Blood And Tissue Flagellates Flashcards by Rae Anne Montealegre

This are parasites which inhibits the tissues and the blood of human with the aid of vectors

Hemoflagellates

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Mode of transmission of hemoflagellates

Bite of arthropod vector

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Member species of hemoflagellates

Leishmania spp.
Trypanosoma brucei gambiense
Trypanosoma brucei rhodesiense
Trypanosoma cruzi

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4 morphologic forms associated with hemoflagellates

Amastigote
Promastigote
Epimastigote
Trypomastigote

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Basal body in certain flagellated protozoans that consists of a minute mass of chromatin embedded in the cytoplasm at the base of the flagellum
Give rise to and is attached to an axoneme

Blepharoblast

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Located adjacent to the blepharoplast

Parabasal body

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A disk-shaped mass of circular DNAs inside a large mitochondrion that contains many copies of the mitochondrial genome
Collective term refers to both parabasal body and blepharoplast

Kinetoplast

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A locomotory organelle of certain flagellate parasites, consisting of a finlike extension of the limiting membrane with the flagellar sheath; wavelike rippling of the undulating membrane produces a characteristic movement
Assist in locomotion of parasites

Undulating membrane

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Size: 5 by 3 um
Shape: round to oval
Nucleus: 1, usually off center
Other: kinetoplast present, consisting of dot-like blepharoplast from which emerges a small axoneme.
Parabasal body located adjacent to the blepharoplast.
Non flagellate, intracellularly seen in bone marrow or tissue samples
DIAGNOSTIC STAGE FOUND IN HUMAN SAMPLES

Amastigote
Leishman Donovan Body
Leishmanial form

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Shape: round to oval
Nucleus: 1 toward the edge of the organism
Kinetoplast: seen anteriorly
Diagnostic feature: absence of flagellum

Amastigote

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Size: 9-15 um long
Shape: long and slender
Nucleus: 1, located in or near center
Other: kinetoplast, located in anterior end
Single free flagellum, extending from anterior end usually an extracellular phase as in
the insect intermediate host of leishmania parasites

Promastigote
Leptomonal form

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Shape: spindle body
Nucleus: single nucleus located near or in the center
Kinetoplast: seen anteriorly
Flagellum: single
Diagnostic feature: absence of undulating membrane

Promastigote
Leptomonal form

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Size: 9-15 um long
Shape: long and slightly wider than promastigote form
Nucleus: 1 located in posterior end
Others: kinetoplast located anterior to the nucleus
Undulating membrane, extending half of the body length
Free flagellum, extending from anterior end
FOUND IN THE INTESTINE OF VECTORS

Epimastigote
Crithidial form

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Shape: body is wider compared to promastigote
Nucleus: 1 nucleus found posteriorly
Kinetoplast: seen anteriorly
Flagellum: free flagellum seen at anterior end
Diagnostic feature: presence of undulating membrane that extends HALF of the body length

Epimastigote
Crithidial form

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Size: 12-35 um long by 2-4 wide
Shape: C, S, U shape often seen in stained blood films
Nucleus: 1, located anterior to the kinetoplast
Other features: kinetoplast located in the posterior end
Undulating membrane, extending entire body length
Free flagellum, extending from anterior end when present

Trypomastigote
Trypanosomal form

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Shape: body is wider compared to promastigote
Nucleus: 1 found anteriorly
Kinetoplast: posteriorly located
Flagellum: anterior free flagellum may or may not be present
Diagnostic feature: presence of full body length undulating membrane

Trypomastigote
Trypanosomal form

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What is the disease associated with Trypanosoma cruzi?

Chagas disease or American Trypanosomiasis

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He found that the trypanosome on the intestine of a triatomid bug were the same parasite found in a child suffering from fever and enlargement of lymph nodes

Carlos chagas

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What does trypanosoma cruzi primarily infect being an intracellular parasite?

Myocytes
Reticuloendothelial system

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What stages does trypanosoma cruzi exhibit?

All four

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In human, the trypomastigote form of trypanosoma cruzi is found where?

Blood stream

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In human, the amastigote form of trypanosoma cruzi is found where?

Tissue cells

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In insect vector, where does the amastigote, epimastigote and promastigot form of typanosoma cruzi occur?

Midgut

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In insect vector, where does the infective metacyclic form of trypanosoma cruzi found?

Hindgut

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Biological vector of trypanosoma cruzi (bugs)

Triatomine bug Reduviid bug Assassin bug Conenosebug Kissing bug

Biological vector of trypanosoma cruzi (genera)

Triatoma Rhodnius Panstrongylus

Reservoir of trypanosoma cruzi

Domestic animals Armadillos Raccoons Rodents Marsupials Primates

It eliminates parasite in blood

Gentian violet

A prevalent mode of transmission of t cruzi in urban area

Transfusion

Natural transmission of t cruzi by triatomine bugs through blood, meal/ contamination with infected feces

Vector-borne

Type of biological vector: Transmission via mouth parts VERY EFFICIENT Infection rate in vector is low TSETSE FLY (T. Brucei complex)

Salivarian

Where is the infective form found in salivarian biological vectors?

