Page 9 of 11: DEADLY PARASITES!!!

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naegleria:
in hot summer months
young swimmers

invades nasal mucosa -----------> olfactory plate ---------->meninges

t/t: amphotericin B
no satisfactory treatment.

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one thing to add: infecive form for naegleria is both ameboid and flagellates form!

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acanthmeba:

no flagellate stage,
has acantopodia

difference b/w naegleria and acanthmeba!
it forms cysts in tissue and no flageelae unlike naegleria.
and alos not associated with swimming.
naegleria is manifested in immunocompromised persons mostly but acanthmeba keratitis affects healthy persons!

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and acanthmeba has been associated with contact lens wearers especially th soft lens..

t/t is oral ketoconazole with topical miconazole

lab d:
culture and serology!

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PROTOZOA ARE DIVIDED AS FOLLOWS --
A. AMOEBAE
B. CILLIATES
C. FLAGELLATES
D. SPOROZOA
Should we start one by one in a systematically

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AMOEBAE include following species
Acanthamoeba
Balamuthia
Endolimax
Entamoeba
Hartrnanella
Lodameoba
Naegleria

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Protozoa are unicellular microorganisms that lack cell walls and obtain nutrients by ingesting other microbes, or by ingesting macromolecules in solution in a process of pinocytosis. They lack pigments and may be motile. There are four major groups, which are distinguished by their mechanism of motility (flagella vs. pseudopodia vs. cilia vs. non-motile), as well as the characteristics of their life cycles. Mastigophora (flagellates) are motile through the use of flagella, Sarcodina (amoebas) are motile with amoeboid movement, Ciliophora use cilia for movement and Sporozoa are non-motile. Each group contains representatives that cause important human diseases.
On the basis of light and electron microscopic morphology, the protozoa are currently classified into six phyla. Most species causing human disease are members of the phyla Sacromastigophora and Apicomplexa.

MORPHOLOGY

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Intestinal Protozoa: Amebas : Entamoeba Histolytica -- Clinical Manifestations

Patients have acute or chronic diarrhea, which may progress to dysentery.
Diagnosis
Acute diarrhea is the usual presentation of symptomatic disease. Ulceration is associated with occult or gross blood in stool and/or with a visceral abscess. The condition may be confirmed by identification of E histolytica in the stool or in abscess aspirates.

TREATMENT:
Acute intestinal disease is best treated with metronidazole at a dose of 750 mg three times a day orally for 10 day. In children the dose is 40 mg/kg/day divided into three doses and given orally for 10 days.

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Intestinal Protozoa : Giardia Lamblia
Clinical Manifestations
Giardiasis may be asymptomatic or may cause a variety of intestinal symptoms, including chronic diarrhea, steatorrhea (fatty diarrhea), cramps, bloating, fatigue, and weight loss.
Diagnosis
Traditionally, Giardia is identified by cysts or trophozoites in stool. Some cases are difficult to diagnose. Other methods are to examine duodenal specimens for Giardia.
Control
Attention to personal hygiene (e.g., handwashing) will reduce direct transmission. Another method of control is to treat drinking water by disinfection and/or filtration. In the U.S., infections are treated with quinacrine or furazolidone. Metronidazole is also effective, but not officially approved.

This is an image of GIARDIA.

Giardia lamblia. Indirect fluorescent antibody stain. Positive test.

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OTHER INTESTINAL PROTOZOA

Balantidium coli and Cryptosporidium (parvum) are both zoonotic protozoan intestinal infections with some health significance. Isospora belli is an opportunistic human parasite.
Balantidium coli
This is a parasite primarily of cows, pigs and horses.Man-to-man transmission is rare but possible.Metronidazole and iodoquinol are effective.

above is life cycle and below is trophozoites in cross section of intestine.

Cryptosporidium parvum:
C. parvum is a small round parasite measuring 3 to 5 micrometers which is found in the gastrointestinal tract of many animals and causes epidemics of diarrhea in humans via contaminated food and water.Humans are infected by ingestion of C. parvum oocysts containing many sporozoites.
When a large number of humans in a community have diarrhea, the most likely cause is C. parvum. A small bolus of infection may cause mild diarrhea, whereas a larger intake of organisms may cause more pronounced symptoms including copious watery diarrhea, cramping abdominal pain, flatulence and weight loss. Severity and duration of symptoms are related to immuno-competence. In AIDS patients, the organism may cause prolonged, severe diarrhea and the organisms may invade the gallbladder, biliary tract and the lung epithelium. There is no approved effective treatment for cryptosporidiasis, although paromycin is used as an investigational drug.

life cycle of C.parvum

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