Term
|
Definition
Fungus
Tissue sample: irregular broad hyphae, aseptate, 90* branching, ribonny
Culutre: lid-lifter, sporangia with conidia inside, rhizoids between sporangia bases |
|
|
Term
| Absidia diagnosis and treatment |
|
Definition
Dx: Culture (lid-lift, sporangia with rhizoids between bases)
Tx: treat underlying IMC, surgical debridement, AmpB + Caspofungin or prosaconazole + caspofungin |
|
|
Term
|
Definition
Mucormycosis
Rhinocerebral: DM with ketoacidosis
Pulm/systemic: transplant pts |
|
|
Term
| Absidia virulence factors |
|
Definition
necrotic tissue around inflammation
angioinvasive |
|
|
Term
|
Definition
| facultative parasite, small, free-living amoeba, soil and water |
|
|
Term
| Acanthamoeba diagnosis and treatment |
|
Definition
Dx: trophozoites in CSF, H&E in fixed tissue, Culture on water agar, Corneal scraping stains, Immunofluoro Ab
Tx: combination Rx, problematic |
|
|
Term
|
Definition
Eye entrance: severe keratitis
Nasal entrance: granulomatous amebic encephalitis, disseminates in IMC
Skin Entrance: granulomatous amebic encephalitis, dissem disease or skin lesion in IMC |
|
|
Term
|
Definition
| cysts mature in water to trophozoites, cysts or trophozoites can enter human (eye, nasal passage, or broken skin) |
|
|
Term
Acylostoma caninum, Ancylostoma braziliense, Unicaria stenocephala
biology |
|
Definition
|
|
Term
Acylostoma caninum, Ancylostoma braziliense, Unicaria stenocephala
pathogenesis and presentation |
|
Definition
larvae wonder about in subcutaneous tissue
Cutaneous larva Migrans
Significant inflammation and painful swelling, itching that can lead to 2* infection |
|
|
Term
| Alternaria, Curvularia, Bipolaris biologies |
|
Definition
Dematiaceous fungi
Pigmented (brown), septate hyphae, sometimes yeast, visible in H&E stain of tissue |
|
|
Term
| Alternaria, Curvularia, Bipolaris disease |
|
Definition
Sinusitis that can lead to brain abscesses
If presents like aspergillis = poor prognosis (i.e. lung, liver or brain involvement with bloody sputum, vascular invasion, infarctions) |
|
|
Term
| Alternaria, Curvularia, Bipolaris epidemiology |
|
Definition
traumatic wounds and lacerations
IMC |
|
|
Term
| Alternaria, Curvularia, Bipolaris virulence factors |
|
Definition
|
|
Term
| Ancylostoma duodenale (Hookworm) biology |
|
Definition
Helminth, nematode, intestinal
small, characteristic TEETH, multi-cell, visible to naked eye, cuticular, roundworm, extracellular |
|
|
Term
| Ancylostoma duodenale (Hookworm) diagnosis and treatment |
|
Definition
Dx: ID in feces
Tx: Mebendazole or albendazole |
|
|
Term
| Ancylostoma duodenale (Hookworm) disease |
|
Definition
Asymp unless high number
Ground itch: skin penetration, 2* infection
Pulmonary: cough, wheeze, fever
Intestinal: worms attach to mucosa and feed on blood, cont. move to new areas, exacerbated blood loss, iron deficiency |
|
|
Term
| Ancylostoma duodenale (Hookworm) life cycle |
|
Definition
| lay egg (passed in feces), hatch in environment, larvae stage grow and shed cuticule layers, penetrate skin, larvae enter blood and go to heart, leave circulatory system in alveoli, larvae move up trachea and are swallowed, mature to adults in intestine, male and female mate, lay eggs, repeat |
|
|
Term
| Ancylostoma duodenale (Hookworm) transmission |
|
Definition
| Trans: skin penetration, indiscriminate disposal of human waste |
|
|
Term
| Ascaris lumbricoides biology |
|
Definition
Helminth, nematode, intestinal
Very large, ant. end has 3 lips, multi-cell, visible to naked eye, cuticular, roundworm, extracelluar |
|
|
Term
| Ascaris lumbricoides diagnosis and treatment |
|
Definition
Dx: ID in feces or larvae in sputum
Tx: Mebendazole or albendazole |
|
|
Term
| Ascaris lumbricoides disease |
|
Definition
Asymp unless high number
Pulmonary: cough, wheeze, fever, eosinophilia
Children under 10: intestinal obstruction, fever, diarrhea, vomit, penetration of bile duct and liver by adult worms, peritonitis (perforation of intestinal wall) |
|
|
Term
| Ascaris lumbricoides epidemiology |
|
Definition
Most common parasitic helminth in world
Assoc. w/ poor sanitation |
|
|
Term
| Ascaris lumbricoides life cycel |
|
Definition
male and female mate, lay eggs which embryonate in soil, larvae stages grow and shed cuticle layers, mature into adults, repeat
Eggs are sensitive to sun but otherwise environmental resistant |
|
|
Term
| Ascaris lumbricoides pathogenesis |
|
Definition
| infective eggs are swallowed, hatch in small intestine, L3 larvae migrate to hepatic portal, larvae enter lung and alveolar spaces causing cough, coughed up larvae are swallowed, larvae reach SI 2nd time, mature into adults and mate, lay unembryonated eggs, passed in feces, embryonate in soil, repeat |
|
|
Term
| Ascaris lumbricoides virulence factors |
|
Definition
| Eggs can live in human for up to 2 years |
|
|
Term
| Aspergillis flavus biology |
|
Definition
Fungus
Tissue sample: narrow septate hyphae, 45* branching
Culture: grow at 25*C, 24-48hrs, narrow septate hyphae, few aerial, granular, "FRUITING HEAD"; yellow/brown, CONIDIA ARE CIRCUMFERENTIAL ON VESICLE |
|
|
Term
| Aspergillis flavus diagnosis and treatment |
|
Definition
Asthma: sputum culture, wheezing, infiltrates, eosinophils
Fungus ball: chest X-ray or CT
Disseminated: sputum culture |
|
|
Term
| Aspergillis flavus disease |
|
Definition
Allergic: IgE mediate
Fungus ball: overgrowth in existing lung cavity, not invasive, tangled mass of hyphae
Disseminated: IMC pts, spreads to lung/liver/brain/anywhere, vascular invasion and destruction, causes INFARCTIONS |
|
|
Term
| Aspergillis flavus treatment |
|
Definition
Voriconazole
or AmpB, itraconazole or caspofungin |
|
|
Term
| Aspergillis flavus virulence factors |
|
Definition
Elastase - vascular invasion
Aspiration can cause astham |
|
|
Term
| Aspergillis fumigatus biology |
|
Definition
Fungus
Tissue sample: narrow hypahe, septate, 45* branching
Cutlure: grow at 25*C, 24-48hrs, narrow septate hyphae, few aerial, granular; FRUITING HEAD (aspergillum), green/brown, conidia COVER ONLY 1/2 VESICLE;
Killed by cyclohexamide (no mycobiotic culture growth) |
|
|
Term
| Aspergillis fumigatus diagnosis |
|
Definition
Allergic: sputum culture, wheezing, infiltrates, eosinophils
Fungus ball: chest X-ray or CT
Disseminated: sputum culture |
|
|
Term
| Aspergillis fumigatus disease |
|
Definition
Allergic: IgE mediated
Fungus ball: overgrowth into existing lung cavity, not invasive, tangled mass of hyphae, BLOODY SPUTUM, most severe in IMC
Disseminated Aspergillosis: IMC pts; spreads to lung/liver/brain/anywhere, vascular invasion and destruction, causes INFARCTION, bloody sputum |
|
|
Term
| Aspergillis fumigatus treatment |
|
Definition
Voriconazole
or AmpB, itraconzole, caspofungin |
|
|
Term
| Aspergillis fumigatus virulence factors |
|
Definition
elastase - vascular invasion
Aspiration can cause asthma |
|
|
Term
| Aspergillis niger biology |
|
Definition
Fungus
Tissue sample: narrow septate hyphae, 45* branch
Cutlure: grow at 25*C, 24-48hrs, narrow septate hyphae, few aerial, granular, FRUITING HEAD, black dots on white background, conidia are CIRCUMFERENTIAL |
|
|
Term
| Aspergillis niger diagnosis |
|
Definition
Allergic: culture sputum, wheezing, infiltreates, eosinophils
Fungus ball: chest x-ray or CT
Diseeminated: sputum culture |
|
|
Term
| Aspergillis niger disease |
|
Definition
Allergic: IgE mediate
Fungus ball: overgrowth in existing lung cavity, not invasive, tangled mass of hyphae
Disseminated: IMC pts; spreads to lung/brain/liver/anywhere, vascular invasion and destruction causes IUNFARCTION |
|
|
Term
| Aspergillis niger treatment |
|
Definition
Voriconazole
or AmpB, itraconazole, or caspofungin |
|
|
Term
| Aspergillis niger virulence factors |
|
Definition
Elastase - vascular invasion
Aspiration can cause asthma |
|
|
Term
|
Definition
| apicomplexan parasite, piroplasm |
|
|
Term
| Babesia microtti diagnosis and treatment |
|
Definition
Dx: parasites in blood smear
Tx: clindamycin + quinine |
|
|
Term
|
Definition
1-4wk incubation with malaise
Occasional hemolytic anemia and renal failure |
|
|
Term
| Babesia microtti epidemiology |
|
Definition
Endemic in NE seaboard of US
