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Keywords
- whipworm infection
- by Trichuris trichuria

Sign and symptoms
- nervousness
- irritability
- vomiting
- abdomen swelling
- headache
- bloody diarrhea
- insomnia

Pathogenesis
By Trichuris trichuria
Eggs hatch in small intestine ➡️ release to large intestine➡️  larvae mature and establish in large intestine ➡️ Larvae migrate to the cecum and ascending colon and penetrate crypts ➡️ In 2 to 3 months, the larvae mature into adult worms that measure approximately 3 to 5 cm in length

Virulence Factors
Invasion - The adult Trichuris trichiura invade the colonic mucosa which is the main mechanism of its pathogenicity

Epidemiology
-spread via fecal-oral transmission
-caused by ingesting the eggs of Trichuris trichuria
-Very common in children

Diagnosis
Diagnosing the presence of whipworm is by microscopically identifying whipworm eggs in a stool sample.

Treatment
- Administration of antiparasitic  medication - albendazole & mebendazole

Prevention
- Proper hygiene
- Avoid ingesting food tha contain soil that may be contaminated with feces
- Proper method of cooking
food

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Sign and symptoms
Abdominal pain, nausea, vomit, abdominal distention, diarrhea, blood and mucus in stool as well as fever.

Pathogenesis
Consumption of infected raw fish entered the host stomach then gastric enzymes released the parasites into the stomach and further to small intestine. Tissue invasion is facilitated by release of hydrolytic enzymes from the parasites. In human the anisakiasis die within a few days provoking an eosinophil granulonatous reaction

Diagnosis
Direct visualisation of the larvae through endoscopy or radiography

Treatment
Removal of the larvae
Albendazole 400mg orally twice day for 6 to 21 days

Prevention
Avoid eating raw or undercooked fish or squid

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Sign and symptoms
- nausea
- abdominal pain
- diarrhoea

Pathogenesis and Virulence Factor
- ingest contaminated food or water contain tapeworm larvae or eggs
- eggs stage : migrate outside intestinal wall form cysts on nearest organ tissues
- larva stage: infestation in intestines
- they can migrates to other organ and cause organ and tissue damage

Diagnosis
- stool sample
- blood test (antibodies)
- imaging exam ( xray, ultrasound)

Treatment
- anti-helmintic drugs (praziquantel, albendazole, nitazoxanide)
- surgery (removal of cyst)

Prevention
- avoid raw food
- proper handwashing
- cook food thoroughly

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Diagnosis, Treatment and Prevention

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Signs and Symptoms

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Signs and Symptoms

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Pathogenesis and Virulence Factor

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Signs and Symptoms

Usually asymptomatic but some may experience:
- Itching of anal and vaginal area
- Insomnia, irritability, teeth grinding and restlessness
- Occasional stomach pain and nausea

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Signs and Symptoms
- abdominal pain
- nausea
- vomiting
- abdominal distention
- diarrhoea
- blood and mucus in stool
- mild fever
- allergic reaction ( rashes, itching)

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Pathogenesis and Virulence Factor

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Pathogenesis and Virulence Factor

- Intestinal infestation by Enterobius vermicularis
- Ova is transferred from perianal area to forties → transmitted to mouth and swallowed
- Reinfection can occur if individual touches mouth area without proper hand washing

- Adult pinworms have a cuticle with 3 main outer layers made of collagen and other compounds to protect form the environment of the digestive tract
- Eggs have 5 membranes that produce a sticky substance that protects it in the digestive tract until matured

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Diagnosis, Treatment and Prevention

Diagnosed by visual inspection of perianal area or stool for pinworms

Treated with anthelmintic medication such as mebendazole, albendazole and pyrantel pamoate are effective treatments

Practice proper hygiene and hand washing to avoid infection

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Pathogenesis and Virulence Factor

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Signs and Symptoms

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Signs and Symptoms

1. Watery diarrhea

2. Stomach cramps or pain.

3. Dehydration

4. Vomiting

5. Nausea

6. Fever

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SIGN AND SYMPTOMS

Abdominal pain

Fatigue

Diarrhea

Rectal pain while having bowel movement

Excessive gas

Unintentional weight loss

PATHOGENESIS

Trophozoites adhere to colonic mucin, disrupting mucosal barrier with proteolytic enzymes, and contact dependent lysis of host cells, including inflammatory cells.

