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tin g fr o m a ce ll d ia te d im m u n ity
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a w e u n th e v u

w hy re s is ta n c e to in fe c tio n te n d s to in c r e a s e a s th e a g e a d v a n c e s

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,

th ro u g h w h ic h it p a s s e s a r e s tu d ie d T h e p a r a s ite m a h t o r it m a y c h a n g e its
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f In fe c tio n T ra n s m is s io n o
kn o w n as in fe c tiv
m ean s w h ic h d iffe r e n t in fe c tin g a g e n ts a r e tr a n s fe r r e d fr o m
e s ta ge s T he by o n e h o s t to a n o th e r a n d
h h
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q ,

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g
a n im a ls o r m a n W n e r e a n in s e c t in te r m e d ia te h o s t (v e c to r ) la s th e
p y p a r t in d is s e m in a tio n o f th e d is e a s e its b io n o m
ic s s h o u ld a ls o b e c a r e fu lly s tu d ie d

R
e s e r v o ir s o f 1w c tio n In a m a jo r ity o f c a s e s m a n is th e m a in r e s e r v o ir In s u c h c a s e s th e p a r a s ite d o e s n o t r o d u c e a n
, p y
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an
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m

c a r r ie r s ta te th e p a r a s ite e v o lv e s c e r ta in r e s is ta n t fo r m s w h ic h h e lp in th e d is s e m in a tio n o f th e d is e a s e e
g c y s ts o f E h is lo iy ıic a
g a m e to c y te s o f m a la r ia l p a r a s ite In c e r ta in s p e c ie s o f p a r a s ite s b o th m e n a n d lo w e r a n im a ls a r e in fe c te d th e ı a tte r s e r v in g a s
r e s e r v o ir s o f in fe c tio n : e x a m p le s a r e R h o d e s ia n tr y p a n o s o m ia s is (a n te lo p e ) O r ie n ta l s o r e (d o ) k a la a z a r o c c u r r in in C h in a
g g
a n d M e d ite m n e a n a r e a s (d o g ) b a la n tid ia s is (p ig ) tr ic h in e llia s is ( i a n d r a t) a n d h d a tid d is e a s e
p g y (s h e e p a n d c a ttı e )

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3 an d v id e ta b le b e lo w )
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B Y c o N T A M IN A T Jo N o F F o o D o R D R IN K u p g a in e n tr a n c e in to th e d ig e s tiv e tr a c t So m e o f
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e e
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T h e in fe c tiv e fo rm s m a y r e m a in in th e fle s h o f so m e in te r m d ia te h o s ts
ta k e n a s fo o d s u c h a s : (i) B e e f
e w h ic h a re
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c o n ta in
g e a r v a l fo r m s o f T s o liu m (ņ s
lic e r c u s c e llu lo s a e ) a n d th e la r v a l fo rm s o f T x ) ir a /is (iii) P is h c o n ta in in h
g t e p le r o c e r c o id la r v a e o f D ta tu m a rıd
m e ta c e r c a r ia l fo r m s o f C s in e n s is (iv ) C r a b o r c r a y fis h c o n ta in in g m e ta c e r c a r ia l fo r m s o f p w e s le r m a n i
(c ) S o m e tim e s th e in te r m e d ia te h o s t h a r b o u r in g th e in fe c tiv e fo rm m a y b e ta k e n u a s a w h o le
p e g c y c lo p s in fe c te d w ith
th e la r v a l fo r m s o f D m e d in e n s is a r e in g e s te d w ith w a te r
(d ) T h e in fe c tiv e fo rm s m a y c o m e o u t o f its in te r m e d ia te h o s t a n d e n c y s t in a u a tic l
q p a n ts , e a te n a s fo o d b y m a n e g
m e ta c e rc a r ia l fo r m s o f P b u s k i a n d P h e a lic a
p
II B Y C O N T A M IN A H O N O P T H E S K IN O R M U C O U S M E ĦĄB R A N E E x am p le s a re

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3 B Y T H E A G E N C Y o p iN s B c r H O S T A in fe c te d b lo o d k in g
n su c a r th r o po d y in tr o d u c e th e
o o d o r
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) L e is h m a n ia b y P h le b o to m u s (s a n d flie s ) a n d W
u c h e re ń a b y C u lic in e m o s q u i
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g e o p m e n t fo r a c e r ta in
p e ń o d b e fo r e b e c o m in g in fe c tiv e to m a n
4 B Y s E x u A ı c O N T R A C T T r o p h o z o ite s o f T v a i ti
g n a s c a n b e tr a n s m itte d b y s e x u a l c o n tr a t
c
 G E N E R A L IN T R O D U C T IO N

