Actinomycete Israelii

(GC)

G + ROD - long branching filaments - like hyphae fungi

Strict Anaerobe

Non-Acid Fast 

Actinomycete Israelii

(SC)

MIS - Mouth, Invasive, Sulfur granules

INVASISVE 

Sulfur Granules - at site of entry; tooth extraction enters and disseminates (invades) via sinus tracts

Reservoir: MOUTH - endogenous bacteria

Non-communicable 

TX: Pen G, Surgical Drainage 

Nocardia Asteroides

(GC)

Gram +

Fac Aerobe

ACID FAST 

Nocardia Asteroids

(SC)

Lives in SOIL - Inhalation

Lung Infection

Non-Communicable 

IMMUNICOMPROMISED

TX: Trimethoprim Sulfamethoxazole, Surgical Drainage

Treponima Pallidum

(GC)

Spiral Rod, Thin, Flexible, Motile

Strict Anaerobe

Non Acid Fast 

Treponima Pallidum

(SC)

Treponima Pallidum

(SC - reservoir, TX)

Reservoir: STD (human); Infects small vessel endothelium; transplacentally (congenital) - Hutchinson's incisors and "mulberry"

TX: Pen G; Benzathin Pen G (slow release); Doxycycline (for those w/ Pen allergy)

Jarisch-Herxheimer rxn: fever results from abx admin. (TNF)

Treponima Pallidum

(course of syphilis)

Primary syph- ulcer/chancre (contagious)

Secondary syph- spread to blood stream and lymph nodes

Tertiary syph - Gumas (CNS involvement), few treponemes

maculopapular rash - palms, soles, genitals (Condylomata lata)

Borellia Burgdorferi

(GC)

Irregular Spirochetes, Motile

Fac AEROBE

Acid Fast (+) - weak

Borellia Burgdorferi

(SC)

Lymes Disease - Chronic Arthritis 

Transmitted by Ixodes Scapularis (east) - Pacificus (west)  (1-2 days contact time)

1 - erythema migrans (skin) 1-5 weeks

2 - dissemination - skin, CNS, MSK, Heart, Eyes, joints

3 - Chronic Arthritis - polyneuropathy or leukoencephalitis, cardiomyopathy

Irreg. Spirochetes - MOTILE

Fac AEROBE

Acid Fast (+) – weak

Recurrent Fever 

Borrelia Recurrentis/ Hermsii

(SC)

Pathogen undergoes slight variation – Relapsing fever – 3-10 times Tetracycline is effective early

Leptospira 

(GC)

Leptospira

(SC)

Multi organ involvement –Renal, lungs, eyes

Biphasic Fever – Short resolution of  initial symptoms, followed by meningitis,jaundice, 

Passes to Water from Urine of infected animals – Triatheletes/adventure racers, Human-human is rare

TX: Pen G, Doxycycline for prophylaxis

Erlichia Chafeensis

(GC)

Human Monocytic Erlichosis 

= No RASH

Rickettsia family

Obligate Intracellular

Erlichia chaffeensis

(SC)

Tests- Serology for specific species

Virulence Factors – Forms morulae in cytoplasm (Inclusion body); Infects leukocytes Chloramphenacol Resistant (Not Rickettsia)

Resevoir/Infected- Endemic in dogs, transmitted by ticks, Lone Star Tick Invades Monocytes and Granulocytes (HGE) in blood

Tx/Pv - Doxycycline, Rifampacin for preg. Limit exposure possibilities

Info- Multi organ involvement –Renal, lungs, eyes Biphasic Fever – Short resolution of initial symptoms, followed by meningitis, jaundice,

Chlamydiae trachomatis 

(GC)

EYE, RESPIRATORY, GENITAL TRACT

Gram(-)

Obligate Intracellular 

No Peptidoglycan layer, no muramic acid (ghonorrea would be diplococci in PMN's) 

Chlamydiae trachomatis 

(SC)

Tests - Compliment Fixation, LPS Ag (15 serotypes), Cytoplasmic inclusions, C. trachomatics IB's contain glycogen (brown/iodine), others lack glycogen in IB

VFs - Elementary Body - infective, extracellular form "spore-like", Reticulate Body - replicative, intracellular form "inclusion body" 

