Exam 3 Flashcards

1
Q

Nematoda: Form and Function

A
  • bilaterally symmetrical, posses a pseudocoel
  • most are dioecious; considerable sexual dimorphism
  • elongated, tapered at both ends; from < 1 mm to > 10 meters
  • digestive tract usually complete; mouth at extreme anterior and anus near posterior tip
  • noncellular cuticle that is secreted by an underlying hypodermis
  • chitinous cuticle is shed 4 times during ontogeny (4 molts)
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2
Q

Nematoda: Form and Function
Bodv Wall

A
  • nematode body wall consists of cuticle, hypodermis, and body wall musculature
  • an important function of the hypodermis is secretion of cuticle.
  • hypodermis is syncitial in adult worms; nuclei lie in 4 epidermal cords
  • epidermal cords run longitudinally and divide body into 4 quadrants
  • dorsal and ventral cords contain longitudinal nerve trunks
  • lateral cords contain lateral canals of the excretory system in most species
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3
Q

Nematoda: Form and Function
Musculature

A
  • muscles of the body wall are all longitudinally with no circular layer
  • nematode muscles have a contractile portion and a noncontractile cell body (myocyton)
  • muscle contraction occurs similar to vertebrate striated muscle with myosin & actin
  • cuticle, hypodermis, somatic musculature, fluid filled pseudocoel functions as a hydrostatic skeleton
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4
Q

Nematoda: Form and Function
Pseudocoel and Hydrostatic Skeleton

A
  • pseudocoel differs from a true coelom in that it has no peritoneal (mesodermal) lining
  • pseudocoel is a fluid-filled cavity enclosed by body wall
  • pseudocoelomic fluid in known as hemolymph
  • pseudocoel functions as a hydrostatic skeleton that depends on:
    (1) enclosed volume of non-compressible fluid
    (2) ability of muscle contraction to apply pressure to that fluid
    (3) transmission of the fluid pressure in all directions
  • alternation of contraction and relaxation in dorsal and ventral muscles produces the characteristic S-shaped motion seen in nematode locomotion

*water balloon *

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5
Q

Nematoda: Form and Function
Nervous System

A
  • nervous system is relatively simple
  • 2 main concentrations of nerve elements; connected by longitudinal nerve trunks
    one in esophageal region
    one in anal region
  • nematodes have a variety of sensilla (small sense organs)
  • sensilla are most prominent in the cephalic and caudal regions
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6
Q

Nematoda: Form and Function
Digestive System and Acquisition of nutrients

A
  • digestive system is complete; mouth, gut, and anus
  • buccal muscles and anterior esophageal muscles contract to open mouth; suck in food
  • hydrostatic pressure in pseudocoel closes the mouth and esophageal lumen
  • food passes down the esophagus via muscle contractions until it reaches the intestine
  • posterior bulb, one-way valve
  • hydrostatic pressure pushes food posteriorly; newly ingested food & locomotor helps
  • intestine constructed of a single layer of intestinal cells
  • depressor ani (anal dialator muscles) contracts to open anus
  • hydrostatic pressure causes defecation when the anus is opened
  • food of nematodes include blood, tissue cells, fluids, and intestinal contents
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7
Q

Nematoda: Form and Function
Secretory-Excretory system

A
  • most excretion occurs through the intestine
  • no flame cells or nephridia
  • 2 long canals in the lateral hypodermis connect near the anterior end
  • secretory-excretory canal opens to the excretory pore
  • ability to osmoregulate varies greatly; depends on habitat
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8
Q

Nematoda: Form and Function
Reproduction

A
  • most are dioecious
  • females generally larger; tail of males is more curled
  • most nematodes are oviparous
  • gonads of nematodes are solid cords of cells; germ cells move via rachis
  • testes are generally paired, but some species only have one
  • nematode spermatozoa use pseudopodium
  • males have cloaca, ejaculatory duct opens into rectum
  • the female reproductive system opens through a central vulva
  • copulatory spicules of male are used in copulation
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9
Q

how young develop

A

-Oviparous: Animals that lay eggs, which hatch and develop outside of the parent’s body.

-Viviparous: Animals that give birth to live young after developing inside the parent’s body

-Ovoviviparous: Animals that produce eggs that hatch inside the parent’s body.

