BIOLOGY/VECTORS CLINICAL FEATURES PATHOGENESIS DIAGNOSIS TREATMENT (DOC)

Ascaris polymyarian 1. Loefflers 1. Tissue rxn to invading larvae 1) Supportive 1) Albendazole

lumbricoides INFECTIVE: embryonated egg 2. Pneumonitis 2. Intestinal irritation to adult 2) DFS, Kato Thick 2) Mebendazole
HABITAT: SI 3. Vague abdominal pain mechanical & toxic actions Smear, Kato Katz 3) Pyrante pamoate
4. Complications: 3. Complicxn from heavy infxn Tech
-bowel obstruction
& extraint migrxn
-intussusception
-volvulus
-ectopic migration
Trichuris trichiura holomyarian 1. Asymptomatic 1. anterior portion of worms 1) DFS, Kato Thick, 1. Mebendazole (2x/day;
NATURAL HOST: man 2. Classic Trichuriasis w/ Dysentery embedded in mucosa Kato-Katz Tech 3 days)
HABITAT: cecum/colon 3. Chronic Trichuriasis 2. resemble ulcerative colitis 2) Concn Met: 2. Albendazole
-growth stunting 3. allergy -acid-ether
-rectal prolapse
-FECT
-tenesmus
-Protoscopy
-geophagia
-finger clubbing
-chronic bloody mucoid stools
-abdominal pain
Hookworms meromyarian Cutaneous: 1. Skin @ entry site of L3 1) DFS if heavy infxn 1. Albendazole
Necator HABITAT: SI 1. creeping eruptions = CLM (filariform) 2) Kato Thick/Kato
americanus INFECTIVE: filariform (2wks) 2. Ground itch, dew itch 2. Lung during larval migration Katz
Ancylostoma FEEDING: rhabditiform Pulmonary: Loefflers 3. SI habitat of adult worms Concn Meth:
duodenale EGGS: early cleavage (feces) Intestinal: acute chronic / heavy -Zinc-Sulfate
-A. d. = 20k-25k infection; microcytic, hypochromic -FECT; FLOTAC
-N. a. = 10k; average = 7k/day anemia Culture: Harada-Mori
Hypoalbuminea
Strongyloides HABITAT: SI IMMUNOCOMPETENT: 4. Skin invasion by filariform Harada-Mori Albendazole 400mg for
stercoralis INFECTIVE: filariform 1. Cutaneous: larva currens 5. Larval migration through body String test, duodenal 3 days
MOT: skin penetration 2. Pulmonary infxn: Loefflers 6. Penetration of int mucosa by asp, small bowel Thiabendazole 25
3. Intestinal: painless, intermittent adult female worms biopsy mg/kg in 3 div.doses for
diarrhea w/ thin watery bloody 3 days
stools Ivermectin chronic
IMMUNOCOMPROMISED: disseminated uncomplicated
strongyloidiasis strongyloidiasis
Enterobius enterobiasis/oxyuriasis 1. nocturnal pruritus ani 1. migration of gravid females EGG RECOVERY: 1. pyrantel pamoate
vermicularis human pinworm; seatworm COMPLICATIONS: from anus to perianal skin 1. perianal scrapings 2. mebendazole
EGG: 50-60 um x 20-30 um 1. appendicitis 2. complications due to adult -swabs 3. piperazine citrate
-outer triple albuminous covering 2. vaginitis worm migration -stool exam;
-inner lipoidal for chemical protxn 3. endometritis fingernails
-D-shaped 4. salphingitis ALL MEMBERS OF FAMILY 2. Grahams scotch
- 5. peritonitis SHOULD BE SCREENED tape
-toluene for clearing
Capillaria EGG: peanut-shaped; bioperculated w/ 1. abdominal pains; borborygmi 1. membrane distention of mucous STOOL EXAMINATION 1. Supportive: fluid &
philippinensis flat polar plugs 2. intermittent diarrhea & weight loss glands & plasma cell ALL STAGES ARE SEEN electrocyte
MOT: eating raw freshwater fishes w/ 3. voluminous, sprue-like stools 2. flattened villi, atrophied crypts of replacement; high
larvae; raw animal organs 4. malabsorption cachexia - death Lieberkuhn; edema in basement protein diet
3. infiltration in the lamina propria
INFECTIVE: 2. Mebendazole 400
4. severe protein-losing
HABITAT: SI mg/day in 2 div.doses
enteropathy, malabsorption of fat
for 20 days
&sugars; excretion of
xylose,electrolyte lvls, IgE lvl 3. Albendazole 400
mg/day for 10 days
Wuchereria VECTOR: Culex, Anopheles minimus 1. Adenolymphangitis (ADL) WITH MICROFILAREMIA: DETECTION OF MF SPECIFIC
bancrofti flavirostis, Aedes poecilus 2. Orchitis, epidymitis, funiculitis Clinical course: immune response 1) Direct smear 1) DEC -
90% India, SEA, Pacific Islands, Africa, 3. Hydrocele or chylocoele a. Relatively asymptomatic w/ 2) Stained thick smear Diethylcarbamazine
S. & C. America 4. Lymphedema, elephantiasis marked & prolonged filaremia -Giemsa standard SUPPORTIVE
->cont. exposure to infxn
INFX RATE: 0.88-25%; MF rate: 15% in 5. Tropical pulmonary eosinophilia -fields stain -2x/day washing of
->modulated IR: tolerant
endemic areas (Weingartens syndrome) -rapid giemsa affected parts
immune status
EMBRYONIC: microfilaria Recent residence in endemic b. Recurrent lymphangitis & -haematoxylin -raising limbs at night
Hypereosinophilia eventual chronic stage INVOLVE BLOOD CON -exercise to promote
Brugia malayi VECTOR: Anopheles, Aedes, Mansonia Chest xray, diffuse military moulting ->repeated exposure to infective 1) Knotts concn lymph flow
bonnea/uniformis Respiratory probs larva 2) Nucleopore mem -clean nails
India, SEA, Malaysia, Indonesia, Phil., IgE & antifilarial antibodies ->induce desensitization & loss in ANTIGEN DETECTION -shoes
China capacity to respond to filarial 1) CFA circulating -use of antiseptics/biotic
antigen filarial antigen (gold CHEMOPROPHYLAXIS:
W/O MICROFILAREMIA: stan for bancrofti) -1x/year single dose of
a. Early lymphangitis & ANTIBODY DETECTION DEC or Ivermectin +
lymphadenitis in persons
1) IFAT, IHA, ELISA Albendazole
from area w/o to endemic
Intradermal test,
b. TPE
lymphoscintigraphy
c. Extreme elephantiasis ff
recurrent course
Onchocerca Onchocerciasis 1. Onchocercoma: nodules (scalp, 1. Demonstration of 1) DEC diethyl
volvulus River blindness scapulae, ribs, elbows, etc.) microfilaria: skin carbamazine
Saudi Arabia and Africa 2. Microfilaria: skin, eyes (keratitis, strips 2) Nodulectomy
VECTOR: female Simulium (black fly): iridocyclitis) 2. Corneal biopsy
no animal reservoir
Loa loa Loaiasis 1. Migratory nodules/swelling Demonstration of MF 1) DEC
Calabar & fugitive swelling 2. Hypersensitivity to filarial antigen in PBS 2) Surgery
Africa rainforest & rubber plant. 3. Eosinophilia Serology
NATURAL HOST: HUMAN 4. Eye involvement
VECTOR: Tabanid flies (Chrysops)
Trichinella spiralis Trichiniasis/Trichinosis/Trichinelliasis 1) Asymptomatic 1. Muscle biopsy 1) Supportive
Temperate region 3 Stages: 2. Eosinophilia 2) Mebendazole
MOT: ingestion of uncooked pork w/ a. Incubation 3. Bentonite 3) albendazole
encysted larva b. Larval migration & muscle invasion flocculation
HABITAT: SI c. Encystation 4. Serology
LARVA: striated muscles
Parastrongylus adult female uterine tubules neurologic manifestations Presumptive 1) mebendazole
(Angiostrongylus) "Barbers pole eosinophilia a. based on travel 2) albendazole
cantonensis DEFINITIVE HOST: rat (pulmonary art) self-limiting exposure
INFECTIVE: larvae b. history
INTERMEDIATE H: snails/slugs c. serology and
PARATENIC HOST: prawn/crabs imaging results
MOT: incidental ingestion
Dracunculus Dracontiasis, dracunculosis, medina 1. Papulo-nodular lesion, vesicles Demonstration of 1) Hetrazan
medinensis serpent, guinea worm infection Gravid female: subcutaneous tissue lay adult worm in lesions 2) worm removal
MOT: ingestion of contaminated water larvae (lower extremities) -eosinophilia
with cyclops/copepods w/ larva
DH: man other animals

