Protozoa of the Blood Flashcards
Trypanosoma cruzi
lab tests
Cruizin’ through Che’s gas (Chagas disease)
Diagnosed by a blood smear during an active infection.
Trapanosomes burrow into endocardium and can be found in cardiac myocytes during heart biopsy.
Trypanosoma cruzi
Source
Cruizin’ through Che’s gas (Chagas disease)
South and Central America.
Transmitted by reduviid (kissing bug).
Reduviid bug (vector) bites (painless) the victim near the mouth → deposits T. cruzi infected feces into the open wound → T.cruzi gets into tissue when the victim scratches the wound → T.cruzi tunnels into the tissue and feeds on blood and lymph.
(trypomastigote in the blood and into an amastigote in tissues)
Trypanosoma cruzi
signs and symptoms
Cruizin’ through Che’s gas (Chagas disease)
Infection may be asymptomatic but 10-20 years later Chagas disease may set in. Symptoms of Chagas include:
- Megacolon w/ extreme constipation
- Dilated cardiomyopathy
- Megaesophagus
Trypanosoma cruzi
Treatment
Cruizin’ through Che’s gas (Chagas disease)
Acute infection: Nifurtimox
Chronic infection: No known effective tx
Babesia
lab tests
The Vampire Babes
Diagnosed by a thick blood smear
Maltese cross appearance in RBC’s (Tetrad of trophozoites, which will help dx babesiosis from maleria)
Babesia
Source
The Vampire Babes
North East U.S.
Ixodes tick (Found on deer, and also transmits Borrelia Burgdorferi AKA Lyme disease. Co-infection is common).
Transfered from Ixodes tick saliva. The longer the tick is attached the more likely the babesia infection occurs.
Babesia
signs and symptoms
The Vampire Babes
- Most will be mild or asymptomatic, can have maleria-like symptoms.
- Blood related symptoms, specifically hemolytic anemia → can lead to jaundice.
- Irregularly cycling fevers
- Higher risk of severe disease in Sickle cell disease → asplenia
Babesia
Treatment
The Vampire Babes
Atovaquone and Azithromycin (a macrolide)
Plasmodium maleriae, vivax, ovale, and falciparum
lab tests
The queens and warlords of Plasmodium
Diagnosed by blood smear** **Giemsa stain (see parasites in RBC’s).
Plasmodium falciparum is banana shaped under microscope.
Plasmodium maleriae, vivax, ovale, and falciparum
Source
The queens and warlords of Plasmodium
African Wilderness
also South East Asia, Caribbean, and South America
Anopheles mosquito!
Plasmodium maleriae, vivax, ovale, and falciparum
signs and symptoms of Malaria
The queens and warlords of Plasmodium
- Fever
- Headache
- Anemia
- Splenomegaly
Plasmodium maleriae, vivax, ovale, and falciparum
3 main life cycle stages
The queens and warlords of Plasmodium
- Stage of infection: Infected female anopheles mosquito bites a person and injects saliva (infected with sporozoites) into the blood circulation.
- Asexual reproduction: Sporozoites travel to liver → enter liver cells and start dividing, leading to schizonts → Schizont gives birth to thousands of merozoites that are released into the blood stream → merozoites target red blood cells (RBCs) → ring form stage that evolves into a trophozoite → erythrocytic schizont → gives birth to new generation merozoites → RBCs rupture, merozoites are released in the blood stream in order to invade other RBCs.
- This is when parasitaemia occurs and cinical manifestations appear. The liver phase occurs only once while the erythrocytic phase undergoes multiple cycles; the merozoites release after each cycle creates the febrile waves
3. Sexual reproduction: Female anopheles mosquito bites an infected person, and takes up these gametocytes with the blood meal. The parasite reproduces (I am not listing all the steps of reproduction and travel inside the mosquito)
Plasmodium maleriae, vivax, ovale, and falciparum
Plasmodium maleriae
The queens and warlords of Plasmodium
Quartan fever cycle
Fever is highest on days 1 and 4 (72 hours later)
Plasmodium maleriae, vivax, ovale, and falciparum
Plasmodium vivax** and **ovale
The queens and warlords of Plasmodium
Tertian fever cycle
Fever is highest on days 1 and 3 (48 hours later)
Produce dormant hypnozoites in the liver
Plasmodium maleriae, vivax, ovale, and falciparum
Plasmodium falciparum
MOST SEVERE malaria illness!
The queens and warlords of Plasmodium
Irregular fever cycle
The mature schizonts change the surface properties of infected erythrocytes, causing them to stick to blood vessel walls → leads to obstruction of the microcirculation and results in dysfunction of multiple organs like the brain (neurologic symptoms!), kidney, and lungs.
Plasmodium maleriae, vivax, ovale, and falciparum
Treatment for:
maleriae, vivax, ovale:
The queens and warlords of Plasmodium
Chloroquine (Blocks plasmodium heme polymerase)
For hypnozoites in the liver (vivax, ovale): Primaquin + Chloroquine. *** (Be careful w/ G6PD deficient, can create severe anemia.) ***
Plasmodium maleriae, vivax, ovale, and falciparum
Treatment for:
Caribbean (travelers / prophylaxis)
or Chloroquine resistant areas
The queens and warlords of Plasmodium
Mefloquine
Atovoquone w/ proguanil
Plasmodium maleriae, vivax, ovale, and falciparum
Treatment for:
falciparum
sickle cell anemia pt.
The queens and warlords of Plasmodium
Artimesians w/ atovaquine
IV artesonate for severe malaria infections.
Quinidine for resistant P. falciparum infections.
*** Quinidine can cause cinchinism (headaches and tinnitus) ***
Leishmania donovani and braziliensis
lab tests
Desert Mania
Purple stained nuclei are filled with tiny stained nuclei of amastigotes
Leishmania donovani and braziliensis
Source
Desert Mania
Sand Fly’s are the vector.
Vertebrates (like humans) are the host.
L. braziliensis: South America
L. donovani: Tropical and subtropical areas, middle east, Africa
Leishmania donovani and braziliensis
signs and symptoms of:
L. braziliensis
Desert Mania
Cutaneous leishmaniosis
Consumes flesh → Disfiguring ulcers
Leishmania donovani and braziliensis
signs and symptoms of:
L. donovani
Desert Mania
Visceral leishmaniosis (AKA Black fever or Kala-azar)
Hyperpigmented spots that look black.
100% fatal if left untreated.
Usually infects liver, spleen (hepatosplenomegaly), and bone marrow (pancytopenia).
Can also cause fever and weakness
Leishmania donovani and braziliensis
life cycle stages
Desert Mania
Sand fly’s carry the promastigote (infectious form) → becomes an amastigote (intracellular form) in the vertebrate host → ends up in macrophages
Leishmania donovani and braziliensis
Treatment
Desert Mania
Cutaneous leishmaniosis: Stibogluconate
Visceral leishmaniosis: AMP B
