Course Title

Module #23 Student Activity Sheet

Name: Class number:

Section: Schedule: Date:

LESSON TITLE: FUNGAL INFECTIONS Materials:

Pen, paper, index card, book, and class List
LEARNING OUTCOMES:
At the end of the lesson, the nursing student can:
1. Categorize various fungal diseases by body system Reference:
(e.g., respiratory system, circulatory system, etc.);
2. Correlate a particular fungal disease with its major Engelkirk P. G., Duben-Engelkirk J., Burton’s
characteristics, etiologic agent, reservoir(s), mode(s) Microbiology for Health Sciences 9th ed.
of transmission, and diagnostic laboratory procedures; Texas, USA: Lippincott Williams and Wilkins
3. Briefly explain how fungi cause disease;
4. Classify a given fungal infection as being a
superficial, cutaneous, subcutaneous, or systemic
mycosis; and, State several diseases caused by
dimorphic fungi.

A. LESSON PREVIEW/REVIEW (5 minutes)

Instruction: Complete the table below.

Typhoid Fever Gonorrhea Tetanus

Pathogens: Salmonella typhi also caused by Neisseria Tetanus is caused by

known as the typhoid
bacillus, a Gram-negative
bacillus that releases
endotoxin and produces
exotoxins.
gonorrhoeae (also known as
gonococcus or GC), a Gram-
negative diplococcus
Clostridium tetani, a motile,
Gram-positive, anaerobic,
spore-forming bacillus that
produces a potent
neurotoxin -called
tetanospasmin.

Reservoirs and Mode of Infected humans serve as
Transmission reservoirs for typhoid and
paratyphoid
Infected humans serve as Reservoirs include soil
reservoirs. Transmission contaminated with human,
occurs via direct mucous horse, or other animal feces.
membrane-to-mucous Person-to-person transmission
membrane contact, usually does not occur.
sexual contact; adult-to-
child (may indicate sexual
abuse); and mother-to-
neonate during birth.

Patient Care: Use Standard Precautions for Use Standard Precautions for Use Standard Precautions for
hospitalized patients hospitalized patients. hospitalized patients.

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B. MAIN LESSON (50 minutes)
Classification of Fungal Infections
1. Superficial mycoses
⎯ These are fungal infections of the outermost areas of the human body, including the outer surfaces of hair
shafts and the outermost, nonliving layer of the skin (the epidermis).
⎯ Superficial mycoses include otomycosis,a black piedra, white piedra, tinea (or pityriasis) versicolor, and
tinea nigra. All are caused by moulds.
⎯ Black piedra, caused by Piedraia hortae, is a fungal infection of scalp hair and, less commonly, eyebrows
and eyelashes.
⎯ White piedra, usually caused by Trichosporon beigelii, is a fungal infection of moustache, beard, pubic, and
axilla hair.
⎯ Tinea versicolor, caused by Malassezia furfur, is a ringworm infection that affects the skin of the chest or
back and, less commonly, the arms, thighs, neck, and face.
⎯ Tinea nigra, caused by Hortaea werneckii, is a ringworm infection of the palms of the hands and,
less commonly, the neck and feet.

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2. Cutaneous, hair, and nail mycoses

⎯ Fungal infections of the living layers of skin (the dermis), hair shafts, and nails—commonly called tinea
infections or ringworm infections—are caused by a group of moulds collectively referred to as dermatophytes.
⎯ (A) Tinea pedis (athlete’s foot), (B) tinea corporis (ringworm of the trunk, shown here on the shoulder), (C) tinea
capitis (ringworm of the head), (D) tinea cruris (ringworm of the groin area), and (E) tinea unguium (ringworm of
the nails).
3. Subcutaneous mycoses.
⎯ These are fungal infections of the dermis and underlying tissues. They are more severe than superficial
and cutaneous mycoses.
⎯ Sporotrichosis is caused by Sporothrix schenckii, a dimorphic fungus, and typically affects the skin of
an extremity.
⎯ Chromomycosis, caused by various species of moulds, is a chronic, spreading infection of the skin
and subcutaneous tissues, usually affecting a lower extremity.
⎯ Mycetomas, caused by various moulds, are chronic granulomatous infections that involve the feet
(usually), hands, or other areas of the body
4. Systemic mycoses
⎯ Systemic mycoses—also known as generalized or deep-seated mycoses— are the most serious types of
fungal infections.
⎯ They are fungal infections of internal organs of the body, sometimes affecting two or more organ
systems simultaneously—for example, simultaneous infection of the respiratory system and the
bloodstream, or simultaneous infection of the respiratory tract and the central nervous system.