* in endosome of epi cells --> not infective outside of cells

Type A,B,C --> trachoma in Africa & Asia - Congential blindess

D-K --> Genital Infections - can spread to Eyes, Lungs

thE CLAP - PID, Epididymitis, Cervicitis, Lymphogranuloma venerum (L1-L3) sexual, Conjuctivitis Neonatal Inclusion, Asymptomatic genital tract infection

TX: Tetracyclins & Macrolides , Abs not protective

Most common bacterial STD

Parrot Fever / Ornothosis

Infect Kupffer cells

Each have 1 Serotype

Pneumoniae - person-to-person

can lead to Reiters Syndrome - urethritis, arthritis

Ricketsiae ricketsii 

(GC)

RM Spotted Fever = RASH

Very short G(-) (weak) coccobacilli

Outer Membrane + thin Murein (Peptidogly) layer

Obligate Intracellular 

Ricketsiae ricketsii 

(SC)

* Multi-organ involvment, Biphasic Fever , Cause Vasculitis, Macules on Hands and Feet

* Delerium and DIC

Enters via pathogen directed endocytosis via Phospholipase

Reservoir: Dog tick, flea, lice - primarily on East coast

TX: Tetracycline, Chloramphenicol

Typhus 

Human Body Louse

Fever, Macular-Papular Rash

Fatal if Untreated  

Coxiella burnetii

(GC)

Q Fever – LUNGS

Rash is rare

Q-Fever = pneumonia + fever, hepatomegaly, endocarditis   

"Spore-like" stage = ID 50 of 1

Transmitted by aerosol droplets, Non-pasteurized milk

Phase I - In patient, Virulent, synthesize Ag

Phase II - non virulent, cell culture, no Ag synth

chitin cell wall - polysaccharide

B-glucon - cell wall polymer (D glu) = sit of capsofungin

Ergosterol membrane - not cholesterol = site of action of ampho B and azoles 

Zygospores - single, large

Ascospores - ascus (sac)

Basidospores - externally, tip of pedistal

Arthrospores - fragment of ends of hyphae - Coccidiodes immitis

Chlamydospores - round, thick walled - C. Albicans

Blastospores - budding of yeast (pseudohyphae)

Sporangiospores - formed in a sac, mushroom looking Rhizopus 

ie. Aspregillus

IgE broncho constriction, eosinophilia, "Wheel and Flare" 

slow growers,

low pH

high Dextrose

Dermatophytoses: Epidermophyton, Trichophyton and Microsporum

Human-to-Human contact 

Dermatophytid - "id" reactions, vesicles on fingers

Tinea (pityriasis) Versicolor: Malassezia furfur - hypopigmented areas; spaghetti and meatballs

T. tonsurans - tinea capitis in kids, endothrix - inside hair 

T. Rubrum, schoenleinii - tinea capitis 

Trauma

"Beer, Bricks and Sporothrix"

Sporothrix schenckii - thorn -- rose gardners

asexual budding

* oval conida resembling a daisy, cigar shaped 

* TX: Itraconazole 

Coccidioides immitis 

(SC)

Tests- Hyphae c/ Barrel Shaped Arthrospores On SBA @ 25 – HIGHLY INFECTIOUS!! Forms Mycelium (hyphae mat) IgA, IgG – 2-4 wks Increased titer c/ dissemination Skin test shows CMI response (can be (-) in dissemination)

Virulence Factors – Forms Arthrospores in soil inhailed into lungs Aspr’s form spherules filled c/ endospores released, form more spherules, Decreased CMI allows dissemination, Delayed type hypersens restricts growth

Resevoir/Infected- Southwest, and Latin America – “Lower Sonoran Life Zone” Granulomas in any organ

Tx/Pv - No tx for asymptomatic AmphoB Ketoconazole – meningitis Avoid travel to endemic areas

Info- * Dissemination more common in Preg Women, African Amer, Filippino * Erethema Nodosum – Red tender bumps on extensor surfaces – DTH * No organisms, not disemination (like Histoplasma)

Tests- SGA @ 37 – Multi buds (ships wheel) Disease is present c/ sig Ab titer

Virulence Factors – Forms spores in soil inhailed into lungs forms lesions, Sometimes disemination, oral mucous membranes Dec. CMI is predisposing

Resevoir/Infected- Moist soil in Lat Am.

