Hemoflagellates Flashcards
Flagellates that are found in the blood and other fluids (CSF) and in tissues
Hemoflagellates
They are vector-borne parasites
Hemoflagellates
Hemoflagellates
Another important note, they are transmitted by the bite of the ______.
arthopod
Hemoflagellates
Medically Important Genera
● Trypanosoma
● Leishmania
Generalities
Only Trypanosoma and Leishmania infect ________
humans
Generalities
There are four morphological forms encountered in the life cycle of Hemoflagellates:
■ Amastigote
■ Promastigote
■ Epimastigote
■ Trypomastigote
Generalities
What would be the basis of differentiating the four morphologic forms?
- location of the nucleus.
- location of the kinetoplast
Generalities
the energizing structure of the parasite
kinetoplast
four morphological forms
Amastigote is also know as
Donovan Leishman Body
four morphological forms
This would appear as a round to oval structure
Amastigote
four morphological forms
Aside from being round to oval in shape, the amastigote would have no _______
flagella
four morphological forms
Another feature of the parasite, this would be found inside the cell, an intracellular form
Amastigote
four morphological forms
The kinetoplast is adjacent or near your basal body.
Amastigote
four morphological forms
Also known as
Promastigote
Leptomonas Stage
four morphological forms
long and slender, and it would
already have a flagella, in the anterior part.
Promastigote
four morphological forms
The nucleus will be found in the center of the parasite
Promastigote
four morphological forms
kinetooplast is found
anterior (nasa harap) to your nucleus
Promastigote
four morphological forms
also known as
Epimastigote
Crithidia Stage
four morphological forms
Nucleus is more posterior when compared to the promastigote
Epimastigote
four morphological forms
kinteoplast is found anterior to the nucleus. But the kinetoplast is more adjacent to the nucleus
Epimastigote
four morphological forms
presence
of the undulating membrane (one half (1/2) the body length)
Epimastigote
four morphological forms
helping in the
motility of the parasite.
undulating
membrane
four morphological forms
It is also long or elongated, but if you would notice, the shape would look like S, C, or U shaped
Trypomastigote
four morphological forms
the location of the nucleus, would be found more anterior than the kinetoplast
Trypomastigote
four morphological forms
undulating membrane is also found here, but is
now full body length
Trypomastigote
four morphological forms
Another unique feature would be the granules found in your trypomastigote, called the
Trypomastigote
volutin granules
Other Present Generalities: Life Cycle
All forms are found in __________ infections
Trypanosoma cruzi
Other Present Generalities: Life Cycle
Only the _________ and _______ are seen in
Tryanosoma brucei infections
epimastigote and trypomastigote
Other Present Generalities: Life Cycle
seen in the insect vector of Trypanosoma brucei
Epimastigote
Other Present Generalities: Life Cycle
found in the
humans in Tryanosoma brucei infections.
trypomastigote
Other Present Generalities: Life Cycle
Only the _________ and ___________ are seen in Leishmania infections
amastigote and promastigote
Other Present Generalities: Life Cycle
seen in the insect vector of Leishmania
Promastigote
Other Present Generalities: Life Cycle
will be found in humans in Leishmania infections
amastigote
Other Present Generalities: Life Cycle
Diagnostic Stages (found in humans) include:
- amastigote
- trypomastigote
Other Present Generalities: Life Cycle
For Trypanosoma cruzi and Trypanosoma brucei, the infective stage of these two would be the __________.
metacyclic trypomastigote
Other Present Generalities: Life Cycle
On the other hand, for the members of Leishmania, the infective stage would be the