Increased risk: asplenia, IMC and elderly |
|
|
Term
|
Definition
Vector: deer tick
Also blood transfusion transmission |
|
|
Term
| Blastomyces dermatitidis biology |
|
Definition
Dimorphic fungus
Mold at 25* (nature), slow growth, LOLLIPOPS conidia
Yeast at 37* (body)
Intra or extracellular
Thick cell wall, double refractile, BROAD-BASED BUD
Mixed purulent PMNs and granulomas |
|
|
Term
| Blastomyces dermatitidis diagnosis and treatment |
|
Definition
Dx: PNA-FISH or PCR, broad based buds
Tx: AmpB if disseminated, fluconazole, intraconazole |
|
|
Term
| Blastomyces dermatitidis disease |
|
Definition
| Blastomycosis: cutaneous ulcers or pustules (may mimic melanoma), pulmonary disease with dissemination |
|
|
Term
| Blastomyces dermatitidis epidemiology |
|
Definition
probably water, soil, vegetation sources
Endemic in Midwest and SE U.S. |
|
|
Term
| Blastomyces dermatitidis virulence factors |
|
Definition
| reactivation possible with new IMC status |
|
|
Term
|
Definition
Fungus
White, round to oval hyaline, budding yeast, PSEDUOHYPHAE, Germ tubes
Culture: grow at 25* or 37*C within 24hrs, grow on blood agar |
|
|
Term
| Candida albicans diagnosis |
|
Definition
KOH prep, silver stain, or blood culture
PSEUDOHYPHE, germ tube
(positive test does not mean this is the causitive agent) |
|
|
Term
|
Definition
Mucocutaneous: thrush, oral and vaginal most common, relies on adherence to mucosa
Cutaneous: common on skins of fat folds
Systemic: multiple organ involvement, fungemia, mostly IMC pts |
|
|
Term
| Candida albicans epidemiology |
|
Definition
Pregnant with hx of yeast infection
Cystitis with hx of bladder infection
Increased risk: DM, cancer+chemo, braod-spec Abx, AIDS, urinary or vascular catheters
3rd most common cause of blood infection
1st or 2nd most deaths of blood infections |
|
|
Term
| Candida albicans treatment |
|
Definition
Superficial: topical clotrimazole or miconazole
Oral: nystatin
Life-threatening: AmpB, voriconazole, itraconazole
Blood: FLUCONIZOLE |
|
|
Term
| Candida albicans virulence factors |
|
Definition
| NF through GI tract (thus broad Abx creates opportuinity) |
|
|
Term
|
Definition
Fungus
Tissue sample: round to oval hyaline, budding yeast, GERM TUBE
Culture: grow at 37* or 25*C within 24hrs, grows on blood agar |
|
|
Term
| Candida glabrata diagnosis |
|
Definition
KOH stain, silver stain
Germ tubes
presence does not mean causative |
|
|
Term
|
Definition
UTI and torulopsis
Can disseminate in IMC |
|
|
Term
| Candida glabrata treatment |
|
Definition
Superfiicial: topical clotrimazole or miconazole
Oral: nystatin
Life-threatening: AmpB, voriconazole, itraconazole
Blood: MICAFUNGIN |
|
|
Term
| Cemix hemipterus biology and disease |
|
Definition
|
|
Term
| Clonorchis sinensis biology |
|
Definition
Helminth, platyhelminth, trematodes/fluke, visceral
multicell, extracell, visible to naked eye |
|
|
Term
| Clonorchis sinensis disease site |
|
Definition
|
|
Term
| Coccidiodies immitis (posadasii) diagnosis and treatment |
|
Definition
Dx: DNA probe, Immunodiffusion, complement fixation, skin test (useless in endemic regions)
Tx: AmpB, itraconazole, or voriconazole |
|
|
Term
| Coccidioides immitis (posadasii) biology |
|
Definition
Dimorphic fungus
Mold at 25* (nature)
Yeast at 37* (body)
Tissue sample: spherules/sporangia that have endospores within
Culture: slow growth at 25*, fluffly white or dermatophyte mold, BARREL-SHAPED artrhoconidia, No yeast grow-able in lab |
|
|
Term
| Coccidioides immitis (posadasii) disease |
|
Definition
Coccidioidomycosis: pulmonary is asymp in 60% of cases, 1-2% get disseminated disease
A (-) skin test + high titer Abs -> poor prognosis |
|
|
Term
| Coccidioides immitis (posadasii) epidemiology |
|
Definition
Endemic in SW US (San Juan Valley, Phoenix)
Dust storms, migrant workers, farmers, military
Highly contagious in lab |
|
|
Term
| Coccidioides immitis (posadasii) virulence factors and transmission |
|
Definition
reactivation possible with new IMC status
Endospores are the infectious agent
Trans: aerosols of endospores, desert soil related |
|
|
Term
| Cryptococcus gattii biology |
|
Definition
Fungus
Tissue sample: narrow-based budding yeast with halo, India ink, mucin stains wall/capsule, GMS and Giemsa
Culture: slimey colonies, 48-72 hrs, killed by cyclohexamide, Urease(+), melanin produced on bird seed/niger seed agar |
|
|
Term
| Cryptococcus gattii diagnosis and treatment |
|
Definition
Dx: India ink, Latex agglutination
Tx: AmpB or fluconazole or voriconazole; if meningitis: 5-FC b/c better CSF penetration |
|
|
Term
| Cryptococcus gattii disease |
|
Definition
Early: pulmonary, cough, weight loss
Followed by: Fungemia
Then: Meningitis w/ headache, vomit, nuchal rigidity (neck stiffness), 100% fatal w/o treatment
Disseminates mostly in IMC pts |
|
|
Term
| Cryptococcus gattii epidemiology |
|
Definition
| soil enriched with pigeon droppings |
|
|
Term
| Cryptococcus gattii virulence factors and transmission |
|
Definition
little tissue inflammation
trans: aerosols, resp |
|
|
Term
| Cryptococcus neoformans biology |
|
Definition
Fungus
Budding yeast with capsule (India Ink)
Tissue sample: narrow-based budding yeast with halo, mucin stains wall/capsule, GMS and Giemsa stains
Culture: slimey colonies 48-72hrs, killed by cyclohexamide, Urease(+), melanin production on niger seed/bird seed agar |
|
|
Term
| Cryptococcus neoformans diagnosis and treatment |
|
Definition
Dx: India Ink, Latex agglutination
Tx: AmpB or fluconazole or voriconazole; if meningitis: 5-FC b/c better CSF penetration, keep txing until CSF is clear |
|
|
Term
| Cryptococcus neoformans disease |
|
Definition
Early: pulmonary, cough, weight loss
Followed by: Fungemia
Then: Meningitis w/ headache, vomit, nuchal rigidity (neck stiffness), 100% fatal w/o treatment
Disseminates mostly in IMC pts |
|
|
Term
| Cryptococcus neoformans epidemiology |
|
Definition
| soil that is enriched with pigeon droppings |
|
|
Term
| Cryptococcus neoformans virulence factors and transmission |
|
Definition
little tissue damage
Trans: aerosols, resp. |
|
|
Term
| Cryptosporidium parvum biology |
|
Definition
| Apicomplexan parasite, zoonotic, intracellular/extracytoplasmic, asexual and sexual repro, oocysts are product of sexual (GI tract) and are infectious agent |
|
|
Term
| Cryptosporidium parvum diagnosis and treatment |
|
Definition
Dx: oocysts in stool, Kinyoun acid fast stain, IMF microscopy, PCR for species
Tx: Otherwise healty-support, rehydrate; IMC-nitazoxanide (also for otherwise healthy kids), paromomycin (high tox) and HAART |
|
|
Term
| Cryptosporidium parvum disease |
|
Definition
3-10d incubation
Otherwise healthy: freq. watery diarrhea, nausea, vomit, abdominal cramps, low-grade fever, last 1-2wks
IMC pts: severe, persistent diarrhea (life-threatening), disseminates to liver and pancreas (cholangiohepatitis/cholecysitis/choledocthitis/pancreatic); profound disruption of mucosal surfaces -> fibrosis/cellular infiltration/crypt abscessation |
|
|
Term
| Cryptosporidium parvum transmission, virulence factors and pathogenesis |
|
Definition
Trans: antrhoponosis (daycare, nosocomial, fecal-oral); zoonosis (deer, swine, cat, dogs, fecal-oral); waterborne (swimming pool, resist chlorine); foodborne
VFs: large number oocysts in feces
Path: live in brush border of intestine |
|
|
Term
| Diphyllobotrhrium latum biology |
|
Definition
Helminth, platyhelminth, cestode/tapeworm
multicell, extracell, visible to naked eye
proglottids and scolex |
|
|
Term
| Diphyllobotrhrium latum cycle |
|
Definition
| embryos ingested, develops to adult hood, adult can live for several decades, eggs and gravid proglottids released in feces, eggs hatch in water, embryos eaten by FISH and develop to larval stages, FISH ingested by human |
|
|
Term
|
Definition
Helminth, nematode, tissue
multi-cell, extracell, roundworm, visible with naked eye, cuticular |
|
|
Term
| Dracunuculus life cycle and transmission |
|
Definition
male and female mate, lay eggs, hatch to larvae, larvae grow and shed layer, mature to adults, repeat
trans: ingestion |
|
|
Term
Entamoeba histolytica biology
(type, motility, reproduction) |
|
Definition
Amitochondridate parasite, amoeba
