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2025 SEM 2 CLINICAL PARASITOLGY (LEC) > hemoflagellates > Flashcards

hemoflagellates Flashcards

1
Q

list of hemoflagellates

A

 Leishmania braziliensis complex
 Leishmania donovani complex
 Leishmania mexicana complex
 Leishmania tropica complex
 Trypanosoma brucei gambiense
 Trypanosoma brucei rhodesiense
 Trypanosoma cruzi
 Trypanosoma rangeli

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2
Q

general characteristics of hemoflagellates

A

Unicellular
Found in blood and tissues.
Flagellated
Habitat: Reticuloendothelial cells (special immune system cells that can help clean the blood and fight infections)
Phagocytosis [This is the process where immune cells “eat” harmful invaders like bacteria or parasites to destroy them. However, some hemoflagellates can survive inside these immune cells instead of being destroyed, which helps them spread in the body.]

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3
Q

mode of transmission of hemoflagellates

A

Vector-borne
Vertical transmission (mother to child)
Blood transfusion
Accidental needle prick
Organ transplant (hemoflagellates reside in lymph nodes, spleen, liver)

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4
Q

what do u call a parasite that are found in the blood but live inside cells

A

intracellular parasites

[ they hide and grow inside the body’s immune cells (like macrophages). This helps them avoid being attacked by the immune system.]

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5
Q

morphologic form of hemoflagellates

A

A.P.E.T (index card)
AMASTIGOTE
PROMASTIGOTR
EPIMASTIGOTE
TRYPOMASTIGOTE

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6
Q

diagnostic form of hemoflagellates

A

Leishmania:
→ Amastigote is the primary diagnostic form.

Trypanosoma:
→ Trypomastigote is the primary diagnostic form, except in Trypanosoma cruzi, where amastigotes can also be found.

*diagnostic stage that can be seen under the microscope

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7
Q

Where are amastigotes usually found?

A

usually lives inside immune cells (macrophages)in tissues, muscles and CNS whr they multiply

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8
Q

specimen of choice in hemoflagellates

A

Blood
Lymph node or ulcer fluid
Tissue biopsies
Bone marrow
Cerebrospinal fluid (CSF) (the fluid around the brain and spine)

  • can also use serologic and molecular test to confirm infection
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9
Q

symptoms of hemoflagellates

A

usually starts:
small red papule at the infection site w intense itching

if untreated:
secondary bacterial infections
fever and diarrhea
kidney involvement ((organ damage)

severe cases:
mental retardation
comatose state and health

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10
Q

these are two forms routinely found in human species

A

amastigote
trypomastigote
*found in human infections

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10
Q

where can trypomastigote be found

A

found freely moving in the blood and can reproduce there

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11
Q

this stage may not be seen only if blood sample is collected immediately after transmission into a healthy individual or when the appropriate sample is cultured.

A

promastigote

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12
Q

infective stage of Leishmania

A

promastigote

  • that are transmitted to humans by sandflies. However, they are not normally found in human blood as they are quickly taken up by immune cells (macrophages) and transform into amastigotes inside the cells.
  • hence, they much change into amastigote to survive (diagnostic stage)

[Infective Stage → Promastigote,found in sandfly saliva
Diagnostic Stage → Amastigote, found inside macrophages in tissue]

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13
Q

What are the main types of Leishmania that infect humans?

A

Leishmania braziliensis complex
Leishmania donovani
Leishmania mexicana
Leishmania tropica complex

  • Leishmania braziliensis complex found in:
    Mexico, Argentina, Panama, Colombia, Peru (Andes region), Guiana, Brazil, Bolivia, Paraguay, Ecuador, Venezuela.
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14
Q

where can the New World Leishmania be found?

A

north, south or central america

they are:
Leishmania braziliensis
Leishmania panamensis
Leishmania peruviana
Leishmania guyanensis

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15
Q

where can the Old World Leishmania be found

A

Africa, Asia, and Europe

(L. donovani and L. tropica.)

