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Common Name Name

Disease

Life Cycle

Balantidium coli

Balantidiasis, balantidial dysentery

Balantidiasis

B. coli is a tissue invader and its infective stage is the cyst. Once the cyst is ingested via fecescontaminated food or water, it passes through the host digestive system. The mucosa and submucosa of the large intestine are invaded and destroyed by the multiplying organism. Excystation produces a trophozoite from the cyst stage. Trophozoites are abundant in the exudates on the mucosal surfaces while the inflammatory cells and trophozoites are numerous in the base of ulcers. Secondary bacterial infection of these ulcers result in the formation of abscesses The supposed life cycle begins with ingestion of the cyst form. After ingestion, the cyst develops into other forms which may in turn re-develop into cyst forms. Through human feces, the cyst forms enter the external environment and are transmitted to humans and other animals via the fecal-oral route, repeating the entire cycle

Morpholo gyof Cyst and Trophozoi te Cysts: has 2 nuclei (macro and micronucle us) Trophozoit e: has 2 contractile vacuoles w/ cilia around the cell

Diagnostic Tool

Treatment

The diagnosis of Balantidiasis can be an intricate process, partly because the related symptoms may or may not be present. However, the diagnosis of Balantidiasis can be considered when a patient has diarrhea combined with a probable history of current exposure to amebiasis through travel, contact with infected persons, or anal intercourse. In addition, the diagnosis of Balantidiasis can be made by microscopic examination of stool or tissue samples.

Balantidiasis can be treated with tetracycline, carbarsone, metr onidazole, or diiodohydroxyq uin

Blastocystis hominis

Blastocystis

Inflammatory Bowel disease

Vacuolar, granular, ameboid and cyst forms

Diagnosis is performed by determining if the infection is present, and then making a decision as to whether the infection is responsible for the symptoms. Diagnostic methods in clinical use have been reported to be of poor quality and more reliable methods have been reported in research papers

There is a lack of scientific study to support the efficacy of any particular treatment. Physicians have described the successful use of a variety of discontinued antiprotozoals in treatment of Blastocystis infection. Emetine was reported as successful in cases in early 20th century with British soldiers who contracted Blastocystis infection while serving in Egypt

Chilomastix mesnili

C. mesnili

A cyst forms within the intestine. Cyst or trophozoite combines with fecal stream. Whole cyst reaches water or soil. Cyst is consumed via contaminated water or food. Trophozoites are released from out of the cyst into the intestinal environment. Chilomastix then multiply through nuclear division.

Cysts: 5- Microscopic 10um and examination oval stools Trophozoit e: 5-25um pear shaped and motile

of

Cryptosporodium parvum

Cryptosporodiu m
Cryptosporidiasis, a diarrheal disease is characterized by watery diarrhea, nausea and vomiting, dehydration, abdominal cramps and fever. Symptoms usually resolve in 2-4 weeks in immunocompetent hosts. Cryptosporidiosis can also manifest as pulmonary or tracheal disease, causing cough and fever. However, these patients also manifest with the intestinal component of the disease. The type I schizont produces zoites that can produce either type I or type II schizonts, thus the parasite can undergo continuous asexual reproduction as type I schizonts. Type II schizonts produce zoites which develop into gametocytes. Sporulated oocysts leave the cells and most of them pass out with the feces. However, some of the oocysts will excyst in the intestine invade cells and begin the life cycle over.

The oocyst in the stool is ovoid or spherical measuring 3 4 micra and contains four naked sporozoites , which is the infective stage.

There are many diagnostic tests for Cryptosporidium. They include microscopy, staining, and detection of antibodies. Fecal flotation . It may be very difficult to identify the oocysts. Acid Fast Stain of a Direct Smear to identify oocysts. Polymerase chain reaction (PCR) is another way to diagnose cryptosporidiosis. It can even identify the specific species of Cryptosporidium.

There is no reliable treatment for cryptosporidium enteritis; certain agents such as paromomycin, atovaq uone, nitazoxanide and azithromycin are sometimes used, but they usually have only temporary effects. Treatment is primarily supportive. Fluids need to be replaced orally.

Dientamoeba fragilis

parasites which can at times infect the human digestive tract. Many of those infected are asymptomatic carriers. These parasites can, however, be associated with a range of gastrointestinal symptoms including diarrhoea/constipation, mushy stools, abdominal discomfort, bloating, gas

The life cycle of this parasite has not yet been completely determined, but some assumptions have been made based on clinical data. Recently a cyst stage has been reported, although it is yet to be independently confirmed. If true, D. fragilis is probably transmitted by the fecaloral route. Prior to the

The small, round trophozoite measures 5 12 micron and is provided with two nuclei. The

The diagnosis of parasites is usually diagnosed by identifying the cyst form in the stool. Cysts on average every four to eight days excreted and therefore are not always present in stool in unusual cases, the cysts even once every twenty

