Exercise No. 6c-2 PROTOZOA Phylum Sarcomastigophora - Subphylum Mastigophora - Hemoflagellates Flashcards
four morphologic forms of clinical significance associated with hemoflagellates
amastigote, promastigote, epimastigote, and trypomastigote
amastigote was formerly called
leishmania
promastigote was formerly called
leptomonas
epimastigote was formerly called
crithidia
trypomastigote was formerly called
trypanosoma
This stage is adapted to intracellular existence, being found inside macrophages, monocytes, neutrophils, or endothelial cells.
Amastigote
It is also known as the L-D (Leishman-Donovan) body.
Amastigote
The body is slightly wider than that of the promastigote.
Epimastigote
Volutin granules are found in the cytoplasm.
Trypomastigote
shape and size: ovoidal in shape and, on an average, measures 5 µm long by 3 µm wide
Amastigote
shape and size: spindle-shaped and measures 9 to 15 µm in length
Promastigote (typical)
shape and size: spindle-shaped and measures approximately 9 to 15 µm in length
Epimastigote (average)
shape and size: may be long and slender or assumes the shape of the letters C, S or U, and measures 12 to 35 µm long by 2 to 4 µm wide
Trypomastigote
nucleus: large single nucleus that is typically located off-center, sometimes present more toward the edge of the organism
Amastigote
nucleus: large single nucleus is located in or near the center of the body
Promastigote
nucleus: large single nucleus
Epimastigote; Trypomastigote
kinetoplast: consists of a deeply staining rod-like parabasal body and adjacent dot-like blepharoplast
Amastigote
kinetoplast: located in the anterior end of the organism and gives rise to an axoneme
Promastigote
kinetoplast: located anterior to the nucleus
Epimastigote
kinetoplast: located posteriorly from which emerges a full body length undulating membrane
Trypomastigote
blepharoplast: gives rise to and is attached to an axoneme
Amastigote
axoneme: extends to the anterior tip of the organism
Amastigote
flagellum: absent
Amastigote
flagellum: single free; extends anteriorly from the axoneme
Promastigote
undulating membrane: short; arising from the kinetoplast forms into a free flagellum at the anterior end
Epimastigote
undulating membrane: short; arising from the kinetoplast forms into a free flagellum at the posterior end
Trypomastigote
involve some combination of the four morphologic forms
Leishmania and Trypanosoma
Leishmania and Trypanosoma species are morphologically indistinguishable, but they can be differentiated by
isoenzyme analysis, molecular methods, or monoclonal antibodies
move by means of flagella
hemoflagellates
shape and size: ovoidal in shape and, on an average, measures 5 µm long by 3 µm wide
Amastigote
shape and size: spindle-shaped and measures 9 to 15 µm in length
Promastigote (typical)
shape and size: spindle-shaped and measures approximately 9 to 15 µm in length
Epimastigote (average)
shape and size: may be long and slender or assumes the shape of the letters C, S or U, and measures 12 to 35 µm long by 2 to 4 µm wide
Trypomastigote
nucleus: large single nucleus that is typically located off-center, sometimes present more toward the edge of the organism
Amastigote
nucleus: large single nucleus is located in or near the center of the body
Promastigote
nucleus: large single nucleus
Epimastigote; Trypomastigote
kinetoplast: consists of a deeply staining rod-like parabasal body and adjacent dot-like blepharoplast
Amastigote
kinetoplast: located in the anterior end of the organism and gives rise to an axoneme
Promastigote
kinetoplast: located anterior to the nucleus
Epimastigote
kinetoplast: located posteriorly from which emerges a full body length undulating membrane
Trypomastigote
blepharoplast: gives rise to and is attached to an axoneme
Amastigote
axoneme: extends to the anterior tip of the organism
Amastigote
flagellum: absent
Amastigote
flagellum: single free; extends anteriorly from the axoneme
Promastigote
undulating membrane: short; arising from the kinetoplast forms into a free flagellum at the anterior end
Epimastigote
The specimen of choice depends on the nature of disease.
Leishmania
Fluid aspirate beneath the ulcer bed, biopsy of skin ulcer
Old World cutaneous leishmaniasis (CL)
Same as in CL, and mucosal scrapings
Mucocutaneous leishmaniasis (ML)
Tissue aspirates (liver, splenic, sternal marrow), blood (buffy coat)
Visceral leishmaniasis (VL)
Stains used in Direct microscopy of Leishmania
Giemsa, Wright’s or Leishman’s stains, or Hematoxylin-Eosin
Direct microscopy Objective: Leishmania
oil immersion objective
In culture, Leishmania species behave as if they are in the
insect vector
NNN medium was described by
Novy, MacNeal and Nicolle
This is a rabbit blood agar slope consisting of two parts of salt agar and one part of defibrinated rabbit blood.
NNN medium
NNN medium: The material is inoculated into the water of condensation and culture is incubated at
22- 24°C for 1-4 weeks.
NNN medium: At the end of each week, a drop of culture fluid is examined under
high power objective or phase contrast illumination
This medium was originally designed for cultivation of insect tissue culture cells.
Schneider’s Drosophila medium
This medium is used containing inactivated fetal bovine serum and antibiotic and antimycotic solution to isolate and grow etiologic agents of leishmaniasis.
