ZOONOSIS

INTRODUCTION
Zoonosis : skin disease caused by various
parasites
This disease is often found in :
o Crowded areas
o Low socio-economic condition
o Poor sanitation and hygiene
In the eradication effort, these attempts
are needed :
o Early diagnosis and prompt treatment
o Public health education about :
Prevention
Proper hygiene
Reservoir-host-vector control

The causes of this disease are divided into 3 major

groups :

1. PROTOZOA :
2.

NEMATODA:

3.

ARTROPODA

- Amoebiasis
- Trichomoniasis
- Oxyuriasis /
enterobiasis
- Ground itch
- Cutaneous larva
migrans
- Current larva
- Filariasis
- Dracunculiasis
: - Scabies

- Pediculosis

AMOEBIASIS CUTIS
Causative agent : Entamoeba histolytica
The amoeba may affect the skin through these
mechanisms :
1. Direct invasion of intestinal amoeba on the
surrounding skin
2. directly from hepatic abscess
3. Direct implantation of trophozoit on skin
with / without lesion
Clinical manifestation :
Ulcer : well-defined border, erythema on
the surrounding skin, base necrotic &
purulent
Destruction muscles and bones
Diagnosis :
Material scrapes and biopsy taken from
the edge of the ulcer
Microscopic trophozoit
Treatment :
Metronidazole 3 x 750 mg / day 10 days
Dihydroemetin : 1,5 mg/kgBW/day IM
10 days

TRICHOMONIASIS
Causative agent : Trichomonas vaginalis
Clinical manifestation :
Vaginal discharge seropurulent, yellow /
greenish yellow, foul-smelling and fizzy.
Vulva pruritus, irritant dermatitis
Strawberry appearance the vaginal wall is
red and swollen.
Diagnosis : vaginal discharge / urine + NaCl
microscopic movement of T.vaginalis
Treatment :
Metronidazole 3 x 250 mg 7 10 days
Metronidazole single dose 2 gr

OXYURIASIS / ENTEROBIASIS
Causative agent : Enterobius vermicularis
Often affects children aged 5 14 years old.
The transmission is through :
- food / beverage
- egg-infested hands
Clinical manifestation :
Perianal / perineal pruritus, especially at
night
Perineal intertrigo excoriation &
superinfection.
Diagnosis : Worm (+) or egg (+), obtained
through the scotch tape method.
Treatment :
Mebendazole 100 mg, SD
Piperazine citrate 65 mg/kgBW/day,
max. 2 gr 7 days
Thiabendazole 25 mg / kgBW / day

GROUND ITCH
Causative agent : Necator americanus &
Ancylostoma duodenale
Pathogenesis : penetration of filariform larvae
plantar skin blood circulation
Clinical manifestation :
Skin lesion : maculae, papule, vesicle, bulae,
sometimes urticaria and oedema.
2 weeks self-limiting, except in the
events of secondary infections.
Diagnosis : microscopic egg (+)
Treatment :
Secondary infection on the skin AB
Intestinal infection :
o Mebendazole 2 x 100 mg/day 3 days
o Albendazole 200 mg/day 3 days

CUTANEOUS LARVA MIGRANS

(CREEPING ERUPTION)
Causative agent : Ancylostoma braziliensis,
Acaninum & Uncinaria stenocephala
Mostly affects children, miners and farmers.
Pathogenesis :
Adult hookworm in dogs / cats small intestines

Eggs

Rhabditiform larvae

Filariform larvae

The skin

Creeping eruption

Clinical features :
Common locations are on the buttocks, feet
and hands
The diameter of the lesion is 1 4 mm, red
in color, a bit raised, like a coiled thread.
Diagnosis : typical lesion manifestation
Treatment :
Topical
o Classic : Chlorethyl, CO2, liquid N2
o Thiabendazole 10%
o Albendazole 2%
Systemic
o Thiabendazole 25 mg/kgBW/day
2 days
o Albendazole 50 mg/kgBW/once a week

CURRENT LARVAE
Causative agent : Strongyloides stercoralis
Method of transmission : autoinfection
Clinical features :
Lesion urtica ribbon, quickly lengthening,
10 cm / hour
Location : anus, spreading to the buttocks,
abdomen or thighs.
Diagnosis :
Typical lesion
Larva in the feces (microscopic)
Treatment :
Thiabendazole 25 mg/kgBW/day 5 days
Albendazole / Mebendazole

FILARIASIS
Causative agent :
Vector

Wucheria bancrofti
Brugia malayi
: anopheles, culex, aedes and
mansonia mosquitos.

