SkM-Parasites

12/17 - "we're intestinal parasites - we don't need to thank the host"

Giardia lamblia

#1 “Giardia Jungle Ride”

Giardia intestinalis (an intestinal protozoan)

Giardia lamblia

#2 poopy water

cysts (the infectious stage of the parasite) are transmitted via the fecal-oral route, often through contaminated water or food

Giardia lamblia

#3 bubble in water

form of infectious cysts, which are shed in the feces of infected individuals, contaminating water and food sources

Giardia lamblia

#4 backpacks

giardiasis is a concern for individuals consuming water from natural sources, such as hikers and campers, due to the risk of ingesting contaminated water

Giardia lamblia

#5 water bottle + poopy water

poorly purified or untreated water is a common vehicle for g. intestinalis transmission

Giardia lamblia

#6 campers holding noses

the clinical presentation of giardiasis includes characterisic foul-smelling, greasy, non-bloody diarrhea

Giardia lamblia

#7 yellow stool

giardiasis may impair nutrient absorption, resulting in steatorrhea (excess fat in the stools), a manifestation of fat malabsorption

Giardia lamblia

#8 trophozoite shields

the flagellated trophozoites of g. intestinalis have a distinctive pear-shaped morphology

Giardia lamblia

#9 shields in water

detection of cyts or trophozites in stool specimines confirms dx

Giardia lamblia

#10 “O&P”

stool ova and parasite (O&P) examination and ELISA for antigens are reliable diagnostic methods for giardiasis

Giardia lamblia

#11 “ELISA” boat

stool ova and parasite (O&P) examination and ELISA for antigens are reliable diagnostic methods for giardiasis

Giardia lamblia

#12 metro

effective treatments of giardiasis include metronidazole, tinidazole, and nitazoxanide

Entamoeba histolytica

#1 “Do not ENTer - HISTorical site”

E. histolytica (an intestinal protozoan that causes amebiasis)

Entamoeba histolytica

#2 bubbles in water

forms infectious cysts that are passed through stool

Entamoeba histolytica

#3 drinking bubbly water

amebiasis is primarily acquired through ingestion of food or water contaminated with E. histolytica cysts

Entamoeba histolytica

#4 holding hands

can be transmitted via anal-oral sexual contact

Entamoeba histolytica

#5 R lobe liver dig site

the most common extraintestinal manifestation of amebiasis is liver abscess, typically occurring in the R hepatic lobe

Entamoeba histolytica

#6 clutching right side

clinical presentation of hepatic amebiasis often includes RUQ pain, fever, and hepatomegaly

Entamoeba histolytica

#7 anchovy paste truck

aspirates from amebic liver abscesses often have a characteristic “anchovy paste” appearance

Entamoeba histolytica

#8 colon drainage pipe with rust spots

flask-shaped ulcerations in the colon is a characteristic finding in intestinal amebiasis

Entamoeba histolytica

#9 flask water bottles

the presence of flask-shaped ulcers is a hallmark of invasive amebiasis, observable through histopathological examination

Entamoeba histolytica

#10 red stools

bloody diarrhea in amebiasis is a result of ulceration in the intestinal mucosa

Entamoeba histolytica

#11 “O&P” pipe

Diagnosis of infection can be confirmed by identifying E. histolytica cysts or trophozoites in stool samples using O&P examination

Entamoeba histolytica

#12 trophozoite puddle + red cups

the presence of E. hystolytica trophozoites containing ingested RBCs in stool or tissue samples is diagnostic of invasive amebiasis

Entamoeba histolytica

#13 flask in colon pipe

intestinal biopsy may show flask-shaped lesions in intestinal amebiasis

Entamoeba histolytica

#14 Metro

metronidazole is part of the primary treatment for amebiasis, targeting trophozoites

Entamoeba histolytica

#15 pair of mice

Paromycin and iodoquinol are luminal agents used to eradicate residual E. histolytica cysts from the intestinal lumen after treatment with metronitazole or tinidazole

Entamoeba histolytica

#16 “Queen Iodo’s Tomb”

Paromycin and iodoquinol are luminal agents used to eradicate residual E. histolytica cysts from the intestinal lumen after treatment with metronitazole or tinidazole

Cryptosporidium spp.

#1 flooded crypt

cryptosporidium spp. (intestinal protozoa)

Cryptosporidium spp.

#2 immunocompromised cane

cryptosporidiosis is a significant cause of diarrheal illness, particularly in HIV-positive individuals with advanced immunosupression

Cryptosporidium spp.

#3 diarrhea water

in immunocompromised hosts, cryptosporidiosis may manifest as severe, chronic, and watery diarrhea

Cryptosporidium spp.

#4 pink-acid fast poncho

the oocyst walls are acid-fast or partially acid-fast

Cryptosporidium spp.