A. Fungal Infections of the

Skin Dermatophytoses
⎯ Dermatophytoses are also known as tinea (ringworm) infections and dermatomycoses.
⎯ Some of the dermatomycoses cause only limited irritation, scaling, and redness. Others cause itching,
swelling, blisters, and severe scaling.
Pathogens: Dermatomycoses are caused by various filamentous fungi (moulds), collectively referred to as
dermatophytes. Examples include species of Microsporum, Epidermophyton, and Trichophyton.
Reservoirs and Mode of Transmission: Infected humans and animals and soil serve as reservoirs. Transmission is by
direct or indirect contact with lesions of humans or animals; or contact with contaminated floors, shower stalls, or locker
room benches; barbers’ clippers, combs, and hairbrushes; or clothing.
Patient Care: Use Standard Precautions.

B. Fungal Infections of the Lower Respiratory

Tract Histoplasmosis
⎯ Histoplasmosis is a systemic mycosis of varying severity, ranging from asymptomatic to acute to chronic. The
primary lesion is usually in the lungs.
⎯ The acute disease involves malaise, fever, chills, headache, myalgia, chest pains, and a nonproductive cough
(i.e., sputum is not produced). Histoplasmosis is the most common systemic fungal infection in AIDS patients.
Pathogen: Histoplasmosis is caused by Histoplasma capsulatum var. capsulatum, a dimorphic fungus that grows as a
mould in soil and as a yeast in animal and human hosts.
Reservoirs and Mode of Transmission: Reservoirs include warm, moist soil containing a high organic content and bird
droppings, especially chicken droppings, but also bat droppings in caves and around starling, blackbird, and pigeon
roosts. Transmission occurs via inhalation of conidia (asexual spores) from soil. Bulldozing and excavation may produce
aerosols of spores. Histoplasmosis is not transmitted from person to person.
Patient Care: Use Standard Precautions for hospitalized patients.

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Pneumocystis Carinii Pneumonia (PCP, Interstitial Plasma-Cell Pneumonia)

⎯ PCP is an acute-to-subacute pulmonary disease found in malnourished, chronically ill children; premature infants;
and immunosuppressed patients, such as those with AIDS.
⎯ Patients have fever, difficulty in breathing, rapid breathing, dry cough, cyanosis, and pulmonary infiltration of
alveoli with frothy exudate. PCP is usually fatal in untreated immunosuppressed patients.
⎯ It is a common contributory cause of death in AIDS patients. Pneumocystis causes an asymptomatic infection
in immunocompetent people
Pathogen: The etiologic agent of PCP is Pneumocystis jiroveci (formerly P. carinii). This organism has both protozoal and
fungal properties. It was classified as a protozoan for many years, but is currently classified as a nonfilamentous fungus.
Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. The mode of transmission is unknown—
perhaps direct contact, perhaps transfer of pulmonary secretions from infected to susceptible persons, perhaps airborne.
Patient Care: Use Standard Precautions for hospitalized patients. Do not place PCP patients in the same room with an
immunocompromised patient.

C. Fungal Infections of the Oral

Region Thrush
⎯ Thrush is a yeast infection of the oral cavity. It is common in infants, elderly patients, and
immunosuppressed individuals.
⎯ White, creamy patches occur on the tongue, mucous membranes, and the corners of the mouth
Pathogens: The yeast, C. albicans and related species. C. albicans is the yeast and the fungus most commonly isolated
from clinical specimens.
Reservoir and Mode of Transmission: Infected humans serve as reservoirs. Transmission occurs by contact with
secretions or excretions of mouth, skin, vagina, or feces of patients or carriers; also, by passage from mother to neonate
during childbirth and by endogenous spread (i.e., from one area of the body to another)

D. Fungal Infections of the Oral

Region Yeast Vaginitis

⎯ The three most common causes of vaginitis, each causing about one third of the cases, are C. albicans (a yeast),
Trichomonas vaginalis (a protozoan), and a mixture of bacteria (including bacteria in the genera Mobiluncus and
Gardnerella).
⎯ Typical symptoms of yeast vaginitis are vulvar pruritis (itching), a burning sensation, dysuria, and a white
discharge. Vulvar erythema (redness) and rash sometimes occur.
Pathogens: The yeast, C. albicans, causes about 85% to 90% of yeast vaginitis; other Candida spp. can also cause this
disease.
Reservoir and Mode of Transmission: (See previous section on ―Thrush.‖)

