Free-living Pathogenic Amebae

Question 1

Found in warm bodies of water, including lakes, streams, ponds, and swimming pools.

Answer 1

Naegleria Fowleri

Question 2

Can survive in up to 0.5 ug/ ml of hyper chlorinated water.

Answer 2

Naegleria Fowleri

Question 3

Higher in the summer months of the year.

Answer 3

Naegleria Fowleri

Question 4

Able to survive in elevated temperatures up to 46° C.

Answer 4

Naegleria Fowleri

Question 5

Can be acquired in contaminated dust.

Answer 5

Naegleria Fowleri

Question 6

3 Clinical Symptoms of Naegleria Fowleri

Answer 6

Asymptomatic
Kernig’s sign
Primary Amebic Meningoencephalitis (PAM)

Question 7

CSF findings:
- pleocytosis (high percentage of PMN cells)
- hypoglycorrhacia
- elevated protein levels

Answer 7

Naegleria Fowleri

Question 8

2 Treatments of Naegleria Fowleri

Answer 8

Amphotericin B - DOC
Amphotericin B with rifamfin/miconazole

Question 9

First noted as a contaminant in tissue cultures and subsequently was found to produce lethal meningoencephalitis on nasal instillation into mice and other animals.

Answer 9

Acanthamoeba

Question 10

Culture: Proteose -peptone, yeast extract, glucose and cysteine (PYGC) containing antibiotics.

Answer 10

Acanthamoeba

Question 11

Reported from many countries worldwide both CNS and eye infection.

Answer 11

Acanthamoeba

Question 12

CNS infection appears in patient who are immunocompromised.

Answer 12

Acanthamoeba

Question 13

Isolated from air, aquaria, bottled mineral water, soil swimming pools, deep well water, contact lens solution.

Answer 13

Acanthamoeba

Question 14

GAE means

Answer 14

Granulomatous Amebic Encephalitis

Question 15

First documented by “Stamm”

Answer 15

Granulomatous Amebic Encephalitis

Question 16

Incubation period: 10 days

Answer 16

Granulomatous Amebic Encephalitis

Question 17

May be caused by several species Acanthamoeba, including A. castellani, A. culbertsoni, A. polyphaga, and A. astronyxis, among others.

Answer 17

Granulomatous Amebic Encephalitis — Acanthamoeba

Question 18

Infection is thought to spread hematogenously from primary foci in skin, the pharynx, or the respiratory tract.

Answer 18

Granulomatous Amebic Encephalitis — Acanthamoeba

Question 19

Systemic infections occur in individuals with AIDS and may present as ulcerative skin lesions, subcutaneous abscesses, or erythematous nodules.

Answer 19

Granulomatous Amebic Encephalitis — Acanthamoeba

Question 20

2 Clinical Symptoms of Acanthamoeba

Answer 20

Granulomatous Amebic Encephalitis
Acanthamoeba keratitis

Question 21

The disease is characterized by development of a paracetamol ring infiltrate of the corneal stroma, which progresses to ulceration and possible perforation, with loss of the eye.

Answer 21

Acanthamoeba keratitis

Question 22

It is required in cases of extensive and refractory disease.

Answer 22

Keratoplasty

Question 23

Diagnosis usually is established by demonstrating amebic trophozoites or cysts in corneal scrapings or biopsies.

Answer 23

Acanthamoeba keratitis

Question 24

6 Treatments of Acanthamoeba

Answer 24

Sulfamethazine
Itraconazole
Ketoconazole
Miconazole
Propamidine isethianate (DOC)
Rifampin

Question 25

Infective stage: cyst, viable for several weeks.

Answer 25

Balantidium Coli

Question 26

Human infection results from ingestion of food or water contaminated with fecal material containing this cysts.

Answer 26

Balantidium Coli

Question 27

Incubation period: 4-5 days

Answer 27

Balantidium Coli

Question 28

Ingested cysts excysts in the small intestine.

Answer 28

Balantidium Coli

Question 29

Trophozoites inhabit the lumen, mucosa and submucosa of the large intestine, primarily the cecal region.

