PRL U4 Flashcards
Parasite
African trypanosomiasis
Trypanosoma brucei brucei
Trypanosoma brucei gambiense
Trypanosoma brucei rhodesiense
Parasite
Chagas disease, American trypanosomiasis
Trypanosoma cruzi
Parasite
Leishmaniasis
Leishmania spp.
Parasite
Malaria
Plasmodium spp.
Parasite
Babesia
Babesia spp.
Vector of Trypanosoma brucei complex
Glossina spp. (Tsetse fly)
Vector of Trypanosoma cruzi
Triatoma (“kissing”) bugs
Vector of Leishmania spp.
Phlebotomine sand flies
Vector of Malaria
Anopheles mosquitoes
Vector of Babesia spp.
Ticks
4 morphological forms
- Amastigote – (Donovan Leishman)
- Promastigote – (Leptomonas)
- Epimastigote – (Crithidia)
- Trypomastigote
Characteristics of Amastigote
non-flagellated oval form
Characteristics of Promastigote
Flagellated stage found in the vector, rarely seen in the blood
Characteristics of Epimastigote
Long, slender flagellated form Found in arthropod vectors
Characteristics of Trypomastigote
has undulating membrane running the length of the body, found in the vector and bloodstream of humans
forms are found in Trypanosoma cruzi infections
All forms : amastigote, promastigote, epimastigote, trypomastigote
forms seen in Trypanosoma brucei infections
epimastigote and trypomastigote
forms seen in Leishmania infections
amastigote and promastigote
Diagnostic Stages (found in humans)
amastigote and or trypomastigote
Mature forms
promastigote, epimastigote, trypomastigote
Trypanosoma is also called
African Sleeping Sickness
American Trypanosomiasis
General characteristics of Trypanosoma
- Multiply by binary fission
- Found in the blood
Trypanosoma cruzi Infective Stage
Metacyclic trypomastigote
Trypanosoma cruzi Diagnostic Stage
Humans : amastigote
Blood : trypomastigote
Diagnosis of Trypanosoma is made by
microscopic examination of blood, CSF, lymph node aspirate, chancre aspirate, microhematocrit centrifugation, serologic testing
Trypanosomiasis occurs mainly in
Africa and South America
2 species of Trypanosoma brucei complex
Trypanosoma brucei gambiense
Trypanosoma brucei rhodesiense
causes African trypanosomiasis or african sleeping sickness
Trypanosoma brucei
Trypanosoma brucei infects (system)
the lymphatic system and CNS
Symptoms caused by Trypanosoma brucei
Swollen lymph nodes at the posterior base of the neck
Causes Chagas disease or American Trypanosomiasis
Trypanosoma cruzi
symptoms of Trypanosoma cruzi
lesion formation, conjunctivitis, edema of the face and legs, and heart muscle involvement leading to myocarditis
periorbital swelling caused by Trypanosoma cruzi
Romañas sign
other called African Trypanosomiasis
“African Sleeping Sickness”
MOT African Trypanosomiasis
Mother to child infection, Blood transfusion, Sexual contact, Mechanical transmission
East african Trypanosoma
Trypanosoma brucei rhodesiense
Primary reservoir of Trypanosoma brucei rhodesiense
Animals (wild and domestic), antilope, cows and carabaos
Illness caused by Trypanosoma brucei rhodesiense
Acute (early CNS invasion), <9 mos
Lymphadenopathy of Trypanosoma brucei rhodesiense
Minimal
Parasitemia of Trypanosoma brucei rhodesiense
High
Epidemiology of Trypanosoma brucei rhodesiense
Antropozoonosis
Recommended specimes
Trypanosoma brucei rhodesiense
Chancre aspirate, lymph node aspirate, blood, CSF
West african Trypanosoma
Trypanosoma brucei gambiense
Primary reservoirs
Trypanosoma brucei gambiense
Humans
Illness
Trypanosoma brucei gambiense
Chronic (late CNS invasion), months to years
Trypanosoma brucei gambiense
Lymphadenopathy
Trypanosoma brucei gambiense
Prominent
Parasitemia
Trypanosoma brucei gambiense
Low
Epidemiology
Trypanosoma brucei gambiense
Anthroponosis, rural populations
Recommended specimens
Trypanosoma brucei gambiense
Chancre aspirate, lymph node aspirate, blood, CSF
Initial lesion of African Trypanosomiasis
local, painful, pruritic, erythematous
African Trypanosomiasis Stage 1
Early HAT (Haemolymphatic Stage)
Symptoms of African Trypanosomiasis Stage 1
Fever
Headache
Joint pain
Malaise
Winter bottom’s sign
Occurs when trypomastigotes enter the hemolymphatic system to