Tx/Pv - Itraconazole Ampho B if necessary

Tests- SBA @ 37 – Yeast c/ single, broad based bud @ 20 – Hyphae c/ microconidia (“pear shaped”)

Virulence Factors – Inhailation of spores - diseminates Granulomas in skin, bones…

Stays mostly in U/LRT Dec CMI is predisposing

Resevoir/Infected- Endemic in Eastern N. Amer. Moise soil - Beaver dams Kids, Pets

Tx/Pv - No tx for asymptomatic Itraconazole AmphoB - severe

Tests- SBA @ 25 – Micro and Macroconidia Macro – “underwater land mines” - for ID Micro – small bulbs – infectious Skin test shows false +/- small yeast cells c/in Mac’s Radioimmunoassay, CF, ID

Virulence Factors – Inhailed arthrospores engulfed by Mac’s

- Intracellular Survives P-L fusion

– makes alkali Diseminates to Hepatosplenomegaly – Ususlly in Imcp’d Can progress to severe pulmonary infection

Resevoir/Infected- Ohio and Mississippi River Valleys

Tx/Pv - No tx for asymptomatic Oral Iitraconazole – lung lesions, pulmonary, Imcp’d Ampho B – Dissem Fluconazole – meningitis No specific prevention Info- Erethema Nodosum – Red tender bumps on extensor surfaces – DTH No organisms, not disemination (like Coccidioides)

Candida albicans 

(GC)

Candida albicans 

(SC)

Tests- Budding yeasts & pseudohyphae @ 37 c/ Calcofluor White Germ Tubes in Serum @ 37 – random “bulbs on stick” – Not other Candida Forms chlamydospores @ 20, has rigid cell wall Chitin Skin tests not (+) in Imcp’d “Anergic” – Skin tests don’t work

Virulence Factors – See tissues infected

Resevoir/Infected- On skin – Indwelling catheters are predisposing – R Side Endocarditis High pH, Abx’s, diabetes  Vulvovaginitis Repeated imersion in water  Fingers and Nails Imcp’d  Dissemination

Tx/Pv - Thrush – Fluconazole Skin – Topical clotrimazole Dissem – Ampho B/fluconazole Can prevent c/ swish and spit clotrimazole Fluconazole for Imcp’d No Vaccine

Aspergillus Fumagatous 

(GC)

Tests- Conida in radiating chains (not enclosed sporangia like Mucor) High IgE Titer, X-ray of ball (mobile) Culture less useful

Virulence Factors – Wide distribution in nature Inhailed mold, Can colonize and invade open skin, cornea, ear

Most common fungal sinusitis

Invades lungs in Imcp’d – Fungus ball (maybe in TB damaged area) ABPA – Bronchal infection – bloody, contaminated sputum Resevoir/Infected- everywhere in nature

Tx/Pv - Ampho B, surgery of fungus ball; Capsofungin, Steroids

Mucor / Rhizopus 

(SC)

Tests- Difficult culture  no septa, one long cell

Virulence Factors – Sporangiospores - inhailed Invades BV walls of sinuses, lungs, or gut  infarction & necrosis

Resevoir/Infected- Soil c/ bird (PIGEON) droppings no human-to-human Tx/Pv - Must ID early!!! – Treat underlying order + Ampho B Deadly

Info- Mucormycosis – group of zygomycosis

Cryptococcus neoformans 

(SC)

Tests- Oval, narrow based budding yeast c/ Polysach capsule Seen w/ India Ink Methenamine Silver Muccoid colonies on culture capsule Latex Agg of CNS Cryptococc. Ag “CRAG” test

Virulence Factors – Inhailed yeast Dissem to CNS Often see SubQ nodules Resevoir/Infected- Soil c/ bird (PIGEON) droppings no human-to-human

Tx/Pv - Ampho B + Flucytosine – dissemination Fluconazole – LT supression c/ AIDS

Pneumocystis jevorci 

(GC)

