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; M2 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

in feces = light worm,
>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)
Weingartens
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

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
<13 lateral branches; 3m
Taenia
Saginata

Miracidium
present in
The egg once
Deposited by
adult
Metacercaria

oral sucker with collar of

spines; 2 lobed testes in
tandem, reddish-grey

indistinguish
from each
other and from
E. granulosus;
hexacanth (6
hooklets);
radially
striated shell

complement
fixation
Unmebryo
Eggs in feces

eggs cause
cysticercosis
Cysticercous
bovis

Snail Miracidia (M)

Cercaria (C)
Antemelania
Asperta;
Antemelania
Dactylus
Snails
MC
Segmentina,
Hippeutis

Unembryo
Eggs in stool
Using
Kato-Katz
method

Small
Intestines
Reservoir
Fish eating
mammals

Snails :
Freshwater,
Brackish or
Marine

2ND INT
HOST

Crabs
Sundathelphusa
Philippina

Unembryo
Eggs in
feces

Small
Intestines

Aquatic
Vegetation
C meta-C
Water caltrop,
Water chestnut,
Water morning
Glory, lotus
Many fish in the
Phil. (30
Species); in
muscles at base
of the fin

MC

Reservoirrats
Ripe or gravid
Proglottid

Small intestines
of man

formaldehyde
soln

cysticercosis
in muscles

Hogs, wild
Boars, sheep,
Deer, dogs,
Monkeys, rats,
cats
eggs
cysticercous
cellulosae

Scolex after
therapy
Ripe or gravid
Proglottid

Snails:
-Gyralus
Convexlusculus
-Hippeutis
Umbilicalis
MC

Man SI
(accidental)

Cattle, llama,
Giraffe,
Carabao
eggs
cysticercous
bovis

PATHOLOGY

MOT

Granulomatous
rxn in lungs; rustcolored sputum,
w/ Foul fish Odor

Ingestion
Of Infected
crustaceans

PHIL

Tx

Yes

Praziquantel

Asia

Bithionol
Triclabendazole

C meta-C

C meta-C

Scolex after
therapy

no rostellum, hooklets
ripe >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
Angularissuso
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
<8%

Sparganosis

Spirometra

Plerocercoid
In toads,
frogs, snakes,

Mansoni,
Erinacei,
Ranarum

White larvae
In lesion

paratenic
hosts - pigs

Adult
Intestines of
Cat/man

Cyclops,
copepods

Frogs,
Snakes,
Toads, rats

Larvae
any part, eye,
subQT,
muscles

mistaken for D. latum;

pseudosegmentation w/
slit-like invagination

Painful edema
Due to migrating
Larvae
Eosinophilia,
Edema and
erythema

Ingestion
Of
Infected
interM
hosts

Not sure

surgical

- COPYRIGHT 2005 - AUDS MARTINEZ

- USTMED SEC C 07 -

PARASITE

Entamoeba
Histolytica

Naegleria
fowleri

A.K.A.

CYST

TROPHOZOITE

Ameba

Qudri cysts

greenish-yellow
quadrinucleate,
thick, rodlike
chromatoidal bodies
CB, central karyosome
(K), w/ chromatin dots
No cyst only
Flagellated form

Large, usually Central K

active, progressive,
directional;
pseudopod PSD:
finger-shape,
hyaline; w/
ingested RBC

Entamoeba
coli

yellow-brown; 1-8
nuclei, K eccentric;
CB : splinter-like

sluggish, rarely prog

and dir; PSD: short,
blunt; Bacteria/
debris Inclusions
Mod active, prog
PSD : blunt, hyalin

-Trophozoites
In liquid stools
-Cysts in
Formed stools

Large
Intestines
(cecal and
sigmoidorectal)

ELISA most
Sensitive indicator
Trophozoites
In CSF and tissue

liver in
extraint
amebiasis
Brain

INT
HOST

2ND INT
HOST

PATHOLOGY

Flasklike Primary ulcer;

Histo changes:
Histolysis, Thrombosis,
Petechiae, Round
Cell Infiltration, Necrosis

Cysts and Trophs

inTissue
Giemsa or PAS of
Scrapings or
Cornial biopsy

CNS
cornea

MOT

Ingestion
Of
Infective
cysts

PHIL

Yes
Most
Common
Are
Asympto
carriers

Bacilliary vs
Amebic dysentery
Meningoencephalitis
Severe frontal
Headache,Blocked nose,
Altered taste and smell
Kernigs sign; Leukocytosis
w/ neuts, prot, glu

trophozoite

large central K;
double cell wall

HOST LOC.

