Species
| infective stage
| infective route
| Site of inhabitation
| Intermediate host
| Reservoir host
| Harms to man
| Diagnostic method
| Drug of choice
|
Ascaris Lumbricoides
| Embryonate eggs
| By mouth
| Upper part of small intestine
| no
| no
| Loeffler’s syndrome
Biliary ascariasis
| Direct fecal film
Brine-floatation method
| Albendazole 400mg/d 1-2d
Mebendazole 100mg/d 3-4d
Piperazine Ivermectin
|
Trichuris trichiura (whip worm)
| Embryonate eggs
| By mouth
| ileocecum
| no
| no
| Middle infection
Heavy infection
| Brine-floatation method
Direct fecal film
| Albendazole 400mg/d 1-2d
Mebendazole 100mg/d 3-4d
(prolonged for 5 days)
|
Enterobius vermicularis
| Embryonate eggs
| By mouth or retro-infection
| ileocecum
| no
| no
| Children
Ectopic injure
| Cellophane tape method
| Albendazole Mebendazole
(repeated treatment)
|
Hookworms
| Larva 3 or filariform larva
| By skin
| Upper part of small intestine
| no
| no
| Dermatitis pneumonitis
Microcytic hypochromatic anemia
Allotriophagy
| Hemoglobin lower 12m,11F
Saturated brine floatation
| Albendazole Mebendazole
Avoid skin contact
|
Filariae
| filariform larva(L3)
| By skin
| Lymphatic tissues
| mosquitoes
| no
| Filarialfever, retro-lymphangitis, lymphadenitis Elephantiasis Chyluria Hydrocele
| Thick blood smear Millipore membrane filtration
| Diethylcarbamazine(DEC, Hetrazan)
DEC table salt, Ivermectin
|
Trichinella spiralis
| Juvenile in the cyst
| Eating raw meat
| Adults in small intestine, juvenile in skeletal muscle
| mammals
| mammal
| 1 Invading Stage
Intestinal bleeding, etc.
2 Larva migrating stage
Vessels, skeletal cell
3 Encysted stage
Acute symptoms subside, muscular pain continues
| Muscular biopsy, Examination and xenodiagnosis of the remainder of the raw or uncooked meat
| Albendazole Mebendazole(not well),
Corticosteroids in acute stage
|
Clonorchis sinensis
| metacercaria
| Eating raw freshwater fish and shrimp with metacercaria
| Bile ducts
| 1st Bithynia snail
2nd Family of Cyprinidae
| Cat, dog
| General case:
Severe case:
In child case:
| 1.Alkli digestive method(NaOH10%)
2.water sedimentation
3.direct fecal smear
4.duodenal aspiration
| Praziquantel (吡喹酮)
Hexachloroparaxylol
(六氯对二甲苯)
Bithionol(硫双二氯酚;bitin)
albendazole
|
Fasciolopsis buski
| metacercaria
| Eating raw water plants with M
| Small intestine
| Planorbis snail
| pig
| (adhesion)abdominal discomfort and diarrhea
Malnutrition
| 1.direct fecal smear 2.water sedimentation method
| Praziquantel Hexachloroparaxylol
Bithionol(bitin)
(pig) dipterex (敌百虫)
|
Paragonimus westermani
| metacercaria
| Eating raw fresh water crabs and crayfish with M
| Lungs and ectopic parasitism
| 1st melania snail
2nd fresh water crab and crayfish
| Carnivores
(tiger lion wolf etc)
| (Invading and migrating .Suppurative. Cystic. Fibrous-scar stage)
Pulmonary Brain Abdominal Subcutaneous type
| Sputum:1.Alkali digestive 2.direct
Stool: 1.Alkali 2.water 3.direct
Biopsy(Subcutaneous type).CT X-ray
| Praziquantel Hexachloroparaxylol
Bithionol(bitin)
|
Schistoma japonicum
| cercaria
| Contact with the infective water(cercaria invade skin)
| Portal vein system, mainly in the inferior mesenteric vein
| Oncomelania snail(钉螺)
| Herbivorous, carnivorous, and omnivorous mammal.
| 1.Cercaria and schistosomulum
2.Adults
3.Eggs:(SEA) eggs inlaid in the portal areas and intestinal wall
| 1.Stool examination(direct-acute stage; concentration method)
2.Biopsy (proctoscopy)
| 1.Praziquantel Hexachloroparaxylol
Antimony potassium(酒石酸锑钾)
2.dipterex(敌百虫) for domestic animal.
|
Taenia solium
| Cysticercus and egg
| Ingesting raw bean-pork or egg
| Adult:human small intestine
Cysticercus:pig or human tissues
| Pig and man
|
| 1.Teaniasis
2.Cysticercosis:
(Subcutaneous and muscular type, Ocular type, Brain type)
| 1.Find gravid proglottids (direct,floatation, scotch tape)
2.Cysticercosis: Biopsy(S.type) Ophthalmoscope, CT,MR(B.S.M.type)
| 1.Teaniasis:(Chinese herb Med)Areca nut(槟榔)and Pumpkin seed.---(stool scolex recognition). Praziquantel (no cysticercus)
2.Cysticercosis: surgical removal, Praziquantel(cerebral C)
|
Echinococcus granulosus
(pastoral areas)
| egg
| Ingesting eggs
| Adult in small intestines of canine animals
Metacestode (larval stage) in tissues of herbivores or man
| Herbivores (sheep,goat,etc) human
|
| 1.Hydatidosis(liver,lung, CNS,bone,peritoneal cavity)
2.Allergic reaction
3.secondary infection
| 1.Detection of indication of hydatid cys(H.thrill)
Puncture(dangerous)
B ultrasonography, CT,MR,X-ray (cyst in lung and bone)
| 1.Surgery (large and accessible unilocular hydatid)
2. Praziquantel and albendazole (early small cysts)
|
Entamoeba histolytica
| Cyst with 4 nuclei
| By mouth
| Intestine;
Excystation in duodenum; Encystations in colon
|
|
| 1.Materials: lectin, amoebic pore forming(穿孔素), protein dissolving enzyme.