Tests- Methenamine Silver – “Crushed Ping Pong Ball” appearence “Ground Glass” X-ray Flouresence

Virulence Factors – Cholesterol in cell wall  not ergosterol Inhailation Resevoir/Infected- Worldwide

Tx/Pv - Trimethoprim, not the azoles, Ampho  no ergosterol Prophylaxis for CMI

Intestinal Protozoa – Non-motile Cyst – 4 nuc ingested F-O/A-O 8 Motile Trophozoite – 1 nuc  invade Colon Epi Infectious – Cyst Disease – Trophozoite Tests- Trophozoites/Cysts in Stool Need Three Samples- Cysts passed variably Last 1 hour  Antigens or NA’s by PCR assay Iodine, Saline and Trichrome preparations No PMN’s, unlike other bacterial dysentary Serology, Indirect HGA  (+) in Invasive forms

Virulence Factors – Enzymes secreted by Trophozoite – necrosis  Flask Shaped Ulcer Destroys colonic tissue on contact INVASIVE – most common systemic disease is Liver Abcess – RUQ pain Sometimes asymptomatic,       Can penetrate diaphragm to Lung, Brain Aspiration yeilds brown-yellow pus – Anchovey Paste May Form Ameboma in colon - granuloma

Resevoir/Infected- No Animal Res F-O spread

Tx/Pv - Metronidazole (Flagyl) – Symptomatic – (Trophozoite) Iodoquinol/paromomycin – Asymptomatic (Cysts) Personal Hygene, purification of water No “Night Soil” for food fertilization Info- Distinguishing Char – Small central Nucleolus c/ chromatin granules Small Cyst c/ 4 Nuc’s Common in Tropics, male homosexuals Cysts killed by boiling, filtration, NOT Chloronation

Giardia lamblia 

(GC)

Giardia lamblia 

(SC)

Tests- Trophozoites/Cysts in Stool String test NO Serology Virulence Factors – Excystation occurs in Duodenum Tropos attach but NOT INVADE Malabsorption of protien/fat No Fever

Resevoir/Infected- No Animal Res Upper Bowel (duodenum)

Tx/Pv - Metronidazole (Flagyl) Quinacrine hydrochloride Personal Hygene, purification of water No Vaccine

Info- IgA deficency leads to symptoms Common EVERYWHERE, male homosexuals Cysts killed by filtration, boiling, NOT Chloronation

Cryptosporidium parvum 

(GC)

Cryptosporidium parvum 

SC

Infectious – Oocyst Disease - Tropoozoite Tests- Oocytes with Kinyoun acid fast stain

Virulence Factors – F-O, Water Trophozoites attach to SI – Not Invasive

Resevoir/Infected- Worldwide – Contaminated water

Tx/Pv - No effective drug therapy – parmomycin for diarrhea (Nitazoxanide for children) Info- Cysts killed by filtration, boiling, NOT Chloronation

Trichomonas vaginalis

GC

Trichomonas vaginalis

Tests- Wet mount shows jerky motions – Leaf-like c/ 1 Nuc No serology

Virulence Factors – Vagina and Prostate

Resevoir/Infected- Transmitted sexually – vagina and prostate

Tx/Pv - Metronidazole – Treat both partners

Info- Killed by filtration, boiling, NOT Chloronation Greenish, Foul Smelling discharge Low vaginal pH helpful for prevention 25-50% of women are carriers

Tests- Ring-formed Trophozoites – can infect Multi RBC’s (Other plasmodium only infect 1/RBC) Thick (screning) and thin (Species ID)Giemsa Cresen, or, “Banana” shaped (others are spherical) >5% parisitization of RBC’s, multi ring-forms/RBC (not other two)

Virulence Factors – Bites/Trnasplacenta Symptoms occur ~ 2wks p bite Malaria paroxysm – abrupt fever, chills – Present in RBC’s Uses salicilic acid for RBC penetrance

Resevoir/Infected- Humans  Anopheles Paracitised RBC’s clog capillariesnecrosisAnemia Taken up by hepatocytes w/in 30min of bite Hepatosplenomegaly Kidney and Brain damage when untreated

