prophylaxis – chloroquine or mefloquine, pyrimethamine/ sulfadoxine (fansidar)
165. Babesia microti infection, Giemsa stained thin smear. The organisms resemble P. falciparum; however Babesia parasites present several distinguishing features: they vary more in shape and in size; and they do not produce pigment.
166. Infection with Babesia. Giemsa stained thin smears showing the tetrad, a dividing form pathognomonic for Babesia. Note also the variation in size and shape of the ring stage parasites and the absence of pigment.
167. TRYPANOSOMA BRUCEI Disease: African trypanosomiasis T. b. gambiense: Gambian trypanosomiasis, West & Mid-African sleeping sickness T. b. rhodesiense: Rhodesian trypanosomiasis, East African sleeping sickness Lab Dx:Giemsa stained thick and thin blood smears or lymph exudate (early stage); Giemsa stained smears of CSF (late stage)
168. Site in host: lymph glands, blood stream, brain Portal of entry: skin Source of infection: tsetse fly Winterbottom’s sign: enlargement of posterior cervical LNs
169.
170. Trypomastigote: slender to fat and stumpy forms; in Giemsa stained films – C or U shaped forms NOT seen; small, oval kinetoplast located posterior to the nucleus; a centrally located nucleus, an undulating membrane, and an anterior flagellum. The trypanosomes length range is 14-33 µm
171. A dividing parasite is seen at the right. Dividing forms are seen in African trypanosomiasis, but not in American trypanosomiasis (Chagas' disease)
174. TRYPANOSOMA CRUZI Disease: American trypanosomiasis, Chaga’sdisease Lab Dx:Giemsa stained thick and thin blood smears for the trypomastigote; histopath exam for the amastigote Site in host: Tissues – heart; blood Portal of entry: skin Source of infection: Kissing bug Triatomidae
175. Trypomastigote: shape is short & stubby to long & slender; in Giemsa stained blood films – C or U shaped; kinetoplast is large, oval & located posterior to the nucleus; anterior long free flagellum
186. Diagnosis– clinical, serology, blood smear microscopy Treatment- not very good, especially for late complications Prevention– clear houses of bugs, use netting for sleeping
187. TOXOPLASMA GONDII Disease: Toxoplasmosis Site in host: All organs Portal of entry: Ingestion of oocyst contaminated water Aerosolization of oocyst contaminated dust or litter Consumption of raw or undercooked cyst infected meat Transplacental passage of the tachyzoite
188. - Definitive host: domestic cats - Intermediate host: infected rodents Accidental intermediate host: humans Lab Dx: IFAT and ELISA; Giemsa-stained smears of exudates, aspirates or tissues
189. Toxoplasma gondii, parasite Affects birds, mammals i.e. cats Infected person may carry the organism for life (reactivation is possible) 161 TOXOPLASMOSIS
190. 162 PATHOGENESIS ingestion of cyst from uncooked meat / fecal oral route from infected cats (feces) Quickly multiply in the GIT Distributed to CNS, lymphatic tissue, skeletal muscle, myocardium, retina and placenta
204. L. tropica amastigotes: ovoid in shape; large & eccentric nucleus; small, rodlike kinetoplast positioned opposite the nucleus; rodlike axoneme perpendicular to the kinetoplast
215. N. fowleri trophozoites cultured from cerebrospinal fluid: cells have characteristically large nuclei, with a large, dark staining karyosome. The amebae are very active and extend and retract broad pseudopods. Trichrome stain.
216. Acanthamoeba spp.:the cysts are spherical, 15-20 µm in diameter, having a thick double wall. The outer wall may be spherical or wrinkled, the inner wall appear stellate or polyhedral
224. Trophozoites of T. vaginalis: large, pyriform flagellate exhibiting rapid & jerky motility. The wavelike motion of the undulating membrane is often apparent
225. Trichomonas vaginalis:flagellates are 10-30 µm in lenght and 6-20 µm in breadth. Flagella, nucleus, axostyle and undullating membrane are visible. Filamentous form of Lactobacillus Döderleini is present. Giemsa-Romanowski stain.
265. Life Cycle: unembryonated eggs are passed in the human stool and become embryonated after ingestion by freshwater fish-- larvae hatch & penetrate the intestine-- migrate to the tissues -Ingestion of raw or undercooked fish Adults worm -small intestine females deposit unembryonatedeggs (autoinfection) -- hyperinfection(a massive number of adult worms) .
266. Life Cycle: Capillaria hepatica adult worms reside in the liver of various animals, especially rats. Capillariaaerophila adult worms reside in the epithelium of the tracheo-bronchial tract of various animals.
267. Clinical Features: Intestinal capillariasis-- pain and diarrhea autoinfection. protein-losing enteropathy-- cachexiaand death Hepatic capillariasis (C. hepatica) -- acute or subacute hepatitis with eosinophilia-- dissemination -- fatal Pulmonary capillariasis (C. aerophila) -- fever, cough, asthma, and pneumonia-- fatal.
275. Adult Ascaris worm: tapered ends; length 15 to 35 cm (the females tend to be the larger ones). This worm is a female, as evidenced by the size and genital girdle (the dark circular groove at bottom area of image).
276.
277. Causal Agent: Ascarislumbricoidesis the largest nematode (Adult females: 20 to 35 cm; adult male: 15 to 30 cm.) Geographic Distribution:most common human helminthic infection. Worldwide distribution. Highest prevalence in tropical and subtropical regions, and areas with inadequate sanitation.
278.
279. Life Cycle: Adult worms live in the lumen of the small intestine--produce 200,000 eggs/day Fertile eggs embryonate- infective eggs swallowed -- the larvae hatch &, invade the intestinal mucosa-- portal-- systemic -- lungs . lungs -- alveolar walls-- bronchial tree – throat swallowed-- small intestine-- adult worms .
280. Clinical Features: adult worms usually cause no acute symptoms. High worm burdens –abd pain & obstruction. Migrating worms – occlusion of biltract or oral expulsion. lung phase of larval migration, pulmonary symptoms can occur (cough, dyspnea, hemoptysis, eosinophilicpneumonitis - Loeffler’s syndrome).
