Parasitology

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This is a series of lectures on microbiology useful for undergraduate medical and paramedical students.. This lecture is a comprehensive coverage of all parasites, protozoa and helminths...

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Parasitology

  1. 1. PARASITOLOGYPARASITOLOGY Protozoa and HelminthsProtozoa and Helminths Dr. Ashish V. JawarkarDr. Ashish V. Jawarkar M.D.M.D.
  2. 2. ParasitesParasites ►Organisms which are dependent on otherOrganisms which are dependent on other organisms for survivalorganisms for survival ►EukaryotesEukaryotes ►Unicellular – ProtozoaUnicellular – Protozoa ►Multicellular - HelminthsMulticellular - Helminths
  3. 3. ►Host – organism that provides nutrition toHost – organism that provides nutrition to parasiteparasite ►Definitive host – adult stage of parasite isDefinitive host – adult stage of parasite is lodged – undergoes sexual reproduction –lodged – undergoes sexual reproduction – both males and females are presentboth males and females are present ►Intermediate host – harbours larval stage ofIntermediate host – harbours larval stage of helminths, asexual reproduction of protozoahelminths, asexual reproduction of protozoa
  4. 4. For toxoplasmaFor toxoplasma
  5. 5. PROTOZOAPROTOZOA
  6. 6. ProtozoaProtozoa ►Classified according to organ of motilityClassified according to organ of motility ►Pseudopodia – amoebaPseudopodia – amoeba ►Cilia – ciliatesCilia – ciliates ►Flagella – flagellatesFlagella – flagellates ►Sporozoa (non motile)Sporozoa (non motile)
  7. 7. ► AmoebaAmoeba  E histolytica, N. fowleriE histolytica, N. fowleri ► FlagellatesFlagellates  GiardiaGiardia  T. vaginalisT. vaginalis  LeishmaniaLeishmania ► SporozoaSporozoa  PlasmodiumPlasmodium  ToxoplasmaToxoplasma ► CiliatesCiliates  B. coliB. coli
  8. 8. Classification according to site ofClassification according to site of infectioninfection ►IntestineIntestine  E histolyticaE histolytica  G. lambliaG. lamblia ►Genital tractGenital tract  T. vaginalisT. vaginalis ►BloodBlood  PlasmodiumPlasmodium  L. donovaniL. donovani
  9. 9. Entamoeba HistolyticaEntamoeba Histolytica
  10. 10. Entamoeba HistolyticaEntamoeba Histolytica ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  11. 11. DistributionDistribution ►World wideWorld wide
  12. 12. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  13. 13. LocationLocation ►Parasite found in large intestineParasite found in large intestine
  14. 14. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  15. 15. Life cycleLife cycle ►Entire life cycle completed in one host -Entire life cycle completed in one host - humanshumans
  16. 16. Morphological formsMorphological forms ►CystsCysts  Round, 10-15 micronsRound, 10-15 microns  4-6 microns nucleus4-6 microns nucleus  Highly refractile cyst wallHighly refractile cyst wall  Four or more nucleiFour or more nuclei
  17. 17. TrophozoitesTrophozoites ►18-40 microns18-40 microns ►Cytoplasm – outer ectoplasm, innerCytoplasm – outer ectoplasm, inner endoplasmendoplasm ►Nucleus – 4-6 micronsNucleus – 4-6 microns ►Ingested red blood cellsIngested red blood cells
  18. 18. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  19. 19. Diseases causedDiseases caused ►Dysentry - Trophozoites burrow intoDysentry - Trophozoites burrow into intestinal wall and cause dysentry withintestinal wall and cause dysentry with ulcersulcers
  20. 20. ►Extra intestinal manifestationsExtra intestinal manifestations  Amebic hepatitisAmebic hepatitis  Infection of lungs/brainInfection of lungs/brain
  21. 21. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  22. 22. Lab diagnosisLab diagnosis ►DysentryDysentry  Examine freshly passed stools or ulcerExamine freshly passed stools or ulcer scrapings for trophozoite formsscrapings for trophozoite forms  Iodine mount for cystsIodine mount for cysts ►Amoebic hepatitisAmoebic hepatitis  Liver aspirationLiver aspiration
  23. 23. ►Serological testsSerological tests  ELISAELISA  IHAIHA
  24. 24. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  25. 25. TreatmentTreatment ►MetronidazoleMetronidazole
  26. 26. Giardia LambliaGiardia Lamblia
