Cyclospora

cayetanensi
s
Sarcosystis
lindemanni
Pneumocys
tic carinii
Trichomona
s vaginalis
Toxoplasma
gondii
Naegleria
fowleri
Acanthamo
eba sp.
Giardia
duodenalis
Balantidium
coli
Crytosporidi
um parvum
Isospora Microspore
a
Entamoeba
histolytica
Ass. ds Diarrhea Muscle
cramp
Pneumocys
tosis
Trichomoni
asis
Toxoplasmo
sis
PAM,kerato
conjunctivit
is
GAE,kerato
conjunctivit
is
Giardiasis Balantidial
dysentery
Cryptospori
diasis
Isosporiasis Amoebic
dysentery,
extraintesti
nal tissue
invasion
Hosts Man Man-IH,
ZOONOSIS
Immuno
compromis
ed patients
Man Cat
Man-blind-
end host
Free-living Free-living Man Pig,
ZOONOSIS
IC,
travellers
IC IC
Infective
stage
Sporulated
oocyst ( 2
sporocyst x
2
sporozoite)
Oocyst
mature
tetrasporoz
oic
sporocyst
Mature
cyst- 8
tropho/spor
o zoite
Trophozoite
s
NO CYST
Oocyst-
disporocysti
c
tetrasporoz
oite
Cyst Cyst Sporulated
oocyst-
disporocysti
c
tetrasporoz
oite
Sporulated
oocyst-
disporocysti
c
tetrasporoz
oite
Mature cyst
( 4 nuclei)
Transmissio
n
Food/
water
contamin
ation
Raw/
undercoo
ked meat
Sexual
intercours
e
Ingestion
of oocyst,
transplac
ental,
blood
transf,
organ
transplan
t
Swimmin
g
Diving
Swimmin
g
Diving
Inhalation
of cyst
Food/wat
er
contamin
ation
Anal-oral
intercours
e
Faecal-
oral
Water-
borne
outbreak
Hand-to-
mouth
ingestion
Ingestion
Inhalation
Inoculatio
n
Water &
food
contamin
ation
Homosex
ual
Pathology +
symptoms
Prolonged
watery
diarrhea
Abdomin
al cramp
Weight
loss
Anorexia
Myalgia
Vomiting
Fever
o Incubat
ion period-
1 week
o Persist
for 1
Local-
muscle
tendernes
s
Generaliz
ed- pain&
swelling
of
isolated
muscle,
dyspnea,
wheezing
Self-
limiting
Macrosco
py-
firm,gray(
cut
surface),
airless
lung
Microsco
py- adult :
alveolar,
infants :
interstitial
Incubatio
n period
2-3 wk
FATAL
pH 5-5.5
predispos
ing
condition
s -
lactoba
cilli,
superadd
ed
infection
@ vagina
burrows
in
epitheliu
m
Degenera
Asympto
matic
mild flu-
like
Congenita
l 1
st

trimester
:
abortion,
2
nd
: still
birth, 3
rd

congenita
l
infection-
intra-
cerebral
PAM- CNS
involvem
ent,
death 4-5
days after
infection
GAE- IC,
subacute,
CNS
manifesta
tion
KC-
unilateral
severe
ocular
pain,
stromal
infiltrate,
recurrent
breakdow
n +
healing
Excystatio
n @
upper
small int
Mucosal
injury
attachme
nt +
cytopathi
c subst
GIT
symptom
s
diarrhea,
steatorrh
ea,
Hyaluroni
dase-
tissue
invasion
Small
abscesses
ulcers
Acute-
dysentery
Chronic-
diarrhea,
constipati
on,
anaemia,
cachexia
Immuno
competen
t- gastro
enteritis,
self-
limiting
diarrhe
IC-
persistent
, cholera-
like,
cramping
abdomina
l pain,
fever,
dehydrati
Symptoml
ess
Mild GIT
distress
Severe
dysentery
/
diarrhea,
loss fecal
fat
Ocular
Neuroloic
al
Muscular
Dissemina
ted
Intestinal-
dysentery
,
appendici
tis,
intestinal
perforatio
n,
amoebom
a
Extra-
intestinal-
emboli,
abscess
month or
more
Villous
atrophy
Crypt
hyperplas
ia
Exudate-
clusters
of PC,
degenera
ted cells,
hosts
proteins,
few
alveolar
m0
tion+
desquam
ation
Leukocyti
c
inflamma
tion,
hyperaem
ia,
petetchial
haemorrh
age
strawberr
y vagina
Frothy,
seropurul
ent,
creamy/y
ellow
discharge
calcificati
on,
chorioreti
nitis
hydrocep
halus
IC-
meningoe
ncephaliti
s
duodeniti
s,
cholecysti
tis,
abdomina
l cramp
on
Diagnosis Stool
exam
oocyst []
technique
, acid-fast
stain,
fluoresce
blue/gree
n
PCR
Cysts in
muscle
Oocyst+
sporozoit
e in feces
X-ray
IgM
Biopsy,
Gomori
methena
mine
silver
stain
Immune
fluoresce
nce
Strawberr
y vagina
Microsco
pic-
actively
motile
parasites
in
vaginal/pr
ostate
discharge
Direct
method
biopsied
LN,
muscle,
CSF
,blood
staining,IF
,PCR,
culture
Indirect-
serology,
IFAT,ELIS
A
Trophozoi
te in CSF,
cornea
Intracere
bral
inoculatio
n at mice
E.coli
seeding
Trophozoi
te in CSF,
cornea
Intracere
bral
inoculatio
n at mice
E.coli
seeding
Stool
exam,
steatorrh
ea,
cyst+trop
hozoite
Duodenal
aspiration
Trophozoi
te / cyst
in stool
Segmoids
copy
Stool
exam
acid-fast
stain
IgG & IgM
IFAT
Stool
exam- []
method,
oocyst
Specific
trichrome
stain
Giemsa
stain

Stool
exam
trophozoi
te,cyst
Sigmoidsc
opy
Barium
enema
Serology

Treatment Co-
trimoxazo
le
Pyrimeth
amine
Sulphadia
zine
NO
STEROIDS
Local
cleaning
metronid
azole
pyrimeth
amine
spiramyci
n
amphoter
icin B
metronid
azol
tinidazol
oxytetrac
ycline
metronid
azol
spiramyci
n
self-
limiting
albendaz
ol

metronid
azole
emetine
hydrochlo
ride