CQW

F ig 3 T h e in fe c tiv e fo rïn s o f th e p a r a s ite a re d e p ic te d w ith in th e c ir c le u n der ea ch h o s t I n E c h in o co ceus lo th e e g g ı

s th e
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8 P A R A S IT O LO G Y

N I I C T IO N S
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ın fe c ıı
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In g e s t io n A I ta c t
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A l Tr a c t 7 : + /ıin ı/ix
(b ) E n c y s te d la r v a e in m u s c ıe s
In g e s t io n

n g e s t io
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(d ) C y s ts o f B r n li in fa e c e s In g e s t iu n

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D o a Eggs o fE g rn n u ln çu s a n d T c a ıłiF in fa e c e s In g e s t io n
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T HRO UG H A R T H R O PO D

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C Y C L O PS L a rv a e in s id e th e b o d y cav ity In g e s t io n A l Tr a c t D rn r d in ť rıs ix
,

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en ïc e rc o id ta r (łe

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bn s iı
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M O S O U ïT O E S

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a rv a e ro o n rıu ł yi
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S IM U H U M L a rv a e in p r o b o s c is Dm ppc d o n S k in O v o lv u tu s
H O U SE FLY C y s ts in A l c an a l co n ta m in a tio n o f fo o d n g e s tio n
ı A l Tr a c t E h is ro ly tï t a
T HRO UG H H U M A N FA EC ES

C o n ta m in a tio n o f fo o d (a ) E g g s o rE n te r o b iu s H ym eno le p is n an a ı
n g e s tio n A l Tr a c t E v e rm iĽ tt ta r is
T so liu rıı ł1 N a n a

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(b ) C y s t s o f E h is to ı
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n g e s tio A ı Tr a c t
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a rv a e o fH oo kw o rm a n d D ir e c t p e n e tra tio n S k in A Uuo den a le
S tr o n g y lo id e s
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a ń fo r m
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A b r a z ilie n s e
(C u ta n e o t« )
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C e r c a r ia e o f S c h lis to so m a fm in w a te r D ir e c t p e n e tr a tio n S k in
 G E N E R A L IN T R O D U C T IO N 9

P a th o g e n ic E fle c ts T h e s e v a ry w it h th c n a tu r e o t Pitmsitic in fe c tio n s

In p r o to z o a l in fe t tio n x Th c Ic x io n x a r e r e a tl in ll u e n e c d b i d is ta n t
g y y p r o litė r a tio n m u ltip lic a tio n a n d m e ta s ta s s to
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p p y g
pı a s m o d ia th c pł ï msitc w h ilL u n d e r g o in g erythmcytic s c h iz o g o n y c a u s e s d e s tr u c tio n o f e r y th r o c y te s (R B C )
ın th e ı n a ju r ity u ï h e lm in th iL in ı b c tio n s Th c a d u lt p a r a s ite s a r e fo u n d in s id e th e h u m a n b o d y a n d n o m u ltip lic a tio n
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th e p a r a s ite s a tta c k th e tis s u e s a n d a ls o o n th ep a tte r n o f la y in g e g g s o r ı a rv a e In c e r ta in h e ı m in th ic in fe c tio n s th e ,

l a ıs e c r e t io n s a n d e x c re t io
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be re c o g n is e d b y s k in te s ts (in tr a d e r m a ) w ith
ı spe c ific an tig e n s (v id e in fr a )

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S o m e p a r a s itic in fe c tio n s p r o d u c e a n im m u n o s u
p p r e s s iv e s ta te th e r e b y a llo w in g th e p a th o g e n ic b a c te r ia to in v a d e th e tis s u e s
w h ic h th e p a tie n t is u n a b le to re s is t a s in tr y p a n o s o m ia s is k a la a z a r a n d m a ı a r ia Im m u n o s u p p re s s iv e s ta te s o r a g e n ts m a y h e lp

p a r a s itic m u l t ip lic a t io n R e s u ltin g in fu lm in a n t p a r a s ta e m a a s n a c p a r u m m a la r ia o r m a y fa v o u r m a s s iv e in v a s io n o f th e

i i i f l i
tis s u e A s in s tr o n g y ı o id ia s is o r m a y h e lp o p p o r tu n is t in fe c tio n a s in to x o p la s m o s is

