Parasitology Table Review 3

PARASITE

Trichuris trichiura

A.K.A.

EGG

INFECTIVE

Whip worm

Embryonated Egg in soil/feces

Barrel-S, 2 plugs unembryo Enterobius Vermicularis

ADULT

M – curved 360 F – blunt; stichocytes

Seat Worm Pin worm

spindle-S, cephalic ala, corpus, isthmus, bulb M – curved tail F – pointd tail

Trichinella Spiralis

DFS Unembryo eggs in feces

Encysted larvae in Inad cooked pork

HOST LOC.

LI, Whip inserted into wall no migration phase to lungs

embryonated in soil Embryonated ova

D-shape, football

DIAGNOSTIC

Scotch tape Swab

Ileum of SI, Cecum,LI man

Embryonated Eggs

Gravid female Migrates to Perianal area

Tissue biopsy

Muscle tissue of man, pigs

Xenodiagnosis larva – w/ spearlike burrowing tip

thread-like ; F – blunt; M – curved w/ 2 lobular appendages; A-end- non-papillated

Capillaria Philippinensis

Larva in raw fish

peanut shape

Ascaris Lumbricoides

Necator Americanus

Strongyloides Stercoralis

embryonated eggs in F typical F – 8 in 1 row atypical F – 40 in 2 M – w/ chitin spicule

Giant Round Worm

Most common Intestinal nematode Ancyclostoma Duodenale

Bachman Intradermal test

Embryonated Egg

Old World Hook worm

Thread Worm

DFS of eggs

SI (jejunum ) of fish, man larvae in gastric mucosa and intestines SI of man (not attach)

Decorticated, Unembryo egg

New World Hook worm

Eggs embryonate in Fresh water

DFS -eggs (E) -larva (L) -adults (A)

tri-radiate xs

F-3 lips; M–2 spicules teeth

larvae, corticated 3rd stage filariform

Adults in SI Gall bladder, Liver, nares, appendix DFS EIA -ELA

8-cell stage

cutting plates

filariform; no F M Long eso, Prominent Genital primordium, notched tail

pointed tail, short esophagus 3rd stage filariform

Liver-lung Migration (larv swallowed)

SI Lung migration

DFS EIA

short buc cav

2NDINT HOST

PATHOLOGY

-Prolapse of Anus -IDA, Alb, D -Sometimes appendicitis -symptoms due to unique mode of attachment 1) site - ulceration 2) eggs - prupritus 3) migration -vulvuvag & salphingitis

-Rheumatic pain (intestinal flu) - M eosin -swollen eyelids -3 stages of inf: intest,larval,encap -Stage of conval - death due to Myocard or enceph -int mal-ab -Borborygmi -Ab Pain -Diarrhea -Villus flat -Atrophy COL -death

MOT

F-O-R (fecaloral route)

H-M (handmouth)

PHIL

Tx

Yup

Albendazole

80-90%

Mebendazole

warm, tropical regions Yup (F>M)

OxantelPyrantel Mebendazole Pyrantel pamoate

inhalation Retro infection Ingestion of encysted larvae in pork

yup

Thiabendazole Corticosteroid (for allergic rxn)

Mebendazole? Ref (5F 20d, 20F10d, 20F 6d)

Ingestion Of larva In raw fish

Yup (M>F) I. Norte (N.Luzon)

Mebendazole Albendazole

THA,JPN, EGY,TAI, IRAN

Lung mig –Asthma; Capil penetration –Pneumonia; Ab Pain due to adult Migration; Int Obst;  eosin

Ingestion

Yup

Burrowing of Sin of foot

Most Common In world

Ground itch; 500 eggs = heavy worm; Hookworm anemia due to suction of blood/ bleeding

Oral percutaneous

Yes Tropics, subT

Skin Penetration

Peperazine Citrate Albendazole Mebendzaole Pyrantel Pam Pyrantel Pamoate Mebendazole Iron replacement

Microcytic Hypochromic

-ELA Rhab in stool

INT HOST

SI man; Lung Migr aftr skin Penet; repro parthogenesis Eggs hatch SI

Larval migration – Lobular pneu w/ hem; like PUD, Hyper Infection, Peripheral Eosinophilia, malab syndrome

- Skin Penetration of FL - Free-living - auto infection

Yes

Albendazole

Tropics, SubT

Thiabendazole

PARASITE

A.K.A.

