Parasites (Infection, Symptoms, Treatment, Prognosis)

darodri6's version from 2016-03-15 19:05


ParasiteSubspeciesInfection Method/RouteState of Parasite during Human Inoculation
TrematodesSchistosoma mansoni, japonicum, & haemotobiumEntry through tissue in fresh water via infective cercariae (released from snail)Cercariae (released by snail)
CestodeTaenia soliumingestion of Egg (causes cystercercosis) or Larva/Cysticerci (causes Teniasis) from an infected PIGingestion of Egg from Human Feces
OR Cysticerci from Pig
CestodeTaenia saginataIngestion of Larva from an infected & undercooked COWingestion of Egg from Human Feces
OR Cysticerci from Cattle
CestodeEchinococcus granulosaIngestion of eggs-contaminated feces from definitive host (DOGS)egg-contaminated dog feces
CestodeD. latumDiphylobrothriasis: ingestion of raw/undercooked, infected fresh water SEAFOOD
Sparagnosis: drinking water containing PROCEROID-infected copepods
Diphylobrothriasis = Pleroceroid from larger fish

Sparagnosis = Proceroid from water containing infected crustacean copepods
CestodeD. caninumingestion of adult dog/cat flea, either by dog/cat or accidentally by humansCysticercoid larvae of adult flea (Ctenocephalides canis spp.)
CestodeH. diminutaingestion of CYSTICERCOID-containing beetles, which normally get into CEREAL:
NematodeAscaris lumbricoidesingestion of eggs from contaminated SOIL, or Fecal:OralFertilized (embryonated) Eggs from Vegetation
NematodeWuchereria BancroftiMOSQUITO bite releases 3rd-stage filarial larvae unto skin, where it crawls into wound after mosquito blood meal3rd-stage filarial invasion following mosquito bite (Anopheles or Culex)
NematodeTrichinella spiralisIngestion of encysted larvae in under-cooked, infected PORK or wild game. Eggs hatch in the intestine, therefore no eggs present in stool (end-cycle).
Trichinosis: eating eggs results in encysted larvae in human muscle
Trichinellosis: eating raw or undercooked pork gives you adult intestinal worm
Ingestion of encysted larvae from pig/wild game
GiardiaG. lambliaCyst ingestion via contaminated food or water OR direct Fecal:OralCysts from contaminated water
TrypanosomaT. b. gambiense (W. Africa) & T.b. rhodesiense (E. Africa)Saliva from Tsetse fly (genus Glossina) enters blood/lymphaticsMetacyclic Trypomastigote from Glossina Tsetse Fly
TrypasonomaT. cruzi (S. America)via Stercoraria = host rubs feces from "kissing" or "assasin" bug into wound siteMetacyclic Trypomastigote from Kissing/Assassin Bugs
Toxoplasmaghondiingestion of cysts via contaminated water/soil/vegetation/under-cooked, intermediate host (i.e. pigs, sheep, goat), Fecal:Oral, or Transplacental transmission (congenital)-Sporulated Oocyst from environment
-Tissue Bradyzoite from another intermediate host
-Unsporulated oocyst from cat feces (fecal:oral)
PlasmodiumP. vivax, P. ovale, P. malariae, P. falciporumSporulation in salivary glands Female Anopheles transfer Plasmodium sporozoites and later on pick ups gametes during subsequent blood meal which were produced in human RBCsSporozoite from mosquito saliva


