Clinical Parasitology

Parasitic Infections: Clinical Manifestations, Diagnosis and Treatment www.freelivedoctor.com

The Reality ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Case1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Case 1 ,[object Object],[object Object],[object Object],www.freelivedoctor.com

Diagnosis? www.freelivedoctor.com

Giardiasis ( G. lamblia ) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Giardiasis Tests of choice ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Case 2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Case 2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Sigmoidoscopy revealed… ,[object Object],[object Object],www.freelivedoctor.com

Case 2 ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Entamoeba histolytica ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Trophozoites with ingested RBC www.freelivedoctor.com

Trophozoites in colon tissue (H & E stain) www.freelivedoctor.com

Cyst (wet mount) www.freelivedoctor.com

Amoebiasis: Clinical Manifestations ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Amoebiasis: Clinical Manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Amoebic abscess—remember… ,[object Object],www.freelivedoctor.com

Amoebic Abscess ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Remember… ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Amoebiasis Treatment ,[object Object],[object Object],www.freelivedoctor.com

Case 3 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Diagnosis? Case 3 & 4 www.freelivedoctor.com

Three cysts stained pale red are seen in the center with this acid fast stain www.freelivedoctor.com

Modified acid-fast stain of stool showing red oocysts of Cryptosporidium parvum against the blue background of coliforms and debris www.freelivedoctor.com

Cryptosporidium parvum ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Cryptosporidium parvum ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Diagnosis and Treatment ,[object Object],[object Object],[object Object],www.freelivedoctor.com

Case 5 ,[object Object],[object Object],www.freelivedoctor.com

Falciparum vs. Vivax ,[object Object],[object Object],[object Object],www.freelivedoctor.com

Malaria: Genetic susceptibility ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Malaria: Clinical manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Malaria: Clinical manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Malaria: Clinical manifestations ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Differences in strains ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Differences in strains ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Treatment ,[object Object],[object Object],[object Object],www.freelivedoctor.com

Treatment Uncomplicated malaria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Treatment Severe malaria ,[object Object],[object Object],[object Object],www.freelivedoctor.com

Prevention ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

And don’t forget baggage malaria! www.freelivedoctor.com

Case 5 ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

An intact macrophage practically filled with amastigotes (arrows), www.freelivedoctor.com

Leishmaniasis ,[object Object],[object Object],www.freelivedoctor.com

Leishmaniasis ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Leishmaniasis: Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Visceral Leishmaniasis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Hepatosplenomegaly www.freelivedoctor.com

Splenic aspirate ,[object Object],[object Object],[object Object],www.freelivedoctor.com

Leishmaniasis: treatment ,[object Object],[object Object],[object Object],www.freelivedoctor.com

Remember.. ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Cases 7 & 8 ,[object Object],[object Object],www.freelivedoctor.com

AIDS Patient www.freelivedoctor.com

Toxoplasma gondii cyst in brain tissue with H & E stain (100x) www.freelivedoctor.com

For the businessman… ,[object Object],[object Object],[object Object],www.freelivedoctor.com

Transmission ,[object Object],[object Object],[object Object],www.freelivedoctor.com

Toxoplasma gondii ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Toxoplasma gondii: Immunocompetent hosts ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Toxoplasma gondii: Immunocompromised hosts ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Toxoplasma gondii: Clinical manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Toxoplasma gondii: Clinical manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Toxoplasma gondii: diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Toxoplasma gondii: Treatment ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Toxoplasma gondii: Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Thick smear www.freelivedoctor.com

Thin smear Maltese cross www.freelivedoctor.com

Diagnosis?? www.freelivedoctor.com

Babesiosis ,[object Object],[object Object],[object Object],www.freelivedoctor.com

Babesiosis ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Babesiosis ,[object Object],www.freelivedoctor.com

Babesiosis ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Case 9 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Ascaris lumbricoides ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Effects of Adult Ascaris Worms ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Ascaris lumbricoides Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Enterobius (Pinworm) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

[object Object],[object Object],[object Object],[object Object],[object Object],Case 11 www.freelivedoctor.com

On the day of admission… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Diagnosis www.freelivedoctor.com

Strongyloides: Crucial Aspects of Life Cycle ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Disseminated Strongyloidiasis ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Summary—Clinical Findings ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Summary—Clinical Findings ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Summary-Clinical Findings ,[object Object],[object Object],www.freelivedoctor.com

Hookworm ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Trichuris trichiura (Whipworm) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Diagnosis ? www.freelivedoctor.com

Cutaneous Larva Migrans ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Cutaneous larva migrans (creeping eruption) ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Cutaneous larva migrans (creeping eruption) ,[object Object],www.freelivedoctor.com

Cutaneous larva migrans (creeping eruption) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Visceral Larva Migrans ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Chronic intestinal schistosomiasis www.freelivedoctor.com

Schistosomiasis: Epidemiology and life cycle ,[object Object],[object Object],[object Object],www.freelivedoctor.com

Schistosomiasis: Epidemiology and life cycle ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Schistosomiasis: Clinical manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Chronic Schistosomiasis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Schistosomiasis: Diagnosis and Treatment ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

S. mansoni Stool S. haematobium Urine S. japonicum www.freelivedoctor.com

Case 18 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Investigations ,[object Object],[object Object],www.freelivedoctor.com

Blood smear www.freelivedoctor.com

African trypanosomiasis Trypanosoma brucei gambiense www.freelivedoctor.com

Tsetse fly www.freelivedoctor.com

Treatment ,[object Object],[object Object],www.freelivedoctor.com

Reduviid bug (assassin bug) www.freelivedoctor.com

Chagas disease: Clinical manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Chagas disease: Diagnosis and treatment ,[object Object],[object Object],[object Object],www.freelivedoctor.com

Chagas Disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Case 20 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Taenia saginata ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Beef Tapeworm www.freelivedoctor.com

Tapeworms (Cestodes) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Cystercercosis ,[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Cystercercosis ,[object Object],[object Object],www.freelivedoctor.com

Cysticercosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Cysticercosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Cysticercosis ,[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

Classification of Parasitic Diseases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],www.freelivedoctor.com

General rules of treatment ,[object Object],[object Object],www.freelivedoctor.com

General rules of treatment of metazoa www.freelivedoctor.com Nematodes Intestinal Mebendazole or Albendazole Tissue Albendazole Filiariae Ivermectin, doxycycline Cestodes Praziquantel, Albendazole, Niclosamide Trematode Praziquantel Ectoparasites Permethrin, Ivermectin

This is just the beginning of a great adventure in infectious diseases Sine qua non : history and physical examination www.freelivedoctor.com

Thank you Lennox K. Archibald, MD, PhD, FRCP [email_address] www.freelivedoctor.com

Clinical Parasitology

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Clinical Parasitology