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Vector for Leishmaniasis
Sandfly Phlebotomus and Lutozomya
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Commonly found in US soldiers returning from Afghanistan
Cutaneous Leishmaniasis
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Infective form of Leishmaniasis for Man vs Fly?
Promastogote vs Amastigote
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Describe the general invasion of Leishmania
- Sandfly transmission
- Promastigote invades macrophages
- Transforms into nonmotile amastigote
- Multiplies within cells of reticuloendothelial system (lymph, spleen, liver, bone marrow)
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Initial skin ulcer (oriental sore) that hears in a year but leaves depigmented scar is characteristic of what?
Simple Cutaneous Leishmaniasis
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Immunity and Hypersensitivity type associated with Leishmaniasis
Cell-mediated, Type IV (PPD-like test, positive only if cell-mediated immune system is intact, as in simple cutaneous Leishmaniasis)
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Nodular skin lesion that does not ulcerate; over time more lesions arise diffusely over body with a concentration near the nose.
Diffuse Cutaneous Leishmaniasis
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Initial dermal ulcer at entry site that heals; months to years later ulcers in mucous membranes of nose and mouth aris; chronic leads to erosion (disfigurement) of nasal septum, soft palate, and lips over 20-40 years. Death by secondary bacterial infections.
Mucocutaneous Leishmaniasis (L. braziliensis only)
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Treatment for Leishmaniasis
Stibogluconate
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Visceral Leishmaniasis (Kala-azar) species & most commonly infected/symptom?
- L. donovani or L. chagasi
- Infects malnourished children
- MASSIVE SPLEENOMEGALY (increased abdominal girth, feeling of heaviness, appetite loss)
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Chagas' Disease is caused by what organism & vector?
- Trypanosoma cruzi
- Feces of the Reduviid (kissing) bug
- (rodent, opossum, armadillo reservoirs)
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Hardened, red chagoma, followed by systemic spread with fever, malaise, swollen lymph nodes.
Acute Chagas' Disease (T.cruzi)
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Organs primarily affected in Chronic Chagas' Disease
- Heart (arrhythmias)
- Megacolon
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Treatment for Acute Chagas' Disease
Nifurtimox and Benznidazole (does not help for chronic form)
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Test for Leishmania
Montenegro test (DTH) with leishmanin
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Causative agent of Cutaneous Larva Migrans, and frequent site of contraction
- Dog or cat hookworm: Ancylostoma braziliensis
- Sand/beach (animal feces)
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Intense skin itch and inflammation; creeping eruption. Characteristic of?
Cutaneous Larva Migrans (remember no adult worm infection)
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Treatment for CLM?
- Albendazole oral or topical
- Ivermectin and thiabendazole are alternatives
- Anti-histamines control itching
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Adult worm in subcutaneous tissues, releases eggs when wet; contracted from contaminated water supply.
Dracunculus medinensis (Dragon or guinea worm)
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Treatment for Dracunculiasis
- Benzimidazoles (Niridazoles, Metronidazole, Thiabendazole)
- Stick winding
- Match stick removal
- Surgery
- Education
- Better water resources
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Fugitive or Calabar swellings, microfilaria in blood, continuous adult worm subcutaneous migration (including conjuctiva): characteristic of?
Loasis (Loa Loa; Mango fly vector, equatorial Africa)
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Treatment of Loaisis
DEC (Diethylcarbamazine), surgicial removal of worms
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Treatment of centipede bite
Local measures: Sodium bicarbonate compresses or Epsom salt solutions
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Vector of Head Lice in school children
Pediculus humanus var capitus
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Important vector in transmission of Ricketsia (typhus-trench fever) and spirochetes (relapsing fever)
Body louse (Pediculus humanus var humanus)
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What is Phthirus pubis, and where is it acquired?
- Crab louse
- toilet seat, contaminated clothes
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Symptoms and treatment for Phthirus pubis
- intense itching, secondary infections
- gamma benzene hexachloride or copper oleate
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Infestation with fly larvae (maggots) that live in human tissue; Dermatobia hominis (human botfly); presents with a boil-like lesion; common in travelers returning from tropical countries.
Furuncular Myasis
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Cimex lectularius
Bed bugs
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Ascending flaccid paralysis, fever, generalized toxemis caused by what ticks?
Dermocenter andersoni
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Pimple-like irritation in interdigital spaces of wrist, forearms, genitalia; intense pruritus. Characteristic of?
Itch or Mange Mite (Scabies)
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Releases Alpha-latrotoxin nonhemolytic, neurotoxic venom
Lactrodectus mactans (Black widow spider)
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Releases necrotoxin that may have hemolytic properties, and causes radiating necrotic spreading lesions with deep tissue damage; 2nd infections and gangrene may follow.
Loxosceles laeta (Brown recluse)
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Proper course of treatment for Brown Recluse spider bite
- most require no specific therapy
- cleansing, tetanus prophylaxis, antibiotics
- excision only if not healed naturally after 3 to 6 weeks
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