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sc h is to so m ia s is an d (iii) B u r k itt s ly m p h o m a in m a la r ia l in fe c tio n

In so m e h e lm in th ic in fe c tio n s th e m ig ra tin g la r v a e m a y c a n y v ir u se s a n d G ra m n e g a tiv e b a c te r ia fro m th e in te s tin e to th e

oo d
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e x am p le s : (a ) N e p h ro t ic s y n d r o m e a n d id io p a th ic tr o p ic a l s p le n o m e g a ly in m a la r ia (b ) A u to im m u n e h a e m o ly tic a n a e m ia o b
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im m u n ity (d ) M a n ife s ta tio n s o f o c c u lt fila r ia s is

i ra to r y D ia g n o s is D e p e n d in g o n th e n a tu re o f th e p a r a s itic in fe c tio n s , th e fo llo w in g m a te r ia ls s h o u ld b e

/óllected fo r spe c ific d ia g n o s is

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, c ir c u ı
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/

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n 1 p u rr g u re in c a se s o f k a la a za r

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a ń d M e d ite r ř in ie a u a ie a s

(iv ) in c a se s o f de m ia ıl is h m a n o id e spu n d ia a n d o n c ho c e r c ia s is

/ ( ) S y in c a s e s o f c y s tic e r c o s is tr ic h in e llia s is D is e
v a n d Chag a se

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(v iii) A s p ir a tio f (a ) h y d a tid flu id (b ) m
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G ta n zb /ia m a y b e d e m o n s tr a te d in d u o de n a l a s p ir a te s
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is a fe a tu r e o f k a la a z a r a n d n e u w p h ilic le u c o c y to s is is o b s e r v e d in a m
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B io c h e ın ic a / A tte r a ï io n o f lite B /o o R g » m o b u l i n a e m i a in
d c a se s o ar 1 m pa n o so m ia s is s c h is
tq s o m ia s is a n d v is c e r a l la r v a m ig r a n s T h iş m te c te d a s 1 e l te s t (a ld Æ y d e te s t o FN a p ie r i a a u e c ip ita tie n
rq o n m ra h m ac ha ri s or S ia s Ię ș t, A n tim o n
y te s t o f C h o p r a e ıa l )
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p a r a s itic in fe c tio n s s u c h a s !a s m o s is a n d h y d a tid o s is w h e r e p a r a s ite s a re ld o d e te c te d g ic a l [c s th
se m s e r o lo a re
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p y
a ls o be de m o n si m d b y flo c c u la tio n te s t s u c h as b e n to n ite flo c c u la tio n te s t in tr ic h in e llia s is a n d h d a tiđd is e a s e
(c ) S p e c ific a m Ħa t i o n Te s t a s in ]eishmaniasis y
(d ) S p e c ific d y e te s t o f S a b in a n d a s in toĮ casmnsis

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tio n s (s c h is to s o m ia s is , tr ic h in e llia s is a n d o n c h o c e r c ia s is a n e m n t
), a n d a ı s o in m a la r i
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se s ite s o f e le c tio n H e lm in th s ,
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G E N E R A L IN T R O D U C T ı 11

(9 ) E L IS A te s t (E n į y m !￠
n ke d IE Ę Ĺlm m u n o e le c tro p h o r e s is )
e im m u n o so rbe n t a s sa y ) R IA (R a d io im m u n o a s s a y ),
C IE P (C d ia g n o s is f th e
p h o r e s is ) a n d d o u b le d iffū s io n te s ts a r e n o w a v a ila b e o r
o u n te rc u lT L n l im n m n o e le c [ro l f o
d is e a s e

(h ) M o le c lıln r m e th o d U l pC R D N A p e fo d ia g n o s is í y p a r a s itic in fe c tio

p ro b e s h o ld b e tte
se o r sc o r o m an n

(iv ) ıııır a d e ıllltı/ R (' (lcriol) T h it oși [i ve in m any h e ]m in th ic in fe c tio n s su c h as h y d a tid d is e a se ĺ c

te s t) s c h is to s o m ia s is (F a ir ie y s te s t) iita r ia s is tr ic h in e llia s is a s c a r ia s is a n d s tr b n g y ı
o id ıa s is ; it is tive in c e r ta in