  27. 27. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  28. 28. DistributionDistribution ►World wideWorld wide
  29. 29. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  30. 30. LocationLocation ►Small intestine – duodenum and upper partSmall intestine – duodenum and upper part of jejunumof jejunum
  31. 31. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  32. 32. Life cycleLife cycle ►Entire life cycle is completed in one host -Entire life cycle is completed in one host - humanshumans
  33. 33. Morphologic formsMorphologic forms ►TrophozoiteTrophozoite  Shaped as a badminton/tennis racquetShaped as a badminton/tennis racquet  Two sucking discs on ventral surfaceTwo sucking discs on ventral surface  Bilaterally symmetricalBilaterally symmetrical  Two nuclei, two axostyles and four flagellaTwo nuclei, two axostyles and four flagella
  34. 34. ►CystCyst  Infective stageInfective stage  Egg shapedEgg shaped
  35. 35. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  36. 36. Diseases causedDiseases caused ►steatorrhoea – excessive fat in stoolssteatorrhoea – excessive fat in stools
  37. 37. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  38. 38. PathogenesisPathogenesis ►Steatorrhoea is due to malabsorption of fatSteatorrhoea is due to malabsorption of fat ►Disease is never invasive – no dysentryDisease is never invasive – no dysentry
  39. 39. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  40. 40. Lab diagnosisLab diagnosis ►Demonstration of cysts and trophozoites inDemonstration of cysts and trophozoites in stoolstool
  41. 41. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  42. 42. TreatmentTreatment ►MetronidazoleMetronidazole
  43. 43. Trichomonas VaginalisTrichomonas Vaginalis
  44. 44. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  45. 45. DistributionDistribution ►World wideWorld wide
  46. 46. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  47. 47. LocationLocation ►Female genital tractFemale genital tract
  48. 48. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  49. 49. Life cycleLife cycle ►Human beings are the only hostHuman beings are the only host
  50. 50. Morphological formsMorphological forms ►Only one form – trophozoiteOnly one form – trophozoite ►Pear shapedPear shaped ►Single ovoid nucleusSingle ovoid nucleus ►3-5 pairs of flagella3-5 pairs of flagella ►One axostyleOne axostyle ►One undulating mebrane formed by flagellaOne undulating mebrane formed by flagella
  51. 51. Life cycleLife cycle
  52. 52. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  53. 53. Diseases causedDiseases caused ►Trichomoniasis in females which is aTrichomoniasis in females which is a sexually transmitted disease – presents assexually transmitted disease – presents as UTIUTI ►In males - urethritisIn males - urethritis
  54. 54. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  55. 55. Lab diagnosisLab diagnosis ►Demonstrate organism in vaginal dischargeDemonstrate organism in vaginal discharge from females and urethral discharge fromfrom females and urethral discharge from malesmales ►Saline preparation shows characteristicSaline preparation shows characteristic corkscrew motilitycorkscrew motility  Please see the linkPlease see the link https://www.youtube.com/watch?v=9B1PFJXuJUshttps://www.youtube.com/watch?v=9B1PFJXuJUs for motilityfor motility
  56. 56. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  57. 57. TreatmentTreatment ►Metronidazole to both partnersMetronidazole to both partners
  58. 58. HAEMOFLAGELLATESHAEMOFLAGELLATES LeishmaniaLeishmania PlasmodiaPlasmodia
  59. 59. Leishmania DonovaniLeishmania Donovani
  60. 60. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  61. 61. DistributionDistribution ►India - endemicIndia - endemic
  62. 62. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  63. 63. LocationLocation ►Reticuloendothelial systemReticuloendothelial system  Bone marrowBone marrow  LiverLiver  SpleenSpleen
  64. 64. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  65. 65. Life cycleLife cycle ►Two hostsTwo hosts  Humans – definitive host (sexual reproduction)Humans – definitive host (sexual reproduction)  Sandfly – intermediate host (asexualSandfly – intermediate host (asexual reproduction)reproduction)
