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Clinical Parasitology (Lecture) > Week 4: Free-living Pathogenic Amebae > Flashcards

Week 4: Free-living Pathogenic Amebae Flashcards

1
Q

Size range of Naegleria fowleri
(Trophozoite)?

A

8-22 um

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2
Q

Motility of Naegleria fowleri
(Trophozoite)?

A

Sluglike, blunt pseudopods

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3
Q

No. of nuclei of Naegleria fowleri
(Trophozoite)?

A

One

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4
Q

Karyosome of Naegleria fowleri
(Trophozoite)?

A

Large and usually centrally located

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5
Q

Peripheral Chromatin of Naegleria fowleri (Trophozoite)?

A

Absent

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6
Q

Cytoplasm of Naegleria fowleri (Trophozoite)?

A

Granular, usually vacuolated

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7
Q

Size range of Naegleria fowleri (Flagellated forms)?

A

7-15 um

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8
Q

Motility of Naegleria fowleri (Flagellated forms)?

A

2 flagella; spinning or jerky movements

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9
Q

No. of nuclei of Naegleria fowleri (Flagellated forms)?

A

One

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10
Q

Karyosome of Naegleria fowleri (Flagellated forms)?

A

Large and usually centrally located

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11
Q

Peripheral Chromatin of Naegleria fowleri (Flagellated forms)?

A

Absent

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12
Q

Cytoplasm of Naegleria fowleri (Flagellated forms)?

A

Granular, usually vacuolated

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13
Q

Size range of Naegleria fowleri (Cyst)?

A

5-22 um

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14
Q

Shape of Naegleria fowleri (Cyst)?

A

ovoid, ellipsoid, triangular

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15
Q

No. of nuclei of Naegleria fowleri (Cyst)?

A

One

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16
Q

Karyosome of Naegleria fowleri (Cyst)?

A

large, eccentric achromatic granules on one side may be present

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17
Q

Peripheral Chromatin of Naegleria fowleri (Cyst)?

A

Absent

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18
Q

Cytoplasm of Naegleria fowleri (Cyst)?

A

coarsely granular and vacuolated

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19
Q

Cytoplasmic Inclusions of Naegleria fowleri (Cyst)?

A

well-defined glycogen mass Granules may be present

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20
Q

Naegleria fowleri:

Enter through the olfactory neuroepithelium causing __________ in healthy individuals

A

primary amebic meningoencephalitis (PAM)

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21
Q

Naegleria fowleri:

Trophozoites in __________and tissue Flagellated forms occasionally in __________

A

CSF

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22
Q

Acanthamoeba spp. and Balamuthla mandrillaris:

Enter through lower respiratory tract or through ulcerated or broken skin causing __________ in individuals with compromised immune system.

A

granulomatous amebic encephalitis (GAE)

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23
Q

Acanthamoeba spp.:

Enter the eye causing severe __________

A

keratitis

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24
Q

Microscopic examination: Trophozoite

What are the 4 specimens?

A
  • CSF
  • brain
  • Tissue
  • nasal discharge
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25
Q

Microscopic examination: Trophozoite

Wet preparation?

A

Saline and lodine

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26
Q

Microscopic examination: Trophozoite

Culture?

A

Balamuth medium

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27
Q

Microscopic examination: Trophozoite

Molecular Techniques?

A

ELISA, PCR

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28
Q

Epidemiology of Trophozoite:

Found in __________, including lakes, streams, ponds, and swimming pools.

A

warm bodies of water

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29
Q

Epidemiology of Trophozoite:

Can survive in up to __________ of hyperchlorinated water

A

0.5µg/ml

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30
Q

Epidemiology of Trophozoite:

Higher in the __________ months of the year

A

summer

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31
Q

Epidemiology of Trophozoite:

Able to survive in elevated temperatures up to __________

A

> 46°C

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32
Q

Epidemiology of Trophozoite:

Can be acquired in contaminated __________

A

dust

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33
Q

What are the clinical symptoms of Trophozoite?

A
  • Asymptomatic
  • Kernig’s sign
  • Primary amebic meningoencephalitis (PAM)
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34
Q

Clinical symptoms of Trophozoite:

3 CSF findings?

A
  • pleocytosis (high percentage of PMN cells)
  • hypoglycorrhacia
  • elevated protein levels
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35
Q

What are the two treatments of Trophozoite?

A
  • Amphotericin B - DOC
  • Amphotericin B with rifamfin/miconazole
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36
Q

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

A

Acanthamoeba

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37
Q

Size range of Acanthamoeba (Trophozoite)?

A

12-45 um

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38
Q

Motility of Acanthamoeba (Trophozoite)?

