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Home , Brugia timori, Dirofilariasis, Ecthyma, Erysipeloid, Protothecosis, Trombicula

boards’ fodder Parasites John Chapman, MD, and Robert Bacigalupi, MD

DISEASE ORGANISM MODE OF TRANSMISSION OTHER INFORMATION Parasite and others Fecal-oral route or sexually transmitted Cutaneous lesions are a result from extension of amebic Amebiasis cutis Entamoeba histolytica disease (STD) , except penile which are sexually transmitted Granulomatous amebic Acanthamoeba genus Occurs in immunocompromised patients; large pink nodules Fecal-oral route; ubiquitous encephalitis Balamuthia mandrillaris with suppuration and ulcers after organism disseminates Leishman-Donovan bodies - 3µm nonflagellate oval organisms Leishmaniasis Dx with Montenegro Test; Culture in Nicolle-Novy-MacNeal media Cutaneous Leishmaniasis Leishmaniasis major Old world L. aethiopia Leishmaniasis recidivans - soft red papules that appear after L. infantum Sand fly: Phlebotomus genus initial lesions heal. More common in urban type; apple-jelly color Rural/moist type L. tropica on diascopy Urban/dry type L. donovani L. mexicana Sand fly: L. braziliensis gyanensis New world Phlebotomus perniciosus Chiclero ulcer - chronic ulcer commonly on the ear L. b. braziliensis Lutzomyia genus L. b. panamensis Mucocutaneous L. braziliensis braziliensis leishmaniasis Sand fly: Lutzomyia genus L. b. panamensis (Espundia) Sand fly: L. donovani donovani (India) P. argentipes (India) Kala-azar is the initial lesion L. d. infantum (China, Africa, Visceral leishmaniasis P. perniciosus and P. ariasi (China, Post-Kala-azar dermal leishmaniasis - occurs after treatment in Near and Middle East, (Kala-azar) Africa,Near and Middle East, African form Mediterranean) Mediterranean) L. d. chagasi (Americas) L. longipalpis (Americas) Trypanosomiasis American trypanosomiasis Reduviid bug (kissing bug, assassin bug) Romana’s sign; chagoma; Parinaud sign; Tx with nifurtimox Trypanosoma cruzi (Chagas disease) May lead to megacolon, myocarditis, cardiac failure Tsetse fly: T. brucei gambiense African trypanosomiasis Palpalis group (West African type) Winterbottom’s sign - posterior cervical (West African) Glossina morsitans (East African East African type is faster progressing T. b. rhodesiense (East African) type) Congenital or ingestion of cysts Part of TORCH syndrome in newborns Portuguese Man-of-War Physalia physalis Envenomation of nematocysts on Intense pain followed by linear lesions dermatitis P. urticulus tentacles Chironex fleckeri Envenomation of nematocysts on Jelly fish dermatitis Carybdea marsupialis tentacles Linuche unguiculata Cnidarian larvae release toxin from Seabather’s eruption Covered areas Edwardstella lineata nematocysts during pressure Implantation of fragments after cuts by Coral dermatitis Milleporina order exoskeleton Produce irritants such as halitoxin and Sponge dermatitis Poriferaphylum okadaic toxin Diadema genus Puncture wound with implementation Sea urchin dermatitis Echinothrix genus of spines Tripneustes genus Lyngbya majuscula gomont Seaweed dermatits Contact with organism Covered areas (alga) Protothecosis Prototheca species (alga) Contact with organism Numerous septations Alcyondium hirsutum (sea Dogger bank Itch Contact with organisim Found in the North sea between Scotland and Denmark chervil) Cercarial dermatitis Avian Schistosomes cercariae: Freshwater swimmer’s itch Microbilharzia variglandis Cercarial burrow into skin Found on exposed areas Saltwater marine dermatitis spindale (Clam digger’s itch) (Caribbean, S. America) Visceral schistosomiasis cercaria burrow into skin Cercaria mature in the aquatic snail; bladder cancer John Chapman, MD, S. haematobium (Bilharziasis) cercaria mature in the aquatic snail S. japonicum can cause Urticarial /Katayama fever is a PGY2 dermatology (Middle East, Africa) S. japonicum (Southeast Asia) resident at Tulane (pork tapeworm) larvae named Medical Center. Ingestion of Scolex has hooklets and two pairs of sucker caps Cysticercus cellulosae T. saginata (cattle tapeworm) Direct application of a wound or Spirometra species ingestion of larvae infected undercooked No solex meat Fecal-oral Host is dog; cysts often in lung and liver (Hydatid disease) Enterobiasis Enterobius vermicularis Ingestion of ova Scotch tape test (,Oxyuriasis) disease Penetration of skin by larvae Dermatitis at site of infection (Ground itch) dermatitis Ancylostorma caninum Penetration of hair follicle by larvae Widespread Loeffler syndrome - creeping eruption, patchy infiltrate of the Penetration of skin by larvae (Creeping eruption) A.canium lungs, eosinophilia dolorosi Ingestion of cyst in raw fish Intermittent migratory plaques that can last for years (Larva migrans profundus) G.spinigerum Initially ingestion of larva then penetration Larva Currens Perianal petechia, purpura, and urticaria Strongyloides stercoralis of perianal skin during defecation (Perianal larva migrans) Thumbprint sign - periumbical ecchymoses (autoinfection) Dracunculus medinesis Ingestion of larvae contaminated water Extract worm gradually each day Robert Bacigalupi, MD, Culex, Aedes, and Anopheles malayi Treat co-infection of with mosquitoes is a PGY2 dermatology Mango fly: resident at Tulane Loiasis Chrysops dimidia Non-pitting edema called calabar or fugitive swelling Medical Center. C. silacea Erisipela de la costa - acute facial swelling and erythema Mal morado - urticarial eruption with hyperpigmentation Black fly: Simulium genus Elephant, lizard, leopard skin variants (River blindness) Sowda - darkly pigmented plaque Mazzotti test reaction irinections D­Residency p. 4 • Spring 2012 boards’ fodder Parasites (continued) John Chapman, MD, and Robert Bacigalupi, MD

