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Chapter 19 lecture 10 (Scabies (Pathogenesis and epidemiology (Adult…

- - - - Cutaneous
        
        Produces large, painless skin lesions that form around bite wounds
      - Mucocutaneous
        
        Skin lesions enlarge to include mucous membranes of mouth, nose, or soft palate. Not fatal but will disfigure
      - Visceral (kala-azar)
        
        Parasite is spread by macrophages throughout the body. Affects the liver, spleen, bone marrow and lymph nodes. 100% fatal of untreated
    - - Leishmania is the causative agent and is a flagellated protozoan
        
        Protozoan transmitted by female sand flies
    - - Infected macrophages stimulate inflammatory responses
      - Leishmaniasis is endemic in parts of the tropics and subtropics
    - - Diagnosed by microscopic identification of the protozoa
      - Most cases heal without treatment and confer immunity upon recovered patients
      - Let small children purposely infect with lesions on buttocks
      - Antimicrobials are needed for severe infections sodium stiboglucanate or Amp B
      - Prevention involves reducing exposure to the