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PHYLUM




NOW KNOWN AS




     Presented by:
Raissa Tutanes Guldam
       BSMT-IV
Objectives:

At the end of the lecture, you should be able to at
least learn the:
  Parasite Biology
  Pathogenesis and Clinical
    Manifestations
  Diagnosis
  Treatment
  Prevention & Control
SPOROZOANS

 Sarcocystis spp. (hominis, suihominis &
    lindemanni)
   Cryptosporidia spp. (parvum)
   Eimeria spp.
   Isospora spp. (hominis & belli)
   Plasmodium spp. ( falciparum, vivax, malariae &
    ovale)
   Toxoplasma gondii
SPOROZOANS (contd.)
           *General    Characteristics*

 Tissue parasites
 Obligate parasites
 Have no definite organelle for locomotion
 Have complex life cycle with alternating sexual
 and asexual generations

 Asexual – schizogony – schizogonic cycle
 Sexual – sporogony – sporogonic cycle

    Female  – macrogametes
    Male - microgametes
A. SARCOCYSTIS SPP.

S. HOMINIS, S. SUIHOMINIS, &
      S. LINDEMANNI
General Characteristics

 Infect humans (DH) and animals (IH)
 Sarcosporidiosis or sarcocystosis - infection
 Spread throughout various organs and tissues


 MOT – ingestion of uncooked or undercooked
    meat containing the SARCOCYSTS

 Infective Stage: Human – SARCOCYSTS
                   IH - SPOROCYSTS
Parasite Biology

 Zoite – simplest form
 Banana-shaped cell
 Pointed end – equipped for entering the host cells
 Sporocyst = 4 zoites  sporozoites
 Sarcocyst = formed from sporozoites


 Asexual cycle – occurs in IH
 Sexual cycle – occurs in DH
Parasite Biology (contd.)

             S. hominis      S. suihominis
  IH             cattle           swine
  DH            human            human
Sporocyst        bigger          smaller
  Effect       Intestinal       Intestinal
             sarcocystosis    sarcocystosis
Sarcocystis
 hominis
Pathology & Clinical Manifestation

 Gastroenteritis with diarrhea
 Eosinophilic enteritis
 Myalgia
 Weakness
 Mild increase of creatine kinase
Diagnosis

 Fecal flotation method – sporocysts
   9-16um in length

   Oblong or cylindrical

   4 long teardrop-shaped sporozoites



 Western blot
 IFA and ELISA
Treatment & Prevention

 No effective treatment is known
 Corticosteroid – treat muscular inflammation
 Trimethoprim-sulfamethoxazole – treat
 intestinal infections

 “Cook the meat well before eating!!!”
B. CRYPTOSPORIDIA SPP.

       C. PARVUM
       C. HOMINIS
Parasite Biology

 Cryptosporidiosis – infection
 Causes severe diarrhea (immunocompromised)
    and transient diarrhea (healthy persons)
   Water-borne transmission – is the most
    common source of this infection
   MOT: ingestion of oocysts
   IS: oocysts containing sporozoites
   1 oocyst = 4 sporozoites
   Oocyst = 4 to 5 um
                      Watch this!
Pathogenesis & Clinical Manifestations

 Self-limiting diarrhea
 Abdominal pain
 Anorexia
 Fever
 Weight loss
Diagnosis

 Intestinal biopsy – identification of organism
 Duodenal string test (Enterotest) – to recover
    oocysts
   Zinc Sulfate Centrifugal Flotation Technique
   Sheather’s Sugar Flotation Procedure
   Formalin-Ethyl Acetate Sedimentation
   Acid-fast Stain – red-pink doughnut-shaped
    circular in blue background (quickest and
    cheapest method)
Cryptosporidia spp.
Treatment & Prevention

 Nitazoxanide – effective
 Paromomycin         treat
 Clarithromycin      diarrhea
 Azithromycin
 Spiramycin


   “Multiple disinfectant & water treatment
                     process”
C. Toxoplasma gondii

  A PARASITE OF COSMOPOLITAN
         DISTRIBUTION
General Characteristics

 House Cat – definitive host
 MOT – consumption or handling of infected
  meat or from contact with cat feces
 IS – oocysts
 Cysts – found in muscles and CNS