Flask-shaped ulcer
2.Intestinal amoebiasis: A.dysentery
3.Extra-intestinal(complications):A.abcess of L.P.B..
| 1.Stool E.
Living trophozoite in unformed feces(direct or NS)
Cyst in formed feces(Iodine stain for chronic case or carrier)
2.Immunological.T
| (Destroy intra or extra-intestinal pathogens)
Metronidazole(甲硝唑)
(acute A.dysentary)
Chloroquine(氯喹) (liver A.abcess)
Compatibility of the two drugs.
|
Leishmania donovani
| Promastigotes
(Amastigotes is pathogenic stage)
| Bitten by sandfly
| macrophages
|
| dogs
| (Visceral leishmaniasis)
1.prolonged low grade F
2.Hepto-splenomegaly, B.marrow hyperplasia
3.Anemia,Leukopenia, Decrease in platelets
4.ratio of A:G inverted
5.Bleeding and infection
| Demonstration of L.D body in D.smear or promastigotes in 3N medium.
B.marrow puncture
Lymph N.puncture
| 1.Antimony sodium gluconate葡萄糖酸锑钠
(pentavalent) (I.V or I.M)
2.Pentamidine(戊烷脒) for patient resistant to the pentavalent
3.Stibiihexonas(斯锑黑\克)?
|
Giardia lamblia
| Cyst with 4 nuclei
| By mouth
| Upper part of small intestine and bile passage
|
|
| (adhering and covering epithelia) diarrhea,anorexia, A.pain, weight loss, malnutrition, cholecystitis
| 1.Iodine stain (find cyst in F feces)
2.NS D.smear to detect trophozoites in diarrhea feces
3.duodenal aspiration
(differential Diag..)
| Metronidazole
(patient abstain from alcohol during treatment with metronidazole)
|
Trichomonas vaginalis
| trophozoite
| Direct or InD contact
(Sextual life, swimming pool,swimsuit, commode坐便器)
| Female: vagina and urethra;
Male: urethra and prostate
|
|
| (Consume glycogen, elevate pH, T.vaginalis flourish)
Trichomonas vaginitis
(secreat buring, itching, vaginal discharge frothy, creamy white full of……)
| Specimen: vaginal discharge,prostatic fluid or urine.
NS direct smear
(trophozoites)
| Metronidazole(F and M)
For women:
vaginal suppository(栓剂)
(patient abstain from
alcohol)
|
Plasmodium
(P. vivax
P. falciparum
P. malariae
P. ovale)
(Mosquito is final host and vector)
| Sporozoite (or erythrocytic stage asexual parasite)
(tachy-, brady-)
| Mosquito bite human skin;
Blood transfusion via damaged placenta
| Liver and red blood cells
| human
|
| Parasitemia(原虫血症)
(sudden liberation of merozoites,malarial pigment and RBC debris into blood)
Chill-fever-sweating
Anemia, splenomegaly, Malignant malaria (P.f)
| 1.Thin and thick film
(Giemsa’s stain)
2.P.f: only ring forms and
gametocytes can
be found in blood.
| Principles: eradication of----
Parasites in RBC(control of symptoms);
Gametocytes to prevent transmission;
Bradysporozoites to prevent relapse
Drugs: chloroquine, quinine, artemisinin, artemether
(anti-erythrocytic drugs)
Primaquine, pyrimethamine
(anti-exoerythrocytic, &gametocyte)
Prevention:
(chemoprophylaxis)
Chloroquine, pyrimethamine
|
Toxoplasma gondii
(cat is final host)
| Oocysts, tachyzoite cyst
(bradyzoites)
| By mouth, skin, or
placenta(most important)
| Obligate intracellular parasite(reticuloendothelial cells and many other nucleated cells)
| Human and almost all mammals
|
| 1.(most asympotomatic)
Hepatitis, pneumonia,
Blindness, severe neurological disorders
(immune system
compromised individuals)
2.Congenital infention:
(transplacental transmit)
Spontaneous abortion, still born死产, still birth死胎
| 1.Isolation of
Organism at biopsy of lymph gland,liver,spleen, and intraperitoneal inoculation into mice.
2.Serological tests:
Dye test,IHA, IEA, ELISA,PCR…….
| Pyrimethamine, sulphadiazine磺胺
Spiramycin.
|
cryptosporidium
| oocyst
| By mouth
| Epithelial cells of small intestine
|
|
| 1.Immunocompetent host: Self-limiting watery
diarrhea, malaise, nausea, fever, crimpy abdominal pain
2.immunocompromised:
cholera-like watery or mucus diarrhea.
| Examine oocyst
from feces: direct fecal smear and stain
| Spiramycin,
allimin(大蒜新素)
|
Pneumocystis jiroveci
|
|
|
|
|
| 1.Epidemic or infantile pneumocystosis: dyspnea, non-productive cough, fever. Chest radiography shows bilateral infiltrates
2.Sporadic
pneumocystosis: immunosuppressive therapy patients
| 1.Pathogenic diagnosis
2.Serodiagnosis
3.DNA probe,
rDNA probe,
PCR
| Pentamidine,
Pyrimethamine,
SMZco复方新诺明
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自制的表格,略显粗糙,拿出来大家共享。