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 A 7 yr old boy in Brasil is small for his age and having abdominal pain. His mother also says she thinks he could have asthmaand that this seems a lot like the appendicitis her mother had. What is the most likely worm and why? How did he get the infection? How would you test? |
 Ascariasis Lumbricoides (roundworm): most prevalent parasite worldwide and mostly in kids 5-15, Loeffler’s asthma/eopsinophilia is seen during pulmonary migration, high burden of worms causes abdominal pain and chronic growth impairment Transmission: he ingested eggs in soil/water witch migrated through GI->Lung-> SI ID: fecal smear |
 Working in tropical Vietnam a 10 year old girl comes in with rectal prolapse. She has been having dysentery for weeks. You run blood tests and she has no eosinophilia. He mom says the little often eats dirt. What is the parasite? Why does it cause rectal prolapse? Why no eosinophilia? Is this parasite common? |
 Thrichuris trichiura (whipworm) Rectal P: Because trichuriasis lives in the colon and caused children to feel the need to deficate No Eosinophilia: There is no migration of trichuriasis. It stays in the colon Second most common parasite in the world behing Ascariasis (holy trinity) Holy (trinity) Shit (rectal prolapse) that’s tric-y tric-y |
 You’re Zanzibar. A pregnant woman comes in iron deficiency anemia and protein malnutrition. She eats a balanced diet. She has also brought along her cousin who has now grown in the past year and is showing memory and cognition deficits. You perform a fecal smear to ID the parasite. What is the parasite? Parasites life cycle? Why are the pts showing such deficits? |
 Hookworm (Nacator sp.) Life-cycle: Larvae live in soil and penetrate the skin migrate through the lung and live in the SI where the suck blood and cause iron deficiency. Deficits: Women and children have low iron stores, so blood sucking=iron deficiency |
 You are in the Appalachians and an HIV pt comes in with gram- bacterial meningitis and severe diarrhea. He has a rash on his buttocks and remembers a few months ago he had abdominal pain followed by a cough and coughed up some blood. What is the parasite? What type of infection does the pt have, why? What is the best way to ID? |
 Strongyloides stercoralis Infection: Hyperinfection. strongyloides can reproduce in the host causing autoinfection+ immuno comp pt ID: agar plate: bacteria migrate in lines as larva move, eosinophilia and serology (poor septicity) |
 You’re a US pediatrician. 5 yr old comes in who can’t sleep at night and says her bottom it itchy. She is irritable and had a stomache ache a week ago. She is average intelligence and above the average height for her age. Her mother’s only complaint is that she still sucks her thumb. What is the parasite? Where does this parasite live and #1 symptom? What diagnostic test will you preform? Complications? |
 Enterobius Vermicularis Life cycle: ingest parasite>colon> migrated to anus and lays eggs (autoinfection potential), #1 symptom: puritis of the perianal area at night ID: Scotch tape test Complications: Vaginal or GU infection, appendicitis if worm is an idiot scotch tape to fix to pin worm hole in the flat tire of the Entero-bus to the anus |
 Pt comes in after a hunting trip in Alaska where he ate bear and walrus. He said he has a "stomach flu a week ago" and now has a fever with diffuse myalgia. What does he have? Hoe can you confirm the diagnosis (3 tests)? |
 Trichinella spiralis ID: VERY high eosiniphilia, muscle biopsy, serology |
 You’re running a clinic in West Africa. Pt comes in with nodules in skin, dermatitis and some depigmentation. He is also experiencing lymphadenopathy. Many other people in his village have these symptoms and then go blind. What is the parasite? What is the vector? How do you diagnose? |
 Onchocerciasis (river blindness) Vector: black fly ID: Skin skips (NO microfilarea in blood! lymphatics only) oncho (uncle) Nile got bit by a fly and it all went black (fly and blind) |
 In Africa. Pt comes with angioedema and a complaint that yesterday she saw a full sized worm wiggle across her eye. She has NO eye problems. What is the parasite? Vector? How and what time of day do you test? |
 Loa loa (african eye) Vector: fly (bites during day) ID: Blood test during the day shows microfilaria and eosinophilia, Ag test. Woahhh loa you fly cross my white (conjutiva and lympatics) eye all day |
 You are in South Sudan. Pt comes in with an ulcer on her foot. She says that she often drinks water form a local river and goes swimming with friends in the same place. She now has a secondary infection in her ulcer. What is the parasite? Vector and transmission? Treatment? |
 Dracunculus (Guinea worm) Vector: Drinking copepods in water Treatment: SLOW extraction or adult worm, filter water and avoid swimming in water with open wounds |
 Pt comes in with severe lymphadenopathy and hydrocephele (lymphedema of scrotum). Acutely the pt had fever with adenolymphangitis (lymphangitis and lymphadienitis). As a young man he experienced tropical pulmonary eosinophilia. Parasite? Vector? Diagnosis? |
 Wuchereria bancrofti Vector: mosquito ID: NIGHT blood sample for microfilaria, ultrasound Lymphatics: filarial dancing Only a lymph (limp) could be wursh, at least you still have your scortum |
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A homeless man sleeps with his dog at night. Five years later he devlopes unilateral vision disturbances, siezures and hepitis.
What type of infection deos he have? |
 Toxicara (dog/cat roundworm (ascariasis) Oral ingestion->larva penitrate tissue but cannot mature-> visceral larval migrans (symptoms=tissue), Ocular larva migrans Puppies aren't toxic |
 You go to Something's Fishy for dinner and order lost of sushi. That night you go home and have terrible stomach pain. What parasite did you have? Where is it now? What is the best way to remove it? |
 Anisakiasis It dies in the stomach (huaman incidental host) Gastroscopy removal want some SAKI with your parasite? |
