Protozoa - Gastrointestinal Infections
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Questions and Answers

Giardia Lamblia causes severe diarrhea with a high frequency of bloody stools.

False

Toxoplasma Gondii can be transmitted through oocysts found in cat feces.

True

Cryptosporidium is primarily transmitted through direct contact with infected individuals.

False

Trypanosoma Brucei is responsible for African Sleeping Sickness and is transmitted by the Anopheles mosquito.

<p>False</p> Signup and view all the answers

Entamoeba Histolytica causes amebiasis, which can lead to bloody diarrhea and liver abscesses.

<p>True</p> Signup and view all the answers

Plasmodium Malariae exhibits a 48-hour fever cycle.

<p>False</p> Signup and view all the answers

Naegleria Fowleri is known for causing rapidly fatal meningoencephalitis upon entering the CNS.

<p>True</p> Signup and view all the answers

Babesia is primarily transmitted through the bites of the Anopheles mosquito.

<p>False</p> Signup and view all the answers

Trichomonas Vaginali can form cysts and survive outside of the human host.

<p>False</p> Signup and view all the answers

Treatment for Chagas Disease involves the use of Benznidazole and Nifurtimox.

<p>True</p> Signup and view all the answers

Giardia Lamblia is transmitted by cysts found in contaminated water.

<p>True</p> Signup and view all the answers

Entamoeba Histolytica can cause a non-bloody, fatty diarrhea.

<p>False</p> Signup and view all the answers

Cryptosporidium infection primarily affects immunocompromised hosts, causing severe diarrhea.

<p>True</p> Signup and view all the answers

The Tsetse fly is responsible for transmitting Toxoplasma Gondii.

<p>False</p> Signup and view all the answers

Naegleria Fowleri enters the CNS through the olfactory nerve.

<p>True</p> Signup and view all the answers

Plasmodium Falciparum is transmitted by the Ixodes tick.

<p>False</p> Signup and view all the answers

Leishmania spp. can cause cutaneous leishmaniasis and is transmitted by sandfly bites.

<p>True</p> Signup and view all the answers

Trichomonas Vaginali can exist outside the human body because it can form cysts.

<p>False</p> Signup and view all the answers

For Plasmodium Vivax, the dormant form in the liver is known as a hypnozoite.

<p>True</p> Signup and view all the answers

Chagas Disease is caused by Trypanosoma Borrelia.

<p>False</p> Signup and view all the answers

Giardia Lamblia is primarily transmitted through cysts found in contaminated air.

<p>False</p> Signup and view all the answers

Naegleria Fowleri is known to enter the central nervous system through the olfactory nerve.

<p>True</p> Signup and view all the answers

Plasmodium Falciparum is responsible for cyclic fevers with a 48-hour pattern.

<p>False</p> Signup and view all the answers

Toxoplasma Gondii can cross the placenta, posing a risk to pregnant individuals.

<p>True</p> Signup and view all the answers

Entamoeba Histolytica can lead to histology findings of flask-shaped ulcers in the colon.

<p>True</p> Signup and view all the answers

Cryptosporidium primarily causes severe diarrhea in immunocompromised individuals.

<p>False</p> Signup and view all the answers

Benznidazole is a treatment specifically used for infections caused by Cryptosporidium.

<p>False</p> Signup and view all the answers

Babesia is transmitted primarily by the Ixodes tick.

<p>True</p> Signup and view all the answers

Trichomonas Vaginali can survive outside the human body because it can form cysts.

<p>False</p> Signup and view all the answers

Trypanosoma Brucei is transmitted by the tsetse fly and can cause African Sleeping Sickness.

<p>True</p> Signup and view all the answers

Study Notes

Protozoa - Gastrointestinal Infections

  • Giardia Lamblia causes giardiasis, characterized by bloating, flatulence, foul-smelling, non-bloody diarrhea, and fatty stools.

  • Giardia Lamblia is transmitted through cysts found in water.

  • Diagnosis involves identifying multinucleated trophozoites, cysts in stool, utilizing antigen detection, or PCR.

  • Treatment options include Tinidazole, Nitazoxanide, Metronidazole, and Paromomycin.

  • Entamoeba Histolytica causes amebiasis, which manifests as bloody diarrhea (dysentery), liver abscess, and flask-shaped ulcers observed in colon biopsy.