281. Diagnostic findings Microscopy Treatment:The drugs of choice for treatment of ascariasis are albendazole* with mebendazole, ivermectin*, and nitazoxanide as alternatives. In the United States, ascariasis is generally treated for 1-3 days with medication prescribed by a health care provider. The drugs are effective and appear to have few side effects.
282. Ascaris lumbricoides In GI tract, few symptoms in light infections Nausea Vomiting Obstruction of small bowel or common bile duct. Pulmonary: symptoms due to migration Alveoli (verminous pneumonia)—cough, fever wheeze, dyspnea, X-ray changes, eosinophilia
283. Effects of Adult Ascaris Worms Depends on worm load Effects Mechanical: obstruction, volvulus, intussusception, appendicitis, obstructive jaundice, liver abscesses, pancreatitis, asphyxia Toxic and Metabolic Malnutrition (complex)
284. Ascaris lumbricoidesDiagnosis Characteristic eggs on direct smear examination If treating mixed infections, treat Ascaris first Mebendazole Pyrantel Control: Periodic mass treatment of children, health education, environmental sanitation
285.
286. Causal Agent:The nematode (roundworm) Trichuristrichiura, also called the human whipworm. Geographic Distribution:The third most common round worm of humans. Worldwide, with infections more frequent in areas with tropical weather and poor sanitation practices, and among children. It is estimated that 800 million people are infected worldwide. Trichuriasis occurs in the southern United States.
287.
288. Life Cycle: The unembryonated eggs are passed with the stool . In the soil, the eggs develop into a 2-cell stage embryonate eggs After ingestion (soil-contaminated hands or food), the eggs hatch in the small intestine-larvae - adults in the cecum and ascending colon. Female worms in the cecum shed between 3,000 and 20,000 eggs per day.
289. Clinical Features: Most frequently asymptomatic. Heavy infections, especially in small children, can cause gastrointestinal problems (abdominal pain, diarrhea, rectal prolapse) and possibly growth retardation.
290. Diagnostic findings microscopy Examination of the rectal mucosa by proctoscopy (or directly in case of prolapses) can occasionally demonstrate adult worms. Treatment:Mebendazole is the drug of choice, with albendazole as an alternative.
291. Case 13 8-yr-old schoolgirl visiting the U.S. from Malaysia 1 week history of epigastric pain, flatulence, anorexia, bloody diarrhea No eosinophilia noted Clinical diagnosis of amoebic dysentery made However, microscopy of stool prep…
294. Trichuris trichiura (Whipworm) Common in Southeast U.S. Frequently coexists with ascaris Entirely intraluminal life cycle—eggs are ingested Frequently asymptomatic Severe infections: diarrhea, abdominal pain and tenesmus Rectal prolapse in children DS-eggs in stool Mebendazole 100 mg bid x 3 days
306. Causal Agent: The nematode (roundworm) Enterobiusvermicularis (previously Oxyurisvermicularis) also called human pinworm. (Adult females: 8 to 13 mm, adult male: 2 to 5 mm.) Humans are considered to be the only hosts of E. vermicularis. Geographic Distribution:Worldwide, with infections more frequent in school- or preschool-children and in crowded conditions. Enterobiasis appears to be more common in temperate than tropical countries. The most common helminthic infection in the United States (an estimated 40 million persons infected).
307.
308. Life Cycle: Eggs are deposited on perianal folds . Self-infection occurs by transferring infective eggs to the mouth with hands that have scratched the perianal area . Person-to-person transmission can also occur through handling of contaminated clothes or bed linens. Enterobiasis may also be acquired through surfaces in the environment that are contaminated with pinworm eggs (e.g., curtains, carpeting). Some small number of eggs may become airborne and inhaled. .
309. Life Cycle: These would be swallowed and follow the same development as ingested eggs. -larvae hatch in the small intestine -adults in the colon . Gravid females migrate nocturnally outside the anus and oviposit while crawling on the skin of the perianal area . The larvae contained inside the eggs develop (the eggs become infective) in 4 to 6 hours under optimal conditions . Retroinfection, or the migration of newly hatched larvae from the anal skin back into the rectum
310. Clinical Features Enterobiasis is frequently asymptomatic. The most typical symptom is perianalpruritus, especially at night, which may lead to excoriations and bacterial superinfection. Occasionally, invasion of the female genital tract with vulvovaginitis and pelvic or peritoneal granulomas can occur. Other symptoms include anorexia, irritability, and abdominal pain.
311. Diagnostic findings Microscopy Treatment:The drug of choice is pyrantelpamoate. Measures to prevent reinfection, such as personal hygiene and laundering of bedding, should be discussed and implemented in cases where infection affects other household members.
312. Case 10 11-year-old female Doing poorly in school Not sleeping well Anorectic Complains of itching in rectal region throughout the day A Scotch-tape test reveals…
317. Enterobius (Pinworm) 18 million infections in U.S. Incidence higher in whites Preschool and elementary school most often Mostly asymptomatic Nocturnal anal pruritis cardinal feature due to migration and eggs May have insomnia, possible emotional symptoms DS-eggs or adults on perineum {scotch tape} Mebendazole 100 mg. Repeat in 2 weeks. Pyrantel pamoate 11 mg/kg; repeat 2 weeks
336. B A A: Adult worm of Ancylostoma duodenale. Anterior end is depicted showing cutting teeth.B: Adult worm of Necator americanus. Anterior end showing mouth parts with cutting plates.
337.
338.
339. Causal Agents: The human hookworms include two nematode (roundworm) species, Ancylostomaduodenale and Necatoramericanus. A smaller group of hookworms infecting animals can invade and parasitize humans (A. ceylanicum) or can penetrate the human skin (causing cutaneous larva migrans), but do not develop any further (A. braziliense, A. caninum, Uncinariastenocephala). Occasionally A. caninum larva may migrate to the human intestine causing eosinophilic enteritis; this may happen when larva is ingested rather than through skin invasion.
340. Geographic Distribution: The second most common human helminthic infection (after ascariasis). Worldwide distribution, mostly in areas with moist, warm climate. Both N. americanus and A. duodenale are found in Africa, Asia and the Americas. Necatoramericanus predominates in the Americas and Australia, while only A. duodenale is found in the Middle East, North Africa and southern Europe.