undergo asexual reproduction
Early HAT (Haemolymphatic Stage)
enlargement of cervical lymph node
Winter bottom’s sign
has CNS involvement
Late HAT (Meningoencephalitic stage)
delayed sensation caused by trypanosomes affecting BBB
Kerandel’s sign
Symptoms of Late HAT (Meningoencephalitic stage)
- Sleeping sickness
- Neurologic symptoms
- Personality changes, headaches, and withdrawal from the environment
- Nocturnal
- Insomnia
- Daytime lethargy
- Secondary infections = pneumonia
Stage 1 treatment
Pentamidine, Suramin
Stage 2 treatment
Melarsoprol, Eflornithine, Nifurtimox
Prevention of African Trypanosomiasis
- Control in the reservoir like livestock
- Remove scrub
- Education
- Public awareness
- Hygiene
Diagnosis of African Trypanosomiasis
- Demonstration of trypomastigote in chancre, lymph node aspirate, CSF
- Thick and thin blood smear (Giemsa)
- Buffy coat concentration
- Lymph node aspirates
other term for American Trypanosomiasis
Chagas Disease or South American trypanosomiasis
Transmission of American Trypanosomiasis
- Mediated via vectors = Kissing Bugs
- Ingestion of food contaminated with parasites
- Blood transfusions
- Fetal transfusion
- T. cruzi = by Carlos Chagas
Diagnostic stage of American trypanosomiasis
- Trypomastigotes: bloodstream
- Amastigotes: tissue cells
Pathogenesis of American Trypanosomiasis (Acute phase)
- 1 week after infection
- Fever, lymph node enlargement,
unilateral swelling of eyelids - Damaged muscle cells and
edema
Pathogenesis of American Trypanosomiasis (Intermediate phase)
Asymptomatic
MOT of Romana’s sign
accidentally rubbing of eyes using hands with feces
Pathogenesis of American Trypanosomiasis (Chronic phase)
Cardiac manifestation & gastrointestinal manifestation
Diagnosis stage of Acute Phase
- Wet smear – blood, CSF = examination for motile
trypomastigote - Thick and Thin Smear (Stain = Giemsa)
- CSF, tissue samples, lymph examination
- Xenodiagnosis
Diagnosis stage of Chronic Phase
Serological testing
Leishmaniasis Old World
L. tropica, L. aethiopica, L. major
Leishmaniasis New World
L. mexicana, L. amazonensis, L. guyanensis, L. braziliensis, L. chagasi
Agent of Leishmaniasis
Phlebotomus sp. (old world); Lutzomyia (new world)
Primarily a zoonotic disease
Leishmaniasis
most common form of leishmaniasis
Cutaneous Leishmaniasis (CL)
causes Cutaneous Leishmaniasis (CL)
Leishamania tropica
Usually with one or more painless ulcers
Cutaneous Leishmaniasis (CL)
Usually occurs months or years after healing of primary CL
Mucosal/Mucocutaneous Leishmaniasis (ML)
Etiologic agent of Mucosal/Mucocutaneous Leishmaniasis (ML)
L. braziliensis
can cause destruction of the nasal septum, palate, and other mucosal structures, leading to devastating facial mutilation and, rarely, death from airway involvement
Mucosal/Mucocutaneous Leishmaniasis (ML)
Lesions confused with lepromatous leprosy
Diffuse or disseminated CL (DCL)
nodules are often described as soft and fleshy, while those of leprosy are
generally more indurated.
Diffuse or disseminated CL (DCL)
febrile illness with weight loss, enlargement of the spleen and liver, and decreases in the production of blood cells
Visceral Leismaniasis (VL)
Etiologic agent of Visceral Leismaniasis (VL)
L.donovani and L.infantum
Agent of visceral fever/ Dum-dum fever/ Donovani Kala-azar fever (VL)
Leishmania donovani
Agent of cutaneous oriental sore
Leishmania tropica
Agent of mucocutaneous lesion/ mucocutaneous Leishmaniasis
Leishmania braziliensis
Diagnosis of Leishmaniasis
Sx: Tissue biopsy, skin, spleen, lymphnodes
Tests for Leishmaniasis
- Stained smears
- Culture (NNNmedium;Schneider’smedium)
- Montenegro skin test - Intradermal Testing
Treatment for Leishmaniasis
Amphotericin B; Pentamidine; Nifurtimox & Antimony compounds
Epidemiology of Leishmaniasis
Primarily a disease of poverty
Prevention of Leishmaniasis
Early diagnosis and effective treatment
Vector control
Effective disease surveillance
Control of animal reservoir hosts
Social mobilization and strengthening partnerships