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 ID: 778855
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Slide1
Lecture originally from University of Warwick Medical Student websiteadapted by Siobhan Quenby
Professor
of Obstetrics
Slide2Yeasts vs Moulds
Single cell
Reproduce by budding
Identify using biochemical tests
tubular structures called hyphae grow by branching and longitudinal extension.
…and dimorphic fungi
Slide3Yeasts: Candida sp.
Slide4Mucocutaneous candidiasis
Slide5Protozoa
Slide6Unicellular, simple eukaryoteBroad range of diseases
Slide7Plasmodium sp.MalariaGiardia sp.
Diarrhoea
Leishmaniasis
Cutaneous and systemic infections
AmoebiasisDysentery, liver abscessTrypanomonisasisSleeping sickness, Chagas disease
Slide8Leishmaniasis
Slide9Malaria
Slide10Slide11Malaria and pregnancy
Slide12WHO malaria in pregnancy
Slide13Malaria in pregnancysulfadoxine-pyrimethamine (SP)
Slide14Insecticide treated nets
Slide15Slide16Arnold Mkandawire
Slide17Felix Simbeye
Slide18Lenard Gama
Slide19Malaria – Life
Cycle
Life Cycle of
Plasmodium vivax
Slide20Malaria – Pathology : Sepsis
Sepsis due to Malaria
Slide21Malaria – Pathology :
Haemolysis
Jaundice due to Malaria
Slide22Malaria – Pathology :
Sequestration
Erythrocyte Sequestration due to Falciparum Malaria
Slide23Malaria – 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
Slide24Malaria – Investigations (Blood Films)
Thick & Thin Blood Films
Slide25Malaria – Investigations (Blood Films)
Thick & Thin Blood Films
Slide26Malaria – Investigations (Blood Films)
Malaria
Parasites at Various
Stages
Slide27Malaria
–
Investigations (Malaria Antigen Tests)
Slide28Malaria – Investigations (Malaria Antigen Tests)
Slide29Malaria – Investigations (Malaria Antigen Tests)
Negative Non-Falciparum Falciparum or Mixed
Slide30Malaria –
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
)
Slide31Malaria –
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
Slide32Malaria – 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 10
9
/ litre + signs of bleeding
consider clotting factors (FFP) if DIC develops
consider haemodialysis if ARF develops
Slide33TreatmentsMalariaQuinine, artesunate
,
chloroquine
Giardiasis
MetronidazoleLeishmaniasisAmphotericin B
Slide34Helminths
Slide35HelminthsMost prevalent human infectionMulticellular
Usually life cycle involving more than one host with an egg, larval and adult stage
Slide36HelminthsRound wormsNematodesTape worms
Cestodes
Schistosomiasis
Trematodes
Slide37Roundworms : hookworm10% worlds populationCan cause iron deficiency anaemia
Slide38Roundworms: Enterobius
Slide39Tapeworms – Taenia sp.
Slide40Tapeworms: Taenia sp.
Slide41Slide42Neurocysticercosis
Slide43Slide44Schistomomiasis
Slide45Katayama fever
Slide46Schistosomiasis
Slide47Schistosomiasis
Slide48Cutaneous larva migrans
Slide49Slide50TreatmentsHookwormsMebendazole
Albendazaole
Schistosomiasis
/ tapeworms
Priziquantel
Slide51Parasite resourceshttp://dpd.cdc.gov/dpdx/html/Para_Health.htm