#5 bubbles

these protozoa form infectious oocysts that are passed through stool

Cryptosporidium spp.

#6 multifaceted amethyst gems

the oocysts are composed of 4 motile sporozoites

Cryptosporidium spp.

#7 broken pipe

upon ingestion, sporozoites invade the epithelial cells of the small intestine, leading to diarrheal illness through direct cellular damage

Cryptosporidium spp.

#8 knitted sock

nitazoxanide is approved for treating cryptosporidiosis in immunocompetent individuals and may offer some benefit in immunocompromised patients, though efficacy is variable

Cryptosporidium spp.

#9 sock filter

effective filtration of drinking water is crucial for removing oocysts, preventing infection

Cryptosporidium spp.

#10 spirit crows

spiramycin, a macrolide antibiotic, may be useful for alleviating cryptosporidial diarrhea in some immunocompromised patients

Toxoplasma gondii

#1 gandhi cat

toxoplasma gondii (a CNS protozoan)

Toxoplasma gondii

#2 pregnant woman

it is considered a TORCHeS infection (“T”) as it can be transmitted transplacentally, leading to congenital infection

Toxoplasma gondii

#3 litter box

cats are the definitive hosts, and humans are at risk of infection through exposure to oocyst-contaminated cat feces

Toxoplasma gondii

#4 egg in litter box

oocysts are shed in cat feces and con contaiminate soil, water, or food

Toxoplasma gondii

#5 immunocompromised cane

individuals with compromised immune systems, particularly those with HIV/AIDS, are susceptible to severe toxoplasmosis

Toxoplasma gondii

#6 ring-shaped glasses

cerebral toxoplasmosis can manifest as multiple ring-enhancing lesions on neuroimaging, especially in immunocompromised individuals

Toxoplasma gondii

#7 red turban

toxoplasmic encephalitis is a common complication of toxoplasmosis in severely immunocompromised individuals

Toxoplasma gondii

#8 turban pin

brain biopsy may be utilized to distinguish between cerebral toxo and CNS lymphoma

Toxoplasma gondii

#9 meaty cat food

ingestion of undercooked or raw meat containing toxo cysts is a common mode of human infection

Toxoplasma gondii

#10 torch

it is considered a TORCHeS infection (“T”) as it can be transmitted transplacentally, leading to congenital infection

Toxoplasma gondii

#11 milk on head

the classic presentation of congenital toxo includes intracranial calcifications, hydrocephalus, and chorioretinitis

Toxoplasma gondii

#12 water bowl on head

the classic presentation of congenital toxo includes intracranial calcifications, hydrocephalus, and chorioretinitis

Toxoplasma gondii

#13 flash bulb

the classic presentation of congenital toxo includes intracranial calcifications, hydrocephalus, and chorioretinitis

Toxoplasma gondii

#14 deaf Beethoven

congenital toxo is a known cause of hearing loss

Toxoplasma gondii

#15 sulfur eggs

sulfadiazine, in combo with pyrimethamine, is a cornerstone in the tx of toxo

Toxoplasma gondii

#16 pyramid pattern

sulfadiazine, in combo with pyrimethamine, is a cornerstone in the tx of toxo

Toxoplasma gondii

#17 immunocompromised cane + $100 bill

prophylaxis with TMX-SMX is recommended for toxo IgG positive HIV patients with a CD4+ count below 100 cells/microL to prevent reactivation of toxo

Toxoplasma gondii

#18 “+” kite with IgG antibody key

prophylaxis with TMX-SMX is recommended for toxo IgG positive HIV patients with a CD4+ count below 100 cells/microL to prevent reactivation of toxo

Toxoplasma gondii

#19 sulphur egg by $100

prophylaxis with TMX-SMX is recommended for toxo IgG positive HIV patients with a CD4+ count below 100 cells/microL to prevent reactivation of toxo

Trichomonas vaginalis

#1 magic trichs

trichomonas vaginalis (a unicellular protozoan parasite of the reproductive system)

Trichomonas vaginalis

#2 magic scarves

is a motile organism with whip-like flagella and an undulating membrane

Trichomonas vaginalis

#3 trophy

exists ONLY as a trophozoite form, it does NOT have a cyst form

Trichomonas vaginalis

#4 couple kissing

is a sexually transmitted infection of the urogenital tract

Trichomonas vaginalis

#5 cobblestone sidewalk

has a tropism for squamous epithelial cells —> infection and inflammation of the vulva, vagina, cervix, and urethra

Trichomonas vaginalis

#6 smiling delivery man

asymptomatic carriage, primarily in MEN, contributes to the spread of trich infection; tx of sexual partners reduces this risk

Trichomonas vaginalis

#7 vaginal flowers

causes vulvogaginitis, inflammation of the vulva and vagina marked by erythema, burning, pruritis, and discharge

