Aspectos gerais da

estrongiloidías
e
Docente: Esp. Luiz Carlos Marques
Taxonomia
Filo: Nematoda

Classe: Chromadorea

Ordem: Rhabditida

Família: Strongyloididae

Gênero: Strongyloides

Espécie: 52
Taxonomia
Gênero: Strongyloides

Espécie: 52

S. Fuelleborni

S. stercoralis
Estrongiloidíase
1876
Médico
Louis-Philippe Normand

Arthur R. J. B. Bavay

Fezes diarreicas
Larvas do helminto
Fonte:https://www.elmundo.es/cultura/2016/01/17/569959ce46163fb60f8b45ef.html
Anguillula stercoralis

Diarreia da Cochinchina Enguia / peixe alongado Esterco

 Estrongiloidíase

1876 1902
Médico Stiles e Hassall
Louis-Philippe Normand
Strongylos stercoralis
Arthur R. J. B. Bavay

Fezes diarreicas
Larvas do helminto
tml
Anguillula stercoralis
Enguia / peixe alongado Esterco
EPIDEMIOLOGIA
Ampla distribuição geográfica

30 – 100 milhões
Pessoas infectadas

Relevância para a saúde pública

Frequentemente encontrado em regiões de

clima tropical e subtropical
EPIDEMIOLOGIA

Doenças parasitárias com maior

prevalência

3% a 82% prevalência
Não é notificação compulsória

Doenças tropicais Negligenciadas (DTN)

Estrongiloidíase
Geohelminto

Fonte: https://recantoestela.com.br/criancas-brincando-na-areia-beneficios/ Fonte: https://www12.senado.leg.br/noticias/materias/2013/12/06/situacao-

de-trabalhadores-rurais-e-tema-de-debate-na-cdh-na-segunda-feira
morfologias
6 formas evolutivas

Fêmea Partenogenética Fêmea Macho Larva Larva

Vida Livre Vida Livre Rabditóide Filarióide
Formas evolutivas
Fêmea Partenogenética
Corpo Cilíndrico – Aspecto Filiforme

Extremidade Anterior = Arredondada

Extremidade Posterior = Afilada

1,7 a 2,5 mm de comp. x 0,03 a 0,04 de largura

Esôfago – Filarióide

Útero em disposição anfidelfa/Divergente

30 a 40 ovos/dia
Não há receptáculo seminal
Formas evolutivas
Fêmea Partenogenética
Não há receptáculo seminal
Autossuficiente

Partenogênese

Reprodução assexuada em que o embrião se

desenvolve de um óvulo sem ocorrência da
fecundação
Formas evolutivas
Fêmea de Vida Livre
Fusiforme
Extremidade Anterior = Arredondada
Extremidade Posterior = Afilada

0,8 a 1,2 mm de comp. X 0,05 a 0,07 de largura

Esôfago – Rabditóide
Útero em disposição anfidelfa/Divergente

Há receptáculo seminal
Formas evolutivas
Macho de Vida Livre
Fusiforme
Extremidade Anterior = Arredondada
Extremidade Posterior = Recurvada Ventralmente

0,7 mm de comp. X 0,04 de largura

Esôfago – Rabditóide / Testículos, vesícula seminal,
canal deferente e ejaculador
2 pequenos espículos = Auxiliar na cópula

Gubernáculo = Guia durante a cópula

Formas evolutivas
Ovos
Elípticos
Parade fina e transparente

0,7 mm de comp. X 0,04 de largura

Fezes diarreicas

Fêmea de Vida livre = 0,07 x 0,04 mm

Fêmea Partenogenética = 0,05 x 0,03 mm

Formas evolutivas
Larva Rabditóide
Filiforme
Esôfago = Rabditóide

Similar as F. de Vida livre

Vestíbulo bucal curto/ Primórdio genital nítido

Cauda pontiagula/ Movimento ondulatórios

Atingem o meio externo/ 25 larvas por g/fezes

Formas evolutivas
Larva Filarióide
Filiforme
Esôfago = filarióide

Vestíbulo bucal curto

Anterior= Ligeiramente afilada

Posterior= afilada e terminando em duas pontas

Cauda entalhada

Forma infectante (L3) – Penetrar na pele ou mucosas

Habitat
Fêmeas Partenogenética

Glândulas de LieberKuhn e na porção superior do

jejuno = Postura
Formas mais graves = Porção pilórica do
estômago até no intestino grosso
Ciclo biológico
Ciclo direto/Partenogenético

Ciclo indireto/Sexuado/Vida Livre

F. Partenogenética = Triplóides (3n)

Simultaneamente 3 tipos de ovos

1- L. Rabditóide (3n)

