EssentialsofMEDICALPARASITOLOGY
Essentials of MEDICAL PARASITOLOGY
Essentials ofMEDICALPARASITOLOGYApurbaSankarSastryMD(JIPMER),DNB,MNAMS,PDCRAssistantProfessorDepartmentofMicrobiologyJawaharlal InstituteofPostgraduateMedicalEducation&Research(JIPMER)Pondicherry.IndiaSandhyaBhatKMD,DNB,MNAMS.PDCRAssistantProfessorDepartmentofMicrobiologyPondicherry Instituteof Medical Sciences (PIMS)(AUnitofMadrasMedicalMission)Pondicherry.IndiaForewordRebaKanungoJAYPEEJAYPEEBROTHERSMEDICALPUBLISHERS(P)LTDNewDelhi·London·Philadelphia·Panama
Essentials of MEDICAL PARASITOLOGY JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD New Delhi • London • Philadelphia • Panama Apurba Sankar Sastry MD (JIPMER),DNB, MNAMS, PDCR Assistant Professor Department of Microbiology Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) Pondicherry, India Sandhya Bhat K MD, DNB, MNAMS, PDCR Assistant Professor Department of Microbiology Pondicherry Institute of Medical Sciences (PIMS) (A Unit of Madras Medical Mission) Pondicherry, India Foreword Reba Kanungo
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Jaypee Brothers Medical Publishers (P) Ltd Headquarters Jaypee Brothers Medical Publishers (P) Ltd 4838/24, Ansari Road, Daryaganj New Delhi 110 002, India Phone: +91-11-43574357 Fax: +91-11-43574314 Email: jaypee@jaypeebrothers.com Overseas Offices J.P. Medical Ltd 83 Victoria Street, London SW1H 0HW (UK) Phone: +44-2031708910 Fax: +02-03-0086180 Email: info@jpmedpub.com Jaypee-Highlights Medical Publishers Inc. City of Knowledge, Bld. 237, Clayton Panama City, Panama Phone: +1 507-301-0496 Fax: +1 507-301-0499 Email: cservice@jphmedical.com Jaypee Brothers Medical Publishers (P) Ltd Bhotahity, Kathmandu, Nepal Phone: +977-9741283608 Email: kathmandu@jaypeebrothers.com Website: www.jaypeebrothers.com Website: www.jaypeedigital.com © 2014, Jaypee Brothers Medical Publishers The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) of the book. All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book. This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought. Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity. Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com Essentials of Medical Parasitology First Edition: 2014 ISBN: 978-93-5152-329-1 Printed at Jaypee Brothers Medical Publishers (P) Ltd 17/1-B Babar Road, Block-B, Shaymali Mohammadpur, Dhaka-1207 Bangladesh Mobile: +08801912003485 Email: jaypeedhaka@gmail.com Jaypee Medical Inc. The Bourse 111 South Independence Mall East Suite 835, Philadelphia, PA 19106, USA Phone: +1 267-519-9789 Email: joe.rusko@jaypeebrothers.com
DedicatedtoOurBelovedParents,FamilymembersAndaboveall theAlmighty"Life is the mostdifficultexam.Manyfail becausetheytendto copy othersNot realizing that everyone has different question paper
Dedicated to Our Beloved Parents, Family members And above all the Almighty “Life is the most difficult exam. Many fail because they tend to copy others Not realizing that everyone has different question paper
ForewordOur understanding of human diseases has been greatly benefited from therapidstridesmadeinMedical Science.Itisnecessarytocompileanddocumenttheseadvancesintextbooksforstudentswhoarepursuingmedicalandalliedcourses.To add the existing resources of information on parasitic diseases,DrApurbaSankarSastryandDrSandhyaBhatkhaveconceptualizedandcompiled this book entitled“Essentials of Medical Parasitology"They haveaddressed detailsofinformationrequiredbyamedicalgraduatetohelphimtounderstand the subjectand alsokeep abreast with latestdevelopments in thefield of Medical Parasitology.The book is divided intofour sections that deal withProtozoa,Helminths,etcthat areof importancetohumanhealthand disease.Each sectiondealswithgeneral concepts including commonly used terminologies and theirdefinitions which will help the reader to understand their implications when used later in the text.Everychapterisdesigned inathematicmannerwithabriefclassificationincludingclassificationbased onthehabitatand siteofinfection.Thisisfollowedbydescriptionoftheparasite'smorphology,epidemiologyofthe diseaseandpathogenesis.Clinical spectrumofthedisease isdescribed with emphasis on pathology,clinical features and stages of the parasite that are encountered in the human host. Life cycle outsidethehumanhostandnatural habitat intheenvironmentoranimalshavebeenexplained indetail intherespective chapter.Thee chapters are interspersed with relevant illustrations.Photomicrographs are clear emphasizingthenaturalappearancein clinicalmaterial.Diagrams andflowchartsof lifecycles areclearandwellrepresented. The authors have collected original images from several sources to highlight the actualmicroscopic images seen in the laboratory and in situ appearancein tissue sections.Laboratorymethods to detectthe agents inrelevant clinical material havebeen described indetailineasyprocedural steps.Several additionaland