Flagellate form in
CSF

slug-like;
PSD: blunt;

sluggish; PSD: spinelike

No peripheral chrom

DIAGNOSTIC

Culture, serology
to detect invasive
Amebiasis (IHAT)

Trophozoite

Acanthamoeba

Entamoeba
Gingivalis

INFECTIVE

Amebic Encephalitis
(immunocompromised)
Amebic Keratitis
(assoc w/ use of
contam contact lenses)

EntersThru
Nose
Penetrate
Cribriform Plate
Multiply in
brain
Thru
Lower respi
Tract or
Thru ulcerated,
Broken skin

Tx

Supportive,
Chemotherapy
Asympto
Diiodohydroxyquin
Mod severe
Metronidazole

rare

Severe D + M
Hepatic M + emetine
Amphotericin

all types
of soil

Amp + miconazole and

rifampicin

Rare

Propamidine,
Miconazole, neomycin

All types
Of soil

Corneal grafting

Endolimax
nana
pale green;
1-4 nuc; K irreg
CB : bacilliform

sluggish prog; PSD:blunt

/hyaline; K L, cent

1 nuc
yellow green; K surr
w/ granules; endosome

slug, prog;
PSD : Blunt/Hyaline

1-4 nuc;
K small/Central;
Diffuse glyco mass

non prog;
PSD : fingerlike

Iodamoeba
butschlii

Entamoeba
hartmanii

PARASITE

A.K.A.

CYST

TROPHOZOITE

Balantidium
Coli
Largest
prot parasite
Only ciliate
Giardia
Lamblia

INFECTIVE

cyst

bean-shaped nuc

cytostome; cytopyge;

gay
bowel
syn

Quadri
cysts

young 2 nuc;
mature 4 nuc;
flagella retracted
into axonemes
No cyst stage

Trichomonas
vaginalis

pyriform/tear-drop;
bi-symm; erratic
tumbling motion; 8 flag
Troph

No known cystic
stage

DFS of
Troph and
Cysts in
Feces
Sigmoidoscopy
DFS Cysts and
Trophs
Biopsy,
Entero-test,
IF and antigen
detection

pyriform; jerky
movements; 4 free
flag +1 undulating; axos
Dientamoeba
Frgilis

DIAGNOSTIC

Troph

HOST LOC.

INT
HOST

Old
World
Cut
Leish

w/ ovoid or
rounded bodies

Ulcer w/ rounded
Base and wide
Neck (vs flask shape)

LI (cecal
area) troph
SI
Duo, jeju,
upper il

Diarrhea and Dysenter

(indisting. from Amebic)
Villus flat and crypt
Hypertrophy;electrolytes,
glu, fluid abs,
disacchs; diarrhea
most common symptom
(89%); spont recovery in
6 wks; chronic steato,
diarr altern w/ constip
-Vaginal discharge
Liquid, green to yellow,
Irritating
-Speculum Strawberry
Cervix (diagnostic)
-Vaginitis; urethritis

Attaches
To int villi
Via adhes
Disc on ven

Trophozoites
In urine,
Urethral sec,
Vaginal sec,
Cervical sec,
Semen,
Prostatic sec

Female
Vaginal epi

Binucleate
Trophs in fresh
Stool samples

In lumen
Of LI

Male
Urethra,
Epididymis,
Prostate g

-Increase excess mucus

-Hypermotility of the bowel

MOT

in skin tissue
biopsy

Lives
Intracellular
In
Macrophages

Sand fly
Pheobotomus
Spp

-Mimics IBS (irrit bow syn)