Watch the video here   I’m cute but
                         deadly!!!
Parasite Biology

 Oocyst = 2 sporocysts, each encloses
              4 sporozoites
             (passed in the feces)
      Similarin appearance to those
       of Isospora belli but smaller



 Trophozoites – found in the mesenteric lymph nodes
 and other organs of the cat
    Tachyzoites – multiply quickly and spread the infection
    Bradyzoites – slow-developing and form cysts
Toxoplasma
  gondii
Pathogenesis & Clinical Manifestations

 Toxoplasmosis – commonly asymptomatic
 Cysts – can be found in the brain, skeletal and heart
  muscles, and retina
 Encephalitis, myocarditis & focal pneumonia –
  immunocompromised
 Stillbirth & abortion – 1st trimester of pregnancy
 Congenital toxoplasmosis
Diagnosis

 Examination of tissue imprints stained with Giemsa
 Sabin-Feldman methylene blue dye test –
    detect Ab against T. gondii
   Biopsy
   PCR
   ELISA
   Latex Agglutination Test
Treatment & Prevention

 Pyrimethamine + sulfadiazine – for 1 month
     -To keep under control but do not kill it


 Cook food well
 Pregnant women should avoid contact with cats
 Avoid unpasteurized milk
D. EIMERIA SPP.

RESPONSIBLE FOR THE POULTRY DISEASE
           COCCIDIOSIS
General Characteristics

 4 sporocysts , each containing 2 sporozoites
 Causes bloody diarrhea


 E. tenella
 E. maxima
 E. necatrix
 E. fraterculae
Eimeria spp.
E. ISOSPORA SPP.

   ISOSPORA HOMINIS
     ISOSPORA BELLI



     ISOSPORIASIS
Isospora hominis

 Host: men
 Vector: Dog
 MOT: Ingestion of mature oocyst
 Symptoms:
   Stomach pain

   Diarrhea

   Steatorrhea

   Anorexia

   Fever
General Characteristics

                              I. hominis              I. belli
     Other name          Cytospermium hominis     Cytospermium
                                                   intestinalis
    Oocyst shape                Oblong                papaya
        Layer                Double-layer            One layer
Presence of microphyle            yes                    no
      sporocysts                   2                     2
     sporozoites                   4                     4
        Host                      Men                   Men
        MOT                Ingestion of oocyst   Ingestion of oocyst
Isospora
  spp.
F. PLASMODIA SPP.

   THE GENUS THAT CAUSES




    MALARIA
MALARIA
 Is still considered the most important parasitic
  disease affecting man, responsible for 1.5 to 2.7
  million deaths annually
 One of the three major infectious disease threats,
  along with HIV and tuberculosis (WHO)
 Transmitted by the bite of an infected female
  Anopheles mosquito
 A protozoan disease caused by members of the
  genus Plasmodium characterized by recurring
  fever, chills and sweats.
MALARIA          (contd.)


 P. falciparum   responsible for over 90%
 P. vivax        of all the cases of human malaria
 P. ovale
 P. malariae


 Pigment producers – malarial parasites feed on
  Hgb
 Ameboid in shape
Parasite Biology

     Asexual Cycle              Sexual Cycle
       Human (IH)          Anopheles mosquito (DH)
 Schizogony  merozoites   Sporogony  sporozoites
Gametogony  gametocytes


 MOT: bite of vectors & blood transfusion
Parasite Biology (contd.)

• life cycles of all four human species of malaria are
  similar
• sporozoites – infective stage to human
         • Injected to human and carried to the liver