supportiveteststodiagnosethe infections havebeenmentioned in each chapter.Recent techniques and current tests including specific antigen and antibodydetection methods used in the laboratories have been described.This will help a fresh graduate inclinical practice to use the information inday today practice.An interesting feature in each chapter is thepreventiveaspect of commonly encountered parasiticdiseases,withanoteonvaccination.Anadditional featureofthebook isanup-to-dateinformation ontheparasitic diseases ofpublic health importancein Indiaincludingnationalprograms forpreventionand control.Opportunistic parasitic infections in the immunocompromised patients includingHiVinfected individualshavebeendescribedalongwiththespecificindicatorsfordetection.Eachchapterendswithasetofselfassessmentquestionswhichwillhelpastudenttopreparefortheexamination.This is a well planned and executed parasitologybook whichboth MBBS undergraduatestudents and postgraduates pursuing a course in Medical Microbiology willfind useful I congratulatethe authors for bringing out this comprehensive textbook on parasitology.RebaKanungoMDPhDDean ResearchandProfessorandHeadDepartment of Clinical MicrobiologyPondicherryInstituteofMedical SciencesPuducherryPast President, Indian Association ofMedical MicrobiologistsFormerEditor-in-Chief,IndianJournal of Medical MicrobiologyE-mail:reba.kanungo@gmail.com
Foreword Our understanding of human diseases has been greatly benefited from the rapid strides made in Medical Science. It is necessary to compile and document these advances in textbooks for students who are pursuing medical and allied courses. To add the existing resources of information on parasitic diseases, Dr Apurba Sankar Sastry and Dr Sandhya Bhat k have conceptualized and compiled this book entitled “Essentials of Medical Parasitology.” They have addressed details of information required by a medical graduate to help him to understand the subject and also keep abreast with latest developments in the field of Medical Parasitology. The book is divided into four sections that deal with Protozoa, Helminths, etc that are of importance to human health and disease. Each section deals with general concepts including commonly used terminologies and their definitions which will help the reader to understand their implications when used later in the text. Every chapter is designed in a thematic manner with a brief classification including classification based on the habitat and site of infection. This is followed by description of the parasite’s morphology, epidemiology of the disease and pathogenesis. Clinical spectrum of the disease is described with emphasis on pathology, clinical features and stages of the parasite that are encountered in the human host. Life cycle outside the human host and natural habitat in the environment or animals have been explained in detail in the respective chapter. Thee chapters are interspersed with relevant illustrations. Photomicrographs are clear emphasizing the natural appearance in clinical material. Diagrams and flow charts of life cycles are clear and well represented. The authors have collected original images from several sources to highlight the actual microscopic images seen in the laboratory and in situ appearance in tissue sections. Laboratory methods to detect the agents in relevant clinical material have been described in detail in easy procedural steps. Several additional and supportive tests to diagnose the infections have been mentioned in each chapter. Recent techniques and current tests including specific antigen and antibody detection methods used in the laboratories have been described. This will help a fresh graduate in clinical practice to use the information in day to day practice. An interesting feature in each chapter is the preventive aspect of commonly encountered parasitic diseases, with a note on vaccination. An additional feature of the book is an up-to-date information on the parasitic diseases of public health importance in India including national programs for prevention and control. Opportunistic parasitic infections in the immunocompromised patients including HIV infected individuals have been described along with the specific indicators for detection. Each chapter ends with a set of self assessment questions which will help a student to prepare for the examination. This is a well planned and executed parasitology book which both MBBS undergraduate students and postgraduates pursuing a course in Medical Microbiology will find useful. I congratulate the authors for bringing out this comprehensive textbook on parasitology. Reba Kanungo MD PhD Dean Research and Professor and Head Department of Clinical Microbiology Pondicherry Institute of Medical Sciences Puducherry Past President, Indian Association of Medical Microbiologists Former Editor-in-Chief, Indian Journal of Medical Microbiology E-mail: reba.kanungo@gmail.com