Gnathostoma MOT: ingestion of improperly cooked CLM and VLM

spinigerum fish, frogs, birds and snakes w/
encapsulated larvae
DH: dogs, cats and hogs
IH: copepods/Cyclops
Adult: globose, cephalic head
separated from body w/ constriction
rows of recurved spines
Schitosomiasis Parasitic blood flukes 1. Migratory Phase 1. Massive invasion of cercariae Detection of Parasite 1. Praziquantel
japonicum Intestinal schistosomiasis (mansoni, a. Cercarial dermatitis 2. Adult worms produce 1. DFS; stool concn; Single dose 40-50
mekongi, intercalatum) b. Intial exposure, mild repeated massive eggs glycerine mg/kg; or 25
Urinary schistosomiasis exposure: sensitize person- 3. Liberation of large amt of sedimentation; mg/kg in two
(haematobium) pruritus & painful dermatitis SEA FECT doses every 4 hrs
Endemic in 24 provinces 2. Acute Schistosomiasis 4. Host producing antibodies 2. Kato-Katz
GENERAL CHARACTERISTICS: a. Dysentery 5. Antigen/antibody complex 3. Rectal Biopsy
1. Dioecious b. Katayama syndrome 6. Immune complex disease 4. ELISA
2. No muscular pharynx 3. Chronic Schistosomiasis (18 mo.) 7. SEA
3. Do not have encysted a. Hepatosplenic hypertension 8. Immunologic response
metacercarial stage b. Varices (lymphokines)
4. Non-operculated eggs c. Ascites 9. Migration of macrophages;
5. Fork-tailed cercaria d. Pipestem fibrosis (liver) eosinophils
6. Entry: skin 10. Hoeppli phenomenon:
INTERMEDIATE HOST: Oncomelania First exposure humoral Ag/Ab complex
hupensis quadrasi Not light infxn 11. Lymphocytes, histiocytes,
INFECTIVE: cercariae Not resident in endemic plasma cells
Coincides w/ oviposition (4-8 wks) 12. SEA secretion-inflammatory
Self-limiting granuloma fibrosis
13. Scarification
14. Calcification
CREEPING ERUPTIONS (CLM)
1. Animal hookworm
2. Ancylostoma braziliense
3. Erythematous, serpiginous linear elevated tunnels
VISCREAL LARVA MIGRANS
1. Human toxocariasis
2. Toxocara canis/cati
3. Ingestion of embryonated eggs from soiled hands, food and water
4. Larvae to visceral organs