Ĵ r o to z o a l infectio o s is
s n d is e a s e e spu n d ia O r ie n ta l s o re am oe b ia s is an d to xo p la s m
N o te M o st o r th e im m u n o ı
o g ic a l te s ts m e n tio n e d a bo v e c an be c a r r ie d o ut o n ly in la b o ra to r ie s w he re s p e c ia l a n tig e n s a re

a v a ila b le

Teatment M a n y o f th e p a r a s itic in fe c tio n s c a n b e c u re d b y s p e c ific c h e m o th e ra py a n d th e g r e a te s t a d v an ce ha s

be e n m a d e in th e tr e a tm e n t o f p r o to z o a l d is e a s e s (v id e r e s p e c tiv e c h a p te r s )

Fo r th e tr e a tm f in te s tin a l h e lm in th ia s is d r u g s a r e g iv e n o r a lly fo r d ir e c t a c tio n o n th e h e lm in th s T o

en t o o b ta in
,

m a x im u m p a r a s itic id a l e ffe c t it is d e s ir a b le th a t th e d r u g s a d m in is te r e d s h o u ld n o t b e a b s o r b e d a n d th e d r u g s
,
sh o u ld
a ls o hav e m in im u m to x ic e ffe c t o n th e h o s t

In th e tr e a tm e n t o f s o m a tic
h e lm in th ia s is d r u g s a d m in is te r e d b y m o u th s h o u ld b e r e a d ily a b s o r b a b le a n d th e y
,

sho u ld h a v e m d p a r a s ito tr o p ic a n d th e le a s t o rg a n o tr o p ic a c tio n W h e n a d m in is te r e d b y p a r e n te r a l in je c tio n s th e

a rk e ,

d ru g s m u s t r e a c h th e v a r io u s tis s u e s o f th e b o d y w h e r e th e h e lm in th s a re lo c a te d A lth o u g h e ffe c t iv e r e m e d ie s h a v e

,

n o t y e t b e e n d is c o v e re d fo r so m a tic h e lm in th ia s is so m e a dv an ce s hav e re c e n tly b e e n m a de re g a r d in g th e tr e a tm en to f

p a ra g o n im ia s is ,
c lo n o r c h ia s is ,
sc h is to so m ia s is fa s c io lia s is a n d w u c h e r e r ia s is
P ro p h y la x is P r o p h y la c tic m e a su re s th a t m a y be a d o p te d in p a r a s itic in fe c tio n s in c lu d e th e fo llo w in g
1 T /ıe r a p e u tic P ro p lıy ta x is T h e p a r a s ite is a tta c ke d w ith in th e h o s t th e r e b y p r e v e n tin g th e d is s e m in a tio n o f th e in fe c tin g
a ge n t

2 D r ıtg P ro p lıy ia x is M e a s u re s a re a d o p te d n o t to p r e v e n t th e in fe c tio n b u t to a b o r t th e c lin ic a l m an ife s ta tio n s by spe c ifıc d ru g

th e r a py h e n c e th is m e th o d is a ls o kn o w n a s c lin ic a l p r o p lı y la x is o r su p p r e s s iv e tlte r a p y
3 E r a d ic a tio n o f th e in fe c tio n in th e r e s e r v o ir h o s ts an d d e s tr u c tio n o f in te rm e d ia r y h o s ts T h e in fe c tiv e a g e n ts m a y a ls o be
d e s tr o y e d w h ile th e y e x is t fr e e o u ts id e th e h u m a n h o s t

4 P e rso n a ıp ro p h y la x is m ay fu r th e r b e e n s u re d b y p re v e n tin g th e su sc e p tib le in d iv id u a ls co m in g in c o n ta c t w ith in fe c tin g

a g e n ts
5 A id a n f p tio f d de r k e d fle s h f be e f p o rk k e d fis h b fıs h e s ,
v o ce o c o n su m n o ra w an u n co o o o r n o n co o c ra c ra y c yc ı
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re p ro d u c tio n d ig e s tio n r e s p ir a tio n e x c re tio n e tc p a r tic u la r fu n c tio n

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lo c o m o tiv e a n d s e n s o ry