Treatments reported to be successful for dientamoebiasis include carbarsone, diphetarsone, tetracyclines, paromomycin, erythromycin, hydroxyquinolines and the 5-nitroimidazoles, including metronidazole, secnidazole, tinidazole and ornidazole

and pain. Other symptoms may include nausea, vomiting, headaches, dizziness, weight-loss, chronic fatigue, depression, lowgrade fever, bloody stools and anal itching

Entamoeba coli

E. Coli

It is not harmful and lives in the GI Tract of humans

report of this cyst stage in the life cycle of Dientamoeba it was postulated that transmission occurred via helminth eggs The rationale for this suggestion was that D. fragilis is closely related to the turkey parasite Histomonas, which is known to be transmitted via the eggs of the helminth Heterakis. A host ingests cysts through feces and raptures producing amoebae. The amoeba, which reproduces by binary fission, enters the large intestines crypts and feeds on the mucosa causing ulcers

pseudopod ia are blunt and leaflike and the movement is sluggish.

days and then it becomes very difficult to find them. A single analysis is not sufficient, and if nothing is found, the laboratory repeated several times.

Cysts: 8-40 um contains 18 nuclei

It is not harmful and lives in the GI Tract of humans

Entamoeba Gingivalis Entamoeba histolytica

E. Gingivalis

Gingivitis

Trophozoites oral cavity residing in pockets near the teeth

live in the of humans, the gingival the base of

Trophozoit e: 10-60um, motile with pseudopod s Same as Fine Needle Antibiotics E. Apiration histolytica
Cyst: 8-22 um, fully mature cysts contain 4 nuclei Trophozoite: motile with pseudopods

A host ingests cysts through feces and raptures producing amoebae. The amoeba, which reproduces by binary fission, enters the large intestines crypts and feeds on the mucosa causing ulcers

Amoeba

Extraintestinal amoebiasis

Cysts are the infective stage when digested. Excystation occurs during transit through the gut

The presence intracellular RBCs intestinal amebae considered diagnostic of histolytica

of in is E.

two antibiotics. The preferred drugs are metronidazole or tinidazole immediately followed with paromomycin, diloxanide furoate or iodoquinol. Asymptomatic intestinal amoebiasis is treated with paromomycin, diloxanide furoate or iodoquinol

Giardia Intestinalis

Giardia lamblia

Giardiasis

Excystation occurs in the large intestines and cysts will pass in the host

Cysts: 12um long, 8um wide oval shaped Trophozoite: 15um long, 10um wide motile pear shaped

Micrscopic examination stools

Nitroimidazole of agents (ex. Metronidazole, tinidazole,etc)

Plasmodium falciparum

Malaria

Infection with malaria parasites may result in a wide variety of symptoms, ranging from absent or very mild symptoms to severe disease and even death. Malaria disease can be categorized as uncomplicated or seve re. In general, malaria is a curable disease if diagnosed and treated promptly and correctly

Malaria is carried by Anopheles mosquitoes. Of the over 400 Anopheles species, only 3040 can transmit malaria. The infection starts, when a female mosquito injects "sporozoites" into human skin while taking a blood meal. A sporozoite travels into the liver where it invades a liver cell. It matures into a "schizont" which produces 3000040000 "merozoites" within six days. The merozoites burst out and invade red blood cells. Within two days one merozoite transforms into a trophozoite, then into a schizont and finally 824 new merozoites burst out from the schizont and the red cell as it ruptures. Then the merozoites invade new red cells. P. falciparum can prevent an infected red cell from going to the spleen (the organ where old and damaged red cells are destroyed) by sending adhesive proteins to the cell membrane of the red cell. The proteins make the red cell to stick to small blood vessel walls. This poses a threat for the human host since the

Some general characteristics are common to all malarial parasites, but differential features make it possible to identify species. The earliest form after invasion of red blood cells is a ring of bluish cytoplasm with a dot like nucleus of red chromatin and this is the trophic stage. When growing, the parasites divides, it is called a schizont, showing multiple masses of nuclear chromatin. Merozoites are observed in mature schizont. Some of the trophozoites develop into gametocytes or sexual stages,

Malaria is usually diagnosed by examining a blood sample under a microscope. There are also test kits that detect antigens of P. falciparum in the patient's blood. These immunologic tests are known as rapid diagnostic tests. RDTs can detect two different malaria antigens, one for P. falciparum and the other is found in all four human malaria species. RDTs usually show results in about 20 minutes. It is a good alternative to microscopy, when reliable microscopic diagnosis cannot be done. RDT might not detect some infections, if there are not enough malaria parasites in the patients blood. A negative RDT result can be followed up by microscopy. If a patient with positive RDT result is not responding to treatment, another blood sample should be taken. This time

Taking into account the pharmacokinetic and pharmacodynamic properties of the various anti-malarial agents, artemisinin-based combination therapy (ACT) seems to be the best option. This strategy should be used in conjunction with early diagnosis and appropriate vector control measures to achieve reduction in the emergence and spread of drug resistance.

clustered red cells might create a blockage in the circulation system.

which are differentiated by compact cytoplasm and the absence of nuclear division. Some general characteristics are common to all malarial parasites, but differential features make it possible to identify species. The earliest form after invasion of red blood cells is a ring of bluish cytoplasm with a dot like nucleus of red chromatin and this is the trophic stage. When growing, the parasites divides, it is called a schizont, showing multiple masses of nuclear chromatin. Merozoites are observed in mature schizont. Some of the trophozoites develop into gametocytes or sexual stages, which are differentiated by compact

using microscopy to determine whether the medicine was appropriate for the Plasmodium speci es.

