ENTEROBIASIS (PINWORM INFECTION)
DEFINITION
- Is a human parasitic disease caused by the pinworm. The most
common symptom is itching in the anal area. This can make
sleeping difficult. The period of time from swallowing eggs to
the appearance of new eggs around the anus is 4-8 weeks.
- This diseases is spread between people by pinworm eggs. The
eggs initially occur around the anus and can survive for up to
three weeks in the environment.
ETIOLOGIC AGENT
- The cause of a pinworm infection is the worm Enterobiasis
Vemicularis. The entire life-cycle from egg to adult takes place
in the place in the human gastrointestinal tract of a single
human host.
LIFE-CYCLE
- The life cycle begins with eggs being ingested. The eggs
hatched in the duodenum. The emerging pinworm larvae grow
rapidly to a size of 140-150 micrometers in size, and migrate
through the small intestine towards the colon. During this
migration the moult twice and become adults.
MODE OF TRANSMISSION
- (Threadworms) Pinworm are transmitted by direct-transfer of
infected eggs by hand from the anus to the mouth of the same
or another person. They can also be transmitted indirectly
through bleeding, clothing, food, or other articles.
- -
PATHOGENESIS
- The infection of pinworm is called “Enterobiasis”. The person
infected may experience intense itching in the anal region.
Children especially, may become irritable and not sleep well.
- General symptoms are restlessness, nervousness, appendicitis,
irritability, nausea, constipation, diarrhea, abdominal pain,
insomnia. Loss of appetite, bed wetting and grinding the teeth.
- In women and girls, pinworm may crawl into the genital
opening and cause inflammation and irritation of genitalia by
pinworms leads to an early sexual desire. Lesions in colon and
appendix are also associated with pinworm infection.
CLINICAL MANIFESTATIONS
- Pruritis ani and perineal pruritis
- Itching occurs mainly during the night
- Insomnia, irritability and restlessness
- Intermittent abdominal pain and nausea
DIAGNOSIS
- Invisible eggs are to the naked eye, but they can be seen using
a low power microscope.
- Transparent Adhesive Tape (Scotch Tape) applied on the anal
area will pick up deposited eggs.
-
EPIDEMIOLOGY
- Pinworm infection occurs worldwide, and is the most common
helminth infection in the United States and Western Europe.
Pinworm infection is most common in persons who love in
crowded living conditions and in individuals who live in
crowded living conditions and in individuals who are
institutionalized.
Of all age groups, school-aged children are most at risk for
pinworm infections. In adults, pinworm infection is most
common in parents aged 30-39 years old, typically because of
transmission from their children aged 5-9 y/o.
-
TREATMENT
- Benzimidazole
- Albendazole
- Mebendazole
- Has no serious side effects, although abdominal pain
and diarrhea are reported.
- Pyranted pampate
- Kills adult pinworms through neuromuscular blockade
and is considered as effective as the benzimidazole compounds
and is used as a second line medication.

PREVENTION
- Pinworm infection cannot be totally prevented under most
circumstances
- Prevention actions revolves around personal hygiene and the
cleanliness of the living quarters. The rate of reinfection can be
reduced through hygienic measures and this is recommended
especially in recurring cases.
- The entire household should be treated simultaneously.
Treatment is much more effective if the child’s family and
classmates are treated at the same time
TOXOCARIASIS
- In heavy infection migrating larvae result in severe damage of
DEFINITION
lungs leads to pulmonary edema.
- Is an illness of humans caused by larvae of either the dog - Adult parasites cause mucoid enteritis, diarrhea, and
roundworm (toxocara canis), the cat roundworm (toxocara
partial/complete obstruction and may also cause perforation
cati) or the fox roundworm.
and peritonitis.
- Toxocariasis is often called Visceral Larva Migrans. The soil of
- Human beings can also be infected and they suffer from
parks and playgrounds is commonly contaminated with the
Visceral Larva Migration.
eggs of T canis, and infection may cause human disease that
involves the liver, heart, lung, muscle, eye, and brain.
CLINICAL MANIFESTATIONS
- Covert toxocariasis
ETIOLOGIC AGENT
- Coughing
- Toxocariasis canis- is the main etiologic agent of visceral and
- Fever
ocular larva migrans, covert toxocariasis and neurological
- Abdominal pain
toxocariasis in humans.
- Headaches
-
- Changes in behavior and ability to sleep
MODE OF TRANMISSION
- Humans become infected by ingesting either embryonated
DIAGNOSIS
toxocara eggs from soil, dirty hands or raw vegetables or
- PCR- serological testing are dependent on the number of
toxocara larvae from under-cooked giblets (mainly liver). No
larvae.
evidence for direct human-to-human transmission.
- ELISA within the patient and are unfortunately not very specific