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16
Q

Common Diseases Associated with Leishmania

A

Mucocutaneous leishmaniasis (affect the oral and mucosal area)
Espundia [another name for mucocutaneous leishmaniasis in South America.]
Forest yaws/ Pian bois [Local terms for skin infections caused by Leishmania in forested areas.]
Uta [mild form of cutaneous leishmaniasis found in Pe]

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17
Q

Leishmania Lifecycle (Step-by-Step)

A

Mosquito (sandfly) bites a human, injecting promastigotes into the skin.

Macrophages (immune cells) engulf promastigotes – They transform into amastigotes, multiply inside the cells, and cause the cells to rupture.

Another mosquito bites the infected human, ingests amastigotes from the blood.

Inside the mosquito, amastigotes change back into promastigotes, multiply in the mosquito’s gut, and move to the proboscis (mouthpart).

The cycle repeats when the mosquito bites another person, transmitting the parasite again.

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18
Q

What are the vectors (carriers) of Leishmania braziliensis complex?

A

Sandflies – Lutzomyia and Psychodopygus.

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19
Q

What disease does Leishmania braziliensis complex cause?

A

Mucocutaneous Leishmaniasis.

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20
Q

the spread of mucocutaneous leishmaniasis to the mouth, nose, and throat.

A

espundia

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21
Q

A deformed, swollen nose caused by severe tissue destruction in mucocutaneous leishmaniasis.

A

tapir nose

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22
Q

What is the main laboratory test for diagnosing Leishmania braziliensis?

A

Biopsy of the infected ulcer (examined under a microscope).
*uses giemsa stain

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23
Q

What two research methods are used to identify Leishmania?

A

Schizodeme analysis – Examines kinetoplast DNA. (structure in the parasite)
Zymodeme analysis – Studies isoenzyme patterns (to identify diff leishmania spp)