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10
Q

Nematoda: Trichuris trichiura
Whipworm

A
  • tissue parasite
  • 3 to 5 cm in length; adults live several years
  • females produce 3,000 to 20,000 eggs per day
  • embryonation, 21 days in moist and shady soil
  • swallowed, hatch in small intestine, and enter intestinal crypts of large intestine
  • slender anterior end embeds in gut mucosa; enlarged posterior portion in lumen
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11
Q

Nematoda: Trichuris trichiura
Pathology

A
  • < 100 worms, often asymptomatic
  • heavy burden may result in death; 200 to 1,000 in small children
  • trauma to intestinal epithelium and underlying mucosa; chronic hemorrhage
  • intense trichuriasis: dysentery, anemia, growth retardation, rectal prolapse, finger and toe clubbing, adversely affect cognitive function
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12
Q

Nematoda: Trichuris trichiura
Epidemiology

A
  • poor standards of sanitation; night soil for fertilizer
  • physical conditions for egg survival include: warm, high rainfall and humidity, moisture retaining soil, dense shade
  • house flies can serve as mechanical vectors
  • prevalence may reach 20-25% in small children in Southeastern US
  • prevalence estimated at 795 million worldwide
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13
Q

layers of GI tract

A

-mucosa
-submucosa
-muscularis
-serosa

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14
Q

Nematoda: Trichinella spiralis
Porkworm

A
  • smallest nematode parasite of human
  • world’s largest intracellular parasite
  • same individual host can be both intermediate and definitive host
  • juveniles (J1) reside in “nurse cells” of skeletal muscle fibers of intermediate host
    -increases angiogenesis factor (more blood cells grow) J1 gets fed
  • definitive host eats contaminated meat with nurse cells
  • infective juveniles (J1) are released from nurse cells in stomach
  • undergo 4 molts in small intestine, then copulation within mucosal epithelium
  • adults are intramulticellular parasites in intestinal epithelium
  • female gives birth (ovoviviparous) to thousands of juveniles over 4 months
  • juveniles carried by hepatoportal system through liver, heart, lungs and arterial system
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15
Q

Nematoda: Trichinella spiralis
Pathology

A

Pathogenesis of trichinosis in 3 stages
(1) penetration of adult females into mucosa
- traumatic damage to host tissue
- host reacts to their waste products: nausea, vomiting, sweating & diarrhea
(2) migration of juveniles
- damage to blood vessels: localized edema
- wandering juveniles: pneumonia, encephalitis, meningitis, etc.
- death can result from myocarditis
(3) penetration and nurse cell formation
- intense muscular pain, difficulty breathing or swallowing
- heavy infection suppresses muscle contractibility

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16
Q

Nematoda: Trichinella spiralis
Epidemiology

A
  • zoonotic disease: humans not important for life cycle
  • eating infected pork is most common source of infection
  • solid meat is safe when all traces of pink have disappeared
  • well known in Mexico, parts of South America, Africa, southern Asia, & Middle East
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17
Q

Nematoda: Ascaris lumbricoides

A
  • females up to 49 cm long
  • unembryonated develop into J3s in 13 days
  • juveniles molt twice to become infective J3 inside egg
  • infection occurs when unhatched juveniles are swallowed
  • hatch in duodenum and penetrate small intestine and enter venules
  • enter pulmonary circulation and break out of capillaries
  • juveniles usually molt once in lungs, migrate up trachea and swallowed (must molt to J4 or they’ll be killed by gastric juices)
  • pass through stomach and mature in small intestine
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18
Q

Nematoda: Ascaris lumbricoides
Pathology

A
  • many worms get lost and cause acute tissue reactions, inflammatory response
  • breaking out of lung capillaries causes a small hemorrhage at each site
  • small pools of blood accumulate in lungs causing edema, clogging air spaces
  • lung can become diseased and result in bacterial infection, death
  • massive infections can cause fatal intestinal blockage
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19
Q

Nematoda: Ascaris lumbricoides
Epidemiology

A
  • contamination is the typical means of infection
  • eggs infective after 10 years in soil
  • cockroaches can be mechanical vectors
  • dogs are reservoir host
  • one quarter of world population infected
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20
Q