Cutaneous leishmaniasis
Lesions resembling
Lepromatous leprosy

PHIL

Tx

FOR

Siguro

Tetracycline

Ingestion of
Contam Food
And water

Uncommon
In Temperate;
Assoc w/
Pigs in tropics
siguro

Metronidazole

FOR

Outbreaks
Are waterborne

Sexual
intercourse
Passed thru
Birth canal

Yes
Hostpitality
Girls 24%

Iodoquinol
Oral
Metronidazole
Tinidazole
Furozolidone
Quinacrine
paromomycin
Oral
Metronidazole
Acid douches

Other groups
- 3-8%
Co-infection
With
E. vermicularis

-Colicky ab pain; anal

Pruritis; Peripheral
eosinophilia
Pro M

promastigote

PATHOLOGY

SI
Cysts
Troph

rosette-shaped nuclei;
no peri chromatin; K
w/ 4-6 granules; no flag
Leishmania
Tropica

2ND INT
HOST

Bite of
Sandly vector

Siguro

Iodoquinol

as long as
may infection
w/ E. vermic
-in pre-schools
in Germany,
Israel, Holland
Wala

Tetracycline

Africa, India
South amercia

Metronidazole

Antimony
Compounds

Leishmania
Donovani

1 free flagella
arising from kinetoplast

Bone marrow,
Spleen or
Lymph nodes

Pro M
A-Mast

amastigote
Leishmania
Braziliensis

New
World
Cut
Leish

knob-

like prod, LemonS

PARASITE

Trypanosoma
Gambiense

Trypanosoma
Rhodesiense

Trypanosoma
Cruzi

A.K.A.

Smaller and longer than

T. vaginalis
spiral
forW;
3 ant
flag +
1

CYST

West
African
Sleepng
Sicknes
East
African
Sleepng
Sicknes
Chagas
Disease

Visceral Leishmaniasis or
Kala-azar

A-Mast
Pro M in
gut of fly

Troph

swabbing

cysts

Cysts in
Semi-formed
Stools;
Trophs in
Liquid stools

Mucocutaneous or
American Leishmaniasis
Tapir nose
Erosion of pinna of forest
workers

Oral cavity
-tartar
Cecal region
Of LI

TROPHOZOITE

INFECTIVE

DIAGNOSTIC

Trypomastigote

T-mastigote

Parasite in
Blood tissues
Or CSF

HOST LOC.

In blood,
Lymph and
CSF

ELISA, IF

Toxoplasma
gondii

Trypomastigote

(cat?)

(man)
bradyzoite, cyst
male and female
gametocytes
Isospora
Belli

Schizont, gametes
Inside host

immature cyst

T-mastigote

Blood smear

Droplets,
kissing
FOR

yes
Rare
<1%

Serology for
Large scale
Screening

Epimastigote

Second line
Drugs:
Amp B,
Pentamidine
(Kala-azar),
Metronidazole
Nifurtimox

Splenomegaly, presence of
Parasites in RE cells;

Serology
For supportive
diagnosis

amastigote
Trichomonas
Tenax
Chilomastix
Mesnili

PMS and
Endothelial
Cells

Serology CF
Xenodiag
biopsy

Histiocytes
RE cells
(adipose,
myocardial,
RE, Neuroglial)

pseudocyst
and oocyst w/
Sporozoites
-Oocyst prod
By sexual
Cycle in cat;
Pseudocystsasexual

Serology
IgM detection
By ELISA;
IFA for IgG
And IgM; PCR
Of Toxo DNA

In SI of
Cat (sexual
And asexual
Cycle); in
Tissues in
Asexual cycle

Mature oocyst
w/ sporozoites

Immature
Cysts in feces
-Oocysts/
Sprorcysts in
dudenum

Definitive CAT
SI of man
Definitive
MAN

INT
HOST

Tsetse Fly
Reservor
Host:
Domestic
Animals
Tsetse Fly
Reservor
Host: Game
animals
Reduviids,
Triatomid
Bugs
Reservoir:
Wild
mammals
Mouse or
Rat
Man, pigs,
Sheep,
Accidental
Intermediate
hosts