A

Sluggish, spinelike pseudopods

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39
Q

No. of nuclei of Acanthamoeba (Trophozoite)?

A

One

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40
Q

Karyosome of Acanthamoeba (Trophozoite)?

A

Large

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41
Q

Peripheral Chromatin of Acanthamoeba (Trophozoite)?

A

Absent

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42
Q

Cytoplasm of Acanthamoeba (Trophozoite)?

A

Granular and vacuolated

43
Q

Size range of Acanthamoeba (Cyst)?

44
Q

Shape of Acanthamoeba (Cyst)?

A

roundish with ragged edges

45
Q

No. of nuclei of Acanthamoeba (Cyst)?

46
Q

Karyosome of Acanthamoeba (Cyst)?

A

Large and central

47
Q

Peripheral Chromatin of Acanthamoeba (Cyst)?

48
Q

Cytoplasm of Acanthamoeba (Cyst)?

A

Disorganized, granular, sometimes vacuolated

49
Q

Cytoplasmic Inclusions of Acanthamoeba (Cyst)?

A

Double cell wall, smooth smooth inner cell wall and outer jagged cell wall

50
Q

Microscopic Examination: Acanthamoeba

__________ is the specimen of choice
Also: __________ & __________

A
  • CSF
  • Brain tissue
  • Corneal scrapings
51
Q

Microscopic Examination: Acanthamoeba

Culture?

A

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

52
Q

Microscopic Examination: Acanthamoeba

Molecular techniques?

53
Q

Epidemiology of Acanthamoeba:

Reported from many countries worldwide both __________ and __________

A

CNS, eye infection

54
Q

Epidemiology of Acanthamoeba:

CNS infection appears in patient who are __________ isolated from air, aquaria, bottled mineral water, soil swimming pools, deep well water, contact lens solutions.

A

immunocompromised

55
Q

Clinical symptoms of Acanthamoeba:

First documented by Stamm?

A

Granulomatous amebic encephalitis (GAE)

56
Q

Clinical symptoms of Acanthamoeba:

Incubation period of Granulomatous amebic encephalitis (GAE)?

57
Q

Clinical symptoms of Acanthamoeba:

Infection is thought to spread __________ from primary foci in skin, the pharynx, or the respiratory tract. Systemic infections occur in individuals with __________ and may present as ulcerative skin lesions, subcutaneous abscesses, or erythematous nodules.

A

hematogenously, AIDS

58
Q

Clinical symptoms of Acanthamoeba:

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

A

Acanthamoeba keratitis

59
Q

Clinical symptoms of Acanthamoeba:

__________ is required in cases of extensive and refractory disease.

A

Keratoplasty

60
Q

6 treatments of Acanthamoeba?

A
  • Sulfamethazine
  • Itraconazole
  • Ketoconazole
  • Miconazole
  • Propamidine isethianate (DOC)
  • Rifampin
61
Q

Size range of Balantidium coli (Trophozoite)?
__________ um in length
__________ um wide

A

28-152 um in length
22-123 um wide

62
Q

Motility of Balantidium coli (Trophozoite)?

A

Rotary, Boring

63
Q

No. of nuclei of Balantidium coli (Trophozoite)?

A

Two
Kidney shaped (macronucleus)
small spherical (micronucleus)

64
Q

Other features of Balantidium coli (Trophozoite)?

A
  • One or two visible contractile vacuoles
  • Cytoplasm may contain food vacuoles or bacteria
  • Small cytostome present
  • Layer of cilia around organism
65
Q

Size range of Balantidium coli (Cyst)?

66
Q

Number and app. of nucleus of Balantidium coli (Cyst)?

A

Two
Kidney shaped (macronucleus)
small spherical (micronucleus)

67
Q

Other features of Balantidium coli (Cyst)?

A
  • One or two visible contractile vacuoles in young cyst
  • Double cyst wall
  • Row of cilia visible in between cyst wall layers of young cyst
68
Q

Balantidium coli:

Infective stage?

A

cyst, viable for several weeks

69
Q

Balantidium coli:

Human infection results from ingestion of food or water
contaminated with fecal material containing __________

A

Balantidium coli cysts

70
Q

Balantidium coli:

Incubation period?

71
Q

Balantidium coli:

Ingested cysts excysts in the __________

A

small intestine

72
Q

Balantidium coli:

Trophozoites inhabit the lumen, mucosa and submucosa of the __________, primarily the __________

A

large intestine, cecal region

73
Q

Pathogenesis of Balantidium coli:

Disease?