341.
342. Life Cycle: Eggs are passed in the stool-released rhabditiform larvae grow in the feces and/or the soil , and after 5 to 10 days (and two molts) they become filariform (third-stage) larvae that are infective . On contact with the human host, the larvae penetrate the skin and are carried through the veins to the heart and then to the lungs. They penetrate into the pulmonary alveoli, ascend the bronchial tree to the pharynx, and are swallowed The larvae reach the small intestine- adults. Adult worms live in the lumen of the small intestine, where they attach to the intestinal wall with resultant blood loss by the host . In addition, infection by A. duodenale may probably also occur by the oral and transmammary route. N. americanus, however, requires a transpulmonary migration phase
343. Clinical Features: Iron deficiency anemia is the most common symptom of hookworm infection, and can be accompanied by cardiac complications. Gastrointestinal and nutritional/metabolic symptoms can also occur. local skin manifestations ("ground itch") can occur during penetration by the filariform (L3) larvae, and respiratory symptoms can be observed during pulmonary migration of the larvae.
344. Diagnostic Findings Microscopy between N. americanus and A. duodenale. Larvae can be used to differentiate between N. americanus and A. duodenale, by rearing filariform larvae in a fecal smear on a moist filter paper strip for 5 to 7 days (Harada-Mori).
345. Treatment: In countries where hookworm is common and reinfection is likely, light infections are often not treated. In the United States, hookworm infections are generally treated with albendazole* Mebendazole* or pyrantelpamoate* can also be used. Eosinophilic enteritis caused by A. caninum and for cutaneous larva migrans(creeping eruption) caused by canine and feline hookworms.
346. Case 12 57 year old farmer from Dixie County Presents with profound SOB Physical examination: anemic otherwise unremarkable Laboratory examination reveals a profound anemia (hct 24) with aniso and poikilocytosis Remainder of laboratory examination normal.
350. Hookworm Hookworm responsible for development of USPHS Caused by two different species (North American and Old World) Very similar to strongyloides in life cycle Attaches to duodenum, feeds on blood Elaborates anticoagulant, attaches and reattaches many times Loss of around 0.1 ml/d of blood per worm
351.
352.
353. Case 14 18-year-old trailer park handyman seen in ER Worked under trailers wearing shorts and no shirt Developed intensely pruritic skin rash Unable to sleep WBC 18,000 65% eosinophils.
354.
355. Case 15 An 8 year old boy Presents with skin lesions and itching after spending the summer at a beach condo in St. Augustine with his family (mother, father, younger sister, dog and cat). Legs show several raised, reddened, serpiginous lesions that are intensely pruritic.
358. Cutaneous Larva Migrans Caused by filariform larvae of dog or cat hookworm (Ancylostoma braziliense or Ancylostoma duodenale Common in Southeast U.S. Red papule at entry with serpiginous tunnel Intense pruritis Self limiting condition Diagnosis clinical Topical or oral thiabendazole 25 mg/kg bid for 3-5 days May use ethyl chloride topically
359. Cutaneous larva migrans (creeping eruption) More common in children Larvae penetrate skin and cause tingling followed by intense itching. Eggs shed from dog and cat bowels develop into infectious larvae outside the body in places protected from desiccation and extremes of temperature Shady, sandy areas under houses, at beach, etc.
361. Cutaneous larva migrans (creeping eruption) Diagnosis and treatment Skin lesions are readily recognized Usually diagnosed clinically Generally do not require biopsy Reveal eosinophilia inflammatory infiltrate Migrating parasite is generally not seen Stool smear will reveal eggs
362.
363.
364. Visceral Larva Migrans Infection with dog or cat round worms Toxocara canis; Toxocara catis Underdiagnosed based on seroprevalence surveys Heavy infections associated with fever, cough, nausea, vomiting, hepatomegaly, and eosinophilia Uncommon in adults Ocular type more common in adults Diagnosis-ELISA Thiabendazole: 25 mg/kg bid X 5 days
365. Case 17 A 34 yr-old woman from Saudi Arabia Radiation and cyclophosphamide, adriamycin, vincristine and prednisone for diffuse large B cell lymphoma of the neck. Mild eosinophilia (AEC=500) at the time of diagnosis 4 months after initiation of chemo, c/o intermittent diffuse abdominal pain, bloating, constipation and occasional rectal bleeding. Absolute eosinophil count: 1000
366. Case 17 No evidence of lymphoma found on re-staging Completed chemo, was deemed to be in complete remission, but had persistence of GI complaints. Upper endoscopy was unrevealing. Colonoscopy and biopsy revealed granulomatous inflammation, prominent eosinophilic infiltrate, surrounding a collection of eggs.
375. Causal Agent: The nematode (roundworm) Strongyloidesstercoralis. Other Strongyloides include S. fülleborni, which infects chimpanzees and baboons and may produce limited infections in humans. . Geographic Distribution:Tropical and subtropical areas, but cases also occur in temperate areas (including the South of the United States). More frequently found in rural areas, institutional settings, and lower socioeconomic groups
376.
377. Life Cycle: The Strongyloides life cycle is more complex than that of most nematodes with its alternation between free-living and parasitic cycles, and its potential for autoinfection and multiplication within the host. Two types of cycles exist:
378. Life Cycle: Free-living cycle: The rhabditiform larvae passed in the stool (see "Parasitic cycle" below) can either molt twice and become infective filariform larvae (direct development) or molt four times and become free living adult males and females that mate and produce eggs from which rhabditiform larvae hatch . The latter in turn can either develop into a new generation of free-living adults (as represented in ), or into infective filariform larvae . The filariform larvae penetrate the human host skin to initiate the parasitic cycle (see below) .
379. Life Cycle: Parasitic cycle:Filariform larvae in contaminated soil penetrate the human skin , and are transported to the lungs where they penetrate the alveolar spaces; they are carried through the bronchial tree to the pharynx, are swallowed and then reach the small intestine . In the small intestine become adult female worms . The females live threaded in the epithelium of the small intestine and by parthenogenesis produce eggs , which yield rhabditiform larvae. The rhabditiform larvae can either be passed in the stool (see "Free-living cycle" above), or can cause autoinfection .
