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Case Study in Parasitology






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Case Study in Parasitology. 温锦娣 0456208 3 November 2006. Case 4: geohelminths. 36-year old woman History of travel to Puerto Rico Submitted routine stool specimen. Wet Mount Examination of the Concentrate from the Stool Specimen. Fertile (infective) Ascaris eggs bile stained
Case Study in Parasitology

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Case study in parasitology l.jpgSlide 1

Case Study in Parasitology

温锦娣 0456208

3 November 2006

Case 4 geohelminths l.jpgSlide 2

Case 4: geohelminths

  • 36-year old woman

  • History of travel to Puerto Rico

  • Submitted routine stool specimen

Wet mount examination of the concentrate from the stool specimen l.jpgSlide 3

Wet Mount Examination of the Concentrate from the Stool Specimen

  • Fertile (infective) Ascaris eggs

    • bile stained

    • thick, warty, albuminous coat

    • thick transparent inner shell

    • Crescent-shaped spaces

    • 45~75 x 35~50 mm in length

  • Resistant: chemicals, temperature, pH, irradiation

Slide4 l.jpgSlide 4

  • Infertile egg

    • elongated and larger than fertile egg

    • thin shelled

    • shell ranges from irregular mammillations to smooth

    • internal contents: a mass of disorganized, highly refractive granules

    • 85-95 mm x 43-47 mm

Diagnosis l.jpgSlide 5

Diagnosis

Disease Ascariasis

Transmission fecal-oral route (soil, water, foodborne)

Occurrence 1.5 billion (25%) infections worldwide

Detection direct microscopic observation

Symptoms l.jpgSlide 6

Symptoms

  • Vague intestinal pain, nausea, diarrhea, malnutrition

  • Intestinal obstruction

  • Larva migrans: allergic hypersensitivity reactions such as asthmatic attacks, pulmonary infiltration and urticaria and oedema of the lips

Wet mount examination of the concentrate from the stool specimen7 l.jpgSlide 7

Wet Mount Examination of the Concentrate from the Stool Specimen

  • Trichuris trichiura (Whipworm)

    • characteristic opercular plugs at each end of the egg

    • Barrel-shaped

    • yellow-brown, thick smooth shell

    • 50-55 mm x 22-24 mm

Diagnosis8 l.jpgSlide 8

Diagnosis

Disease Trichuriasis

Transmission fecal-oral route (soil-borne, contaminated vegetables)

Diagnosis direct microscopic observation of the egg from stool specimen: smear, sedimentation

Symptoms9 l.jpgSlide 9

Symptoms

  • Chronic dysentery, bloody stools

  • Iron-deficiency anemia

  • Rectal prolapse

Wet mount examination of the concentrate from the stool specimen10 l.jpgSlide 10

Wet Mount Examination of the Concentrate from the Stool Specimen

  • Enterobius vermicularis (Pinworm)

    • elongated and flattened on one side

    • thick colorless shell

    • 50-60 mm x 20-30 mm

  • Found in feces: unembryonated

  • Cellulose tape preparation: embryonated (infective)

Diagnosis11 l.jpgSlide 11

Diagnosis

Disease Enterobiasis

Transmission anal-oral route, airborne

Detection cellophane tape

Symptoms12 l.jpgSlide 12

Symptoms

  • majority of infections are asymptomatic

  • irritation of the perianal region

  • Appendicitis

  • Pelvic inflammation

Treatment l.jpgSlide 13

Treatment

  • administration of an anti-helminthic drug

    • Mebendazole

    • Albendazole

Association between multiple geohelminth species infection l.jpgSlide 14

Association between Multiple Geohelminth Species Infection

  • Infection intensities of different species were positively correlated

  • Individuals with single-species infections had generally lower species-specific egg counts than individuals with multiple-species infections.

Association between multiple geohelminth species infection15 l.jpgSlide 15

Association between Multiple Geohelminth Species Infection

  • individuals with multiple species infections are likely to be at highest risk of geohelminth-related morbidity

    • number of infections they harbour

    • carry heavier infections of each species


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