EGG

ADULT

Brugia Malayi

INFECTIVE

kinky, overlapping nuclei, nuclei reach tail end (terminal, subterminal n.) giemsa – sheath

Larvae In Arthropod Vector Bites at Night

unstained Wuchereria Bancrofti

smooth, single row of nuclei, no term nuc, >L than BM giemsa – pink stain

Loa Loa

Enters Bite wound Bioincub - 1 year Larvae crawl into wound

DIAGNOSTIC

Blood smear (thick And Knott Conc)

HOST LOC.

Lymphatics Bloodstream Peripheral Blood

Microfilaria In blood at Night CARD Test – Antigen det DNA probes Thin blood Smear

Subcutaneous tissue

INT HOST

mosquitos W.B. – Culex Quinque Fasciatus RuralAnoph; UrbanFatigans; Pacificaedes VectorDipteran (chrysops)

2ND INT HOST

PATHOLOGY

Acute – Hypersensitizatn Chronic – (poor prog), elephantiasis (blocks lymphs) Weingarten’s Syndrome – Hyper-eosin of Peripheral blood

MOT

PHIL

Skin

Yup

Larva Enter bite wound

Warm regions

Tx

Diethylcarbamazine (not effective on adult worms) Ivermectin

Mosquito Bites at night

corticosteroids supportive – pressure bandaging surgery

Calabar swelling

Skin

No

Diethylcarbamazine

Adult in eye

Larva Enter bite wound

Africa

Corticosteroids

Ingestion Of Infective copepods

NO

Metronidazole

Middle East, Africa

Thiabendazole

Skin

NO

Diethylcarbamazine

Larva Enter bite wound Ingestion Of larva In snails

Africa C. and S. America NO

Corticosteriods

TAI, THAI, CAM, VIET, Hawaii, Tahiti

Dead parasite Could exacerbate Tissue reaction

biopsy hypersensitivity

surgery

shedding of sheath, Dracunculus Medinensis

Fiery Serpent Israelites Guinea worm

Larvae in copepods

larva migrates to lower ext.

Oncocerca Volvulus

Angiostrongylu s Cantonensis

Larvae Crawl into Bite wound 3rd stage larva in snails and slugs or rats ingested by man

Rat Lung worm

adult emale “Barber pole” dark red intestinal tract

snails – paratenic hosts 3rd stage larva in snails/ slugs ingested by man nd cotton rat

Angiostrongylu s costaricensis

Local lesion Worm/Larvae

Mesenteric Tissues

Calcifiqed Worms by x-ray Biopsy

Larva migrate To lower ext Subcutaneous tissue

Copepods Ingest Larva in water

Blister w/ Serous exudates

VectorBlack fly

-River Blindness -Eye lesions - Skin lesions - Scrotum enlargement Eosinophilic Meningoencephalitis

Mazzotti Slit lamp History -eating, travel

Brain Spinal cord

leukocytosis & eosinophilia Skin test needs evaluation

ManAccidental hosts Intestines (gut wall)

Mollusks, Snails: Achantina, Pila Planaria, Slugs, prawns Mollusks Snails, slugs

(Sigmodon hispidus)

Anisakis

Herring disease

Terranova sp – juveniles Pseudoterranova sp – not penetrate Eustrongylides sp – perforates large bowel

3rd stage larva in flesh of raw fish; larva migrate from viscera to muscle after death of fish