380. Life Cycle: Parasitic cycle: In autoinfection, the rhabditiform larvae become infective filariform larvae, which can penetrate either the intestinal mucosa (internal autoinfection) or the skin of the perianal area (external autoinfection); To date, occurrence of autoinfection in humans with helminthic infections is recognized only in Strongyloidesstercoralis and Capillariaphilippinensis infections.
381. Clinical Features Frequently asymptomatic. Gastrointestinal symptoms include abdominal pain and diarrhea. Pulmonary symptoms (including Loeffler’s syndrome) can occur during pulmonary migration of the filariform larvae. Dermatologic manifestations include urticarial rashes in the buttocks and waist areas. Disseminated strongyloidiasis occurs in immunosuppressed patients, can present with abdominal pain, distension, shock, pulmonary and neurologic complications and septicemia, and is potentially fatal. Blood eosinophilia is generally present during the acute and chronic stages, but may be absent with dissemination.
382. Diagnostic findings Microscopy Treatment:The drug of choice for the treatment of uncomplicated strongyloidiasis is ivermectin with albendazole* as the alternative. All patients who are at risk of disseminated strongyloidiasis should be treated.
383. On the day of admission… Fever, confusion, and not able to get out of bed---transported to the hospital Initial blood work: Elevated WBC Raised eosinophil count 4 times normal Underwent UGI endoscopy Duodenal biopsy obtained
384.
385. Strongyloides: Crucial Aspects of Life Cycle Infection acquired through penetration of intact skin Infection may persist for many years via autoinfection In immunocompromised patients, there is risk of dissemination or hyperinfection Hyperinfection syndrome
386. Disseminated Strongyloidiasis High mortality75% Penetration of gut wall by infective larvae Gut organisms carried on the surface of larvae results in polymicrobial sepsis, meningitis Larvae disseminate into all parts of body: CNS, lungs, bladder, peritoneum
387. Summary—Clinical Findings Defective cell-meditated immunity: steroids, burns, lymphomas, AIDS (?) Gl symptoms in about two-thirds: Abdominal pain Bloating Diarrhea Constipation Wheezing, SOB, hemoptysis
388. Summary—Clinical Findings Skin rash or pruritis in ~ one-third Larva currens (racing larva) Intensely pruritic Linear or serpiginous urticaria with flare that moves 5-15 cm/hr Usually buttocks, groin, and trunk In dissemination, diffuse petechiae and purpura
399. Eggs of D. latum:oval or ellipsoidal, with at one end an operculum that can be inconspicuous. At the opposite (abopercular) end is a small knob that can be barely discernible.
400. Eggs of Diphyllobothrium latum:are oval or ellipsoidal, with at one end an operculum (arrows) that can be inconspicuous. The eggs are passed in the stool unembryonated.
403. Proglottids of Diphyllobothrium latum. These proglottids tend to be passed in strands of variable length in the stool. The proglottids tend to be broader than long.
404. Proglottids of D. latum:broader than it is long; size 2 to 4 mm long by 10 to 12 mm wide; uterus coiled in rosette appearance; genital pore at the center of the proglottid.
405. Causal Agents: The cestodeDiphyllobothriumlatum (the fish or broad tapeworm), the largest human tapeworm. Geographic Distribution:Diphyllobothriasis occurs in the Northern Hemisphere Freshwater fish infected with Diphyllobothrium sp. larva may be transported to and consumed in geographic areas where active transmission does not occur, resulting in human diphyllobothriasis.
406.
407. Life Cycle: Immature eggs are passed in feces -oncospheres -develop into a coracidia . After ingestion by a suitable freshwater crustacean (the copepod first intermediate host) the coracidia develop into procercoid larvae . second intermediate host, typically minnows and other small freshwater fish, the procercoid larvae are released from the crustacean and migrate into the fish flesh where they develop into a plerocercoid larvae (sparganum) plerocercoid larvae are the infective stage for humans. Because humans do not generally eat undercooked minnows and similar small freshwater fish, these do not represent an important source of infection.
408. Life Cycle: After ingestion of the infected fish, the plerocercoid develop into immature adults and then into mature adult tapeworms which will reside in the small intestine. The adults of D. latum attach to the intestinal mucosa by means of the two bilateral groves (bothria) of their scolex . The adults can reach more than 10 m in length, with more than 3,000 proglottids. Immature eggs are discharged from the proglottids (up to 1,000,000 eggs per day per worm) and are passed in the feces .
409. Clinical Features: Diphyllobothriasis can be a long-lasting infection (decades). Most infections are asymptomatic. Manifestations may include abdominal discomfort, diarrhea, vomiting, and weight loss. Vitamin B12 deficiency with pernicious anemia may occur. Massive infections may result in intestinal obstruction. Migration of proglottids can cause cholecystitis or cholangitis.
410. Diagnostic findings Microscopy Treatment:Praziquantel* is the drug of choice. Alternatively, Niclosamide can also be used to treat diphyllobothriasis.
419. Egg packets of Dipylidium caninum:Proglottids of Dipylidium caninum contain characteristic egg packets that are round to ovoid and contain 5 to 15 (sometimes more) eggs each.
420. Proglottids of D. caninum: barrel-shaped proglottids (average mature size 12 mm × 3 mm) have two genital pores, one in the middle of each lateral margin. Proglottids may be passed singly or in chains, and occasionally may be seen dangling from the anus. Proglottids are much longer than broad.
421. Adult tapeworm of Dipylidium caninum. The scolex of the worm is very narrow and the proglottids, as they mature, get larger.
422. Causal Agent: Dipylidiumcaninum(the double-pored dog tapeworm) mainly infects dogs and cats, but is occasionally found in humans. Geographic Distribution:Worldwide. Human infections have been reported in Europe, the Philippines, China, Japan, Argentina, and the United States
423.
424. Life Cycle: Gravid proglottids are passed intact in the feces or emerge from the perianal region of the host . Subsequently they release typical egg packets . ingestion of an egg by the intermediate host (larval stages of the dog or cat flea Ctenocephalides spp.), an oncosphere is released into the flea's intestine. The oncosphere penetrates the intestinal wall, invades the insect's hemocoel (body cavity), and develops into a cysticercoid larva . The larva develops into an adult, and the adult flea harbours the infective cysticercoid . The vertebrate host becomes infected by ingesting the adult flea containing the cysticercoid . The dog is the principal definitive host for Dipylidiumcaninum. Other potential hosts include cats, foxes, and humans (mostly children) , .
