Parasitology Overview

8/13/2019 Parasitology Overview

1/12

Protozoa

Entamoeba histolytica Free Living Amoebae

Naegleria ssp. Acanthamoeba ssp.

Identification cyst: spherical, 4 nuclei, infective wheneliminatedtrophozoite: pseudopodia - high motility,

hematophagus agressive stage

cyst: round, only in culture, small numbertrophozoite: anterior pseudopodia, binary fission

cyst: 1 nucleus, external layer polygonal shape,internal layer wrinkled surface with porestrophozoite: rough exterior, several proections,1

nucleus - infectiv

Transmission digestive, sexual in water water, ubi!uitar "everywhere existence#

Life cycle 1$ dirty hands, fly, vegetables, water%$ ingestion

&$ mouth cyst

4$ small intestine trophozoite

'$ colon pre-cyst

($ stool cyst

1$ streams, pounds, lakes, swimming pools

%$ trophozoite, flagellate, cystsnasal route

&$ trophozoite)*+ multiplication .

4$ trophozoite

1$ trophozoites, cysts%$ mucous, skin, cornea

&$ immunocompotent: corneal multiplication

keratitis

immunocompromised:haematogenous spread)*+ encephalitis

Clinical

pictre

primary location: submucosal colon lesion,

bloody mucous diarrhoea, self limiting of &-'

years

secondary location: amoebic liver abscess,

peripheral zone of abscess, no inflammatory

reaction or capsule surrounding, hepatomegaly

primary meningo-encephalitis "/#

acute hemorrhagic meningo-encephalitis

death after &-0 days

chronic amoebic meningoencephalitis, death

after weeksmonths, brain abscess-es, headache,

fever, focal epileptiform attacks

progressive corneal ulcer

Complications blood metastasis of amoebic trophozoits

amoebic liver abscess, lung abscess, brain,

kidney, pancreas, pleural cavity, cutaneous

amoebiasis, cyst rupture, distance

haematogenous metastasis, aundice, anemia!iagnosis trophozoite: stool "acute stage#

cysts: stool "chronic stage#2 3.5, 36.5,

antigen detection in stool2 liver abscess: 3.5,

immuno-electrophoresis, agglutination, increase

of leukocytes, anemia, /+7 increase 8-ray, 9+,

)5, 73, scintigraphy isotope

trophozoites: )+ cysts, trophozoites "rare#: )+

culture on xenicalaxenical media

Treatment yloxanide, etronidazole, 5inidazole ".mphotericine ;# ".mphotericine ;#


2/12

Flagellates

"iardiasis Trichomonas vaginalis Leishmaniasis

#isceral Leishmaniasis Ctaneos Leishmaniasis

Identification cyst: oval, 4 nuclei, double

coat, infective

trophozoite: flatten, pear-

like, 4 flagella, ventral

concave w sucking disc,

dorsal convexbinary fission

cyst: not proved

trophozoite: pear-like, 4 ant$

flagella, 1 recurrent flagella,

actively phagocytic, active

motility

amastigote: roughly spherical, % nuclear chromatin "nucleus


3/12

chronic ulcer, @)hicleroA

!iagnosis cysts: direct examination

"lugol#, smear giemsa stain

trophozoites: stool, duodenal

li!uid, duodenal biopsy,

enterotest "string test#,endoscopic isolates

trophozoites: genital

dischargeurine, giemsa

stain, phase contrast

microscopy, antigen

detection, saline wetpreparation

amastigote: liver, spleen, bone marrow

punctureBiemsa stain

promastigote: in cultures ***

/?3+., 3.5

smear, Biemsa stain, biopsy, ***

medium, leishmanianin test "montenegro

test#

Treatment etranidazole, .lbendazole,

milk intolerance

metronidazole

Tripanosoma $rcei

%African Trypanosomiasis&

Tripanosoma Crzi

%American Trypanosomiasis&

Identification flattened, fusiform shaped, slender pointed leaves, actively motile

trypomastigote: 1 nucleus, post$ kynetoplast, flagellum arises, simple

fission, general configuration variable, antigenic variation

similar to brucei, but larger nucleus

Transmission Blossina spp$ - tsetse fly fly, blood transfusionLife cycle 1$ tsetse fly: infected blood meal - trypomastigotes

