LUMEN DWELLING FLAGELLATES - GIARDIA
REFS:
INTERNATIONALLY ACCEPTED BOOK OF MEDICAL PARASITOLOGY BY K. D. CHATTERJEE
TEXT BOOK OF MEDICAL PARASITOLOGY BY PANIKER
IMAGE SOURCES : FROM INTERNET
LUMEN DWELLING FLAGELLATES - GIARDIA
REFS:
INTERNATIONALLY ACCEPTED BOOK OF MEDICAL PARASITOLOGY BY K. D. CHATTERJEE
TEXT BOOK OF MEDICAL PARASITOLOGY BY PANIKER
IMAGE SOURCES : FROM INTERNET
Everything you wanna know about Chagas disease and Trypanosoma cruzi in a nutshell, including the morphology and life-cycle of the parasite ,diagnosis treatment and prophylaxis of Chagas disease.
• Onchocerciasis also known as ‘’river blindness’’ and ‘’Robles disease.’’
• It is a parasitic disease caused by infection by Onchocerca volvulus, a nematode (roundworm).
• It is the world's second-leading infectious cause of blindness.
• The parasite is transmitted to humans through the bite of a black fly of the genus Simulium.
• The larval nematodes spread throughout the body
Figure 1 Onchocerciasis
CAUSES
The disease is caused by filaria of O Volvulus.
Figure 2 O Volvulus.
LIFE CYCLE OF O. VOLVULUS
1. A Simulium female black fly takes a blood meal on an infected human host, and ingests microfilaria
2. microfilaria enter the gut and thoracic flight muscles of the black fly
3. progressing into the first larval stage.
4. The larvae mature into the second larval stage
5. move to the proboscis and into the saliva in its third larval stage
6. Maturation takes about 7 days.
7. After maturing, adult male worms mate with female worms in the subcutaneous tissue to produce Simulium female black fly takes a blood meal on an infected human host, and ingests between 700 and 1,500 microfilaria per day.
8. the black flies only feed in the day
Figure 3 LIFE CYCLE OF O. VOLVULUS
SIGNS AND SYMPTOMS
Skin involvement
• Typically consists of intense itching, swelling, and inflammation.
• Skin atrophy - loss of elasticity, the skin resembles tissue paper 'lizard skin' appearance.
• Depigmentation
• Nodules under the skin form around the adult worms.
Ocular involvement
• may involve any part of the eye from conjunctiva and cornea to uvea and posterior segment, including the retina and optic nerve
• cornea: Punctate keratitis
• can lead to visual impairment and permanent blindness
Figure 4 'lizard skin'
Onchocerciasis – the disease and its impact
Onchocercal skin disease also has an important socio-cultural impact. People with the disease often have low self esteem, experience social isolation, and worry that they will never marry. Children are distracted in school due to constant itching.
Blindness is caused when microfilariae migrate to the eye and die, causing an inflammatory response. Over time the affected area becomes opaque, leading to impaired vision and eventually blindness.
TREATMENT
• infected people can be treated with two doses of ivermectin,
• six months apart, repeated every three years
• Ivermectin treatment is particularly effective because it only needs to be taken once or twice a year
PREVENTION
Primary prevention:
• Vector control- applications of environmentally safe insecticides to the black flies breeding areas during rainy seasons.
• Mass treatment with Ivermectin.
• Various control programs aim to stop Onchocerciasis from being a public health problem
• larvicide spraying of fast-flowing rivers to control black fly populations
• The disease can be controlled by actions at the primary level with the village health worker administering the drug according to t
occulomycosis- infections of eye and its related structures by various fungal agents.
3 broad category
1.keratomycosis
2.fungal endophthalmitis
3.fungal infections of occular adnexa
Everything you wanna know about Chagas disease and Trypanosoma cruzi in a nutshell, including the morphology and life-cycle of the parasite ,diagnosis treatment and prophylaxis of Chagas disease.
• Onchocerciasis also known as ‘’river blindness’’ and ‘’Robles disease.’’