425. Life Cycle: Humans acquire infection by ingesting the cysticercoid contaminated flea. This can be promulgated by close contact between children and their infected pets. In the small intestine of the vertebrate host the cysticercoid develops into the adult tapeworm (measuring up to 60 cm in length and 3 mm in width) reside in the small intestine of the host, where they each attach by their scolex. They produce proglottids (or segments) which have two genital pores (hence the name "double-pored" tapeworm). The proglottids mature, become gravid, detach from the tapeworm, and migrate to the anus or are passed in the stool .
426. Clinical Features:Most infections with Dipylidiumcaninum are asymptomatic. Pets may exhibit behavior to relieve anal pruritis (such as scraping anal region across grass or carpeting). Mild gastrointestinal disturbances may occur. The most striking feature in animals and children consists of the passage of proglottids. These can be found in the perianal region, in the feces, on diapers, and occasionally on floor covering and furniture. The proglottids are motile when freshly passed and may be mistaken for maggots or fly larvae.
427. Diagnostic findings Microscopy Treatment:Treatment for both animals and humans is simple and very effective. Praziquantel is given either orally or by injection (pets only). The medication causes the tapeworm to dissolve within the intestines. Since the worm is usually digested before it passes, it may not be visible in the dog's stool. These drugs are generally well tolerated.
439. Three adult Hymenolepis nana tapeworms. Each tapeworm (length: 15-40 mm) has a small, rounded scolex at the anterior end, and proglottids can be distinguished at the posterior, wider end.
449. Causal Agents:Hymenolepiasis is caused by two cestodes (tapeworm) species, Hymenolepis nana (the dwarf tapeworm,) and Hymenolepisdimnuta (rat tapeworm). Hymenolepisdiminuta is a cestode of rodents infrequently seen in humans and frequently found in rodents. Geographic Distribution:Hymenolepis nana is the most common cause of all cestode infections, and is encountered worldwide. In temperate areas its incidence is higher in children and institutionalized groups. Hymenolepisdiminuta, while less frequent, has been reported from various areas of the world.
450.
451.
452. Life Cycle: Eggs of Hymenolepis nana eggs are ingested by an arthropod intermediate host (various species of beetles and fleas may serve as intermediate hosts), they develop into cysticercoids, which can infect humans or rodents upon ingestion and develop into adults in the small intestine. When eggs are ingested (in contaminated food or water or from hands contaminated with feces- oncospheres (hexacanth larvae) penetrate the intestinal villus and develop into cysticercoid larvae . Upon rupture of the villus, the cysticercoids return to the intestinal lumen, evaginate their scoleces , attach to the intestinal mucosa and develop into adults that reside in the ileal portion of the small intestine producing gravid proglottids . Eggs are passed in the stool when released from proglottids through its genital atrium or when proglottids disintegrate in the small intestine internal autoinfection, where the eggs release their hexacanth embryo, which penetrates the villus continuing the infective cycle without passage through the external environment .
453. Life Cycle: . Eggs of Hymenolepisdiminuta are passed out in the feces of the infected definitive host (rodents, man) . The mature eggs are ingested by an intermediate host (various arthropod adults or larvae) , and oncospheres are released from the eggs and penetrate the intestinal wall of the host , which develop into cysticercoid larvae. Species from the genus Tribolium are common intermediate hosts for H. diminuta. The cysticercoid larvae persist through the arthropod's morphogenesis to adulthood. H. diminuta infection is acquired by the mammalian host after ingestion of an intermediate host carrying the cysticercoid larvae . Humans can be accidentally infected through the ingestion of insects in precooked cereals, or other food items, and directly from the environment (e.g., oral exploration of the environment by children). After ingestion, the tissue of the infected arthropod is digested releasing the cysticercoid larvae in the stomach and small intestine. Eversion of the scoleces occurs shortly after the cysticercoid larvae are released. Using the four suckers on the scolex, the parasite attaches to the small intestine wall. Maturation of the parasites occurs within 20 days and the adult worms can reach an average of 30 cm in length . Eggs are released in the small intestine from gravid proglottids that disintegrate after breaking off from the adult worms. The eggs are expelled to the environment in the mammalian host's feces .
454. Clinical Features:Hymenolepis nana and H. diminuta infections are most often asymptomatic. Heavy infections with H. nana can cause weakness, headaches, anorexia, abdominal pain, and diarrhea.
455. Clinical Features:Hymenolepis nana and H. diminuta infections are most often asymptomatic. Heavy infections with H. nana can cause weakness, headaches, anorexia, abdominal pain, and diarrhea.
465. Taeniid eggs: rounded or subspherical, diameter 31 to 43 µm, with a thick radially striated brown shell. Inside each shell is an embryonated oncosphere with 6 hooks (hexacanth embryo).
466. Taenia egg. Note the thick, "striated" shell and several of the larval hooks; approximate size = 40 µm.
467. T. Saginata gravid proglottid:has 15 to 30 main uterine branches on each side of central stem; proglottids are much longer than wide
478. Scoleces of Taenia saginata and Taenia solium: Scolex of T. saginata has 4 suckers and no hooks. T. solium has 4 suckers in addition to a double row of hooks.
479. Scolex of Taenia solium:measures approximately 1 mm across. The four suckers are numbered. Note the presence of an armed (hooked) rostellum (*); the scolex of Taenia saginata, the beef tapeworm, does not have an armed rostellum.
480. A cysticercus of Taenia in muscle. Note the fibrous capsule (*) around the cysticercus.
481. Causal Agents: The cestodes (tapeworms) Taeniasaginata (beef tapeworm) and T. solium (pork tapeworm). Taeniasolium can also cause cysticercosis. Geographic Distribution:Both species are worldwide in distribution. Taeniasolium is more prevalent in poorer communities where humans live in close contact with pigs and eat undercooked pork and is very rare in Muslim countries
482.