no mitochondria, motile, shape shifters
Cysts and trophozoites |
|
|
Term
| Entamoeba histolytica disease |
|
Definition
Amebiasis: intermittent diarrhea with blood and mucus, vomit, cramps, ulcers, colitis, colon perforation
Extraintestinal amebiasis: penetration of muscularis mucosa, 2* lesions anywhere (mostly liver abscess), fasting growing, acute or chronic, gradual or sudden onset, risk of rupture, responds well to drugs |
|
|
Term
| Entamoeba histolytica dx and tx |
|
Definition
Dx: identify cyst or trophozoites in stool or tissues, serology in invasive disease
Tx: Asymp - iodoquinol, Mild to severe - MNZ followed by iodoquinol |
|
|
Term
| Entamoeba histolytica transmission and pathogenesis |
|
Definition
Trans: contaminated food/water, anthropoeisis (only humans)
Path: colonize colon, reproduce, trophozoites invade mucosa, grow lengthwise due to muscularis mucosa blocking, can invade past sometimes and get to liver, encystation in colon |
|
|
Term
| Entamoeba histolytica virulence factors |
|
Definition
adhere to host cell membranes, contact-dependent cytotoxicity
can live in environment for 9-30days
fairly resistant to chlorine |
|
|
Term
| Enterobius vermicularis (Pinworm) biology |
|
Definition
Helminth, nematode, intestinal
Multi-cell, visible to naked eye, cuticle, extracellular, roundworm |
|
|
Term
| Enterobius vermicularis (Pinworm) diagnosis and treatment |
|
Definition
Dx: ID in feces, Scotch tape test
Tx: Mebendazole or pyrantel pamoate; treat whole family, clean bedding and house |
|
|
Term
| Enterobius vermicularis (Pinworm) disease |
|
Definition
Asymptomatic unless high number
Anal itching, irritability, insomnia, 2* rashes and infection
Vaginitis and vaginal discharge if migrate to vagina
Rare cases lead to appendicitis |
|
|
Term
| Enterobius vermicularis (Pinworm) epidemiology |
|
Definition
Most common worm infection in US
Most common in kids (daycare/schools)
Re-infection and cure rates are both high |
|
|
Term
| Enterobius vermicularis (Pinworm) life cycle |
|
Definition
| male and female adults mate in colon, females come out of anus at night and lay eggs, larvae stages grow and shed cuticle layers, mature into adults, repeat |
|
|
Term
| Enterobius vermicularis (Pinworm) prevention |
|
Definition
|
|
Term
| Enterobius vermicularis (Pinworm) transmission |
|
Definition
Trans: ingestion
req. indiscriminate disposal of human waste, fecal egg contamination of soil/foodstuff/animal food/hands/etc.; autotransmission |
|
|
Term
| Epidermophyton floccosum biology |
|
Definition
Fungus
Uses keratin as nitrogen source
Macroconidia in pairs/triplets, large, club-like, thin-walled
Sabouraud's culuture (w/ cyclohexamide)
Killed by refrgeration |
|
|
Term
| Epidermophyton floccosum diagnosis and treatment |
|
Definition
Dx: KOH prep (macoconidia in pairs/triplets, thin-walled, club-like, large)
Tx: Oral terbinafine |
|
|
Term
| Epidermophyton floccosum disease |
|
Definition
Lesion: outer area is red, inner area pale
Groin: cruris
Feet: pedis, Athlete's foot
Dermatophytosis: groin and feet |
|
|
Term
| Epidermophyton floccosum virulence factors |
|
Definition
Minimal to moderate inflammation
deep invasion is RARE |
|
|
Term
| Fasciola hepatica biology |
|
Definition
Helminth, platyhelminth, trematodes/fluke, visceral
multicell, extracell, visible to naked eye |
|
|
Term
| Fasciola hepatica disease site |
|
Definition
|
|
Term
| Fasciolopsis buski biology |
|
Definition
Helminth, platyhelminth, trematodes/fluke, visceral
multicell, extracell, visible to naked eye |
|
|
Term
| Fasciolopsis buski disease site |
|
Definition
|
|
Term
|
Definition
Fungus
Macroconidia are sickle-shaped and contain many cells
Macrocondiia are the infectious agent |
|
|
Term
|
Definition
| Fusariosis/hyalohyphomycosis: keratitis, disseminated infection burn unit, |
|
|
Term
Giardia lambia biology
(type, stages) |
|
Definition
Amitochondridate parasite (lack mitochondria)
Extracellular
Trophozoite - motile, two nuclei, adhesive ventral disk, divides by binary fission
Cyst - 2 trophozoites encysted, protected against heat and disinfected; infectious agent |
|
|
Term
| Giardia lambia diagnosis and treatment |
|
Definition
Dx: cyst or trophozoite in stool, Ag detection, UGI aspirates/biopsy, endoscopy
Tx: MNZ or nitazoxanide |
|
|
Term
|
Definition
Giardiasis
1-2wk incubation, most cases asymp
Diarrhea (sudden, explosive, malodorous, greasy, floats), flatulence, sulfuric-belch, cramps, nausea, weight loss, prolonged symptoms |
|
|
Term
| Giardia lambia epidemiology |
|
Definition
Worldwide, endemic in US
Most common non-bacterial diarrhea cause in US
Most common protozoan disease in US
Assoc. with backpacker, hikers, and daycares |
|
|
Term
| Giardia lambia pathogenesis |
|
Definition
ingest cyst
trophozoites excystate in small intestine and attach via suction and cytoskeleton rearrangement, reproduction and proliferation
encystation in colon and desposit in feces
can cause malabsorptioin in high number |
|
|
Term
| Giardia lambia prevention |
|
Definition
| boil drinking water or filter |
|
|
Term
| Giardia lambia virulence, reservoirs, transmission |
|
Definition
VF: as symptoms improve, become more infectious b/c more cyst formation and deposition in stool; resistant to chlorine; adhere to membrane of host cells, contact-dependent cytotoxicity
Reservoirs: domesticated cats and dogs
Trans: ingesting cyst, fecal-oral, STD (oral/anal sex) |
|
|
Term
| Histoplasma capsulatum biology |
|
Definition
Dimorphic Fungus
Mold at 25* (nature): aerial hyphae, silky, slow growth, tuberculate/spikey macroconidia
Yeast at 37* (body): intracellular, no capsule, found in sputum/lung wash/biopsies, very small with hint of halo but NO CAPSULE, GMS stain good |
|
|
Term
| Histoplasma capsulatum diagnosis and treatment |
|
Definition
Dx: Skin test (useless in endemic regions), Abs (useless unless in urine which indicates active disease), DNA probe for definitive
Tx: Asymp-no tx; Dissem-voriconazole, itraconazole; Life-threatening-AmpB via IV |
|
|
Term
| Histoplasma capsulatum disease |
|
Definition
90-95% minor cold symptoms
5% severe flu-like, dosage is factor in the severity, causes clusters of cases
1-5% get dissemination, mostly IMC
1& get chronic pulmonary disease (cough, fever, wt. loss) |
|
|
Term
| Histoplasma capsulatum epidemiology |
|
Definition
AIDS, IMS, corticosteroids pts
Mississippi River Valley, Indianapolis
Black birds, chicken, bats, geese
80-85% of Midwest population has positive skin test |
|
|
Term
| Histoplasma capsulatum virulence factors |
|
Definition
Reactivation possible with new IMC status
Multiplies within macrophages and sometimes PMNs
Granulomatous inflammation, similar to TB |
|
|
Term
| Hortaea werneckii biology |
|
Definition
fungus
Brown pigmented branched septate hyphae, budding yeast
Culture with cyclohexamide |
|
|
Term
| Hortaea werneckii diagnosis and treatment |
|
Definition
Dx: KOH prep (brown, branched, septate hyphae, budding yeast)
Tx: Selenium (dandruff shampoo) |
|
|
Term
| Hortaea werneckii disease |
|
Definition
| Tinea nigra: dark brown or black patches on soles of hands or feet; superficial infection only |
|
|
Term
| Hortaea werneckii virulence factors |
|
Definition
| does not invade skin, little to no inflammation, easily treated |
|
|
Term
| Leishmania cutaneous disease |
|
Definition
Cutaneous leishaminiasis
Starts 1mo after infection, remains localized to skin, chronic but self-limiting;
Dry, painless ulceratin; occaissionally satellite lesions
Granuloma forms and heals leaving a depressed scar
Assoc. w/ major and aethiopica = oriential sore
Assoc. w/ Mexicana and braziliensis = bay sores |
|
|
Term
|
Definition
Cutaneous - ulcer smear or biopsy
Visceral - bone marrow or liver biopsy, clinical signs |
|
|
Term
| Leishmania diffuse cutaneous disease |
|
Definition
rare, chronic, non-healing, non-ulcerating nodules all over body,
Assoc. with Mexicana and aethicopica
Due to lack of CMI |
|
|
Term
| Leishmania mucocutaneous disease |
|
Definition
localized to skin initially, then metastasizes to mucosa
Initial cutaneous ulcer that heals spontaneously, spreads via lymph/blood to nasal and buccal mucosa (up to 16yr post infection)