• Merozoites – enter the rbc
        - Develop into microgametocytes (male) and
         macrogametocytes (female) which are picked up by the
         mosquito for completion of the cycle
• Hypnozoites – produced by P. vivax and P. ovale ;
                    resting stage
• Trophozoites – developed in the rbc
Exo-erythrocytic Stage

 sporozoites
     enters hepatocytes of liver
 schizonts
     dividing forms of liver stages
 merozoites
     are released by hepatocytes
 hypnozoites
     resting liver stages
Blood Stages

 merozoites
     enter erythrocytes
 trophozoites
     feeding and growing stages
     in red cells
 schizonts
     multinuclear stages
     in red cells
 gametocytes
     sexual blood stages
1. early trophozoite
 2. early trophozoite (double infection)
 3. early trophozoite double chromatin with a few Maurer's dots
4. late throphozoite with Maurer's dots and crenated red cell
5. Mature schizont with merozoites and clumped pigment
6. macrogametocyte with bluish cytoplasm and compact chromatin
7. microgametocyte with pinkish cytoplasm and dispersed
chromatin.
             Watch the life cycle
Pathogenesis & Clinical Manifestations

                    P.         P.vivax          P. ovale      P. malariae
               falciparum
Other name     Malignant     Benign tertian   Ovale malaria     Quartan
               tertian or       malaria                         malaria
               subtertian
                malaria
 Pre-patent     11-14 days     11-15 days      14-26 days      3-4 weeks
   period
 Incubation     8-15 days     12-20 days       11-16 days     18-40 days
   period
Erythrocytic    48 hours       48 hours         48 hours       72 hours
   Cycle
 Chromatin      Maurer’s      Schuffner’s      Schuffner’s     Zieman’s
    dots       (coarse red     (fine red
                granules)      granules)
P.         P.vivax       P. ovale      P. malariae
              falciparum
trophozoite   Ring & comma   Signet-ring      Ring to      Band form
                  forms         shape        rounded
gametocytes     Banana-         Oval          Round         Round
                shaped
Merozoites        8-40         12-24          14-16          6-12
 Schizont      Single dark   Loose mass    Concentrated   concentrated
 pigment          mass                        mass
Pathogenesis & Clinical Manifestations (contd.)

 Regular Paroxysms of fever with asymptomatic
  intervals
 Prodromal symptoms
    Weakness and exhaustion
    Desire to stretch and yawn
    Aching bones, limbs and back
    Loss of appetite
    Nausea and vomiting
    Sense of chilliness
    Malaise
    Diarrhea
    Epigastric discomfort
3 Stages of Classical Malaria Paroxysm

 Cold Stage                              Pressure goes down
     Chilling                            Intense headache
     Loss of appetite                    Dry skin which lasts for 2-4 hours
     Goose flesh
     Convulsion of children which    Sweating Stage
      lasts for 1-2 hours                 Profuse sweating
     Temp. Is going up                   Gradually, temp. Goes down
                                          Less intense headache which lasts
 Hot Stage                                for 2-5 hours
     Sensation of great heat             Patient feels exhausted until falls
     Restlessness                         asleep
     Pulse is full and pounding
     Vomiting
Diagnosis

 Thick and thin blood smears – “gold standard”
 Quantitative Buffy Coat (QBC) Method – screening
 RDT = Immunochromatographic Methods – detect
  Plasmodium Ag
 Serologic Tests – IHA, IFAT, ELISA and PCR
Diagnostic Points
1. Red Cells are not
enlarged.
2. Rings appear fine and
delicate and there may be
several in one cell.
3. Some rings may have two
chromatin dots.
4. Presence of marginal or
applique forms.
5. It is unusual to see
developing forms in
peripheral blood films.
6. Gametocytes have a
characteristic crescent
shape appearance.
However, they do not
usually appear in the blood
for the first four weeks of
infection.
7. Maurer's dots may be
present.
Diagnostic Points

1. Red cells containing
    parasites are
    usually enlarged.

2. Schuffner's dots are
frequently present in
the red cells as shown
above.

3. The mature ring
forms tend to be large
and coarse.

4. Developing forms
are frequently
present.
Diagnostic Points
1. Ring forms may have a squarish appearance.
2. Band forms are a characteristic of this species.
3. Mature schizonts may have a typical daisy head appearance with up to ten merozoites.
4. Red cells are not enlarged.
5. Chromatin dot may be on the inner surface of the ring.
Diagnostic
Points
1. Red cells
   enlarged.

2.Comet forms
common (top
right).