Schneider’s Drosophila medium
Immunodiagnosis: Serologic testing for Leishmania
IFA (indirect fluorescent antibody), ELISA (enzyme-linked immunosorbent assay), and DAT (direct agglutination test)
Molecular diagnosis: Leishmania
Western blot and PCR
confined to specialized laboratories and is yet to be used for routine diagnosis of visceral leishmaniasis in endemic areas
PCR
delayed hypersensitivity test
Leishmanin skin test (Montenegro test)
Skin test: What is injected intradermally on the dorsoventral aspect of forearm?
0.1 mL of killed promastigote suspension (106 washed promastigotes/mL)
Leishmanin skin test (Montenegro test) Positive result
induration and erythema of 5 mm or more after 48-72 hours
Leishmanin skin test (Montenegro test)
It has been tested in all types of leishmaniasis with high percentage of positivity in cutaneous leishmaniasis and 95% positivity in mucocutaneous leishmaniasis.
Leishmanin skin test (Montenegro test)
In active visceral leishmaniasis, this test is negative and becomes positive usually 6-8 weeks after cure from the disease.
The concentration of gammaglobulins in blood increases considerably following infection with
L. donovani
In visceral leishmaniasis, the test becomes positive only when infection is at least three months old and may remain so even after six months of cure.
Nonspecific serum test
1 mL of clear serum from the patient is taken in a small test tube, a drop of formalin (40% formaldehyde) is added, shaken and kept in a rack at room temperature. A control tube with normal serum is also set up.
walang answer nakalagay, no. 24 sa may “laboratory” part ng exercise 6c2
Aldehyde test of Napier (or formol gel test): specimen
1 mL of clear serum
Aldehyde test of Napier (or formol gel test): reagent
1 drop of formalin (40% formaldehyde)
Aldehyde test of Napier (or formol gel test): incubation
room temperature
A control tube with normal serum is also set up.
Aldehyde test of Napier (or formol gel test)
Aldehyde test of Napier (or formol gel test): positive result
opaque jellification of the test serum
Aldehyde test of Napier (or formol gel test): positive result resemblance
coagulated white of egg
Aldehyde test of Napier (or formol gel test): positive result (reaction time)
3-30 minutes
Antimony test of Chopra: specimen
0.2 mL of serum diluted 1:10 with distilled water
Antimony test of Chopra: reagent
4% solution of urea stibamine
Aldehyde test of Napier (or formol gel test): glassware
small ordinary test tube
Antimony test of Chopra: glassware
Dreyer’s tube
Antimony test of Chopra: positive result
flocculent precipitate
microscopic examination of chancre fluid, lymph node aspirates, blood, bone marrow, or, in the late stages of infection, cerebrospinal fluid demostrates
highly pleomorphic trypanosomes
Concentration techniques such as centrifugation can be used prior to microscopic examination.
Trypanosoma
Trypomastigotes are barely visible, but their motion against the RBCs makes them apparent.
Wet mount preparation
The specimen is fixed on a slide and stained with Giemsa (most sensitive) or other Romanowsky’s stain (Wright, Leishman)
Permanent staining
malaria diagnosis
Quantitative buffy coat (QBC) technique
Almost all patients with African trypanosomiasis have very high levels of which immunoglobulin classes?
IgM and IgG
Immunodiagnosis: Serologic testing for Trypanosoma
Indirect hemagglutination (IHA), indirect immunofluorescence (lF), enzyme-linked immunosorbent assay (ELISA), card agglutination trypanosomiasis test (CATT), and complement fixation test (CFT)
Immunodiagnosis: Antigen detectionfor Trypanosoma
ELISA
T or F: Molecular diagnosis: Nucleic acid-based tests are validated for the diagnosis of African trypanosomiasis, and diagnostic performance varies considerably among these tests.
F - No nucleic acid-based tests are validated for the diagnosis
Direct microscopy: Trpanosoma acute stage specimen
trypomastigotes in circulating blood or cerebrospinal fluid (CSF)
Trypomastigotes are barely visible, but their motion against the RBCs makes them apparent.
Wet mount preparation
Trypomastigotes can be seen in thick and thin blood smear stained with Giemsa (most sensitive) or other Romanowsky’s stain (Wright, Leishman)
Permanent staining
malaria diagnosis
Quantitative buffy coat (QBC) technique
Direct microscopy: Trpanosoma chronic stage specimen
biopsy specimens stained with hematoxylin-and-eosin (H&E) or Giemsa
also used for growing T. cruzi
NNN (Novy, MacNeal and Nicolle) medium
found in trypanosoma culture
Epimastigotes and trypomastigotes
This is the method of choice in suspected Chagas’ disease, if other examinations are negative, especially during the early phase of the disease onset.
Xenodiagnosis
allowed to feed on patient suspected to have Chagas’ disease
pathogen-free laboratory-bred triatomine bugs
The bugs’ feces are examined 3-4 weeks later for the presence of trypomastigotes.
Xenodiagnosis
a useful technique for determining whether the patient is infected
Immunodiagnosis
parasitemia is low
chronic phase of infection
can be detected in urine and sera in patients with chronic Chagas disease
T. cruzi antigen
Other tests: Trypanosoma
Electrocardiography (ECG) and chest X-ray; Endoscopy
useful for diagnosis and prognosis of cardiomyopathy seen in chronic Chagas disease
Electrocardiography (ECG) and chest X-ray
helps in visualization of megaesophagus in Chagas disease
Endoscopy
Which test/tests give false-positive reactions in several other disease such as multiple myeloma, cirrhosis of liver, tuberculosis, leprosy, shictosomiases , African trypanosomiasis, etc. where hypergammaglobulinemia is a feature?
Nonspecific serum test (Aldehyde test of Napier and Antimony test of Chopra)