Assoc. w/ braziliensis |
|
|
Term
| Leishmania new and old world species |
|
Definition
New: Mexicana, braziliensis
Old: aethicopica, donovani, major, tropica |
|
|
Term
Leishmania sp. biology
(type, motility, reproduction) |
|
Definition
Kinetoplastid parasite, protozoa
Cork-screw like movements, single flagella, divide by binary fission |
|
|
Term
| Leishmania sp. pathogenesis |
|
Definition
| injected (via bite) as promastigotes, phagocytosed by macrophages, mature to amastigotes, repro by fission, rupture host cell, infect neighbor cells |
|
|
Term
| Leishmania sp. vector and reservoir |
|
Definition
Vector: sandfly
Reservoirs: dog, sloth, fox, hyrax |
|
|
Term
|
Definition
Cutaneous - AmpB, cryosurgery
Mucocutaneous - AmpB, cryosurgery
Visceral - pentavalent antimony |
|
|
Term
| Leishmania visceral disease |
|
Definition
Visceral leishaminiais (kala azar)
infects reticuloendothelial cells (mostly macrophages)
Assoc. w/ donovani only
Parasite in blood, spleen, nodes and liver
High fever oscillates every 48hrs
Abdominal swelling, progressive and drastic weight loss
High mortality w/o tx
2* post-kala-azar dermal leishmaniniasis |
|
|
Term
| Loa Loa (filarial worm) biology |
|
Definition
Helminth, nematode, tissue
multicell, extracell, visible to naked eye, cuticular, roundworm |
|
|
Term
| Loa Loa (filarial worm) disease |
|
Definition
|
|
Term
| Loa Loa (filarial worm) life cycle |
|
Definition
male and female mate, lay eggs, hatch to larvae, grow and shed cuticle layers, mature to adults, repeat
L1 form in humans, arthropod takes up L1 and deliver L3 |
|
|
Term
| Loa Loa (filarial worm) transmission and pathogensis |
|
Definition
Trans: skin penetration via insect
Path: most due to release of symbiotic bacteria from dead worm |
|
|
Term
| Loa Loa (filarial worm) treatment |
|
Definition
| Ivermectin or diethylcarbamazine |
|
|
Term
| Malassezia furfur (flobus) biology |
|
Definition
Fungus
"Spaghetti and meatballs"
Req. olive oil to grow and Cyclohexamide |
|
|
Term
| Malassezia furfur (flobus) diagnosis and treatment |
|
Definition
Dx: KOH prep (short curved, unbranched hyphae, spherical yeast; spaghetti and meatballs
Tx: Selenium (dandruff shampoo) |
|
|
Term
| Malassezia furfur (flobus) disease |
|
Definition
| Tinea versicolor: hypo or hyperpigmented patches on skin, superficial infection only |
|
|
Term
| Malassezia furfur (flobus) virulence factors |
|
Definition
| interferes with melanin production, does not invade skin, little to no inflammation, easy to treat |
|
|
Term
| Microsporum audouinii biology |
|
Definition
Fungus
Uses keratin as nitrogen source
Macroconidia are spindle-shaped, pitted walls
Grows on Sabouraud's and mycobiotic cultures |
|
|
Term
| Microsporum audouinii diagnosis and treatment |
|
Definition
Dx: KOH prep (spindle shaped, pitted walls)
Tx: topical imidazole |
|
|
Term
| Microsporum audouinii disease |
|
Definition
Dermatophytoses
Lesion: red outer, inner pale
RARE IN HUMANS, more in soil |
|
|
Term
| Microsporum audouinii virulence factors |
|
Definition
minimal to moderate inflammation
deep invasion is RARE |
|
|
Term
| Microsporum canis biology |
|
Definition
Fungus
Uses keratin as nitrogen source
Macroconidia have thick/rough walls, 8-15cells, curved tip
Sabourauds and mycobiotic (cyclohexamide) growth
Fluffy granule colones and bright yellow on reverse |
|
|
Term
| Microsporum canis diagnosis and treatment |
|
Definition
Dx: KOH prep (thick/rough walls, 8-15cells, curved tip)
Tx: topical imidazole |
|
|
Term
| Microsporum canis disease |
|
Definition
Dermatophytoses
Lesion: outer is red, inner pale area (healing)
Capitis (head), corpus (body, ringowrm), Pedis (food, Athlete's), cruris (Groin), barbae (beard), unguium (nail, onychomycosis) |
|
|
Term
| Microsporum canis virulence factors |
|
Definition
minimal to moderate inflammation
deep invasion is RARE |
|
|
Term
| Microsporum gypseum biology |
|
Definition
Fungus
Uses keratin as nitrogen source
Macroconidia are ellipsoidal, round ends, thin walls, 2-7cells
Grow on Sabourauds and mycobiotic cultures
Powdery cinnamon colored colonies, orange/brown |
|
|
Term
| Microsporum gypseum diagnosis and treatment |
|
Definition
Dx: KOH prep (ellipsoidal, thin walls, round ends, 2-7 cells)
Tx: topical imidazole |
|
|
Term
| Microsporum gypseum disease |
|
Definition
Dermatophytoses
Lseion: outer red, inner pale area (healing)
Capitis (head), corpus (body, ringworm), pedis (foot, Athlete's), cruris (groin), barbae (beard), unguium (nail, onychomycosis) |
|
|
Term
| Microsporum gypseum virulence factors |
|
Definition
minimal to moderate inflammation
deep invasion is RARE
NO HIAR PERFORATION |
|
|
Term
|
Definition
Fungus
Tissue sample: irregular, BROAD hyphae, aseptate, 90* branching, ribonny
Culture: slimey, lid-lifter, SPORANGIA with conidia inside, NO RHIZOIDS |
|
|
Term
| Mucor diagnosis and treatment |
|
Definition
Dx: culture (lid-lift, sporangia with conidia inside, no rhizoids)
Tx: treat underlying issue of IMC, sugical debridement, AmpB + caspofungin or prosaconazole + caspofungin |
|
|
Term
|
Definition
Mucormycosis
Rhinocerebral: nasal sinus infection that rapidly spreads to brain, DM with ketoacidosis
Pulm/Systemic: transplant patients |
|
|
Term
|
Definition
necrotic tissue around inflammation
angioinvasive |
|
|
Term
| Naegleria fowleri biology |
|
Definition
| facultative parasite, free living amoeba |
|
|
Term
| Naegleria fowleri disease |
|
Definition
Primary Amebic Meningioencephalitis: swimming in contaminated water/in Neti pot; consumes brain cells; rapid course; headache, fever, stiff neck, unusual taste/smells, acute hemorrhagic brain abscess, invade vessel walls, purulent CSF with motile trophozoites, convulsions, coma, death in 5-6days
persistent seizures = 95% death rate |
|
|
Term
| Naegleria fowleri life cycle |
|
Definition
| cysts mature to trophozoite or flagellated-form in water bodies, penetrate nasal mucosa of humans, migrates to brain via olfactory nerve |
|
|
Term
| Naegleria fowleri treatment |
|
Definition
|
|
Term
| Necator americanus (Hookworm) life cycle |
|
Definition
| lay egg (passed in feces), hatch in environment, larvae stages grow and shed layers, larvae penetrate skin, access blood and travel to alveoli, larvae crawl up trachea and are swallowed, larvae mature to adults in intestine, mate, lay eggs, repeat |
|
|
Term
| Necator americanus (Hookworm) biology |
|
Definition
Heminth, nematode, intestinal
small, characteristics PLATES for teeth, multi-cell, extracellular, visible to naked eye, cuticular, roundworm, |
|
|
Term
| Necator americanus (Hookworm) diagnosis and treatment |
|
Definition
Dx: ID in stool
Tx: mebendazole or albendazole |
|
|
Term
| Necator americanus (Hookworm) disease |
|
Definition
Asymp unless high number
Ground itch - skin penetration, 2* infection
Pulmonary: cough, wheeze, fever
Intestinal: worm attach to mucosa and feed on blood, cont. move to new area, exacerbated blood loss, iron deficiency |
|
|
Term
| Necator americanus (Hookworm) transmission |
|
Definition
| Trans: skin penetration, indiscriminate disposal of human waste |
|
|
Term
| Onchocerca volvulus (filarial worm) biology |
|
Definition
Helminth, nematode, tissue
multicell, extracell, visible with naked eye, cuticular, roundworm |
|
|
Term
| Onchocerca volvulus (filarial worm) disease |
|
Definition
| River blindness, onchocerciasis |
|
|
Term
| Onchocerca volvulus (filarial worm) life cycle |
|
Definition
male and female mate, lay eggs, hatch to larvae, grow and shed layers, mature to adult, repeat
L1 form in humans
Arhtropod takes up L1 and deliver L3 |
|
|
Term
| Onchocerca volvulus (filarial worm) transmission and pathogenesis |
|
Definition
Trans: skin penetration by insect
Path: mostly from release of symbiotic bacteria from dead worms |
|
|
Term
| Onchocerca volvulus (filarial worm) treatment |
|
Definition
| Ivermectin or diethylcarbamazine |
|
|
Term
| Paracoccidioides brasiliensis biology |
|
Definition
dimorphic fungus
Mold at 25* (nature): small lollipops
Yeast at 37* (body): large, MARINER'S WHEEL, |
|
|
Term
| Paracoccidioides brasiliensis disease |
|
Definition
Lung infection that can disseminate widely