• It is a parasitic disease caused by infection by Onchocerca volvulus, a nematode (roundworm).
• It is the world's second-leading infectious cause of blindness.
• The parasite is transmitted to humans through the bite of a black fly of the genus Simulium.
• The larval nematodes spread throughout the body
Figure 1 Onchocerciasis
CAUSES
The disease is caused by filaria of O Volvulus.
Figure 2 O Volvulus.
LIFE CYCLE OF O. VOLVULUS
1. A Simulium female black fly takes a blood meal on an infected human host, and ingests microfilaria
2. microfilaria enter the gut and thoracic flight muscles of the black fly
3. progressing into the first larval stage.
4. The larvae mature into the second larval stage
5. move to the proboscis and into the saliva in its third larval stage
6. Maturation takes about 7 days.
7. After maturing, adult male worms mate with female worms in the subcutaneous tissue to produce Simulium female black fly takes a blood meal on an infected human host, and ingests between 700 and 1,500 microfilaria per day.
8. the black flies only feed in the day
Figure 3 LIFE CYCLE OF O. VOLVULUS
SIGNS AND SYMPTOMS
Skin involvement
• Typically consists of intense itching, swelling, and inflammation.
• Skin atrophy - loss of elasticity, the skin resembles tissue paper 'lizard skin' appearance.
• Depigmentation
• Nodules under the skin form around the adult worms.
Ocular involvement
• may involve any part of the eye from conjunctiva and cornea to uvea and posterior segment, including the retina and optic nerve
• cornea: Punctate keratitis
• can lead to visual impairment and permanent blindness
Figure 4 'lizard skin'
Onchocerciasis – the disease and its impact
Onchocercal skin disease also has an important socio-cultural impact. People with the disease often have low self esteem, experience social isolation, and worry that they will never marry. Children are distracted in school due to constant itching.
Blindness is caused when microfilariae migrate to the eye and die, causing an inflammatory response. Over time the affected area becomes opaque, leading to impaired vision and eventually blindness.
TREATMENT
• infected people can be treated with two doses of ivermectin,
• six months apart, repeated every three years
• Ivermectin treatment is particularly effective because it only needs to be taken once or twice a year
PREVENTION
Primary prevention:
• Vector control- applications of environmentally safe insecticides to the black flies breeding areas during rainy seasons.
• Mass treatment with Ivermectin.
• Various control programs aim to stop Onchocerciasis from being a public health problem
• larvicide spraying of fast-flowing rivers to control black fly populations
• The disease can be controlled by actions at the primary level with the village health worker administering the drug according to t
occulomycosis- infections of eye and its related structures by various fungal agents.
3 broad category
1.keratomycosis
2.fungal endophthalmitis
3.fungal infections of occular adnexa
The corneal diseases are one of the leading causes of blindness in the world. in most cases, these infections are preventable or treatable.
This seminar provides an overview of the anatomy and physiology of the cornea, as well as an overview of common conditions.
Usage of contact lenses has increased markedly in the last few years .. for cosmetic or medical reason with some serious complications, here we focused on acanthamoeba as a great danger to contact lens wearer.
fungal / mycotic corneal ulcer power point presentation for O.A 2nd year stud...Vinitkumar MJ
Belong suborder Acanthopodina and the genus Acanthamoeba
• Family of free-living cyst-forming protozoans that are ubiquitous in air, soil, dust and water.
• 11 species of which A. Castellanii and A. polyphaga are the most common in keratitis
• Life cycle consist of motile trophozoite and cyst dormant stage
2. FREE-LIVING AMOEBA
Amphizoic amoebae
- They have also been
called amphizoic amoebae
because these amoebae
have the ability to exist as
free-living organisms in
nature and only occasionally
invade a host and live as
parasites within host tissue.
3. ACANTHAMOEBA
A microscopic, free-living amoeba that can cause rare,
but severe infections of the eye, skin, and central
nervous system.
Several species of Acanthamoeba, including A.
culbertsoni, A. polyphaga, A. castellanii, A. astronyxis,
A. hatchetti, A. rhysodes, A. divionensis, A. lugdunensis,
and A. lenticulata are implicated in human disease.