Nematoda: Strongyloides stercoralis
Threadworm

A
  • parasitic females burrow into submucosa of small intestine
  • parthenogenic females release eggs in mucosa, hatch and migrate to lumen
  • J1s are passed in feces and become either:
    •non-infective rhabditiform in soil that give rise to free-living adults in soil
    •infective filariform J3s in soil
  • both free-living and parasitic females can produce free-living and parasitic juveniles (ambient temperature <34C then free-living)
  • infective filariform J3s continue development after they penetrate skin
  • migrate to small intestine usually via lungs, coughed up and swallowed
  • autoinfection may occur if juveniles molt twice before exiting in feces
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21
Q

Nematoda: Strongyloides stercoralis
Pathology

A

-Strongyloidiasis can be described in 3 stages:
(1) invasive: intense itching at site of entry, slight hemorrhage & swelling
(2) pulmonary: burning sensation in chest, nonproductive cough, and possible bronchial pneumonia
(3) intestinal: worms migrate randomly through mucosa, intense localized burning sensation in abdomen, intestinal ulceration and septicemia

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22
Q

Nematoda: Strongyloides stercoralis
Epidemiology

A
  • contacting filariform juveniles in contaminated soil
  • transmammary infection in dogs, and presumably humans
  • present under conditions of low sanitation standards
  • cats and dogs serve as reservoir hosts
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23
Q

Nematoda: Onchocerca volvulus

A
  • females up to 50 cm long; males up to 42 cm long
  • adult worms located under the skin; become encapsulated by host (onchocercomas)
  • encapsulated nodules are located at site of black fly (Simulium spp.) bite
  • adult females produce microfilariae (ovoviviparous)
  • microfilariae concentrate in skin where black flies bite
  • black fly becomes infected when it takes tissue fluid / blood meal
  • microfilariae penetrate fly midgut and molt twice in black fly thoracic muscles
  • infective filariform J3s move to fly mouth parts to infect new host
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24
Q

Nematoda: Onchocerca volvulus
Pathology

A
  • River Blindness; not fatal, but does cause disfigurement and blindness
  • most middle-aged people and older are blind in some communities
  • adult worms stimulate the growth of benign subcutaneous nodules (onchocercomas)
  • onchocercomas consist of collagen fibers surrounding up to several adult worms
  • pruritus and severe dermatitis occurs because of degenerating juveniles in skin
  • degenerating juveniles in eyes resulting in sclerosing keratitis
  • true elephantiasis may occur and also hanging groin
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25
Q

Nematoda: Onchocerca volvulus
Epidemiology

A
  • significant public health problem in Africa and South America
  • black fly larval stages only in clear, fast-running streams
  • adult flies survive in high humidity and plenty of streamside vegetation
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26
Q

Nematoda: Dirofilaria immitis

A
  • females up to 30 cm long; males are shorter
  • adult worms located in right side of heart and pulmonary arteries
  • adult females produce microfilariae (ovoviviparous)
  • microfilariae are found in peripheral blood circulation
  • mosquitoes get infected when they ingest blood meal
  • microfilariae develop into J3s inside Malpighian tubules
  • infective filariform J3 moves to mosquito proboscis to infect new host
27
Q

Nematoda: Dirofilaria immitis
Pathology

A
  • dangerous pathogen for dogs
  • prevalence & intensity is typically lower in cats
  • cats need fewer adults to cause serious disease
  • symptoms include: respiratory distress, vomiting, chronic cough, & exercise intolerance
  • adults worms may prevent proper sealing of tricuspid and semilunar valves
  • pulmonary arteries often show signs of inflammation and thickening
28
Q

Nematoda: Dirofilaria immitis
Epidemiology

A
  • host specificity is low for species of mosquito vectors
  • within the U.S. prevalence is highest in southeastern US & Gulf Coast (ave. 3.9%)
  • heartworm has been diagnosed from domestic dog in all 50 U.S. states
  • 60 cases of human pulmonary dirofilariasis documented in U.S.
29
Q