  • Entamoeba Histolytica is transmitted through cysts in water.

  • Diagnosis involves serology, antigen testing, PCR, identifying trophozoites with engulfed RBCs in cytoplasm, and observing cysts with up to 4 nuclei in stool.

  • Treatment includes Metronidazole and Paromomycin (for asymptomatic cyst passers). Preventive measures include filtering city water supplies. Nitazoxanide is used for immunocompromised hosts.

  • Cryptosporidium causes severe, watery diarrhea in immunocompetent individuals.

  • Cryptosporidium is transmitted through oocysts in water.

  • Diagnosis is established by detecting oocysts through acid-fast staining, antigen detection, or PCR.

  • Treatment options include Nitazoxanide. Prevention involves filtering city water supplies.

Protozoa - CNS Infections

  • Toxoplasma Gondii infection in immunocompetent individuals manifests as mononucleosis-like symptoms. It can reactivate in AIDS patients.

  • Toxoplasma Gondii is most commonly transmitted through cysts present in meat, and also through oocysts in cat feces. It can cross the placenta, so pregnant women should avoid contact with cats

  • Diagnosis involves serology, biopsy (tachyzoite), and PCR of amniotic fluid.

  • Treatment involves Sulfadiazine + pyrimethamine. Prophylaxis is recommended with TMP-SMX for individuals with low CD4+ cell counts.

  • Naegleria Fowleri causes rapidly fatal meningoencephalitis.

  • Naegleria Fowleri enters the CNS through the olfactory nerve via the cribriform plate.

  • Diagnosis is confirmed by identifying amoebas in CSF or trypomastigotes in blood smear.

  • Treatment involves Amphotericin B.

  • Trypanosoma Brucei causes African Sleeping Sickness, characterized by recurrent fever due to antigenic variation, enlarged lymph nodes, somnolence, and coma.

  • Trypanosoma Brucei is transmitted through the bite of the tsetse fly.

  • Diagnosis involves identifying trypomastigotes in blood smear.

  • Treatment includes Suramin for bloodborne infection and Melarsoprol for CNS penetration.

Protozoa - Hematologic Infections

  • Plasmodium Malariae causes malaria, characterized by cyclic fevers, headaches, anemia, splenomegaly, and hypoglycemia in severe cases. It presents with a 72-hour fever cycle (quartan).

  • Plasmodium Malariae is transmitted through the Anopheles mosquito.

  • Diagnosis involves identifying trophozoite rings, trophozoites with Schüffner stippling (small red granules), and gametocytes in blood smear.

  • Treatment options include chloroquine for sensitive strains, mefloquine, doxycycline, atovaquone/proguanil for resistant strains, and intravenous quinine or artesunate for life-threatening cases. It's crucial to test for G6PD deficiency before treatment.

  • Plasmodium Vivax/ Ovale causes malaria with a 48-hour fever cycle (tertian). It has a dormant form (hypnozoite) in the liver.

  • Plasmodium Vivax/ Ovale is transmitted through the Anopheles mosquito.

  • Diagnosis involves identifying trophozoite rings, trophozoites with Schüffner stippling (small red granules), and gametocytes in blood smear.

  • Treatment involves adding primaquine alongside other medications to target the hypnozoites.

  • Plasmodium Falciparum causes severe, irregular fever patterns, and parasitized red blood cells. It can occlude capillaries in the brain (cerebral malaria), kidneys and lungs.

  • Plasmodium Falciparum is transmitted through the Anopheles mosquito.

  • Diagnosis involves identifying trophozoite rings, gametocytes (crescent-shaped), and ring forms in blood smear. PCR is also used for diagnosis.

  • Treatment options include Atovaquone + azithromycin.

  • Babesia causes babesiosis, characterized by fever and hemolytic anemia. It's prevalent in the northeastern and north central United States. Asplenia increases the risk of severe disease.

  • Babesia is transmitted through the Ixodes tick (also a vector for Borrelia burgdorferi and Anaplasma spp).

  • Diagnosis involves identifying ring forms in blood smear and through PCR.

  • Treatment options are available.

Protozoa - Others

  • Trypanosoma cruzi causes Chagas Disease, characterized by dilated cardiomyopathy with apical atrophy, megacolon, and megaoesophagus.