Salivary glands

Vector for t brucei, gambiense, rhodesiense

Tsetse fly

Type of biological vector: Hind gut station: acquired from feces or eating the vector Inefficient Infection rate Triatomine bug (T. cruzi)

Stercoralian

Where is the infective form of parasite found in the stercoralian biological vector?

Hidngut Rectum

Erythematous nodule

Chagoma

Patients who contract T. Cruzi through the ocular mucosa develops a characteristic conjunctivitis and edema of the eyelids

Romana’s sign

What is the duration of the acute phase of t cruzi?

1-4 months

Children present with symptoms of CNS involvement

Acute phase of t cruzi

Symptoms of acute phase of t cruzi

Fever Malaise Lymphadenopathy Hepatosplenomegaly Nausea Diarrhea

Treatment for acute phase of t cruzi

Nifurtimox (8-16 mg/kg/day 60-90 days) Benzidazole (5-7 mg/kg/day 30-120 days) Allopurinol (experimental) Azole antifungal agents (experimental)

How many years can the indeterminate phase/ latency phase last?

10-40 years

Asymptomatic but still capable of transmitting it to others

Seropositive

10-30% of infected exhibit cardiomyopathy or megasyndromes (megaesophagus, megastomach, megacolon) due to decrease nerve ganglia

Chronic phase of t cruzi

How long is the incubation of the acute phase of t cruzi?

1-2 weeks

Has CNS involvement, cardiomegaly, and electrocardiographic changes Complete blockage of the heart and brain damage may cause sudden death Long latency characterized by seropositivity and no parasitemia

Chronic chagas’ cardiomyopathy

What is the main site of infection of t cruzi?

Heart

Where is the amastigotes of t cruzi indistinguishable from?

L. Donovoni

Direct examination method that reveals the trypomastigotes of t cruzi

Giemsa blood smear

Specimen of choice for blood smear of t cruzi

Giemsa-stained blood slide

What specimens may reveal amasigotes of t cruzi?

Lymph node, biopsy, blood culture

Allow trypanosome-free triatomine bugs to feed on patient and look in the bug’s intestine for flagellates Examined monthly over a period of 3 months

Xenodiagnosis

Found in regions where t cruzi exists

Trypanosoma rangeli

What is the vector of t rangeli?

Reduviid bug (rhodonius sp.)

What is the reservoir of wild rodents?

Wild rodents

What is the diagnostic stage for t rangeli?

Trypomastigote

Disease associated with t brucei

Human African trypanosomiasis

T brucei found in east africa, wild and domestic animal reservoirs EAST AFRICAN/RHODESIAN SLEEPING SICKNESS Zoonosis of cattle and wild animals Human serves as accidental host

T brucei rhodesiense

Found in west and central africa, mainly human infection WEST AFRICAN/GAMBIAN SLEEPING SICKNESS

T brucei gambiense

What are the forms exhibited by t brucei?

Epimastigote Trypomastigote

Where does t brucei live in humans?

Blood, reticular tissue of lymph, spleen, and csf

Biological vector for t brucei rhodesiense

Glossina morsitans

Biological vector for t brucei gambiense

Glossina palpalis

What are the other mode of transmissions of t brucei?

Accidental needle pricks Transmitted vertically

How long does the initial symptoms of Gambain trypanosomiasis last?

2-3 days

Earliest sign gambain trypanosomiasis

Chancre

How long does the acute phase of gambain trypanosmiasis last?

1-6 months

Stages human african trypanosomiasis undergo to:

Hemolymphatic stage Meningoenciphalitic

Parasites proliferate in the blood stream and lympahtics Winterbottom’s sign Edema of arms and legs

Hemolymphatic phase

Enlarged, non-tender posterior cervical lymph nodes with a consistency of ripe plums

Winterbottom’s sign

How long does the late phase of gambain trypanosmiasis last?

3-10 months

Meningoencephalitic phase Kerandel’s sign Rhodesian trypanosomiasis

Late phase of gambain trypanosomiasis

CNS invasion, more severe headache, increased mental dullness and apathy, tremors, hyperesthesia

Kerandel’s sign

What form of t brucei gambiense and rhodensiense are morphologically identical?

Trypomastigote

Detects parasite that occur in low numbers

Quantitative buffy coat concentration method

An ornithine decarboxylase inhibitor that is highly effective in earlly and late phase of Gambain trypanosomiasis

DL-alpha-difluoromethylyornithine

What are the two morphological forms of leishmania spp.?

Amastigote Promastigote

Causative agent of Baghdad boils, oriental sore (cutaneous form of leishmaniasis)

Leishmania tropica

Causative agent of bay sore, chiclero ulcer (cutaneous leishmaniasis)

Leishmania mexicana

Causative agent of dum dum fever, kala-azar (visceral leishmaniasis

Leishmania donovani

Causative agent of espundia, uta (cutaneous leishmaniasis)

Leishmania braziliensis

Causative agent of forest yaws, pian bois (cutaneous leishmaniasis)

Leishmania guyanensis

Infective stage of leishmania spp. to humans

Promastigote

Where is the promastigote found in the sandfly?

Proboscis

Leishmania morphlogical form that lives intracellularly in monocytes, PMNs, endothelial cells of the vertebrate hosts

Amastigote

Leismania form that is present only in small number in the blood in which its multiplication inside phagocytes can cause destruction of the host cells

Phagocytose amastogotes