parasite intestinal flagellates

1. INTESTINAL CILIATES, INTESTINAL, ORAL AND
GENITAL FLAGELLATES. PT-2
Done by: marah Al-Hilou
Supervised by: Dr. Nader Alaridah

2. DIENTAMOEBA FRAGILIS
General characteristics:
• It has no cyst stage (only trophozoite), hence the name “fragilis”
• Broad hyaline pseudopodia; progressive movement
• Two (usually i.e., 80%) or one nuclei, each nucleus has 4-8 chromatin
granules (Large fragmented karyosome)
• No peripheral membrane chromatin
• RBCs are rarely ingested

3. Life cycle:
Location in host: large intestine, could lead to diarrhea or other mild
intestinal symptoms (The most common symptoms appear to be
intermittent diarrhea and fatigue)
Definitive host: human
Intermediate host: not present
Infective & diagnostic stage: trophozoite
Disease: diantamoebiasis

5. Laboratory diagnosis:
• Sample: stool
1. Routine methods:
– diagnosis depends on proper collection and processing techniques (a
minimum of three fecal specimens).
– permanent stained smears of stool are examined with an oil immersion
objective (x100)
– Organisms seen in direct wet mounts may appear as refractile, round
forms & the nuclear structure cannot be seen without examination of the
permanent stained smear.
– Stained with Trichrome
2N TROPHOZOITE 1N TROPHOZOITE

6. 2.Antigen detection:
– fecal immunoassays for antigen detection are not yet available
commercially.
– Detection of deoxyribonucleic acid (DNA) from feces also is being used
in some labs.
3. Antibody Detection:
– serum samples from patients with confirmed infections showed positive
titers On indirect immunofluorescence assay. However, these tests are
not routinely used.

7. treatment:
– Tetracycline, iodoquinol, or paromomycin. (& metronidazole, as
mentioned on CDC)
Prevention:
– if transmission occurs from ingestion of certain helminth eggs, to
prevent contamination with fecal material, the appropriate prevention
requirements are hygiene and sanitary measures

8. TRICHOMONAS SPP
1. Trichomonas hominis,
2. Trichomonas vaginalis,
3. Trichomonas tenax (also known as trichomonas buccalis)
The 3 spp commonly lack a cyst stage and have an undulating
membrane.

9. General characteristics:
• considered nonpathogenic (doesn’t cause disease) and noninvasive
• Presence indicates exposure to fecal contamination
• has both an axostyle and an undulating membrane which extends the
entire length of the body
• Has an anterior nucleus, 4 anterior flagella &1 flagellum that lines the
undulating membrane and becomes free at posterior end
• Jerky, nondirectional movement
1. TRICHOMONAS HOMINIS
“Pentatrichomonas hominis”

10. Life cycle:
Location in host: lives in the large intestine (cecum) and feeds on
bacteria
Definitive host: human
Intermediate host: not present
Infective & Diagnostic stage: trophozoite
Disease: nonpathogenic

11. Laboratory diagnosis:
• Sample: Stool, for trophozoite detection. Best
by direct wet mount of fresh stool (shows jerky
movement)
• Trichrome stain (best; stains flagella and
axostyle)
• Iron hematoxylin stain (stains costa)
Treatment: Specific treatment is not
recommended for this nonpathogen
(metronidazole?)
Prevention: Adequate disposal of human
excreta and improved personal hygiene

12. General characteristics:
• Pathogenic, causes trichomoniasis. Disease is sexually transmitted
Usually symptomatic in females; present in vagina. While it’s
asymptomatic in males
• Only trophozoite stage
• 1 anterior nucleus.4 anterior flagella,& 1 flagellum that lines the
undulating membrane (it covers 1/2~2/3 of the length)
• Axostyle runs through the length of the organism and protrudes
posteriorly
2. TRICHOMONAS VAGINALIS
• Affects the urogenital tract

13. Life cycle:
Location in host: mucosal surface of the vagina in female, prostate gland
and the epithelium of the urethra in male
Definitive host: human
Intermediate host: not present, direct transmission by sexual contact
Infective & Diagnostic stage: trophozoite
Disease: trichomoniasis, with persistent or recurring urethritis

15. Clinical features:
Females:
• Vaginitis with a purulent discharge (prominent symptom)
• frequent urination & dysuria (painful urination), Urethritis
• Vulvar and cervical lesions
• Abdominal pain
Males:
• Frequently asymptomatic. Occasionally, urethritis, & prostatitis can occur

16. Laboratory diagnosis:
Samples:
• Females: Vaginal and urethral secretions
• Males: Urethral or prostatic secretions (or centrifuged urine from both
genders)
1. Wet mounts: must be performed within 10 to 20 minutes after sample
collection; if not, organisms lose motility and may not be identified
(Relatively insensitive).
2. Stained smears: Giemsa or Papanicolaou stain can be used.
3. Culture: most sensitive method, but results are available within 5 days
4. Antigen detection: Direct immunofluorescent antibody staining is more
sensitive than wet mounts
5. Molecular methods: by use of PCR

17. • Treatment: Metronidazole for both sexual partners

18. 3. TRICHOMONAS TENAX
General characteristics:
• Also known as trichomonas buccalis.
• Considered nonpathogenic (harmless commensal)
• Lives in the mouth between teeth and gum
• Only trophozoite form
• Resembles Trichomonas vaginalis but is smaller in size
• Has 4 anterior & 1 posterior flagellum
• Transmitted orally, by kissing, or sharing eating or drinking utensils

20. Laboratory diagnosis:
• Sample: sputum, usually examined as a wet mount (mouth
scraping could also be used as a sample)
Prevention: adequate oral hygiene is recommended

21. RETORTAMONAS INTESTINALIS
General characteristics:
• Nonpathogenic flagellate found in the large intestine.
• Has both trophozoite and cyst forms
• Trophozoite: possess two flagella, one directed anteriorly and one
extending posteriorly
• has jerky movement
• Least frequently encountered
trophozoite
cyst

22. Life cycle:
Location in host: lives in the large intestine
Definitive host: human
Intermediate host: not present
Infective stage: cyst
Diagnostic stage: trophozoite & cyst
Disease: nonpathogenic

24. Laboratory diagnosis:
• Identification is best accomplished by direct wet mounts of freshly
produced stool, R. intestinalis trophozoites exhibit rapidly directional
corkscrew motility
• These protozoa may also be identified in permanent stained smears,
using trichrome stains
Prevention: Adequate disposal of human excreta and improved
personal hygiene