Method of transmission :
Wecheria bancrofti (adult form)
lymphatic glands
Microfilaria (peripheral lymphatic glands /
blood vessels)

Mosquito (infective)

Human
Clinical features :
1. Asymptomatic stage
- Incubation period 8 12 months
- Lab : microfilaria in the blood
Eosinophilia
2. Acute inflammation stage
- Lymphangitis on the extremities /
scrotums, pain, rigid, glossy skin, heat.
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- Lymphadenitis
- Orchitis, funiculitis, epididimiti3
3. Chronic obstructive stage
- Repetitive inflammations & fibrosis of
the lymphatic glands obstruction
- Obstruction disturbance of the
lymphatic drainage liquid accumulation
in the tissue and lymphatic glands
progressive in nature due to repetitive
inflammations.
- Manifestations : varicose lymph &
lymphedema
- Chronic edema connective tissues
deformity & elephantiasis
Diagnosis :
Examination of the peripheral blood vessels
at night-time microfilaria
Examination of the hydroceles liquid or
urine
Treatment :
Diethilcarbamazine 2 mg/kgBW/day 3 weeks

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DRACUNCULIASIS
Causative agent : Dracunculus medinensis
Intermediate host :
Crustacea species from the Cyclops genus
Consumption of Cyclops-infested water /
beverage

Intestinal walls & retroperitoneal tissues (adult

worms)

Sub-cutaneous tissues (body part that has

contact with the water / feet)

Larvae
Clinical features :
Erythema, urticaria, itch, several hours
papule vesicle bullae erosion / ulceration
Diagnosis :
Radiology examination calcification of the
dead worms
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Treatment :
Thiabendazole 50 100 mg/kgBW 2 days
Metronidazole 30 40 mg/kgBW/day
3 days

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HUMAN SCABIES
Method of transmission :
Direct handshake, sexual contact
Indirect through objects
Etiology : Sarcoptes scabiei var hominis
Life cycle :
Female mites in stratum corneum

Eggs
3 4 days
Larvae
1014

days
Mites
Clinical features :
Predilection : in-between fingers, flexor of the
wrists, genitalia, axillae folds, lower abdomen,
buttocks.
Lesion papule, vesicle, excoriation / secondary
infection, sometimes forming burrows.

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Clinical variations :
Incognito scabies
Scabies in infants and children
Noduler scabies
Scabies transmitted by animals
Scabies in a clean
Norwegian scabies
Additional examinations :
Microscopic mites, eggs, faeces
Burrows tetracycline
Skin biopsy
Diagnosis :
Itch, especially at night-time
History of infection on members of the
family / people living under the same roof
Characteristic distribution of lesion
Characteristic lesion burrows
Definite diagnosis mites, eggs, faeces
Tx antiscabies improvement

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Treatment :
- Gamexan 1%
- Crotamiton 10%
- Sulfur 5 10%
- Benzoil benzoate 20 35%
- Permitrin 5%

To achieve treatment success :

Treat every contact person
Correct drug administration
Washing clothes and towels with hot water,
air mattress under the sun
Avoid excess treatment

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PEDICULOSIS
P. capitis P. humanus var capitis
P. corporis P. humanus var corporis
P. pubis Phtyrus pubis
Pathogenesis :
- Direct contact
- Indirect contact

P. CAPITIS
Clinical manifestation : often affects children
Symptoms :
- itch, especially on the occipital &
temporal parts excoriation, erosion /
secondary infection
- swelling of the lymph glands

P. CORPORIS
Clinical features :
- hemorrhagic macules / papules with
punctum in the middle
- urtica

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P. PUBIS
Mites pubic hair, eyebrows, eyelashes, axillae
region, sometimes body hair
Clinical features :
- itch excoriation / secondary infection
- Characteristic maculae cerulae
Diagnosis :
P. capitis : shiny eggs on hair, mites
P. corporis : eggs / mites on clothes folds
P. pubis
: eggs / mites on pubic hair,
eyelashes, body hair
Treatment :
P. capitis : - gamexan 1% shampoo
- permetrin 1% cream
- crotamiton 10% cream / lotion
P. corporis : - gamexan 1%
- Washing clothes / bed sheets
using hot water / ironing them
P. pubis
: - petrolatum
- physostigmine 0,025% eye
ointment

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MYASIS CUTIS
Causative agents :
- Oestrus
- Gasterophillus
- Hypoderma
- Chrysomya
Predisposing factors :
- Open suppurative lesion
- Habit of sitting down / sleeping on the
ground
- Unclean environment
Myasis classification :
1. Specific
2. Semi specific
3. Accidental
Clinical features, based on the type of lesion :
Subcutaneous burrows pinkish papules,
followed by spiraling lines
On the wound untreated lesion
Subcutaneous shifting nodule / tumour

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 Furunculoid papule pustule incision

larvae
Based on the locations :
The skin
The orifices (nose, ears, eyes)
Internal organs digestive tract, urinary
tract
Diagnosis :
Larva on the lesion (+)
Treatment :
Furunculoid :
o Seal with petrolatum / paraffin, then
press larvae will be squeezed out
On the wound : irrigation with chloroform /
ether
Classic : fish the larvae out with clover
liquid

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CIMICOSIS
Causative agent :

Cimex lectularis
Cimex hemipterus

Clinical features :
Mite bite papule with punctum
Hemorrhagic bulla
Treatment :
Eradication of mites with mallation / DDT
Lesion with anti-itch lotion

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