Leishmaniasis
Trypanosomiasis
Helminths!
More Worms!
More fun:(
100
What is the vector for Leishmaniasis?
Sandfly (that is infected with promastigotes)
Sandfly bites human and transfers promastigotes which then transform into amastigoes and multiple which leads to cutaneous manifestations within weeks.
Reservoirs are mainly canines and rodents
100
What are the two types of Trypanosomiasis that are known to cause human disease?
Chagas Disease (American Trypanosomiasis) - Caused by T. Cruzi and vector is Reduviidae Bug. Central & South America
African Trypanosomiasis ("sleeping sickness") - Caused by T. Brucei Gambiense (West Africa) and T. Brucei Rhodesiense (East Africa). Vector is Tsetse Fly
100
Can Cutaneous Larva Migrans cause systemic disease?
No!
Why? larva penetrate intact epidermis but they are unable to penetrate human BM zone.
100
Vector for Onchocerciasis (River Blindness)?
Black Fly, present near fast flowing rivers in places like sub saharan Africa, South America, Yemen
100
Primary dermatologic manifestations of Trichonosis (where you eat undercooked pigs that contain larval cysts)
Periorbital Edema (from Type 1 allergic rxn)
Splinter Hemorrhages (petechiae during parasite migration)
200
What is the most common cutaneous finding associated with leishmaniasis?
papule at site of inoculation (usually exposed skin sites like arms, face, legs) that classically evolves into an ulcer (or becomes verrucous).
May later develop sporotrichoid spread that heals with scarring.
200
Earliest sign of African Trypanosomiasis (Sleeping Sickness)?
Trypanosomal Chancre (local pruritic inflammatory reaction at site of inoculation that leads to local LAD and ulcerates leading to eschar)
200
Most common species that causes Cutaneous Larva Migrans?
Ancylostoma Braziliense
200
Clinical Findings of Onchoceriasis (River Blindness)?
Itchy Papules that can be acute, chronic or lichenified.
Leopard Skin (depigmentation)
Nodules (Onchocercomas) over bony prominences.
200
Species that causes Swimmer's itch
Schistosoma (snails are the vector)
300
What type of leishmaniasis is this called? 
"Chiclero Ulcer"
Results from infection on the ear in forest workers who collect gum from the chicle ear in Mexico and Central America
300
Other cutaneous findings of African Trypanosomiasis (sleeping sickness)?
*hint they have specific names
Winterbottom Sign: posterior cervical LAD
Trypanids: transient annular erythematous eruption that coincides with fever spikes.
2nd Stage (meningoencephalitic stage): neuro manifestations with irritability, changes in personality, daytime somnolence
300
What caused this??
disseminated Strongyloides (we are seeing periumbilica or thumbprint purpura)
300
TOC for Onchocerciasis?
Ivermectin (TOC)
Surgical excision of onchocercomas also often needed.
300
Where can you get Swimmer's Itch?
Swimming in North United states and Canada Fresh Water.
ie. Crosslake Minnesota where I got this
400
Which subspecies of leishmaniasis is associated with the mucocutaneous classification that can lead to progressive nasopharyngeal destruction (including perforation of the nasal septum known as "tapir face.")
Leishmaniasis Braziliensis
*most cases of Old World CL self resolve. New World CL due to L Mexicana self resolves in 75% BUT mucocutaneous leishmaniasis does not resolve resolve and requires treatment to prevent progressive destruction
400
In association with Chagas Disease, what is this called and what causes it?
Romana Sign
Unilateral eyelid edema and conjunctivitis that occurs at site of inoculation
400
Name of Syndrome that is chronic strongyloidiasis where the lungs are affected and you have peripheral eosinophilia?
Loeffler's Syndrome
400
Helminth that can cause acute lymphangitis (inguinal nodes #1 site) and lymphedema?
Filariasis
- Vectors are mosquitoes
400
How is the clinical presentatino of Seabather's Eruption different from Swimmer's Itch?
Seabather's eruption has itchy papules and wheals in COVERED areas whereas Swimmer's itch has these findings on uncovered skin 
500
Name of condition that is associated with lesions that arise up to 20 years after presumed recovery from untreated visceral leishmaniasis?
Post-kala-azar dermal leishmaniasis (occurs when parasite spreads to the BM, spleen and liver).
Most commonly seen in Sudan and India
500
Late complications of Chagas Disease?
heart (CHF, arrhythmias, dilated cardiomyopathy), megaesophagus and intestinal enlargement (megacolon)
30% of patients develop symptoms of chronic chags disease
500
This patient recently ate sushi and presents with this finding + GI symptoms/Fevers. What do they have?
Gnathosomiasis
Vector: raw freshwater fish (humans get disease by eating things like sushi)
Clinical Presentation: GI symptoms/fevers and a nodular migratory panniculitis that can look like cutaneous larva migrans or can have a single tender nodule that moves around the skin.
500
TOC for Filariasis?
Diethylcarbamazine
500
Can Entamoeba Histolytica cause Cutaneous Findings?
YES :(
Cutaneous lesions may spread to perianal region from GI involvement or be sexually transmitted with a painful, ulcerating plaque