%$ midgut: procyclic trypomastigotes "epimastigote#

salivary glands: metacyclic trypomastigotes "infective form#

free in blood


4/12

'ematozoa ( )alaria

Plasmodim #iva* Plasmodim +vale Plasmodim )alariae Plasmodim Falciparm

Identification sporozoites: elongated, crescent shape, central nucleusmerezoites: inside hepato-erythrocytes

Transmission anopheles spp$ mos!uito, intravenous drug users, blood transfusion

Life cycle 1$ insectsporozoites - sexual

%$ pre-erytrocytic schizogony "liver# asexual

&$ erythrocytic schizogony "diagnostic stage#:

asexuate formsyoung trophozoite, mature trophozoite, schizont,

sexuate formsfemale, male gametocytessporozoites

Clinical

pictre

irregular fever becomes regular

cold stage, hote stage, sweating stage

anemia, splenomegaly, aundicep$ falciparum: cerebral malaria, hypoglycemia

black water fever, abortion

!iagnosis thin blood film Biemsa, ?eishman, 7omanovski

thick blood film ield, Biemsa

antigen detection, specific antibody detection

most common: 3.5

Festern blot, )7, anemia, leukopoenia, leukocytosis, thrombopaenia, hyperglobulinaemia

Treatment specific chemotherapy

)hloro!uine but resistance rapidly installed


5/12

Cestodes

Taenia ,aginata

%beef tape-orm&

Taenia ,olim

%beef tape-orm&

Cysticercosis 'ymenolepis Nana

%!-arf tape-orm&

!iphyllobotrim

latm%fish tape-orm&

Echinococs

Lifespan %'-&' years 1'-%H years %I years

Identification scolex: 4 suckers, no

hooks

scolex: 4 suckers, short

pigmented rostellum,

%H-'H hooklets

C. celllosae

scolex: 4 suckers,

rostellum, hooklets

C. racemoss

no scolex

scolex: 4 globular

suckers, subglobular,

rostellum,

%H-&H hooklets

scolex: % slit

longitunial grooves

"like suckers#

no rostellum, no

hooklets

piriform scolex, %

rows of hooks, 4

suckers

body: 1$HHH-%$HHH

proglottis "J-1Hm#

body: JHH-1HHH

proglottis "4-(m#

body: &HHH-4HHH

proglottis "1H-1%m#

proglottis: contain

fertilized eggs

proglottis: inside

uterus &H$HHH-'H$HHHfertilized eggs

proglottis: 1HH-%HH,

increase in sizeposterior

proglottis: genital pore

in middle

contineous

discharge of eggs

"&($HHH-1 mio day#

proglottis: &-',

containing up to '$HHHeggs

Larvae cystercercus bocis

intra-muscularadipose

cystercus cellulosae

intramuscularadipose,

eyes, )*+,

subcutaneous

cystercoid, inside

interstinal villous

plerocercoid

encysted in fish

visceramuscles

hydatid cyst

ectocyst

endocyst

Egg roundoval, thick

membrane

embryo ( hookletsacid fast

roundoval, thick

membrane

embryo ( hookletsno acid fast

JH-1JH in each

segment, oval

globular, infective% membranes % poles

w 4-J filaments

embryo ( hooklets

operculated, brown

shell

no embryono inf$water dependent

% shells, inner thicker,

oncosphere contains &

pairs of hooklets,discharge infective

Transmission raw beef raw pork 5$ solium eggs direct, person-person

faecal cont$ waterfood

raw fish 6: dogs

3: sheep, goat, man

Life cycle 1$ eggs in feces

%$ cattle: ingestion of

1$ eggs in feces

%$ pig: ingestion of

1$ unembryonated eggs

in feces

1$ embryonated eggs in

feces


6/12

eggsgravid proglittis

&$ oncosperes hatch

intestinal wall,

circulate in musculatur

4$ cystercerci in mm$

'$ hman: ingestion ofraw infected meat

($ scolex attaches to

intestine

0$ adults in s$ intestine

eggsgravid proglittis

&$ oncosperes hatch

intestinal wall,

circulate in musculatur

4$ cystercerci in mm$

'$ hman: ingestion ofraw infected meat

($ scolex attaches to

intestine

0$ adults in s$ intestine

%$ embryonate in water

&$ crstaceans:

ingestion

4$ procercoid larvae in

body cavity

'$ small fish:plerocercoid larva

($ predator fish

0$ hman adults in s$

intestineI$ proglottids release

eggs

%$ dog: oncosphere

hatches, penetrates

intestinal wall

&$ hydated cyst in liver,

lung, etc$

4$ protoscolex formcyst

'$ scolex attaces to

intestine

($ adult in s$ intestine

accidentally in

human

Clinical

pictre

digestive complaints,

neuro-psychic signs,

general signs,

allergies: cutaneous


neuro-psychic signs,

general signs,

allergies: cutaneous

neuro-cysticercosis,

ocular cysticercosis,

muscle cysticercosis,

subcutaneous

cysticercosis: not

painful nodes, become

painful when larvae

dead

a-symptomatic,

digestive,

allergies,

a-symptomatic,


general signs,

allergies: cutaneous,

neurovegetative signs,

neuropsychiatic signs

liver hydatid cyst

(HK right lobe, bile

duct compression, liver

abscess

lung hydatid cyst

lung abscess

other: spleen, kidney,

bone, cerebral

Complications acute appendicitis

intestinal obstruction

megaloblastic anemia

!iagnosis proglottis: clothes,

stool

eggs: ziehl neelsen

red

scotch testhypereosinophilia

proglottis: -

eggs: ziehl neelsen

blue

hypereosinophilia

eggs: stool,

/?3+., /35;,

western blot, soft

tissue x-ray, 73,

ventriculography,mielography, )+

hypereosinophilia,

eggs: stool eggs: direct coprology,

Lit;1% deficiency,

anemia, leukopenia,

throbopenia,

hypereosinophilia

protoscolices in urine,

sputum,pleural

effusion etc$, /?3+.,

3.5, Festern blot

6emagglutination, skintest, chest x ray,

ultrasound, )5, 73,

hypereosinophilia

Treatment parazi!uantel,

niclosamide

parazi!uantel,

niclosamide

parazi!uantel,

albendazole, surgery,

antiepileptic and

steroids in ocular)*+

parazi!uantel,

niclosamide

parazi!uantel,

niclosamide

albendazole, surgery


7/12

locations

Trematodes

Fasciola hepatica %liver fl/es& Paragonims ssp. %lng fl/es& ,chistosoma spp. %blood fl/es&Lifespan 1H-%H years '-&H years

Identification in large bile ducts of sheep, cattle, accidentally

in human, brwonish, hermaphrodite

in lung cavities, cuticle harboring spines, %

ventreal and oral suckers, reddish-brownish,

hermaphrodite

in mesenteric venous system, separated sex

m: % suckers "ventral


8/12

liver phase: reaches bile duct, hepatomegaly,

aundice

ectopic migration: pruritic nodules abscesses

halzoun: painful local allergic reaction

pharangeal mucosa

pulmonary stage: cough, bloody sputum, chest

pain, fever, night sweating, right heart

insufficiency, fibrosis

ectopic worms: eye, epididimitis, testis, )*+,

abdomen, painful lymphadenopathy, migrating

subcutaneous swelling, rarely abscess

hypereosinophilia, hepatomegaly,

splenomegaly, cough, katayama fever

chronic phase: granuloma formation

+$ mansoni liver, intestine, spleen, cerebral

+$ haematobium bladder, kidney

+$ aponicum katyama fever, bloody, mucousdiarrhoea "close to mansoni#

!iagnosis eggs: bile fluid or feces

serology in migration phase

eggs: sputum, feces, abscess fluid

)5, hypereosinophilia, x ray, )5

eggs: urine "+$ haematobium#, feces,

biopsies of rectum, bladder, liver

/?3+., haemagglutination, 3.5

ultrasonography, intravenous urography, chest x

ray, chistography

Treatment parazi!uantel

triclobendazole

parazi!uantel arazi!uantel, .mbilhar, Lansil, +urgery

Nematodes

Ascaris Lmbricoides To*ocara ,pp. Trichris Trichira %-hip-orm& Enterobis #ermiclaris