Tx/Pv - Chloroquine resistant (others are not) Primaquine for vivax and ovale in liver disease Malarone IV quinidine/quinine/doxycycline Chemoprophylaxis for travelers – Mefloquine/doxycycline Malarone Primaquine Netting, DDT is often ineffective

Info- Mosquito ingests RBC’s w/ male and female merozoites/trophozoites  forms 1 female and 8 malein stomach  forms gamete, releases sporozoites that travel to mouth  released to humans in bitelivermerozoitesRBC’s

“Blackwater Fever” – dark urine Premunition – low level infection

P.vivax – infects only reticulocytes (Splenic Rupture), P. malarae – mature RBC’s, P. falciparum – all RBC’s P. malarae – quartan cycle, others – tertian cycles Duffy Homozygous recessive is protective for P.vivax Sickle cell trait is protective  Decreased ATPase activity G6PD defeciency is protectiveLimits Replication after infection Primaquine will Kill these patients!!!!!

Toxoplasma gondii 

GC

TOXOPLASMOSIS – congenital!!!

(Only human-human) Intestinal Protozoa –

Oocyst sporozoitetrophozoiteseveral stagesmicro and macro gametesZygote Infect – Cysts Disease - Tachyzoite

Toxoplasma gondii 

SC

Tests- SEROLIGIC IgM, IgG, IgE, IgA antibody – immunofluorescence, ELISA (IgG may be from mother, measure rise),   Giemsa stain - Crescent trophozoites c/ flagella Innoculation of cyst tx into mice

Virulence Factors – Invades gut wall ingested by Mac’sTachyzoites Cysts form in brain, muscle Bradyzoites Remain forever Congenital infection only when mother is actively infected c/ Trophozoites– Prev infection and cysts will not infect fetus Imcpt are asymptomatic CMI

Resevoir/Infected- Domestic cats are host Ingestion of Cysts in undercooked meat (from animals who ate feces) Chorioretinitis (one of leading causes of blindness), Intracranial calcifications

Tx/Pv - Congenital – sulfadaizine+pyrimthamine (Symptomatic or not!!) Dissemination - sulfadaizine+pyrimthamine ***(Also in Imcp’d)*** Acute is self limiting Cook meat thouroughly Keep cats away from preg women

Info- Progression normally inhibited by CMI Usually asymptomatic in Imcpt

Trypanosoma cruzi 

GC

Trypanosoma cruzi 

SC

Tests- Thick and thin films Stained prep of Bone Marrow Special culture Xenodiagnosis - bite from non-infected bug Serology, IDF

Virulence Factors- Amastogotes infect and kill mononuclear cells, Cardiac muscle most frequently and severly infected

Resevoir/Infected- Rural central and S America – Walls composed of Earth/Mud Bite from Reduviid Bug - Kissing Bug Bites @ Eyes and Mouth, or hand-eye transmission Myocardial, glial, RES cells Megaesophagus, Megacolon Tx/Pv - Nifurtimox – kills trypomastigotes Benznidazole

No drug for chronic No vaccine – protect from bites Info- EpimastigotesTrypomastigotes (acute)Amastigotes (acute & chronic)

Most are asymptomatic after 2month acute phase Bug does not deficate while feeding in US

Leishmania donovani 

GC

Leishmania donovani 

SC

Tests- Serology (Not too relaible in cutaneous forms)

Amastogote presence in RES

High IgG is indicative, not diagnostic

Skin test (will be - during active infective)

Virulence Factors – F-O Trophozoites attach to SI – Not Invasive, Potientiated by malnutrition

Resevoir/Infected- Sandfly Vector Infects macrophages, Reticuloendothelial System (spleen, liver and bone marrow  Pancytopenia)

Tx/Pv - Na-stibogluconate - pentavalent antimony cmpd,   Ampho B Bite protection,

Info- Untreated severew disease nearly always fatal,  Black Sickness(hyperpigmentation),    Death d/t Bacerial Infection - Pneumonocc. pneumanea

Cutaneous Leishmania 

GC

Cutaneous Leishmania 

SC

Infect – Promastigote Tests- PCR if available Disease - amastigote

Amastiogotes in smear from lesions Leischmanin skin test + when ulcer forms

Virulence Factors – Same lifecycle as donovani Cutaneous - Red papule @ bite site, slowly enlarges – multi nodules that coalesce Usually heals spontaneously in Imcpt  CMI, but Imcp’d can spread Mucocutaneous – Papule @ bite site, metastatic lesions form @ mucocutaneous jct of nose and mouth. Disfiguring, granulomatous lesions

Heal slowly, if at all. HOST INFLAMM RXN!!!