_________.
promastigote
Other Present Generalities: Life Cycle
Final host
humans
Other Present Generalities: Life Cycle
intermediate host
insect vector
Trypanosoma cruzi
Belongs to Trypanosome Group:
Stercoraria
Trypanosoma cruzi
Primarily Infects:
Myocytes and cells of RESs
Trypanosoma cruzi
RES meaning
reticulo-endothelial system
Trypanosoma cruzi
reticulo-endothelial system:
- spleen
- lymph node
- immune cells
Trypanosoma cruzi
causes
Chagas’ Disease or
American Trypanosomiasis
Trypanosoma cruzi
Majority of cases are found in
South America
(Brazil)
Trypanosoma cruzi: Life Cycle
Triatomine Bug other names:
Triatomine Bug to Human transmission
Kissing Bug,
Reduviid Bug, and Assassin Bug
Trypanosoma cruzi: Life Cycle
Usually the ____ triatomine bug bites
humans to take a blood meal
Triatomine Bug to Human transmission
female
Trypanosoma cruzi: Life Cycle
Usually occurs during the ____
Triatomine Bug to Human transmission
night
Trypanosoma cruzi: Life Cycle
Prefer biting near the _________
Triatomine Bug to Human transmission
mucosal membrane
Trypanosoma cruzi: Life Cycle
After the triatomine bug is full from feeding on the blood, it will ______
Triatomine Bug to Human transmission
defecate
Trypanosoma cruzi: Life Cycle
Infective stage of the parasite is found in the
_____ of the kissing bug
Triatomine Bug to Human transmission
feces
Trypanosoma cruzi: Life Cycle
__________ will penetrate cells at the bite site and will transform into
amastigotes
Human Stages
Metacyclic trypomastigotes
Trypanosoma cruzi: Life Cycle
Amastigotes multiply by ________
Human Stages
binary fission
Trypanosoma cruzi: Life Cycle
Some amastigotes will be released and will transform into _________ (found extracellularly); some are released in the ______
Human Stages
- trypomastigotes
- blood
Trypanosoma cruzi: Life Cycle
Repeating cycle inside the body:
Human Stages
- Amastigotes multiply
- Intracellular amastigotes transform into trypomastigotes, then burst out of the cell and enter the blood stream (Diagnostic Stage)
- Trypomastigotes can infect other cells and transform into intracellular amastigotes in new infection sites
Trypanosoma cruzi: Life Cycle
Another kissing bug will bite the infected person and will get the ______
Triatomine Bug Stages
trypomastigote
Trypanosoma cruzi: Life Cycle
Once ingested, it transforms into an _______ in the midgut or GI track
Triatomine Bug Stages
epimastigote
Trypanosoma cruzi: Life Cycle
Epimastigote will multiply by _________
Triatomine Bug Stages
asexual
reproduction
Trypanosoma cruzi: Life Cycle
Eventually, this epimastigote will become a _________ found in the hindgut
Triatomine Bug Stages
metacyclic trypomastigote
Trypanosoma cruzi: Life Cycle
is found on the posterior part of the kissing bug
Triatomine Bug Stages
Hindgut
Trypanosoma cruzi: Life Cycle
It would then be released in the ________ after the blood meal of the kissing bug
Triatomine Bug Stages
feces
Trypanosoma cruzi: Life Cycle
Final host
humans
Trypanosoma cruzi: Life Cycle
Intermediate host vector
Reduviid bug/ kissing bug
(Triatoma, Panstronglylus, Rhodnius)
Trypanosoma cruzi: Life Cycle
MOT
- Feces of vector entering bite wound
- blood transfusion
- organ transplants
- transplacentally
Trypanosoma cruzi: Life Cycle
Unknowingly, organs transplanted may have
________ that will multiply and release trypomastigote which will start the life cycle on the person
amastigotes
Trypanosoma cruzi: Life Cycle
Infective stage to humans
Metacyclic trypomastigote
Trypanosoma cruzi: Life Cycle
Diagnostic stage
- trypomastigote (found in the blood)
- amastigote (inside the cells and tissue)
Trypanosoma cruzi: Life Cycle
Amastigotes inside tissues in the _____
phase of the illness
chronic
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Acute Phase
- fever and lymphadenopathy
- diffuse inflammation
- malaise
- nausea
- vomiting
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
local inflammation; reddish
nodule; central edema, regions;
lymphadenopathy
Acute Phase
Chagoma
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
periorbital swelling (edema
of eyelid and conjunctiva); periorbital swelling (swelling is usually on one side)
Acute Phase
Romana’s sign
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
After the acute stage is the ________, wherein all of the symptoms and manifestation seen will eventually disappear
but the parasite is still present.