E. Fungal Infections of the Central Nervous

System Cryptococcosis (Cryptococcal Meningitis)
⎯ Cryptococcosis starts as a lung infection, but spreads via the bloodstream to the brain.
⎯ It usually presents as a subacute or chronic meningitis. Infection of the lungs, kidneys, prostate, skin, and bone
may also occur.
⎯ Cryptococcosis is a common infection in acquired immunodeficiency syndrome (AIDS) patients.
Pathogens: Cryptococcosis can be caused by three subspecies of C. neoformans, an encapsulated yeast. The capsule
enables C. neoformans to adhere to mucosal surfaces and avoid phagocytosis by white blood cells.
Reservoirs and Modes of Transmission: Reservoirs include pigeon nests; pigeon, chicken, turkey, and bat droppings;
and soil contaminated with bird droppings. Growth of C. neoformans is stimulated by the alkaline pH and high nitrogen
content of bird droppings. Transmission occurs by inhalation of yeasts, often projected into the air by sweeping or
excavation. Cryptococcus is not transmitted from person to person or animal to person.
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Parasitism is a symbiotic relationship that is of benefit to one party or symbiont (the parasite) at the expense of the
other party (the host).

Parasites are defined as organisms that live on or in other living organisms (hosts), at whose expense they gain some
advantage. Parasites that live outside the host’s body are ectoparasites; those that live inside the host are
endoparasites.

The definitive host harbors the adult or sexual stage of the parasite or the sexual phase of the parasite’s life cycle. The
intermediate host harbors the larval or asexual stage of the parasite or the asexual phase of its life cycle. Facultative
parasites are organisms that can be parasitic but are also capable of a free-living existence. Obligate parasites have no
choice; to survive, they must be parasitic.

In general, parasitic infections are diagnosed by observing and recognizing various parasite life cycle stages in clinical
specimens.

Protozoa
⎯ Protozoa are classified taxonomically by their mode of locomotion. Some move by pseudopodia, others by
flagella, others by cilia, and some are nonmotile.
⎯ The trophozoite is the motile, feeding, dividing stage in the protozoal life cycle, and the cyst, oocyst, and spore
are dormant stages. Protozoal infections are most often acquired by ingestion or inhalation of dormant stages.

Protozoal Infections of the Skin

Leishmaniasis
⎯ There are three forms of leishmaniasis: cutaneous, mucocutaneous (or mucosal), and visceral.
⎯ The cutaneous form starts with a papule that enlarges into a craterlike ulcer
⎯ Individual ulcers may coalesce, causing severe tissue destruction and disfigurement.
⎯ Visceral leishmaniasis, also known as kala-azar, is characterized by fever, enlarged liver and
spleen, lymphadenopathy, anemia, leukopenia, and progressive emaciation and weakness.
⎯ Death may result in untreated cases
Parasite: Leishmaniasis is caused by various species of flagellated protozoa in the genus Leishmania. The nonmotile,
intracellular form of the parasite is called an amastigote. The motile, extracellular form of the parasite is called a
promastigote.
Reservoirs and Mode of Transmission: Reservoirs include infected humans, domestic dogs, and various wild animals.
Leishmaniasis is principally a zoonosis and is usually transmitted via the bite of an infected sand fly. Transmission by
blood transfusion and person-to-person contact have been reported.

Protozoal Infections of the Eyes

Amebic Eye Infections

⎯ Amebic conjunctivitis and keratoconjunctivitis are amebic infections causing inflammation of the conjunctiva, corneal
ulcers, pus formation, and severe pain.
⎯ These infections can lead to loss of vision.
⎯ The disease process is more rapid if corneal abrasions are present.
Parasites: Amebic eye infections are caused by several species of amoebas in the genus Acanthamoeba. Because these
amoebas are capable of either a free-living or a parasitic existence, they are referred to as facultative parasites.

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Reservoirs and Mode of Transmission: The amoebas enter the eye from ameba-contaminated waters. Infections have
occurred primarily in people who wear soft contact lenses and have used nonsterile, homemade cleaning or wetting
solutions, or have become infected in ameba-contaminated spas or hot tubs.
Patient Care: Use Standard Precautions for hospitalized patients.

