Post on 14-Jul-2016
description
GASTRO-INTESTINAL TRACT
ORDO COCCIDIA:– Cryptosporidium– Cyclospora– Isospora
Cryptosporidium parvum• Cosmopolite, causing cryptosporidiosis• recognized as one of the most common
causes of waterborne disease • Found in human and animals• Prevalence: especially in children ( Brazil :
90 % < 5 years age)• Incidens: >> in AIDS patients (12-48% )
Life cycle• Size: 4- 5 µ • spherical• Habitat : cell
membrane of epithel of all parts of GI tract
• Sporogony produce 2 kinds of oocyst:–Thick wall oocyst, released and
comes out with feces–Thin wall oocyst, excysted in the
lumen auto-infection
Pathogenesis & Clinical symptoms• Infection: swallowing contaminated
drinking water or recreational water ( swimming pools, hot tubs, fountains, lakes, rivers) containing oocyst
• Incubation period: 2-10 days ( average 7 days)
• Watery diarrhea, no blood and mucous• nausea, vomiting, anorexia
Clinical symptoms (cont’d)• In immunocompetent person: self
limited • In immuno compromised :
–Cholera- like diarrhea dehydration– can be found in respiratory tract and
hepato-biliary system
Diagnosis• Detection of oocyst in the feces• Difficult to differentiate with yeast cell in
direct examination using different techniques (e.g., acid-fast staining, direct fluorescent antibody)
• Molecular methods :PCR
Epidemiology• Animals could become a source of infection• Prevention:
–Wash hands with soap and water for at least 20 seconds, after contact with animal, gardening
–All fruits and vegetables you plan to eat raw should be thoroughly washed with uncontaminated water.
Prevention
• Drink only boiled water• Oocyst resistant to chlorine
Source: CDC
Cyclospora cayetanensis• causing cyclosporiasis• Cosmopolite, >> in developing
countries• most common in tropical and
subtropical areas• Persons of all ages are at risk for
infection (>> children)• Cyclospora infects the small intestine
Life Cycle
The oocysts are require days to weeks in favorable environmental conditions to sporulate
Clinical symptoms
• watery diarrhea, which can be severe. • anorexia, weight loss, abdominal pain,• nausea and vomiting,• myalgias, low-grade fever, and
fatigue.
Diagnosis• identification of oocysts in stool specimens
by light microscopy• Stained smears: using modified acid fast
stain
Epidemiology
• commonly occurred in persons who traveled (traveler’s diarrhea)
• chlorine or iodine is unlikely to kill Cyclospora oocysts.
• Prevention: avoiding food or water that may have been contaminated with feces
Isospora belli/ Isospora hominis(Cystoisosporiasis)
• Causing : isosporiasis / cystoisosporiasis• Rarely found in human• Incidens increased in AIDS patients• Bentuk infektif : ookista
Life cycle
Bentuk lonjong 2 sporocyst with 4 sporozoitesOocyst will be mature within 1 – 5 days
• Clinical symptoms: diarrhea• In immuno competent : mild infection
and self lilmited• In the severe cases need therapy• In immuno compromised need longer
treatment
Epidemiology• self limiting disease• Avoiding food or water that might be
contaminated with stool may help prevent infection.
• good handwashing• personal-hygiene practices should be
followed.