A

Balantidiasis, balantidial dysentery

74
Q

__________ invades the intestinal epithelium through release of the enzyme hyaluronidase and creates a characteristic ulcer with a rounded base and wide neck

A

Balantidium coli

75
Q

Pathogenesis of Balantidium coli:

__________ with mucus and blood, cramps

Complications include __________ and __________

A

Acute diarrhea

intestinal perforation, acute appendicitis

76
Q

Pathogenesis of Balantidium coli:

usually __________ in the large intestine

A

non-pathogenic commensal

77
Q

Pathogenesis of Balantidium coli:

Many infected individuals are __________

A

asymptomatic

78
Q

Pathogenesis of Balantidium coli:

Majority of the symptomatic patients complain of __________ and __________

A

diarrhea, dysentery

79
Q

Pathogenesis of Balantidium coli:

__________ or pain associated with nausea and vomiting

A

Abdominal discomfort

80
Q

Diagnosis of Balantidium coli:

Microscopic identification of trophozoites and cysts in the feces using __________

Repeated stools for __________

A

direct examination, increase sensitivity

81
Q

Diagnosis of Balantidium coli:

Concentration techniques:
Biopsy from sigmoidoscopy?

A

trophozoite

82
Q

Treatment of Balantidium coli:

Treatment?

A

metronidazole, tetracycline or iodoquinol

83
Q

Prevention of Balantidium coli:

Prevention?

A

proper sanitation, safe water supply, and protection of food from contamination

84
Q

Treatment and Prevention of Balantidium coli:

Cyst is resistant to environmental conditions and may survive for long period, they are easily inactivated by __________ and __________

A

heat, 1% sodium hypochlorite

85
Q

Other intestinal protozoa: Blastocystis hominis

Five morphological forms?

A
  1. Vacuolated forms
  2. Ameba-like forms
  3. Granular forms
  4. Multiple fission form
  5. Cystic form
86
Q

Five morphological forms:

*Most predominant
*Large central vacuole (reproductive organelle) and very thick capsule

A

Vacuolated forms

87
Q

Five morphological forms:

*Active extensions and pseudopodia
*Nuclear chromatin: peripheral clumping
*Intermediate stage between vacuolar and pre-cystic

A

Ameba-like forms

88
Q

Five morphological forms:

*Observed from old cultures
*Granular contents develop into daughter cells of the ameba-form when it ruptures

A

Granular forms

89
Q

Five morphological forms:

*Arise from vacuolated forms
*Produce many vacuolated forms

A

Multiple fission form

90
Q

Five morphological forms:

*Very prominent and thick osmophilic electron dense wall
*Thick-walled cyst: responsible for external transmission
*Thin-walled cyst: reinfection within a host’s intestinal tract

A

Cystic form

91
Q

Other intestinal protozoa: Blastocystis hominis in cystic form:

responsible for external transmission

A

Thick-walled cyst

92
Q

Other intestinal protozoa: Blastocystis hominis in cystic form:

reinfection within a host’s intestinal tract

A

Thin-walled cyst

93
Q

Size range of Blastocystis hominis (Vacuolated form)?

94
Q

Vacuole of Blastocystis hominis (Vacuolated form)?

A
  • Centrally located
  • Fluid-filled structure
  • consumes almost 90% of organism
95
Q

Cytoplasm of Blastocystis hominis (Vacuolated form)?

A

Appears as a ring around periphery of organism

96
Q

Nuclei of Blastocystis hominis (Vacuolated form)?

A

Two or four located in cytoplasm

97
Q

Diagnosis of Blastocystis hominis:

__________ is the specimen of choice for the recovery of blastocystis

98
Q

Diagnosis of Blastocystis hominis:

Concentration technique?

A

increase sensitivity

99
Q

Diagnosis of Blastocystis hominis:

__________ or __________ to differentiate various stages

A

Hematoxylin or Trichrome

100
Q

Diagnosis of Blastocystis hominis:

Culture?

A
  • Boeck and Drbohlav’s media
  • Nelson and Jones media
101
Q

Epidemiology of Blastocystis hominis:

B. hominis infections indicated that they occurred as __________ in __________ countries.

A

epidemic, subtropical

102
Q

Clinical symptoms of Blastocystis hominis?

A
  • mild to moderate diarrhea
  • vomiting
  • nausea
  • fever
  • abdominal pain and cramping
  • bloating
  • flatulence
103
Q

Treatment of Blastocystis hominis?

A
  • lodoquinol
  • Metronidazole (DOC)
  • Trimethroprim-sulfamethoxazole
104
Q

Prevention and control of Blastocystis hominis?

A
  • Proper treatment of fecal material
  • Proper hand washing
  • Subsequent proper handling of food and water

Clinical Parasitology (Lecture) (4 decks)

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