483. Life Cycle: Taeniasis is the infection of humans with the adult tapeworm of Taeniasaginata or Taeniasolium. Humans are the only definitive hosts for T. saginata and T. solium. Eggs or gravid proglottids are passed with feces ; Cattle (T. saginata) and pigs (T. solium) become infected by ingesting vegetation contaminated with eggs or gravid proglottids . Humans become infected by ingesting raw or undercooked infected meat . In the human intestine, the cysticercus develops into an adult tapeworm The adult tapeworms attach to the small intestine by their scolex and reside in the small intestine .
484. Life Cycle: Length of adult worms is usually 5 m or less for T. saginata (however it may reach up to 25 m) and 2 to 7 m for T. solium. The adults produce proglottids which mature, become gravid, detach from the tapeworm, and migrate to the anus or are passed in the stool (approximately 6 per day). T. saginata adults usually have 1,000 to 2,000 proglottids, while T. solium adults have an average of 1,000 proglottids. The eggs contained in the gravid proglottids are released after the proglottids are passed with the feces. T. saginata may produce up to 100,000 and T. solium may produce 50,000 eggs per proglottid respectively.
485. Clinical Features: Taeniasaginatataeniasis produces only mild abdominal symptoms. The most striking feature consists of the passage (active and passive) of proglottids. Occasionally, appendicitis or cholangitis can result from migrating proglottids. Taeniasoliumtaeniasis is less frequently symptomatic than Taeniasaginatataeniasis. The main symptom is often the passage (passive) of proglottids. The most important feature of Taeniasoliumtaeniasis is the risk of development of cysticercosis.
486. Diagnostic findings TAKE EXTREME CARE IN PROCESSING THE SAMPLES! INGESTION OF EGGS CAN RESULT IN CYSTICERCOSIS! Microscopy Antibody detection may prove useful especially in the early invasive stages, when the eggs and proglottids are not yet apparent in the stools. Treatment:Treatment is simple and very effective. Praziquantel* is the drug of choice.
487. Taenia saginata Ingestion of raw or poorly cooked beef Cows infected via the ingestion of human waste containing the eggs of the parasite Cows contain viable cysticercus larvae in the muscle Humans act as the host only to the adult tapeworms Up to 25 meters in the lumen of intestine Found all over the world, including the U.S.
490. Tapeworms (Cestodes) Adult worms inhabit GI tract of definitive vertebrate host Larvae inhabit tissues of intermediate host Humans Definitive for T. saginata Intermediate for Echinococcus granulosus (hydatid) Both definitive and intermediate for T. solium Adult worms shed egg-containing segments in stool ingested by intermediate host larval form in tissues
491. Cystercercosis Symptoms depend on location of cysts, but frequently include motor spasms, seizures, confusion, irritability, and personality change In the eye, often subretinal or in vitreous. Movement may be seen by the patient. Pain, amaurosis, and loss of vision may occur.
492. Cysticercosis Clinical manifestations Adult worms rarely cause sxs Larvae penetrate intestine, enter blood, and eventually encyst in the brain. Cerebral ventircles hydrocephalus Spinal cord compression, paraplegia Subarachnoid space chronic meningitis Cerebral cortex seizures Cysts may remain asymptomatic for years, and become clinically apparent when larvae die Larvae may encyst in other organs, but are rarely symptomatic
493. Cysticercosis Diagnosis CT and MRI preferred studies Discrete cysts that may enhance Usually multiple lesions Single lesions especially common in cases from India Older lesions may calcify CSF Lymphs or eos, low glucose, elevated protein Serology Especially in cases with multiple cysts
494. Cysticercosis Treatment Complex and controversial Praziquantel and albendazole may kill cysts, but death of larvae can increase inflammation, edema and exacerbate sxs When possible, surgical resection of symptomatic cyst is preferred Corticosteroids vs. edema and inflammation; antiseizure meds
495.
496.
497. Causal Agents: Schistosomiasis is caused by digenetic blood trematodes. The three main species infecting humans are Schistosomahaematobium, S. japonicum, and S. mansoni. In addition, other species of schistosomes, which parasitize birds and mammals, can cause cercarial dermatitis in humans. Geographic Distribution: Schistosomamansoni is found in parts of South America and the Caribbean, Africa, and the Middle East; S. haematobium in Africa and the Middle East; and S. japonicum in the Far East.
498.
499. Life Cycle: Eggs are eliminated with feces or urine .- eggs hatch and release miracidia , which swim and penetrate specific snail intermediate hosts . The stages in the snail include 2 generations of sporocysts and the production of cercariae . Upon release from the snail, the infective cercariae swim, penetrate the skin of the human host , and shed their forked tail, becoming schistosomulae . The schistosomulae migrate through several tissues and stages to their residence in the veins (, ). Adult worms in humans reside in the mesenteric venules in various locations, which at times seem to be specific for each species . S. japonicum is more frequently found in the superior mesenteric veins draining the small intestine , and S. mansoni occurs more often in the superior mesenteric veins draining the large intestine . S. haematobium most often occurs in the venous plexus of bladder , but it can also be found in the rectal venules.
500. Life Cycle: . Pathology of S. mansoni and S. japonicumschistosomiasis includes: Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal fibrosis, portal hypertension, and occasional embolic egg granulomas in brain or spinal cord. Pathology of S. haematobiumschistosomiasis includes: hematuria, scarring, calcification, squamous cell carcinoma, and occasional embolic egg granulomas in brain or spinal cord. Human contact with water is thus necessary for infection by schistosomes. Various animals, such as dogs, cats, rodents, pigs, hourse and goats, serve as reservoirs for S. japonicum, and dogs for S. mekongi.
501. Clinical Features Many infections are asymptomatic. Acute schistosomiasis (Katayama's fever) may occur weeks after the initial infection, especially by S. mansoni and S. japonicum. Manifestations include fever, cough, abdominal pain, diarrhea, hepatospenomegaly, and eosinophilia. Occasionally central nervous system lesions occur: cerebral granulomatous disease may be caused by ectopic S. japonicum eggs in the brain, and granulomatous lesions around ectopic eggs in the spinal cord from S. mansoni and S. haematobium infections may result in a transverse myelitis with flaccid paraplegia. .