Nematoda: Wuchereria bancrofti

A
  • females up to 10 cm long; males up to 4 cm long
  • adult worms located in lymphatic ducts of humans
  • found in afferent lymph channels near major lymph glands in lower half of body
  • adult females produce microfilariae (ovoviviparous)
  • microfilariae show periodicity in their migrations to peripheral blood circulation
  • night-feeding mosquitoes get infected when they ingest blood meal
  • microfilariae penetrate gut and molt twice in mosquito thoracic muscles
  • infective filariform 3s move to mosquito proboscis to infect new host
30
Q

Nematoda: Wuchereria bancrofti
Pathology

A
  • lymphatic filariasis can be described in 3 phases:
    (1) Asymptomatic: seen in large proportion of infected endemic individuals where
    microfilaremia and symptoms are not present
    (2) Inflammatory (Acute): caused by antigens (Wolbachia) released from adult worms
  • adult worms cause dilation of lymph channels
  • may result in lymphedema and hydrocele
  • invasion of bacteria from skin surface
    (3) Obstructive: infiltration of the affected area with fibrous connective tissue
  • elephantiasis results from repeated attacks of acute lymphatic inflammation
31
Q

Nematoda: Wuchereria bancrofti
Epidemiology

A
  • 2018 global prevalence was estimated at 51 million cases
  • mosquito vectors are primarily night feeders
  • tropical areas provide suitable breeding sites for mosquitoes
  • prevention involves protection against mosquito bites in endemic areas
32
Q

Nematoda: Loa loa

A
  • known as “eye worm”
  • females up to 7cm long; males are up to 3.5cm long
  • adults actively migrate throughout subcutaneous connective tissue of body
  • microfilariae appear in peripheral blood during day, in lungs at night
  • several species of deer fly, genus Chrysops, are intermediate hosts
  • microfilariae develop into J3s thoracic muscles of deer fly & migrate to mouthparts
33
Q

Nematoda: Loa loa
Pathology

A
  • adults live in subcutaneous and intermuscular connective tissues, including back, chest, axilla, groin, penis, scalp, and eyes in humans
  • Calabar “fugitive swellings” result as worms wander through subcutaneous connective tissue
  • intense pruritis, arthralgia, and fatigue are common
  • infection of deep tissues, including fatal encephalitis is known
34
Q

Nematoda: Loa loa
Epidemiology

A
  • distributed in rain forest areas of Central and West Africa
  • several species of deer fly, genus Chrysops, serve as vectors
  • microfilariae have diurnal periodicity, (daylight in peripheral blood vs. night in lungs)
  • control of deer flies breeding in swampy areas is extremely difficult
35
Q

Nematoda: Anisakis simplex

A
  • eggs produced by females worms embedded in stomach of marine mammal
  • eggs become embryonated in water and juveniles molt once to become J2’s in egg
  • J2’s hatch out of egg and become free-swimming and are ingested by crustaceans
  • J2’s molt once inside crustacean to become J3’s and are eaten by fish or squid
  • J3’s migrate to peritoneal cavity and grow up to 3cm in fish or squid
  • upon death of host the J3’s migrate to the muscle tissues
  • J3’s are transferred via fish to fish predation and then finally to marine mammal
36
Q

Nematoda: Anisakis simplex
Pathology

A
  • symptoms begin within 1 to 12 hours when juveniles begin to penetrate the stomach
  • symptoms of intestinal penetration may commence up to 14 days after ingestion
  • symptoms include extreme gastric pain, nausea, vomiting, diarrhea, and hives
  • Anisakis-associated severe IgE-mediated hypersensitivity reactions may occur
37
Q

Nematoda: Anisakis simplex
Epidemiology

A
  • eating undercooked or raw fish, such as sushi and ceviche, is a risk factor
  • ‘Sushi parasites’ have increased 283-fold in past 40 years (Fiorenza, et al. 2020)
  • in US, majority of anisakiasis cases are due to ingestion of Pacific salmon
  • in Western Europe, majority of anisakiasis cases are due to ingestion herring
  • in Spain, most cases have been related to the consumption of pickled anchovies
38
Q

Nematoda: Enterobius vermicularis

A

Pinworm
- females up to 13 mm long; males up to 4 mm long
- adult worms congregate in the ileocecal region of intestine
- attach to mucosa and feed on epithelial cells and bacteria
- after copulation males die; females lay eggs onto perianal skin then die
- eggs laid have partially developed juveniles; in 6 hours they are infective J3s
- eggs can become airborne and accidentally swallowed; retroinfection can occur