Edoscopy Immunologic Tests under Study

Marine Crustaceans And fish

Pseudoperitoneal syndromes

+ eosins in CSF, CN involve, diplopia and strabismus CSF >= 500 cells/ml w/ 10-90% eosins “acute abdomen” - inflamm of ileocecal region; Ab pain loc to right lower quad + palpable tumor-like m Pseudoterranova spp – Not penetr8 stom, Throat irrit, coughed Anisakis simplex (USA) Stom, int, inflamm Rxn surrounding larva Anisakiasis – local Tissue response; (Eustrongylides spp) Perforation of L bowel

Surgery None recommended

Surgical if ncessary

Ingestion Of raw Marine Food w/ Alcohol, “green” herring, sashimi

NO JPN, Netherlands

Remove larvae By biopsy Forceps Surgical Intervention For obstruction Manage conservatively

PARASITE

A.K.A.

EGG

Schistosoma Hematobium

ADULT

INFECTIVE

S. Japonicum

Platyhelminthes

Freeswimming Cercaria

Freeswimming Cercaria

Platyhelminthes

Fasciolidae

Fasciola Gigantica

Cercaria

Larger than F. hepatica

Fasciolidae Clonorchis Sinensis

no shoulders Chinese Liver Fluke

branched testes; spatulate

Opistorchidae Opistorchis Felineus

Cat Liver Fluke

lancet S reddishbile color

Opistorchidae Opistorchis Viverrini Opistorchidae Dicrocoelium Dendriticum Dicrocoellida

Ova in feces, Rectal biopsy, COPT test, ELISA

Liver, Mesenteric Venules, SI, heart, Spleen, CNS

knob at abopercular end Lancet fluke deep golden-brown

Metacercaria Encysted On aquatic vegetation

Unembryo ova

Metacercaria Encysted On Fresh Water fish

Embryo ova In feces or Biliary duodenal aspiratesBDA Embryo ova In feces or BDA

Metacercaria Encysted On fresh Water fish Metacercaria

Adults Bladder, liver larva – Venous Plexuses Liver

in copula, males have lateral knob gynecophoric canals (smallest) Like Schistosoma Mansoni in terms of life cycle, pathology and clinical features Intermediate host – Biomphalaria snail Lide Schistosoma Japonicum in terms of life cycle, pathology and clinical features Intermediate host – Lithoglyphopsis aperta Sheep Metacercaria Unembryo Liver Encysted ova in feces, Fluke On aquatic duodenal vegetation aspirates leaf S, w/ shoulders cephalic “popping cone, spinous, dendritic testes operculum” Giant Liver Fluke

HOST LOC.

Ova in feces (blood, mucus) Rectal biopsy

lateral spine

Schistosoma Japonicum

Schistosoma Intercalatum Schistosoma Mekongi Fasciola Hepatica

Eggs, miracidia in urine

terminal spine

Schistosoma Mansoni

Platyhelminthes

DIAGNOSTIC

Mesenteric venules, SC, lungs

Bile duct of Sheep Herbivore animals Giant AnimalsCattle Biliary tract (BT) Man BT

Embryo ova In feces Or BDA

Small AnimalsCats, dogs, etc (BT SI) Civet cat, Dog, fisheating

Embryo ova

sheep

lobed testes like O. felineus 2 large testes lancet, flat, transparent, aspiny

Metacercaria

w/ fully dev miracidium

INT HOST

Bulinus Snail (Miracidia to cercaria)

Biomphalaria Snail

Oncomelania Quadrasi, Formosa

SnailsLymnea Philippinensis, Lymnea swinhoe (TAI) (sporocystredia-cercaria) Snail

Operculate Snails (Alocinma, Parafossarulus, Bithynia) Snails Bithynia Funiculate Snails Bithynia Goniomphalus, Funiculate, laevis Snails- Abida, Cochilcopa, Helicella, Zeb

