LEISHMANIA

33問 • 2年前

問題一覧

___________ is one of the seven most important tropical diseases and it represents a serious world health problem that presents a broad spectrum of clinical manifestations with a potentially fatal outcome

Leishmaniasis

1. Old World Species- ________, Africa and Asia 2. New World Species- _______

Europe, America

HISTORY of Leishmania sp. • 2000BC - __________ infection in ancient Egyptian and Christian Nubian mummies

Leishmania donovani

HISTORY of Leishmania sp. • ________ (10th century AD) - Description on cutaneous lesions called “ __________ ” and probability of mosquito intervention • _________ (1756): First detailed clinical description of the disease

Avicena, Balakh sore, Russell

HISTORY of Leishmania sp. • _________ (1756): Description of kala azar clinical symptoms (kālā āzār: kālā meaning black and āzār meaning fever or disease). • _________ (1764): First suspicions reporting the probable role of phlebotomine sandflies in disease transmission in the New World.

Indian physicians, Cosme Bueno

HISTORY of Leishmania sp. • Scottish Pathologist and • British Army medical officer • Patient from Dum Dum, Kalkota, India • Spleen specimen • Oval bodies

Lieutenant General Sir William Boog Leishman

HISTORY of Leishmania sp. • Irish medical officer in the Indian Medical Service • Found round bodies in kala-azar patients

Charles Donovan MD

IMPORTANT SPECIES of Leishmania 1. 2. 3. 4. 5. 6. 7.

Leishmania donovani Leishmania tropica Leishmania mexicana Leishmania braziliensis Leishmania major Leishmania guyanensis Leishmania lainsoni

Life Cycle of Leishmania sp. • Parasite exists in 2 forms: 1. __________ - aflagellar stage 2. __________ - flagellar stage

Amastigote, Promastigote

__________ a network of circular DNA (called cDNA) inside a large mitochondrion that contains many copies of the mitochondrial genome.

KINETOPLAST

AMASTIGOTE _________ stage Occurs in the __________ Divides by binary fission at __⁰C Round or oval; ___ µm along longitudinal axis Spindle-shaped; ___µm in length and 1-2µm in width Nucleus relatively larger and situated ______

Aflagellar, vertebrate host, 37, 2-4, 15-20, centrally

PROMASTIGOTE Flaggelar stage Occurs in the __________ Divides by binary fission at ______ Spindle-shaped; 15-__um in length and 1-__ um in width Nucleus _____ and situated in the middle of the cell or along the ____ of cell wall

sandfly, 27°C, 20, 2, smaller, side

________ - amastigotes reside in the large mononuclear cells of the skin ________ - amastigotes found in reticuloendothelial cells and lymphatic tissues of the skin ________ - amastigotes are found in reticuloendothelial cells and lymphatic tissues of skin and mucus membrane and promastigote reproduce at hindgut of sandfly

Leishmania tropica, Leishmania mexicana, Leishmania braziliensis

Amastigotes can be found in man in reticuloendothelial cells of 1. 2. 3. 4. 5.

Liver, Intestinal mucosa, Mesenteric lymph node, Bone marrow, Spleen

Initial stage in the sandfly

Procyclic Promastigote

product of replication; infective for the vertebrate host

Metacyclic Promastigote

Transmission Bite of Sandly (Phlebotomus sp.)- __________ transmission Take note: Culicoides sp., ticks ( __________ and Rhipicephalus sanguineus) and _____ fleas have suggested possible mechanical vectors for some Leishmania spp. Less frequently by: • Blood transfusion • ____________ • ____________

primary, Dermacentor variabilis, canine, Congenital infection, Sexual intercourse

Phlebotomus sp. aka: Sandfly, ______

Owl midges

RISK FACTORS • Young (2-4 years) and old (more than __ years) dogs seem to be more commonly with symptomatic infections. • The breed has also been incriminated as a risk factor. Certain dog breeds are more susceptible to disease (German shepherd, Rottweiler, _______, ________) • while others are resistant because of co- evolution with the pathogen (___________)

7, boxer, cocker spaniel, Ibizan hound

RESERVOIR HOST OF L. donovani HUMAN: in Indian subcontinent RODENTS: in _____ FOXES: in _____ and Central Asia DOGS: in ___ (L. infantum)

Africa, Brazil, China

CLINICAL MANIFESTATIONS • Fever • ____________ • ____________ • Darkening of the skin ("Kala azar", meaning Black Fever) ✓Complications: ________, ТВ, _______, uncontrolled haemorrhage ✔Prognosis: with an early treatment, cure rate >90%; if not treated, death occurs within 2 years

Spleen Enlargement, Lymphadenopathy, pneumonia, dysentery

CLINICAL SYNDROMES • Leishmaniasis is divided into clinical syndromes according to what part of the body is affected most: 1. ______________ 2. ______________ 3. Mucocutaneous Leishmaniasis

Visceral Leishmaniasis, Cutaneous Leishmaniasis

__________ LEISHMANIASIS • Also known as KALA-AZAR (Black Fever), DUM-DUM FEVER • most fatal form • Caused by: 1. L. donovani 2. 3.

VISCERAL, Leishmania infantum, Leishmania chagasi

_________________ • Incubation period: 3 to 8 months • It is manifested by lymphadenopathy, hepatomegaly, splenomegaly, cutaneous pigmentation, thrombocytopenia, anemia and weight loss, which can progress rapidly in weeks or months. • In addition, affected children present characteristic chronic diarrhea and growth retardation. at risk population: 1. 2. 3.

VISCERAL LEISHMANIASIS, preschool, undernourished, AIDS

The blackening of the skin that gave the disease its common name in India (KALA-AZAR) does not appear in most strains of the disease, and the other symptoms are very easy to mistake for those of _______.

malaria

CANINE LEISHMANIASIS • _________ - Viscerocutaneous Leishmaniasis • _________ - Tegumentary Canine Leishmaniasis (South America) • Dogs with or without clinical signs are infectious to sandflies and may transmit leishmaniosis.

L. infantum, L. braziliensis

__________________ • Also known as ORIENTAL SORE, JERICHO BOIL, ALEPPO BOIL and _______ • Either Localized or Disseminated • most common form • Caused by L. tropica, _______ (old world); L. mexicana (new world)

Cutaneous leishmaniasis, DELHI BOIL, L. major

CUTANEOUS LEISHMANIASIS • ____________ - found in more densely populated areas. Its lesion is dry, persists for months before ulcerating, and has numerous amastigotes within it. • _____________- found in sparsely inhabited regions. Its papule ulcerates quickly, is of short duration, and contains few amastigotes

L. tropica, L. major

_________________ • Also known as ESPUNDIA, ____ • Caused by __________ • lesions start in the nasal mucosa and spread to the oral and pharynx mucosa, the larynx, and the skin of the nose and lips

Mucocutaneous leishmaniasis, UTA, L. braziliensis

Microscopic observation of biopsy of lymph node, bone marrow, spleen or skin

Thick film method

Zoonotic potential 1. 2.

Leishmania tropica, Leishmania donovani

inhibit enzymes responsible for oxidatiom of FA and glycolysis of parasite

Meglumine antimoniate

its capacity of being metabolized by the parasite into an analogue of inosine.

Allopurinol

PHYSIO LEC MODULE 7

Reinhard Lowell Sabido · 48問 · 2年前

PHYSIO LEC MODULE 7