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Nematodes (Round Worms)
Filariasis and Other Tissue Nema
Cestodes
Trematodes
Schistosomes (Blood fluke)
Protozoan Parasites
Trypanosomes
"All Drawings from the Sheet"

was converted to an Excel worksheet. All

arate worksheets. Please be aware that

Excel Worksheet Name

Sheet 1 - Nematodes (Round Worm

Sheet 1 - Filariasis and Other
Sheet 1 - Cestodes
Sheet 1 - Trematodes
Sheet 1 - Schistosomes (Blood f
Sheet 1 - Protozoan Parasites
Sheet 1 - Trypanosomes
Sheet 1 - Drawings

Nematodes (Round Worms)

Parasite/Disease

Life Cycle

Ascaris

Eggs in feces -> cleave/divide in soil -> ingested -> larva

hatch in intestines -> migrate to lungs via bloodstream ->
ascend airways and swallowed (live 1-2 yrs) / migrate to
pancreatic/biliary ducts
Eggs passed in feces -> larva hatch and develop in soil ->
penetrate skin -> enter bloodstream -> larvae reach heart
-> pulmonary capillaries/alveolar spaces -> coughed up ->
swallowed -> live 1-9 yrs in intestines

Hookworm
(Necatur
americanus,
Ancylostoma
duodenale)

Trichuris (whip Eggs ingested -> larva hatch and migrate to cecum ->
worm)
Eggs passed in feces (2-4 wks to become infective)

Strongyloides
stercoralis

Rabditiform Larvae excreted in stool (NOT EGGS) ->

develop into free-living worms (male/female) -> eggs
produced -> hatch, become infective filariform ->
penetrate skin -> circulatory sys -> lungs -> alveoli ->
trachea/pharynx -> swallowed -> sml intestines -> females
deposit eggs in intestinal mucosa -> autoinfect

Paracapillaria
phillipinensis

Eat infected raw fish -> larvae release into intestine ->
adult burrows in mucosa -> female lay eggs -> autoinfect

Pinworm
(Enterobius
vermicularis)

Fecal/oral (humans only host) -> eggs on perianal folds ->

larvae mature in 4-6 hours -> embryonated eggs ingested
-> hatch in small intestines -> adults in lumen of cecum ->
gravid females migrate to perianal region at night to
explode her uterus

Nematodes (Round Worms)

Clinical

Diagnosis

Treatment

Intestinal obstruction, pulmonary infiltrates,

abdominal distention, pain, Loefflers Syndrome
(eosinophil pneumonitis), biliary/pancreatic
obstruction
Severe iron deficiency anemia, fatigue, hives,
pulmonary infiltrates, wheezing/dyspnea, abd
pain, cutaneous larva migrans

Eggs 2-3 mo. after pulmonary Pulmonary: self-limited

symptoms
GI: mebendazole,
albendazole
Eggs in stool 6-8 wks. after
infection

Mebendazole,
albendazole

Colitis, abd pain, diarrhea, Trichuris dystentery

syndrome (chronic dysentery, rectal prolapse),
impaired growth, anemia.
Heavy Infections: loose, freq stools, with mucus,
tenesmus, blood

Doubly operculated eggs

(football).

Ivermectin,
mebendazole,
albendazole

Diarrhea, abd pain, nausea, vomiting, heartburn,

occult blood, wheezing, transient infiltrates,
urticarial rashes, larva currens,
HYPERINFECTION Syndrome: millions of larvae,
gram neg meningitis, gram negative sepsis,
mostly in immunocompromised state

Stool o/p, multiple stools on

multiple days, larvae on
duodenal aspirate, serology

Ivermectin,
albendazole,
thiabendazole

Borborgymus, abd pain, watery diarrhea,

electrolyte loss and DEATH

Stool o/p test

Albendazole (10 day) +

supportive rx

Asymptomatic or PERI-ANAL ITCHING!

