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parasites - helminths
GI
39
Medical
Graduate
09/09/2010

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Term
how do pts with enterobius vermicularis (pinworms) present?
Definition
anal itching - particularly at night, when the female migrates through the anal canal to deposit her eggs. pts may also be asymptomatic
Term
what is the tx for enterobius vermicularis (pinworms)?
Definition
albendozole or mebendazole (works on all roundworms). the course should be repeated a few weeks later and family members should also be treated.
Term
will enterobius vermicularis (pinworms) show up on a O & P stool test?
Definition
no
Term
are enterobius vermicularis (pinworms) invasive?
Definition
only sometimes, they can travel to the vagina in females commonly
Term
do pts infected with enterobius vermicularis (pinworms) have eosinophilia?
Definition
sometimes
Term
what do the eggs of enterobius vermicularis (pinworms) look like?
Definition
"rugby balls"
Term
what are the modes of transmission for enterobius vermicularis (pinworms)?
Definition
autoinfection by fingernails, contamination of clothing/bedsheets/fomites, and retroinfection
Term
how is anisakiasis (sushi worm) diagnosed?
Definition
endoscopy - 3rd stage larva is seen in the stomach b/c we are just incidental/dead end hosts between small and large fish. (not stool sample).
Term
what do pts with an infection of anisakiasis (sushi worm) present with? how are they treated?
Definition
dyspepsia due to stomach inflammation, sometimes intestinal obstruction. treatment is generally sx.
Term
what kind of infection is trichinella spirallis?
Definition
reportable (along with toxoplasma and cryptosporidium)
Term
how are trichinella spirallis infections transmitted?
Definition
through ingestion of wild game
Term
where in the body are trichinella spirallis infections located?
Definition
skeletal muscle
Term
what are the presenting features of trichinella spirallis?
Definition
periorbital edema, vasculitis, myalgia and eosinophilia
Term
how are trichinella spirallis infections treated?
Definition
albendazole
Term
where are strongyloides stercoralis infections often seen?
Definition
louisiana, kentucky
Term
who are strongyloides stercoralis infections more commonly seen in?
Definition
immune compromised hosts, sometimes AIDS pts, but more often bone marrow transplant pts or malnourished/chronic steroid pts
Term
what is the itchy rash due to strongyloides stercoralis called?
Definition
larva currens (racing larva)
Term
what is used to treat strongyloides stercoralis?
Definition
thiabendazole
Term
can strongyloides stercoralis disseminate? what is the major problem with this?
Definition
yes - and it can carry gram negative bacteria with it, resulting in sepsis/hyperinfection syndrome: bronchopneumonia, enteritis, gram negative sepsis, and meningitis
Term
what is the "thumbprint" sign associated with strongyloides stercoralis?
Definition
periumbilical purpura
Term
what is commonly seen on agar plates with strongyloides stercoralis?
Definition
"winding trails" which are due to the worms dragging and inoculating across the plate
Term
can a strongyloides stercoralis infection last long?
Definition
yes, many years
Term
what is another drug tx for strongyloides stercoralis?
Definition
ivermectin
Term
what is the morphology of trichuris trichiura (whipworm)?
Definition
trichuris trichiura (whipworm) appears long and whip-like and its eggs appear lemon/barrel-shaped
Term
how do pts with trichuris trichiura (whipworm) infections present?
Definition
dysentery, anemia, and *rectal prolapse (due to mechanical pressure of worms in the cecum)
Term
how are ascaris lumbricoides infections transmitted?
Definition
foot contact with nightsoil
Term
how can pts with ascaris lumbricoides infections present?
Definition
pancreatitis, jaundice, volvulus, intussusception
Term
what is the loeffer's syndrome associated with ascaris lumbricoides infections?
Definition
the ascaris lumbricoides larvae may migrate through the lungs and induce fever, cough, dyspnea, wheezing, and migratory infiltrates
Term
what is tx for ascaris lumbricoides?
Definition
mebendazole
Term
what are the dilated bowel loops due to ascaris lumbricoides infections called?
Definition
the spaghetti sign
Term
what do pts with necator americanus & ancyclostoma duodenale (hookworms) present with?
Definition
ground itch (when larva penetrate the skin to enter the body), iron-deficiency anemia (due to blood sucking), edema, and dyspnea
Term
what is tx for necator americanus & ancylostoma duodenale (hookworm)?
Definition
mebendazole, albendazole, and ferrous sulfate
Term
what tapeworms (cestodes) are found in pork?
Definition
taenia solium
Term
what tapeworms (cestodes) are found in beef?
Definition
taenia sagginata
Term
what tapeworms (cestodes) are found in fish?
Definition
diphyllobathrum latum - common in scandinavian countries
Term
what is neurocysticercosis?
Definition
new-onset epilepsy as a result of tapeworm infection - most commonly caused by taenia solium
Term
what is one of the presenting symptoms of pts infected with tapeworms?
Definition
tenesemus
Term
what are cestode infections treated with?
Definition
praziquantel
Term
what are cysticerci? how do they appear?
Definition
tapeworm cysts - which can appear as bumps in skin or nodules on x-ray
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