3. Rings large
and coarse.

4. Schuffner's
dots, when
present, may be
prominent.

5. Mature
schizonts similar
to those of P.
malariae but
larger and more
coarse
Treatment & Prevention

 Chloroquine – treatment of choice
 Sulfadoxine-pyrimethamine or quinine – alternative
  for chloroquine-resistant
 Artemisinin and derivatives


 Use mosquito nets
 Use insect repellants
 Wear light-colored clothing
Thanks for listening! 

      ANY QUESTION?

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Sporozoa

  • 1. PHYLUM NOW KNOWN AS Presented by: Raissa Tutanes Guldam BSMT-IV
  • 2. Objectives: At the end of the lecture, you should be able to at least learn the: Parasite Biology Pathogenesis and Clinical Manifestations Diagnosis Treatment Prevention & Control
  • 3. SPOROZOANS  Sarcocystis spp. (hominis, suihominis & lindemanni)  Cryptosporidia spp. (parvum)  Eimeria spp.  Isospora spp. (hominis & belli)  Plasmodium spp. ( falciparum, vivax, malariae & ovale)  Toxoplasma gondii
  • 4. SPOROZOANS (contd.) *General Characteristics*  Tissue parasites  Obligate parasites  Have no definite organelle for locomotion  Have complex life cycle with alternating sexual and asexual generations  Asexual – schizogony – schizogonic cycle  Sexual – sporogony – sporogonic cycle  Female – macrogametes  Male - microgametes
  • 5. A. SARCOCYSTIS SPP. S. HOMINIS, S. SUIHOMINIS, & S. LINDEMANNI
  • 6. General Characteristics  Infect humans (DH) and animals (IH)  Sarcosporidiosis or sarcocystosis - infection  Spread throughout various organs and tissues  MOT – ingestion of uncooked or undercooked meat containing the SARCOCYSTS  Infective Stage: Human – SARCOCYSTS  IH - SPOROCYSTS
  • 7. Parasite Biology  Zoite – simplest form  Banana-shaped cell  Pointed end – equipped for entering the host cells  Sporocyst = 4 zoites  sporozoites  Sarcocyst = formed from sporozoites  Asexual cycle – occurs in IH  Sexual cycle – occurs in DH
  • 8.
  • 9. Parasite Biology (contd.) S. hominis S. suihominis IH cattle swine DH human human Sporocyst bigger smaller Effect Intestinal Intestinal sarcocystosis sarcocystosis
  • 11. Pathology & Clinical Manifestation  Gastroenteritis with diarrhea  Eosinophilic enteritis  Myalgia  Weakness  Mild increase of creatine kinase
  • 12. Diagnosis  Fecal flotation method – sporocysts  9-16um in length  Oblong or cylindrical  4 long teardrop-shaped sporozoites  Western blot  IFA and ELISA
  • 13. Treatment & Prevention  No effective treatment is known  Corticosteroid – treat muscular inflammation  Trimethoprim-sulfamethoxazole – treat intestinal infections  “Cook the meat well before eating!!!”
  • 14. B. CRYPTOSPORIDIA SPP. C. PARVUM C. HOMINIS
  • 15. Parasite Biology  Cryptosporidiosis – infection  Causes severe diarrhea (immunocompromised) and transient diarrhea (healthy persons)  Water-borne transmission – is the most common source of this infection  MOT: ingestion of oocysts  IS: oocysts containing sporozoites  1 oocyst = 4 sporozoites  Oocyst = 4 to 5 um Watch this!
  • 16.
  • 17. Pathogenesis & Clinical Manifestations  Self-limiting diarrhea  Abdominal pain  Anorexia  Fever  Weight loss
  • 18. Diagnosis  Intestinal biopsy – identification of organism  Duodenal string test (Enterotest) – to recover oocysts  Zinc Sulfate Centrifugal Flotation Technique  Sheather’s Sugar Flotation Procedure  Formalin-Ethyl Acetate Sedimentation  Acid-fast Stain – red-pink doughnut-shaped circular in blue background (quickest and cheapest method)
  • 20. Treatment & Prevention  Nitazoxanide – effective  Paromomycin treat  Clarithromycin diarrhea  Azithromycin  Spiramycin  “Multiple disinfectant & water treatment process”
  • 21. C. Toxoplasma gondii A PARASITE OF COSMOPOLITAN DISTRIBUTION