Toxoplasmosis
⎯ Toxoplasmosis is a systemic sporozoan infection that, in immunocompetent persons, may be asymptomatic
or resemble infectious mononucleosis.
⎯ However, serious disease, even death, may occur in immunodeficient persons.
⎯ Disease typically involves the central nervous system, eyes (chorioretinitis), lungs, muscles, or heart.
Cerebral toxoplasmosis is common in AIDS patients.
⎯ Infection during early pregnancy may lead to fetal infection, causing death of the fetus or serious birth defects
(e.g., brain damage).
Parasite: Toxoplasmosis is caused by Toxoplasma gondii, an intracellular sporozoan.
Reservoirs and Mode of Transmission: Definitive hosts include cats and other felines that usually acquire infection by
eating infected rodents or birds. Intermediate hosts include rodents, birds, sheep, goats, swine, and cattle. Humans
usually become infected by eating infected raw or undercooked meat (usually pork or mutton) containing the cyst form of
the parasite or by ingesting oocysts that have been shed in the feces of infected cats. Oocysts may be present in food or
water contaminated by feline feces. Children may ingest oocysts from sand boxes containing cat feces. Infection can also
be acquired transplacentally, by blood transfusion, or by organ transplantation.
Patient Care: Use Standard Precautions for hospitalized patients.

Protozoal Infections of the Gastrointestinal Tract

Amebiasis
⎯ Amebiasis or amebic dysentery is a protozoal gastrointestinal infection that may be asymptomatic, mild, or severe
and is often accompanied by dysentery, fever, chills, bloody or mucoid diarrhea or constipation, and colitis.
⎯ The amoebas may invade mucous membranes of the colon, forming abscesses and amebomas, which
are granulomas that are sometimes mistaken for carcinoma.
⎯ Amoebas also may be disseminated via the bloodstream to extraintestinal sites, leading to abscesses of the liver,
lung, brain, and other organs. Depending on their location, untreated extraintestinal amebic abscesses can be
fatal.
Parasite: Amebiasis is caused by Entamoeba histolytica. Like all amoebas, E. histolytica has two stages: the cyst stage,
which is the dormant, infective stage, and the motile, metabolically active, reproducing trophozoite stage.
Reservoirs and Mode of Transmission: Reservoirs include symptomatic and asymptomatic humans and fecally
contaminated food or water. Transmission occurs in one of several ways: (a) via ingestion of fecally contaminated food or
water containing cysts, (b) by flies transporting cysts from feces to food, (c) via the fecally soiled hands of infected food
handlers, (d) by oral–anal sexual contact, or (e) by anal intercourse involving multiple sex partners.
Patient Care: Use Standard Precautions for hospitalized patients.

Cyclosporiasis
⎯ Cyclosporiasis is a coccidial gastrointestinal infection, causing watery diarrhea (6 or more stools per day),
nausea, anorexia, abdominal cramping, fatigue, and weight loss.
⎯ The diarrhea lasts between 9 and 43 days in immunocompetent patients, and months in
immunocompromised patients.
Parasite: Cyclosporiasis results from ingestion of oocysts of Cyclospora cayetanensis, a coccidian.
Reservoirs and Mode of Transmission: Reservoirs include fecally contaminated water sources and produce that has
been rinsed with fecally contaminated water. Transmission is primarily waterborne, but outbreaks have involved
contaminated raspberries, basil, and lettuce
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Patient Care: Use Standard Precautions for hospitalized patients.

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Giardiasis
⎯ Giardiasis is a protozoal infection of the duodenum (the uppermost portion of the small intestine) and may
be asymptomatic, mild, or severe.
⎯ Patients experience diarrhea, steatorrhea (loose, pale, malodorous, fatty stools), abdominal cramps,
bloating, abdominal gas, fatigue, and possibly weight loss.
Pathogen: Giardiasis is caused by Giardia lamblia (also called Giardia intestinalis), a flagellated protozoan). Trophozoites
attach by means of a ventral sucker to the mucosal lining of the duodenum. Trophozoites and/or cysts are expelled in
feces.
Reservoirs and Mode of Transmission: Reservoirs include infected humans, possibly beavers and other wild and
domestic animals that have consumed water containing Giardia cysts; and fecally contaminated drinking water and
recreational water. The disease commonly occurs in day care centers. Transmission occurs via the fecal–oral route,
usually by ingestion of cysts in fecally contaminated water or foods, or from person to person by soiled hands to mouth
(as occurs in day care centers). Large community outbreaks have resulted from drinking treated but unfiltered water.
Smaller outbreaks have involved contaminated food, person-to-person transmission in day care centers, and fecally
contaminated recreational water (e.g., swimming and wading pools).
Patient Care: Use Standard Precautions for hospitalized patients. Add Contact Precautions for diapered or incontinent
patients.