39
Q

Nematoda: Enterobius vermicularis
Pathology

A
  • one-third of infections asymptomatic
  • very large numbers of worms can cause pathogenesis in 2 ways
    (1) damage caused by worms attached within the intestine
  • minute ulcerations lead to mild inflammation and bacterial infection
    (2) damage resulting from egg deposition around the anus
  • perianal tickling sensation causes intense itching resulting in bacterial infection
  • common for pinworms to wander into the vulva causing mild irritation
  • cases have reported wandering up vagina, uterus, and oviducts into coelom
40
Q

Nematoda: Enterobius vermicularis
Epidemiology

A
  • humans can inhale and subsequently swallow eggs
  • clothing and bedding rapidly becomes contaminated with eggs
  • curtains, carpet, and dust are sources of infection or reinfection
  • all bed linens, towels and clothes must be washed in hot water
  • entire household needs chemotherapy, mebendazole (Vermox) or pyrantel pamoate
41
Q

Nematoda: Ancylostoma duodenale
Hookworm

A
  • females up to 13 mm long; males up to 11 mm long
  • mature and copulate in small intestine of host
  • direct life cycle, eggs passed with feces
  • eggs require warmth, shade, and moisture for continued development
  • newly hatched J1s live in the feces and feed on fecal matter
  • undergo 2 molts to become infective J3s; can live for several weeks in soil
  • penetrate skin, get to heart via blood vessels, then to lungs, coughed up, & swallowed
  • in small intestine they molt twice to become adults
42
Q

Nematoda: Ancylostoma duodenale
Pathology

A
  • presence and severity depends on 3 factors:
    (1) number of worms present
    (2) species of hookworm
    (3) nutritional condition of infected person
  • hookworm disease manifests in 3 main phases
    (1) Cutaneous phase: “ground itch” caused by bacterial infection of invading juvenile
  • cutaneous larva migrans “creeping eruption”, from cat and dog hookworms
    (2) Pulmonary phase: dry coughing and sore throat as worms break out of capillaries
    (3) Intestinal phase: attach to mucosa, suck blood producing iron deficiency anemia
  • 0.26 ml blood loss per day (0.26 ml x 100 worms = 26 ml blood loss)
43
Q

Nematoda: Ancylostoma duodenale
Epidemiology

A
  • lack of adequate sanitation
  • economic dependence on night soil
  • 23°C to 30°C optimal for juveniles
44
Q

Nematoda: Ancylostoma sp.

A

Anderson, Foster & Forrester (2003) performed a study of feral cats in Florida.
-75% were infected with Ancylostoma tubaeforme
-33% were infected with Ancylostoma braziliense;
most commonly associated with cutaneous larval migrans

45
Q

Anhelmintics
Albendazole (Albenza)

A
  • developed by SmithKline in 1972
  • broad-spectrum anhelmintic
  • on the World Health Organization’s List of Essential Medicines
  • recommended drug by CDC effective against: Trichuriasis, Trichinosis, Strongyloidiasis, Ascariasis, Anasakiasis, Enterobiasis, Ancylostomiasis, Loiasis
  • binds to colchicine-sensitive site of tubulin eliminating its polymerization into microtubules leading to impaired uptake of glucose
  • available in the United States as Albenza by GlaxoSmithKline
    (1 dose pack - 2 tablets - $215.00)
46
Q

Anhelmintics
Ivermectin (Stromectol, Mectizan, Heartgard)

A
  • broad-spectrum anhelmintic
  • on the World Health Organization’s List of Essential Medicines
  • recommended drug by CDC effective against: Trichuriasis, Strongyloidiasis, Ascariasis, Anasakiasis, Onchocerciasis, Wuchereriasis, and Dirofilariasis
  • only effective against microfilariae, but can sterilize female macrofilariae (adults)
  • binds to and activates glutamate-gated chloride ion channels present on neurons and myocytes, thus enhancing inhibitory neurotransmission
  • available in the United States as Stromectol by Merck Sharp & Dohme
    (1 pack - 4 tablets - $42.00)
47
Q