Scotch tape test

albendazole,
mebendazole, pyrantel
pamoate, ivermectin

Filariasis and Other Tissue Nematodes

Parasite/Disease

Life Cycle

Lymphatic
filariasis

Mosquito bite -> adults in lymphatics -> produce sheathed

microfilariae, migrate into lymph/blood -> mosquito bite ->
mf shed sheath and migrate to thoracic muscles -> L1
larvae -> L3 larvae -> migrate to mosquito head

Loa loa

Deerfly vector -> human host -> microfilariae is blood

borne (day) -> adult worms in subcutaneous tissue -> no
animal reservoir

Onchocerciasis Blackflies vector -> adult worms in subcutaneous nodules

-> microfilariae is skin dwelling -> no animal reservoir

Rat lungworm In fresh water -> consumed by snails/slugs -> consumed

(Angiostrongylu and larvae penetrate gut to CNS (then lungs in Rat) ->
s cantonensis) eosinophilic meningitis
Trichinellosis

Eat meat containing cysts -> larvae released from cysts ->
adults invade sm. bowel -> make more larvae -> migrate
to striated mm -> encyst and live in nurse cells

Dracunculus
medinensis

L1 larvae consumed by copepods -> become L3 -> human

drinks water with copepods -> larvae penetrate stomach
and intestinal wall -> male/females reproduce -> fertilized
females exits through skin surface -> one year after,
female emerges and releases larvae into water

Toxocariasis

Anasakis

Young dogs, eggs hatch in duodenum -> larvae penetrate

intestinal wall -> liver -> heart -> lungs -> trachea ->
swallowed into GI -> mature to adult and lay eggs, passed
in GI. (In old dogs, undergo somatic arrest after migrating
to organs. Reactivate when pregnant).
Ingest raw/uncooked seafood -> parasite buries head into
gastric mucosa (not the definitive host) -> can cause abd
abscess if penetrate wall

Filariasis and Other Tissue Nematodes

Clinical

Diagnosis

Asymptomatic microfilaremia, filarial fevers,

lymphangitis, lymphatic obstruction
(lymphedema, elephantiasis, hydrocele, chyluria),
tropical pulmonary eosinophilia

Microfilariae in nighttime
blood, decline in circulating
antigen, ID of adult worm
(filaria dance sign), PCR,
antifilarial antibodies, treat
bacterial skin and soft tissue
infections
Asymptomatic microfilaremia (peak day), fatigue, Microfilariae in daytime blood,
urticaria, arthalgias, myalgias, calabar swelling,
ID adult worm in
eyeworm, end organ complications
subconjunctiva or
subcutaneous tissue, PCR
Nodules, pruritis, rash, depigmentation,
Serology (anti-filarial), skin
lichenification, sowda, keratitis river blindness, nips, nodulectomy, PCR
chorioretinitis, hanging groin, elephantiasis
(lymphatic obstruction)

Treatment

DEC, doxycycline for

Wolbachia bacteria

DEC, albendazole

Ivermectin, target the

obligate intracellular
bacteria Wolbachia w/
doxycycline!

Headache, paresthesias, neck stiffness,

photophobia, (Uncommon fever), eosinophilic
meningitis

Meningitis + CSF eosinophilia Lumbar punctures,

corticosteroids

Muscle pain, periorbital edema, eosinophiia,

occasional CNS/heart damage

Muscle biopsy showing L1

larvae, serologies

Excruciatingly painful worm emergence,

predisposed to superinfection

Obvious

Natural recovery,
symptomatic,
analgesics,
antipyretics,
prednisone,
mebendazole,
albendazole,
None
thiabendazole

Visceral larval migrans: fever, eosinophilia,

hepatomegaly, cough, wheeze, pneumonia,
splenomegaly. Ocular larval migrans: retinal
lesions, near macula. Covert Larval migrans:
abd pain, GI symptoms, pruritis

Clinical + Ab testing (ELISA of Self limited disease.

serum or ocular fluid)
Acute is treated with
albendazole or steroids

Abd pain, epigastric pain, vomiting, allergic

reactions (urticaria, itchy throat, anaphylaxis)

Eosinophilia, endoscopy
showing worm in ulcer

Endoscopic removal,
surgical removal,
albendazole if worm
spread

Cestodes
Parasite/Disease

Life Cycle

Taenia solium
(pork worm) Taeniasis

Eggs/gravid proglottids in feces -> ingested by

pigs/humans -> oncospheres hatch, penetrate intestines
and circulate to musculature -> oncospheres develop into
cysterci in pigs -> humans ingest infected meat -> Scolex
attaches to intestines -> adults in sm. intestines

Taenia solium
(pork worm) Cysticercosis

Embryonated eggs ingested by humans -> develop

cysticerci in muscles of humans -> cysticerci may develop
in any organ, brain, eyes after ingesting

Taenia saginata Eggs/gravid proglottids in feces => cattle/pigs ingest ->

(beef worm)
oncospheres hatch, penetrate intestines, migrate to
musculature -> become cysticerci -> humans ingest
infected raw/undercooked meat -> Scolex attaches in
human intestines -> adults in intestines!!!!
Echinococcus
granulosus

