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What do filariae inhabit?
- Lymphatic system
- Connective tissues
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Lymphatic filariases caused by...
- Wuchereria bancrofti
- Brugia malayi
- Brugia timori
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Wuchereria bancrofti - Where?
Worldwide tropics and subtropics
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Wuchereria bancrofti - Life Cycle?
- Infected mosquite deposits infective larva
- Larva develops in lymphatics
- Adults live in lymph nodes
- Worm-like eggs (microfilariae) circulate in bloodstream
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Wuchereria bancrofti - Diagnosis?
Blood smear - microfilariae in blood
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Wuchereria bancrofti - Presentation?
- Fever, lymphangitis, lymphadenitis
- Common to limbs, breast, scrotum
- Edema
- Elephantiasis
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Wuchereria bancrofti - Treatment?
Diethylcarbamazine (DEC) AND Ivermectin
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Loa loa - Life cycle?
- Infective larva penetrates at mango fly (vector) bite
- Larva mature in subcutaneous tissue
- Produce microfilariae (in circulation)
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Loa loa - Presentation?
- Painful when pass over bridge of nose or through conjuctiva (can be excised here)
- Calabar swellings
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Loa loa - Diagnosis?
- Filarial antibody
- Microfilariae in blood
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Loa loa - Treatment?
- Surgical removal
- Diethylcarbamazine (DEC)
- Ivermectin
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Onchocerca vovulus - Where?
Africa, S. America, Middle East
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Onchocerca vovulus - Life cycle?
- Blackfly vector - bite with infective larva
- Develops in subcutaneous tissue
- Females live in subcutaneous nodules
- Microfilaria in skin, not blood
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Onchocerca vovulus - Presentation?
- Subcutaneous nodules
- Onchodermatitis, subcutaneous thickening
- Pruritis
- Hanging groin
- Eye lesions
- Intrauterine transmission
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Onchocerca vovulus - Diagnosis?
Microfilariae in skin
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Onchocerca vovulus - Treatment?
- Diethylcarbamizine
- Ivermectin
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Tropical pulmonary eosinophilia
- Hypereosinophilia, cough, wheezing
- No microfilariae in blood, found in lung biopsy
- Treat with DEC
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Dracunculus medinensis
Guinea Worm
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Dracunculus medinensis - Where?
Africa, Middle East, India
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Dracunculus medinensis - Life Cycle?
- Larva ingested by copepod
- Develops to filariform larva, leaves copepod
- Ingested via drinking contaminated water
- Adult worm in subcutaneous tissue
- Larva liberated from skin lesions
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Dracunculus medinensis - Diagnosis?
- Development of characteristic lesion
- Can obtain larva from ulcer
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Dracunculus medinensis - Presentation?
- Worms usually on legs or feet
- Pruritus, neausea, allergic symptoms
- Ulcer above female worm, discharge of larvae
- Removal of worms extremely painful
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Dracunculus medinensis - Treatment?
- Surgical removal or worms
- No effective treatment - but metronidazole facilitates removal
- Mebendazole may kill worm
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Trichinellosis - Where?
- Worldwide
- Arctic and subarctic zones
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Trichinellosis - Life cycle?
- Ingested larva via uncooked pork
- Adults in wall of small intestine
- New larvae encyst in skeletal muscle
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Trichinellosis - Presentation?
- Nonspecific gastroenteritis
- Fever and eosinophilia
- Circumorbital edema***
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Trichinellosis - Diagnosis?
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Trichinellosis - Treatment?
- Albendazole or mebendazole
- Corticosteroids for symptamatic cases
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Angiostrongylus cantonensis
Rat lungworm
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Angiostrongylus cantonensis - Where?
Tropics and subtropics
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Angiostrongylus cantonensis - Life cycle?
- Ingestion of larva
- Cannot complete life cycle in humans - larva carried to meninges but cannot leave to migrate to lungs
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Angiostrongylus cantonensis - Presentation?
- Abrupt onset meningoencephalitis
- Nausea, vomiting, fever
- Eve invasion with visual impairment
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Angiostrongylus cantonensis - Treatment?
Mebendazole
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Toxocariasis - How do you get it?
Ingestion of dog or cat ascaris eggs
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Toxocariasis - Presentation?
- Larva leave intestine, go to liver, spleen, lungs, brain, eye
- Hepatosplenomegaly, pneumonia
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Toxocariasis - Treatment?
Albendazole
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