LIFE CYCLE
EPIDMIOLOGY
- Cats, dogs and foxes become infected with toxocara through
- Toxocariasis is a worldwide infection
the ingestion of eggs or by transmission of the larvae from a
- Mortality/Morbidity
mother to her offspring. Transmission to cats and dogs can also
- Toxocariasis is almost always a benign, asymptomatic
occur by ingestion of infected accidental hosts such as
and self-limiting disease, although brain involvement can cause
earthworms, cockroaches, rodents, rabbits, chickens or sheep.
severe morbidity.

PATHOGENESIS
TREATMENT
- In mild infection no most damage in migratory phase
- Corticosteroids (in severe VLM)
-
 - Albendazole/ Mebendazole
- Antiparasitic Drugs
- Albendazole
- Tiabendazole/ diethylcarbamazine

PREVENTION
- Controlling toxocara infection in dogs and cats will reduce
number of infectious eggs in the environment and reduce the
risk of infection for people.
- More on handwashing
- Many common disinfectants are not effective against toxocara
eggs but extreme heat has been shown to kill the eggs. Prompt
removal of animal feces can help prevent infection since the
eggs require 2-4 wks to become infective once they are out of
the animal.
LEPROSY

DEFINITION Cell. Since it like in lower temperatures than human body it is

- Also known as Hansen disease, Is a long term infection by the mostly found on the skins surface.
bacterium Mycobacterium Leprae or Mycobacterium PATHOGENESIS
Lepromatosis. It can affect the nerves, skin, eyes, and the lining - The portal of entry for M. Leprae is widely to be the nose,
of the nose (nasal mucosa). With early diagnosis and although skin-skin transmission has not been excluded. The
treatment, the disease can be cured. People with Hansen’s earliest lesions in the nasal mucosa cause mild, non-specific
disease can continue to work and lead an actie life during and symptoms and are not biopsied, so the hispathological features of
after treatment. this lesion are not known.
- It spread between people and possible from armadillos. This
thought to occur through a cough or contact with fluid from CLINICAL MANIFESTATIONS
the nose of an infected person. - Pale or pinkish patches of skin that may be insensitive to
temperature of pain.
ETIOLOGIC AGENT - Numbness/ tenderness in the hands or feet.
Mycobacterium Leprae - Secondary Infection
Mycobacterium Lepromatosis - Tissue loss, causing fingers and toes to become shortened and
are the causative agent of leprosy deformed.
- Mycobacterium Lepromatosis is a relatively newly
identified mycobacterium isolated from a fatal case of DIAGNOSIS
diffuse lepromatous leprosy - Physical Exam
- To look for telltale sign and symptoms of the disease.
MODE OF TRANSMISSION - Skin biopsy/Scraping
- Transmission of leprosy occurs during close contact with those - Removing a small piece of skin
who are infected. Transmission is proposed to be by nasal - Lepromin skin test
droplets. - To determine the form of leprosy
- Leprosy is not known to be either sexually transmitted or highly
infectious. TREATMENT
- Rifampacin
LIFE CYCLE - Dapsone and clofazamine
- The bacteria Mycobacterium Leprae can have a difficult time - Quinolones
replicating. When it find a host it can take as long as 13 days to - Minocycline
fully go through one replication cycle when not in the hosts - Azithromycin
PREVENTION
- Early detection of the disease is important, since physical and
neurological damage may be irreversible even if cured.
- Medications can decrease the risk of those living with people
with leprosy from acquiring the disease and likely those with
whom people with leprosy come into contact outside the
home.