Trichomonas vaginalis

#8 burning trash can

causes vulvogaginitis, inflammation of the vulva and vagina marked by erythema, burning, pruritis, and discharge

Trichomonas vaginalis

#9 itching dog

causes vulvogaginitis, inflammation of the vulva and vagina marked by erythema, burning, pruritis, and discharge

Trichomonas vaginalis

#10 leaking fluid

causes vulvogaginitis, inflammation of the vulva and vagina marked by erythema, burning, pruritis, and vaginal discharge

Trichomonas vaginalis

#11 frothy green puddles

causes a classically copious, yellowish-green, frothy, malodorous vaginal discharge

Trichomonas vaginalis

#12 strawberry hat trick

cervical inflammation marked by erythema, edema, and punctate hemorrhages (AKA strawberry cervix)

Trichomonas vaginalis

#13 “4.50 and up”

thrives in a basic environment, so vaginal pH testing will show a pH of 4.5 or greater

Trichomonas vaginalis

#14 leaking package

in men, usually asyptomatic, but may present as urethritis, marked by dysuria and thin, white discharge

Trichomonas vaginalis

#15 pear puddle

performing a wet mount (saline microscopy) on a collected sample will show a moving, pear-shaped trophozoite

Trichomonas vaginalis

#16 metro

metronidazole is effective against t. vaginalis

Trichomonas vaginalis

#17 metro couple

tx of sexual partners for those with infection is recommended to reduce risk of recurrence and spread

Trichomonas vaginalis

#18 condom hat

consistent use of barrier contraception prevents retransmission of trich until treatment is complete

Trypanosoma brucei

#1 3 feathers

trypanosoma brucei, the causative agent of sleeping sickness

Trypanosoma brucei

#2 feather’s stem

t. brucei protozoa are motile with a single flagellum

Trypanosoma brucei

#3 variable peacock cloak

t. brucei protozoa have variable surface glycoprotein coats which constantly undergo antigenic variation

Trypanosoma brucei

#4 gambia spot on map

t. brucei gambiense

Trypanosoma brucei

#5 rhodesiense spot on map

t. brucei rhodesiense

Trypanosoma brucei

#6 tea fly

the tsetse fly is the insect vector for trypanosomiasis

Trypanosoma brucei

#7 gambia stream

T.b. gambiense found in streams in Western to Central Africa

Trypanosoma brucei

#8 trees

t.b. rhodesiense found in woodlands in East and SE African Savannahs

Trypanosoma brucei

#9 antelope mark

t.b. rhodesiense are found in an animal reservoir (antelope and other wild game)

Trypanosoma brucei

#10 withering map

t.b. gambiense causes a slowly progressing, chronic infection

Trypanosoma brucei

#11 torn map

t.b. rhodesiense causes a severe, rapidly progressing, acutely fatal illness

Trypanosoma brucei

#12 great lake sore

a trypanosomal chancre may develop at the site of inoculation (1st stage)

Trypanosoma brucei

#13 dripping red ink

trypanosomes travel from the skin to the blood and lymphatics (i.e. hemo-lymphatic/1st stage)

Trypanosoma brucei

#14 flame headband

the first stage of disease is a nonspecific febrile illness with associated headache, malaise, weakness, lymphadenopathy, and puritus

Trypanosoma brucei

#15 intermittent spikes on crown

sleeping sickness presents with a characteristic intermittent, spiking fever (where intervals can vary from days to months)

Trypanosoma brucei

#16 string of pearls

t. brucie infections can lead to cervical and axillary lymphadenopathy

Trypanosoma brucei

#17 sleep mask

the second stage of illness is marked by daytime sleepiness (among other neuropsychiatric abnormalities; mood changes, psychomotor slowing, seizures, and coma)

Trypanosoma brucei

#18 trypomastiGOAT + blood spot

trypomastigotes are seen on blood smear

Trypanosoma brucei

#19 spine splinter

CSF analysis enables definitive staging of sleeping sickness (1st stage: scant WBC, NO organisms vs. 2nd stage: high WBC count, organisms present)

Trypanosoma brucei

#20 fogger

control the fly population with aerial insecticides and other environmental controls

Trypanosoma brucei

#21 pentagon around gambia

pentamidine is reserved for 1st stage t.b. gambiense infections ONLY

Trypanosoma brucei

#22 serum

suramin is reserved for 1st stage t.b. rhodesiense infections ONLY

Trypanosoma brucei

#23 hummingbird feeder near gambia

NECT (2nd stage t.b. gambiense infections only!)

Trypanosoma brucei

#24 soap

melarsoprol is reserved for 2nd stage t.b. rhodesiense infections

Trypanosoma brucei

#25 toxic soap

melarsoprol is a highly toxic treatment for 2nd stage sleeping sickness (thus, NECT is preferred for t.b. gambiense)