Flagellates And Hemoflagellates Flashcards
Flagellates includes
Giardia lamblia
Trichomonas vaginalis
Which is the most common parasitic infection in world and most commonly found in stool
Giardia lamblia
Habitat of Giardia lamblia
Mucosa of duodenum and upper ileum
Infective stage of Giardia lamblia
Cyst
Infective dose of Giardia lamblia
Small dose - 10-25
Route of infection of Giardia lamblia
Feco oral route
Giardia lamblia attaches to duodenum with the help of
Sucking disk
Lectin Antigen
Attachment of Giardia lamblia to duodenum results in
Blunting of villi - Malabsorption (Vit B12, FA, Protein)
Iron deficiency anemia
Disaccharide enzymes -
Life cycle of Giardia lamblia
Ingestion of dormant cysts - Excystation( Trophozoite emerges) - Trophozoites undergoes asexual reproduction - both trophozoites and cyst in feces - Only cyst can survive outside host (human) - can survive weeks to month in cold water - Ingestion
Sample and Trophozoites in M/E in Giardia Lamblia
Sample - Stool (3 consecutive days)
M/E - Trophozoites: Pear/tennis racket appearance, attaches by suckling disc
2 nuclei
4 pairs of Flagella
Cyst of Giardia lamblia on M/E
1-4 nuclei
No Flagella
Which test is done im case of Giardia lamblia to do pull out Duodenal contents
String test/Enterotest
Other diagnosis methods of Giardia lamblia and gold standard
Copro antigen detection
Antibody
Gold standard - PCR
Giardia lamblia appearance on Duodenal biopsy
Luminal organism - Sickle shaped Organism in lumen
Giardia lamblia shows which type of Motility
Falling leaf Motility
Treatment of Giardia lamblia
DOC - Metronidazole or Tinidazole
Most common cause of STD and Non Gonococcal urethritis
Trichomonas vaginalis
Mode of transmission of Trichomonas vaginalis
Sexual
Reservoir in case of Trichomonas vaginalis
Female
Infective and diagnostic forms of Trichomonas vaginalis
Trophozoite only
Cyst -ve
IP and Clinical features seen in males in case of Trichomonas vaginalis
IP - 4 to 28 days
C/F - Urethritis, Cystitis, Prostatitis
Clinical features seen in females in case of Trichomonas vaginalis
Strawberry cervix/Colpitis macularis
Greenish discharge
Structure of Trophozoite of Trichomonas vaginalis on M/E
Only one nucleus
4 ant Flagella
1 post flagella with undulating membrane
Motility seen in case of Trichomonas vaginalis
Jerky/twitching Motility
Culture medium used for diagnosis of Trichomonas vaginalis
Lash cysteine Hydrosylate medium
Trussell and Johnson medium
Diamond medium
Site commonly affected in case of Trichomonas vaginalis
Genitals
Hemoflagellates includes
Leishmania
Trypanosoma
Development stages or morphological forms in case of Hemoflagellates
APET
Amastigote
Promastigote
Epimastigote
Trypomastigote
Protozoan bodies seen in case of Hemoflagellates
Parabasal body and Blepharoplast - Kinetoplast
Kinetoplast position in comparison to nucleus and exception
Present anterior to nucleus
Except - Trypomastigote - have Post nuclear Kinetoplast
BET CATE LAP Mnemonic
BET - Brucii Epimastigote Trypomastigote
CATE - T. Cruzi, Amastigote, Trypomastigote, Epimastigote
LAP - Leishmania Amastigote Promastigote
Trypanosomes are divided into
2 groups
Salivaria - organism passed in saliva
Ex - T Brucii
Stercoraria - insect passes organism in feces
Ex - T Cruzii
Trypanosoma Cruzii AKA
South American Trypanosomiasis
Definitive and intermediate host in Case of Trypanosoma cruzii
Definitive - Man
Intermediate - Reduvid bug/Triatomine bug (nocturnal) AKA Kissing bug
Reservoir in case of T Cruzii infection
Armadillo/Cat/dog/pig
Infective form in case of T Cruzii
Trypomastigote
Mnemonic for T Cruzzii
Rich American couple
Merc Benz
Cruise
Rome (kiss)
Jhakaas life
Bade log badi baatein