Echinococcus
multilocularis
Hymenolepis
diminuta

(Canine definitive host, sheep/goat/swine intermediate,

humans accidental) Adult in sm. intestine -> embryonated
egg in feces -> oncospheres hatch, penetrate intestinal
wall -> hydatid cyst in liver/lungs/bone/spleen/heart/etc ->
Protoscolex from cyst -> scolex attach to intestine -> adult
in intestine
Similar to E. granulosus, parasite of wild carnivores and
small prey animals, humans accidental host with close
contact
Eggs passed in feces -> ingested by
arthropod/intermediate host -> oncospheres hatch and
penetrate intestinal wall -> cysticerci in body cavity of
insect -> ingest by rodent/human -> scolex -> adults in
sm. intestine -> gravid proglottids

Diphyllobothrium Unembryonated eggs in feces -> embryonate in water

latum (the fish -> coracidia hatch and ingested by crustaceans ->
tapeworm)
Procercoid in crustacean body cavity -> ingest by small
fish, procercoid larva released, developes into plerocercoid
larva (INFECTIVE) -> ingest by big fish -> ingest by human
-> adults in sm intestine -> release proglottids/eggs in
feces

Cestodes
Clinical

Diagnosis

Treatment

Frequent asymptomatic, appendicites or

cholangitis (rare), proglottids crawl out of anus
and tickle the thigh

Eggs and proglottids in feces, Praziquantel,

antibody detection
niclosamide

Neurocysticercosis (Space occupying lesion,

seizures, death), Ocular, Spinal, cardiac lesions,
subcutaneous nodules

Cysticerci in the tissue,

antibody detection, Dx of
taeniasis

Praziquantel, antiseizures, steroids,

albendazole, surgery,
cysticercoidal drugs

Saginata has NO rostellum or

hooks, so it is NOT solium.
More branches of uterus in
saginata.

Same as solium

Silent for years, abd pain, biliary duct obstruction, Imaging, fine needle
chest pain, cough, hemoptysis, Rupture (fever,
aspirates, antibody detection
urticaria, anaphylaxis), brain/heart/bone problems

Surgery, albendazole,
PAIR
(Puncture/Aspirate/Intro
duce protoscolicide/Reaspirate)

Same as above, but multilocular structure with

metastasis spreading throughout the tissue

Same as above

Surgery only real option

Non-pathogenic .... just a sign that pt eats feces,

so look for other parasites

Eggs in feces

Praziquantel (just once)

Asymptomatic, abd pain, vomiting, diarrhea,

weight loss, intestinal obstruction, competes for
Vit B12 (pernicious anemia)

Eggs in feces, proglottids have Praziquantel,

Rosette-shaped uterus
Niclosamide

Trematodes
Parasite/Disease

Life Cycle

Opisthorchis and Embryonated eggs pass in feces -> eggs ingested by

Clonorchis (Liver snails -> free-swimming cercariae encyst in skin or flesh of
Flukes)
fresh water fish -> Metacercariae in skin/flesh ingested by
human host -> Excyst in duodenum -> Adults in the biliary
duct
Fasciolidae (Liver Unembryonated eggs pass in feces -> embryonated eggs
Flukes)
in water -> Miracidia hatch, penetrate the snail ->
(sporocysts to cercariae in snail) Free-swimming
cercariae encysts on water plants -> metacercariae on
water plant ingested by human/sheep/cattle -> excysts in
duodenum -> migrate via peritoneal cavity + liver
parenchyma -> adults in biliary tracts
Paragonimus spp. Unembryonated eggs passed in sputum or stool ->
- Paragonimiasis embryonated egg in water -> Miracidia hatch and
penetrate snail -> sporocysts grow to cercariae -> cercaria
invade a crustacean and encyst into metacercariae ->
humans ingest poorly cooked crustacean -> excyst in
duodenum -> adults in cystic cavities in lungs lay eggs ->
excreted in sputum or swallowed and passed in feces
Paragonimus
westermani
(ACUTE)
Paragonimus
westernmani
(CHRONIC)

Fasciolopsis buski Unembryonated eggs passed in feces -> embryonated

(Giant intestinal eggs in water -> Miracidia hatch, penetrate the snail ->
fluke)
grow from sporocysts to cercariae -> free-swimming
cercariae -> Metacercariae on water plant ingested by
pigs/humans -> excyst in duodenum -> adults in small
intestine -> more feces!

