Parasites Associated with HIV and their Importance

Let us make an in-depth study of the parasites associated with HIV infection and their importance in other branches such as:- 1. Parasites of Radiologic Importance 2. Parasites of Ophthalmic Importance 3. Parasites of Cardiac Importance and 4. Parasite of Gynaecological Importance.

Parasitic Opportunists Associated with HIV Infection:

The spectrum of parasitic opportunists found in association with Human Immunodeficiency Virus (HIV) infection or Acquired immunodeficiency Syn­drome (AIDS) are protozoa —

Pneumocystic carinii, Toxoplasma gondii, Isospori belli, Leishmania sp. Cryptosporidium and Microsporidia.

Importance of Parasites:

Parasites of Radiologic Importance:

E. histolytica (X-ray of abdomen is done), G. lamblia (X-ray may reveal mucosal defects), P. falciparum (recent MRI can be used to diagnose cerebral malaria), T.gondii (X-ray of skull to show cer­ebral calcification — ventriculogram).

Pneumocystis carinii (radiological appearance of Pneumocystis pneumoniae), E. granulosus (roentgenogram is useful in the diagnosis). T.solium (cysticercus cellulosae – cerebral cysticercosis can be diagnosed by (CT, MRI or sonography).

S. hematobium (bladder calcification, characteristic feature of urinary schistosomiasis and urinary tract pathology are detected by ultrasonography). P. Westermani (chest radiographs early in the disease show patchy cloudy infiltration. Pleural thickening and calcification may be seen late in the disease).

T.solium (In ocular cysticercosis — calcified lar­vae are detected by roentgenologic diagnosis). Cal­cified adult worm of W. bancrofti can be detected by X-ray.

D. medinensis (X-ray can detect dead calcified worms of D. medinensis).

Parasites of Ophthalmic Importance:

T. cruzi (edema of eyelids — Romana’s sign)

T.gondii (pseudocysts in the eyes).

E. granulosus (hydatid cyst may develop in or­bital capillary).

Multiceps brauniwas found located in the eye.

T. solium causes ocular cysticercosis.

F.hepatica is seldom found in the eye. During the migration, the larvae of T. spiralis cause edema around the eyes, retinal and subconjunctival petechiae and hemorrhages.

Larvae of T.canisand T.catisare carried into the capillaries of the eyes which is known as ocular larva migrans.

The larvae of A. lumbricoides which migrate through the capillaries of the eye ball may cause retinitis.

Microfilariae of O. volvulus circulate into the eye ball and cause the corneal opacity. Keratitis, iridocy­clitis, secondary glaucoma are irreversible damages to the optic nerve leading to blindness.

The migrating adult worms of Loa loa are trou­blesome while passing in front of the eye ball and they have been removed from the eyelids, anterior chamber of the eye and bulbar conjunctiva.

Thelazia callipaeda (oriental eye worm) and T. californiensis have a predilection for the conjunctiva.

D. medinensis (guinea worm) was removed from the subconjunctival space of the eye of an In­dian patient.

Parasites of Cardiac Importance:

T.cruzi. Cardiac rhythm is disturbed; cardiomyopathy.

P.falciparum. Coronary edema and thrombosis.

T. solium. Cysticercus cellulosae may rarely pro­duce myocarditis or congestive heart failure.

E. granulosus. Hydatid cyst may develop on the heart valve.

C. sinensis produces the symptoms of palpita­tion of the heart, tachycardia.

In T.spiralis infection blood pressure falls rapidly, serious complications are myocarditis.

S. stercoralis larvae may be found in the heart.

Larvae of T. can/sand T. cat is may cause cardiac dysfunction.

In A. duodenale infection, palpitation of the heart and signs and symptoms of high output congestive heart failure are evident.

The wandering worms of A. lumbricoides may invade the heart.

Parasite of Gynaecological Importance:

Trichomonas vaginalis causes trichomonas vaginitis (Sexually transmitted disease).