Medical Parasitology lab - humsc.net
Transcript of Medical Parasitology lab - humsc.net
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Medical Parasitology lab
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Entamoebia
• Constantly change in shape
1. Intestinal
• Pathogenic E. histolytica
• No pathogenic (E. coli (>4 nuclei in the cyst)
2. Free living
• Feco-oral rout
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E hostylitica
• Habitat
• Mucosa and submucosa of large intestine
• 3 stage
• Trophozoite
• Precyst : intermediate stage between Trophozoite and cyst
• Cyst
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Trophozoite
• invasive form• Passed only of patient with active dysentery• Its size is 15-30 µm.• The cytoplasm has 2 zones
• a hyaline outer margin (ectoplasm) • a granular inner region that may contain red
blood cells ,food vacuoles (endoplasm). • Single nucleus, spherical contain central dot
(karysome)• It has pseudopodia: long finger like projection of
endoplasm through ectoplasm• Motile: active unidirectional progressive and
purposeful movement
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Cyst
• Infective form found in formed stool• Cysts are present in the lumen of the
colon and in formed feces.• Subspherical cysts of pathogenic
amebas range from 10-20 µm. • Smaller cysts 10 -3.5µm are
considered nonpathogenic (E. hartmanni).
• Cysts may contain 1-4 nuclei, a glycogen vacuole and chromatoidalbodies with characteristic rounded ends.
• Covered with smooth chitinous wall
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Flagellate
• Tissue flagellat:
• Giardia lamblia (Intestinal)
• Trichomonas vaginalis (STD)
• The hemoflagellates of humans
• Trypanosoma
• Leishmania
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Giardiasis
• Highest in developing countries
• Highest in children
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Trophozoite• heart-shaped, symmetric, 10-20 µm
in length, • 4 pairs of flagella,• 2 nuclei with prominent central
karyosomes, • A large concave sucking disk in the
anterior portion occupies much of the ventral surface.
• The swaying or dancing motion of trophozoites in fresh preparations is unmistakable.
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Cysts • found in the stool-often in enormous
numbers. • As the parasites pass into the colon, they
typically encyst.• They are thick-walled, highly resistant,• 8-14 µm in length, • contain 2 nuclei as immature & 4 as mature
cysts.
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Giardia lamblia
Trophozoites Cysts
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Trichomoniasis
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• Trophozoites of Trichomonas vaginalis
are
• Oval shape
• 7-30 µm long.
• They have five flagella: four anteriorly
directed flagella and one posteriorly
along the outer membrane of the
undulating membrane.
• The large nucleus is usually located at
the wider, anterior end and contains
many chromatin granules and a small
karyosome.
• It moves with wobbling and rotating
motion
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T. Vaginalis trophozoite
• Oval shape typically measure 7-15um
• Fg=flagella
• Bb=basal body
• Nu=nucleus (single elongated nucleus)
• Ax=axostyle
• um=undulating membrane
• Cy=cytostomal groove
• Cs=costa
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• Leishmaniasis is transmitted by the bite of female phlebotomine sandflies. The
sandflies inject the infective stage, promastigotes, during blood meals .
Promastigotes that reach the puncture wound are phagocytized by macrophages
and transform into amastigotes . Amastigotes multiply in infected cells and affect
different tissues, depending in part on the Leishmania species . This originates the
clinical manifestations of leishmaniasis. Sandflies become infected during blood
meals on an infected host when they ingest macrophages infected with
amastigotes. In the sandfly's midgut, the parasites differentiate into
promastigotes , which multiply and migrate to the proboscis .
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AmastigotesPromastigotes:
a flagellum and a kinetoplast
(arrow) anterior to the nucleus.
They are the infective stage to
humans.
Promastigotes:
Note the multiplication by
longitudinal binary fission (arrow)
that occurs naturally in the gut of
sandfly vectors.
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Helminthes
• Helminths are invertebrates characterized by elongated, flat or round bodies.
• Platyhelminthes (flat) (hermaphrodite)
• Trematodes (flukes)
• Cestodes (tapeworms )
• Nemathelminthes (circular)
• Nematodes (Roundworms)
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Trematodes
• Flat
• Suckers
• Digestive system
• Genetal system (testes and uterus)
• Intermediate host : snail
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Schistosomiasis (‘bilharziasis)
• Schistosomiasis (‘bilharziasis’) is an infection with parasitic blood flukes:
Schistosoma mansoni, S. haematobium, S. japonicum,
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Cestodes
• Flat, segmented, tape worm
• Scolics
• Neck dividing
• Up to 10 meter
• No digestive system
• Gental system (male, female)
• Immature segment, mature segment, gravid segment
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Echinococcus granulosus and Echinococcus
multilocularis
• Echinococcus granulosus and Echinococcus multiloculariscause echinococcosis (Hydatid disease), common in central and Eastern Europe
• Patients presenting with primary infection are often asymptomatic. Latent infections may present years later with symptoms caused by mass effect within organs, obstruction of blood or lymphatic flow, or complications such as rupture or secondary bacterial infections. Fever and acute hypersensitivity reactions, including anaphylaxis, may be the principal manifestations of cyst rupture.