Plasmodium vivax

The infection of Plasmodium vivax takes place in human when an infected female anopheles mosquito sucks blood from a healthy person. During feeding, the mosquito injects saliva to prevent blood clotting (along with sporozoites), thousands of sporozoites are inoculated into human blood; within a half-hour the sporozoites reach the liver. There they enter hepatic cells, transform into the tropozoite form and feed on hepatic cells, and reproduce asexually. This process gives rise to thousands of merozoites (plasmodium daughter cells) in the circulatory system and the liver.

The incubation period for the infection usually ranges from ten to seventeen days and sometimes up to a year. Persistent liver stages allow relapse up to five years after elimination of red blood cell stages and clinical cure.

Diagnosis can be done with the strip fast test of antibodies,

Chloroquine and primaquine have been the companion therapies of choice for the treatment of vivax malaria.

cytoplasm and the absence of nuclear division. Trichomonas Vaginalis Trich, Trichomoniasis Vaginitis Only the trophozoite stage is found in its life cycle. The trophozoite is ovoid or pearshaped, 10~305~15m in size. It has 4 anterior flagella and one posterior flagellum which turns back and is attached to the body by an undulating membrane. The undulating membrane of T. vaginalis is very short, only onehalf of its body length. There is nucleus and the axostyle project posteriorly out of the body. The motility is jerky and nondirectional The parasite forms trypomastigotes in vertebrate hosts and epimastigotes in the insect vector. The trypomastigotes (with posterior kinetoplast and long undulating membrane) are Classically, with a cervical smear, infected women have a transparent "halo" around their superficial cell nucleus. It is unreliably detected by studying a genital discharge or with a cervical smear because of their low sensitivity. T. vaginalis was traditionally diagnosed via a wet mount, in which "corkscrew" motility was observed. Currently, the most common method of diagnosis is via overnight culture, with a sensitivity range of 75-95%. Newer methods, such as rapid antigen testing and transcriptio n-mediated amplification, have even greater sensitivity, but are not in widespread use. Infections were conventionally diagnosed by the direct detection of parasites in blood, bone marrow or cerebrospinal fluid by microscopic examination before or after centrifugation. In vitro cultivation has proven difficult and in vivo inoculation into

The life cycle of T. vaginalis is simple in that the trophozoite is transmitted through coitus and no cyst form is known. The trophozoite divides by binary fission and, in natural infections, gives rise to a population in the lumen and on the mucosal surfaces of the urogenital tracts of humans.

Trichomoniasis can be cured with a single dose of prescription antibiotic medication (either metronidazole or tinidazole), pills which can be taken by mouth. It is okay for pregnant women to take this medication. Some people who drink alcohol within 24 hours after taking this kind of antibiotic can have uncomfortable side effects.

Trypanosoma brucei

African Trypanosomiasis, African Sleeping Sickness

African trypanosomiasis (sleeping sickness) is an illness endemic to subSaharan Africa. It is caused by 2 subspecies of the flagellate protozoan Trypanosoma brucei, which are transmitted to human hosts by bites of infected tsetse flies.

The infected Glossina (Tsetse fly) bites man, wherein these infected flies, metacyclic trypomastigotes passed through the salivary ducts after cyclic development in gut. After inoculation, the trypomastigotes enter the circulation and the lymphatics and they multiply by binary fission. Terminally they invade the

Historically, arsenical drugs have been used despite major toxicity problems. Melarsoprol and trypursamide are used to treat chronic infections (involving CNS signs). Other drugs have proven more effective against systemic infections (suramin, pentamidine) and neurological

CNS.

pleomorphic in size ranging from 16-42m in length by 13m in width. They occur as elongate slender dividing forms (with long free flagellum) or stumpy nondividing infective (metacyclic) forms (with no free flagellum). The epimastigotes (with anterior kinetoplast and short undulating membrane) are also variable in size ranging from 10-35m in length by 13m in width.

laboratory animals yields variable results. More recently, a variety of immunoserological tests have been developed to detect host antibodies using fluorescent, agglutination or enzyme markers. Card-agglutination and dot-spot tests are

infections (berenil, eflornithine, difluoromethylornithine).

Millan, Abram Jeremy R. 2APh 30