PARASITOLOGY

Medical Parasitology – deals with parasites which

infects man and the disease they produce
Parasites – organisms that infect other living
organisms
Host – an organism that harbors the parasite
Types of hosts:
 Definitive hosts – harbors the adult stage of
the parasite or where sexual stage of
reproduction takes place
 Intermediate host – harbors the larval stage of
the parasite or where asexual stage of
reproduction takes place
 Paratenic host – a host where the parasite
merely remains viable without development or
multiplication
 Reservoir host – harbors the parasite and
where it can reproduce
Protozoa – single celled microorganisms
 Amoebas
 Entamoeba histolytica – causes amoebiasis
- With a large centrally located karyosome
- The cyst (dormant) is the infective stage
- Trophozoites are motile, metabolically active, and
capable of reproduction
- Transmission through ingestion of fecally
contaminated water or food, flies on food, soiled
hands of infected food handlers, oral-anal sexual
contact
- S/Sx: abdominal cramps, watery stool usually mucoid
or blood streaked
- Amoebae may invade mucus membranes of the colon
forming abscesses
- May also be disseminated via the bloodstream
leading to abscess in the liver, lung, brain, and other
organs
- Dx: stool exam
- Treatment: Metronidazole for symptomatic patients
and Iodoquinol for asymptomatic carriers
Enatamoeba histolytica cyst
Entamoeba histolytica
trophozoite
 Entamoeba coli – commensals but may
produce amoebiasis in multiple
infections
- With 4-8 nuclei with large
eccentrically placed nucleus
 Entamoeba gingivalis – only amoeba in
the oral cavity
- Causes halithosis
- Transmitted through saliva
Entamoeba coli cyst
Entamoeba coli trophozoite
 Naegleria fowleri and Acanthamoeba
acanthusis – free living amoeba w/c
inhabits fresh water lakes and
streams
- May accidentally infect bathers
- Parasite invades the nasal mucosa
and destroys the olfactory nerves
which is a point of entry into the
brain
- May cause meningoencephalitis
(fatal)
- Treatment: Amphotericin B and
Rifampicin
Naegleria fowleri
Acanthamoeba cyst
Ciliates
 Balantidium coli – only ciliate known to parasitize
man
- largest of the protozoans
- cyst is the infective stage acquired by ingestion of
contaminated food or water
- trophozoites colonize in the ileum and colon of
infected humans
- w/ a prominent cytostome (cell mouth) and
cytopyge ( cell anus)
- reproduce by binary fission
- pig is the reservoir host
- with 2 nuclei: macronucleus and micronucleus
- causes Balantidial dysentery/Balantidiasis/Ciliary
dysentery
- Diagnostic exam: cysts in the stool exam
- Treatment: Tetracycline
Balantidium coli trophozoite
Balantidium coli cyst
 Flagellates
 Giardia lamblia – only flagellate in the small
intestine (duodenum)
- Also known as Giardia duodenalis
- reproduce by binary fission
- causes Giardiasis
- infection is caused by consuming contaminated
food or water
- cyst is the infective stage
- S/Sx: dull epigastric pain, flatulence, diarrhea,
steatorrhea
- some do not manifest symptoms but are carriers of
the parasite
- Diagnostic exam: stool exam
- under the light microscope it looks like a “clown
face” w/ 2 nuclei outlined by adhesive discs above
dark median bodies that form the mouth
- Cysts have 4 nuclei
Giardia lamblia trophozoite
Giardia lamblia trophozoite
Giardia lamblia
Giardia lamblia
cyst
Giardia lamblia cyst
 Trichomonas vaginalis – sexually transmitted
- causes cervicitis in females and urethritis in
males
- S/Sx: profuse, thin, foamy, malodorous (fishy
odor) vaginal discharge
- often asymptomatic
- largest flagellate
- Dx: wet mount examination of the discharge,
sometimes trophozoites can be seen in urine and
Papanicolau smears
- Treatment: Metronidazole
 Trichomonas tenax – only flagellate found in the
oral cavity
- causes dental caries and tartar formation
Trichomonas vaginalis
Trichomonas vaginalis
Trichomonas vaginalis
trophozoite
Trichomonas tenax
 Leishmania sp. - a blood flagellate, can be transmitted
intravenously
- transmitted by a sandfly w/ 2 different vectors:
1. Phlebotomus – Old World
2. Lutzomyia – New World
- causes Leishmaniasis
- mucocutaneous (espundia) infections will start off as a reaction
at the bite and metastasize into mucus membranes and be fatal
- visceral infections appear w/ fever, weight loss,
hepatosplenomegaly and anemia
- it has 2 different morphological states:
1. Promastigote (leptimonad) – lives in the digestive tract of the
fly
2. Amastigote – found in the lysosomes of the macrophages of
vertebrates
- Treatment: a solution containing Antimony
Leishmania amastigote
Leishmania sp.
promastigote
 Trypanosoma brucei – a blood flagellate
- transmitted by a tsetse fly
- causes African sleeping sickness (African
Trypanosomiasis)
- S/Sx: (early stage) painful chancre at the site
of the bite, fever, headache, insomnia,
lymphadenitis, anemia, edema, rash;
(late stage) body wasting, falling asleep,
coma, death
- 2 types:
1. T. Brucei gambiense
2. T. Brucei rhodesiense
- Dx: observations of trypomastigote in
blood, lymph or CSF
T. Brucei gambiense
T. Brucei rhodesiense
 Trypanosoma cruzi – a hemoflagellate (trypomastigote
form) and an intracellular parasite (amastigote)
- transmitted by a reduviid bug/kissing bugs/assassin
bugs
- can also be transmitted by blood transfusion
- the bugs become infected when they take blood
meals from an infected animal
- the bugs defecate as they take a blood meal or feed
at the corner of a sleeping person’s eye, the feces
containing the parasite are rubbed into the bite or the
eye
- causes Chaga’s Disease. (American
Trypanosomiasis)
- S/Sx: inflammatory response at the site of the bite,
fever, malaise, lymphadenopathy, hepatosplenomegaly
(at times may be asymptomatic)
Trypanosoma amastigote
Trypomastigote in blood
 Sporozoa
 Plasmodium sp. – causes malaria