Trematodes
Clinical

ACUTE(rare): fever, fatigue, abd pain, enlarged

liver, eosinophilia. CHRONIC: asymptomatic
unless heavy (>10,000 eggs/gram), fatigue, abd
pain, dyspepsia, hepatomegaly BOTH: bile duct
proliferation, squamous metaplasia,
cholangitis/pancreatitis, cholangiocarcinoma

Diagnosis

Eggs in feces, recovery of

flukes immediately after
treatment, ultrasound of
cystic/mulberry dilations of
intrahepatic bile ducts

ACUTE HEPATIC (Invasive): eosinophilia, abd pain, Eggs in feces (after 3-4
intermittent fever, malaise, weight loss. CHRONIC months), antibody detection,
BILIARY (Obstructive): intermittent biliary
CT, ultrasound
obstruction, abd pain, ascending cholangitis,
juandice, Lithiasis

Treatment

Praziquantel,
Albendazole

Triclalbendazole,
Bithionol, Nitazoxanide

EXTRAPULMONARY PARAGONIMIASIS: cerebral

Eggs in sputum or feces (after Praziquantel, Bithionol
paragonimiasis, cutaneous paragonimiasis, (liver, 2-3 months), Biopsy, Antibody
spleen, peritoneum, gut wall, mesenteric lymph
detection
nodes)

Asymptomatic: small amount of worms. Young

Migrating worms: may cause diarrhea, pain,
eosinophilia. Worms entering Lungs: fever,
chills, chest pain
Often asymptomatic, productive cough, rusty
brown flecks, hemoptysis, pleural lesions,
diffuse/segmental/patchy infiltrates, may
resemble tuberculosis on x-ray.

Fluke attaches to intestinal mucosa, causing focal Presence of eggs in feces

inflammation, ulceration, abscesses.
Asymptomatic in mild infections. 30-60 days post
exposure. Epigastric pain, diarrhea, focal ileus
(intermittent obstruction)

Praziquantel

Schistosomes (Blood fluke)

Parasite/Disease

Life Cycle

Schistosomiasis Eggs in feces/urine -> hatch and release miracidia (in

water) -> miracidia penetrate snails -> sporocysts in snail
-> cercariae released by snail into water as free-swimming
-> penetrate human skin -> cercariae lose tails during
penetration, becomes schistosomulae -> circulation ->
portal blood and mature to adults -> paired adult worms
migrate to mesenteric venules in bowels/rectum laying
eggs and shedding
S. mansoni, S.
japonicum (S.
intercalatum, S.
guineensis, S.
mekongi) INTESTINAL AND
LIVER
S. haematobium URINARY
Acute
schistosomiasis
Chronic
schistosomiasis

Schistosomes (Blood fluke)

Clinical

Laying of eggs in liver and intestinal wall causes

intense inflammatory response

Fatigue, URQ Pain, BLOODY diarrhea,

Hepatosplenomegaly, periportal fibrosis, Portal
hypertension, Portosystemic shunts -> Intestinal
Polyps, Iron Deficiency anemia,

Diagnosis

Eggs in feces or urine, use

Kato-Katz method, Use
concentration techniques
(formalin - ethyl acetate),
large non-operculated
transparent shell with
lateral/terminal spines,
ANTIBODY serology, Urine
dipstick (for parasite antigen),
Ultrasound

Hematuria, Dysuria, Hydroureter, hydronephrosis,

repeated bacterial infection, Renal failure,
associated squamous cell carcinoma
Fever, sweats, chills, cough, headaches, Diarrhea,
URQ Pain => Lymphadenopathy,
hepatosplenomegaly, eosinophilia, may have neg.
exam for eggs in feces
Typical presentation in endemic areas, progressive illness

Treatment

Praziquantel,
Artemesinin (antimalarial)

Oxamniquine (S.
mansoni only!)

Protozoan Parasites
Parasite/Disease

Life Cycle

Intestinal
Amebiasis
(Entamoeba
histolytica)

Cysts in stools -> Mechanical contamination (on feet of

flies) -> contamination of water/food -> ingestion by
humans -> trophozoites secrete enzymes that lyse tissue
-> form and deepen ulcers -> rupture capillaries -> feed on
tissue and blood and multiply -> invasive to brain, lung,
liver

Ameboma

Tumor formation as sequal to amebiasis -> granulomatous

reaction w/ nodule formation -> center has necrotic
material and trophozoites

Extra-intestinal Ulcers perforate bowel -> trophozoites enter peritoneal

Amebiasis
cavity -> enter portal circulation -> trophozoites carried to
the liver and other organs -> extensions into pleural and
pericardial cavities -> also invade skin, brain