Lifespan 1-% years & months ( weeks

Identification largest round worm, in small bowel

cylindrical, creamy-brown color

head: & ant$ lips, teeth

thick


9/12

Transmission ingestion of eggs cats, dogs, vegetables, dirty hands,

congenital transmission of toxocara

larvae in dogs

accidental ingestion of fertilized

eggs

man to man transmission

digestive

retro-infection

Life cycle 1$ eggs soil development

%$ infective larva hatches small

bowel, penetrates gut wall&$ liver "circulatory system#

4$ lung

'$ pharyngessmall intestine

"sexually mature worm#

1$ eggs soil development

%$ migration phase: larvae trapped

in tissue granuloma&$ wondering of larvae

pathology due to antigenic

stimulation < granulomatous

reaction

1$ embryonated in soil

%$ larvae hatch in intestine

&$ penetration and development inmucosa

4$ adults in caecum

'$ eggs in feces

1$ human: embryonated eggs ing$

%$ larvae hatch in s$ intestine

&$ adults in lumen of ceacum4$ f$ migrates to perianal region at

night to lay eggs

&$ eggs on perianal folds "larvae

inside eggs mature within 4-(h#

retroinfection

Clinical

pictre

a-symptomatic

migration phase: fever, cutaneous,

respiratory allergies, ?oefflerDs

syndrome

adult stage: intestinal obstruction,

ectopic migration appendix,

biliary tree, pancreatic duct

liver - colangitis, liver abscesses,granuloma formation

small intestine acute peritonitis

1$ visceral larva migrans : pruritus,

abdominal pain, fever

hepatosplenomegaly, respiratory

complains, myocarditis, )*+

damage

%$ covered toxocariasis :

lymphadenopathy, asthenia,

rheumatoid syndrome, fever oflong period of time

&$ asymptomatic patiens:

hypereosinophilia

4$ ocular larva migrans: loose of

vision, granuloma formation

a-symptomatic

abdominal pain, dysenteric

syndrome "bloody, mucous

diarrhoea, sometimes pus#,

rectaltenesmus, nausea, vomiting

rectal prolapsed, anemia,

appendicitis, death "in

malnourished subects#

a-symptomatic

abdominal pain, anal pruritus,

behaviour chages, insomnia, vulvo-

vaginitis, urethritis, cutaneous larva

migrans

apendicitis, peritonitis, urinary tract

migration

!iagnosis un-fertilized eggs: stool

larvae: sputum, gastric uice

hypereosinophilia

liver biopsy

stool examination not positve

/?3+., )3/, F;, )+high leukocytosis,

hypereosinophilia, increase muscle

enzymes, 3g/, biologic

inflammatory syndrome

9+, )5, 73

opthalmologic and fundus

examination

eggs: stool

anemia, hypereosinophilia

adults: stool

eggs: stool "1'K of cases#

scotch test


10/12

Treatment .lbendazole, ebendazole,

yrantel pamoate, ?evamisole

iethylcarbamazine, .lbendazole,

3vermectine

.lbendazole, ebendazole .lbendazole, ebendazole

'oo/-orms ,trongyloides ,tercoralis Trichinella spp.

Identification slender, cylindrical, ant$ mouth


11/12

hypoalbuminaemia hypereosinophilia, chronic diarrhoea,

cutaneous-, pulmonary signs

specific 3gB antibodies /?3+., latex

agglutination, western blot,tyvelose, multiplex -)7

Treatment .lbendazole, ebendazole .lbendazole .lbendazole, ebendazole, )orticosteroids "severe#

Filiarial -orms +ncocercaiasis Loa Loa !racontiasis

Identification wuchereris bancroftibrugia malayi (not as severe)round, slender, white cuticle, in

lymph nodes, lymphatic system

round worm, free living insubcutaneous fibrous nodule,

moving freely

adult: slender, white, round worm,inhabits subcutaneous tissue,

moves freely, lifespan:M1J-%Hyears

longest filarial worm, uterus filledwith rhabditoidform larvae,

eliminate in water through blister

microfiliaria:motile larval worms,

noctal periocidy

microfilaria: living


12/12

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Parasitology Overview