Lectin mediated adherence is important, along with the capacity to lyse host cells on contact.

Virulence is increased with passage through humans.

Malnutrition, corticosteroids, pregnancy and childhood render the host more susceptible to invasion.

Lysis of colonic epithelial cells produces small mucosal ulcerations.

There is edema and hyperemia, but minimal inflammatory response.

The inflammatory cells are also lysed, thus explaining the paucity of leukocytes

Is associted with the occurrence of antigen-specific suppression of cell mediated rsponse

Trophozoites are present in the base of the ulcer. The lesion spreads laterally in the submucosa, producing a flask-shaped ulcer.

Granulation tissue and fibrotic thickening will occasionally produce an ameboma.

Spread to the portal circulation, and rarely to lung, spleen or brain results in metastatic abscesses.

VIRULENCE FACTOR

Three major virulence factors are Gal/GalNAc lectin, amoebapore and proteases

DIAGNOSIS

Endoscopic biopsy of ulcers and demonstration of organisms

Enzyme immunoassays detecting E. histolytica antigens in stool have been developed.

Ultrasonography and computed tomography can effectively identify liver abscesses and other extraintestinal sites of infection.

CT guided fine needle aspiration: Aspirates from a liver abscess usually show neither trophozoites nor leukocytes. The trophozoites are found in tissue at the periphery of the liver abscess.

TREATMENT

Alternatives are tetracycline, paromomycin, and dehydroemetine.

Entamoeba dispar infection does not require treatment.

Corticosteroids and antimotility drugs administered to persons with amebiasis can worsen symptoms and the disease process.

To prevent spontaneous rupture of an abscess, patients with large liver abscesses may benefit from percutaneous or surgical aspiration.

PREVENTION

Sanitary disposal of fecal material

Treatment of drinking water . Boiling is the only reliable way to kill the cysts.

Avoid uncooked food such as vegetables and salads in endemic areas

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Pathogenesis and Virulence Factor

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Diagnosis, Treatment and Prevention

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Signs and Symptoms

Most patients are asymptomatic; most infections are self-limited

Diarrhoea, abdominal pain, steatorrhea, dehydration, nausea, vomiting weight loss; nutrient malabsorption serious manifestation.

Less common: fever, itchy skin, hives, and swelling of the eyes and joints.

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Diagnosis, Treatment and Prevention

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Diagnosis

Stool sample to identify Giardia intestinalis trophozoites / cysts (traditional)

Stool antigen detection

Treatment

Fluids & electrolyte management

Antibiotic therapy; metronidazole, Tinidazole, paromomycin (pregnancy)

Prevention

Good hygiene

avoid eating/drinking contaminated F&B; Chlorination, sedimentation, and filtration methods

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Pathogenesis and Virulence Factor

Caused by Giardiasis intestinalis; fecal oral transmission / ingestion of contaminated water.

Two forms; trophozoites & cysts.

Upon ingestion of cysts, excystation occurs in the stomach and duodenum resulting in tetranucleated entity splitting into two binucleated trophozoites binding to intestinal epithelium.

Trophozoites adhered to microvilli of S.I; fed and grow until dehydration begins resulting in cyst formation and expelled with the faeces.

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Pathogenesis
Cryptosporidium.
Spread by swallowing recreational water (water in swimming pool, lakes, river)

Virulence factor

1. Genes involved in the initial interaction processes of Cryptosporidium oocysts and sporozoites with host epithelial cells.

2. Gliding motility

3. Attachment

4. Hemolysin H4 - membrane lysis

5. Intracellular multiplication

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Diagnosis, Treatment and Prevention

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Diagnosis

1. Stool sample - acid-fast staining, direct fluorescent antibody (DFA)

2. Blood - PCR

- Enzyme immunoassays for detection of Cryptosporidium sp. antigens

Treatment

1. Not necessary if the patient can bear with it.

2. Treatment is based on the signs and symptoms.

3. Stay hydrated or take ORS.

4. Anti-diarrheal - Based on healthcare provider's advise

Prevention

1. Practice good hygiene

2. Use alcohol based hand sanitizer

3. Do not swim or let kids swim if sick with diarrhea

4. Do not drink untreated water or use untreated ice from lakes, rivers, springs, ponds, streams, or shallow wells.

5. Avoid eating uncooked foods