Quiescent infection can be activated by new IMC status |
|
|
Term
| Paracoccidioides brasiliensis epidemiology |
|
Definition
Rare in US
Assoc. with agricultural immigrants from Brazil or other endemic area |
|
|
Term
| Paracoccidioides brasiliensis virulence factors |
|
Definition
| reactivation possible with new IMC status |
|
|
Term
| Paragonimus westermani biology |
|
Definition
Helminth, platyhelminth, trematodes/fluke, visceral
multicell, extracell, visible to naked eye |
|
|
Term
| Paragonimus westermani disease site |
|
Definition
|
|
Term
| Pediculus humanus biology and disease |
|
Definition
Ectoparasite
Body or head louse |
|
|
Term
| Penicillum marneffei biology |
|
Definition
Dimorphic fungus
Mold at 25* (nature)
Yeast at 37* (body): fission style budding |
|
|
Term
| Penicillum marneffei diagnosis, treatment, and prevention |
|
Definition
Dx: fission budding, hx of SE Asia, IMC
Tx: AmpB, for IMC has to life-long
Prevent: Fungal prophylaxis for HIV pts |
|
|
Term
| Penicillum marneffei disease |
|
Definition
Pulmonary infection that mimics TB/cryptococcosis; disseminates to skin via blood
Skin lesions: similar to molluscum contagiosum, eventually become BLACK AND NECROTIC |
|
|
Term
| Penicillum marneffei epidemiology |
|
Definition
Rare in US
Endemic in SE Asia |
|
|
Term
| Penicillum marneffei virulence factros |
|
Definition
Reactivation possible with new IMC status
Reservoirs: soil, bamboo rats |
|
|
Term
| Phthirus pubis biology and disease |
|
Definition
Ectoparasite
Pubic or crab louse |
|
|
Term
|
Definition
Fungus
must be culture with cyclohexamide |
|
|
Term
|
Definition
| Black piedra: black hair spots |
|
|
Term
| Piedriae hortae virulence factors |
|
Definition
| does not invade skin, little to no inflammation, easily treated |
|
|
Term
| Plasmodium falciparum biology |
|
Definition
| amicoplexan parasite, protozoa |
|
|
Term
| Plasmodium falciparum diagnosis |
|
Definition
Travel hx, Giemsa stain, can have multiple trophozoites in one cell, gametocytes are banana-shaped
Schizont = large number of merozoites |
|
|
Term
| Plasmodium falciparum disease |
|
Definition
General Malaria: 7-21d inc, 48hr cyclic fever
Complicated Malaria: severe anemia, resetting from clumping RBCs, renal and hepatic disease, blackwater fever (dark urine), splenomegaly, dysenteric malaria
Erythrocytic Schizogony: infection of blood cells with ring form undergo trophic phase (ingests Hb and grows dark), division via schizogony, lyses the RBC to release merozoities, 48hr periodid cycle, high fever and anemia
Cerebral Malaria: impaired consciousness, w/ or w/o seizures; due to blocking blood flow from inflammation to parasitized and lysed RBCs; rapidly progressive to coma and death; RETINAL WHITENING
Pregnancy Malaria: maternal anemia, increased risk of miscarriage/stillbirth/low birth weight, due to damage of vessels and tissues from blood cell defects |
|
|
Term
| Plasmodium falciparum epidemiology |
|
Definition
3rd most common microbe killer
90% of deaths are in Africa
Most severe of plasmodium sp. and responsible for almost all deaths
Sickle-cell is protective
G6PD Deficiency is resistant |
|
|
Term
| Plasmodium falciparum pathogenesis/life cycle |
|
Definition
mosquito bites and injects sporozoites from a rupture oocyst; sporozoites infect liver cells and multiply; ruptures liver cell and infects blood cells -> ring form; matures in blood cell and then ruptures it; continues
ring form can also form gametocytes in blood cells; can be picked up by mosquito and united (male/female) in mosquite -> oocyst-> rupture -> sporozoites |
|
|
Term
| Plasmodium falciparum prevention |
|
Definition
| Insecticiees, larvicides, mosquito nets |
|
|
Term
| Plasmodium falciparum treatment |
|
Definition
Central America: chloroquine
Pyrimethamine and sulfadiazine
Artemisin
Atavaquone/proguanil(malarone)
Doxycycline
Mefloquine (ok for preggers)
Primquine (not in G6PD deficient pts) |
|
|
Term
| Plasmodium falciparum vector and virulence factors |
|
Definition
Vector: anopheline mosquito (females, night feeding)
VFs: PfEMP (membrane protein, attaches to epithelial cell receptors), antigenic variation of PfEMP |
|
|
Term
| Plasmodium malariae biology |
|
Definition
| amicoplexan parasite, protozoa |
|
|
Term
| Plasmodium malariae diagnosis |
|
Definition
Travel history, Giemsa stain
Parasitized RBCs are smaller than normal |
|
|
Term
| Plasmodium malariae disease |
|
Definition
General Malaria: inc. 3+wks, initially flu-like, can be sudden and severe, intermittent fevers every 72hrs, anemia, jaundice, splenomegaly
incomplete tx -> low persistent parasitemia |
|
|
Term
| Plasmodium malariae epidemiology |
|
Definition
| most persistent but least severe sp. of plasmodium |
|
|
Term
| Plasmodium malariae pathogenesis |
|
Definition
mosquito bites and injects sporozoites from ruptured oocyst, infect liver cells and multiply, rupture host cell and infect blood cell, ring form stage, mature in blood cell and rupture it
ring stage can also form gametocytes, which when picked up by mosquitos can mate and form oocyst |
|
|
Term
| Plasmodium malariae prevention |
|
Definition
| larvacides, insecticides, mosquito nets |
|
|
Term
| Plasmodium malariae treatment |
|
Definition
Central America: chloroquine (ok for preggers)
Pyrimethamine and sulfadiazine
Artemisin
Atavaquone/proguanil(malarone)
Doxy
Mefloquine (ok for preggers)
Primquine (not for G6PD deficiency) |
|
|
Term
| Plasmodium malariae vector and virulence factors |
|
Definition
Vector: anopheline mosquito (female, night feeding)
VF: can survive up to 20yrs in peripheral blood |
|
|
Term
|
Definition
| amicplexan parasite, protozoa |
|
|
Term
| Plasmodium ovale diagnosis |
|
Definition
| Travel history, Giemsa stain, Infected RBC's with ring stage and Schuffner's dots, Oval RBCs |
|
|
Term
|
Definition
General malaria: 15d-4yr incubation, initially flu-like, sudden and can be severe, intermittent fever (every 48hrs), anemia, jaundice, enlarged spleen, relapses due to latent form
Relapsing Malaria: can occurs years after initial infection, latent form = hypnozoite, often in liver |
|
|
Term
| Plasmodium ovale epidemiology |
|
Definition
| least prevalent of plasmodium sp. |
|
|
Term
| Plasmodium ovale pathogenesis |
|
Definition
mosquito bites and injects sporozoites (from rupture oocyst), infect liver cells and multiply, ruptures hepatocytes and infects blood cells (ring stage, immature), matures and ruptures blood cell
can also form gametocytes after ring stage, then picked up by mosquito and male/female gametocytes can mate and mature to oocyst filled with sporozoites |
|
|
Term
| Plasmodium ovale prevention |
|
Definition
| larvicide, insecticide, mosquito nets |
|
|
Term
| Plasmodium ovale treatment |
|
Definition
Central America: Chloroquine (ok for preggers)
Pyrimethamine and sulfadiazine
Artemisin
Atavaquone/proguanil(malarone))
Doxy
Mefloquine (ok for preggers)
Primquine (not for G6PD deficiency) |
|
|
Term
|
Definition
| Vectors: anopheline mosquito (female, night feeding) |
|
|
Term
|
Definition
| amicoplexan parasite, protozoa |
|
|
Term
| Plasmodium vivax diagnosis |
|
Definition
Travel history, Giemsa stain,
RBCs with ring stage and Schuffner's dots
Parasitized RBCs are larger than normal |
|
|
Term
|
Definition
General Malaria: 15d-9mo incubation, initially flu-like, can be sudden and severe, intermittent fever (every 48hrs), anemia, jaundice, splenomegaly, relapse due to reactivation of latent form; only infects Duffy(+) people
Relapsing Malaria: can occur years after initial infection, latent form = hynozoite, often in liver |
|
|
Term
| Plasmodium vivax epidemioloy |
|
Definition
| Duffy(-) people are immune |
|
|
Term
| Plasmodium vivax pathogenesis |
|
Definition
mosquito bites and injects sporozoites (from ruptured oocyst), infect liver cells and multiply, rupture host cell, infect RBCs, ring stage form, mature and rupture blood cell
ring stage form can also make gametocytes, which when picked up by mosquito can mate and form oocyst filled with sporozoites |
|
|
Term
| Plasmodium vivax prevention |
|
Definition
| larvacides, insecticides, mosquito nets |
|
|
Term
| Plasmodium vivax treatment |
|
Definition