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24
What is the most widely used treatment for mucocutaneous leishmaniasis?
Antimony-based drugs: - Meglumine antimoniate (Glucantime). - Sodium stibogluconate (Pentostam).
25
Is Leishmania donovani Complex Old World or New World?
Old World or New World? species in the complex: Leishmania donovani donovani Leishmania donovani chagasi Leishmania donovani infantum
26
Other Names for Leishmania donovani Infection
Visceral leishmaniasis (most severe form, affecting internal organs like the liver and spleen) also known as: - Kala-azar - Dum-Dum fever - Black fever
27
what are the symptoms and advanced stage of Visceral Leishmaniasis
✅ Early Stage: Mild abdominal pain. Swelling of the liver and spleen (hepatosplenomegaly). Symptoms resemble malaria. ✅ Advanced Stage: Glomerulonephritis (kidney damage). Darkening of the skin.
27
how does Visceral Leishmaniasis (Leishmania donovani Complex) is being transmitted
Spread by sandfly bites. Can also be transmitted from person to person through blood transfusions.
28
how does the Visceral Leishmaniasis (Leishmania donovani Complex) diagnosed
Montenegro Skin Test (MST): - Used to check past exposure, but not reliable for active infections. - A skin reaction ≥5 mm means the person was exposed to Leishmania. Giemsa-Stained Slides: - Examining samples from bone marrow, lymph nodes, or infected areas under a microscope. Serological Tests (Blood Tests): - IFA, ELISA, DAT – Detect antibodies against Leishmania. Advanced Research Methods: - Schizodeme analysis – Studies Leishmania DNA. - Zymodeme analysis – Identifies enzyme patterns to classify the parasite. - "LISA’s Plan" 💊 L – Liposomal Amphotericin B (Ambisome) – Most effective drug. 💊 I – Interferon-γ + Pentavalent Antimony – Helps boost immune response. 💊 S – Sodium Stibogluconate (Pentostam) – A commonly used drug. 💊 A – AIDS patients respond well to Allopurinol. 💊 S – Secondary prophylaxis is recommended for HIV-infected patients to prevent
29
Leishmania mexicana Complex
"New World Leishmania" This group is found in the Americas (New World). Species Included: Leishmania mexicana Leishmania pifanoi Leishmania amazonensis Leishmania garnhami Leishmania venezuelensis
30
disease caused in Leishmania mexicana Complex
New World Cutaneous Leishmaniasis – Skin infections. Chiclero ulcer Bay sore Cutaneous leishmaniasis
31
Leishmania tropica Complex
"Old World Leishmania" Main Species: Leishmania tropica Leishmania aethiopica Leishmania major
32
disease caused by Leishmania tropica Complex
Old World Cutaneous Leishmaniasis: (aka) 🦠 Oriental sores 🦠 Delhi boils 🦠 Baghdad boils 🦠 Dry/Urban Cutaneous Leishmaniasis
33
how is Leishmania tropica Complex diagnosed
🔬 Microscopic Examination: Giemsa-stained slides from ulcer fluid to detect amastigotes. Culture of infected oral tissue. 💉 Serologic Tests: Indirect Fluorescent Antibody Test (IFA) – Detects antibodies against Leishmania. 🧬 Research Methods: Schizodeme analysis – Studies Leishmania DNA. Zymodeme analysis – Identifies enzyme patterns. Nuclear DNA hybridization – Genetic test to confirm species. 🩺 Montenegro Skin Test: Used to check for past infection. May be negative in active cases.
34
Treatment & Control of Leishmania tropica Complex
💊 Drugs Used: Sodium stibogluconate (Pentostam) – First-line treatment. Meglumine antimonate (Glucantime) Pentamidine, ketoconazole Paromomycin – Helps heal ulcers. Steroids & Heat Application – Helps reduce inflammation. 🧪 Vaccine Trials: Researchers are testing vaccines to prevent Leishmania infections. 🛡 Prevention & Control: Same as for other leishmaniasis species (e.g., avoiding sandfly bites).
35
it is a disease caused by Trypanosoma parasites, which are hemoflagellates (parasites that live in the blood).
Trypanosomiasis Types of Trypanosoma that Cause Disease: 1️⃣ Trypanosoma brucei gambiense – Causes West African Sleeping Sickness 2️⃣ Trypanosoma brucei rhodesiense – Causes East African Sleeping Sickness 3️⃣ Trypanosoma cruzi – Causes Chagas’ Disease 4️⃣ Trypanosoma rangeli – Does not cause disease in humans but infects them. !!!!!!!!!!!!! [the only commenced between the 4]
36
What is the infective and diagnostic stage of Trypanosoma?
INFECTIVE 🦠 Metacyclic Trypomastigote (transmitted by the insect vector to humans). DIAGNOSTIC 🩸 Trypomastigote (found in blood smears).
37
What is the difference between East & West African Sleeping Sickness?
(table)
38
What are the symptoms of African Sleeping Sickness and Chagas' Disease (Trypanosoma cruzi)?