ParasiteSubspeciesDisease CausedSymptoms
TrematodesSchistosoma mansoni & S. japonicumSchistosomiasisPruritus at entry sites, constitutional symptoms, eggs in stool, malaise, fever, abdominal pain, cough as it migrates through lungs, spit of blood, acute hepatitis as it enters liver, to chronic hepatitis,
-Acute phase (1-3 months after infection): fever, skin pustules (i.e. wheals), abdominal pain, liver tenderness, diarrhea or dysentery,
-Chronic: eggs (ROSE-THORNED in small vessels close to lumen of intestine or bladder, eggs contain miracidia which contain protease and stimulate abscess formation, liver granulomas (if eggs containing miracidia get washed back into liver, get stuck), hepatosplenomegaly (if liver blockage with eggs --> portal hypertension--> varicose veins esophagus). Intestinal schistosomiasis (instead of liver)--> anal polyps, weight loss, anemia.
TrematodesS. haematobiumSchistosomiasisHematuria, dysuria, frequency, urgency, squamous cell carcinoma of the bladder, eggs in urine
TrematodesS. DermatitisSwimmer's Itchskin infections, "swimmers itch" with lots of red pustules on skin
CestodeTaenia solium-Teniasis (adult tapeworm)
-Teniasis (from ingested Larva (aka Cysticerci)): abdominal pain, malnutrition, Gravid Proglottids (eggs) in stool, eosinophilla, harsh immune response
-Cystercercosis (from ingested EGG within human feces): systemic infestation via accessing hepatic portal vein, brain lesions ("swiss cheese look" on a CT scan). Cysticercosis normally found in human CNS and muscles of pigs --> cysticerci die & become calcified (easily palpable if subcutaneous) --> most common form if neurocysticercosis = meningitis
CestodeTaenia saginataabdominal pain, malnutrition, eggs in stool (proglottids)
CestodeEchinococcus granulosaHyatadiasisHydatid cycst ("egg-shell calcifications"), organ dysfunction (liver, lungs, brain), cyst rupture --> anaphylaxis (therefore, must kill cyst before their removal!), hepatomegaly, liver cysts, RUQ pain, bloody sputum (from lung infection), eggs in stool
CestodeD. latumTape worm infections:
-diphyllobothriasis -sparganosis
Diphyllobothriasis: B12 deficiency, pernicious/megaloblastic/macrocytic anemia, malnutrition, eggs in stool, nausea, vomiting, diarrhea
Sparagnosis: larval stage and infective adult stage in human body cause invasive & painful, inflammatory infection of various tissues due to growth of larvae proceroid larvae into Pleuroceroid larvae (Sparagnum) within them
NematodeAscaris lumbricoidesAscariasis (intestinal roundworm of humans)PNEUMONIA, malnutrition, bowel obstruction (in heavy infection), biliary obstruction, eosinophilia w/lots of IgE, eggs in stool, asthma-like attacks, diarrhea/flatulence mimic lactose intolerance
NematodeWuchereria BancroftiNematode Elephantis &
Tropical Pulmonary Eosinophilia
-Elephantis: Fever, chills, lymphadenopathy, LIMB infection with LYMPHANGITIS & DISTENDED/ERYTHEMATOUS/HOT overlying skin --> BALLOONS due to blockage by filarial worms) = ELEPHANTITIS (not the inevitable result, only in severe/late/untreated cases). Orchitis & inflammation of spermatic cord/breast also possible.
-Tropical Pulmonary Eosinophilia: due to rare, immunologic rxn to infection. Pulmonary eosinophilia with increased IgE and Filaria-specific Ab's, paroxysmal non-productive cough, wheezing, weight loss
NematodeTrichinella spiralisTrichinellosis, trichinosisEarly symptoms: nausea, vomiting, diarrhea, and other constitutional symptoms.
Middle symptoms (invasion): high fever, eosinophilia (high IgE), MYALGIA, CLASSIC TRICHINOSIS = CIRCUMORBITAL EDEMA + muscle inflammation + fever + eosinophilia) , conjunctival and splinter hemorrhages, urticarial rash.
Late symptoms: calcified cysts, invasion of heart, lungs and brain. Muscle biopsy or serology is usually used.
GiardiaG. lambliaGiardiasis (infection of upper intestinal tract; duodenum or jejunum)-Acute = DIARRHEA GREATER THAN 10 days due to malabsorption. Abdominal pains, flatulence, bloating, vomiting, weight loss. Explosive diarrhea, excessive lipids (steatorrhea), no blood in feces, no necrotic tissue
-Chronic form = B12 malabsorption, lactose intolerance
TrypanosomaT. b. gambiense (W. Africa)African Sleeping Sickness, Trypanosomiasis, Gamiense=Chronic,-Chancre at site of bite, slow travel to brain (Chronic), Winterbottom Sign, Malnutrition, pneumonia, heart failure, apathy, disinclination to work, mental dullness, poor motor coordination, tremors leading to paralysis, sleep, coma and death. -Haemolymphatic phase (First stage)= blood and lymph with bouts/undulate fever, headache, joint pains and itching.
-Neurological phase (Second Stage)= pass BBB, neuro symptoms, sleepiness, coma, death.
TrypanosomaT.b. rhodesiense (E. Africa)African Sleeping Sickness, Trypanosomiasis, Rhodesiense=AcuteFast transition to brain (Acute), Winterbottom Sign, Malnutrition, pneumonia, heart failure, apathy, disinclination to work, mental dullness, poor motor coordination, tremors leading to paralysis, sleep, coma and death.
Haemolymphatic phase (First stage)= blood and lymph with bouts of fever, headache, joint pains and itching.
Neurological phase (Second Stage)= pass BBB, neuro symptoms, sleepiness, coma, death.
TrypasonomaT. cruziChagas Disease (American Sleeping Sickness)Romana Sign (eye lymph node swelling), targets heart and nervous system, dilated cardiomyopathy, megaesophagus, megacolon and meningoencephalitis
ToxoplasmaT. ghondiToxoplasmosis“Mistaken for Flu”, swollen lymph nodes, fever, headache and anemia.
Congenital: hydrocephalus, jaundice, and mental retardation. Blindness, pneumonia, cyst formation, intracranial calcifications, chorioretinitis -->blindness
PlasmodiumP. vivax, P. ovale, P. falciporum, P. malariaeMalariaCyclic fever, hemolytic anemia, myalgias, gastroenteritis and splenomegaly. Paroxysms= release of parasites causing toxic effect/fever
Fever Cycles;
P. vivax: Quotidian (every 24 hours as doble infection with P. falciparum) OR Benign Tertian Fever (every 48 hours)
P. ovale: Mild Tertian Malaria (every 48 hours)
P. falciparum: Quotidian (every 24 hours and double infection with P. vivax) OR Malignant Tertian (every 48 hours)
P. malariae: Quartan (every 72 hours)


