Intestinal` Protozoa

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Intestinal Protozoa
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Giardia lamblia
Giardia trophozoites (light microscope)
Giardia trophozoites ( SEM)
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Giardia trophozoites (light microscope)
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Giardia cyst (light microscope)
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Giardia trophozoites (light microscope)
Trichrome stain
Unstained
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Giardia lamblia Life cycle
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Giardia cyst (light microscope)
Trichrome stain
Unstained
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Giardia trophozoites in tissue section
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Giardia cyst and trophozoites IH stain
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Giadriasis Clinical Picture
Asymptomatic infections ( majority) Symptomatic
Infections Typical picture IP 1-2 wks
followed by diarrhoea for about 6 wks, Atypical
Severe diarrhoea , malabsorption especially in
children
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Giardiasis Laboratory diagnosis

• Stools examination cysts or trophozoits
• Examination of duodenal contents trophozoites

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Giardiasis Chemotherapy

• Drug of choice Metronidazole

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Intestinal Amoebae
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Entamoeba coli
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Iodamoeba butschlii trophozoite
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Iodamoeba butschlii cyst
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Endolimax nana cyst
Endolimax nana cyst
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• Endolimax nana trophozoite

Endolimax nana cyst
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• E. polecki cyst

• E. polecki trophozoite

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Entamoeba coli (drawing)
Entamoeba coli (Eosin)
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Entamoeba coli ( cyst )
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Entamoeba coli ( trophozoite)
Entamoeba coli ( trophozoite)
Entamoeba coli ( trophozoite)
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Entamoeba hartmanni
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Entamoeba hartmanni
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Entamoeba histolytica
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Entamoeba histolytica
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E. histolytica
E. histolytica
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Entamoeba histolytica
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Entamoeba histolytica
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ENTAMOEBA HISTOLYTICA 500 million people are
infected. 100,000 deaths per year. Worldwide
distribution. It is a waterborne infection.
There are 6 species of Entamoeba histolytica
dispar hartmanni coli gingivalis polecki
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E. histolytica vs E. dispar
Entamoeba histolytica amoebae that are
pathogenic. E. dispar The non invasive form
. The 2 amoebae cant be distinguish by
microscopic observation.
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Entamoeba histolytica
Mode of infection Water, food Flies can act as
vector.. Can be sexually transmitted person -to
-person contacts Not a zoonosis
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Entamoeba histolytica
Life cycle Trophozoite vegetative stage, must
encyst to survive in the environment. It is a
fragile structure. Pre cyst encysting
trophozoites disgorging any undigested food.
Cyst infective stage. Resist to the harsh
conditions of the environment.
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Entamoeba histolytica
The infective dose can be as little as 1 cyst. be
as little as 1 cyst. The incubation period can be
from few days to can be from few days to few
weeks depending on the infective dose Cysts can
survive for weeks at appropriate weeks at
appropriate temperature and humidity.
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Entamoeba histolytica
PATHOLOGY Intsetinal amoebiasis Remarkable and
unique ability a to hydrolyse host host tissues
with their active cysteine proteases present on
the surface membrane of the trophozoite. Lesions
are found in the caecum, appendix, or colon. They
may heal. If perforation of the colon occurs,
They may heal. If perforation of the colon
occurs, My lead to a peritonitis that can lead
to death. Amoeboma Granuloma obstructing the bowel
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PATHOLOGYIntsetinal amoebiasis
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PATHOLOGYIntsetinal amoebiasis
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PATHOLOGY Intsetinal amoebiasis
Complications
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PATHOLOGY Intsetinal amoebiasis
Entamoeba histolytica
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PATHOLOGY Intsetinal amoebiasis
Entamoeba histolytica
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PATHOLOGY Intsetinal amoebiasis
E. Histolytica in mucosa. in mucosa. Numerous
Numerous trophozoites can be seen with ingested
seen with ingested erythrocytes.
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PATHOLOGY Extra-intsetinal amoebiasis
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Main Drugs for Treatment of Amoebiasis

• Intestinal
• Asynpromatic (cysts only) diloxanide furoate
  (Furamide)
• Sympromatic(cysts and trophozoites)
  metronidazole
• Extra-intestinal
• Metronidazole

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• Free-living Amoebae
• Naegleria fowleri and Acanthamoeba

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Acanthamoeba keratitis

• Patient upon presentation with Acanthamoeba
  keratitis. No severe pain was experienced by this
  patient, which made diagnosis difficult

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Acanthamoeba keratitis

• The same patient who had just developed a classic
  ring infiltrate

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Acanthamoeba keratitis

• The same patient1 year later with 20/30 vision.

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Acanthamoeba keratitis

• Acanthamoeba culture with a trophozoid in culture

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Acanthamoeba in corneal scraping
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• Acanthamoeba trophozoite

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Acanthamoeba brain
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Acanthamoeba
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Acanthamoeba ulcer
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• Naegleria brain

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Cryptosporidium Parvum
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Cryptosporidium Diagnosis
Cryptosporidium oocysts
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Cryptosporidium Diagnosis
Cryptosporidium , safranin
Cryptosporidium , acid-fast stain
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Cryptosporidium Diagnosis
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Cryptosporidium Diagnosis
Crypto-Gardia FAT
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CryptosporidiosisTreatment

• Self-limited in immunocompetent patients
• In AIDS patients paromomycin