African sleeping sickness: 💤 Stage 1 (Early) – Fever, headache, swollen lymph nodes. 🧠 Stage 2 (Late) – Neurological symptoms, sleep disturbances, coma. Chagas' Disease (Trypanosoma cruzi): 🚨 Acute Stage – Swelling at bite site, fever, enlarged organs. ⏳ Chronic Stage – Heart failure, digestive problems, sudden death.
39
How is Trypanosomiasis diagnosed?
🩸 Blood smears (Giemsa stain) – Detects Trypomastigotes. 🦴 Bone marrow/Lymph node aspirates – Advanced diagnosis. 🧪 Serological tests (ELISA, IFA) – Detect antibodies.
40
What is the treatment for African Trypanosomiasis and Chagas' Disease?
💊 Early Stage: Pentamidine (T. b. gambiense) Suramin (T. b. rhodesiense) 💊 Late Stage (CNS Involvement): Melarsoprol (to cross blood-brain barrier) Eflornithine (T. b. gambiense only) _____________________________________ 💊 Acute Stage: Benznidazole or Nifurtimox 💊 Chronic Stage: Symptom management (heart & digestive support).
41
What are the vectors for Trypanosomiasis?
🦟 Tsetse fly (Glossina spp.) → African Trypanosomiasis 🦟 Triatomine (kissing bug) → Chagas' Disease
42
lifecycle of Trypanosoma brucei?
1️⃣ Tsetse fly injects metacyclic trypomastigotes into the human bloodstream. 2️⃣ Parasites spread through the lymphatic system and organs. 3️⃣ Trypomastigotes multiply and circulate in the blood. 4️⃣ Tsetse fly bites infected host, ingesting trypomastigotes. 5️⃣ Parasites transform inside the fly into metacyclic trypanosomes. 6️⃣ Tsetse fly transmits Trypanosoma to a new host, restarting the cycle.
43
What is the infective and diagnostic stage of Trypanosoma brucei?
INFECTIVE: Metacyclic Trypomastigote (transmitted by the tsetse fly). DIAGNOSTIC: Trypomastigote (found in blood, lymph, or cerebrospinal fluid).
44
What are the early symptoms of West African Sleeping Sickness?
🩸 Painful chancre at the bite site. 🌡️ Fever, headache, weakness, and loss of appetite. 🦠 Trypomastigotes spread through the lymphatic system. ⚠️ Winterbottom’s sign – Swollen cervical lymph nodes.
45
What happens during the glandular and late phase of West African Sleeping Sickness?
GLANDULAR PHASE: 🔴 Red rash (erythematous rash). 🤕 Delayed pain response (Kerandel’s sign). 🦵 Swelling & itchiness due to inflamma LATE STAGE: 🧠 CNS symptoms: Mental impairment, tremors, and confusion. 💤 Excessive sleepiness (somnolence) and personality changes. ⚰️ Coma & death due to secondary infections (pneumonia, malaria). *it last for several years before fatality if left untreated
46
How does East African Sleeping Sickness differ from West African Sleeping Sickness? (T. b. gambiense)
index card
47
What are the fatal complications of East African Sleeping Sickness in T. b. gambiense?
Myocarditis – Heart inflammation. 🩸 Glomerulonephritis – Kidney damage. ⏳ Rapid weight loss leading to death in 9-12 months.
48
causes, symptoms, diagnosis and treatment of Trypanosoma brucei (African Sleeping Sickness)
Cause: A parasite transmitted by the tsetse fly Symptoms: Fever, swollen lymph nodes, sleep disturbances, confusion, and coma if untreated. Diagnosis: History of travel to Africa Physical signs like Winterbottom’s sign (swollen lymph nodes in the neck) Blood tests to find the parasite Spinal fluid tests if the brain is affected Treatment: Pentamidine, Suramin (for early stages) Melarsoprol, Tryparsamide (for late-stage with brain involvement)
49
causes, symptoms, diagnosis and treatment of causes, symptoms, diagnosis and treatment of
Cause: A parasite transmitted by the kissing bug Symptoms: Acute phase: Fever, swelling at the bite site (Romaña’s sign – swollen eyelid if infected through the eye). Chronic phase: Years later, it can cause heart disease, digestive problems, and nerve damage. Diagnosis: Blood tests (look for the parasite under a microscope) Biopsy (check for parasites in tissues) PCR (genetic test to detect the parasite) Treatment: Benznidazole & Nifurtimox (work best in the early stage)
50
What is the key symptom of early African Sleeping Sickness?
Winterbottom’s sign (swollen lymph nodes in the neck)
51
how is Trypanosoma brucei diagnosed?
Blood smear, spinal fluid test, and travel history
52
What is the treatment for early African Sleeping Sickness?
Pentamidine or Suramin
53
What is the vector of Trypanosoma cruzi?
Kissing bug (Reduviid bug)
54
What disease does Trypanosoma cruzi cause?
Chagas Disease (American Trypanosomiasis)v
55
What is a classic symptom of acute Chagas Disease?
Romaña’s sign (swollen eyelid)
56
How is Chagas Disease diagnosed?
Blood smear, biopsy, PCR test
57
What are the treatments for Chagas Disease?
Benznidazole & Nifurtimox
58

2025 SEM 2 CLINICAL PARASITOLGY (LEC) (8 decks)

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