You are on page 1of 4

Parasitic Amoebas | Dr. C. J.

Castro Macrofaj

I. TAXONOMIC CLASSIFICATION

 Kingdom: Protista
 Subkingdom: Protozoa (single celled organism)
 Phylum: Sarcodina (pseudopods)
o Other phyla: Ciliophora (cilia – Balantidium coli), Mastigophora (flagella – Giardia, Trichomonas) &
Sporozoa (non-motile)
o Classified by their organ of locomation
 Class: Lobosea
 Order: Amoebida
 Family: Endamoebidae (amebas)
o Closely related: Blastocystidae (Blastocystis hominis)

II. AMOEBAS

 Belong to a group of protozoans that are motile through cytoplasmic extensions known as pseudopods
 Two major groups:
o Free living (Nigleria, acanthamoeba) – can survive at environment
o Parasitic (Pathogenic & Non-pathogenic)

III. PARASITIC AMOEBAS – Large intestine is the major habitat except E. gingivalis

 Entamoeba histolytica – most important; only one pathogenic (others are commensals)
 Entamoeba coli
 Entamoeba dispar
 Entamoeba hartmanii
 Entamoeba gingivalis
 Endolimax nana
 Iodamoeba butschii/butschlii

IV. Entamoeba histolytica

 Pathogenic
 Habitat: Large Intestine
 Human beings are the prinicipal host and source of infection
 Can cause:
o Amebiasis
o Amebic dysentery (bloody diarrhea)
 Bacillary – Etiologic Agent: Bacilli (Shigella)
o Amebic hepatitis
 Appears as cyst or trophozoite
o Cyst mas matibay kasi may cyst wall pa, found in formed stool, infective stage
 Watery stool - trophozoites
 Epidemiology
o Incidence of infection varies from 0.2% to 50%
o Infection is most prevalent among people living under crowded conditions
o Prevalence in homosexual is as high as 25-35% because of their sexual practices

V. MORPHOLOGY

 Trophozoite
o Active vegetative form, “kumakain”
o 15-30 um
o Ectoplasm sharply separated from the endoplasm

Page 1 of 4
Parasitic Amoebas | Dr. C. J. Castro Macrofaj

o Endoplasm: includes RBC


o It has a single eccentric nucleus that contains a centrally located karyosome (nucleolus) – important
feature to differentiate from others
o Finger-like pseudopodia are extended rapidly (explosive)
 Direction of movement: where the pseudopod is

 Cyst
o Round to oval
o 10-20 um
o Can survive for 2 days at 37C or 60 days at 0C
o Has a smooth refractile wall
o Cystoplasm contains glycogen and chromatoid bodies (sausage-
shaped with blunt ends) -> for nutrition since di pa makakain
o Types
 Immature cyst – mono/binucleated
 Mature cyst – tetranucleated, infective form

VI. REPRODUCTION

 Binary fission (trophozoite)


o 1 becomes 2, 2 becomes 4…etc
 Cyst formation

Cyst – resistant to gastric acid


but when reaches SI, undergo
excystation becomes
metacystic trophozoite

8 small trophozoites aka


amebulae (still in SI)

At colon, will undergo binary


fission to become trophozoites
or
cysts when there’s
dehydration in the colon
(encystation)

*liquid stool – trophozoite


*formed stool - cyst

VII. PATHOLOGY

 Intestinal – Primary
o Colonization of the large intestine - flask shaped ulcers with a wide base and narrow opening and with
irregular slightly elevated, overhanging edges
 Kapag naharangan ng smooth muscle ng muscularis mucosa yung pag-invade, magdedetour kaya
pagilid instead of palalim
o Complications: appendicitis, intestinal perforation, hemorrhage, stricture, granuloma (in chronic cases)
 Extraintestinal – Secondary {liver - most common}
o Hepatic amebiasis
 Dissemination from the intestine chiefly by the blood stream thru portal vein

Page 2 of 4
Parasitic Amoebas | Dr. C. J. Castro Macrofaj

 The wall of the abscess thickens and the center liquefies becoming a red brown mass of
autolysed hepatic cells, RBCs, bile (produced in the live; stored in the gallbladder), etc.
 Appears as anchovy-paste
 80% are confined to the right lobe.
o Pulmonary amebiasis
o Cerebral amebiasis

VIII. DIAGNOSTIC TEST

 Microscopic identification of the cysts/trophozoites in feces or tissues


 Amebic stools
o Acidic, few neutrophils, with degenerated RBCs, (+) Charcot Leyden crystals (derived from eosinophils)
 If bacillary – alakalinic, many neutrophils (since bacterial), intact RBCs, (-) Charcot Leyden crystals

IX. TREATMENT
 Metronidazole 750mg TID for 5-10 days or
 Iodoquinol 650mg TID for 20 days

X. NON PATHOGENIC AMEBAS – do not cause disease

 Entamoeba Coli
o Prevalence 10-30%; mistaken for E.
histolytica
o Same life cycle
o Trophozoite
 More granular endoplasm
containing ingested bacteria
instead of RBC
 Narrower ectoplasm
 Broader or blunter
pseudopodia instead of finger
like and sluggish instead of
explosive
 Eccentric karyosome in the
nucleus
 More sluggish movements
o Cyst
 Larger, with more granular
cytoplasm
 Slender, splinter-like
chromatoid bodies
 8 nuclei with eccentric
karyosome
o Tx : NONE

 Entamoeba dispar
o 1993 – proposed name for non pathogenic E. histolytica
o Identical to e histolytica but does not invade the tissues; incidental findings only

 Entamoeba hartmanii
o Originally thought to be a "small race" of E. histolytica, now considered as a separate species (12-15u)

Page 3 of 4
Parasitic Amoebas | Dr. C. J. Castro Macrofaj

 Entamoeba gingivalis
Iodamoeba butschlii
o Non pathogenic inhabitant of the mouth
o Most striking feature: Large number of food vacuoles

 Endolimax nana
o Also with tetranucleated cyst
o Karyosome centrally located and larger
o Prevalence of 10-20%
o Small (5-14u), sluggish
o Nana = maliit

 Iodamoeba butschlii
o With characteristic nucleus and with large glycogen body in the uninucleated cyst
o With refractile bodies near the nucleolus

XI. Blastocystis hominis


 Different family from amoeba
 Formerly classified as yeast -->now classified as protozoan
 Appear in the feces as spherical cyst-like stage containing a large central vacuole
with a narrow rim of cytoplasm containing nuclei
 Commonly found in the stool
 Large number are found in the feces of patients with severe diarrhea
 No pathology (but this claim is still in question)
 Tx: Metronidazole if it caused diarrhea

I will appreciate it very much if you will inform me of any errors (typographical, grammatical or theoretical) in this trans. Kindly comment
on the Facebook post where this file is uploaded. Thank you & good luck!

Yes, I can!

Page 4 of 4