Matrices of tropical infection

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Protozoa
Overview of protozoa Overview of medicine for protozoa Malaria Chagas disease African trypanosomiasis Leishmaniasis Trichomoniasis Toxoplasmosis Amoebiasis Giardiasis Cryptosporidiosis Cyclosporiasis Isosporiasis Pentatrichomoniasis Microsporidiasis Babesiosis

Fungi
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Nematode (roundworm)
Nematode principles Lympatic filariasis Onchocerciasis Loiasis Microscopic differentiation of microfilariae Strongyloidiasis Ascariasis Ancylostomiasis (hookworm) Trichuriasis (whipworm) Enterobiasis (pinworm) Angiostrongyliasis (rat lungworm) Dracunculiasis (Guinea worm) Anisakiasis Trichinellosis (Trichinosis) Gnathostomiasis Spirurinasis Soil-transmitted helminths

Trematode (fluke, distoma)
General issues of Helminths Trematode principles Schistosomiasis Clonorchiasis Fascioliasis Paragonimiasis Metagonimiasis

Cestode (tapeworm)
General issues of Helminths Cestode principles Diphyllobothriasis Sparganosis Taeniasis Echinococcosis

Medical Zoology
Zoonosis Insectology Mosquitology Acarology Batology Snake toxicology Scorpion and spider toxicology Marine toxicology

Reproduction of protozoa

	Virus	Bacteria/ Rickettsia	Protozoa	Fungi	Nematode	Trematode	Cestode
asexual (fission)			Intestinal amoeba Giardia Trypanosoma Leishmania
sexual (zygote)			Plasmodium Cryptosporidium Cyclospora Isospora
both of asexual and sexual			Trypanosomiasis Leishmaniasis

Routes of transmission

Vertical transmission

	Virus	Bacteria/ Rickettsia	Protozoa	Fungi	Nematode	Trematode	Cestode
placental	HIV Hepatitis B	Syphilis	Chagas
transvaginal	HIV Hepatitis B	Neonatal gonococcal conjunctivitis
breastfeeding	HTLV-1

Soil and Water

	Virus	Bacteria/ Rickettsia	Protozoa	Fungi	Nematode	Trematode	Cestode
Soil to skin		Melioidosis	Sporotrichosis	Ancylostomiasis (hookworm) (by larvae) Strongyloidiasis (by larvae)
Soil to mouth					Ascariasis (by eggs) Toxocariasis (by eggs)
Soil to airway				Coccidioidomycosis
Anus to mouth※					Enterobiasis (pinworm) (by eggs) Trichuriasis (whipworm) (by eggs)
Direct contact to freshwater		Leptospirosis Melioidosis	Acanthamoeba spp. (cornea)			Schistosomiasis (by cercariae)
Aspiration of freshwater		Melioidosis	Naegleria fowleri
Ingestion of freshwater		Melioidosis	Naegleria fowleri		Dracunculiasis (Guinea worm)

※Direct transmission from anus to mouth, though classified as Soil-Transmitted Helminths

Animals and Aquatic organism

	Virus	Bacteria/ Rickettsia	Protozoa	Fungi	Nematode	Trematode	Cestode
Rodent	Hantavirus Lassa Monkeypox	Leptospirosis Plague
Domestic animals		Bartonellosis Brucellosis Anthrax			Trichinellosis		Taeniasis
Freshwater fish					Gnathostomiasis (by larvae)	Metagonimiasis (by metacercariae) (sweetfish 鮎)
Freshwater crab						Paragonimiasis (by metacercariae)
Sea fish					Anisakiasis (by larvae)		Diphyllobothriasis

Flies

	Virus	Bacteria/ Rickettsia	Protozoa	Nematode	Trematode	Cestode
Sandfly Phlebotomus - old world (Africa)			Leishmaniasis
Sandfly Lutzomyia - new world (Americas)		Bartonellosis (Oroya fever, Carrion's disease)	Leishmaniasis
Blackfly				Onchocerciasis
Tse Tse fly			African trypanosomiasis
Deer fly Chrysops				Loiasis
Horse fly Tabanus				Loiasis

Acari, Fleas, Lice

		Virus	Bacteria/ Rickettsia	Protozoa	Nematode	Trematode	Cestode
hard ticks	Ixodes	Tick-borne encephalitis	Lyme disease Tularaemia
	Dermacentor	Omsk hemorrhagic fever	Rocky Mountain spotted fever
	Haemaphysalis	Kyasanur Forest disease
	Hyalomma	Crimean-Congo hemorrhagic fever
	Rhipicephalus		Mediterranean spotted fever
	Amblyomma		African spotted fever (African tick bite fever)
soft ticks	Ornithodoros		Relapsing fever
chigger mite	Leptotrombidium		Scrub typhus
flea			Plague Murine typhus
lice			Epidemic typhus