Central America: chloroquine (ok for preggers)
Pyrimethamine and sulfadiazine
Artemisin
Atavaquone/progaunil(malarone)
Doxy
Mefloquone (ok for preggers)
Primquine (not for G6PD deficient) |
|
|
Term
|
Definition
| Vector: anopheline mosquito (female, night feeding) |
|
|
Term
| Pneumocystis jiroveci (carinii) biology |
|
Definition
Fungus
Giemsa stain on lung fluid show trophozoites in cysts (up to 8 cells)
Cysts only seen with GMS |
|
|
Term
| Pneumocystis jiroveci (carinii) epidemiology |
|
Definition
| AIDS, post-transplant, IMS and chemo+leukemia pts |
|
|
Term
| Pneumocystis jiroveci (carinii) treatment |
|
Definition
TMP-SMX = 1*
pentamide = 2* |
|
|
Term
| Pneumocystis jiroveci (carinii) virulence factors |
|
Definition
| does not grow on fungal media in lab |
|
|
Term
|
Definition
Fungus
Tissue sample: irregular, broad hypahe, aseptate, 90* branching, ribonny
Culture: lid-lifter, sporangia with conidia inside, rhizoids at base of sporangia |
|
|
Term
| Rhyzopus diagnosis and treatment |
|
Definition
Dx: culture, lid-lift, sporangia with rhizoids at base
Tx: treat underlying IMC issue, surgical debridement, AmpB + caspofungin or prosaconazole + caspofungin |
|
|
Term
|
Definition
Mucormycosis
Rhinocerebral: nasal sinus infection rapidly progresses to brain; DM with ketoacidosis
Pulm/systemic: transplant patients |
|
|
Term
| Rhyzopus virulence factors |
|
Definition
necrotic tissue around inflammation
angioinvasive |
|
|
Term
| Sarcotes scabiei biology and disease |
|
Definition
Ectoparasite
Itch mite, scabies in humans, mange in animals |
|
|
Term
| Schisotosoma haematobium prevention |
|
Definition
| no human waste in water bodies and reservoirs, snail control |
|
|
Term
| Schisotosoma haematobium treatment |
|
Definition
| Early and intermediate stages" antihistamines, steroids, +/- praziqantel |
|
|
Term
| Schistosoma haematobium biology |
|
Definition
Helminth, platyhelminth, trematode/fluke, blood
extracell, multicell, visible to naked eye |
|
|
Term
| Schistosoma haematobium diagnosis |
|
Definition
Eosinophilia common, Anemia, luekopenia, thrombocytopenia
Skin test postive for 1-2months
Serologic tests
Recovery of eggs in urine |
|
|
Term
| Schistosoma haematobium disease |
|
Definition
Initial: local dermatitis
Migrate: in blood, toxic reaction, pulm congestion, fever, sweating
Acute: 1-2mo after infection, may last 3mo; fever, chills, bloody stools, hematuria, lymphadenopathy; due to eggs moving through intestine and bladder
Chronic: 1-2yrs after initial infection; most serious, fatigue, severe intestinal/hepatic/renal inflammation and scarring, vascular obstruction, granuloma; REDUCED bladder capacity, URETHRAL OBSTRUCTION, renal stones, BLADDER CALCIFY, genital granulomas, carcinoma of the bladder |
|
|
Term
| Schistosoma haematobium epidemiology |
|
Definition
| East Africa, Nile Valley, Middle East |
|
|
Term
| Schistosoma haematobium life cycle |
|
Definition
| eggs in feces, hatch in water environment, larvae penetrate snail tissue, mature to cercariae, released by snail into water, cercariae are free-swimming, penetrate human skin (lose tail in process), access blood, migrate to portal system, infect and mature in liver, pair up (mate for life), migrate to venous plexus of bladder, lay eggs, passed in urine, repeat |
|
|
Term
| Schistosoma japonicum biology |
|
Definition
Helminth, platyhelminth, treamatode/fluke, blood
multicell, extracell, visible to naked eye |
|
|
Term
| Schistosoma japonicum diagnosis |
|
Definition
Dx:Eosinophilia, anemia, leukopenia, thrombocytopenia
Skin tst (+) for 1-2mo
Serology
REcover eggs in stools |
|
|
Term
| Schistosoma japonicum disease |
|
Definition
Initial: local dermatitis
Migrate: in blood, toxic reaction, pulm congestion, fever, sweating
Acute: 1-2mo after infection, fever chills, bloody stools, hematurnia, lymphadenopathy, egg passing through intestine and bladder; 3 mo duration
Chronic: 1-2yrs after initial infection, most severe; fatigue severe intestinal/hepatic/renal inflammation and scarring, vascular obstruction, granuloma; liver CIRRHOSIS, ASCITES, pronounced KATYAMA SYNDROME |
|
|
Term
| Schistosoma japonicum epidemiology |
|
Definition
| China, Japan, Phillippines |
|
|
Term
| Schistosoma japonicum life cycle |
|
Definition
| Egg in feces, hatch in water environment, penetrate snail tissue, mature, cercariae released by snail into water, cercariae are free swimming, penetrate skin of human (lose tail in process), access blood, migrate to portal sys, mature to adults in liver, pair up (mate for life), migrate to mesenteric venules, lay eggs, shed in stool, repeat |
|
|
Term
| Schistosoma japonicum prevention |
|
Definition
| no human waste in water bodies and reservoirs, snail control |
|
|
Term
| Schistosoma japonicum treatment |
|
Definition
| Early to intermediate stages: antihistamines, steroids, +/- praziqantel |
|
|
Term
| Schistosoma mansoni biology |
|
Definition
Helminth, platyhelminth, trematode/fluke, blood
multicell, extracell, visible with naked eye |
|
|
Term
| Schistosoma mansoni diagnosis |
|
Definition
Eosinophilia, Anemia, Leukopenia,
Skin test: positive for 1-2mo
Serology tests
Recovery of eggs in stool |
|
|
Term
| Schistosoma mansoni disease |
|
Definition
Initial: localized dermatitis
Migration: parasite in blood, toxic reaction, pulm congestion, fever, sweating
Acute: 1-2mo after infection, fever, chills, bloody stools, hematuria, lymphadenopathy, last 3mo; eggs in intestine and bladder
Chronic: 1-2yrs after initial infection; fatigue, sever intestinal/renal/hepatic inflammation and scarring, vascular obstruction, granuloma; hepatosplenomegaly -> abdo pain, diarrhea, bloody stools, giant splenomegaly, right heart failure, immune complex neuropathy |
|
|
Term
| Schistosoma mansoni epidemiology |
|
Definition
| Africa, Middle East, parts of S. America, West Indies, Puerto Rico |
|
|
Term
| Schistosoma mansoni life cycle |
|
Definition
| eggs in feces, hatch in water environment, penetrate snail tissue, mature, cecariae released by snail into water, free-swimming, penetrate skin of human (in process, loses tail), accesses circulation, migrate to portal blood and liver, mature into adults, pair up (mate for life), migrate to mesenteric venules, lay eggs, eggs circulate to liver and are shed in stool |
|
|
Term
| Schistosoma mansoni prevention |
|
Definition
| no human waste in water bodies and reservoirs, snail control |
|
|
Term
| Schistosoma mansoni reservoir and pathogenesis |
|
Definition
Reservoir: humans, live in mesenteric venules
Path: cecariae enter by direct penetration, loses tail to become schistosomulae, enter circulation, move to liver and lungs, adults mate and move to colon |
|
|
Term
| Schistosoma mansoni treatment |
|
Definition
| Early-intermediate stages: antihistamines, steroids, +/- praziqantel |
|
|
Term
| Schistosoma presentation in US |
|
Definition
From ducks and other animals (humans 2* host)
Burrows into skin, cercarial dermatitis, multiple exposure will elicit allergic reaction
Tingling, burning, itching, small redish pimples or small blisters |
|
|
Term
| Sporothrix schenckii biology |
|
Definition
Dimorphic fungus
Mold at 25* (nature)
Yeast at 37* (body): CIGAR-SHAPED, small budding, LONG NARROW NECK on bud, STOVEPIPE BUD, rapid growth, 48-72hrs, FLOWERETTES/ROSSETTES/DAISY conidia |
|
|
Term
| Sporothrix schenckii disease |
|
Definition
Sporotricosis: 1*-non-healing ulcer on finger/arm/or leg; 2*-linear series of nodules/ulcers along lymphatic drainage path, puss
Pulmonary form is RARE |
|
|
Term
| Sporothrix schenckii epidemiology |
|
Definition
Worldwide
Farmers, gardeners, florists, horticulturists
Brazilian cat-lovers |
|
|
Term
| Sporothrix schenckii treatment |
|
Definition
AmpB IV for dissemination
Voriconazole, itraconazole
used to use potassium iodide |
|
|
Term
| Sporothrix schenckii virulence factors |
|
Definition
| reactivation possible with new IMC status |
|
|
Term
| Strongloides stercoralis (Threadworm) biology |
|
Definition
Helminth, nematode, intestinal
multi-cell, extracelluar, visible to naked eye, cuticular, roundworm |
|
|
Term
| Strongloides stercoralis (Threadworm) diagnosis and treatment |
|
Definition