latent stage
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
no characteristic symptoms
Chronic Phase
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
20 years or more, the patient will proceed to the chronic phase, wherein there is an ________ of different vital organs due to
the multiplying amastigotes found inside the different tissues
Chronic Phase
enlargement
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Manifestations of Chronic Phase
■ Mega esophagus, mega colon,
cardiomegaly, cardiac arrhythmia
■ Can lead to death; very common cause of death is heart problems
■ In South America, a common cause of cardiac arrhythmia and abnormal ECG results would be the T. cruzi
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Direct inflammatory response:
Pathogenesis
■ Chaga-toxin
■ Damage to infected cells
■ Destruction of autonomic nerve
ganglions
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Uses ____ like carbohydrates for binding
Pathogenesis
lectin
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Acute _______ reaction on bite
Pathogenesis
inflammatory
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Target cells:
Pathogenesis
- cells of RES
- cardiac cells
- skeletal and smooth muscles
- neuroglia cells
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Trypanosoma cruzi: Diagnosis
● Presence of Lesions
● Cardiac symptoms a
● Presence of Trypomastigote (Acute phase)
● Demonstration of trypanosomes
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Demonstration of trypanosomes in blood
thick and thin smears
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Demonstration of trypanosomes in buffy coat
concentration technique (Strout Method)
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Demonstration of trypanosomes in CSF, tissues
Tissue and biopsy samples
You will find amastigotes (chronic stage)
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Demonstration of trypanosomes in:
- blood
- Buffy coat layer
- CSF, tissues
- lymph
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Involves a suspected patient
Xenodiagnosis
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Culture:
■ Chang’s
■ NNN (Novy MacNeal Nicolle)
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Serology
- IFAT
- Complement Fixation
- ELISA
- Western Blot
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
IFAT meaning
Immunofluorescence Antibody Test
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
detection of
complement fixing antibodies.
Complement Fixation
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
ELISA meaning
Enzyme-linked immunoassay
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
Complement fixation test used in T.cruzi
Guerreiro Machado Test
Trypanosoma cruzi: Epidemiology
Occurs only in the ______ continent
American
Trypanosoma cruzi: Epidemiology
Highest prevalence in
Brazil
Trypanosoma cruzi: Epidemiology
More common in _____ areas
rural
Trypanosoma cruzi: Epidemiology
_________ disease is more common
Chronic
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
A kissing bug is placed on the skin of the patient, covered in a _________, for the bug to bite the skin
Xenodiagnosis
copper container
Trypanosoma cruzi: Disease Manifestation and Pathogenesis
If a parasite develops in the kissing bug after a few months, a patient is positive for the
infection
Xenodiagnosis
Trypanosoma cruzi: Epidemiology
Common in _______ housing conditions
unsanitary
Another cause of American Trypanosomiasis
Trypanosoma rangeli
Trypanosoma cruzi: Treatment
Nifurtimox and Benznidazole
Trypanosoma rangeli
Vector
Rhodnius
Trypanosoma brucei complex
Etiologic Agents of African Sleeping Sickness
- Trypanosoma brucei rhodesiense
- Trypanosoma brucei gambiense
Etiologic Agents of African Sleeping Sickness
Causes Rhodesian or East African Sleeping
Sickness
Trypanosoma brucei rhodesiense
Etiologic Agents of African Sleeping Sickness
Endemic (local transmission) in East and South Africa
Trypanosoma brucei rhodesiense
Etiologic Agents of African Sleeping Sickness
is more acute; rapidly progressing; patient is usually in the sleeping phase in less than 9 months
Trypanosoma brucei rhodesiense
Etiologic Agents of African Sleeping Sickness
Causes Gambian or West African Sleeping
Sickness
Trypanosoma brucei gambiense
Etiologic Agents of African Sleeping Sickness
is more chronic; longer
progression; more common and prevalent
Trypanosoma brucei gambiense
Etiologic Agents of African Sleeping Sickness
primarily affects wild and
domestic animals; current research shows that it does
not cause disease/s in humans
T. brucei brucei
Vector Transmitted Parasitic Infections T. brucei
Vector of T. Brucei
Tsetse Fly (Glossina spp.)
Vector Transmitted Parasitic Infections T. brucei
T. b. rhodesiense Glossina spp
- G. pallidipes
- G. morsitans
Trypanosoma rangeli
Difference: Metacyclic Trypomastigote is discharged
via the _________
salivary glands
Trypanosoma rangeli
Is Trypanosoma rangeli pathogenic?
No
Vector Transmitted Parasitic Infections T. brucei
T. b. gambiens Glossina spp
G. palparis
Vector Transmitted Parasitic Infections T. brucei
Infective stage to humans
Metacyclic Trypomastigote
T. brucei: Life Cycle
Humans get the infection when they are bitten by the Tsetse Fly. The fly takes a blood meal while simultaneously injecting __________
metacyclic trypomastigotes
T. brucei: Life Cycle
The injected metacyclic trypomastigote becomes a
_________, which will be distributed to other sites of the body
trypomastigote
T. brucei: Life Cycle
The procyclic trypomastigote will then become an _________.
epimastigote
T. brucei: Life Cycle
The epimastigotes then travel to the salivary glands to multiply and to eventually become _____________.