The important species is A.culbertsoni
4. ACANTHAMOEBA
Acanthamoeba spp. have been found in:
• soil • heating, ventilating, and
• fresh, brackish, and sea air conditioning systems
water • mammalian cell cultures
• Sewage • Vegetables
• swimming pools • human nostrils and
• contact lens equipment; throats
• medicinal pools • human and animal brain,
• dental treatment units skin, and lung tissues.
• dialysis machines
5. ACANTHAMOEBA
Has two stages, cysts and trophozoites, in its life
cycle. No flagellated stage exists as part of the life
cycle.
The trophozoites replicate by mitosis.
When Acanthamoeba spp. enters the eye it can
cause severe keratitis in otherwise healthy
individuals, particularly contact lens users .
When it enters the respiratory system or through
the skin, it can invade the central nervous system
by hematogenous dissemination causing
granulomatous amebic encephalitis (GAE) or
disseminated disease, or skin lesions in
individuals with compromised immune systems
8. ACANTHAMOEBA
There are two morphological forms:
Trophozoite
- A trophozoite is 20-50µm in size
- Rough exterior with several spine like
projections(acanthopoda).
Cyst
- Spherical and 15µm in diameter.
Both forms can be the source of infection
10. ACANTHAMOEBA
Pathogenicity and Clinical Features:
Granulomatous Amebic Encephalitis (GAE) and
disseminated infection primarily affect people with
compromised immune systems.
Commonly seen in immunocompromised patients,
including those with neoplasia, systemic lupus
erythematosus, human immunodeficiency virus
and tuberculosis
Incubation period:
Unknown but estimated at weeks to months. The
route of infection is aerosol or direct inoculation
with hematogenous spread to the CNS.
11. ACANTHAMOEBA
Risk Factors: Symptoms:
• Alcoholism • Headache
• Drug abuse • Confusion
• Chemotherapy • fever,
• Corticosteroids • Lethargy
• Organ transplantation • Nausea and vomiting
• Seizures
Signs: • Photophobia
• Neck stiffness • Neck stiffness.
• Focal neurological deficits • Patients may become
• Patients may also develop frankly psychotic.
raised intracranial pressure
12. Acanthamoeba Keratitis
A progressive disease of the cornea, which
is sight-threatening
Commonly seen in:
- immunocompetent patients.
- However, infection does not
confer immunity and reinfection is
common.
Risk factors:
• poor contact lens hygiene
• corneal abrasion
• exposure of the eye to contaminated water
13. Acanthamoeba Keratitis
Affected individual Signs:
may complain of: • Conjunctival hyperemia
• Eye pain • Episcleritis
• Eye redness • Scleritis
• Blurred vision • Loosening of the corneal
• Sensitivity to light epithelium.
(photophobia) • Rarely, trophozoites can
• Sensation of something
infiltrate the corneal
in the eye
nerve and retina, leading
• Excessive tearing
to chorioretinitis
14. Acanthamoeba Keratitis
Diagnosis
CSF wet mount
-usually lymphocyte
predominance and low
glucose (motile trophozoites)
Culture-Agar plates seeded with
E.coli
Immunofluorescence or
polymerase chain reaction (PCR)
Corneal scrape or biopsy
15. Acanthamoeba Keratitis
Prevention and Control
These guidelines should be followed by all contact lens users to help
reduce the risk of eye infections:
Visit your eye care provider for regular eye
examinations.
Wear and replace contact lenses according to the
schedule prescribed by your eye care provider.
Remove contact lenses before any activity involving
contact with water, including showering, using a hot
tub, or swimming.
Wash hands with soap and water and dry before
handling contact lenses.
16. Acanthamoeba Keratitis
Prevention and Control
Clean contact lenses according to instructions from your
eye care provider and the manufacturer's guidelines.
1. Never reuse or top off old solution. Use fresh cleaning or
disinfecting solution each time lenses are cleaned and stored.
2. Never use saline solution or rewetting drops to disinfect lenses.
Neither solution is an effective or approved disinfectant.
