reoviruses- segmented nonencapsulated RNA

nsp4- enterotoxin->watery diarrh

ssRNA

more infectious than rota

vomiting more than diarrhea

cruise ships

short, less dehydration

herpangina

small vesicular/ulcerous lesion on back of oropharynx

maybe from B, entero 71,

hand-foot-mouth- red blister spots (like chicken pox), more irregular lesion than ch p

acute hem conjunctivitis- also ev70, painful, SW, asia, self-limited

viral myocarditis

pleurodynia- lancinating chest pain, seasonal, fecal-oral

granulomatous ameobic encephalitis

chronic or subacute brain necrosis, keratitis of corneum, granulomatous sinusitis

no good treatment

asymptomatic carrier: paromomycin or iodoquinol

metronidazole/tinidazole for diarrhea or extraGI

primary amoebic meningoencephalitis

acute, fulminating, rapidly fatal

ampho B?

flagellated, beaver contaminated water

steatorrhea-->malnutr

epigastric pain, flatulence, belching

resistant to chlorine

tinidazole/metronidazole

STD, flagellated, aerotol anaer, no cyst stage (only live in human hosts)

can be malodorous discharge, can be asympt

metronidazole

cyst/trophozoites, sexual stage can occur in humans,

reservoirs pigs, calves

profuse watery diarrh, cramps

severe->dehydration in AIDS

animals, water-borne, resistant to water treatment

protozoa/fungus, AIDS patient

airborne transmission?

trimethoprim-sulfamethoxazole (prophylaxis)

can enter skin @ hair follicles

schistosomes: separate sexes, blood: flu-like, maybe chronic intestinal

praziquantal, oxamniquine

flukes: hermaphrodite

snail born, attach to aquatic vegetation

dyspepsia->abd pain/high fever

chronic- liver obstruction

praziquantal, bithionol, triclabendazole

chlonorchis sinensis: undercooked fish

lung fluke, raw or undercooked freshwater shellfish

praziquantal, bithionol

prevention by cooking

live in GI, up to 10m, segmented, increased maturation as proglottids get farther from the head

hermaphr, cysticerosis can have neuro sympt

taenia solium: pork, saginata:beef,

praziquantal

echinococcus:hydatid, dogs as host, cysts in liver and elsewhere, anaphylaxis if cysts rupture, albendazole?

diphyllobothrium latum: fish tapeworm, 15m long, fatigue, diarrh, pernicious anemia

praziquantal, niclosamide

pinworm

female migrates to perianal skin and lays eggs

perianal pruritis

pyrantel pamoate, mebendazole, or albendazole

ingested-> small intestine->blood stream->liver->lungs->coughed and swallowed

eggs survive in soil

cough, dyspnea, fever, GI obstruction, granulomas

albendazole, mebendazole

necator and ancylostoma

actively penetrate through skin, maybe @ hair follicle

migrate to lungs, trachea and swallowed, adult stage in intestine

hypochromic microcytic anemia, rash/pruritis, gi pain, edema

albendazole, mebendazole, pyrental pamoate

fecal contamination of soil, direct penetration thru skin

lungs to GI, lives embedded in col epi,

gi symptoms depending on burden

ivermectin, albendazole

trichuriasis, strictly GI to large intestine to soil

abd pain, distension, bloody diarrh, appendicitis, prolapsed rectum

albendazole, mebendazole

swallows copepod infected water,

migrate for year in walls of small gi, releases larvae into water via ulcer, picked up by copepod