metacyclic trypomastigotes
T. brucei: Life Cycle
Infective stage to humans
metacyclic
trypomastigotes
T. brucei: Life Cycle
Diagnostic stage
presence of trypomastigote
T. brucei: Life Cycle
What form is found in the insect
Epimastigote
T. brucei: Life Cycle
What form is in the
mammalian host
Trypomastigote
T. brucei: Life Cycle
Usually if trypomastigote is found in the blood, it’s _________ stage of the illness
acute or early
T. brucei: Life Cycle
In order for the life cycle to continue, another Tsetse fly will bite the infected patient. The fly would then get the _________
trypomastigote
T. brucei: Life Cycle
The ________ will multiply by binary fission and can be found in different body fluids such as the blood, lymph/lymph nodes, and spinal fluid/CSF.
trypomastigotes
T. brucei: Life Cycle
Inside the G.I. Tract of the Tsetse fly, the trypomastigote will become __________, wherein these will also undergo binary fission to multiply
procyclic trypomastigotes
Disease Manifestation: T.brucei
painful ulceration
Sickness
Gambian or West African Sleeping
Trypanosomal Chancre
Disease Manifestation: T.brucei
Earliest sign :
Sickness
Gambian or West African Sleeping
Trypanosomal Chancre
Disease Manifestation: T.brucei
Patients still appear ______
Trypanosomal Chancre
healthy
Disease Manifestation: T.brucei
Blood smear :
Trypanosomal Chancre
(+) Trypomastigotes
Disease Manifestation: T.brucei
It can last for weeks or months, the parasite would eventually affect the _________
Trypanosomal Chancre
central nervous system
Disease Manifestation: T.brucei
Patients experience fever once the _______ are affected. Other manifestations include malaise, weakness, night sweats, dizziness, and nausea.
Trypanosomal Chancre
lymph nodes
Disease Manifestation: T.brucei
Occurs when there is enlargement
of cervical lymph node
Gambian or West African Sleeping
Winterbottom’s sign
Disease Manifestation: T.brucei
cervical lymph node size
Winterbottom’s sign
“Ripe plum”
Disease Manifestation: T.brucei
Can find the trypomastigotes in the _______
Winterbottom’s sign
lymph or lymphatic fluid
Disease Manifestation: T.brucei
Chronic Disease
Gambian or West African Sleeping
■ CNS invasion
■ Sleeping sickness stage initiated
■ Terminal Phase
Disease Manifestation: T.brucei
Chronic Disease Signs and symptoms:
Gambian or West African Sleeping
- severe headache
- increasing mental deterioration and apathy
- meningoencephalitis
Disease Manifestation: T.brucei
Delayed
sensation to pain
Chronic Disease of Gambian or West African Sleeping
Kerandel’s sign
Disease Manifestation: T.brucei
Some would have Kernig
sign
Gambian or West African Sleeping
Chronic Disease
Disease Manifestation: T.brucei
Terminal Phase:
Gambian or West African Sleeping
Coma leading to
death
Disease Manifestation: T.brucei
appropriate specimen
for diagnosis in chronic disease
Gambian or West African Sleeping
CSF
Disease Manifestation: T.brucei
Causes Rhodesian and East African
Sleeping Sickness
Trypanosoma brucei rhodesiense
Disease Manifestation: T.brucei
Similar to Gambian Sleeping Sickness but _______ and ________
Sleeping Sickness
Rhodesian and East African
acute and rapidly progressing
Disease Manifestation: T.brucei
Less than ___ months, the patient will progress to sleeping sickness stage
Sleeping Sickness
Rhodesian and East African
9
Disease Manifestation: T.brucei
____ stage takes place in the early stages
Rhodesian and East African Sleeping Sickness
CNS
Disease Manifestation: T.brucei
Inflammation of the
glomerulus
Sleeping Sickness
Rhodesian and East African
Glomerulonephritis
Pathogenesis for T. brucei
- Generalized lymphoid hyperplasia
- Anemia
- Thrombocytopenia
- Hypergammaglobulinemia
- Immune Evasion
- Acute infection
- Chronic infection
Pathogenesis: T. brucei
Low hemoglobin and rbc count
Anemia
T. brucei: Life Cycle
Presence of it in the cerebrospinal fluid (CSF), would
indicate the patient to be in _______
“Sleeping phase”
Disease Manifestation: T.brucei
Trypanosoma brucei gambiense causes
Gambian or West African Sleeping Sickness
