1. PARASITIC DISEASES (PD)

2. Parasitic diseases
Protozoan
Helminthic
Malaria Amebiasis Giardiasis Toxoplasmosis Leishmaniasis Trypanosomiasi s
Enterobiasis (pinworm) Cestodiasis (tapeworm) Ascariasis (roundworm) Trichuriasis (whipworm)

3. toxoplasmosis

4. Infection caused by protozoan parasite Toxoplasma gondii
Primary or major host is cat of genus Felis domestica

5. toxoplasmosis …. Common route of infection in humans are:
Ingestion of uncooked meat containing cysts
Ingestion of vegetables contaminated with soil containing infective oocytes
Consuming food or water contaminated with cat feces
Transplacental fetal infection from acutely infected mothers
Breast milk of infected mothers

6. clinical manifestations
Congenital toxoplasmosis manifests as:
Toxoplasmic encephalitis
Chorioretinitis
Convulsion
Nephritis
Hepatitis
Pneumonitis
Hydrocephalis
Skin rashes

7. treatment Pyrimethamine plus Sulphadiazine Spiramycin x 3-4 wk
alternatively
Spiramycin
During pregnancy and in the neonate
x 3-4 wk

8. Parasitic Worms

9. Why it is important
It is estimated that over 100 different types of parasitic worms can be found living in humans.
Infection with helminthes or parasitic worms affects more than 2 million people worldwide.
Infection is prevalent in rural tropics with high poverty rate where simultaneous infection with more than one worm is common.

10. Enterobiasis

11. Enterobiasis is an intestinal infection caused by the pinworm Enterobius vermicularis
Pinworm is the most common helminthic infection

12. case
L.C., a 6-year-old boy, is brought in by his mother, K.C., to see the family physician. K.C. states that L.C. was sent home from school because of inattention and disruptive behavior. L.C. has been very irritable and complained of abdominal discomfort and perianal pain on two occasions the previous week. A cellophane tape swab placed over the perianal skin demonstrates the translucent eggs of E. vermicularis. Question: Explain the symptoms observed in L.C. What pathologic changes are associated with enterobiasis?

13. Signs & symptoms
Pinworm infection can be asymptomatic, but the most common symptom is intense pruritus and is caused by the sticky pinworm eggs in the perianal skin.
Pruritus can cause constant scratching and can result in dermatitis and secondary bacterial infections.
A heavy load of worms can cause anorexia, restlessness, and insomnia, resulting in behavioral changes

14. How should L.C. be treated?

15. Dose repeated in two weeks
treatment
Three different preparations are available to treat pinworm infection
mebendazole
albendazole
pyrantel pamoate
Single dose
Dose repeated in two weeks

16. What advice should be given to L.C.’s mother?

17. Enterobiasis usually infects all members of a family when one member is infected
Pinworm infection can recur as a result of reinfection within families
Therefore, all household residents must be treated simultaneously

18. encourage careful hand washing and fingernail scrubbing after using the toilet and before meals
K.C. needs to be reassured that pinworm infection in the home does not represent substandard hygiene

19. Cestodiasis

20. Cestodiasis (tapeworm infection) is caused by members of the phylum Platyhelminths (flat worms), which include, among others,
Taenia solium(pork tapeworm),
Taenia saginata(beef tapeworm),
Diphyllobothrium latum (broad fish tapeworm), and
Hymenolepis nana(dwarf tapeworm)

21. case
B.R., a 10-year-old boy seen in the clinic complained of vague abdominal discomfort and pain. On questioning, B.R. reports seeing “white noodlelike” objects in his stools. Three stool samples over the course of several days demonstrate infection with T. saginata. IgE level and eosinophil count are within normal limits.
Question:
Are B.R.’s symptoms consistent with Taenia infection?

22. Patients with tapeworm infections (either T. saginata,as in B. R
Patients with tapeworm infections (either T. saginata,as in B.R., or T. solium) present with symptoms ranging from
mild epigastric or abdominal pain to a burning sensation,
general weakness,
weight loss,
headache,
constipation, and diarrhea.
Complications from T. saginata include appendicitis, obstruction of pancreatic ducts, and intestinal obstruction.

23. How can T. saginata infection be differentiated from T. solium in B.R.?

24. The eggs of T. Saginata and T. Solium are identical
presence of gravid proglottids or a scolex in the stool- helpful
India ink test

25. How should B.R. be treated, and how should therapy be evaluated?

26. The drug of choice for both T. Saginata and T
The drug of choice for both T. Saginata and T. Solium intestinal tapeworm infections is praziquantel 5 to 10 mg/kg as a single dose
should be swallowed whole with a liquid with food
If single dose not tolerated because of severe nausea and vomiting- divided doses 4 to 6hr interval

27. Eggs can be released when gravid segments of T
Eggs can be released when gravid segments of T. solium disintegrate after treatment, and the release of embryos from the eggs can cause cysticercosis.
To minimize this possibility, the clinician should give a purgative (magnesium sulfate 15–30 g) 2 hours after administration of praziquantel when T. solium infection is suspected