2- L. Rabditóide (2n) = FVL

3- L. Rabditóide (1n) = MVL

Ciclo biológico
Ciclo direto/Partenogenético

Ciclo indireto/Sexuado/Vida Livre

Melanoproteases
F. Partenogenética = Triplóides (3n)

Simultaneamente 3 tipos de ovos

1- L. Rabditóide (3n)

2- L. Rabditóide (2n) = FVL

3- L. Rabditóide (1n) = MVL

Ciclo biológico
Ciclo biológico
Hiperinfecção

Autoinfecção Disseminação
TRANSMISSÃO
Hetero ou Primoinfecção
As larvas filarióides (L3) – Pele e mucosas

Nas pessoas que não usam calçados = Pés,

espaços interdigitais e lateralmente
TRANSMISSÃO
Auto-infecção Externa ou Exógena

Ciclo Direto
TRANSMISSÃO
Autoinfecção Interna ou Endógena

Luz do intestino = L.R > L.F

Crônico (Meses ou anos)

Constipação (retardo das fezes)

Imunossupressão
Uso de drogas
Radioterapia
imunossupressoras
Mais grave > HIV/AIDS Alcoolismo crônico
Potencialmente Fatal
Patogenia – sintomatologia
Carga parasitária menor = Geralmente são assintomáticos

Carga parasitária maior = Sintomáticos > Gravidade

Autoinfecção interna
Patogenia – sintomatologia
CUTÂNEA

Lesões discretas

Pontos de penetração das larvas pele e mucosas

Reação de hipersensibilidade > Edema, prurido,

eritema..

Migração no tecido subcutâneo > serpiginoso

Larva currens
Patogenia – sintomatologia
PULMONAR

Intensidade variável > em todos os indivíduos

Tosse com ou sem expectoração, dispnéia, crises

asmatiformes
Interior dos alvéolos > hemorragias, infiltrado
inflamatório de linfócitos e eosinófilos

Grave> broncopneumonia, síndrome de Loeffler,

edema pulmonar e insuficiência respiratória
Patogenia – sintomatologia
INTESTINAL

Dor abdominal, diarreia, anorexia

Enterite catarral: secreção mucóide abundante

recobrindo a mucosa
Enterite edematosa: espessamento da parede
intestinal e achatamento das dobras mucosas
devido à edema da submucosa

Enterite ulcerosa: Inflamação eosinofílica

intensa, ulcerações, com invasão de bactérias
Diagnóstico

CLÍNICO

Difícil

Sintomatologia inespecífica
Diagnóstico
LABORATORIAL

Lutz ou Hoffmann; Faust > Não são

adequados > baixa liberação de
larvas nas fezes

Método de Baermann-Moraes e de
Rugai
Diagnóstico
LABORATORIAL

Método de Baermann-Moraes

Consiste no isolamento de larvas

Baseia-se no hidrotropismo,
termotropismo e sedimentação das
larvas quando em contato com a
água aquecida
Diagnóstico
LABORATORIAL

Método de Rugai

Consiste no isolamento de larvas

Baseia-se no hidrotropismo,
termotropismo e sedimentação das
larvas quando em contato com a
água aquecida
tratamento
Benzimidazólicos

Fonte:https://guiadafarmacia.com.br/consulta-medicamentos/remedio/tiadol-4/

Fonte:https://e.drogasul.med.br/
antiparasitario-gene/galbendazol-
400-mg-3-cpr-mastigavel-4844 Fonte:https://farmaciaalvorecer.farmahoje.com.br/
ivermectina-vitapan-6mg-caixa-com-4-comprimidos-
p7898049793310-p13041
PROFILAXIA

Lavagem adequada das mãos, pés ..

Utilização de calçados

Saneamento básico
CASO CLÍNICO

Paciente do sexo masculino, 42 anos, vivendo com HIV

Estrongiloidíase Disseminada Fatal com Pú rpura Periumbilical

História Clínicas
CASO CLÍNICO
D1 de internação P. A D1 de internação D1 de internação

06/ 2021 08/2021 08/2021 29/11/2021

Dor de cabeça intensa e Cansaço, febre, TARV Irregular

diarreia Cansaço, febre, cefaleia, hiporexia
HDA: há 03 semanas cefaleia e hiporexia HDA: Falta de ar,
iniciou quadro de cefaleia TTO: sulfa + TMT fadiga, inapetencia,
hemicraniana D (irregular) tosse não produtiva e
vomito, febre
– Sem melhora ao uso de D7 = melhora do
dipirona, hipotensão quadro 30/11/2021
postural, náuseas
ÓBITO
- Uso irregular de Sulfa
D3 alta
CASO CLÍNICO