Answer 29

Balantidium Coli

Question 30

Disease: Balantidiasis , balantidial dysentery

Answer 30

Balantidium Coli — Pathogenesis

Question 31

It invades the intestinal epithelium through release of the enzyme hyaluronidase and creates a characteristic ulcer with a rounded base and wide neck. [pathogenic amebae]

Answer 31

Balantidium Coli

Question 32

Acute diarrhea with mucus and blood, cramps.

Answer 32

Balantidium Coli — Pathogenesis

Question 33

Complications include intestinal perforation and acute appendicitis.

Answer 33

Balantidium Coli — Pathogenesis

Question 34

Usually non-pathogenic commensal in the large intestine.

Answer 34

Balantidium Coli — Pathogenesis

Question 35

Many infected individuals are asymptomatic.

Answer 35

Balantidium Coli — Pathogenesis

Question 36

Majority of the symptomatic patients complain of diarrhea and dysentery.

Answer 36

Balantidium Coli — Pathogenesis

Question 37

Abdominal discomfort or pain associated with nausea and vomiting.

Answer 37

Balantidium Coli — Pathogenesis

Question 38

3 Treatments of Balantidium Coli

Answer 38

Metronidazole Tetracycline Iodoquinol

Question 39

Prevention: proper sanitation, safe water supply and protection of food from contamination. [pathogenic amebae]

Answer 39

Balantidium Coli

Question 40

It is resistant to environmental conditions and may survive for long period, they are easily inactivated by heat and 1% sodium hypochlorite.

Answer 40

Balantidium Coli — Cyst

Question 41

5 Morphological Forms of Blastocystis Hominis

Answer 41

1. Vacuolated forms 2. Ameba-like forms 3.Granular forms 4. Multiple fission forms 5. Cystic forms

Question 42

Most predominant. [morphological forms of blastocystis hominis]

Answer 42

Vacuolated forms

Question 43

Large central vacuole (reproductive organelle and very thick capsule. [morphological forms of blastocystis hominis]

Answer 43

Vacuolated forms

Question 44

Active extensions and pseudopodia. [morphological forms of blastocystis hominis]

Answer 44

Ameba-like forms

Question 45

Nuclear chromatin: peripheral clumping. [morphological forms of blastocystis hominis]

Answer 45

Ameba-like forms

Question 46

Intermediate stage between vacuolar and pre cystic. [morphological forms of blastocystis hominis]

Answer 46

Ameba-like forms

Question 47

Observed from old cultures. [morphological forms of blastocystis hominis]

Answer 47

Granular forms

Question 48

Contents develop into daughter cells of the amoeba - form when it ruptures. [morphological forms of blastocystis hominis]

Answer 48

Granular forms

Question 49

Arise from vacuolated forms. [morphological forms of blastocystis hominis]

Answer 49

Multiple fission forms

Question 50

Produce many vacuolated forms. [morphological forms of blastocystis hominis]

Answer 50

Multiple fission forms

Question 51

Very prominent and thick osmophilic electron dense wall. [morphological forms of blastocystis hominis]

Answer 51

Cystic forms

Question 52

responsible for external transmission. [cystic forms]

Answer 52

Thick walled cyst

Question 53

reinfection within a hosts intestinal tract. [cystic forms]

Answer 53

Thin walled cyst

Question 54

Stool is the specimen of choice for the recovery.

Answer 54

Blastocystis Hominis — Diagnosis

Question 55

Concentration technique: increase sensitivity.

Answer 55

Blastocystis Hominis — Diagnosis

Question 56

Hematoxylin or Trichome: to differentiate various stages.

Answer 56

Blastocystis Hominis — Diagnosis

Question 57

Culture: Boeck and Drbohhlav’s media, Nelson and Jones media

Answer 57

Blastocystis Hominis — Diagnosis

Question 58

Infections indicated that they occurred as epidemic in subtropical countries. [pathogenic amoebae]

Answer 58

B.hominis

Question 59

3 Treatments of Blastocystis Hominis

Answer 59

1. Iodoquinol 2. Metronidazole 3. Trimethroprim - sulfamethoxazole

Question 60

Kidney shaped

Answer 60

Macronucleus

Question 61

Small spherical

Answer 61

Micronucleus