DISEASE ORGANISM MODE OF TRANSMISSION OTHER INFORMATION Ingestion of cysts in undercooked pork Eyelid edema; diagnosis confirmed by muscle biopsy Gasterophilus nasalis Creeping myiasis Fly larvae Do you have an G. intestinalis Dermatobia hominis (botfly) interesting Boards’ Callitroga americana Fodder? Hypoderma lineatum (cattle Furuncular myiasis grub) Fly larvae infestation Contact Dean Cuterebra cuniculi (rabbit Monti, managing botfly) Wohlfahrtia vigil editor, special Sand flea: burrows into Tungiasis Tunga penetrans the skin publications tunuis Culex, Aedes, and Anopheles at the AAD, D.immitis “heartworms” in dogs mosquitoes D.repens [email protected]. Bacteria Bartonella Oroya Fever/ Verruga Verruga peruana - chronic form; co-infection with salmonella peruana Bartonella bacilliformis Sand fly: Lutzomyia verrucarum increases mortality (Carrion’s disease) Flea bite: Afipia felis Scratch disease B. henselae Oculoglandular syndrome of Parinaud cat scratch/bite Watch for Body louse: Pediculus humanus B. henselae Oral Disease corporus Associated with AIDS B. quintana cat scratch/bite in the next Body louse: Pediculus humanus B. quintana No skin lesions Boards’ Fodder. corporus Borrelia Acrodermatitis chronica Borrelia afzelli Ixodes ricinus Chronic form of atropicans Ixodes dammini B. burgdorferi I. pacificus Lyme Disease B. garinii Erythema migrans I. scapularis Need more Boards’ B. afzelii Amblyomma americanum Fodder? Visit Southern associated B. lonestari Amblyomma americanum rash illness the Directions in Tick paralysis Toxin related Dermacentor genus Residency archive B. duttonii Tick-borne relapsing fever B. hermsii Ornithodoros moubata listed under B. turicata Body louse: Pediculus humanus “Publications” at Louse-borne relapsing fever B. recurrentis corporus www.aad.org. Dermacentor variabilis Rocky Mountain Spotted D. andersoni Rickettsia rickettsii Centripetal rash Fever Amblyomma americanum Rhipicephalus sanguineus Endemic typhus (Murine Rat flea: Xenopsylla cheopis R. typhi (formely R.mooseri) typhus) Cat flea: Ctenocepholides felis Scrub : of Southeast (Trombicula) akamushi Asia (formerly R.tsutsugamushi) L. deliense House mouse mite: Liponyssoides Rickettsial Pox R. akari sanguineus (formerly Allodermanyssus Varicella-like lesion; Negative Weil-Felix test sanguineus) Body louse: Pediculus humanus R. prowazekii Brill-Zinsser disease - relapse of epidemic typhus corporus Ixodes scapularis microti Maltese cross I. dammini Dermacentor andersoni, Dermacentor Francisella tularensis Hosts are rabbits; Ulceroglandular form most common variabilis,deer fly,and black fly, carcasses Ehrlichiosis monocytic Dermacentor variabilis Ehrlichia chaffeensis Morulae: intracytoplasmic microcolonies ehrlichiosis Amblyomma americanum Anaplasma phagocytophilum Ixodes scapularis Human granulocytic (formerly Ehrlichia I. pacificus ehrlichiosis phagocytophilum) Dermacentor variabilis Bubonic Yersinia pestis Rat flea: Xenopsylla cheopis P. vivax Anopheles mosquitoes P. ovale Carcasses of sheep, cows, goats, Use dacron or rayon swabs for cultures Cutaneous anthracis horses Two toxins - edema and lethal toxin Brucella species Ingestion of unpasteurized goat dairy Gram-negative rod Erysipelothrix insidiosa Many , commonly pigs E.rhusiopathiae Coxiella burnettii Exposure to infected livestock Can be cause of blood-culture negative Pseudomonas mallei Inoculation Typhoid fever Salmonella typhi Ingestion Rose spots Virus Flavivirus family Yellow fever Yellow fever virus Aedes aegypti Dengue fever Dengue virus Aedes aegypti Hemorrhagic and break-bone fever West Nile fever West nile virus Culex Sandfly fever (Phlebotomus Phlebovirus (Bunyaviridae Phlebotomus papatasi fever, Pappataci fever) family) Equine encephalitis Alphavirus (Togaviridae family) Culiseta mosquito Poxvirus family ( contagiosum) Orf virus Sheep and goats Milkers’ nodule Paravaccinia virus Cows

nd References: Bolognia JL, Jorizzo JL, Rapini RP. Dermatology. 2 ed. Spain, Mosby-Elsevier; 2009. irinections Spring 2012 • p. 5 D­Residency