- transmitted by a female Anopheles mosquito

- S/Sx: intermittent chills, fever, sweat
- with alternating generations of sexual stage (sporogony)
in the mosquito and asexual stage (schizogony) in man
- Dx: 6 consecutive positive malarial blood smear
- Treatment: Chloroquine
- Types of malaria:
1. Plasmodium malariae – quartan malaria

2. Plasmodium vivax – benign tertian malaria, most widely

distributed
3. Plasmodium ovale – ovale tertian malaria, sporadic

4. Plasmodium falciparum – malignant tertian malaria

Plasmodium malariae
Plasmodium malariae ring
stage
Plasmodium vivax
gametocyte
Plasmodium vivax ring
stage
Plasmodium vivax schizont
stage
Plasmodium ovale
Plasmodium falciparum
gametocyte
Plasmodium falciparum ring
stage
 Toxoplasma gondii – causes Toxoplasmosis
- definitive hosts are cats that acquires infection by eating
infected rodents or birds
- intermediate hosts are birds, rodents, sheep, goats, swine,
cattle
- humans become infected by eating infected raw or undercooked
meat containing the cyst form of the pathogen or ingesting food
or water contaminated w/ oocysts shed from the feces of
infected cats
- can be transmitted transplacentally, blood transfusion, organ
transplantation
– in immunocompetent people it may be asymptomatic or may
resemble Infectious Mononucleosis
- in immunocompromised people, it involves the CNS, lungs,
muscles, heart
- cerebral toxoplasmosis is common in AIDS patients
- infection during early pregnancy may lead to fetal infection
causing death of the fetus or serious birth defects
- Treatment: Pyrimethamine and Sulfadiazine w/ Folinic acid
Toxoplasma gondii cyst
Toxoplasma gondii
tachyzoites