Pathogenesis: T. brucei
Increase amounts of antibodies (IgM) in the
blood and CSF
Hypergammaglobulinemia
Pathogenesis: T. brucei
Immune Evasion through :
Variant surface
glycoproteins
Diagnosis: T.brucei
- Physical Findings and Patient HIstory
- Demonstration of Trypomastigotes in Blood, CSF,
Lymph Node Aspirate - Concentration of Buffy Coat
- Serology
- Molecular Methods
- Animal Inoculation and Culture
Diagnosis: T.brucei
stain for Concentration of Buffy Coat
Giemsa Stain
Diagnosis: T.brucei
Serology:
IHAT, ELISA, Rapid Tests
Pathogenesis: T. brucei
Decrease in platelets
Thrombocytopenia
Clinical Findings: T.brucei
- In-vitro autoagglutination in blood
- Elevated serum and CSF igM
- Mott Cells in CSF
Clinical Findings: T.brucei
High IgM antibodies due to parasite producing __________
variable antigen types
Gambian or Rhodesian
No animal reservoirs
Reservoir host
West African/Gambian sleeping sickness
Gambian or Rhodesian
Chronic
Illness
West African/Gambian sleeping sickness
Gambian or Rhodesian
Animals (wild game animals, domestic animal such as sheep and ox)
Reservoir host
East African/Rhodesian sleeping sickness
Gambian or Rhodesian
Low
Parasitemia
West African/Gambian sleeping sickness
Gambian or Rhodesian
Prominent
Lymphadenopathy
West African/Gambian sleeping sickness
Gambian or Rhodesian
Anthroponosis, rural population
Epidemiology
West African/Gambian sleeping sickness
Gambian or Rhodesian
Acute (<9months)
illness
East african/Rhodesian Sleeping Sickness
Gambian or Rhodesian
High
Parasitemia
East african/Rhodesian Sleeping Sickness
Gambian or Rhodesian
Minimal
Lymphadenopathy
East african/Rhodesian Sleeping Sickness
Gambian or Rhodesian
Anthropozoonosis, game parks
Epidemiology
East african/Rhodesian Sleeping Sickness
Epidemiology of T. brucei
Vectors inhabit areas near _______ and ________
river banks and streams
Epidemiology of T. brucei
Low Prevalence Rate
What percent?
(<1%)
Treatment for T. brucei
Better prognosis if treatment started before ____
CNS stage
Epidemiology of T. brucei
________ transmission is possible
Congenital
Treatment for T. brucei
blood and lymphatic
stage
- Pentamidine
- Suramin
Treatment for T. brucei
late stage
Melarsoprol
Leishmania
Vector
Sandflies
(Phlebotomus spp.)
Phlebotomus spp.:
- Lutzomyia
- Psychodopygus
Obligate Intracellular Parasites
Leishmania
Leishmania
Primarily a _____ disease
zoonotic
Overview of the Life Cycle: Leishmania
Sandfly take a blood meal (injects _________ stage into the skin)
promastigote
Overview of the Life Cycle: Leishmania
Promastigotes are phagocytized by _____
macrophages
Overview of the Life Cycle: Leishmania
Promastigotes transform into _____ inside
macrophages.
amastigotes
Overview of the Life Cycle: Leishmania
______ multiply in cells (including macrophages)
of various tissues
Amastigotes
Overview of the Life Cycle: Leishmania
Sandfly takes a blood meal (ingests ________
infected with amastigotes)
macrophages
Overview of the Life Cycle: Leishmania
Amastigotes transform into _______ stage in midgut
promastigote
Overview of the Life Cycle: Leishmania
Found inside the tissue macrophages
Amastigotes
Morphology: Leishmania
seen in the mammalian host
Amastigote
(Leishmania)
Overview of the Life Cycle: Leishmania
_________ divide in midgut and migrate to proboscis
Promastigotes
Morphology: Leishmania
seen in sand fly
Promastigote
Leptomonad
Morphology: Leishmania
Other MOT
- Blood Transfusion
- Contact
- Contamination of Bite Wounds
Morphology: Leishmania
Target Cells
RE cells
Morphology: Leishmania
Infective Stage
Promastigote
Diseases: Leishmania
Cutaneous Leishmaniasis other names:
- Old World Leishmaniasis
- Aleppo Button
- Delhi Boil
- Baghdad Boil
- Jericho Boil
Diseases: Leishmania
Etiology:
Cutaneous Leishmaniasis
Leishmania tropica
Diseases: Leishmania
Incubation Period:
Cutaneous Leishmaniasis
Weeks to Months
Diseases: Leishmania
Disease Manifestation:
Cutaneous Leishmaniasis
Elevated Skin Ulcers (Painless)
Diseases: Leishmania
The parasite lives in the _______ cells in
the skin capillaries.