Schistosoma (Trematodes)mansoni, japonicum & haemotobiumPraziquantel
Schistosoma (Trematodes)DermatitisImmune system response
CestodeTaenia solium-Teniasis: (from larva/cysticerci ingestion): PRAZIQUANTEL (or Niclosamide-->no longer available in USA)
-(Neuro)cysticercosis (from egg ingestion): PRAZIQUANTEL WITH CAUTION! (could rupture cysts --> anaphylaxis/seizures)
CestodeTaenia saginataNiclosamide or Praziquantel
CestodeEchinococcus granulosa-ALBENDAZOLE (to first kill cyst) or Mebendazole, followed by careful suction/aspiration of cysts
-Praziquantel if there is cyst spillage during surgery (=anaphylactic response!)
CestodeD. latumDiphyllobothriasis: Praziquantel (FDA doesn’t approve), Niclosamide
Sparagnosis: Praziquantel and surgical removal (if only a few within tissues)
CestodeD. caninumtreat dog/cat for fleas (disrupts cycle)
NematodeA. lumbricoides-Mebendazole (drug of choise; stimulates worm migration), may have to do surgical intervention (if worm migrates to vital organs), suction to clear obstruction and/or induce vomiting
-Albendazole = not FDA approved
-Ivermectin = not safe for kids under 50 lbs
NematodeWuchereria Bancrofti-Diethylcarbamazine for parasite (microfilariae) from CDC (no longer FDA-approved; well tolerated)
-Antihistamines (control of lymphangitis)
-Surgical removal
Ivermectin (Vet use) causing worm paralysis
antihistamines (for lymphangitis) and surgery.
NematodeTrichinella spiralis-Albendazole (tolerated best)
-Mebendazole (prevent tissue infection)
-Corticosteroids for heavy infections.
GiardiaG. lamblia-Metronidazole (choice drug)
-Other drugs include: Tinidazole (one pill), Quinacrine, Furazolidone & Paramomycin
TrypanosomaT.b. gambiense (W. Africa)First stage = Pentamidine
Second stage = Melarsoprol
Currently Nifurtimox & Eflornithine (resurrection combo drug) is best and used more frequently
TrypanosomaT.b. rhodesiense (E. Africa)First stage = Suramin, but 1st stage hard to catch
Second stage = Melarsoprol
TrypanosomaT. cruziBenznidazole, Nifurtimox
ToxoplasmaT. ghondiNormal infection in healthy host: no treatment (self-limiting)
Pregnant woman; early = Spiramycin, late = Pyrimethamine, Sulfadizinean and Leucovorin
Immunocompromised: Pyrimethamine
Ocular infection: Pyrimethamine, Sulfadizinean and Leucovorin (folinic acid)
Sulfa allergy? --> use Clindamycin
PlasmodiumP. vivax, P. ovale, P. malariae, P. falciporum-Doxycycline (effective & cheap; also used as a Prophylactic)
-Primaquine (1st world; ONLY drug good for all types; gametocide & hypnozoiticide),
-Mefloquine (if resisant form of P. falciparum; schizonticide),
-Chloroquine (3rd world use, safe & cheap BUT some resistant strains),
-Pyrimethamine (not used in US; good for Chloroquine-resistant strains)
Quinines artemisinin, sulfadoxine-pyrimethamine

Prognosis (omission = never mentioned)

CestodeEchinococcus granulosacan be lethal from cyst invasion and rupture (--> anapyhlactic shock). Treatment has intense symptoms but can be cured.
NematodeTrichinella spiralisdeath by myocarditis, pneumonia, encephalitis
TryponasomaT.b. gambiense & T.b. rhodesiense & T. cruziCured if treated, Death if not treated
ToxoplasmaT. ghonditreatment = cured. If not can have blindness, cyst, abortion or developmental issues if pregnant