  • Trypanosoma cruzi is transmitted through the bite of the triatomine insect (kissing bug) that defecates around the mouth or eyes, leading to fecal transmission into the bite site or mucosa.

  • Diagnosis involves identifying trypomastigotes in blood smear.

  • Treatment options include Benznidazole and Nifurtimox.

  • Leishmania spp is involved in different forms of leishmaniasis, including Visceral leishmaniasis (kala-azar) and Cutaneous leishmaniasis.

  • **Leishmania spp **is transmitted through the sandfly.

  • Diagnosis involves identifying macrophages containing amastigotes.

  • Treatment options include Amphotericin and Sodium stibogluconate.

Sexually Transmitted Infections

  • Trichomonas Vaginali causes vaginitis, characterized by foul-smelling greenish discharge, itching and burning.
  • Trichomonas Vaginali is transmitted sexually and cannot exist outside the human body due to its inability to form cysts.
  • Diagnosis involves identifying motile trophozoites on a wet mount. "Strawberry cervix” is another characteristic of the infection.
  • Treatment involves Metronidazole for both the patient and their partner(s) to prevent reinfection. It's crucial to check for other STIs.

Giardia Lamblia

  • Disease: Giardiasis
  • Symptoms: Bloating, flatulence, foul-smelling, nonbloody, fatty diarrhea
  • Transmission: Cysts in water
  • Diagnosis: Multinucleated trophozoites, cysts in stool, antigen detection, PCR
  • Treatment: Tinidazole, Nitazoxanide, Metronidazole, Paromomycin

Entamoeba Histolytica

  • Disease: Amebiasis
  • Symptoms: Bloody diarrhea (dysentery), Liver abscess, Histology of colon biopsy shows flask-shaped ulcers, RUQ pain
  • Transmission: Cysts in water
  • Diagnosis: Serology, Antigen testing, PCR, trophozoites, Engulfed RBCs in cytoplasm, Cysts with up to 4 nuclei in stool
  • Treatment: Metronidazole, Paromomycin for asymptomatic cyst passers, Prevention by filtering city water supplies, Nitazoxanide for immunocompromised hosts

Cryptosporidium

  • Disease: Severe diarrhea (watery diarrhea, especially in immunocompetent hosts)
  • Transmission: Oocysts in water
  • Diagnosis: Oocysts on acid-fast stain, antigen detection, PCR
  • Treatment: Nitazoxanide, Prevention by filtering city water supplies

Toxoplasma Gondii

  • Disease: Immunocompetent: Mononucleosis-like symptoms, Reactivation in AIDS
  • Transmission: Cysts in meat (most common), Oocysts in cat feces, Can cross placenta (pregnant patients should avoid cats)
  • Diagnosis: Serology, Biopsy (tachyzoite), PCR of amniotic fluid
  • Treatment: Sulfadiazine + pyrimethamine, Prophylaxis with TMP-SMX when CD4+ cell count low

Naegleria Fowleri

  • Disease: Rapidly fatal meningoencephalitis
  • Transmission: Enters CNS through olfactory nerve via cribriform plate
  • Diagnosis: Amoebas in CSF, Trypomastigote in blood smear
  • Treatment: Amphotericin B

Trypanosoma Brucei

  • Disease: African Sleeping Sickness (Recurrin fever due to antigenic variation), Enlarged lymph nodes, Somnolence, Coma
  • Transmission: Tsetse fly
  • Diagnosis: Trypomastigote in blood smear
  • Treatment: Suramin for bloodborne infection, Melarsoprol for CNS penetration

Plasmodium Malariae

  • Disease: Malaria (Cyclic fevers, Headache, Anemia, Splenomegaly, Hypoglycemia in severe disease, 72-hr fever cycle (quartan)
  • Transmission: Anopheles mosquito
  • Diagnosis: Blood smear (trophozoite ring within RBC, trophozoites and Schüffner stippling within RBC cytoplasm), Blood smear (trophozoite ring (headphone shaped) within RBC)
  • Treatment: If sensitive: chloroquine; if resistant: mefloquine, doxycycline, or atovaquone/proguanil; if life-threatening: intravenous quinine or artesunate (test for G6PD deficiency)

