Protozoa

Organism

Characteristics

Associated Disease(s)

Pathogenesis

Treatment

Diarrhea, liver abscess

Cyst enters environ, ingested oral-fecal contamination,

becomes trophozoite in gut attaches to colonic mucosa and
sometimes penetrates and reaches portal circulation

metronidazole

Microscopic, unicellular, PSEUDOPOD

Entamoeba histolytica

Rarely in the US, many in Mexico

Acanthomoeba

Contact lens wearer get infection of cornea

Transmitted by contaminated water

Explosive, sudden onset diarrhea from malabsorption of fat Same entamoeba (cyst=infectious from colon, very resistant
chlorination)

Fecal-oral contact (day-care)

Weight loss in kids with chronic infection, relapses common

Giardia lamblia

Metronidazole
Good personal hygiene
Water treatment plants

Acute disease 1-3 weeks after ingestion, resolve 1-4 weeks

later. Sometimes chronic
Good hygiene
Cryptosporidium

Spread by contaminated water, fecal-oral Diarrhea, worse in immunocompromised, can become

contact
chronic in immunocompromised

Microsporidia

Ingestion of oocysts which develop into sporozoites in

intestine. Invade enterocytes under brush border and develop
into trophozoites. ~1week until diarrhea, ~1-2 weeks til
resolved

diarrhea

Mainly in immunocompromised pt

STD among women, men asymptomatic.

Trichomonas vaginalis
Observe pear shaped organisms with
twitching motility

None necessary except to

restore immunity in
immunocompromomised
Albendazole, more imp
resotre immune fx

Female male female in discharge

Vaginal discharge, vulvovaginal soreness. Frothy/bubbly
discharge. Fish-like odor

metronidazole

Partial immunity w/
repeat infect.
Sporozoites from mosquito bite travel to liver, invade
hepatocytes. Differentiate into schizonts and multiply.
Differentiate into merozoites, exit hepatocytes. Mero invade
Sickle cell partial
RBC, complete several cycles, lyse RBC and release more
resistance
mero. Some become gametocytes which taken up by mosquito
to complete cycle
Prophylaxis (quinilones)

Plasmodium falciparum P. vivax, P

ovale, P. malariae (not as serious)

Ovale and vivax have latent liver forms

(hypnozoites), dont affect all RBC so
less bad

Malaria (cyclic fevers, RBC lysis) microvascular disease,

hypoglycemia, cerebral malaria, renal failure, pulmonary
edema, anemia, multiorgan failure (from RBC obstructions),
coma

Babesia

From ticks; Cape Cod, Vineyard,

Nantuck.

babesiosis

Part life cycle occurs not in people

NOT in US

Cutaneous leishmaniasis: Amer troops Irag/Afghan

Intracellular amastigotes in Macrophage

Central/South America, Middle East,

Africa

Visceral leishmaniasis (kala azar): fevers and

hepatosplenomegaly

Extracellular promastigotes in sandflies

Central/ S. Amer: Chagas Disease

Centra/ S. America by kissing bugs

Africa: sleeping sickness

African: tsetse fly

Clindamycin and quinine

Leishmania

Trypanosoma
Ocular/CNS abnormalities, chorioretinits in newborn
Toxoplasma Gondii
Space occupying lesions in brain

Cyst from cat feces or uncooked meat. Release sporozoites in

intestine, penetrate wall, infect Macrophage and become
tachyzoite. Disseminate via blood to fetus or CNS.

Sulfadiazine and
pyramethamine

Immunosuppression leads to release of tachyzoites from cysts in

brain which cause inflammation and disease.