E n d o p ta sm T h e internal g r a n u la r p o r tio n ; its fu n c tio n is n u tń tiv e a n d r e p r o d u c tiv e

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a sń g o ph o re a

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(iv ) C y s t w a ,

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m o st ,

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th r c iıd s

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ly

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y a t th e p o in t o l o r ig in o t th e n a g e lıu m kn o w n as th e b a su l b u tlj '

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o s in g i

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t hc ( v vr is th e r e s is ta n t s ta g e o f th e p a r a s ite an d is a ı
s o in fe c t iv e to its h u m an h o s t in o r d e r to r e a c h a n ew ho s t, it
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n

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c a t io n a m o n g th c p a r a s itic p r o to z o a a r e o f th e fo lı o w in g ty p e s

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(ii) B Y M U LT ı o N o R s c H Iz o G o N Y
p L E F Is s ı In th is p r o c e s s ,
m o r e th a n tw o in d iv id u a ls p ro d u
a re c e d ,
as in P la s m o

d ia T h e n u c le u s o f th e p a r e n t c e ll a t fir s t u n d e r g o e s re p e a te d d iv is io n s w h ic h a r e th e n s u rr o u n d e d b y th e
cy to p la s m W h e n th e m u ı tip ı ic a tio n is c o m p le te d th e , p a r a s itic b o d y o r th e sc h iz o n t ru p tu re s a n d lib e r a te s
th e s e d a u g h te r in d iv id u a ls w h ic h in th e ir tu r n r e p e a t th e ir life c y c le

2 Sex u a lR ep m» d u c tio n

(i) BY c o N Ju G A T ıIn th is p r o c e s s a te m p o r a r y u n io n o f tw o in d iv id u a ls o c c u r s d u r in g w h ic h tim e in te r

o N ,

c h a n g e o f n u c le a r m a te r ia l ta k e s p la c e L a te r o n th e tw o in d iv id u a ls s e p a r a te e a c h b e in g r e ju v e n a te d
by , ,

th e p r o c e s s a s in C ilia te a ,

(ii) B Y sY N G A M Y In th is p r o c e s s ,
se x u a lly d iffe r e n tia te d c e lls c a lle d g a m e te s u n ite p e r m , ,
an e n tly an d a co m

o f th e n u c le a r m i l ta k e s p la c e T h e r e s u ltin g p r o d u c t is th e n k n o w y g o te in
p le te fu s io n a te r a n as a z ,
as

Pı a s m o d ia

e A p r o to z o a ı ltip ly ig o r o u s ly b y a s e x lm th o d fo lo g tim d ı a te r b y a c h a n g e
L ife C y c ı p a r a s ite m a y m u v u a e r a n e ,
a n

o f p ro c e s s it e ith e r h a s re c o u r s e to se x u a lm e th o d o f r e p r o d u c tio n o r u n d e r g o e s e n c y s tm e n t fo r a c h a n g e o f its h o s t

,

T he se x u a lm e th o d f r e p ro d u ćtio n
o o fte n o c c u rs in a d iffe re n t h o s t o th e r th a n th e o n e u tilis e d fo r a se x u a lm u ltip lic a

tio n ; th e is k n o w n a s a lte m a t io n o f ge n e ra tio n ac co m p a n ie d b y a lte m a tio n o f h o s t , a s se e n in P la s m o d ia A

p ro c e s s ,

a ıp a r a s ite y p a s s its life c e in

yc ı o n e o r tw o h o s ts
p r o to zo m a

S e c o ııu H o s pı e s a r e R h iz o p o d e a
t N u l R e q u ir e d in te s tin a l fla g e lla te s a n d C ilia te a T h e p a r a s ite s in th is
E x am ,

i f r fro m o n e h o s t to a n o th e r b y e n c y s tm e n t T h e s p e c ie s m u ltip lie s a s e x u a ı ly

g r o u p a d a p t th e m s e lv e s fo r p a s s v e r a n s e
t

in its tr o p h ic s ta g e a n d in c ir c u m s ta n c e s u n fa v o u r a b ı e fo r its e x is te n c e s e c r e te s a r e s is ta n t c y s t w a lt, tr a n s fo rm in g ,

a nd
its e lf in to a c y s t W h e n th e c o n d itio n b e c o m e s fa v o u r a b le a g a in th e o r g a n is m le a v e s th e c y s t (e x c y s tm e n t) ,