2ND INT HOST

PATHOLOGY

MOT

PHIL

Calcified Bladder (dead eggs= “sandy patches”); Painful urination; Kala-azar; adults coated w/ RBC An and not detected; trapped egg cause clinical symptoms; Terminal Hematuria; infection linked To S. typhi and paratyphi carriers Claypipe-stem Fibrosis = Thickening of portal vessels due to rxn w/ eggs; Hepatosplenomegaly Portal HTN, ascites, eggs sometimes Deposited in SC, lungs  liver enzy,serum alb, glob(prot) Katayama rxn/ fever, reaction to Eggs in tissue = CNS damage, Hepatosplenomegaly, Portal HTN, Ascites; mucus/blood in feces,  liver enzy,serum alb, glob(prot)

Skin Penetration Thru Infected water

Wala Siguro…

Cercaria Penetrate Skin thru Infected water

Nope

Cercaria Penetrate Skin thru Infected water

Yup

Aquatic vegetation

Ingestion of Infected Vegetation; Infected Liver (false)

Cosmo

Ingestion of Infected Vegetation

Most Probably

Halzoun – ingestion Raw sheep, goat livers (dyspnea, deafness, asphyxiation, death) fibrotic vs. traumatic/ necrotic lesions; obs; False vs true (no eggs)

Aquatic vegetation

Fresh water Fish (FWF) : Cyprinidae, Ctenopharyngodon FWF Cyprinus Carpio (Taiwan) FWF Punteus Orphoides, Hampala dispar Formica Fusca (ants)

Cholangiocarcinoma of liver, liver function Impaired but SGPT and SGOT are normal

Ingestion of Uncooked fish

Periportal fibrosis, Invasion of pancreas, Form bile stones

Ingestion of Infective fish

Hyperplastic biliary Epithelium (Stim by Nitrosamines); assos. w/ cholangiocarcinoma

Ingestion of Infective fish

Same as F. hepatica

Ingestion of ants

Portal cirrhosis, Periductal fibrosis

Tx

Praziquantrel

Tropics Subtropics Praziquantrel

Africa Brazil Praziquantrel

Mindanao, Visayas

Bithionol

In sheep Raising countries

Africa, Asia Rare CHI, JPN, SK, Vietnam Nope USSR, poland Nope

Bithionol

Chloroquine Diphosphate Praziquantel Praziquantel

Praziquantel

Thailand Udorn Wala siguro

Praziquantel

e

PARASITE

Paragonimus Westermani

A.K.A.

EGG

Oriental Lung Fluke operculum at broad end, thick aboper

ADULT

INFECTIVE

DIAGNOSTIC

HOST LOC.

branched testes side by side; coffee bean; integument w/ spines

Metacercaria In crustacean

Unembryo eggs in feces or sputum

Encapsulated in Parenchyma of lung; in fibrotic capsules

Fasciolopsis Buski

Metacercaria In water Plants 2 dendritic testes in tandem

indistinguish from F. hep, F. gigantica Heterophyes Heterophyes

Metagonimus yokogawai

M. eggs no aboper protub; same

hard to distinguish adults; scale-like spines, w/ genital sucker, globular testes

Echinostoma Ilocanum

indisting.from fasciolas Pork Tapeworm

Longest Tapeworm

Beef tapeworm

No sporocyst stage

Cysticercous Cellulosae

rostellum w/ hooks 4 suckers; ripe proglottid 15 branches; 5m;

Reservoir – Cats & dogs Duodenum of Man or pigs

MC are Sensitive to Dryness Metacercaria In fish

H.

Taenia Solium

Cercaria w/ spines

INT HOST

Snails: -Pila luzonica “kuhol” and -Vivipara Angularis“suso” C  meta-C

Misdiagnosed For PTB Worms cause Traumatic, Obstructive and toxic effects; ulceration and  mucus prod.

