parasitology presentation寄生蟲學(xué)表現(xiàn)

AscarisLumbricoides:

Theory&Case-StudyParasitologyPresentation120thNov,2015GroupMembers朱內(nèi)–12952219簡特–11952787艾彬–12952228哈里夫–12952240尤歌–12952227拉娃婭–12952216哈里施-12952242ContentsIntroductionMorphologyLifeCyclePathogenesisTreatmentEpidemiology&RiskFactorsCaseStudyQ&AIntroductionIntroductionCommonName–RoundwormLargest&MostcommonparasiticworminHumansDiseasecaused–AscariasisLivesinthesmallintestineofmanMorphologyMorphology–AdultwormElongated,roundedinshape,taperedinbothendsMale–15-25cminlength,3-4mmindiameterFemale–25-40cminlength,5mmindiameterHighegglayingcapacity-200,000eggsperdayLifespan–1yearMorphology-Egg2types–fertilized&unfertilizedeggsFertilizedeggs–roundoroval60-75μminlength,40–50μminbreadth.Thickandtranslucentshell,bilestained,browncolourUnfertilizedeggs–Narrower,longer80μminlength,55μminbreadth.Bilestained,thinnershell,brownincolourDefinitiveHost:HumansPathogenesisPathogenesis–ModeofInfectionInfectiveForm–EmbryonatedEggsPortalofEntry–AlimentaryCanal(Ingestion)SiteofLocation–SmallIntestinePathogenesis-SymptomsOftennosymptomsareseen(asymptomaticinfection)TheSymptomsaredueto–(i)AdultWorm(ii)MigratingLarvae

(i)EffectsduetoAdultWormIntermittentColickyCrampsLossofAppetiteMalnutritionIntestinalObstruction(heavyinfection)Wormsvomitedoutorpassthroughesophagus,nose,mouth,etc.Toxicbodyfluidrelease(ascaron)–AnaphylacticShock(ii)EffectsduetolarvaemigrationInflammatory&Hypersensitivityreactioninlungs-(a)Cough,Fever,Dyspnea,Eosinophilia(b)Bloodtingesputum,maycontainlarvae&Charcot–laydencrystals(Loeffler’sSyndrome)AllergicInflammatoryreactions–liver&kidneyPathogenesis:DiagnosisLabDiagnosisStoolExaminationDemonstrationofAdultWormDemonstrationofLarvaeSerodiagnosisEosinophiliaTreatmentTreatmentMebendazole–100mgtwicefor3days/AlbendazolePersistentObstruction–SurgicalRemovalofAdultWormsEpidemiologyEpidemiologyAscariasis-MostcommonparasiticdiseaseAffectsmorethan1.4billionpeopleworldwidePrevalence–tropical&temperateareasPoorsanitaryareas,humanfecesusedasfertilizersEggsviableinsoilformanyyearsProphylaxis(Prevention)Propersanitation&hygienepracticesFecaltreatmentshouldbedoneproperly(Hotcompostingmethods)HandlerawfruitsandvegetablewithcareDonotputfingersinyourmouthCaseStudyCaseStudy-HistoryPatient–Female,35YearsoldPresentedwithepigastricpainandnauseafor4hoursHistoryofPepticUlcersOralProtonPumpInhibitorsfor3yearsPulse–110/min,BP–110/80mmHg,T=37.5oCMildtenderness&GuardinginUpperAbdomenMildDehydrationCaseStudy-ExaminationDay1–Serodiagnosis–TotalLeukocyteCount:8300/mm3;80%PolymorphsESR–35mmafterfirsthourXray,UltrasoundNormalDay2–Pulse–140/min,BP–100/60mmHg,TLC–12000/mm3Ultrasound–Freefluidinabdomen

CaseStudy–Diagnosis&TreatmentDiagnosis–PeritonitisduetopepticulcerperforationLaparotomy450mLofpusdrainedPerforationof8mmdiameteronanteriorwalloffirstpartofduodenumLiveA.lumbricoidespouting,removalofwormsAlbendazolewasprescribed,patientrecoveredin8daysCaseStudy-DiscussionCannotdeterminethecauseofperforationPerforationbyascariscannotbecausedbysomewormsSmallIntestinemodation->5000wormsMostCommoncomplication–intestinalobstructionLeadstoBiliaryAscariasis–64%ofthecasesCaseStudy-Discussion2theoriesofperforationinascariasisTheory1–Patienthashistoryofamoebiasis,typhoidenteritis;Incaseofinflammation,bolusformation,wormsmigratetoulcersandperforateTheory2–Largeboluscanformpressurenecrosis&gangreneCausesweaknessofintestinalwall,ingsusceptibletoburrowingactionofworms

ConclusionConclusionAscariasisasapossible,eventhoughararecauseshouldalwaysbeborneinmindasacauseofperforationinpatientswithnonspecificabdominal