Morphological forms seen in insect and Adults human during life cycle of T Cruzii
TAT
In insect - Epimastigotes
Adult human - Amastigotes
Sites commonly affected in case of Acute Chagas disease
Chagoma( entry site edema)
Lymphadenopathy
Hepatosplenomegaly
Specific sign seen in case of Acute Chagas disease
Romana sign - periorbital edema
Sites affected in case of Chronic Chagas disease
Myocarditis, Dilated CM
Megaesophagus (Achalasia cardia)
Megacolon
Brain - Meningoencephalitis
Sample taken in case of T Cruzii infection
Blood/buffy coat
Microscopic finding in case of T Cruzii
Trypomastigote - post. Nucleus Kinetoplast
Culture media used in case of T Cruzii
NNN (Novy Nicolle McNeal)
DOC in case of T Cruzii
Benznidazole
Symptomatic treatment
Trypanosoma Brucie includes which organisms
T.B Gambiense
T.B Rhodesiense
T.B Gambiense and T.B Rhodesiense AKA
Gambiense - West African Sleeping sickness
Rhodesiense - East African Sleeping sickness
Vector for T.B Gambiense and T.B Rhodesiense
Tse Tse fly
Primary Reservoir in case of T.B Gambiense and T.B Rhodesiense
Gambiense - Human
Rhodesiense - Animals
Clinical features in case of T.B Gambiense and T.B Rhodesiense
Gambiense - Chronic CNS Disease, Winterbottom sign - Post cervical Lymphadenopathy
Rhodesiense - Myocarditis
Parasitemia, virulence and Resistance is more in which Trypanosoma Brucei species
more in T.B Rhodesiense
Treatment of T.B Gambiense and T.B Rhodesiense
Gambiense - Pentamidine
Rhodesiense - Suramine
Sample taken in case of Trypanosoma Brucie and finding
Blood/CSF - Trypomastigote
Culture media used in case of Trypanosoma Brucie
Weinmann’s medium
Examples of Parasites causing Myocarditis
TTTTE
Trichinella species
T. Cruzii
T.B Rhodesiense
Toxoplasma gondii
Echinococcus
Vector in case of Leishmania
Sandfly
Infective and diagnostic forms in case of Leishmania
Infective form - Promastigote
Diagnostic form - Amastigote (LD Bodies)
Disease caused by Leishmania
Kala Azar
Clinical features seen in Kala azar
Massive Hepatosplenomegaly
Blackening of skin
Scaly skin
Dark and ashen skin
Night sweats
Severe temp. Or irregular bouts
Bleeding
Cough
Weakness/weight loss
Life cycle of Leishmania Donovani
Human - Promastigote transform into Amastigotes - multiply in cells or various tissues - Sandfly takes a blood meal (ingests Amastigotes) - Amastigotes transform into Promastigote in gut - divide and migrate to Proboscis - Sandfly inject Promastigote into humans skin
Sample taken in case of Leishmania
Spleen aspiration - most sensitive but extremely vascular can result in bleeding
Bone marrow - most preferred
Blood
BAL (HIV)
M/E finding in case of Leishmania
Amastigote (LD- Leishman Donovan Bodies) - Absent flagella, Nucleus Kinetoplasm
Blood test preformed in case of Leishmania
Pancytopenia
Hypergammaglobunemia - Napier’s Aldehyde test, Chopra’s antimony test
Skin test performed in case of Leishmania
Montenegro test (Type 4 HS)
Culture media used in case of Leishmania
NNN (Novy Nicolle McNeal) medium
Treatment or Leishmania
Liposomal Amphotericin B
Post Kala azar Dermal Leishmaniasis seen after how many years of treatment and C/F
1 to 2 years after treatment
C/F - Hypopigmented nodules
DOC in case of Post Kala azar Leishmaniasis
Miltefosine
Leishmania tropica causes
Cutaneous Leishmaniasis - erythematous border, exudate in centre
Cutaneous Leishmaniasis AKA
Oriental sore/Delhi boil/Baghdad boil/Chiclero ulcer
Treatment of Cutaneous Leishmaniasis
Sodium stibogluconate
Mucocutaneous Leishmaniasis/Espudia is caused by
Leishmania Bransiliensis
Treatment of Mucocutaneous Leishmaniasis
Sodium stibogluconate
Leishmaniasis Recidivans AKA and C/F
Relapsing Leishmaniasis
Often due to inadequate treatment
Nodular lesions or rash around Central healing