Ingestion Of Infected Water Plants

Nope

Inflamm, Sloughing off Of layers, xs Mucus prod

Ingestion of MC Encysted in fish

Yes

Ingestion Of encysted MC in snails

Of course

Ingestestion Of inadeq. Cooked Pork

yes

Misdiagnosed For acid Peptic ds (APD), consistent w/ PUD Inflamm, Ulceration, Diarrhea, intoxiacation

Inflamm, Eosinophilia, leukopenia Dev Cisticercosis (ingestion of eggs), larva in brain, muscle, eye Epigastric Pain, vertigo, Nervousness, eosinophilia

Praziquantel

SEA, CHN, India, indonesia Praziquantel

EGY, Greece, CHN, JPN, KOR, TWN, Phil

Praziquantel

N. Luzon, Samar, Leyte, Mindanao Praziquantel

cosmo

Accidental Ingestion of eggs Ingestion Of cysts in beef

Niclosamide -damage to point of dissolution

tree-like dicho branching Echinococcus Granulosus

Parasite Of dog

Eggs – man Hydatid sand

smallest Tapeworm In man

PARASITE Diphyllobothrium Latum

one long gravid proglottid A.K.A. Fish/ Broad t-worm

EGG

ADULT

yellow-brown knob like thickening

dogs

x-ray to detect hydatid ds; immunologic tests

INFECTIVE Plerocercoid Larva Encyted In fish

SI of Dog -Cysts Ingested and Release scolices

DIAGNOSTIC Operculated Eggs; Proglottids Kato tech

Sheep, man (accidental, intermediate– in liver and lungs)

HOST LOC. SI in man Reservoir Host: Dogs, cats,Bears Paratenic host: Carnivore fish

INT HOST copepods (Cyclops & Diaptomus)

Obstruction – Growing cysts; Anaphylactic Shock when Cyst ruptures 2ND INT HOST (fish) perch, trout, salmon, pike ProC  PleroC

Coracidia (CO)  Procercoid (ProC)

FOR

rare

Ingestion Of eggs in feces

Sugery Prev spillage of eggs) Albendazole

PATHOLOGY Anemia (misdiag for pernicious type Vit B12 def); hyperchromic megaloblastic; examine for HCl in gastric juice (+ infection)

MOT Ingestion

PHIL Rare

Tx Praziquantel

Minimal symptoms

Ingestion

yup

Praziquantel

Enteritis due to Necrosis and Desquamation Of intestinal Epithelial cells

FOR

yup

Praziquantel

yes

Praziquantel

Only 7 cases temperat e zone

spatulate, rosette uterus 2 bothria = sucking grooves Dipylidium Caninum

Dog T-worm Double Pored T-worm

Hymenolepsis Nana

egg packets (8-15 eggs) oncosphere w/ 6 hooklets

Cysticercoid Larva in Arthropod Host when ingested retractile, conical scolex; rose-thorn shape hooklets mature proglottid – with 2 lateral genital pores

Dwarf t-worm

Embryo Eggs in Contam food and Water with filaments like D. caninum scolex but with less hooklets; ripe segment

Hymenolepsis Diminuta

Rat T-worm

Cyticerci Can complete Cycle in single Host (autoinf) Cysticercoid Larvae in insects

w/o filaments bile-stained; fan-like

gravid segment; rudimentary, unarmed rostellum

Gravid Proglottids That are passed out/ Crawl out, Egg packets, Melon-shaped Proglottids in Chains (Not stool bec proGlot disint in environment Embryo Eggs in feces

SI of dog or cat

Ctenocephalides canis (dog flea) Ctenocephalides felis (cat flea) Pulex irritans (human flea)

SI of man

Trichodectes canis (dog louse) Insects, rice And flour beetles

Proglottids not Recovered bec They degenerate

Eggs in stool (more circular, larger, lack bipolar thickening vs H. nana

Auto Infection

Direct/indirect pathways SI of man

Fleas, beetles, cockroaches, mealworms & earwigs

Minimal and Non-specific

Ingestion Of Infected insects

In rats