5. Toxoplasma and Pneumocystis - Columbia University · Toxoplasma gondii 2. The Malarias...
Transcript of 5. Toxoplasma and Pneumocystis - Columbia University · Toxoplasma gondii 2. The Malarias...
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Protozoa1. All are single-celled organisms
2. All are eukaryotes
3. Locomotion:
4. Most protozoa are free-living
Balantidium coli Giardia lamblia Entamoeba histolytica
Ciliae Flagellae Pseudopods
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Protozoan Parasites1. Toxoplasma gondii
2. The MalariasPlasmodium falciparumPlasmodium vivaxPlasmodium ovalePlasmodium malariae
3. Diarrheal disease-causing protozoa:Giardia lambliaEntameba histolyticaCryptosporidium parvumCyclospora cayetanensis
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Toxoplasma gondii
and
Pneumocystis jiroveci*
Protozoa:
*actually an unusual fungus
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Toxoplasma gondii
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Toxoplasma gondiiThe Plasmodia (malaria)Cryptosporidium parvum
The Apicomplexa
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Toxoplasma gondii infects all mammals and all tissues in each of them.
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The Sea Otter is at great risk fromdying from acquired toxoplasmosis
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R - rhoptres; C- conoid; MN - micronemes; DG - dense granules; N - nucleus
Tachyzoite stage of Toxoplasma gondii
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Macrophage Infected With Toxoplasma gondii*
* The hunter becomes the hunted
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Toxoplasma gondii in culture
Trophozoites (T) prevent fusionof lysosomal menebranes to theparasitophorous vacuole, therebyescaping digestion
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Toxoplasma gondii in culture
Heat-killed organisms cannotprevent fusion of lysosomal membranes with the parasitophorous vacuole
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Felines are the definitive hosts for Felines are the definitive hosts for Toxoplasma gondiiToxoplasma gondii
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Rack of lamb is usually served rare
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Oocysts of Toxoplasma gondii
Sporulated
Unsporulated
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Congenital
Adult-acquired
AIDS-related
Clinical Disease:
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Congenital Toxoplasmosis
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Congenital Toxoplasmosis:
Still Birth
Chorioretinitis
Mental Retardation
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Adult-Acquired Toxoplasmosis
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Adult-Acquired Toxoplasmosis
Lymphadenopathy
Fever
Headache
Chronic Malaise
Signs and symptoms:
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AIDS-related Disease
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AIDS-related Disease:1. CD4 < 200 and reactivation of latent infection
2. Encephalitis1. Diffuse inflammation and swelling2. Localized ring enhancing lesions on CT scan3. Herniation4. Death if untreated
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Pathology
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Calcified Lesions Due To Congenital Toxoplasmosis
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Congenital Toxoplasmosis
Photo courtsey: Gary Baumbach, M.D., Department of Pathology, University of Iowa College of Medicine
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Toxoplasma abscess in the brain would appear as a ring-enhancing lesion with CT scan.
CT Scans
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Histopathology of Toxoplasma gondii:organisms are hard to demonstrate
by microscopic examination
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Pseudocyst of Toxoplasma gondii in Liver
Pseudocyst
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Pseudocysts of Toxoplasma gondii in a microglial nodule with a variety of inflammatory cell types
in an HIV/AIDS patient
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Differential Diagnosisof LymphadenopathyDifferential Diagnosisof Lymphadenopathy
ToxoplasmosisToxoplasmosis
+++
+
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+
0
0
0
+
ReticulumCells
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0
0
0
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ReticulumCells
Inf. MonoInf. Mono
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+
++++
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++++
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Germinal Cells
+
+++
+
++++
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++++
++++
+
Germinal Cells
LymphomaLymphoma
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+
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+
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0
++
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Bizarre Cells
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+
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0
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+++
Bizarre Cells
Lymphadenopathy WithoutOther Symptoms
Pharyngitis
Monocytosis, Eosinophilia
Atypical Lymphocytes
Anemia
Positive Heterophil
Altered Liver Function
Hilar Lymphadenopathy
Lymph Node Pathology
Lymphadenopathy WithoutOther Symptoms
Pharyngitis
Monocytosis, Eosinophilia
Atypical Lymphocytes
Anemia
Positive Heterophil
Altered Liver Function
Hilar Lymphadenopathy
Lymph Node Pathology
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Serological correlatesin acute and chronic infection
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Serologic Detection of Toxoplasma During Pregnancy
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Indirect Fluorescent Antibody (IFA)Test
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Drugs Of Choice:
Pyrimethamine and Sulfadoxine
Modes of action:1. Pyrimethamine inhibits DNA synthesis by interfering
with folate synthesis
2. Sulfadoxine prevents PABA synthesis by inhibitingthe enzyme dihydropteroate synthetase
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Alternate Drugs:
Spiramycin and Sulfadiazine
Modes of Action:
A. Spiramycin inhibits RNA synthesis
B. Sulfadiazine inhibits PABA synthesis by interfering withdihydropteroate synthetase
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Prevention:
1. Prevent pregnant women from handling cat litter
2. Avoid eating raw or under-cooked meats
Automated litter collection boxTrained cat