Parasite Conference Worms Case 1: Toxacara cati -Pet cat possible taxacara cati, but would have to contact

feces 2-3 weeks after -some respiratory issues develop in lung then move elsewhere -pica gives route for fecal contact -pork sausage taenia solium possible -eosinophilia = parasitic infection -hepatosplenomegaly possible parasitic infection causing portal issues -No stool sample Visceral Larvae MIGRANS = not necessarily in GI tract and contributing to stool

1. Parasitic infection , Other DDx Trichinella spiralis, taneia solium (but NO eosinophilia) a. eosinophilia, pet cat, undercooked pork consumption, pica, hepatosplenomegaly, 2. Serology, could also maybe do eye exam if ocular migrans has occurred a. This worm does NOT leave reminants behind (eggs) or other items other than just humoral immunity against it. Toxacara kitten/puppy roundworms, Lifestyle like ascaris: 3-4 week maturation in the soil before ingestion of eggs, bloodstream lungs Migrate due to NO clues -key symptoms eosinophilia, fever, hepatosplenomegaly In this case kid is sick so use anti-helminth albendazole, possibly also immune suppress if organ damage from inflammatory resonse is a concern Notes: **Eosinophilia worms as they MIGRATE/TRAVEL through your body, not when they sit in the gut.

HIGHEST YEILD rectal test essentially a rectal biopsy 4. Japonicum None Case 3: Ascarius 1. Immunological disease to the EGGS deposited in portal circulation NOT to current worm infection. 3. or swept up by portal circulation c. schistosoma japonicum endemic in area (asia/philippines) a. History treated symptomatically progressed w/ abdominal issues a stool sent. This confirms that a former infection was the original insult and this is resulting form continual immune disease against the eggs depositied then. warty surfaced eggs = ascarius lumbricoides 2. Eggs could be depositied causing continued inflammatory responses (granulamata) without a current infection (current parasites producing eggs into the stool) a. but problem doesn t tell us when or where or if still infectious only timing clue is Ig type d.Case 2: schistosomiasis 1. Since they lay eggs into the venules either go into venous plexus of target organ area. Serologic testing. though endemic in history-related region mansoni is everywhere so cannot be excluded 2. etc) neurological sequelae more common a. Egg deposition in portal circulation causes granuloma like inflammatory reactions in the portal tracts that cause portal hypertension and back up into collateral circulations. Mansoni. Haematobium terminal spine. round and NO SPINE = more likely to embolise b.lateral spine. you would expect no symptoms . Jejunum (japonicum = jejunum) serotype possible a. Blood sample looking for organism (can live in vessels for decades) b. Kind of a TRICK actually normal is NO symptoms. (drainage routes into portal system) 5. Hepatic artery gives adequate perfusion of sinusoids. Yes japonicum egg is smaller and rounded allows more frequent eptopic localization of egg (brain/lungs. Small. See # 2 no curret infection. manifestations of portal hypertension due to previous deposition of eggs and inflammatory rxns. 6. albendazole inhibitor of b-tubulin polymerization 3. The pneumonitis would have been earlier and may be mentioned in an earlier visit 4.

Treat or at least watch entire family 1.4. 4. warty looking egg = ascarius 5. Rule out enterobius. schistasoma haematobium a. 3. 2. Case 5: schistasomiasis 1. other endemic area experiences? 5. albendazole treatment 6. clean all bed linens and clothing etc 6. Vessel-free area = not tumor 3. history/story.hygiene . or enterobius co-infection multiple infections common a. and even with NO symptoms it might be important to check 7. Cysticercosis 2. doubtful . maybe. CSF eosinophillia a. urinary issues (masses/lesions= calcified eggs). won t always see it depends upon location of infection (sub-arachnoid vs other) b. mebendazole or albendazole a. serology menu by WHO has been developed 4. Also MIGHT pick up a tanea solium egg. Calcified eggs in urine? Case 6: cysticercosis from taeina solium tapeworm Neurocystocercosis 1. worm made its way out stimulated by fever bacterial infection also peritonitis may have been stimulated by worm migration and subsequent bacterial infection Case 4: Enterobius ? Ascarius? Warty outer edge of egg? NOPE . Nigerian immigrant. 5. and image = schistasoma eggs with miracidium inside and egg shape with TERMINAL spine 2. Prazequantal 6. ? read about a rare bug? 4. hematouria 3. Fresh water exposure especially SNAIL infested waters. Brother had it.Plant material Scotch tape First thing in the morning Enterobius vermicularis pinworm nematode Standard pyrantel. In practice antihelminthic is often not enough so how else do you break the cycle? . Columbia endemic. various CNS symptoms.

5. so ensure that he has no OTHER opportunistic infections. Roundworms Inside gut mebendazole. Steroid therapy is THE RISK FACTOR for hyperinfection of strongyloides 3. rash a. Three circumstance? a. sometime over 20 years ago when he lived in Vietnam a. Long standing. Acute infection exacerbates previous stronglyoides infection pneumonitis/additional respiratory issues. eaten by intermediate host cysts form in intermediate host we eat cysts within underpreserved or uncooked meat. Or adults just die off (not treated like above) Cycle we have worm pass egg in feces. he will continue asthma treatment which could be risky. and cysts remain after c. Enters skin blood lungs adults move into GI. You can have cysts without eggs in stool if you eat egg get cysticerus (cysts) and NO adults. ivermectin Flat worms Inside gut Niclosamide Outside gut Albendazole Flukes In general Praziquantel . thus no egg-laying b. pyrantal Outside albendazole. You can also have both cysts and adults then the adults are killed off. if other family immigrated from Vietnam? Any current unsanitary practices (hookworm?) Is he anemic? a. Hookworm EGGS should be in stool but in TIME for specimen to be analyzed hookworm incubation finishes and eggs HATCH 4. especially since this was brought on by asthma treatment. Case 7: Long-standing strongyloides stercoralis infection with acute hookworm 1. Anwer this is essentially an opportunistic infection. Yes. Immunosupression therapy downplays the Th2 response to helminthes a. pass larvae which may re-infect AUTOINFECTION 2.

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