-UNl\lERS11Y

- -OF-JORDAN
-+ 1r
____I;_a_cu_It_y_O_"_F_M_e_d_i_c_in_e '

Mf<~o~foLo4Y

J"V ~\
vC.\
'\.
~Lf
/'
~)J
.

LECTURE NO:

DATE: C,-/\! \./ c...,

"----'-~__1 DONE BY: ~ .J \.>/) ~ ~

 Microbiology Sheet #14

From what we said in the last lecture, we discussed

the protozoa and we said something about the tissue
parasites. Also, we've talked a bit about the transmission
of disease from one person to another or from one
primary host to another primary host.

For example: The transmission of Amoeba:

The trophozoyte of Amoeba transforms itself into a

CYST that passes out through the feces and then is
ingested by other people where it resides in their
gastrointestinal tract (GIT) and establishes on infection
in the second primary host.
This transmission is said to be DIRECT of the "FECO­
ORAL" type without the necessity of an intermediate
host. On the other hand, some protozoa need an
intermediate host where there is a cycle of development
in the intermediate and primory hosts.

~Ianation:
Direct transmission ~ cyst passes from host to host
directly.
Indirect transmission ~ cyst passes from host to
intermediate host to other host, and there is a cycle of
development in the intermediate host and other hosts.
 Malaria

It is a protozoa transmitted indirectly by an

intermediate host which is a MOSQUITO (a vector) in
this case. The infected mosquito will bite somebody on
the shoulder for example and spits its saliva which
contains an anti-coagulant in order to suck the blood
without clotting. "an anti-coagulant is a substance that
prevents clotting of the blood'. This saliva contains the
malaria parasite which is injected into the blood
stream.

The life cycle of this parasite is complicated i.e

after it is injected into the blood; it goes to the liver
since it is the only place where it can develop. After
reaching the liver, it divides by BINARY FISSION.
After that it comes out of the liver to enter the blood
stream where it infects RBCs and changes its
morphology in order to adapt to the new environment.
Again, it divides by BINARY FISSION. The result will
be: destruction of the RBCs. (This is the pathology of
the malaria disease).
Actually, this life cycle will continue in the primary
host until the person is treated by drugs, dies or gets
better natura Ily.

 After a while, these parasites or some of them

change their morphology agClin and transform
themselves into gametes that vary in size inside the
RBCs. Usually, the bigger ones are female gametes and
the smaller ones are the male gametes.

These gametes stop dividing and don't do anything

until a new mosquito (uninfected) bites the carrier and
sucks his blood containing the gametes. These gametes
will enter the GIT cells of the mosquito where they will
fuse forming a zygote that will develop into an oocyst.

*Note: you don't have to memorize all these terms

because we will come back to it later in the course.
What we care for is the complicated nature of the life
cycle of these parasites.

In the GIT cells of the mosquito, two gametocytes

(one male gamete and one female gamete) will fuse and
then start dividing. This is referred to as SEXUAL
REPRODUCTION since we have a male and a female
gametes fusing and then dividing. On the contrary, the
division occurring in the primary host (LIVER and RBCs)
is an example of ASEXUAL REPRODUCTION since
there is no fusion of gametes; they are merely dividing
by BINARY FISSION into 2 then 4 then 8 and so on.
Now, this mosquito has the ability to bite someone else
and transmit the disease. (The Iifecycle storts 011 over
ogain).

3
*Summary:
There are 2 kinds of division of the parasite:
1) ASEXUAL: in the human (liver Clnd RBCs) {primary
host}.
2) SEXUAL: in the mosquito (GIT cells) {intermediate
host}.

When we consider protozoa, we have multi-cellular and

unicellular organisms that vary in size; some are very
small that are intracellular e.g: malaria parasite, and some
are bigger.
They cause all kinds of diseases, and they are grouped
into families according to certain categories. For
eXClmple: AMOEBA belongs to a family known as
RHIZOPODA.
Poda means feet, Rhizo means horizontal.
Amoeba moves by PSEUDOPODIA, that is why they are
members of the rhizopoda family.

Some other protozoa have hair-like structures on their

surfaces called CILIA. The purpose of these structures
is actually to propel the organism.
If some of you come across the structure of
paramecium under the light microscope, you will find that
it swims beautifully in water using its cilia.
Paramecium and Balantidium Coli belong to another
family called CILIATES since they have cilia.

 Others belong to a family called FLAGELLATES

because they have FLAGELLA which project from
different sites (from sides, anterior flagella or posterior
flagella).

*What about the action of diagnosis of

protozoa or the disease it causes????

We find that the diseases caused by protozoa are

more serious than the diseases caused by other parasites
such as HELMINTHS (worms), which are multi-cellular
organisms that can't divide in the body therefore their
tendency of disease will be less severe since protozoa can
divide easily in the body by binary fission.

The immune system acts on these parasites but not

necessarily all of them by eosinophils that secrete
granules containing BASIC PROTEIN that acts against
the parasite. (granules are eosinophtlic so they stain pink
in H&E stain). Usually, there is a tendency but not in all
parasitic infections to increase the number of eosinophils
especially in tissue infections, where the immune system
has the chance to mount a reaction against the parasite
by production of a large number of eosinophils.

In addition, we have the immunoglobulins (antibodies)

of the IgE type that are directed against porasites and
work in conjunction with the eosinophils.

5
 So when we check a patient we may find the eosinophil
number or the IgE rlLlmber or both raised especially when
the infection site is a tissue. Nevertheless, this doesn't
happen with luminal parasites since technically speaking
they are still in the lumen (outside the cells of the body)
so the immune system doesn't have the chance to mount a
response against these parasites.

Therefore, if you find an increased number of

eosinophils or IgE or both, you can suspect a parasitic
infection; you can know which kind of parasite by
checking the IgE since they are directed against specific
antigens present on parasites/ (each parasite has specific
antigens i.e specific IgE).

But, in order to make a sure diagnosis, you should test

the parasite itself to find out which type it is, and only
then will you be sure that it is the cause of the symptoms
(disease).

The first step of diagnosis will be looking for

trophozoytes in the feces, but as we said sometimes they
are difficult to be seen unless there is an acute state of
diarrhea. The next step will be to look for the cysts, and
this is quite easy because cysts are passed continuously
with the feces whether the patient has symptoms or not
(no need to have severe cases of diarrhea in order to see
the cysts in cases of Amoebiasis) (infection with
amoeba).

6
 *Summary;
To test for parasitic infection, we usually check feces
for example for trophozoytes (hard to see unless
infection is active), or by checking for cysts (much
easier).

Other tests might be taking a blood film and check

the RBCs such as in malaria infections since malaria is not
present in feces.

Or you can take skin biopsies from the ulcers in case

of legionelliasis (Iegionella infection), since they cause
ulcers we look at the macrophages in the skin and you will
find the pClrasite inside the cells.

That is mainly what we do for diagnosis of parasitic

infections and when we go back and consider individual
parasites we will talk more about these things.

>The End <

Tala Haddadin