II. History
III. Pathophysiology
- Parasites cause acute disease via two primary mechanisms
- Mass Effect
- High parasitic load related obstruction (Intestinal Obstruction)
- Host Inflammatory Response
- TH2 Pattern (release of inflammatory mediators such as Interleukins, Immunoglobulins, Mast Cell activation)
- Jarisch-Herheimer Reaction (Antimicrobial Agent induced reaction to dying organisms)
- Mass Effect
V. Types: Endoparasites
- Protozoa
-
Helminths (worms)
- Tapeworms (Cestodes)
- Flukes (Trematodes)
- Roundworms (Nematodes)
- Enterobius vermicularis (Pinworm)
- Trichinella spiralis (Trichinosis)
- Lymphatic Filariasis
- Toxocariasis
- Soil Transmitted Helminths (STH)
- Worldwide the most common intestinal Parasites worldwide (2.6 billion infections/year)
- Ascaris lumbricoides (roundworm)
- Ancylostoma duodenale or Necator americanus (Hookworm)
- Trichuris trichiura (Whipworm)
VI. Causes: U.S.
VII. Causes: Neglected tropical diseases (per CDC)
- Buruli ulcer
- Chagas Disease
- Cysticercosis
- Dengue Fever
- Dracunculiasis (Guinea Worm Disease)
- Echinococcosis
- Fascioliasis
- Human African Trypanosomiasis (African Sleeping Sickness)
- Leishmaniasis
- Leprosy (Hansen's Disease)
- Lymphatic Filariasis
- Onchocerciasis
- Rabies
- Schistosomiasis
- Soil-transmitted Helminths (STH)
- Ascaris lumbricoides (roundworm)
- Ancylostoma duodenale or Necator americanus (Hookworm)
- Trichuris trichiura (Whipworm)
- Trachoma
- Yaws
VIII. Causes: Waterborne Parasites (common worldwide)
- See Waterborne Illness
- Amebiasis
- Cryptosporidiosis
- Giardiasis
- Guinea worm (Dracunculus medinensis)
- Schistosomiasis
IX. Differential Diagnosis
X. Labs
- See specific agents
- See Fever in the Returning Traveler (includes lab testing)
-
Complete Blood Count with differential
- May demonstrate Eosinophilia
XI. Complications: Organisms with serious secondary effects
-
Anaphylaxis
- Echinococcus species (Hydatid Disease)
-
Anemia
- Babesia species (Babesiosis)
- Diphyllobothirum latum (Fish Tapeworm)
- Necator americanus (New World Hookworm)
- Plasmodium species (Malaria) - Hemolytic Anemia
- Trichuris trichiura (Whipworm)
-
Acute Respiratory Distress Syndrome
- Babesia species (Babesiosis)
- Pneumocystis carinii
- Plasmodium species (Malaria)
- Strongyloides stercoralis (Threadworm)
-
Cardiomyopathy
- Trypanosoma cruzi (Chagas Disease)
- Trichinella species (Trichinosis roundworm)
- Taenia solium (Cysticercosis)
- Entamoeba histolytica (Amoebiasis)
- Encephalitis
- Gastrointestinal Conditions
- Seizure Disorder
XII. Prevention
XIII. Resources
- See Travel Resources
- CDC Neglected Parasitic Infections (U.S.)
- CDC Neglected Tropical Diseases (worldwide)
XIV. References
- Wang and Nguyen (2017) Crit Dec Emerg Med 31(9):13-8