Primary amebic
meningoencepha
litis (Naegleria
fowleri)

Ameba (flagellate and cyst) -> free-living in fresh water ->

enter through olfactory neuroepithelium (through
cribiform plate) -> olfactory nerves to brain -> Parasitic
when in CNS

Granulomatous Free-living/ubiquitous (associated with contact lenses) ->

amebic
organism may be introduced to eyes at time of trauma
encephalitis
(Acanthomoeba)
GAE (from
Balamuthia
mandrillaris)

Giardias lamblia Cysts/trophozoites passed in feces -> contamination of

water/food -> ingestion -> trophozoites develop in
intestines
Toxoplasmosis

Ubiquitous parasite of mammals (Feline Definitive host) ->

cysts in beef/pork (Congenital Disease: TORCH titers) ->
mostly immunocompromised (AIDS defining dx)

Pneumocystitis Mostly in preemies, malnourished, and immunosuppressed

carinii
pneumonia
(jiroveci)
Cryptosporidium Worldwide, cows, self limited mild disease in most hosts
parvum
Isospora belli
Cyclospora
cayetanensis
Localized
Cutaneous
Leishmaniasis
(Leishmania spp)

Mucucutaneous
Leishmaniasis
(Espundia) (L V
braziliensis) Peru/Bolivia/Brazi
l

Foodborne outbreaks -> Raspberries, basil, mesclun,

snowpeas
Sandfly takes bloodmeal -> takes up infected macrophages
containing amastigotes -> amastigotes transform into
promastigotes as macrophage is ingested -> infected
female takes blood meal and transmits promastigote ->
promastigote taken up by macrophage in mammal host ->
promastigote transform into amastigotes -> grow and
multiply in macrophage -> burst macrophage -> infects
other cells

Diffuse
Cutaneous
Leishmaniasis
Leishmania
Recidivanzs
Visceral
Leishmaniasis

Protozoan Parasites
Clinical

Diagnosis

Treatment

Non-pathogenic amoebae indicates fecal

contamination ... be the on the lookout!. No
symptoms = CYST PASSER!. Pathogenic = flask
shaped ulcers primarily in cecal region, then
sigmoid, hepatic flexure, splenic flexure. Acute =
weight loss, abd pain, tenesmus, fever. Chronic =
constipation/diarrhea alternate

Stool examination, direct

concentration/PVA/Trichrome
stain. Microscopic
examination of feces and
mucus. Serology (indirect
hemagglutination)

Amebic Abscesses are STERILE. Prepatent =

several days. Incubation = days to months.
Diarrhea leading to dysentery, mucoid bloody
stools. Symptoms depend where the abscess is!
Liver abscess = fever, RUQ pain, elevated
diaphragm, mass. Lung abscess = cough, bloody
sputum
Acute necrotizing meningoencephalitis,
frontal headahce, fever, anorexia, nausea,
vomiting, stiff neck, taste/smell disturbances,
visual disturbances, CNS problems, coma, death

Symptoms/History, CT/MRI,
ultrasonography. Needle
aspiration of abscess. Liver
has ANCHOVY PASTE. Serology
(indirect hemagglutination)
Trophozoites in CSF and
flagellated forms in CSF. Antisera for FA

Amphotericin B,
Rifampin, Micronazole

Spread to brain from skin, lungs, throat, nose.

Space occupying lesions in the brain, ear
infection, headache, vomiting, fever, CNS

Brain biopsy, H/E stain, FA

staining, organism in urine (if
immunocompromised). NOT
found in CSF. Serology

Amphotericin B,
sulfadiazine,
antibiotics, Miltefosine

Dermatitis, pneumonitis, CNS disease

Always treat both

intestinal and extraintestinal at the same
time. Use
METRONIDAZOLE
(FLAGYL). and
TINIDAZOLE. If you
are a cyst passer, you
get PARAMOMYCIN

ACUTE: Explosive diarrhea, malabsorption, abd

pain, BLOATING, NVD, Steatorrhea. CHRONIC:
weight loss, debilitation, increased risk if IgA
deficiency

Stool exam by direct

microscopy, O+P exam x3 w/
sample every other day,
antigen ELISA tests

METRONIDAZOLE,
tinidazole, nitazoxanide

HA, weakness, balance problem, agitation,

disoriented, CT scan with ring-enhancing lesion
INTERSTITIAL PLASMA CELL PNEUMONIA Fever,
productive coughs, crackles, diffuse infiltrates