Causa morte
Clínicas
RTV + PANCITOPENIA + SINDROME
RESPIRATORIA AGUDA GRAVE + CHOQUE
SÉPTICO DE FOCO PULMONAR
CASO CLÍNICO

NECRÓPSIA
CASO CLÍNICO
CASO CLÍNICO
CASO CLÍNICO
CASO CLÍNICO
CASO CLÍNICO
CASO CLÍNICO

Neurotoxoplasmose

Histoplasmose disseminada
AIDS
 RESUMO
TOXOPLAsma Gondi

TOXOPLASMOSE
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table of contents

01 02 03
Climate
About ethics antibiotics
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Gender
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0
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ABOUT
ETHICS
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TALKING ABOUT ETHICS
Mercury is the closest planet to the Sun and the
smallest one in the entire Solar System. This
planet's name has nothing to do with the liquid
metal, since Mercury was named after the
Roman messenger god. Despite being closer to
the Sun than Venus, its temperatures aren't as
terribly hot as that planet's. Its surface is quite
similar to that of Earth's Moon, which means
there are a lot of craters and plains
Speaking of craters, many of them were named
after artists or authors who made significant
contributions to their respective fields. Mercury
takes a little more than 58 days to complete its
rotation, so try to imagine how long days must
be there! Since the temperatures are so extreme,
albeit not as extreme as in Venus, and the solar
radiation is so high, Mercury has been deemed
to be non-habitable for humans
BIOETHIC
KEYPOINTS
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● You’ll never forget to buy milk!

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Main points
Biology
Mercury is the closest planet to
the Sun and the smallest one in
the Solar System—it’s only a bit
larger than the Moon
ethics
Venus has a beautiful name and is
the second planet from the Sun.
It’s hot and has a poisonous
atmosphere
 0
2
antibiotics
You can enter a subtitle here if you need it
ANTIBIOTIC RESISTANCE
ANTIBIOTICS
Mercury is the closest planet
to the Sun and the smallest of
them all
Anti-
BACTERIA RESISTANCE
Venus has a beautiful name Despite being red, Mars is
and is the second planet from actually a cold place. It’s full
the Sun of iron oxide dust
CLIMATE CHANGE

ECO-
ENVIRON GLOBAL CHANGE
ENERGY MENT LOVE S
Venus is the second Despite being red, Jupiter is the Saturn is a gas giant
planet from the Sun Mars is a actually a biggest planet in the and has several
very cold place Solar System rings
GENETIC TESTING

MERCURY VENUS MARS

It’s the closest planet Venus is the second Mars is actually a very
to the Sun planet from the Sun cold place

JUPITER SATURN NEPTUNE

Jupiter is the biggest It’s composed mainly It’s the farthest planet
planet of them all of hydrogen from the Sun
Biology ethics

mercury venus mars jupiter saturn

Mercury is the Venus is the Despite being Jupiter is the Saturn was
closest planet to second planet red, Mars is a biggest planet of named after a
the Sun from the Sun very cold planet them all Roman god
aweso
me
words
“This is a quote, words full of wisdom
that someone important said and can
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9h 55m 23s
Jupiter's rotation period

333,000
The Sun’s mass compared to Earth’s

386,000 km
Distance between Earth and the Moon
 30% 45% 80%
Venus jupiter mars
Venus is the second Jupiter is the biggest Despite being red, Mars
planet from the Sun planet of them all is a cold place
 0
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Climate change
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Mercury is the closest
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planet's name has
nothing to do with the
liquid metal
Our TEAM

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MERCUR
Y VENUS MARS JUPITER
It’s the closest It is a planet with a Mars is actually a It’s the biggest
planet to the Sun beautiful name very cold place planet of them all
INFOGRAPHIC (DIAGRAM)

bioethics

biology ethic

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BIOETHICS INFOGRAPHIC
About Topic 50
BIOETHICS 1 %
Mercury is the closest planet
to the Sun and the smallest Topic 75
one in the entire Solar
System. This planet's name 2 %
has nothing to do with the
liquid metal
Topic 25
3 %
250 Hours $ 250,000 50%/60%
Time spent for the studies Budget of the subject Biology & ethic percentage
BALANCE BETWEEN BIOLOGY AND
ETHIC

BIOLOGY BALANCE ETHIC

Mercury is the closest Balance is a situation Jupiter is the biggest
planet to the Sun and the in which different planet in the entire Solar
smallest one in the entire elements are equal or System. It was named
Solar System. This in the same after the Roman god of
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BIOETHICS CIRCLE
Mercury
It’s the smallest
planet of them all

Venus Mars
It’s the second planet Despite being red,
from the Sun Mars is a cold place

Saturn
Saturn is a gas giant
with rings
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