Anhelmintics
Pyrantel pamoate (Reese’s Pinworm Medicine)

A
  • on the World Health Organization’s List of Essential Medicines
  • recommended drug by CDC effective against: Enterobiasis, Ascariasis, hookworms (all species), and Acanthocephaliasis
  • acts as a depolarizing neuromuscular blocking agent, which causes sudden contraction, followed by paralysis of the helminths
  • (Reese’s Pinworm Medicine Suspension, 1.0 oz. - $8.99)
  • over-the-counter product
48
Q

Trypanosomatidae : Form and Function

A
  • hemoflagellates
  • heterotrophic, eukaryotic, single celli
  • heteroxenous: a parasite that lives within more than 1 host during their life cycle
  • monoxenous: living within a single host during a parasite’s life cycle
  • kinetoplast: a dark staining mass of DNA within the single mitochondrion;
    situated at the base of the flagellum
  • kinetosome (basal body): centriole from which the axoneme arises
  • axoneme: core of cilium or flagellum, composed of microtubules
  • undulating membrane: a finlike ridge across the surface of the cell with axoneme
49
Q

Trypanosomatidae : Trypanosoma brucei

A
  • 3 morphologically indistinguishable subspecies
    (1) T. b. brucei : humans are not susceptible; causes nagana in livestock
    (2) T. b. gambiense : Human sleeping sickness (chronic form)
    (3) T. b. rhodesiense : Human sleeping sickness (acute form)
  • inside vertebrate host trypomastigotes live in blood, lymph nodes, spleen, and cerebral spinal fluid
  • transmitted by tsetse fly (Glossina spp.); > 90% flies refractive to infection
  • trypomastigote sucked up by tsetse fly; multiplies in midgut of insect
  • migrate to salivary glands and transform into epimastigotes and multiply
  • epimastigotes transform into metacyclic trypomastigotes; infective to vertebrate host
50
Q

Trypanosomatidae : Trypanosoma brucei
Pathology

A
  • small chance at site inoculated; lesion disappears in 2 weeks
  • fever, swelling of lymph nodes, generalized pain, headache, weakness, and cramps
  • Winterbottom’s sign: swollen lymph nodes at base of skull

T. b. rhodesiense : Human sleeping sickness (acute form)
- rapid weight loss, heart problems; death within few months of infection

T. b. gambiense
: Human sleeping sickness (chronic form)
- invades CNS, initiates chronic sleeping sickness
- increased apathy, mental dullness, tremor, paralysis, coma, death

51
Q

Trypanosomatidae : Trypanosoma brucei
Epidemiology

A
  • reservoir hosts for T. b. rhodesiense
  • presence of tsetse fly
  • brush removal and trimming
52
Q

Trypanosomatidae: Trypanosoma cruzi

A
  • triatomine bug “kissing bug” gets blood meal and passes metacyclic trypomastigote in feces
  • trypomastigotes penetrate various cells at bite wound site
  • amastigotes form within monocytes beneath epidermis and multiply
  • trypomastigotes released and enter cells of spleen, liver, lymphatics, cardiac, smooth and skeletal muscle
  • inside cell trypomastigotes transform into amastigotes and multiply; form pseudocyst
  • trypomastigotes released are sucked up by “kissing bug” and become epimastigotes
  • epimastigotes divide in midgut then transform to metacyclic trypomastigotes in rectum
53
Q

Trypanosomatidae : Trypanosoma cruzi
Pathology

A

Chagoma: acute local inflammatory reaction where parasite enters through bite
Romana’s sign: swelling and edema when parasites enter conjunctiva of eye
- disease known as Chagas’ disease
- rupture of pseudocysts causes acute local inflammatory response resulting in necrosis
(1) destruction of autonomic ganglia causes megaesophagus or megacolon
(2) heart disease caused by destroyed nerve ganglia; heart enlarges

54
Q

Trypanosomatidae : Trypanosoma cruzi
Epidemiology

A
  • thatched roofs and cracked walls; ideal breeding for triatomine bugs
  • dogs, cats, opossums, armadillos, and wood rats are reservoir hosts
  • blood transfusion
55
Q