  66. 66. Morphologic formsMorphologic forms ► Promastigote stage –Promastigote stage –  Stage with flagellaStage with flagella  Nucleus in centreNucleus in centre  One kinetoplast at anterior endOne kinetoplast at anterior end  Flagella at anterior endFlagella at anterior end ► Amastigote stage –Amastigote stage –  Seen in humansSeen in humans  Egg shapedEgg shaped  Nucleus at centreNucleus at centre  Kinetoplast at right angleKinetoplast at right angle
  67. 67. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  68. 68. Diseases causedDiseases caused ►Kala Azar a/k/a Visceral LeishmaniasisKala Azar a/k/a Visceral Leishmaniasis ►Fever with enlargement of spleen,Fever with enlargement of spleen, lymphnodeslymphnodes
  69. 69. ►Misdiagnosed as malariaMisdiagnosed as malaria
  70. 70. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  71. 71. PathogenesisPathogenesis ►Affects immune systemAffects immune system ►Complications due to oppurtunisticComplications due to oppurtunistic infectionsinfections
  72. 72. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  73. 73. Lab diagnosisLab diagnosis ►DirectDirect  Demonstration of LD body in bone marrowDemonstration of LD body in bone marrow smearssmears  Culture in NNN mediumCulture in NNN medium ►IndirectIndirect  Indirect Haemagglutination testIndirect Haemagglutination test  ELISAELISA
  74. 74. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  75. 75. TreatmentTreatment ►Amphotericin BAmphotericin B
  76. 76. SPOROZOASPOROZOA PlasmodiumPlasmodium
  77. 77. MalariaMalaria ► Sporozoite – no special organs of locomotionSporozoite – no special organs of locomotion ► Mal-air = Bad airMal-air = Bad air ► Plasmodium discovered by Sir Ronald Ross inPlasmodium discovered by Sir Ronald Ross in Secunderabad, APSecunderabad, AP ► Four speciesFour species  P. vivaxP. vivax  P. falciparumP. falciparum  P. ovaleP. ovale  P. malariaeP. malariae
  78. 78. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  79. 79. DistributionDistribution
  80. 80. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  81. 81. LocationLocation ►Liver cellsLiver cells ►Red Blood cellsRed Blood cells
  82. 82. Life cycleLife cycle ►Definitive host – Female anophelesDefinitive host – Female anopheles mosquitomosquito ►Intermediate host – HumansIntermediate host – Humans
  83. 83. Pre erythrocytic schizogony Erythrocytic schizogony Gametogony
  84. 84. Morphological formsMorphological forms ►Pre erythrocytic schizogony – sporozoitesPre erythrocytic schizogony – sporozoites ►Erythrocytic schizogony – trophozoite,Erythrocytic schizogony – trophozoite, schizont and merozoiteschizont and merozoite ►Gametogony – gamets (micro and macro)Gametogony – gamets (micro and macro) ►Mosquito – ookinete, oocyst, sporozoiteMosquito – ookinete, oocyst, sporozoite
  85. 85. Morphologic formsMorphologic forms ►schizontsschizonts
  86. 86. Ring forms (trophozoites)Ring forms (trophozoites)
  87. 87. gametocytegametocyte
  88. 88. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  89. 89. Disease causedDisease caused ► MalariaMalaria ► Fever with chills – co incides with release ofFever with chills – co incides with release of parasites in bloodparasites in blood ► SplenomegalySplenomegaly ► Hemolytic anemiaHemolytic anemia ► Black water fever – intravascular hemolysisBlack water fever – intravascular hemolysis ► Pernicious malaria – in P. falciparumPernicious malaria – in P. falciparum  Cerebral malaria – brain capillaries clogged withCerebral malaria – brain capillaries clogged with parasitesparasites  Algid malaria – liver failureAlgid malaria – liver failure  septicemiasepticemia
  90. 90. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  91. 91. PathogenesisPathogenesis ►Due to release of parasites in blood –Due to release of parasites in blood – cytokines are released which cause fevercytokines are released which cause fever and chillsand chills ►Hemolytic anemiaHemolytic anemia
  92. 92. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  93. 93. Lab diagnosisLab diagnosis ►Examine blood smears for ringExamine blood smears for ring forms/schizontsforms/schizonts ►Antigen detection testsAntigen detection tests