Cutaneous Leishmaniasis
endophilia
Diseases: Leishmania
Etiologic Agent
Mucocutaneous Leishmaniasis
Leishmania braziliensis
Diseases: Leishmania
Mucocutaneous Leishmaniasis other names
- American
- New World
Leishmaniasis
Diseases: Leishmania
Incubation
Mucocutaneous Leishmaniasis
Weeks to Months
Diseases: Leishmania
Disease Manifestation:
Initial
Mucocutaneous Leishmaniasis
Ulcers similar to Old World
Leishmaniasis
Diseases: Leishmania
Disease Manifestation: Later stage
Mucocutaneous Leishmaniasis
Spread to Oronasal
and Pharyngeal Mucosa
Diseases: Leishmania
affects the nose
Mucocutaneous Leishmaniasis
Espundia
Diseases: Leishmania
affects the
nose (narrow nasal bridge)
Mucocutaneous Leishmaniasis
Tapir Nose
Diseases: Leishmania
affects the
ears
Mucocutaneous Leishmaniasis
Chiclero Ulcer
Diseases: Leishmania
Primarily target the mucosal lining of the
nose, mouth, and throat.
Mucocutaneous Leishmaniasis
Diseases: Leishmania
Etiology
Visceral Leishmania
Leishmania donovani
Diseases: Leishmania
Incubation
Visceral Leishmania
1-3 months
Diseases: Leishmania
Visceral Leishmania other names
- Kala-azar
- Dumdum Fever
- black Fever
Diseases: Leishmania
Fever with twice daily elevations
(dromedary fever peak)
Visceral Leishmania
Diseases: Leishmania
Reticuloendotheliosis
Visceral Leishmania
Diseases: Leishmania
Darkening of Skin (forehead, temples, around the mouth)
Visceral Leishmania
Epidemiology: Leishmania
Endemic in ___ countries on __ continents
- 88
- 5
Diseases: Leishmania
Dermal Leishmaniod Lesions - may
be rarely seen
Visceral Leishmania
Diseases: Leishmania
Most deadly among the species since it
affects different vital organs.
Visceral Leishmania
Epidemiology: Leishmania
Visceral Leishmaniasis
Endemic areas
- Bangladesh
- Brazil
- India
- Nepal
- Sudan
Epidemiology: Leishmania
Cutaneous Leishmaniasis
Endemic areas
- Afghanistan
- Brazil
- Iran
- Peru
- Saudi Arabia
- Syria
Diagnosis: Leishmania
Wait ______ after injecting. If
there is an enlargement in a rash if you were previously exposed with the parasite
Montenegro skin test
72 hours
Diagnosis: Leishmania
Some amastigotes can be found outside the
__________.
macrophage
Diagnosis: Leishmania
Shape of kinetoplast
Rod-shaped
Diagnosis: Leishmania
Golden hamsters can be used. If
they developed the disease then it’s positive
Animal inoculation
Diagnosis: Leishmania
Leishmania donovani amastigotes can be mistaken as __________ of a fungus
yeast cells/forms
(histoplasma capsulatum)
Diagnosis: Leishmania
Donovani has rod-shaped kinetoplast and can be found
____ the macrophage while the yeast cells can be found _____ the macrophage
- outside
- inside
Diagnosis: Leishmania
___ would stain the yeast cells of the cytoplasm but not the Leishmania.
PAS
Treatment for Leishmania:
Antimony Compounds
Treatment for Leishmania:
Antimony Compounds:
- Sodium Stibogluconate
- n-methyl-glucamine
antimonite
Epidemiology: Leishmania
Mucocutaneous Leishmaniasis
Endemic areas
- Brazil
- Eastern Peru
- Bolivia
- Paraguay
- Ecuador
- Colombia
- Venezuela
Diagnosis: Leishmania
also known as
Leishmanin skin test
Montenegro skin test
Diagnosis: Leishmania
○ Demonstration of lesions
○ Tissue biopsies
○ Skin biopsies
○ Examination of BM, spleen, lymph node
○ Montenegro skin test
○ Animal inoculation
○ Serology: IFAT
○ Culture: NNN
○ Molecular methods
Diagnosis: Leishmania
Intradermal skin test involving
injection wherein the patient is
injected with a suspension of
________
Montenegro skin test
promastigote.