Trypanosomatidae : Trypanosoma cruzi
“The New HIV/AIDS of the Americas”,

A
  • Chagas disease and HIV are health disparities
  • Both are chronic conditions
  • Require prolonged treatment
  • Treatment is expensive
56
Q

Trypanosomatidae : Leishmania donovani

A
  • sand fly (Phlebotomus sp.) are vectors for Leishmania donovani
  • promastigotes injected in new vertebrate host with the sand fly’s bite
  • promastigotes are immediately engulfed by macrophages
  • promastigotes transform into amastigotes and divide by binary fission
  • escaping from dead macrophage, parasites are engulfed by other macrophages
  • sand fly ingests amastigotes in blood meall
  • transform into promastigotes in midgut of sand fly; block gut, enter buccal cavity
  • promastigotes ready to be injected in new host with the sand fly’s bite
57
Q

Trypanosomatidae : Leishmania donovani
Pathology

A
  • disease known as kala-azar (visceral leishmaniasis)
  • disease typically begins with low grade fever and malaise
  • destroys phagocytic cells (Kupffer cells, dendritic cells, microglia cells, etc.) of reticuloendothelial (RE) system including spleen, liver, mesenteric lymph nodes,
    intestine, and bone marrow
  • hypertrophy of liver and spleen (hepatosplenomegaly)
  • progressive wasting and anemia
  • death in 2 to 3 years if untreated
58
Q

Trypanosomatidae : Leishmania donovani
Epidemiology

A
  • occurs in Mediterranean basin, China, India, Pakistan, Sumatra, Thailand Africa, and South America
  • control of sand flies and reservoir hosts in endemic areas
  • dogs are the main important reservoir host in most areas
  • 2.5 million dogs may be infected in countries around Mediterranean
  • fatal outcome is most frequent in infants and young children
59
Q

Hexamitidae : Giardia lamblia

A
  • direct life cycle
  • dorsoventrally flattened; ventral surface has bilobed adhesive disk; two nuclei
  • parasite is cosmopolitan; occurs mostly commonly in warm climates
  • most common flagellate of the human digestive tract
  • lives in the small intestine, with adhesive disk fitting over surface of epithelial cell
  • trophozoites divide by binary fission; found in loose stool
  • when feces enter colon and dehydrate the parasite encysts
  • infective stage is the cyst; found in hard stool
60
Q

Hexamitidae : Giardia lamblia
Pathology

A
  • disease is known as giardiasis; typically not fatal
  • some cases asymptomatic (protective immunity)
  • may damage intestinal epithelium
  • interferes with absorption of fats and other nutrients
  • increases mucus production, diarrhea (sometimes incapacitating), dehydration, intestinal pain, flatulence, weight loss
  • gallbladder may become infected causing jaundice and colic
61
Q

Hexamitidae : Giardia lamblia
Epidemiology

A
  • giardiasis is highly contagious
  • if one family member infected, others will also
  • children are especially susceptible
  • prevention depends on high level of sanitation
  • reservoir hosts include: beavers, dogs, cats, and sheep
62
Q

Trichomonadidae : Trichomonas vaginalis

A
  • cosmopolitan species; primarily transmitted by sexual intercourse
  • direct life cycle; has trophozoite stage, but no cyst stage
  • found in reproductive tracts of both men and women
  • lives in the vagina and urethra of women
  • lives in the prostate, seminal vesicles, and urethra of men
  • acidity of normal vaginal (pH 4.0 to 4.5) discourages infection
  • once established pH shifts toward alkalinity (pH 5 to 6), encourages growth
63
Q

Trichomonadidae : Trichomonas vaginalis
Pathology

A
  • most strains have low pathogenicity so person is asymptomatic
    Men:
  • infection is usually asymptomatic, but may have irritating urethritis or prostatitis
    Women:
  • in several days there is degeneration of vaginal epithelium
  • followed by leukocytic infiltration; secretions become abundant and white or greenish, and tissues become intensely inflamed
  • some strains cause intense inflammation, itching, copious white discharge (leukorrhea), burning, and chafing
64
Q

Trichomonadidae: Trichomonas vaginalis
Epidemiology

A
  • transmitted by sexual intercourse
  • infections can be contracted from soiled washcloths, towels, and clothing