502. Clinical Features Continuing infection may cause granulomatous reactions and fibrosis in the affected organs, which may result in manifestations that include: colonic polyposis with bloody diarrhea (Schistosomamansoni mostly); portal hypertension with hematemesis and splenomegaly (S. mansoni, S. japonicum, S. mansoni); cystitis and ureteritis (S. haematobium) with hematuria, which can progress to bladder cancer; pulmonary hypertension (S. mansoni, S. japonicum, more rarely S. haematobium); glomerulonephritis; and central nervous system lesions.
503. Diagnostic findings microscopy Antobodydetrectioncan be useful in both in clinical management (e.g., recent infections) and for epidemiologic surveys. Treatment:Safe and effective drugs are available for the treatment of schistosomiasis. The drug of choice is praziquantel for infections caused by all Schistosoma species. Oxamniquine has been effective in treating infections caused by S. mansoni in some areas in which praziquantel is less effective.
514. Causal Agents: The trematodesFasciola hepatica (the sheep liver fluke) and Fasciolagigantica, parasites of herbivores that can infect humans accidentally. Geographic Distribution:Fascioliasis occurs worldwide. Human infections with F. hepatica are found in areas where sheep and cattle are raised, and where humans consume raw watercress, including Europe, the Middle East, and Asia. Infections with F. gigantica have been reported, more rarely, in Asia, Africa, and Hawaii.
515.
516. Life Cycle: Immature eggs are discharged in the biliary ducts and in the stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host , including the genera Galba, Fossariaand Pseudosuccinea. In the snail the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation or other surfaces. Mammals acquire the infection by eating vegetation containing metacercariae. Humans can become infected by ingesting metacercariae-containing freshwater plants, especially watercress . After ingestion, the metacercariaeexcyst in the duodenum and migrate through the intestinal wall, the peritoneal cavity, and the liver parenchyma into the biliary ducts, where they develop into adults . In humans, maturation from metacercariae into adult flukes takes approximately 3 to 4 months. The adult flukes (Fasciola hepatica: up to 30 mm by 13 mm; F. gigantica: up to 75 mm) reside in the large biliary ducts of the mammalian host. Fasciola hepatica infect various animal species, mostly herbivores.
517. Clinical Features:During the acute phase (caused by the migration of the immature fluke through the hepatic parenchyma), manifestations include abdominal pain, hepatomegaly, fever, vomiting, diarrhea, urticaria and eosinophilia, and can last for months. In the chronic phase (caused by the adult fluke within the bile ducts), the symptoms are more discrete and reflect intermittent biliary obstruction and inflammation. Occasionally, ectopic locations of infection (such as intestinal wall, lungs, subcutaneous tissue, and pharyngeal mucosa) can occur.
518. Diagnostic findings Microscopy and antibody detection Treatment:Unlike infections with other flukes, Fasciola hepatica infections may not respond to praziquantel. The drug of choice is triclabendazole with bithionol as an alternative.
519. Causal Agent:The trematodeFasciolopsisbuski, the largest intestinal fluke of humans. Geographic Distribution:Asia and the Indian subcontinent, especially in areas where humans raise pigs and consume freshwater plants.
520.
521. Life Cycle: Immature eggs are discharged into the intestine and stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host . In the snail the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic plants . The mammalian hosts become infected by ingesting metacercariae on the aquatic plants. After ingestion, the metacercariaeexcyst in the duodenum and attach to the intestinal wall. . The adults have a life span of about one year.
522. Clinical Features:Most infections are light and asymptomatic. In heavier infections, symptoms include diarrhea, abdominal pain, fever, ascites, anasarca and intestinal obstruction.
535. C. sinensis egg: small operculated eggs. Size 27 to 35 µm by 11 to 20 µm. The operculum, at the smaller end of the egg, is convex and rests on a visible "shoulder". At the opposite (larger, abopercular) end, a small knob or hooklike protrusion is often visible (as is the case here). The miracidium is visible inside the egg.
536.
537. Causal Agent:The trematodeClonorchissinensis (Chinese or oriental liver fluke). Geographic Distribution:Endemic areas are in Asia including Korea, China, Taiwan, and Vietnam. Clonorchiasis has been reported in non endemic areas (including the United States). In such cases, the infection is found in Asian immigrants, or following ingestion of imported, undercooked or pickled freshwater fish containing metacercariae.
538.
539. Life Cycle: Embryonated eggs are discharged in the biliary ducts and in the stool . Eggs are ingested by a suitable snail intermediate host ; there are more than 100 species of snails that can serve as intermediate hosts. Each egg releases a miracidia , which go through several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and after a short period of free-swimming time in water, they come in contact and penetrate the flesh of freshwater fish, where they encyst as metacercariae . Infection of humans occurs by ingestion of undercooked, salted, pickled, or smoked freshwater fish . After ingestion, the metacercariaeexcyst in the duodenum and ascend the biliary tract through the ampulla of Vater . Maturation takes approximately 1 month. The adult flukes reside in small and medium sized biliary ducts. In addition to humans, carnivorous animals can serve as reservoir hosts.
540. Clinical Features: Most pathologic manifestations result from inflammation and intermittent obstruction of the biliary ducts. In the acute phase, abdominal pain, nausea, diarrhea, and eosinophilia can occur. In long-standing infections, cholangitis, cholelithiasis, pancreatitis, and cholangiocarcinoma can develop, which may be fatal.
542. Causal Agent: Trematodes (flukes) Opisthorchisviverrini (Southeast Asian liver fluke) and O. felineus (cat liver fluke). Geographic Distribution:O. viverrini is found mainly in northeast Thailand, Laos, and Kampuchea. O. felineus is found mainly in Europe and Asia, including the former Soviet Union.
543.
544. Life Cycle: The adult flukes deposit fully developed eggs that are passed in the feces . After ingestion by a suitable snail (first intermediate host) , the eggs release miracidia , which undergo in the snail several developmental stages (sporocysts , rediae , cercariae ). Cercariae are released from the snail and penetrate freshwater fish (second intermediate host), encysting as metacercariae in the muscles or under the scales . The mammalian definitive host (cats, dogs, and various fish-eating mammals including humans) become infected by ingesting undercooked fish containing metacercariae. After ingestion, the metacercariaeexcyst in the duodenum and ascend through the ampulla of Vater into the biliary ducts, where they attach and develop into adults, which lay eggs after 3 to 4 weeks . The adult flukes reside in the biliary and pancreatic ducts of the mammalian host, where they attach to the mucosa.