Incubation period/Latent infection

	Virus	Bacteria/ Rickettsia	Protozoa	Nematode	Trematode	Cestode
possibly > 1 year		Melioidosis	Leishmania Trypanosoma cruzi

Target organs

Eye involvement

	Virus	Bacteria/ Rickettsia	Protozoa	Nematode	Trematode	Cestode
Conjunctivitis	Zika	Leptospirosis as conjunctival suffusion

Skin involvement

	Virus	Bacteria/ Rickettsia	Protozoa	Nematode	Trematode	Cestode
larvae migrans				Ancylostomiasis (hookworm) Gnathostomiasis
larvae currens				Strongyloidiasis

Liver and spleen involvement

	Virus	Bacteria/ Rickettsia	Protozoa	Nematode	Trematode	Cestode
Jaundice	Viral hepatitis Yellow fever	Leptospirosis	Malaria
Hepatosplenomegaly		Melioidosis Brucellosis Oroya fever	Malaria Visceral leishmaniasis		Schistosomiasis
Hepatomegaly predominant	Viral hepatitis	Leptospirosis
Splenomegaly predominant			Visceral leishmaniasis

Infected cells

	Virus	Bacteria/ Rickettsia	Protozoa	Nematode	Trematode	Cestode
Red blood cell			Malaria Babesiosis
Macrophage		Tuberculosis Brucellosis Melioidosis	Trypanosomiasis Leishmaniasis

Syndromes with special names

	Virus	Bacteria/ Rickettsia	Protozoa	Nematode	Trematode	Cestode
Katayama syndrome						Schistosomiasis
Löeffler syndrome				Ascariasis Strongyloidiasis Ancylostomiasis (hookworm)
Mazzotti reaction				DEC for onchocerciasis highly possible Ivermectin for onchocerciasis sometimes possible Ivermectin for loasis with onchocerca sometimes possible
Wakana syndrome				Ancylostomiasis (hookworm)

Treatment

Treatment for helminths

	Virus	Bacteria/ Rickettsia	Protozoa	Nematode	Trematode	Cestode
Diethylcarbamazine (DEC)				Lymphatic filariasis Loiasis when <8,000MF/mL NEVER for Onchocerciasis and beware of co-infection
Ivermectin				Onchocerciasis but Mazzotti 10% and encephalopathy NEVER for Loiasis and beware of co-infection Strongyloidiasis Ancylostomiasis (hookworm) Gnathostomiasis
Albendazole				Loiasis when >8,000MF/mL Ancylostomiasis (hookworm) Trichuriasis (whipworm) Trichinellosis Toxocariasis Enterobiasis (pinworm) Gnathostomiasis		Echinococcosis
Praziquantel				Ascariasis	Adult of schistosoma Clonorchiasis Paragonimiasis	Diphyllobothriasis Taeniasis Echinococcosis
Triclabendazole					Fasciolasis
Doxycycline				Adult of lymphatic filariae for Wolbachia Adult of onchocerca for Wolbachia
Surgical/Mechanical removal				Dracunculiasis (Guinea worm) Anisakiasis		PAIR for Echinococcus granulosus Surgery for Echinococcus multilocularis
Spontaneous resolution/ No effective treatment				Angiostrongyliasis (rat lungworm) Cutaneous larva migrans by ancylostomiasis

Treatment options of Lymphatic filariasis, Onchocerciasis and Loiasis

	Lymphatic filariasis	Onchocerciasis	Loiasis
Diethylcarbamazine (DEC)	1st line	NEVER possibly Mazzotti	<8,000 MF/mL
Ivermectin		1st line but Mazzotti 10%	NEVER possibly encephalopathy
Albendazole			>8,000 MF/mL

	Lymphatic filariasis	LF & Oncho	Onchocerciasis	Oncho & Loiasis	Loiasis
Diethylcarbamazine (DEC)	1st line	NEVER	NEVER	NEVER	<8,000 MF/mL
Ivermectin		Ivermectin + Albendazole may be safe	1st line but Mazzotti 10%	NEVER	NEVER
Albendazole				may be an option	>8,000 MF/mL
Other option				Cytapheresis of oncho MF before DEC

※MF = microfilariae