Resevoir/Infected- Sandfly Vector, Tx/Pv - Na-Stibogluconate, but unsatisfactory Protect from sandfly Info- Lesions tend to become superinfected c/ bacteria

Taenia solium 

GC

Cestode - Tapeworms Worm -

TEANIASIS -- Larvae(eggs)

CYSTICERCOSIS Cestoda (tapeworm)

Taenia solium 

SC

Tests- Finding the gravid proglottids c/ 5-10 branches (T. saginata has 15-20)

Cysticercosis: cysts in tissue , ELISA, but may not detect neurocysticercosis CT, MRI

Virulence/Cycle – Scolex – 4 suckers and circle of hooks 5-10 uterine branches

Taeniasis: Pork c/ larvae(cysticerci), Eaten 3 months grow to adults in SI – 5 meters Eggs detach, pass in feces, eaten by pigs Become cysticeri in PIG muscle

Cysticercosis: Here humans ingest eggs hatch embryos, release oncospheres, burrow to muscle (just like pigs) Disseminates to many tissue, brain –Space occupying lesion

Resevoir/Infected- Asis, S. America Taeniasis – SI Often Asymptomatic Cyst - In brain causes headaches, vomiting, seizures Eyes Tx/Pv - Praziquantel (or albendazole and surgery in cysticercosis) Proper disposal of waste so pigs don’t eat eggs Proper sanitization of water so humans don’t eat eggs

Taenia saginata

(GC)

BEEF TAENIASIS (no cysticercosis)

Cestoda (tapeworm)

Taenia saginata

SC

Tests- Finding the gravid proglottids c/ 15-20 branches (T. solium has 5-10)

Virulence Factors – 4 Suckers, but NO hooks 15-25 uterine branches Ingestion of larvae in beef 3 months grow to adults in SI – 10 meters

Eggs detach, pass in feces, eaten by Cattle Become cysticeri in BEEF muscle

Resevoir/Infected- Africa, S. America Most asymptomatic

Tx/Pv - Praziquantel, Cook beef properly, dispose of waste properly

Schistosoma mansoni, japonicum (GI); haematobium (UT)

GC

BLOOD FLUKE

Trematode (Fluke)

Infect – Cercariae Disease – Eggs/Flukes?

Schistosoma mansoni, japonicum (GI); haematobium (UT

SC

Tests- Characteristic ova (Lat Spine) in feces/urine Eosinophilia Serology unuseful Urinary symptoms

Virulence/Cycle – Adults exist as separate sexes, live attached – continuously fertilizes

masoni: prominent lateral spine AFRICA Inf Mes

vein japonicum: small lat spine ASIA Inf and Sup

Mes vein haematobium: terminal spine AFRICA, MIDDLE EAST each carried by a specific snail fork tailed cercariae invades skin Differentiate to larva(ova) enter blood To liver to form Flukes or to mesenteric veins (masoni and japonicum) or Bladder (haematobium) lay eggs passed in stool/urinehatch in fresh water Infect snails, multiply and exit Produce proteolytic enzymes (eggs) that degrade tissueInflamm response Coat surface w/ host antigens – EVASION

Resevoir/Infected- Snails are intermediate host

Acute Phase: p/ penetration – itching and dermatitis, fever chills, diarrhea, 2/3 wks later, HSMGLY Chronic phase: massive HSMGLY, excessive bleeding morbidity, mortality Eggs in liver form granulomas, hepatosplenomegaly Host immune response – “symmer’s pipstem fibrosis”?

Tx/Pv - Praziquantel Eradication of snails Info- Swimmers Itch in US lakes

Enterobius vermicularis

GC

PINWORM

Perianal Pruritus -- Kiddos!!! 

