MICRO - Parasites Associated with RTIs (Paragonimus, Pneumocystis)

Animalia

What is the kingdom of Paragonimus species?

Plathyhelminthes

What phylum does Paragonimus belong to?

Trematoda

What class does Paragonimus belong to?

Plagiorchilda

What order does Paragonimus belong to?

Trogotrematidae

What family does Paragonimus belong to?

Paragonimus

What is the genus of the oriental lung fluke?

Paragonimus westermani

What species of Paragonimus is commonly found in the Philippines?

Oriental lung fluke

What is the common name of Paragonimus westermani?

Kerbert

Who first discovered Paragonimus in 1878?

1879

In what year was the first human infection identified by autopsy?

Manson and von Baelz

Who found Paragonimus eggs in sputum in 1880?

1907

When was the first Paragonimus case reported in the Philippines?

Nakagawai

Who described the complete life cycle of Paragonimus in 1916?

Crustaceans

What did Nakagawai identify as the second intermediate host of Paragonimus?

20.7 million

How many million people are infected with Paragonimus worldwide?

292.8 million

How many million people are at risk for Paragonimiasis?

Asia, Latin America, and Africa

What regions have endemic Paragonimus infection?

Paragonimus westermani and Paragonimus siamensis

What are the two Paragonimus species found in the Philippines?

Humans

What is the definitive host of Paragonimus westermani?

Snails

What is the primary intermediate host of Paragonimus?

Crabs or crayfish

What is the second intermediate host of Paragonimus?

Eating undercooked crab or crayfish

How can humans acquire Paragonimiasis?

Applying raw juice of crayfish to skin

What unusual skin practice may transmit Paragonimus?

Oval and operculated

What shape describes the Paragonimus egg?

Brownish yellow

What color are Paragonimus eggs?

80-118 by 48-60 micrometers

What is the size of a Paragonimus westermani egg?

Operculum

What is the term for the flattened cap structure on Paragonimus eggs?

Abopercular end

What is the thickened posterior end of the Paragonimus egg called?

Clonorchis sinensis and Diphyllobothrium latum

What other eggs can Paragonimus be confused with?

In snails

Where do Paragonimus cercariae develop?

Stylet

What structure allows cercariae to pierce their second host?

Spined

What is the appearance of the cercaria’s surface?

Tail

What organ is located opposite the oral sucker in cercariae?

Metacercariae

What is the infective stage of Paragonimus for humans?

Crustaceans

In what host do Paragonimus metacercariae develop?

381-457 micrometers

What is the size of Paragonimus metacercariae?

Cysteine protease

What enzyme helps metacercariae penetrate human tissues?

Reddish brown

What is the color of adult Paragonimus worms?

20 years or more

What is the lifespan of Paragonimus adult worms?

Yes

Are Paragonimus species hermaphroditic?

Vitellaria

What structure of Paragonimus is responsible for egg shell formation?

65-90 days

How long does Paragonimus develop in the definitive host?

Antemelania snail

What is the first intermediate host of Paragonimus?

Sundathelphusa crab

What is the second intermediate host of Paragonimus?

Egg

What is the diagnostic stage of Paragonimus?

Metacercariae

What is the infective stage of Paragonimus?

Duodenum

Where does the metacercaria excyst after ingestion?

Pleural cavity

What body cavity do Paragonimus worms migrate to before reaching lungs?

Sputum or stool

How are Paragonimus eggs expelled from the body?

Brownish, blood-tinged, fishy sputum

What kind of sputum is produced in pulmonary Paragonimiasis?

Tuberculosis

What disease is often mistaken for Paragonimiasis?

Eosinophilia

What lab finding differentiates Paragonimiasis from tuberculosis?

Pleural effusion or pneumothorax

What imaging finding is typical of early Paragonimiasis?

Loeffler syndrome

What syndrome resembles early Paragonimiasis?

Fibrotic capsule and necrosis

What lung changes occur in late Paragonimiasis?

Patchy infiltrates or calcification

What imaging finding appears in late infection?

Migration through tissues

How does Paragonimus spread to other organs?

Cerebral Paragonimiasis

What is the most severe form of Paragonimiasis?

Seizures

What symptom occurs in brain involvement?

Paragonimus skrjabini

What type of Paragonimus causes migratory cutaneous nodules?

Eosinophilia

What blood finding is common in Paragonimiasis?

Chest X-ray

What is the first-line diagnostic imaging for Paragonimiasis?

Sputum

What specimen is most preferred for microscopy?

After 2-3 months of illness

When do eggs become detectable in sputum?

ELISA

What serologic test has 96–99% sensitivity for Paragonimiasis?

Dot-Immunogold Filtration Assay

What test is developed in China for rapid antibody detection?

Loop-mediated isothermal amplification

What nucleic acid test detects Paragonimus DNA?

Praziquantel

What is the drug of choice for Paragonimiasis?

Triclabendazole

What alternative drug is used for Paragonimiasis?

Avoid eating raw crabs

What preventive measure can stop Paragonimus infection?

Hypersensitivity to microfilariae

What causes tropical pulmonary eosinophilia?

Wuchereria bancrofti and Brugia species

What are the main etiologic agents of TPE?

IgE

What immunoglobulin is elevated in TPE?

Eosinophils

What cells respond to the filarial antigen-antibody complex?

Wheezing, nocturnal cough, breathlessness

What are key symptoms of TPE?

Young adults

What age group is most affected by TPE?

Diethylcarbamazine

What is the drug of choice for TPE?

Acute eosinophilic pneumonia

What is Loeffler syndrome also known as?

Ascaris lumbricoides

What parasite commonly causes Loeffler syndrome?

Anyclostoma duodenale and Necator americanus

What hookworms can cause Loeffler syndrome?

Mebendazole

What drug treats Ascaris and hookworm infections?

Ivermectin

What drug treats Strongyloides infection?

Migratory pulmonary infiltrates

What imaging finding is characteristic of Loeffler syndrome?

Fungi

What kingdom does Pneumocystis belong to?

Ascomycota

What phylum does Pneumocystis belong to?

Pneumocystis jirovecii

What is the species of Pneumocystis that infects humans?

Opportunistic fungus

What type of organism is Pneumocystis jirovecii?

Cholesterol

What replaces ergosterol in Pneumocystis cell membrane?

Pneymocystis pneumonia

What disease is caused by Pneumocystis jirovecii?

Trophic form

What is the infectious form of Pneumocystis?

8

How many intracystic bodies does a mature cyst contain?

Gomori’s methenamine silver stain

What stain visualizes cysts as “black ping-pong balls”?

Inhalation of droplets

What is the main mode of transmission of Pneumocystis?

HIV-infected patients

What patient group is most affected by PCP?

Below 200 per mm3

At what CD4 count are HIV patients at risk for PCP?

Type I pneumocyte

What type of pneumocyte does Pneumocystis adhere to?

Foamy exudate

What material fills alveoli in PCP infection?

Non-productive cough

What type of cough is common in PCP?

Tachypnea

What key symptom indicates PCP in infants?

Hypoxemia

What clinical sign shows impaired oxygen exchange?