  • 22. General Characteristics  House Cat – definitive host  MOT – consumption or handling of infected meat or from contact with cat feces  IS – oocysts  Cysts – found in muscles and CNS Watch the video here I’m cute but deadly!!!
  • 23.
  • 24. Parasite Biology  Oocyst = 2 sporocysts, each encloses 4 sporozoites (passed in the feces)  Similarin appearance to those of Isospora belli but smaller  Trophozoites – found in the mesenteric lymph nodes and other organs of the cat  Tachyzoites – multiply quickly and spread the infection  Bradyzoites – slow-developing and form cysts
  • 26. Pathogenesis & Clinical Manifestations  Toxoplasmosis – commonly asymptomatic  Cysts – can be found in the brain, skeletal and heart muscles, and retina  Encephalitis, myocarditis & focal pneumonia – immunocompromised  Stillbirth & abortion – 1st trimester of pregnancy  Congenital toxoplasmosis
  • 27. Diagnosis  Examination of tissue imprints stained with Giemsa  Sabin-Feldman methylene blue dye test – detect Ab against T. gondii  Biopsy  PCR  ELISA  Latex Agglutination Test
  • 28. Treatment & Prevention  Pyrimethamine + sulfadiazine – for 1 month -To keep under control but do not kill it  Cook food well  Pregnant women should avoid contact with cats  Avoid unpasteurized milk
  • 29. D. EIMERIA SPP. RESPONSIBLE FOR THE POULTRY DISEASE COCCIDIOSIS
  • 30. General Characteristics  4 sporocysts , each containing 2 sporozoites  Causes bloody diarrhea  E. tenella  E. maxima  E. necatrix  E. fraterculae
  • 32. E. ISOSPORA SPP. ISOSPORA HOMINIS ISOSPORA BELLI ISOSPORIASIS
  • 33. Isospora hominis  Host: men  Vector: Dog  MOT: Ingestion of mature oocyst  Symptoms:  Stomach pain  Diarrhea  Steatorrhea  Anorexia  Fever
  • 34. General Characteristics I. hominis I. belli Other name Cytospermium hominis Cytospermium intestinalis Oocyst shape Oblong papaya Layer Double-layer One layer Presence of microphyle yes no sporocysts 2 2 sporozoites 4 4 Host Men Men MOT Ingestion of oocyst Ingestion of oocyst
  • 36. F. PLASMODIA SPP. THE GENUS THAT CAUSES MALARIA
  • 37. MALARIA  Is still considered the most important parasitic disease affecting man, responsible for 1.5 to 2.7 million deaths annually  One of the three major infectious disease threats, along with HIV and tuberculosis (WHO)  Transmitted by the bite of an infected female Anopheles mosquito  A protozoan disease caused by members of the genus Plasmodium characterized by recurring fever, chills and sweats.
  • 38. MALARIA (contd.)  P. falciparum responsible for over 90%  P. vivax of all the cases of human malaria  P. ovale  P. malariae  Pigment producers – malarial parasites feed on Hgb  Ameboid in shape
  • 39. Parasite Biology Asexual Cycle Sexual Cycle Human (IH) Anopheles mosquito (DH) Schizogony  merozoites Sporogony  sporozoites Gametogony  gametocytes MOT: bite of vectors & blood transfusion
  • 40. Parasite Biology (contd.) • life cycles of all four human species of malaria are similar • sporozoites – infective stage to human • Injected to human and carried to the liver • Merozoites – enter the rbc  - Develop into microgametocytes (male) and macrogametocytes (female) which are picked up by the mosquito for completion of the cycle • Hypnozoites – produced by P. vivax and P. ovale ; resting stage • Trophozoites – developed in the rbc
  • 41. Exo-erythrocytic Stage  sporozoites enters hepatocytes of liver  schizonts dividing forms of liver stages  merozoites are released by hepatocytes  hypnozoites resting liver stages
  • 42. Blood Stages  merozoites enter erythrocytes  trophozoites feeding and growing stages in red cells  schizonts multinuclear stages in red cells  gametocytes sexual blood stages