Protozoal Infections of the Genitourinary Tract

Trichomoniasis
⎯ Trichomoniasis is a sexually transmitted protozoal disease affecting both men and women.
⎯ The disease is usually symptomatic in women, causing vaginitis with a profuse, thin, foamy, malodorous, greenish-
yellowish discharge.
⎯ It has been estimated that trichomoniasis accounts for approximately one third of the cases of vaginitis or cystitis.
⎯ Although rarely symptomatic in men, trichomoniasis may lead to prostatitis, urethritis, or infection of the
seminal vesicles.
⎯ Persons with trichomoniasis often also have other sexually transmitted diseases, especially gonorrhea.
Parasite: Trichomoniasis is caused by Trichomonas vaginalis, a flagellate.
Reservoirs and Mode of Transmission: Infected humans serve as reservoirs. Transmission occurs by direct contact
with vaginal and urethral discharges of infected people during sexual intercourse. Because this organism exists only in
the fragile trophozoite stage (there is no cyst stage), it cannot survive very long outside the human body.

Protozoal Infections of the Circulatory System

African Trypanosomiasis (African Sleeping

Sickness)
⎯ African trypanosomiasis is a systemic disease caused by flagellated protozoa in the bloodstream, known as
hemoflagellates.
⎯ Early stages of the disease include a painful chancre at the site of a tsetse fly bite, fever, intense headache,
insomnia, lymphadenitis, anemia, local edema, and rash.
⎯ Later stages of the disease include body wasting, falling asleep, coma, and death if untreated.
⎯ The latter stages of the disease have given rise to the name African sleeping sickness or simply sleeping sickness.
Pathogens: Two subspecies of Trypanosoma brucei cause African trypanosomiasis. T. brucei ssp. gambiense, in
western and central Africa, causes most cases of sleeping sickness; the disease may last several years. T. brucei ssp.
rhodesiense, in eastern Africa, causes a more rapidly fatal form of African trypanosomiasis, usually lethal within weeks or
a few months without treatment.
Reservoirs and Mode of Transmission: Infected humans serve as reservoirs of T. brucei ssp. gambiense, whereas wild
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animals and domestic cattle are the primary reservoirs of T. brucei ssp. rhodesiense. Tsetse flies become infected when
they ingest blood that contains the trypanosomes. The parasites then multiply and mature within the infected tsetse flies.

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Humans become infected when mature trypanosomes (trypomastigotes) are injected into the bloodstream as the infected
tsetse flies take blood meals.
Patient Care: Use Standard Precautions for hospitalized patients.

Malaria
⎯ Malaria is a systemic sporozoan infection with malaise, fever, chills, sweating, headache, and nausea.
⎯ The frequency with which the cycle of chills, fever, and sweating is repeated is referred to as periodicity,
which depends on the particular species of malarial parasite that is causing the infection.
⎯ The intermittent bouts of chills and fever are sometimes referred to as paroxysms.
⎯ In addition to these symptoms, falciparum malaria may be accompanied by cough, diarrhea, respiratory
distress, shock, renal and liver failure, pulmonary and cerebral edema, coma, and death.
Parasites: Human malaria is caused by four species in the genus Plasmodium: Plasmodium vivax (the most common
species), P. falciparum (the deadliest), Plasmodium malariae, and Plasmodium ovale. These are intraerythrocytic
sporozoan parasites. Infection with P. vivax and P. ovale results in chills and fever every 48 hours and is referred to as
tertian malaria. P. malariae infection causes chills and fever every 72 hours and is referred to as quartan malaria. P.
falciparum periodicity varies from 36–48 hours. Mixed infections—that is, infections involving more than one Plasmodium
species—occur in certain geographic areas. Drug-resistant strains of P. vivax and P. falciparum are common.
Plasmodium spp. have a complex life cycle involving a female Anopheles mosquito, the liver and erythrocytes of an
infected human, and many life cycles.
Reservoirs and Mode of Transmission: Infected humans and infected mosquitoes serve as reservoirs. Most human
infections occur as a result of injection of sporozoites into the bloodstream by an infected female Anopheles mosquito
while taking a blood meal. Infection may also occur as a result of blood transfusion or the use of blood-contaminated
needles and syringes.
Patient Care: Use Standard Precautions for hospitalized patients

