Blood and Tissue Flagellates II Flashcards
Leishmania have two morphological forms:
- Amastigote
- Promastigote
[5] Causative agent of Leishmania spp.
- Leishmania tropica
- Leishmania mexicana
- Leishmania donovani
- Leishmania braziliensis
- Leishmania guyanensis
Baghdad boils, Oriental sore
Leishmania tropica
Bay sore, Chiclero ulcer,
Leishmania mexicana
Dum dum fever, Kala-azar
Leishmania donovani
Espundia, Uta
Leishmania braziliensis
Forest yaws, Pian bois
Leishmania guyanensis
infective to humans.
Promastigote — Leishmania spp.
have single free flagellum arising from kinetoplast at the anterior end.
Promastigote — Leishmania spp.
promastigote in the proboscis of the insect vector and the one that grow in artificial media.
Promastigote — Leishmania spp.
Lives intracellularly in monocytes, polymorphonuclear leukocytes and endothelial cells of the vertebrate host.
Amastigotes — Leishmania spp.
The reservoir hosts are rodents, dogs, foxes and jackals.
Transmission — Leishmania spp.
The infection is usually transmitted by the bite (blood feed) of the female sandfly, genus Phlebotomus and Lutzomyia.
Transmission — Leishmania spp.
Human infection has been reported from blood transfusion, congenital transmission, contamination of bite wounds and by contact.
Transmission — Leishmania spp.
[2] Clinical types of Cutaneous Leishmaniasis
- Leishmania major
- Leishmania tropica
found in sparsely inhabited areas.
[clinical types of leishmania mexicana]
Leishmania major
Zoonotic cutaneous leishmaniasis.
[clinical types of leishmania mexicana]
Leishmania major
Wet lesions with severe reaction.
[clinical types of leishmania mexicana]
Leishmania major
rapid ulceration; few amastigotes.
[clinical types of leishmania mexicana]
Leishmania major
found in more densely populated regions.
[clinical types of leishmania mexicana]
Leishmania tropica
Anthroponotic cutaneous leishmaniasis.
[clinical types of leishmania mexicana]
Leishmania tropica
Dry lesions with minimal ulceration.
[clinical types of leishmania mexicana]
Leishmania tropica
Many amastigotes; persists for months.
[clinical types of leishmania mexicana]
Leishmania tropica
Disease: New World cutaneous leishmaniasis, chiclero ulcer, bay sore.
Leishmania mexicana
Cutaneous form, increasing in numbers of infected.
Leishmania mexicana
3 clinical manifestastions of Leishmani Mexicana
- Cutaneous – Chiclero-ulcer
- Nasopharyngeal mucosal – rare manifestation
- Visceral – rare manifestation
main reservoir are rodents.
Leishmania mexicana
2 Uncommon types of Leishmania spp.
- Leishmania aethiopica
- Leishmaniasis recidiva
Diffuse cutaneous leishmaniasis (DCL): caused by, diffuse nodular non-ulcerating lesions. Low immunity to Leishmania antigens (anergic) numerous parasites.
[uncommon types of leishmania]
Leishmania aethiopica
lupoid leishmaniasis: severe immunological reaction to leishmania antigen leading to persistent dry skin lesions, few parasites.
[uncommon types of leishmania]
Leishmania recidiva
Causes espundia, uta or mucotaneous/american leishmaniasis.
[leishmania]
Leishmania braziliensis
Found in Central Mexico and Northern Argentina
[leishmania]
Leishmania braziliensis
Find LD bodies in tissues.
[leishmania]
Leishmania braziliensis
Once cured, lifelong immunity; if dormant may re-occur.
[leishmania]
Leishmania braziliensis
Has a clinical picture dominated by great destruction of the nasal mucosa, sometimes with respiratory complications.
Mucocutaneous Leishmaniasis
The most feared form of leishmaniasis because it produces destructive and disfiguring lesions of the face (Tapir nose).
Mucocutaneous Leishmaniasis
Espundia: metastatic spread to the oronasal and pharyngeal mucosa.
Mucocutaneous Leishmaniasis
3 Diagnosis of Mucocutaneous Leishmaniasis
- Smear
- Biopsy
- Serologic techniques
Highly specific and of great use in cutaneous leishmaniasis, although the test may be negative in the disseminated form.
Montenegro Intradermal reaction
Cellular immunity depends on T-lymphocytes and becomes positive 24-48 hours after infection.
Montenegro Intradermal reaction
Disease: Visceral leishmaniasis, kala-azar, dum dum fever.
Leishmania Donovani
Leishmania that mainly affect children.
Leishmania infantum
Leishmania that mainly affects adults.
Leishmania Donovani
There are geographical variations.
Leishmania Donovani
[3] Treatment of Leishmania Donovani
- First line therapy
- Second line therapy
- Liposomal AMB
(Antimonials): SbV, Pentavalent antimonials include sodium stibogluconate and methyl glucamine antimonite.
[treatment for leishmania donovani]
First line therapy
Amphotericin B, pentamidine(for kala-azar), metronidazole, nifurtimox.