3. Be sure to clean, rub, and rinse your lenses each time you
remove your lenses. Rubbing and rinsing your contact lenses will
aid in removing harmful microbes and residues.
17. Acanthamoeba Keratitis
Prevention and Control
Store reusable lenses in the proper storage case.
1. Storage cases should be rubbed and rinsed with sterile contact
lens solution (never use tap water), emptied, and left open to
dry after each use.
2. Replace storage cases at least once every three months.
Contact lens users with questions regarding which
solutions are best for them should consult their eye care
providers. They should also consult their eye care
providers if they have any of the following symptoms: eye
pain or redness, blurred vision, sensitivity to light,
sensation of something in the eye, or excessive tearing.
18. Granulomatous Amebic Encephalitis
A serious
infection of the
brain and spinal
cord that typically
occurs in persons
with a
compromised
immune system.
19. Granulomatous Amebic Encephalitis
Symptoms include:
• Mental status changes body
• Loss of coordination • Double vision
• Fever • Sensitivity to light
• Muscular weakness or • Other neurologic
partial paralysis problems
affecting one side of the
20. ACANTHAMOEBA
Treatment:
Granulomatous Amebic Encephalitis (GAE) is treated
with pentamidine, usually in combination with one or
more of the following:
• Ketoconazole
• Hydroxystilbamidine
• Paromomycin
• 5-fluorocytosine polymyxin
• Sulfadiazine
• Trimethoprim-sulfamethoxazole
• Azithromycin
21. ACANTHAMOEBA
Treatment:
Acanthamoeba keratitis
- Therapy should include the cationic antiseptic
agents, of which chlorhexidine or
polyhexamethylene biguanide (PHMB) is the most
effective.
Ocular lesions
- Enucleation of ulcer and corneal transplant
22. REFERENCES
• Contact Lens News and Information. (2012, February 20). Contact Lens Solutions Ineffective
Against Acanthamoeba, Study Finds. Retrieved August 10, 2012, from
http://t3.gstatic.com/images?q=tbn:ANd9GcTB4chV7tr0UeG44UKnU9qSBv4IOy_0_vA
JrnYHIvhM75iGwMF
• Centers for Disease Control and Prevention (CDC). Acanthamoeba - Granulomatous Amebic
Encephalitis (GAE); Keratitis. Retrieved August 11, 2012, from
http://www.cdc.gov/parasites/acanthamoeba/disease.html
• Centers for Disease Control and Prevention (CDC). Laboratory Identification of Parasites of
Public Health Concern; Free-Living Amebic Infections. Retrieved August 11, 2012, from
http://www.dpd.cdc.gov/dpdx/HTML/FreeLivingAmebic.htm
• Simon Kilvington, PhD. (2008). Physiological Response of Acanthamoeba to
Contact Lens Disinfectants [Powerpoint Format]. Retrieved August 11, 2012, from
http://www.google.com.ph/url?sa=t&rct=j&q=physiological%20response%20of%20ac
• Animal Planet. Monsters inside me. Acanthamoeba picture. Retrieved August 15, 2012,
from http://animal.discovery.com/invertebrates/monsters-inside-me/acanthamoeba-
keratitis/
23. REFERENCES
• The University of Edinburgh. (2003, May 28). Acanthamoeba. Retrieved August 15, 2012,
from http://www.bms.ed.ac.uk/research/others/smaciver/Comp1.jpg
• Baylor College of Medicine. (2008, January, 30). Human Genome Sequencing Center; About
Acanthamoeba castellani Neff. Retrieved August 15, 2012, from
http://www.hgsc.bcm.tmc.edu/microbial-detail.xsp?project_id=163
• Naveed, Khan. (2009). Acanthamoeba Biology and Pathogenesis. Retrieved August 15,
2012, from http://www.caister.com/supplementary/acanthamoeba/c10.html
24. THANK YOU!
• Edna Mae C. Genzola, RMT
• Katherine Royce L. Panizales, RMT
• Mary Jean D. Somcio, RMT