Parasites (protozoa, helmintes, arthropoda) •I. Protozoa •Giardia intestinalis •Patogenicity: watery diarrhea •Therapy: metronidazol •Dg.: cysts + trofozoits in stool, trofozoits in duodenal fluid •Epidemiology: contaminated water D:\Documents and Settings\lenka\My Documents\My Pictures\giardia.jpg G. lamblia D:\Documents and Settings\lenka\My Documents\My Pictures\prujmy.jpg Trichomonas vaginalis •Patogenicity: kolpitis, uretritis •Therapy: metronidazol •Epidemiology: STD •Dg.: native - CAT medium •/Gram – Giemsa staining (MOP V) • •Entamoeba histolytica •2 forms: invasive (magna) and non-invasive (minuta) •Pathogenicity: invasive form damages intestine and causes dysenteric diarrhea, liver absces •Therapy: metronidazol •Dg.: microscopy, cultivation • tva01 T. vaginalis • Trypanosoma cruzi T. brucei •Patogenicity: Chagas disease sleeping sickness •Therapy: benzonidazol, insecticids pentamidin, suramin •Epidemiology: bug fly tse-tse (Glossina) •Dg.: blood smear, serology blood smear • • • Leishmania sp. •Patogenicity: Old and New world – skin and visceral forms (kala azar, dum dum etc.) •Therapy: amphotericin B, Sb (antimon) •Epidemiology: Lutzomya, Phlebotomus •Dg.: cultivation, biopsy, serology in visceral form C:\Documents and Settings\muprac\Dokumenty\Černohorská\LF MUas\podzimní semestr\cutaneous-leishmania.jpg C:\Documents and Settings\muprac\Dokumenty\Černohorská\LF MUas\podzimní semestr\trypanosoma.jpg C:\Documents and Settings\muprac\Dokumenty\Černohorská\LF MUas\podzimní semestr\leishmania1.jpg Toxoplasma gondi •Epidemiology and life cycle: infection via oocyst from cats dung or tissue cyst from host meat (pig). Human ingest cyst and parasite migrates to tissues + forms cysts in these tissues •Pathogenicity: elevated temperature, torpidity, enlargement of lymph nodes, in pregnant leads to malformation and abortion •Therapy + prevention: spiramycin – pyrimethamin, cooked meat, pregnant screening •Dg.: indirect – KFR, ELISA (IgA, IgG) Plasmodia (P. falciparum, P. malariae, P. vivax, P. ovale) •Pathogenicity: malaria •Symptoms: freezing, shakes, fever, swelling - patient feels better until the next attack. Sometimes occurs also anemia, kidney damage or CNS (depends of plasmodium type) •Epidemiology: transfer via mosquito Anopheles, difficult life cycle •Therapy: chlorochin, primachin, meflochin, chinin, atremisins etc., prophylaxis before travelling to malaric areas •Dg.: thick blood drop stained with Giemsa-Romanovsky, fluorescence microscopy, PCR • C:\Documents and Settings\muprac\Dokumenty\Černohorská\LF MUas\plasmodia.jpg II. Helmints (trematodes, taenia, nematodes) •Taenia saginata (taenia, tapeworm) •Morphology + life cycle: human ingests slack cooked beef (cysticercus), maturates in small intestine and form articles full of eggs, come out with stool and infect animals. From their bowels migrate to muscles and form cysticercus. Cycle repeats. •Symptoms: abdominal pain, vomiting, diarhea, tabitude •Dg.: eggs in stool, article observation (more branches womb) •Therapy: praziquantel, niklosamid • C:\Documents and Settings\muprac\Dokumenty\Černohorská\LF MUas\Taenia egg.jpg T. solium (tapeworm,taenia) •Morphology and life cycle: human ingests slack cooked pork (cysticercus), maturates in small intestine and form articles full of eggs, come out with stool and infect animals. From their bowels migrate to tissues (muscles, spinal cord etc.) and form cysticercus. Infection from eggs is also possible, in this case rises cysticercus direct in human (human is a host as well as intermediate host). Cycle repeats. •Symptoms: abdominal pain, vomiting, diarhea, tabitude, cysticercus – headache, pain in muscles, eye damage... •Dg.: eggs in stool, article observing (less branches womb), cysticercus: serology – ELISA, WB, CT, PCR •Therapy: praziquantel, niklosamid • C:\Documents and Settings\muprac\Dokumenty\Černohorská\LF MUas\Taenia egg.jpg C:\Documents and Settings\muprac\Dokumenty\Černohorská\LF MUas\taenia8.jpg Echinococcus granulosus •Morphology: tapeworm of dogs. Egg come out of dog, is ingested by human, in bowel come out larva, migrates to liver/lung/brain where changes to cyst • • • • • • • • • •Symptoms: damage organe function – most frequently liver function, cyst rupture - anaphylactic shock •Therapy: killing with formalin + surgical removement, albendazol •Dg.: indirect – KFR, ELISA, SONO, CT C:\Documents and Settings\muprac\Dokumenty\Černohorská\LF MUas\EchinococcusLifeCycle.gif Nematodes •Enterobius vermicularis (pinworm) •Morphology: ingestion of infectious eggs, live in large intestine, female put eggs in perianal area •Symptoms: restless children, vomiting, intensive claw •Therapy: pyrvinium, prevention - hygiene •Dg.: eggs on sticky tape (lepex) C:\Documents and Settings\muprac\Dokumenty\Černohorská\LF MUas\pinworm1.jpg Ascaris lumbricoides (roundworm) •Morphology: ingest of eggs, in bowel larva come out, migrates to lungs, expectorate and get down, maturate in intestine •Symptoms: depends on life cycle – cough, tiredness, pressure on chest, digestive problems, loss of appetite •Dg.: intestinal phase- eggs in stool, •penetration to tissue - ELISA •Therapy: mebendazol, pyrantel • • •Trichinella spiralis (trichina) •Morphology: ingest of uncooked meat with encysted larvas, larvas free themselves in digestive tract, where maturate. An adult female bear larvas and they migrate into muscles, where form cysts •Symptoms: intestinal phase - vomiting, pain in muscles •Therapy: mebendazol •Dg.: ELISA, WB, muscle tissue biopsy • • C:\Documents and Settings\muprac\Dokumenty\Černohorská\LF MUas\ascaris.jpg C:\Documents and Settings\muprac\Dokumenty\Černohorská\LF MUas\Trichinella%20cyst.jpg larva encysted in muscle egg III. Ectoparasites - arthropods •Serve as vehicle of infection •Ixodes ricinus (dog tick) - boreliosis, tick born encephalitis etc. •Neotrombicula autumnalis - autumn rash •Sarcoptes scabiei - scabies •Pediculus capitis (hair lice), P. humanus – spotted fever, Phtirus pubis (crab louse) •Mosquitos (Anopheles – malaria, Aedes aegypti – yellow fever) •Flea, bug etc. C:\Documents and Settings\muprac\Dokumenty\Černohorská\LF MUas\Anopheles.bmp C:\Documents and Settings\muprac\Dokumenty\Černohorská\LF MUas\podzimní semestr\munka.jpg crab louse