Bronch, BAL, lung biopsy

In AIDS, wasting terminal diarrhea

Acid fast stain or trichrome

stain

Nitazoxanide

Diarrhea in travelers, AIDS (prolonged severe

diarrhea)

Microscopy, autofloresce
characteristic

Trim/sulfa

Acute diarrhea (travelers diarrhea), fatigue

Acid fast stain stool, UV

autoflorescence

Non-healing ulcer (Baghdad boil, Aleppo Evil,

Chicleros ulcer caused by L. Mexicana),
Incubation ~40 days

Scrape and aspirate,

biopsy/microscopy, PCR,
Montenegro skin test

Bactrim
(trimethoprim/sulfamet
hoxazole)
Watchful waiting,
Destructive therapies
(LNO2, Thermo-Med),
Topical creams
(Paramomycin),
Systemic Treatment
(Pentostam,
Fluconazide,
Amphotericin B)
Often refractory,
Pentostam,
Amphoterin, Miltefosine

Mucous membrane involvement of nose, oral

cavity, pharynx, larynx

Chronic disease, extensive non-uclerative nodules

(from diminished resistance to parasite
Recurring cutaneous L, Associated with L. Tropica
in Iraq/Iran
Maculopapular lesions or nodules on face, limbs,
trunk => after treated or partially treated. Known
as Kala-azar or Black fever. CLINICAL: systemic
infection of liver, spleen, bone marrow => fever,
hepatosplenomegaly, Cytopenias,
Hypergammaglobulinemia, Wasting

Bone marrow, liver, spleen

aspirated for
microscopy/culture/PCR,
Serum rK39

Liposomal amphotericin
B, Pentostam,
Paromycin

Trypanosomes
Parasite/Disease

Life Cycle

Human African
Trypanosomiasis
(Sleeping
Sickness) Trypanosoma
brucei
gambiense/rhodi
ense

Tsetse fly takes blood meal -> inject metacyclic

trypomastigotes -> transforms into blood
trypomastigotes -> multiply by binary fission (blood/spinal
fluid/lymph) -> Tsetse fly takes blood meal -> transform
into procyclic trypomastigotes -> binary fission -> become
epimastigotes -> go to fly salivary gland -> transform to
metacyclic trypomastigotes

Chagas Disease
(American
Trypanosomiasis)
- Trypanosoma
cruzi

Kissing bug takes blood meal -> metacyclic

trypomastigotes passed in FECES -> enters wound ->
inside cells, transform to amastigotes -> multiply in tissue
-> transform into tryptomastigotes, burst out of tissue ->
enter blood -> Kissing bug takes blood meal -> multiply in
kissing bug and starts anew, ARMADILLO, POSSUM
(reservoirs)

Trypanosomes
Clinical

Haemo-lymphatic stage: fever, pruritus,

headaches, muscle pain, Winterbottoms sign
(posterior cervical adenopathy). Elevated WBC,
elevated IgM, Mott cells in CSF, abnormal PSG.
ACUTE: nodule at bite, fever, enlarged lymph,
rash. SUBACUTE (Rhodesian): CNS Invasion 36wk, myocarditis, death. CHRONIC (Gambian):
CNS Invasion mo-yrs, meningoencephalitis,
behavior change, vacant expression, psychosis,
seziure, coma, death
Blood transfusion, Organ Transplant, Vertical
transmission. Romanias sign => unilateral,
painless, periorbital edema. Chagoma =>
indurated lesion at bite. Acute phase => chronic
phase => Permanent indeterminate/chronic
cardiac(cardiopathy)/digestive(mega-colon)

Diagnosis

Treatment

Puncture cervical lymph node,

Lumbar Puncture, STAGE 1:
Giemsa-stained blood smear.
STAGE 2: LP, CATT

Stage 1 =>
Pentamidine
(Gambiense), Suramin
(Rhodesiense). Stage 2
=> Melarsoprol (Painful
and Arsenic)

Tryptomastigotes in peripheral Benznidazole/Nifurtimo

circulation, xenodiagnosis,
x
serology, PCR, C-shape,

Ultimate Parasito
2011-2012

Nematodes cause severe long-term morbidity. Most patients asy

stunted growth, reduced physical activity/school attendance (pre
Possible factors: iron deficiency, anemia, decreased appetite, ma
decreased vit A and zinc.

arasitology List

011-2012

ity. Most patients asymptomatic. Organisms cause

chool attendance (pre-school age most at risk).
ecreased appetite, malabsorption, hypoalbuminemia,