2ND INT
HOST

PATHOLOGY

Local Infiltration from

bite area to lymph and
CNS
-Chronic inflammation
Of lymphatics
-Atrophy of dendrons
Of ganglion cells
-Winterbottoms sign,
Kerandels sign
-Engulfed by histocytes
and invade adipose
tissue
-inflamm response w/
fibrotic encapsulation
= chagoma; Romanas sign
Brain lesions; hepatitis;
Chorioretinitis;
Lymphadenitis

MOT

Bite of
Vector
Congenital
Transmission
possible

-Bite of Vector
-feces
-transplacental
-accidental
ingestion
-blood trans
Ingestion,
Transplacenetal

FOR

Tx

Supportive

West and
Central
Africa

Pentamidine
Suramin
Melarsopenol
Tryparsamide
Melarsen

NO
Uh..east
Africa?
No
Income
Groups In
Suburban
rural
Yes

8-amino
quinolones

Many are
Chronic
Ill but are
asympto

Primaquine,
Nifurtomax
(Bayer 2502)
Pyrimethamine
(Daraprim),
TrisulfapyriMidines; Preg
spiramycin,
Clinamycin;
AIDS
Atovaquone

Not sure

Pyrimethamine

Cosmo

2 types of postnatal ds
1) mild lymphatic (lide
infectious Mononucleosis)
2) acute fulminating
Malabsorption syndrome;
Shortened villi, hyperTrophied crypts, infilt
Of lamina propria, w/
Eosins, polys, rounded cells

PHIL

NO

Sulfadiazide or
Trimetroprim

Pneumocystis
Carinii

Surgical open
Lung biopsy;
BronchoAlLav;
Bronchoscopy;
Methenamine
Silver stain

cysts
GAMETE
Plasmodium
Falciparum

Plasmodium
Vivax
Plasmodium
Malariae

Plasmodium
Ovale

SCHIZONT

interstitial pneumonia;
fatal pneumonia in infants;
hypogammaglobulinemia,
leukemia, Hodgkins, etc
-lungs are gray and airless;
death due to asphyxia

Droplets,
Close contact

Yes

Bactrim

cosmo

TROPHOZOITE
Mosquito
Gametocytes;
Man
Sporozoites

Peripheral
Blood smears
-thick
-thin

RBC (Man)
Vivax young
Malariae old
Falciparum all

Anopheles
Flavirostris
Minimus

Hypnoxoite
Latent stage,
Cause relapse

QBC, Para
sight F test
(dipstick test),
IFA

Mosquito :
1)Stomach
Gamete form,
2)Stomach
wall oocyst
and sporozoite
release
3)salivary
glands - sporo

Anopheles
-litoralis
-balabacensis
-mangyanus
-maculates

Sporogany
Mosquito LC;
Schizogony
Human LC
- exoerythro
(merozoites)
- erythro
(gametocytes)

-Tissue anoxia basic pathophysio

change in malaria
-4 mechanisms leading to tissue anox:
1. anemia-hemolysis 2. changes in
blood flow 3. changes in capillary
endothelium 4. histotoxic shock
-parasite virulence factors:
1. multiplication capacity 2. red cell
selectivity 3. cytoadherence and
resetting ability 4. potential to
induce cytokine release 5. antigenicity
6. antimalarial drug resistance
Blackwater fever, liver dys, hypogly,
Acidosis, GI dys, placenta dys, pulmo
edema, renal failure, coagulo and
thrombocyto, coma

Bite of female
Mosquito
Passage of
Blood w/
Erythrocytic
Parasite by:
-blood trans
-contam syringe
-neonatal
-congenital

Yes
Malaria
Free areas
-manila
-aklan
-capiz
-guimara
-siquijor
-biliran
-iloilo
-leyte N
-leyte S
-N Samar
-Camiquin
-Cebu
-Catand.

Vivax and Ova

Chloroquine +
Primaquine
Falci and Mal
-Chloroquine
Chloroquine
Resistant
Falc