Plasmodium Vivax/ Ovale

  • Disease: 48-hr fever cycle (tertian)
  • Transmission: Anopheles Mosquito
  • Diagnosis: Blood smear (trophozoite ring within RBC, trophozoites and Schüffner stippling within RBC cytoplasm), Blood smear (trophozoite ring (headphone shaped) within RBC)
  • Treatment: Add primaquine to target hypnozoites

Plasmodium Falciparum

  • Disease: Severe, irregular fever pattern, Parasitized RBCs, Occlude capillaries (cerebral malaria), kidneys, lungs
  • Transmission: Anopheles mosquito
  • Diagnosis: Blood smear (trophozoite ring, gametocytes are crescent-shaped), Ring form D1, Maltese cross D2, PCR
  • Treatment: Atovaquone + azithromycin

Babesia

  • Disease: Babesiosis - Fever and hemolytic anemia, Predominantly in northeastern and north central United States, Asplenia increasing risk of severe disease
  • Transmission: Ixodes tick
  • Diagnosis: Blood smear (Ring form D1, Maltese cross D2), PCR
  • Treatment: No specific drug but supportive therapy

Trypanosoma cruzi

  • Disease: Chagas Disease (Dilated cardiomyopathy with apical atrophy, Megacolon, Megaoesophagus)
  • Transmission: Triatomine insect (kissing bug)
  • Diagnosis: Blood Smear (trypomastigote)
  • Treatment: Benznidazole, Nifurtimox

Leishmania spp

  • Disease: Visceral leishmaniasis (kala-azar) Cutaneous leishmaniasis
  • Transmission: Sandfly
  • Diagnosis: Macrophages containing amastigotes
  • Treatment: Amphotericin, Sodium stibogluconate

Trichomonas Vaginali

  • Disease: Vaginitis (Foul-smelling greenish discharge, itching and burning)
  • Transmission: Sexual (cannot exist outside human because it cannot form cysts)
  • Diagnosis: Trophozoites (motile) on wet mount, Punctate cervical hemorrhages ("strawberry cervix")
  • Treatment: Metronidazole for patient and partner(s) (prophylaxis; check for STI)

Gastrointestinal Infections

  • Giardia Lamblia causes Giardiasis, characterized by bloating, flatulence, foul-smelling, nonbloody, fatty diarrhea.

  • Giardiasis is transmitted through cysts in water.

  • Diagnosis involves identifying multinucleated trophozoites or cysts in stool, along with antigen detection and PCR.

  • Treatment options include:

    • Tinidazole
    • Nitazoxanide
    • Metronidazole
    • Paromomycin

  • Entamoeba Histolytica causes Amebiasis, resulting in bloody diarrhea (dysentery), liver abscess, and flask-shaped ulcers in the colon.

  • Transmission occurs through cysts in water.

  • Diagnosis involves serology, antigen testing, PCR, and/or identifying trophozoites with engulfed RBCs, cysts with up to 4 nuclei in stool, oocysts on acid-fast stain, and antigen detection.

  • Treatment for Amebiasis includes:

    • Metronidazole for symptomatic infections
    • Paromomycin for asymptomatic cyst passers
    • Nitazoxanide for immunocompromised hosts
    • Prevention involves filtering city water supplies.

  • Cryptosporidium causes severe watery diarrhea in immunocompetent hosts.

  • Transmission occurs through oocysts in water.

  • Diagnosis relies on identifying oocysts on acid-fast stain, antigen detection & PCR.

  • Treatment involves Nitazoxanide and prevention by filtering city water supplies.

CNS Infections

  • Toxoplasma Gondii can cause mononucleosis-like symptoms in immunocompetent individuals.

  • Reactivation in AIDS patients is a significant concern.

  • Transmission occurs through cysts in meat (most common) and oocysts in cat feces.

  • Congenital toxoplasmosis is possible through placental transmission, highlighting the importance of pregnant women avoiding contact with cats.

  • Diagnosis involves serology, biopsy for identification of tachyzoites, and PCR of amniotic fluid.

  • Treatment involves sulfadiazine + pyrimethamine alongside prophylaxis with TMP-SMX when CD4+ cell count is low.

  • Naegleria Fowleri causes rapidly fatal meningoencephalitis.

