Lecture+11+-+Fungi%2C+Protozoa%2C+Helminths.pdf

Lecture 18 — Helminths, Fungi and vector-borne diseases Dr. Ed El Sayed NURS 342 Objectives Few examples of disease causing helminths, fungi and vector borne organisms Risk factors and most common signs and symptoms Treatment and prevention 1. Helminths Helminths is a fancy name for worms! Three kin...

Lecture 18 — Helminths, Fungi and vector-borne diseases Dr. Ed El Sayed NURS 342 Objectives Few examples of disease causing helminths, fungi and vector borne organisms Risk factors and most common signs and symptoms Treatment and prevention 1. Helminths Helminths is a fancy name for worms! Three kinds of helminths of medical importance: A. Nematodes B. Cestodes C. Trematodes Loading… A. Nematodes Cross-sectionally, they are round in shape - Have body cavities with straight alimentary canal and a distinct anus ↑ use to eires the single I identify Female and male — sexual reproduction Examples: 1) distinct 2) Ascaris (roundworm) Enterobius (pinworm) Strongyloides Male 3) round anus Female in shape Penis B. Cestodes Ribbon-shaped Larval form is found in multiple organs Loading… Adult form is found in intestines of host They have a head (aka scolex) with sucking organs They have a segmented body but no alimentary canal = male + at Each segment is a hermaphrodite Most common example is Taenia (tapeworm) Female same time sucks O C. Trematodes Leaf-shaped Non-segmented Two sucking organs but no distinct head Hermaphrodites M + F Exception: Schistosoma (thread-like and have separate sexes male and female) Adult Schistosoma Tests Helminths : Blood test Examples round warm Ascaris (Most common human worm infection) pinworm Nematodes , antibodies against Symptoms Enterobius Strongyloides worm Treatment Usually asymptomatic GI symptoms like abdominal pain (severe infection can cause intestinal blockage) Erare Itchy anus More prevalent in children Also infects female genitals presenting of WBL mainly Cestodes Taenia in shail Schistosoma (Fresh water snail is vector) ↑ ↑ fresh NEC water I Trematodes lives leave snail > and enter through When skin you contact in in of Mebendazole NOT metronidazole = MOA : Paralysis of Albenadazole If >2 household members are infected, all other members should also be treated symptom : Death Usually asymptomatic Severe infection in immunocompromised people associated with -1 eosinophilia > In the paralysis parasite causes the Type tapeworm MOA : (immune) /WBL that fight parasite immunocompromised blood Ivermectin Albendazole Cause : of paralasis parasite most effective GI disturbances, weight loss, loss of appetite CNS + Optomologs Worm can be seen when passing stool symptoms ↓ Severe infection cause eye damage and seizures severe Praziquantel 1) rash Abdominal pain ↳ enlarge liver/spleen in wine Rash RBL of lots 3) Hepatosplenomegaly (enlarged liver and spleen) in Urine RBL of Lots Hematuria (blood in urine) ↳ Praziquantel Not just peeing straight blood MOA parasite 2. Fungi Eukaryotic organisms with cell wall Usually non-motile Absorb nutrients through the cell wall Mainly reproduce by spores (sexual or asexual) Have microscopic structures called hyphae comman intrusi Every Fungi are ubiquitous and involved in many aspects of life (from food/drink production, drug synthesis and diseases) Not tested Loading… Sir Alexander Fleming discovered penicillin in 1929 But not all fungi are good! Fungal infection of medical importance: dimorphic Not Candida Histoplasmosis Coccidioidomycosis Blastomycosis = * Histo, Cocci, and Blasio are dimorphic in nature (spore form in room temperature but yeasts in body temperature)* All these fungi enter through the lungs and can disseminate to bones, skin CNS and prostate (more so in immunocompromised states) The most common Candida species are: C. auris C. krusei C. glabrata KETO - conazols ITRA-conazole VOR) - conazole 1 M Mainly cause bloodstream infections in acutely ill or hospitalized patients who are immunocompromised Most accurate test is blood culture Resistant to most “-azole” antifungals You to I - ~ caspotungin Treated with echinocandins (caspofingin, micafungin, anidulafungin) ~ CasPO Mich anidula 1) W Dimporphic Fungi Histoplasmosis Symptoms Treatment * Anything TB can Associated with bat feces Do Histo can also DO Mainly found in wet areas, like river valleys Lung disease (may resemble viral infections or TB) mm Oral ulcers and bone marrow suppression ↳ know Unwes Most accurate test: Sputum culture - N · Neutropenia/artnin No specific treatment for acute disease in immunocompetent people Severe or disseminated disease is treated with amphotericin and itraconazole mo - Thrombo pancy to Coccidioidomycosis Blastomycosis Respiratory illness Mainly found in dry areas (e.g. Arizona, southern California) mm Joint pain (“desert rheumatism) Most accurate test: Sputum culture Associated with pigeon feces Mainly found in southeast U.S (e.g. Florida) m m Pulmonary disease Bone, skin and prostate disease Most accurate test: Sputum culture Itraconazole for mild disease Severe or disseminated disease is treated with amphotericin B - m Itraconazole for mild disease m Severe or disseminated disease is treated with amphotericin B m Inhibit membrane synthesis cell Mechanism of action of antifungals: Both the “-azole” anti-fungals and amphotericin work by inhibiting ergosterol synthesis in cell membrane - - m g Echinocandins work by inhibiting 1,3 D-dlucan synthase, an enzyme needed for X fungal cell wall synthesis - Toxicity: The “-azole” anti-fungals are associated with drug interactions because they inhibit liver enzymes, may also be associated with arrhythmia Amphotericin B is nephrotoxic, but the liposomal formulation is less so & Nephrotoxic that carries Thing the decree/parasite I 3. Vector-borne disease & Transmitted through to huma rectar won't ask Disease Vector Symptoms Treatment Malaria Female Anopheles mosquito O carrying falciparum m History of travel to endemic areas GI disturbances Hemolysis Fever ↳ Chagas Vector Triatominae bug carrying Trypanosoma - L TICK Lyme Dengue (Most common mosquito borne disease) Zika Ixodes mosquito carrying Borrelia Aedes mosquito carrying dengue virus Aedes mosquito carrying zika virus like dengue O O (risk factor) Jutions History of travel to endemic areas * ACHALASIA GI disturbances and fever Diff.hysfunctional Swallowinsee peristalsis Cardiomyopathy (heart failure) unique I Enlarged lymph nodes ↑ ↓ Describe student travel tacking who onFolaxative , D-2 blocker , Iknow Mefloquine (causes neuropsychiatric side effects) Primaquine (contraindicated in glucose 6 phosphate dehydrogenase deficiency) Atovaquone/proguanil renal end organ liver Artesuante (for severe disease)> CNS Kidney Malawit Herrodinami Doxycycline Lumefantrine (used in pregnancy) psyneds) 3 [ -. ↓ It esophageal History of camping/hiking Common in northeast and midwest US Target shaped rash Joint, cardiac and CNS disease History of travel to endemic areas Bone pain Thrombocytopenia (low platelets) Benznidazole & ONLY IF there Doxycycline Ceftriaxone for cardiac or CNS disease ↓ 3rd History of travel to endemic areas Fever and rash Conjunctivitis Microcephaly in newborns when pregnant women are infected MOA abt gen is NO cardial or CNS disease cephalosporin Vaccine preventable (but only people in endemic places receive the vaccine) No specific therapy & NOT for Supportive treatment = - No specific therapy Supportive treatment -ONly ONLY everyone Target rash Lyme disease Microcephaly Zika virus “Set your soul on fire and seek those who fan your flames.”