  94. 94. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  95. 95. TreatmentTreatment ►ChloroquineChloroquine ►ArtimesinArtimesin ►MefloquineMefloquine ►PrimaquinePrimaquine
  96. 96. HELMINTHSHELMINTHS
  97. 97. HelminthsHelminths ►Commonly called – ‘worms’Commonly called – ‘worms’ ►Three groupsThree groups  Nematodes – unsegmented bodyNematodes – unsegmented body  Cestodes – segmented body – tape likeCestodes – segmented body – tape like  Trematodes – leaf like - flukesTrematodes – leaf like - flukes
  98. 98. ► NematodesNematodes  Round wormRound worm  Hook wormHook worm  Thread worm/pin wormThread worm/pin worm  Filarial wormsFilarial worms ► CestodesCestodes  T. saginata – Beef tape wormT. saginata – Beef tape worm  T. solium – pork tape wormT. solium – pork tape worm  E. granulosus – Dog tape wormE. granulosus – Dog tape worm ► TrematodesTrematodes  Intestinal flukes -Intestinal flukes -  Liver flukes – C. sinensis, f. hepaticaLiver flukes – C. sinensis, f. hepatica  Lung flukes – P. westermaniiLung flukes – P. westermanii  Blood flukes – S. hematobiumBlood flukes – S. hematobium
  99. 99. Round wormRound worm (Ascaris Lumbricoides)(Ascaris Lumbricoides) ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  100. 100. DistributionDistribution ►World wideWorld wide
  101. 101. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  102. 102. LocationLocation ►Small intestine (jejunum)Small intestine (jejunum)
  103. 103. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  104. 104. Life cycleLife cycle ►Humans are the only hostsHumans are the only hosts
  105. 105. Morphologic formsMorphologic forms ►Adult wormsAdult worms  Resemble earth wormsResemble earth worms  Male – female separateMale – female separate  2.5 to 4 cm in length, 5 mm in diameter2.5 to 4 cm in length, 5 mm in diameter  Female worm lays 2.5 lakh eggs every day!!!!!Female worm lays 2.5 lakh eggs every day!!!!!
  106. 106. Morphological formsMorphological forms ►EggsEggs  Bile stainedBile stained  Fertilised/unfertilisedFertilised/unfertilised  Single unsegmented ovum with clearSingle unsegmented ovum with clear crescenteric areascrescenteric areas
  107. 107. Life cycleLife cycle
  108. 108. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  109. 109. Diseases causedDiseases caused ►Malabsorption of nutrientsMalabsorption of nutrients ►CoughCough ►Intestinal obstructionIntestinal obstruction
  110. 110. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  111. 111. Lab diagnosisLab diagnosis ►Stool examinationStool examination  eggseggs
  112. 112. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  113. 113. TreatmentTreatment ►AlbendazoleAlbendazole ►MebendazoleMebendazole
  114. 114. Hook wormHook worm (Ancylostoma Duodenale /(Ancylostoma Duodenale / Necator Americanus)Necator Americanus)
  115. 115. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  116. 116. DistributionDistribution ►World wideWorld wide ►Tropical and subtropical countriesTropical and subtropical countries
  117. 117. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  118. 118. LocationLocation ►Small intestine, mainly jejunumSmall intestine, mainly jejunum
  119. 119. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  120. 120. Life cycleLife cycle ►Only one host - humansOnly one host - humans
  121. 121. Morphologic formsMorphologic forms ►EggsEggs  Not bile stainedNot bile stained
  122. 122. Adult wormsAdult worms ►1-2 cm1-2 cm ►CylindricalCylindrical ►Anterior end is bent – hook likeAnterior end is bent – hook like
  123. 123. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  124. 124. Diseases causedDiseases caused ►Iron deficiency anemia due to chronic bloodIron deficiency anemia due to chronic blood lossloss
  125. 125. ►Itch at the site of entry into the skinItch at the site of entry into the skin ►Cutaneous larva migransCutaneous larva migrans
  126. 126. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  127. 127. Lab diagnosisLab diagnosis ►Stool – look for eggsStool – look for eggs ►Indirect –Indirect –  Iron deficiency anemia on PSIron deficiency anemia on PS  Stool – occult bloodStool – occult blood  EosinophiliaEosinophilia
  128. 128. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  129. 129. TreatmentTreatment ►AlbendazoleAlbendazole ►MebendazoleMebendazole ►PyrantelPyrantel
