Infectious and Parasitic Diseases II

Coordinator: Jim Fishback, M.D.

Introduction to Tropical Medicine

• Typical housing conditions in a Rio de Janeiro favela.
• Typical sanitary conditions in the favela
• Rodent infestation
• Livestock management in the favela
• Case Studies in Tropical Medicine, per Dr. Fred Holmes (Thursday Clinical Correlation lecture)

Fungal infections

Opportunistic yeasts

• Candida spp.
• Oral candidiasis, Candida albicans
• Disseminated Candida albicans, kidney, Grocott methenamine silver
• Cryptococcus neoformans
  • Budding yeast, Crypto, India ink preparation

Molds

Aspergillosis

• hemorrhagic infarct, lung, due toAspergillus spp., gross
• hyphae, Aspergillus spp., Grocott methenamine silver

Mucormycosis (Zygomycosis)

• Patient photograph
• Invasion of blood vessel, Rhizopus spp.

Dimorphic fungi

• Histoplasmosis
  • Histoplasmosis, chest x ray
  • Histoplasmosis, granuloma, calcified, lung
  • intracellular yeast, Histoplasma capsulatum,Wright-Giemsa stain, bone marrow aspirate
• Coccidioidomycosis
  • Coccidioides immitus, patient photo
  • Coccidioides immitus, photomicrograph, PAS stain
• Blastomycosis (North American Blastomycosis)
  • Blastomycosis, patient photo
  • Blastomyces dermatitidis, sputum, calcofluor white
• Paracoccidioidomycosis (South American Blastomycosis)
  • Paracoccidioides brasilensis (South American Blastomycosis), lung, GMS stain

Protozoa

Malaria

• Malaria, life cycle
• Plasmodium falciparum, peripheral smear, gamete and ring form (arrow)

Toxoplasmosis

• Toxoplasma gondii life cycle
• Toxoplasma gondii, morphology, diagram
• Toxoplasma, rupturing tissue cyst, peroxidase stain
• Toxoplasma, tachyzoites
• Toxoplasma, CT scan, ring enhancing lesion
• Toxoplasma, gross brain, (compare with CT scan)

Pneumocystis carinii

• Pneumocystis, Grocott, alveolar exudate

Amebiasis

• Entamoeba histolytica, phase contrast

Giardiasis

• Giardia lamblia, phase contrast

Leishmaniasis

• Leishmania, hand, ulcer
• Leishmania, diffuse cutaneous (anergy)

Chagas' disease

• Chagas' life cycle
• Chronic Chagas' disease, myocarditis

Trichomonas

• Trichomonas vaginalis, PAP smear

Helminthic infections

Enteric helminths

Ascaris (Roundworm)

• intestinal obstruction, ascaris, appendix
• intestinal obstruction, ascaris, post-treatment with mebendezole in a child

Whipworm

• Trichuria, rectal prolapse
• Trichuria, fertile egg in stool
• Trichuria, adult worm

Schistosomes (mansoni and hematobium)

Hookworm

• hookworm, egg, stool
• hookworm, larva in stool
• hookworm, clinical photo

Taeniasis (Tapeworm)

• Taenia life cycle

Tissue helminths

Filarial infections

Life cycle, filaria

Strongyloides

• Strongyloides, lung

Trichinosis

• Trichinella life cycle
• Trichinellosis, muscle

Taeniasis (tapeworms)

• cysticercosis (pork tapeworm).
• creeping eruption, epidemiology
• Hydatid tapeworm cycle

Arthropods

• Pthirus pubis (crab louse), low power
• Pthirus pubis (crab louse), high power