  • Transmission involves entry into the CNS through the olfactory nerve via the cribriform plate.

  • Diagnosis relies on identifying amoebas in CSF and trypomastigotes in blood smear.

  • Treatment involves Amphotericin B.

  • Trypanosoma Brucei causes African Sleeping Sickness, characterized by recurrent fever due to antigenic variation, enlarged lymph nodes, somnolence, and coma.

  • Transmission occurs through the bite of tsetse fly.

  • Diagnosis involves identifying trypomastigotes in blood smear.

  • Treatment is stage-dependent:

    • Suramin for bloodborne infection
    • Melarsoprol for CNS penetration

Hematologic Infections

  • Plasmodium Malariae causes malaria with a 72-hour fever cycle (quartan).

  • Symptoms include cyclic fevers, headache, anemia, splenomegaly, and hypoglycemia in severe disease.

  • Transmission occurs through Anopheles mosquito.

  • Diagnosis involves identifying trophozoite rings within RBCs, trophozoites and Schüffner stippling within RBC cytoplasm, and trophozoite rings (headphone shaped) within RBCs on blood smear.

  • Treatment options include:

    • Chloroquine for sensitive strains
    • Mefloquine, doxycycline, or atovaquone/proguanil for resistant strains
    • Intravenous quinine or artesunate for life-threatening cases.
    • G6PD deficiency testing is essential to ensure patient safety.

  • Plasmodium Vivax and Ovale cause malaria with a 48-hour fever cycle (tertian).

  • Hypnozoites are dormant forms that reside in the liver.

  • Transmission occurs through Anopheles mosquito.

  • Diagnosis involves identifying trophozoite rings within RBCs, trophozoites and Schüffner stippling within RBC cytoplasm, and trophozoite rings (headphone shaped) within RBCs on blood smear.

  • Treatment requires primaquine to target the hypnozoites in addition to other antimalarials.

  • Plasmodium Falciparum causes severe and irregular fever patterns along with parasitized RBCs.

  • Complications include cerebral malaria, kidney failure, and lung involvement due to the occlusion of capillaries by parasitized RBCs.

  • Transmission occurs through Anopheles mosquito.

  • Diagnosis involves identifying trophozoite rings, gametocytes, and ring forms on blood smear.

  • Treatment includes atovaquone + azithromycin.

  • Babesia causes Babesiosis, characterized by fever and hemolytic anemia.

  • Transmission occurs through Ixodes tick, which is also a vector for Borrelia burgdorferi and Anaplasma spp.

  • Diagnosis involves identifying ring forms and "Maltese cross" forms on blood smear and PCR.

  • Treatment is available but varies depending on the severity of the infection.

Other Protozoal Infections

  • Trypanosoma cruzi causes Chagas Disease, resulting in dilated cardiomyopathy with apical atrophy, megacolon, and megaoesophagus.

  • Transmission occurs through Triatomine insect (kissing bug) bites, followed by fecal transmission into the bite site or mucosa.

  • Diagnosis involves identifying trypomastigotes on blood smear.

  • Treatment involves benznidazole or nifurtimox.

  • Leishmania spp causes different forms of leishmaniasis, including:

    • Visceral leishmaniasis (kala-azar)
    • Cutaneous leishmaniasis
    • Mucocutaneous leishmaniasis

  • Transmission occurs through sandfly bites.

  • Diagnosis involves identifying macrophages containing amastigotes.

  • Treatment involves amphotericin, sodium stibogluconate, and other therapies.

Sexually Transmitted Infections

  • Trichomonas Vaginali causes vaginitis with foul-smelling greenish discharge, itching, and burning.
  • Transmission is exclusively sexual as the organism cannot form cysts and survive outside the human body.
  • Diagnosis involves identifying trophozoites (motile) on a wet mount and observing punctate cervical hemorrhages ("strawberry cervix").
  • Treatment involves metronidazole for both the infected individual and their partner(s), along with prophylaxis and STI screening.

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Description

This quiz covers key aspects of gastrointestinal infections caused by protozoa, specifically focusing on Giardia Lamblia and Entamoeba Histolytica. Learn about their transmission, symptoms, diagnostic methods, and treatment options. Test your knowledge on prevention and management of these infections.

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