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Nematodes
• Female or male
• Cylindrical
• 4 tubes
• Digestive system, genital system, excretory system, nervous system.
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Ascaris lumbricoides
Infect by eggs that are strongly resistant to desiccation &
environmental conditions.
• Eggs are 75x40 µm, with a thick mamillated brownish shell.
• Freshly passed eggs in feces are not infective, they require 2-3
weeks to develop to be embryonated (contain larva).
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• Male
• 15-30cm * 2-4mm
• Posterior end curved to form hook
• Femal
• 20-40cm *3-6mm
• Posterior end straight
• Distinct groove is present at valvar opening
• 2,00,000 eggs per day
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• 2 type of eggs
• Fertilized egg
• Embyronated unsegmented ovum
• Develop into the infective form
• Round oval
• Unfertilized
• Atrophied ovum
• Elliptial in shape
• larger
Unfertilized egg
Elongated
Thin shelled
Disorganized internal content
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Ascaris lumbricoides
Unfertilized egg
Elongated
Thin shelled
Disorganized internal
content
Egg containing a larva-
infective if ingested
Adult worms
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Trichuris trichiura• Whip-worm, adults 3-7cm, live in caecum & colon of man.
• Eggs are barrel-shaped, 50x25 µm with a thick brown shell and a
mucoid plug at each pole. They are passed in feces to complete
development in soil as in Ascaris. This emryonated egg is the infective
stage.
Adults of T. trichiura Egg of T. trichiura
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Enterobius vermicularis (Pinworm)
Small nematode, a common parasite among children, it is unique in that
eggs are viable shortly after being laid directly on the perianal skin. They
can be accidentally ingested, or passed on fingers, clothing or fecal flecks
to others.
Itching around the anal or vaginal areas are the most common pinworm
symptoms. Suspect a pinworm infection if the child shows night time
itching in these areas.
Pinworm EggsAn adult pinworm An adult pinworm
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trematodes Other name Site of
infection
presentation Infective stage Diagnostic
stage
treatment
Enterobiasis
(pinworm)
Enterobius
vermicularis
Small
intestine
Pruritus ani, white worms visible in the
stools or perianal region
ingesting the
organism’s eggs
eggs mebendazole
or pyrantel
pamoate
Ascariasis
(roundworm)
Ascaris
lumbricoides
Small
intestine
Larvae grow in the intestine, causing
abdominal symptoms, including
intestinal obstruction
ingestion of soil
containing the
organism’s eggs. Then
to the blood
eggs mebendazole
or pyrantel
pamoate
Trichuriasis
(whipworm)
Trichuris
trichiura
Small
intestine
asymptomatic; however, abdominal
pain, diarrhea, flatulence, and rectal
prolapse can occur
ingestion of soil
containing the
organism’s eggs, dirct
to small intestine
eggs mebendazole
Hookworm Ancylostoma
duodenale and
Necator
americanus
Small
intestine
causing anorexia; ulcer-like symptoms,
and
chronic intestinal blood loss, leading to
anemia.
direct skin
penetration by larvae
found in soil. Then to
the blood
eggs mebendazole
or pyrantel
pamoate
Strongyloidiasis
(threadworm)
Strongyloides
stercoralis
Small
intestine
fatal outcome in immunocompromised
patients because of dissemination to the
CNS or other deep organs
(hyperinfection syndrome)
direct skin
penetration by
filariform larvae
found in soil. Then to
the blood
Rhabditi-form
larvae in the
stool
thiabendazole,
albendazole or
ivermectin
Soil-transmited helminths: egg passed in feces( fertilized, poor sanitation)…infective stage (mature egg or larvae)Eggs: contaminated food, water , hands
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trematodes Other name presentation Infective
stage
Diagnostic
stage
treatment
Onchocerciasis
(river
blindness)
Onchocerca
volvulus
subcutaneous nodules, pruritic skin rash,
and ocular lesions often causing blindness.
bite
of a female
blackfly.
detection of
microfilariae in
skin biopsy.
ivermectin
and/or surgery.
Filariasis
(elephantiasis)
Wuchereria
bancrofti and Brugia
malayi
worms block the flow of lymph, causing
edematous arms, legs, and scrotum
bite of
infected
female
Anopheles
and Culex
mosquitoes
detection of
microfilariae in
blood.
a combination
of
diethylcarbama
zine and
albendazole
Loiasis Loa loa The larvae crawl under the skin, leaving
characteristic tracks. They can enter the
eye where adult worms are visible in the
subconjuctival space around the iris.
deer flies detection of
microfilariae in
blood.
diethylcarbama
zine.
Trichinosis Trichinella spiralis eating
encysted
larvae in
undercooke
d pork.
locating coiled
encysted
larvae in a
muscle biopsy.
thiabendazole;