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Professor of Obstetrics

Lecture originally from University of Warwick Medical Student website adapted by Siobhan Quenby. Professor of Obstetrics. Yeasts vs Moulds. Single cell Reproduce by budding Identify using biochemical tests. tubular structures called hyphae

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Professor of Obstetrics

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  1. Lecture originally from University of Warwick Medical Student websiteadapted by Siobhan Quenby Professor of Obstetrics

  2. Yeasts vs Moulds • Single cell • Reproduce by budding • Identify using biochemical tests • tubular structures called hyphae • grow by branching and longitudinal extension. …and dimorphic fungi

  3. Yeasts: Candida sp.

  4. Mucocutaneous candidiasis

  5. Protozoa

  6. Unicellular, • simple eukaryote • Broad range of diseases

  7. Plasmodium sp. • Malaria • Giardia sp. • Diarrhoea • Leishmaniasis • Cutaneous and systemic infections • Amoebiasis • Dysentery, liver abscess • Trypanomonisasis • Sleeping sickness, Chagas disease

  8. Leishmaniasis

  9. Malaria

  10. Malaria and pregnancy

  11. WHO malaria in pregnancy

  12. Malaria in pregnancysulfadoxine-pyrimethamine (SP)

  13. Insecticide treated nets

  14. Arnold Mkandawire

  15. Felix Simbeye

  16. Lenard Gama

  17. Malaria – Life Cycle Life Cycle of Plasmodium vivax

  18. Malaria – Pathology : Sepsis Sepsis due to Malaria

  19. Malaria – Pathology : Haemolysis Jaundice due to Malaria

  20. Malaria – Pathology : Sequestration Erythrocyte Sequestration due to Falciparum Malaria

  21. Malaria – Symptoms & Signs Benign + Falciparum Malaria : hot + cold sweats headache arthralgia + myalgia diarrhoea + vomiting hepatosplenomegaly anaemia Falciparum Malaria only : hypoglycaemia coagulopathy haemorrhage septic + hypovolaemic shock renal failure respiratory failure cerebral malaria = various CNS features that lead on to  consciousness / fits / coma / death

  22. Malaria – Investigations (Blood Films) Thick & Thin Blood Films

  23. Malaria – Investigations (Blood Films) Thick & Thin Blood Films

  24. Malaria – Investigations (Blood Films) Malaria Parasites at Various Stages

  25. Malaria – Investigations (Malaria Antigen Tests)

  26. Malaria – Investigations (Malaria Antigen Tests)

  27. Malaria – Investigations (Malaria Antigen Tests) Negative Non-Falciparum Falciparum or Mixed

  28. Malaria – Treatment Supportive treatment & management of sepsis … Benign Malaria chloroquine 600 mg then 300 mg after 8 hours then chloroquine 300 mg daily for another 2 days followed by primaquine 15 mg for 14 days to eradicate Falciparum Malaria quinine 600 mg (or 10 mg/kg if IV) every 8 hours for 7 days followed by doxycycline 200 mg daily for 7 days to eradicate alternatives are : malarone (4 tablets daily for 3 days) riamet (4 tablets at 0, 8, 24, 36, 48 & 60 hours)

  29. Malaria – Supportive Management Complicated falciparum malaria should be treated in an ITU / HDU Monitor : Glasgow Coma Scale / AVPU score temperature heart rate blood pressure (invasive CVP monitoring) respiratory rate (urine output / fluid balance) blood glucose FBC (Hb + platelets) clotting tests renal function chest radiograph

  30. Malaria – Supportive Management May also include : nasogastric tube ventilation if GCS < 8 treat seizures + continue anti-convulsants reduce temperature with tepid sponging + paracetamol optimise fluid balance (CVP +5 to +10) + maintain urine output treat pulmonary oedema → sit upright / high % oxygen / IV diuretic consider haemofiltration / venesection treat hypoglycaemia + continue 10% glucose infusion transfuse if Hb < 7 g/dl or haematocrit < 20% (with frusemide cover) transfuse if platelets < 20 x 109 / litre + signs of bleeding consider clotting factors (FFP) if DIC develops consider haemodialysis if ARF develops

  31. Treatments • Malaria • Quinine, artesunate, chloroquine • Giardiasis • Metronidazole • Leishmaniasis • Amphotericin B

  32. Helminths

  33. Helminths • Most prevalent human infection • Multicellular • Usually life cycle involving more than one host with an egg, larval and adult stage

  34. Helminths • Round worms • Nematodes • Tape worms • Cestodes • Schistosomiasis • Trematodes

  35. Roundworms : hookworm • 10% worlds population • Can cause iron deficiency anaemia

  36. Roundworms: Enterobius

  37. Tapeworms – Taenia sp.

  38. Tapeworms: Taenia sp.

  39. Neurocysticercosis

  40. Schistomomiasis

  41. Katayama fever

  42. Schistosomiasis

  43. Schistosomiasis

  44. Cutaneous larva migrans

  45. Treatments • Hookworms • Mebendazole • Albendazaole • Schistosomiasis/ tapeworms • Priziquantel

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