[treatment for leishmania donovani]
Second line therapy
Less toxic than AMB. It has been effective in the primary treatment of VL in both immunocompetent and immunocompromised patients .
[treatment for leishmania donovani]
Liposomal AMB
Disease: Human African Trypanosomiasis
Trypanosoma brucei
It is caused by [two] subspecies of Trypanosoma brucei, namely:
- Trypanosoma brucei rhodesiense
- Trypanosoma brucei gambiense
East Africa, wild and domestic animal reservoirs, East African/Rhodesian sleeping sickness.
Trypanosoma rhodesiense
West and Central Africa, mainly human infection, West African/Gambian sleeping sickness.
Trypanosoma brucei gambiense
[3] Types of Leishmaniasis
- Cutaneous
- Mucocutaneous
- Visceral
(localized and diffuse) infections appear as obvious skin reactions.
[types of leishmaniasis]
Cutaneous Leishmaniasis
espundia) infections will start off as a reaction at the bite, and can go via metastasis into the mucous membrane and become fatal.
[types of leishmaniasis]
Mucocutaneous Leishmaniasis
Infections are often recognized by fever, swelling of the liver and spleen, and anemia. They are known by many local names, Dum Dum Fever, Death Fever and Kala azar.
[types of leishmaniasis]
Visceral Leishmaniasis
The most common is the Oriental Sore (caused by species L. major, L. tropica, and L. aethiopica, L. mexicana.)
[types of leishmaniasis]
Cutaneous Leishmania
L. braziliensis
[types of leishmaniasis]
Mucocutaneous Leishmaniasis
Caused exclusively by species of the L. donovani complex (L. donovani, L. infantum syn. L. chagasi)
[types of leishmaniasis]
Visceral Leishmaniasis
Found in tropical and subtropical areas of all continents except Australia.
[types of leishmaniasis]
Visceral Leishmaniasis
Through the bite of the tsetse fly (Glossina spp.), the metacyclic trypomastigotes will be inoculated to the blood of the host.
Trypanosoma brucei
[2] Gambian Trypanosomiasis of Trypanosoma Brucei
- Winterbottom’s sign
- Kerandel’s sign
Enlarged, non-tender posterior cervical lymph nodes with a consistency of ripe plums.
[Gambian Trypanosomiasis of Trypanosoma Brucei]
Winterbottom’s sign
CNS invasion, more severe headache, increased mental dullness and apathy, tremors, hyperesthesia.
[Gambian Trypanosomiasis of Trypanosoma Brucei]
Kerandel’s sign
more rapid and fatal.
Rhodesian Trypanosomiasis
Occurs in Amazon basin, in Mato Grosso State in Brazil, and in Venezuela.
[uncommon types of leishmania]
Leishmania pifanol
Isolated only from patients with the diffuse cutaneous form of the disease.
[uncommon types of leishmania]
Leishmania pifanol
Initial lesion is a single one, often a period of months or years passes before the disease spreads both locally and to distant skin areas.
[uncommon types of leishmania]
Leishmania pifanol
Irregularly shaped papules.
[uncommon types of leishmania]
Leishmania pifanol
Do not invade in the viscera, and the patient remains in good health.
[uncommon types of leishmania]
Leishmania pifanol
Occurs in the Amazon basin of Brazil and is the cause of cutaneous and diffuse cutaneous forms of leishmaniasis.
[uncommon types of leishmania]
Leishmania amazonensis
Reservoir: small forest mammals, including rodents, marsupials, and foxes.
[uncommon types of leishmania]
Leishmania amazonensis
Principal vector: Lutzomyia sandfly
[uncommon types of leishmania]
Leishmania amazonensis
Causes Venezuelan Andean cutaneous leishmaniasis.
[uncommon types of leishmania]
Leishmania garnhami
Causes cutaneous leishmaniasis in a forested area along the River Turbio, state of Lara, Venezuela.
[uncommon types of leishmania]
Leishmania venezuelensis
Confined to the Western Peruvian Andes, causes a disease in humans known locally as “uta”.
[uncommon types of leishmania]
Leishmania peruviana
Domestic dog and wild rodent are reservoir hosts and sandflies of the genus Lutzomyia are the vectors.
[uncommon types of leishmania]
Leishmania peruviana
Occurs in the Guyanas and Northern Brazil; disease known locally as pian bois, reservoir hosts are arboreal sloths and anteaters, and Lutzomyia is the sandfly vector.
[uncommon types of leishmania]
Leishmania guyanensis
Occurs in Panama, Costa Rica, and Colombia, variety of reservoir hosts, including sloths, rodents, monkeys, and procyonids. Lutzomyia and Psychodopygus sandflies are vectors.
[uncommon types of leishmania]
Leishmania panamensis
Infections have been reported from Brazil and Peru; Lutzomyia sandflies are the natural vector, and agouti is the wild animal reservoir.
[uncommon types of leishmania]
Leishmania lainsoni
Reported to infect human in Colombia, Venezuela, and Panama; Litzomyia is the sandfly vector, and the sloth is a natural reservoir.
[uncommon types of leishmania]
Leishmania Colombiensis
Specimen of choice of Cutaneous Leishmaniasis.
punch biopsy