Dx: ID in feces or intestinal aspirates, Marked eosinophilia
Tx: Ivermectin or albendazole |
|
|
Term
| Strongloides stercoralis (Threadworm) disease |
|
Definition
Asymp unless high number
Skin: raised red serpiginous lesions, recur at irregular intervals, common on lower back/butt
Pulmonary: cough, wheeze, fever
Intestinal: abdo pain/tender, flatulence, nausea, vomit, diarrhea, malabsorption, weight loss, intestinal obstruction, UC, intestinal perforation
Hyperinfection: IMC or debilitated pts, dissem through body, encephalitis, hemorrhagic pneumonia, death |
|
|
Term
| Strongloides stercoralis (Threadworm) life cycle |
|
Definition
| male and female adults mate, lay eggs, larvae hatch, grow and shed cuticle layers, mature to adults, repeat |
|
|
Term
| Strongloides stercoralis (Threadworm) transmission and pathogenesis |
|
Definition
Trans: skin penetration, indiscriminate disposal of human waste
Path: female worm lives in intestine and lays eggs, eggs hatch and are passed in feces as larvae [auto-infection], lives independently in soil, access through skin penetration, disseminates in blood, exits at alveoli, coughed up, swallowed, mature into adults in intestines, repeat |
|
|
Term
|
Definition
Helminth, platyhelminth, cestode/tapeworm
multicell, extracell, visible to naked eye
prolgiottids and scolex |
|
|
Term
| Taenia saginata diagnosis |
|
Definition
"Proglottid in feces, visible to naked eye
Eggs in feces, with 100x
Scotch tape test" |
|
|
Term
| Taenia saginata life cycle |
|
Definition
| embryos ingested, develops to adult hood, adult can live for several decades, eggs and gravid proglottids released in feces, CATTLE ingest eggs, eggs develop to onocosphere (embryo with 4 hooks), human ingest BEEF |
|
|
Term
|
Definition
Helminth, platyhelminth, cestode/tapeworm
multicell, extracell, visible to naked eye
Proglottids = segments, mature ones grow off end and shed into feces
Scolex = head |
|
|
Term
|
Definition
Proglottid/egg in feces; Scotch tape test
Biopsy of cysts
X-ray show calcified cysts
Serology
Eosinophilia |
|
|
Term
|
Definition
Cystercosis: autoinfection, eggs passes through intestine lumen, penetrates tissues, migrates to muscles and brain, encystation and can live up to 5yrs, causes inflammation -> symptoms
Muscle cyst: fever, pain
Eye cyst" impaired vission
Brain cyst: neurocystercosis, epilepsy, look like tumors, mental problems, personality changes and seizures |
|
|
Term
| Taenia solium epidemiology |
|
Definition
| Neurocysticercosis is major causes of epilepsy in endemic countries |
|
|
Term
|
Definition
| Embryos ingested, matures to adult, can liver for several decades in body, eggs and gravid proglottids shed in feces, ingested by PIG, eggs develop to onchospheres, humans ingest PORK and contract onchospheres |
|
|
Term
|
Definition
| Avoid autoinfection via fecal-oral route |
|
|
Term
|
Definition
Niclosamide (usually only one dose)
Praziquantil
Recheck after tx
Cystericercosis: Albendazole + praziquantel, +/- corticosteroids, sometimes surgery |
|
|
Term
| Toxocara canis (Roundworm) biology |
|
Definition
Helminth, nematode, tissue
Multi-cell, extracell, visible with naked eye, cuticular |
|
|
Term
| Toxocara canis (Roundworm) diagnosis and treatment |
|
Definition
Dx: symptoms, history of dog contact, blood tests
Tx: Mebendazole |
|
|
Term
| Toxocara canis (Roundworm) life cycle and transmission |
|
Definition
male and female adults mate, lay eggs, hatch to larvae, grow and shed layers, mature to adults, repeat
Trans: ingestion |
|
|
Term
| Toxocara canis (Roundworm) pathogenesis |
|
Definition
| contact with feces or ingesting worm cysts in other host tissue, ingested eggs hatch and penetrate intestinal wall, move to lots of tissues (lungs/brain/eyes), does not develop past larvae stages, causes local inflammation and severe disease (hemorrhagic, necrosis, eosinophil infiltration) |
|
|
Term
| Toxocara canis (Roundworm) reservoirs and epidemiology |
|
Definition
nematode of dogs
Neglected infection of poverty
trans: ingestion |
|
|
Term
|
Definition
Visceral larva migrans: convulsions, neurological symptoms, myocarditis
Ocular larva migrans: most common at age 7-8, exudative endophthamitis, retinoblastoma |
|
|
Term
| Toxocara cati (Roundworm) biology |
|
Definition
Helminth, nematode, tissue
multicell, extracelluar, roundworm, cuticular, visible to naked eye |
|
|
Term
| Toxocara cati (Roundworm) diagnosis and treatment |
|
Definition
Dx: symptoms, history of cat exposure, blood tests
Tx: mebendazole |
|
|
Term
| Toxocara cati (Roundworm) disease |
|
Definition
Visceral larva migrans: convulsions, neurological symptoms, myocarditis
Ocular larva migrans: most common at age 7-8, exudative endophthalmitis, retinoblastoma |
|
|
Term
| Toxocara cati (Roundworm) pathogenesis |
|
Definition
| contact with feces or ingesting worm cysts in host tissue, ingested eggs hatch, larvae penetrate wall of SI, move to tissues (lung/eye/brain), does not develop past larvae, causes local reaction (hemorrhagic, necrosis, eosinophil infiltration) |
|
|
Term
| Toxocara cati (Roundworm) transmission |
|
Definition
|
|
Term
| Toxoplasma gondii biology |
|
Definition
| apicomplexan parasite, obligate pathogen, intracellular, protozoa |
|
|
Term
| Toxoplasma gondii diagnosis |
|
Definition
Serology: not reliable in AIDS pts
PCR: amniotic fluids
Clinical features and response to tx |
|
|
Term
| Toxoplasma gondii disease |
|
Definition
IMC Toxoplasmosis: reactivation of cysts or 1* infection can lead to encephalitis, headache, confusion, ataxia, hemiparesis, blurred vision; can get brain lesion visible on CT
Congenital Toxoplasmosis: 1* infection during pregnancy, 1st or 2nd tri most fatal; hydrocephalus, calcifications in brain, hepatosplenomegaly, jaundice, fever, anemia, pneumonia, blindness; can cause neuro, chorioretinitis or intellectual problems after birth (normal); might be assoc. with schizophrenia |
|
|
Term
| Toxoplasma gondii epidemiology |
|
Definition
15-30% infected in US, up to 80% in France
IMC at risk for severe disease
1st and 2nd trimester 1* infections are more likely to show symptoms in infant |
|
|
Term
| Toxoplasma gondii hosts, virulence factors, and pathogeneis |
|
Definition
Shedoocysts in feces of definitive host
Def host: felines
Intermediate hosts: rodents, sheep, humans, birds
VF: broad host range, infect any nucleated cell, high prevalence, chronic infection
Path: competent immune system will maintain oocyst form, IMC -> more severe |
|
|
Term
| Toxoplasma gondii transmission |
|
Definition
| Undercook/raw meat (pork, lamb, goat), unwashed veggies contaminated with oocysts, contaminated water, inhale/ingest oocysts in cat litter or gardens, CONGENITAL |
|
|
Term
| Toxoplasma gondii treatment |
|
Definition
Sulfadiazine + pyrimethamine
or Clindamycin + pyrimethamine
or Atavaquone |
|
|
Term
| Trichinella spiralis biology |
|
Definition
Helminth, nematode, tissue
INTRACELLULAR, multi-cell, cuticular, visible with naked eye, roundworm |
|
|
Term
| Trichinella spiralis diagnosis and treatment |
|
Definition
Dx: Ab test, muscle biopsy
Tx: Steroids fro severe symptoms, Mebendazole or Albendazole (esp. if still in intestinal phase) |
|
|
Term
| Trichinella spiralis disease |
|
Definition
1-2d after ingestion: diarrhea, vomit, abdo pain
5-7d later: facial edema, splinter hemorrhage under nails, fever
After 2wks: muscle-assoc. symptoms appear; headache, fever, fatigue, chills, cough, aching joints, muscle tender and pain, itchy skin, death (rare) due to myocarditis/encephalitis CNS damage/or pneumonia |
|
|
Term
| Trichinella spiralis epidemiology |
|
Definition
2% mortality in clinical cases
10% mortality if CNS involved |
|
|
Term
| Trichinella spiralis life cycle |
|
Definition
| male and female adults mate, lay eggs, hatch to larvae, grow and shed cuticle layers, mature to adult, repeat |
|
|
Term
| Trichinella spiralis transmission and pathogenesis |
|
Definition
Trans: raw/undercooked pork or wild game (carnivorous or omnivorous)
Path: larvae stage invades striated muscle, parasite then secretes angeogentic cytokines, blood vessels grow to parasitized cell, conversion of host cell to NURSE CELL |
|
|
Term
Trichomonas vaginalis biology