Protozoal Infections of the Central Nervous System

Primary Amebic Meningoencephalitis

⎯ PAM is an amebic disease-causing inflammation of the brain and meninges, sore throat, severe frontal
headache, hallucinations, nausea, vomiting, high fever, stiff neck.
⎯ Unless diagnosed and treated promptly, death occurs within 10 days, usually on the fifth or sixth day
Parasite: PAM is caused by N. fowleri, an ameboflagellate.a Amoebas in the genera Acanthamoeba and Balamuthia can
cause similar conditions.
Reservoirs and Mode of Transmission: Water and soil serve as reservoirs. The amoebas usually enter the nasal
passages of a person diving and/or swimming in ameba-contaminated water, such as ponds, lakes, ―the old swimming
hole,‖ thermal springs, hot tubs, spas, and public swimming pools. After the amoebas colonize the nasal tissues, they
invade the brain and meninges by traveling along the olfactory nerves.
Patient Care: Use Standard Precautions for hospitalized patients.

Helminths
⎯ Helminths (parasitic worms) are divided into roundworms (nematodes) and flatworms. Flatworms are further
divided into tapeworms (cestodes) and flukes (trematodes).
⎯ The stages of the typical helminth life cycle are the egg, the larva, and the adult worm.
⎯ Helminth infections are usually diagnosed by observing (a) whole worms or segments of worms in clinical
specimens—most often, fecal specimens, or (b) larvae or eggs in stained or unstained clinical
specimens.

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Helminth Infections of Humans

ANATOMIC LOCATION HELMINTH DISEASE HELMINTH THAT CAUSES THE DISEASE

Skin Onchocerciasis (also known as ―river Onchocerca volvulus (N); microfilariae (tiny
blindness‖) prelarval stages of these helminths are found
in the skin

Muscle and Subcutaneous Trichinosis Trichinella spiralis (N)

Tissues
Dracunculiasis Dracunculus medinensis (N); also known as
the guinea worm

Eyes Onchocerciasis Onchocerca volvulus (N); microfilariae enter

the eyes, causing an intense inflammatory
reaction

Loa loa (N); also known as the African

Loiasis eyeworm

Respiratory System Paragonimiasis Paragonimus westermani (T); the lung fluke

Gastrointestinal Tract Ascariasis infection Ascaris lumbricoides (N); the large intestinal
roundworm of humans
Ancylostoma duodenale (N) or Necator
Hookworm infection americanus (N)

Enterobius vermicularis (N)

Pinworm infection (enterobiasis)
Whipworm infection (trichuriasis)
Strongyloidiasis
Beef tapeworm infection
Dog tapeworm infection
Dwarf tapeworm infection
Fish tapeworm infection
Pork tapeworm infection
Rat tapeworm infection
Trichuris trichiura (N)
Strongyloides stercoralis (N)
Taenia saginata (C)
Dipylidium caninum (C)
Hymenolepis nana (C)
Diphyllobothrium latum (C)
Taenia solium (C)
Hymenolepis diminuta (C)
Fasciolopsis buski (T); an intestinal fluke

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Fasciolopsiasis Fasciola hepatica (T); a liver fluke

Fascioliasis Clonorchis sinensis (T); also known as the

Chinese or Oriental liver fluke
Clonorchiasis

Circulatory System Filariasis Wuchereria bancrofti (N) and Brugia malayi

(N); microfilariae of these helminths are found
in the bloodstream

Trematodes in the genus Schistosoma

Schistosomiasis (also known as
bilharzia)

Central Nervous System Cysticercosis Cysts (the larval stage) of the pork tapeworm
(Taenia solium) are found in the brain

Echinococcus granulosis (C) or Echinococcus

Hydatid cyst disease multilocularis (C); in addition to the brain,
hydatid cysts (the larval form of these
helminths) can form in many other locations in
the body

N, nematode; C, cestode; T, trematode.