  130. 130. Thread worm / Pin wormThread worm / Pin worm (Enterobius Vermicularis)(Enterobius Vermicularis)
  131. 131. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  132. 132. DistributionDistribution ►World wideWorld wide
  133. 133. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  134. 134. LocationLocation ►Large intestine – cecum and appendixLarge intestine – cecum and appendix
  135. 135. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  136. 136. Life cycleLife cycle ►Humans are the only hostHumans are the only host
  137. 137. Morphologic formsMorphologic forms ►EggsEggs
  138. 138. ►Adult wormsAdult worms
  139. 139. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  140. 140. Diseases causedDiseases caused ►Pruritis aniPruritis ani ►Nocturnal enuresisNocturnal enuresis
  141. 141. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  142. 142. Lab diagnosisLab diagnosis ►NIH swab (National institute of health) forNIH swab (National institute of health) for demonstrating eggsdemonstrating eggs ►Demonstration of adult worms in stoolDemonstration of adult worms in stool
  143. 143. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  144. 144. TreatmentTreatment ►AlbendazoleAlbendazole ►MebendazoleMebendazole ►PyrantelPyrantel
  145. 145. FILARIASISFILARIASIS (W. bancroftii, B. malayii)(W. bancroftii, B. malayii)
  146. 146. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  147. 147. DistributionDistribution ►World wide – including IndiaWorld wide – including India
  148. 148. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  149. 149. LocationLocation ►Adult worm – lymphaticsAdult worm – lymphatics ►Microfilaria - bloodMicrofilaria - blood
  150. 150. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  151. 151. Life cycleLife cycle ►Humans – definitive hostHumans – definitive host ►Culex/anopheles/aedes mosquito –Culex/anopheles/aedes mosquito – intermediate hostintermediate host
  152. 152. Morphological formsMorphological forms ►Adult wormAdult worm  Female – 10 cmFemale – 10 cm  Male – shorterMale – shorter  Lay eggs containing embryo (microfilaria)Lay eggs containing embryo (microfilaria)
  153. 153. ►MicrofilariaMicrofilaria  290 microns290 microns  Present in peripheral bloodPresent in peripheral blood
  154. 154. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  155. 155. ElephantiasisElephantiasis ►Adult worm causes blockage of lymphaticAdult worm causes blockage of lymphatic channelschannels
  156. 156. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  157. 157. Lab diagnosisLab diagnosis ►Microfilaria demonstrationMicrofilaria demonstration  Parasites seen in blood between 10 pm and 2Parasites seen in blood between 10 pm and 2 amam  Co incides with feeding time of mosquitoesCo incides with feeding time of mosquitoes
  158. 158. ►Adult worm demonstrationAdult worm demonstration  Lymphnode biopsyLymphnode biopsy
  159. 159. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  160. 160. TreatmentTreatment ►DEC (Diethylcarbamazine) helps treatDEC (Diethylcarbamazine) helps treat filariasisfilariasis ►But elephantiasis once developed cannot beBut elephantiasis once developed cannot be curedcured
  161. 161. CestodesCestodes Taenia SaginataTaenia Saginata Taenia SoliumTaenia Solium E. GranulosusE. Granulosus
  162. 162. Taenia Saginata/Taenia soliumTaenia Saginata/Taenia solium (beef tapeworm/pork tape worm)(beef tapeworm/pork tape worm) ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  163. 163. DistributionDistribution ►SaginataSaginata ►World wide in beef eating populationWorld wide in beef eating population  Not seen in India in regions where beef is notNot seen in India in regions where beef is not eateneaten ►SoliumSolium  World wide in pork eating populationWorld wide in pork eating population
  164. 164. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  165. 165. LocationLocation ►Small intestineSmall intestine
  166. 166. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  167. 167. Life cycleLife cycle ►SaginataSaginata  Definitive host – humansDefinitive host – humans  Intermediate host – cows and buffalosIntermediate host – cows and buffalos ►SoliumSolium  Definitive host – humansDefinitive host – humans  Intermediate hosts - pigsIntermediate hosts - pigs