blister erupts a 100 cm worm emerges, abcesses, cellulitis

roll it up, mebendazole

wuncheria bancrofti, elephantiasis

human-human via arthropod

immune mediated, blood or skin biopsy,

diethylcarbamazine, ivermectin

swine, intracellular, nurse cell complex,

undercooked meat

infl in brain, eyes, peri/endocardium, lungs, muscles,

albendazole, mebendazole

cat feces

asexual stage in man

pseudocyst- many thousand

congenital/perinatal, posterior chorioretinitis, hiv

t: pyrimethamine, sulfadiazine and leucovorin

flagellated, cutan, mucocutan, visceral forms

cutaneous at site of sandfly bite

muco- metastasis to oral->destruction

visc:anorexia, hepatosplenomeg

sodium stibogluconate

african sleeping sickness, tsetse fly, t.cruzi- chagas disease, kissing bug,

antigenic variation, invades by scratching the bite

african: torpor and death, nagana in cows

american: cardiac damage

live in macrophage

african:pentamidine, suramin, melarsoprol, eflornithine,

american: nifurtimox, benznidole

terbinafine and naftifine

inh squalene epoxidase

inh glucan (cell wall) synth

caspofungin, micafungin, anidulafungin

microsporum, tricophyton, epidermophyton

azoles, terbinafine, griseofulvin

cauliflower infection of skin

terbinafine or itraconazole/flucytosine

maduromycosis

indolent swollen deformed lesions with draining sinus tracts

nocardia-bactrim

actinomyces-penicillin

river valleys, bats

intracellular yeast w.in macrophages, dimorphism

amphoB then fluconazole

river valleys, dogs horses, soil?

single budding broad based yeast

amphoB if sever

itra or fluconazole

(south american blastomycosis)

soil?

oral/nasal lesion, ship's wheel yeast

amphoB

itracon

valley fever

from soil, arthrospores inhaled

40% exposure->infection (mild pulm)

spherules filled w/ endospores

mostly no tx reqd

leading fungal meningitis

mucopolysacch capsule, pigeon crap, ubiq

diffuse pulm infil pneum-->meningitis spread

india ink, crypto antigen on CSF**,

amphoB

flucytosine

HIV, SE asia, bamboo rats, soil

mimic TB or other HIV opp inf

culture and ID

amphoB

flucyt

EBV, epithelial overgrowth, nonpainful

HIV association

congenital CMV syndrome: primary inf of mom,

only 10% of babies are symptomatic, leading cause infant hearing loss

CMV mono like EBV inf mono exc missing sore throat

and has petechial rash and jaundice

exanthem subitum

HHV 6b/7

CD4 cells, by age 2 have had it 2x

3-day illness, fever->trunk rash

10-15% mortality, indistinguishable from small pox

squirrels natural host

paramyxo, enveloped -RNA,

koplik's spots on buccal mucosa

toga, env +RNA

severe congenital: hearing loss, heart, ophth

toxoplasma, other, rubella, CMV, HSV

syph, hepB, VZV, parvoB19, HIV, HTLV-1

rash, chorioretinits, microcephaly, hepatospleno, IUGR

most severe if primary HSV2 during pregnancy and fetus is born with dissem virus

acyclovir

c-section, prophylaxis

congenital VZV, bad, vaccinate naive women @ childbearing age, acyclovir

-RNA segmented, VHFs

CCHF: wide distribution, nonspecific symptoms (lumbar pain, petechiae between d3-5), ticks,

RVF: ruminants, mosq, carcasses, nosocomial

hepato, renal, hemm, late:meningoenc, retin

HFRS:multiple types, febrile->hypotens->oliguric (mortalities)->diuretic (weeks)->convalescent

abrupt fever, severe headache/myalgia, hemm: acute liver/renal failure, renal necrosis,

supportive, dialysis, ribavarin

rhabdovirus, enveloped rodlike -RNA

hydrophobia- nucleus ambiguus

20% paralytic rabies->coma

pupillary dilation, salivation/sweating, ejaculation

antidiuresis or diabetes insipidus

periodic respiration, arrythmias

DFA staining, neck skin biopsy w/in hairline

benzodiazepines, NOT MORPHINE, isolate, CLEAN WOUND

milwaukee: ketamine, ribavarin, amantadine

ss+RNA, EEE, WEE, VEE, everglades

EEE:highest mortality

also rubella and chikingunya

flavivirus, arbovirus

meningoencephalomyelitis

high morbid/mortality, several endemic areas

pigs, migrating birds

vaccine possible

flavivirus +ssRNA

south america/africa

coffee ground hematemesis

vaccine

flavivirus

urban mosq: aedes

break-bone: bone pain

pos tourniquet test, myocarditis, neuro

petechia on chest

supportive

cand vaccine

togavirus

joint pain, aedes, India, parts of africa

"that which bends up"

cand vaccine