CHECK FOR UNDERSTANDING (30 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
You are given 30 minutes for this activity:

1. Which of the following diseases is caused by an encapsulated yeast?

a. Coccidioidomycosis
b. Cryptococcosis
c. Histoplasmosis
d. Pneumocystis pneumonia
ANSWER: B
RATIO: Cryptococcosis is caused by an encapsulated yeast.

2. Which of the following diseases is not caused by a dimorphic fungus?

a. Coccidioidomycosis
b. Cryptococcosis
c. Histoplasmosis
d. Sporotrichosis
ANSWER: B
RATIO: All of the following choices are caused by a dimorphic fungus except option B.

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3. Which of the following diseases is a synonym for ringworm infection of the nails?
a. tinea barbae
b. tinea cruris
c. tinea nigra
d. tinea unguium
ANSWER: D
RATIO: Tinea unguium is a synonym for ringworm infection of the nails.

4. What do you call an acute-to-subacute pulmonary disease found in malnourished, chronically ill children;
premature infants; and immunosuppressed patients, such as those with AIDS?
a. Cryptococcosis
b. Coccidioidomycosis
c. Histoplasmosis
d. Pneumocystis pneumonia
ANSWER: D
RATIO: PCP is an acute-to-subacute pulmonary disease found in malnourished, chronically ill children; premature infants; and
immunosuppressed patients, such as those with AIDS.

5. A fungal infection characterizes with white, creamy patches occur on the tongue, mucous membranes, and the
corners of the mouth?
a. Cryptococcal meningitis
b. thrush
c. tinea pedis
d. yeast vaginitis
ANSWER: B
RATIO: Thrush is a fungal infection characterized with white, creamy patches occur on the tongue, mucous membranes, and
the corners of the mouth.

6. You are visiting a friend whose parents raise pigs. Which of the following diseases are you most likely to acquire
by drinking well water at their farm?
a. amebiasis
b. balantidiasis
c. cryptosporidiosis
d. giardiasis
ANSWER: B
RATIO: The disease you most likely to acquire by drinking well water at their farm is balantidiasis.

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 Course Title
Module #23 Student Activity Sheet

Name: Class number:

Section: Schedule: Date:

7. You are working on a cattle ranch. Which of the following diseases are you most apt to acquire as you perform
your duties at the ranch?
a. amebiasis
b. balantidiasis
c. cryptosporidiosis
d. giardiasis
ANSWER: C
RATIO: The disease you most likely to acquire as you perform your duties at the ranch is cryptosporidiosis.

8. Which of the following protozoal diseases are you most likely to acquire by eating a rare hamburger?
a. amebiasis
b. balantidiasis
c. giardiasis
d. toxoplasmosis
ANSWER: D
RATIO: Toxoplasmosis is the disease you would most likely to acquire by eating a rare hamburger.

9. Which of the following associations is incorrect?

a. African trypanosomiasis . . . tsetse fly
b. amebiasis . . . fecally contaminated water
c. Chagas’ disease . . . mosquito
d. toxoplasmosis . . .
cats ANSWER: C
RATIO: Option C is incorrect.

10. Which of the following is caused by an ameboflagellate named N. fowleri?

a. African trypanosomiasis
b. giardiasis
c. malaria
d. PAM
ANSWER: D
RATIO: PAM is caused by an ameboflagellate named N. fowleri.

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 Course Title
Module #23 Student Activity Sheet

Name: Class number:

Section: Schedule: Date:

RATIONALIZATION ACTIVITY (THIS WILL BE DONE DURING THE FACE TO FACE INTERACTION)
The instructor will now rationalize the answers to the students. You can now ask questions and debate among yourselves.
Write the correct answer and correct/additional ratio in the space provided.

1. ANSWER:
RATIO:

2. ANSWER:
RATIO:

3. ANSWER:
RATIO:

4. ANSWER:
RATIO:

5. ANSWER:
RATIO:
__

6. ANSWER:
RATIO:

7. ANSWER:
RATIO:

8. ANSWER:
RATIO:

9. ANSWER:
RATIO:

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 Course Title
Module #23 Student Activity Sheet

Name: Class number:

Section: Schedule: Date:

10. ANSWER:
RATIO:

LESSON WRAP-UP (5 minutes)

AL Activity: Turn and Talk

Instruction: The instructor will pose and prompt a question and you will have to discuss it with your partner for 2 minutes.
After 2 minutes, you and your partner will be asked to share your thoughts and ideas from your discussion.

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