  168. 168. Morphological formsMorphological forms ►Adult worm (saginata)Adult worm (saginata)  Inside humansInside humans  Segmented – called proglottids – contain eggs –Segmented – called proglottids – contain eggs – passed in fecespassed in feces
  169. 169. Morphological formsMorphological forms ►Adult worm – soliumAdult worm – solium  Similar except for additional rostellum / hookletsSimilar except for additional rostellum / hooklets
  170. 170. ►Eggs (same for both)Eggs (same for both)  Spherical and bile stainedSpherical and bile stained
  171. 171. Life cycleLife cycle CYSTICERCU S
  172. 172. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  173. 173. Diseases causedDiseases caused ►Disease is asymptomatic and remainsDisease is asymptomatic and remains undiagnosedundiagnosed ►Problem is that humans may act asProblem is that humans may act as occasional intermediate hosts in case of T.occasional intermediate hosts in case of T. soliumsolium  Called cysticercosisCalled cysticercosis  Patients present with seizures/convulsionsPatients present with seizures/convulsions
  174. 174. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  175. 175. Lab diagnosisLab diagnosis ►Not really possible!!Not really possible!! ►Unless there is cysticercosisUnless there is cysticercosis  CT SCANCT SCAN  BiopsyBiopsy
  176. 176. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  177. 177. TreatmentTreatment ►MepacrineMepacrine
  178. 178. Echinococcus GranulosusEchinococcus Granulosus (Dog tape worm)(Dog tape worm)
  179. 179. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  180. 180. DistributionDistribution ►World wideWorld wide ►Where sheep and cattle are bredWhere sheep and cattle are bred ►There must be a close association betweenThere must be a close association between humans, sheep and dogshumans, sheep and dogs
  181. 181. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  182. 182. LocationLocation ►LiverLiver ►LungsLungs ►Wherever embryos settleWherever embryos settle
  183. 183. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  184. 184. Life cycleLife cycle ►Dog is definitive hostDog is definitive host ►Sheep are intermediate hostsSheep are intermediate hosts ►Humans are accidental intermediate hostsHumans are accidental intermediate hosts
  185. 185. Morphological formsMorphological forms ►Adult wormAdult worm  Inside definitive hostsInside definitive hosts  Has head, neck and stobilaHas head, neck and stobila  Has 4 segmentsHas 4 segments  Head has suckers (rostellum)Head has suckers (rostellum)
  186. 186. ►EggsEggs  Indistinguishable from T. saginata/soliumIndistinguishable from T. saginata/solium
  187. 187. ►Larva (hydatid cyst)Larva (hydatid cyst)
  188. 188. Life cycleLife cycle
  189. 189. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  190. 190. Diseases causedDiseases caused ►Hydatid cyst can remain undetected forHydatid cyst can remain undetected for many yearsmany years ►It causes symptoms depending on theIt causes symptoms depending on the organ in which it has formedorgan in which it has formed ►Rupture of cyst can cause anaphylacticRupture of cyst can cause anaphylactic shockshock
  191. 191. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  192. 192. Lab diagnosisLab diagnosis ►Casoni’s testCasoni’s test ►EosinophiliaEosinophilia ►Serological testsSerological tests ►Examination of cyst fluidExamination of cyst fluid ►CT scan, USG, X rayCT scan, USG, X ray
  193. 193. ►DistributionDistribution ►LocationLocation ►Life cycleLife cycle ►Diseases causedDiseases caused ►PathogenesisPathogenesis ►Lab diagnosisLab diagnosis ►TreatmentTreatment
  194. 194. TreatmentTreatment ►Surgical removal without ruptureSurgical removal without rupture
  195. 195. TREMATODESTREMATODES ►Least commonly reported in IndiaLeast commonly reported in India ►Refer to examples at the starting of thisRefer to examples at the starting of this lecturelecture ►Detailed discussion is beyond the scope ofDetailed discussion is beyond the scope of this lecturethis lecture
  196. 196. Thanks !!!Thanks !!! ►LIKE THIS LECTURE!!!!LIKE THIS LECTURE!!!!

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