  • 43. 1. early trophozoite 2. early trophozoite (double infection) 3. early trophozoite double chromatin with a few Maurer's dots 4. late throphozoite with Maurer's dots and crenated red cell 5. Mature schizont with merozoites and clumped pigment 6. macrogametocyte with bluish cytoplasm and compact chromatin 7. microgametocyte with pinkish cytoplasm and dispersed chromatin. Watch the life cycle
  • 44.
  • 45. Pathogenesis & Clinical Manifestations P. P.vivax P. ovale P. malariae falciparum Other name Malignant Benign tertian Ovale malaria Quartan tertian or malaria malaria subtertian malaria Pre-patent 11-14 days 11-15 days 14-26 days 3-4 weeks period Incubation 8-15 days 12-20 days 11-16 days 18-40 days period Erythrocytic 48 hours 48 hours 48 hours 72 hours Cycle Chromatin Maurer’s Schuffner’s Schuffner’s Zieman’s dots (coarse red (fine red granules) granules)
  • 46. P. P.vivax P. ovale P. malariae falciparum trophozoite Ring & comma Signet-ring Ring to Band form forms shape rounded gametocytes Banana- Oval Round Round shaped Merozoites 8-40 12-24 14-16 6-12 Schizont Single dark Loose mass Concentrated concentrated pigment mass mass
  • 47. Pathogenesis & Clinical Manifestations (contd.)  Regular Paroxysms of fever with asymptomatic intervals  Prodromal symptoms  Weakness and exhaustion  Desire to stretch and yawn  Aching bones, limbs and back  Loss of appetite  Nausea and vomiting  Sense of chilliness  Malaise  Diarrhea  Epigastric discomfort
  • 48. 3 Stages of Classical Malaria Paroxysm  Cold Stage  Pressure goes down  Chilling  Intense headache  Loss of appetite  Dry skin which lasts for 2-4 hours  Goose flesh  Convulsion of children which  Sweating Stage lasts for 1-2 hours  Profuse sweating  Temp. Is going up  Gradually, temp. Goes down  Less intense headache which lasts  Hot Stage for 2-5 hours  Sensation of great heat  Patient feels exhausted until falls  Restlessness asleep  Pulse is full and pounding  Vomiting
  • 49. Diagnosis  Thick and thin blood smears – “gold standard”  Quantitative Buffy Coat (QBC) Method – screening  RDT = Immunochromatographic Methods – detect Plasmodium Ag  Serologic Tests – IHA, IFAT, ELISA and PCR
  • 50. Diagnostic Points 1. Red Cells are not enlarged. 2. Rings appear fine and delicate and there may be several in one cell. 3. Some rings may have two chromatin dots. 4. Presence of marginal or applique forms. 5. It is unusual to see developing forms in peripheral blood films. 6. Gametocytes have a characteristic crescent shape appearance. However, they do not usually appear in the blood for the first four weeks of infection. 7. Maurer's dots may be present.
  • 51. Diagnostic Points 1. Red cells containing parasites are usually enlarged. 2. Schuffner's dots are frequently present in the red cells as shown above. 3. The mature ring forms tend to be large and coarse. 4. Developing forms are frequently present.
  • 52. Diagnostic Points 1. Ring forms may have a squarish appearance. 2. Band forms are a characteristic of this species. 3. Mature schizonts may have a typical daisy head appearance with up to ten merozoites. 4. Red cells are not enlarged. 5. Chromatin dot may be on the inner surface of the ring.
  • 53. Diagnostic Points 1. Red cells enlarged. 2.Comet forms common (top right). 3. Rings large and coarse. 4. Schuffner's dots, when present, may be prominent. 5. Mature schizonts similar to those of P. malariae but larger and more coarse
  • 54. Treatment & Prevention  Chloroquine – treatment of choice  Sulfadoxine-pyrimethamine or quinine – alternative for chloroquine-resistant  Artemisinin and derivatives  Use mosquito nets  Use insect repellants  Wear light-colored clothing
  • 55. Thanks for listening!  ANY QUESTION?