Helminths

Organism

Characteristics

Roundworms:

Impoverished rural areas, esp where

night soil used

ascaris lumbricoides

Disease(s)

Pathogenesis

Treatment

Albendazole
Wide range: perianal itch (pinworm) to disseminated infection
(strongyloidiasis)

Pinworm common throughout US

Females in gut produce eggs which embryonate and infect

by ingestion (ascaris, enterobius, whip) or skin penetration Pyrantel for enterobius
by larva (hook, strongyloides)

hookworm (necator americanus)

pinworm (enterbius vermicularis)
strongyloides sterocoralis
whipworm
Flukes: schisotomes

Everywhere except NA, Europe, Australia Acute schistosomiasis (Katayama Fever) then chronic
(liver disease, bladder cancer, neuorlogic disease)

Snails eat eggs, release cercariae into slow moving water,

cerc. Penetrate human skin, migrate lungs/liver mature to
adults, migrate via veins to GI or veins of bladder

praziquantel

Ingesting T. solium eggs or cysticerci

Tapeworms: taenia solium (pork
tapeworm)

Latin America/Asia

Neurocysticerosis: presents seizures

Echinococcus granulosus

Carried by dogs

Hyatid disease

Eggs in GI hatch to from oncospheres, penetrate mucosa and .

enter bloodstream. Encyst in organs, especially liver

Fungi

Organism

Characteristics

Disease(s)

Pathogenesis

Enters by resp tract: pneumoniae, skin infection

Cryptococcus neoformans (yeast)

Encapsulated, budding repro, worldwide

soil/bird droppings, India Ink detect in Meningitis!! hydrocephalus
CSF, sero test for Cryptococcus
polysaccharide

Amphotericin + 5-flucytosine
Polysaccharide capsule prevents phagocytosis; melanin
blocks oxidative stress, grows 37C, CD4 block, so if
immuncomp @ hi risk

Flucanazole

Flucanazole
Candida albicans (yeast)

Aspergillus fumigatus (mold)

A. niger

Unicellular, white spots in vagina, oral,

esophagus. Candida bloodstream. Look
for satellite infections
Branching, septate hyphae .growth
respiratory specimens. Detect
galactomannan
Niger: otomycosis (itchy ear, normal
hosts)

Caspofungin
Airway colonization. Allergic bronchopulmonary
aspergillosis (ABPA) w/ underlying asthma/CF. Secondary
Inhale spores, evade pulm macrophage(immunocomp)
aspergilloma; sit in TB pocket in lung, ball of mold, massive
locally infect lung, enter BV, disseminate other sites
hemotypsis.
Invasive pulmonary aspergillosis (90% fatal)
Resp tract

Rhinocerebral muco. In diabetics!

Nose, sinuses, brain

Sporotrichiosis

Inoculation fungus skin, local lymph spread

Pulmonary disease normal pt.

Histoplasmata capsulatum
(dimorph)

Ohio/ Miss R. Valley.

Coccidiodes immitis (dimorph)

SW U.S

NOT Pitt

Histoplasmosis
Disseminated in immuncomp pt.
Coccididiodomycosis (valley fever) ~ TB

Voriconazole/iatroconazole
NOT flucanazole
caspofungin

Mucormyosis(zygomycetes)
Mucorales (mold)

Sporothrax schenkii (dimorph)

Amphotericin

Spores (mycelial) = infectious spherules internal

endospores leave and cause problems. T cell response
important!

Blastomyces dermatidis (dimorph) Ohio/ Miss R. Valley, Canada around

Great Lakes

blastomycosis
Topical: imidazole

Microsporum canis (zoophil

dermato)

Dx scraping skin, stain KOH

Ring worm (tinea corporis) scalp (tinea capitis)

Oral: griseofulvin or azoles
Topical: imidazole

Tricophyton rubrum(antro dermato) Onychomycosis: fungal infection of nail

Athletes foot (tinea pedis) jock itch (tinea cruris)

Oral: griseofulvin or azoles

Pneumocystis Carinii (formerly

protozoa)

Most people infected as kids

Manifest as pneumoiae (PCP) in T cell impaired pt.

Trimethoprim/sulfamexazole

Prevent w/ prophylaxis of
TMP/SMZ