Atrial Flagellates pathogenic Flashcards
Habitat of giardia lambia
Duodenum
Jejunum
Upper ileum
Upper small intestine
What are synonyms of giardia lambia?
Giardia intestinalis
Lambia intestinalis
Giardia duodenalis
Lambia duodenalis
Epidemiology of gardia lambia
Most common acquired STD
Worldwide distribution
Prevalence is 6%; 14% under 9 years old
Increase frequency in multiple partner
Transmission of giardia lambia
Most common source of outbreak
Water borne
Transmission of giardia lambia
How many cyst the food have to make contaminated?
1-10
Transmission of giardia lambia
Homosexual practices
Oro-Anal
Giardia lambia also called
Traveller’s diarrhea
How many flagella the giardia lambia have?
8
Trophozoite G. Lambia
Shape
Pyriform or teardrop shaped
Trophozoite G. Lambia
Pyriform or teardrop shaped. Pointed posteriorly with a distinct medial line called
Axostyle
Trophozoite G. Lambia
Description
Non infective
Baby stage
9-12 um long, 5-15 um wide
Divide by longitudinal binary fission
Trophozoite G. Lambia
Shape,
Dorsal side and ventral side
Dorsal- convex
Ventral- concave
Trophozoite G. Lambia
Shape
Anterior and posterior
Anterior- round
Posterior- pointed
Trophozoite G. Lambia
Nuclei
A pair of ovoidal nuclei, one on each side of midline
Trophozoite G. Lambia
Flagella
Arise from the ventral side
3 pairs flowing
1 pair fused
Trophozoite G. Lambia
Movements
Slow erratic oscillation or
Falling leaf motility
Cyst G. Lambia
Description
Infective
Adult stage
Cyst G. Lambia
Shape
Ovoid
Cyst G. Lambia
Nuclei
Young cyst - 2 nuclei
Mature cyst- 4 nuclei
Cyst G. Lambia
Flagella
Contracted into axonemes
Cyst G. Lambia
Cytoplasm
Separated from cyst wall
Cyst G. Lambia
Diagnostic
Retracted cytoplasm
Cyst G. Lambia
Resistant to
Chlorine and cold water
Gardia lambia
Incubation period
1-4 weeks
Gardia lambia
Symptomatic in
40% of patients
Gardia lambia
Pathologic changes in the intestinal wall
- Flattened tips of villi and shallow crypts
- Mucosal inflammation
- Hyperplasia of lymphoid follicles
Gardia lambia
Cellular changes
Ventral sucking disc
Mechanical irritation
Malabsorption
Gardia lambia
Mild infection
Moderate and protracted diarrhea
6 weeks spontaneous recovery
Gardia lambia
Acute infection
Cramping and diarrhea Exessive flatus ( rotten egg)
Bloating, nausea, anorexia more reported than diarrhea
Gardia lambia
Chronic infection
Steatorrhea
Cholecystitis
Less diarrhea because pt is already dehydrated
Gardia lambia
Severe infection
Malabsorption in the gut
Very weak
Gardia lambia diagnosis
Watery stool
Not accurate
Gardia lambia diagnosis
Semi formed stool
Best specimen
Gardia lambia diagnosis
Stool exam
Demonstrate trophozoites or cyst
Gardia lambia diagnosis
Direct fecal smear
Trophozoites seen as having a falling leaf-like motility
Gardia lambia diagnosis
Invasive procedure
Duodenojejunal aspiration biopsy
Gardia lambia diagnosis
May demonstrate trophozoite
An expensive test
Entero test
Gardia lambia diagnosis
Enzyme linked immunosorbent assay using giardia antigen in the stool is a more sensitive method for indentifying giardia
ELISA
Gardia lambia treatment
Metronidazole
500 mg TID for 5-10 days
Gardia lambia treatment
Metronidazole
Pedriatic dose
15 mg/kg/day in 3 divided dosed
90% cure rate
Gardia lambia treatment
Metronidazole
Side effect
Metallic taste
Gardia lambia treatment
Tinidazole
2 g single dose for adults;
50 mg/kg in children
Gardia lambia treatment
Furazolidine
100 mg QID for 7-10 days
Gardia lambia treatment
Furazolidine
Pedriatic dose
6 mg/kg/day in 4 diided doses
Gardia lambia prevention
Proper and sanitary disposal of excrete to prevent contamination of watery supplt and food
Avoidance of night soil as fertilizers, flies and infected food handlers
Trichomonas vaginalis
STD
Trichomonas vaginalis
Habitat
Urogenital tract
Vagina, urethra, prostate, epididymis
Trichomonas vaginalis
Cyst
No cyst form
Trichomonas vaginalis
Shape
7-23um
Pyriform shape
Trichomonas vaginalis
Flagella
4 anterior flagella - simple stalk
5th flagella - undulating membrane, extends about 1/2 of original lenght
Trichomonas vaginalis
Nucleus
Median axostyle
Sinke nucleus
Trichomonas vaginalis
Multiply by
Bunary fission
Trichomonas vaginalis
Transmission
Ping pong infection
Trichomonas vaginalis
Diagnostic
Cystostome
Siderophil granules
Trichomonas vaginalis
Aka
Jerky tumbling motility
Trichomonas vaginalis
Trophozoite cant’t live without close association with
Vagina
Urethral
Prostatic tissue
Trichomonas vaginalis
Trophozoite infect the surface but do not appear to invade the
Mucosa
Trichomonas vaginalis
4-28 days after introduction of the trophozhoite into the vagina
Proliferation of flagella
Degenaration of vaginal epithelium
Leukocytic inflammation of tissue
Trichomonas vaginalis
Acute infection
Greenish to yellowish secretion
Intense itchiness
Burning sensation
Trichomonas vaginalis
Chronic stage
Loses purulent appearance due to decrease tirchomonads and leukocytes
Increase epithelial cells
Mixed bacterial flora
Trichomonas vaginalis
Common symptoms
Vaginal discharge
Vulvitis
Dysuria
Postpartum endometritis
Trichomonas vaginalis
Complication include secondary bacterial infection of the
Urogenital tract in male
Trichomonas vaginalis
On speculumexamination, there are punctuate hemorrhages of the cervix
Strawberry cervix
Trichomonas vaginalis diagnosis
Collectiin of discharge
Trichomonas vaginalis diagnosis
From discharges
Saline wet mounts
Trichomonas vaginalis diagnosis
In males
Prostatic secretions and urine
Trichomonas vaginalis diagnosis
Culture using
Diamond ( modfied medium )
Feinberg and whittington culture medium
Trichomonas vaginalis treatment
Metronidazole- 500 mg TID for 7 days (90-98% cure rate)
Tinidazole-2 mg single dose
Trichomonas vaginalis
In RP, prevalence rate is
14-8% among sexual workers
Tenax
Hominis
Vaginalis
Oral cavity
Large intestine
Uro- genital tract