(type, O2 req., motility, repro) |
|
Definition
| amitochondirate parasite, extracellular pathogen, binary fission division (when in UG epi), anaerobic, flagella, protozoa |
|
|
Term
| Trichomonas vaginalis complicatins |
|
Definition
Sterility in men and women (due to chronic inflammation and tissue destruction)
Endometriosis or cervical cancer in women (from constant damage and repair)
Increases chances of miscarriage, premature, low birth wt, and infant mortality
Lesion facilitate HIV infection and increase viral shedding |
|
|
Term
| Trichomonas vaginalis diagnosis and treatment |
|
Definition
Dx: discharge, strawberry cervix, parasites in vaginal secretions
Tx: oral MNZ, tinidazole if resistant to MNZ |
|
|
Term
| Trichomonas vaginalis disease in men |
|
Definition
Usually asymp
Urethritis or prostatitis
Recently assoc. with prostate cancer |
|
|
Term
| Trichomonas vaginalis disease in women |
|
Definition
50% begin asymp, symp w/in 6mo
Vaginitis - redness, irritation, burning, vaginal discharge and odor;
Acute - diffuse vulvitis, yellow-green discharge, hemorrhagic spots on vaginal mucosa (strawberry cervix)
Chronic - mild symp with pruritis, vaginal discharge mixed with mucus |
|
|
Term
| Trichomonas vaginalis epidemiology |
|
Definition
Endemic in US, but worldwide distribution
Most common non-viral STD |
|
|
Term
| Trichomonas vaginalis prevention |
|
Definition
| prevent reinfection by treating sexual partners and using condoms til tx completed |
|
|
Term
| Trichomonas vaginalis transmission and pathogenesis |
|
Definition
Trans: STD
Path: only has trophozoite form, resides in lower UG of women and urethra/prostate of men |
|
|
Term
| Trichomonas vaginalis virulence factors |
|
Definition
adhere to cell membrane (cell-contact-dependent cytotoxity)
often asymptomatic in men -> spread w/o knowing infected
can survive up to 24hr in urine, semen, and water
rod-like axostyle stabs cell, 5 flagella
target glycoproteins, laminins, and fibronectin |
|
|
Term
| Trichophyton mentagrophytes biology |
|
Definition
Fungus
Uses keratin as nitrogen source
Microconidia are grape-like clusters
Sarbourauds and mycobiotic cultures
downy colonies (from feet), granular colonies (from animals)
Urease(+) |
|
|
Term
| Trichophyton mentagrophytes diagnosis and treatment |
|
Definition
Dx: KOH prep (grape-like clusters)
Tx: oral griseofulvin |
|
|
Term
| Trichophyton mentagrophytes disease |
|
Definition
Dermatophytoses: feet and nail
Lesion: red outer, pale inner |
|
|
Term
| Trichophyton mentagrophytes virulence factors |
|
Definition
minimal to moderate inflammation
deep invasion is RARE
CAN PERFORATE HAIR |
|
|
Term
| Trichophyton rubrum biology |
|
Definition
Fungus
Uses keratin as nitrogen source
Microconidia are tear drop and bird on a fence
Sarbourauds and mycobiotic cultures
white fluffy/granular colonies, CHERRY RED ON REVERSE
Urease (-) |
|
|
Term
| Trichophyton rubrum diagnosis and treatment |
|
Definition
Dx: KOH prep (tear drops, birds on a fence)
Tx: oral griseofulvin |
|
|
Term
| Trichophyton rubrum disease |
|
Definition
Dermatophytoses: feet and nail
Lesion: outer red, inner pale |
|
|
Term
| Trichophyton rubrum virulence factors |
|
Definition
minimal to moderate inflammation
deep invasion is RARE
NO HAIR PERFORATION |
|
|
Term
| Trichophyton tonsurans biology |
|
Definition
Fungus
Uses keratin as nitrogen source
MICROconidia are elongated balloons or stretched teardrop shaped
Sabourauds and mycobiotic cultures
Wrinkled/cratered colonies
Growth enhanced by THIAMINE |
|
|
Term
| Trichophyton tonsurans diagnosis and treatment |
|
Definition
Dx: KOH prep (microconidia, tear drop shaped)
Tx: oral griseofluvin |
|
|
Term
| Trichophyton tonsurans disease |
|
Definition
Dermatophytoses: feet (pedis, Athlete's) and nail (unguium, onychomycosis), capitis (head)
Lesion: outer red, inner pale
#1 cause of tinea capitis |
|
|
Term
| Trichophyton tonsurans virulence factors |
|
Definition
minimal to moderate inflammation
deep invasion is rare |
|
|
Term
| Trichosporin beigelii biology |
|
Definition
Fungus
must be cultured with cyclohexamide |
|
|
Term
| Trichosporin beigelii disease |
|
Definition
| White piedra: white hair spots |
|
|
Term
| Trichosporin beigelii virulence factors |
|
Definition
| does not invade skin, little to no inflammation, easily treated |
|
|
Term
| Trichuris trichiura (Whipworm) biology |
|
Definition
Helminth, nematode, intestinal
Multi-cell, visible to naked eye, extracellular, roundworm, cuticular outer layer |
|
|
Term
| Trichuris trichiura (Whipworm) diagnosis, treatment, and prevention |
|
Definition
Dx: ID in feces
Tx: Mebendazole
Prevent: Sanitary disposal of human waste |
|
|
Term
| Trichuris trichiura (Whipworm) disease |
|
Definition
Asymp unless high number
Abdominal pain, diarrhea and weight loss w/ moderate to heavy burder
Rectal prolapse in heavily parasitized children along with diarrhea, cramps, urgency and tenemus |
|
|
Term
| Trichuris trichiura (Whipworm) life cycle |
|
Definition
| Male and female adults attach to mucosa in cecum and mate, lay unembryonated egg, shed in feces, embryonate in soil, ingested by human, larvae grow and shed layers (before and after ingestion), larvae hatch in SI, larvae mature into adults, repeat cycle |
|
|
Term
| Trichuris trichiura (Whipworm) tranmission |
|
Definition
Trans: ingestion
req. indiscriminate disposal of human waste, fecal egg contamination of soil/foodstuff/animal feed/hands/etc. |
|
|
Term
Trypanosomatidae brucei biology
(type, motility, reproduction) |
|
Definition
Kinetoplastid parasite, protozoa
Cork-screw like movements, single flagella, divide by binary fission |
|
|
Term
| Trypanosomatidae brucei disease |
|
Definition
| African sleeping sickness |
|
|
Term
| Trypanosomatidae cruzi biology |
|
Definition
Kinetoplastid parasite, protozoa
Cork-screw like movements, single flagella, divide by binary |
|
|
Term
| Trypanosomatidae cruzi disease |
|
Definition
Chagas: 7-14day incubation, lasts 1-2wks; restlessness, sleeplessness, increasing exhaustion, bone and muscle pain, fever, enlarged spleen/liver/nodes, diffuse myocarditis, possible pericarditis and endocarditis
Children - meningioencephalitis and coma
Death due to CNS involvement or chronic infection
Chronic: low level in blood, but nerve degeneration; cardiomyopathy; megaesophagus; megacolon |
|
|
Term
| Trypanosomatidae cruzi dx and tx |
|
Definition
Dx: symptoms, blood smear (could be too low or be a non-path cousin), ELISA, PCR
Tx: Acute - bidzimidazole or nifurtimox; Chronic - no drugs, manage symptoms |
|
|
Term
| Trypanosomatidae cruzi epidemiology |
|
Definition
South and Central America
Frong roofs and mud walls
Occasionally in TX |
|
|
Term
| Trypanosomatidae cruzi life cycle and reservoirs |
|
Definition
develop and divide in gut of vector, deposited in feces, scratching causes penetration of human skin, divides intracellularly, proliferate locally, 10days later in blood
Reservoirs: monkeys, armadillos |
|
|
Term
| Trypanosomatidae cruzi pathogenesis |
|
Definition
| inject via bite as promastigotes, phagocytosed by macrophages, mature to amastigotes, reproduce by fission, rupture host cell, infect neighboring cells |
|
|
Term
| Trypanosomatidae cruzi transmission |
|
Definition
Kissing bug (triatoma infestans)
Bites sleeping people on face
Also: blood transfusion, congenital, breast feeding, ingest contaminated food/drink |
|
|
Term
| Wucheria sp. (filarial worm) biology |
|
Definition
Helminth, nematode, tissue
multicell, extracell, visible with naked eye, cuticular, roundworm |
|
|
Term
| Wucheria sp. (filarial worm) disease |
|
Definition
| Lymphatic filariasis, elephantitis |
|
|
Term
| Wucheria sp. (filarial worm) life cycle |
|
Definition
male and female mate, lay eggs, hatch to larvae, grow and shed cuticle layers, mature to adults, repeat
L1 form in humans; Arthropod takes up L1 and delivers L3 |
|
|
Term
| Wucheria sp. (filarial worm) transmission and pathogensis |
|
Definition
Trans: skin penetration via insect
Path: most due to release of symbiotic bacteria from dead worms |
|
|
Term
| Wucheria sp. (filarial worm) treatment |
|
Definition
| Ivermectin or diethylcarabamazine |
|
|