545. Clinical Features: Most infections are asymptomatic. In mild cases, manifestations include dyspepsia, abdominal pain, diarrhea or constipation. With infections of longer duration, the symptoms can be more severe, and hepatomegaly and malnutrition may be present. In rare cases, cholangitis, cholecystitis, and chlolangiocarcinoma may develop. infections due to O. felineus may present an acute phase resembling Katayama fever (schistosomiasis), with fever, facial edema, lymphadenopathy, arthralgias, rash, and eosinophilia. Chronic forms of O. felineus infections present the same manifestations as O. viverrini, with in addition involvement of the pancreatic ducts.
561. Causal Agent: More than 30 species of trematodes (flukes) of the genus Paragonimus have been reported which infect animals and humans. Among the more than 10 species reported to infect humans, the most common is P. westermani, the oriental lung fluke. Geographic Distribution:Paragonimus spp. are distributed throughout the Americas, Africa and southeast Asia. Paragonimuswestermani is distributed in southeast Asia and Japan. Paragonimuskellicotti is endemic to North America.
562.
563. Life Cycle: The eggs are excreted unembryonated in the sputum, or alternately they are swallowed and passed with stool . In the external environment, the eggs become embryonated , and miracidia hatch and seek the first intermediate host, a snail, and penetrate its soft tissues . Miracidia go through several developmental stages inside the snail : sporocysts , rediae , with the latter giving rise to many cercariae , which emerge from the snail. The cercariae invade the second intermediate host, a crustacean such as a crab or crayfish, where they encyst and become metacercariae. This is the infective stage for the mammalian host .
564. Life Cycle: Human infection with P. westermani occurs by eating inadequately cooked or pickled crab or crayfish that harbor metacercariae of the parasite . The metacercariaeexcyst in the duodenum , penetrate through the intestinal wall into the peritoneal cavity, then through the abdominal wall and diaphragm into the lungs, where they become encapsulated and develop into adults (. The worms can also reach other organs and tissues, such as the brain and striated muscles, respectively. However, when this takes place completion of the life cycles is not achieved, because the eggs laid cannot exit these sites. Time from infection to oviposition is 65 to 90 days. Infections may persist for 20 years in humans. Animals such as pigs, dogs, and a variety of feline species can also harbor P. westermani.
565. Clinical Features: The acute phase (invasion and migration) may be marked by diarrhea, abdominal pain, fever, cough, urticaria, hepatosplenomegaly, pulmonary abnormalities, and eosinophilia. During the chronic phase, pulmonary manifestations include cough, expectoration of discolored sputum, hemoptysis, and chest radiographic abnormalities. Extrapulmonary locations of the adult worms result in more severe manifestations, especially when the brain is involved.
566. Diagnostic findings Microscopy Antibody detection is useful in light infections and in the diagnosis of extrapulmonaryparagonimiasis. Treatment:Praziquantel* is the drug of choice to treat paragonimiasis. Bithionol is an alternative drug for treatment of this disease.
575. Causal Agent: Metagonimusyokogawai, a minute intestinal fluke (and the smallest human fluke). Geographic Distribution:Mostly the Far East, as well as Siberia, Manchuria, the Balkan states, Israel, and Spain.
576.
577. Life Cycle: Adults release fully embryonated eggs each with a fully-developed miracidium, and eggs are passed in the host’s feces . After ingestion by a suitable snail (first intermediate host), the eggs hatch and release miracidia which penetrate the snail’s intestine . Snails of the genus Semisulcospira are the most frequent intermediate host for Metagonimusyokogawai. The miracidia undergo several developmental stages in the snail, i.e. sporocysts , rediae , and cercariae . Many cercariae are produced from each redia. The cercariae are released from the snail and encyst as metacercariae in the tissues of a suitable fresh/brackish water fish (second intermediate host) . The definitive host becomes infected by ingesting undercooked or salted fish containing metacercariae . After ingestion, the metacercariaeexcyst, attach to the mucosa of the small intestine and mature into adults (measuring 1.0 mm to 2.5 mm by 0.4 mm to 0.75 mm) . In addition to humans, fish-eating mammals (e.g., cats and dogs) and birds can also be infected by M. yokogawai .
578. Clinical Features:The main symptoms are diarrhea and colicky abdominal pain. Migration of the eggs to extraintestinal sites (heart, brain) can occur, with resulting symptoms.
589. Life Cycle: Adults release embryonated eggs each with a fully-developed miracidium, and eggs are passed in the host's feces . After ingestion by a suitable snail (first intermediate host), the eggs hatch and release miracidia which penetrate the snail’s intestine . Genera Cerithidia and Pironella are important snail hosts in Asia and the Middle East respectively. The miracidia undergo several developmental stages in the snail, i.e. sporocysts , rediae , and cercariae . Many cercariae are produced from each redia. The cercariae are released from the snail and encyst as metacercariae in the tissues of a suitable fresh/brackish water fish (second intermediate host) . The definitive host becomes infected by ingesting undercooked or salted fish containing metacercariae . After ingestion, the metacercariaeexcyst, attach to the mucosa of the small intestine and mature into adults . In addition to humans, various fish-eating mammals (e.g., cats and dogs) and birds can be infected by Heterophyesheterophyes .
590. Clinical Features: The main symptoms are diarrhea and colicky abdominal pain. Migration of the eggs to the heart, resulting in potentially fatal myocardial and valvular damage, has been reported from the Philippines. Migration to other organs (e.g., brain) has also been reported.
603. Egg of F. buski:eggs are ellipsoidal, with a thin shell, and a usually small, indistinct operculum. In this particular egg, the operculum is open.
613. Schistosoma mansoni eggs: large (length 114 to 180 µm) and have a characteristic shape, with a prominent lateral spine near the posterior end. The anterior end is tapered and slightly curved. When the eggs are excreted, they contain a mature miracidium