Nematode

Enterobius vermicularis

SC

Tests- Recovering eggs from skin c/ Scotch Tape Eggs not found in stool, but sometimes worms No serology

Virulence/Cycle – Life cycle confined to humans Ingest eggs, hatch in SI Larvae mature, migrate to colonmate Female exits anus @ night and releases thousands of eggs on perianal skin Eggs quickly develop to larvae and become infectious Reinfection by A-O contact (from itching, say)

Resevoir/Infected- Worldwide – most common helminth in US children <12y/o Perianal pruritus

Tx/Pv - Mebendazole/pyrantel pamoate Only kill worms, not eggsreinfection common No specific prevention

Ancylostoma doudenale and Necator americanus 

(GC)

HOOKWORM

Nematode

Ancylostoma doudenale and Necator americanus 

(SC)

Tests- Larger ovum in stool – (Sort of Looks feces filled) Occult blood in stool Eosinophilia

Virulence/Cycle – Filariform larvae penetrate skin (feet, legs) Itching Feet Travel to lungs, enter alveolibronchitrachea swallowed Mature in SI Attach c/ Cutting plates (necator) or Teeth (ancylostoma) Eggs pass in feces rhabditiform larvae non infectious, feeding – Secretes Anticoagulant filaform larvae infections, non feeding (penetrate skin)

Resevoir/Infected- Worldwide/Tropics/southern states (necator) Durrow into intestinal mucosa Cause diarrhea

Tx/Pv - Mebendazole/pyrantel pamoate Not walking barefoot on soil Proper disposal of sewage Info- Causes anemia – d/t Intestinal Blood Loss – Developmental Probs @ Societal Level unlike T. trichuria

Trichuris trichuria 

(GC)

WHIPWORM INFECTION

Nematode - Geohelminth

Trichuris trichuria 

(SC)

Tests- Barrel shaped eggs “Lemon Shaped” c/ plug at each end in stool Worm has long, whiplike anterior end

Virulence/Cycle – Humans ingest eggs in food/water Eggs hatch and mature in SI Mate in colon, produce thousands of eggs Deposited in soil, grow to embryos

Resevoir/Infected- Worldwide/Tropics/southern states Durrow into intestinal mucosa Cause diarrhea

Tx/Pv - Mebendazole Proper disposal of feces

Info- Do not cause anemia (Hookworms do) Rectal prolapse in heavily infected children Extreme Peristalsis  Malnourishment

Ascaris lumbricoides 

(GC)

ASCARIASIS – (no intermed hosts)

Nematode -- longest- 25cm WORM BALL

Ascaris lumbricoides 

(SC)

Tests- Oval egg c/ irregular surface in stool (Can be seen by patients)

Virulence/Cycle – Humans ingest eggs in food/water --> from soil Eggs hatch in SI, larvae invade gut Travel to lungs, enter alveoli--> bronchi--> trachea-->  swallowed Mature in SI, live on host food Major damage is in larval migration

Resevoir/Infected- Worldwide/Tropics/southern states Lungs- Eosinophilic exudate malnutrition – competing for food

Tx/Pv - Mebendazole/pyrantel pamoate Proper disposal of feces

Info- Ascaris pneumonia can occur (pneumonia c/ eosinophilia)

Trichinella spiralis

(GC)

TRICHINOSIS

Nematode

Trichinella spiralis

(SC)

Tests- Subconjunctival hemmorhage Larvae c/in striated muscle Serologic bentonite flocculation after 3 wks,    Sometimes Eosinophilia

Virulence/Cycle – Humans eat meat w/ infected larvae in cysts - Home prepared sausage, wild game Larvae mature in SI--> release eggs

Eggs travel the BS to Striated Muscle --> Cardiac Encyst here c/in fibrous capsule Can remain here for years (humans are end stage host)

Resevoir/Infected- Worldwide – Eastern Europe/Africa Any mammal, usually pigs are resivoirs Eary diarrhea, fever, muscle pain, periorbital edema - Conjunctivitis Often cardiac/neuro involvement (death rare)

Tx/Pv - No tx, Steroids + mebendazole for severe cases Maybe thiabendazole in early infection Proper food preparation, don’t feed pigs garbage Info- Causes anemia unlike T. trichuria