c o n tin u e s its life in th e tro p h o z o ite s ta g e T h u s e n c y s m e n

t t is n o t a r e p r o d u c tiv e p ro c e s s b u t a m e a n s o f p r o te c tio n o f
,

li i t k e p la c e w ith in th e c y s t w h e r e th e n u c le u s
th e s p e c ie s fr o m e x tin c tio n In a m o e b a h o w e v e r m u ltip c a t o n m a y a
l d iv is io n o f th e c e ll o c c u r s
d iv id e s in to 2 4 o r 8 d a u g h te r n u c le i L a te r w h e n th e o r g a n is m le a v e s th e c y s t c o m p e te
,
,

a n d a n u m b e r o f in d iv id u a l o r g a n is m s a re
lib e r a te d B o th th e p r o c e s s e s e n c y s tm e n t a n d e x c y s tm e n t o c c u r in o n e a n d , ,

th e r n e w h o s t is r e q u ir e d fo r fu r th e r d e v e lo p m e n t
th e s a m e h o s t b u t a fte r e n c y s tm e n t a tr a n s fe r e n c e to a n o
,
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n ia Th e s e c o n d h d s l is r e q u ire d tb r th c d c v c ı o p m c n t u ı \ Sptcinıc y c ı c w h ic h is c s s e n t ia ılb r th e L o n t in u a tio n o f th e
s pe c ie s fm m o n e h o s t to a ı ìo th c r In p la s m o d ia Th c ı m Lıo l m tı ic a titm is c a r r ie d o u t in o n e h o s t a n d th e
a l m c tı
ts c x tı ıtiı»ı
s e x u a l m e th o d o f re p n ì d u c ti«m in a ı1t) th e r h o s t

n C ı
n s s lfic łıtio n o f Pmtozoa

a s s iíic a tio
人 S y s ￠c ıï ła lic C ı n

(1 ) B ase d o n th c r e c o m m e n d a tio n o l th c C tt m m itte c o ı

1 S y s tt:m a tic s a m ıIīv u ı
u t iu n o f th c S o c ie ty o l P r o to zo o ı
o

g is ts c o n s is t in g o tL e v in e ť / n / ( 19 8 0 ) Th c p r u to im a l pa ıa s itc s o t n ia n a rc ( i \s s ił
ie d as fo ı
lo w s

K IN G D O M P R O T IS T A

S U B K ïN G D O M PR N TO ZO A

P h y lu m S' "hJHl S'

"rı C la ss
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Sa« o m asū s o ph o M a s t ig o p ho o o m a s tig n a tin a lx is h m a n ia

ra ra Z p hn n a K in c m p ı
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R c to r ta n m na d iu a C h ilo m a s tix

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ls ľ '" ;I

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M ic ro s p o ra M ic m s p ìm a h liv ru s p ìr i a
d A pa n s p t \n r b la s t in a E n tc m c y lo z n o n

E n c e p h a lito z o o n
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io p h o ra K in e to fm g m in o p h o m a V e s tib u life r ia T r ic h o s to m a tid a T r ic h tıs to n a t in a Ħa ı
ı a n t id iu m

So m e w o rk e rs p la c e P ııe iłıııo r v s riç u n d e r p h y lu m A p ic o m p le x a w h e re a s o th e n i c o n s id e r it a s p m t o z o a o lu n c e r ta in c la s s ific a ı

io n
O th e r A p ic o m p le x a p a r a s ite s u n d e r th e s u b c la s s C o c c id ia in c lu d e C ņ p rel r p n r id iıtın a n d C \ T /n V ) tJr rï

(2 ) A r e v is e d sc he m e o f c la s s ifıc a tio n of p r o to z o a re p la c in g th e sc he m e c o n v e n tio n a ı

ly in u se h a s b e e n p ro p o se d
by H o n ig b e rg e t t ı/
*
( 19 6 4 ) a n d is g iv e n be ı
o w

T h e p h y lu m P R O T O Z O A h a s b e e n d iv id e d in to 4 s u b p h y la : S u b p h y ı u m I S a r c o m a s tig o p h o ra S u b phy ı
u m ll
II C n id o s p o r a (n o h u m a n r e p r e s e n ta tiv e ) a n d S u b p h y lu m IV C ilio h o r a
S p o ro z o a S u b p h y lu m ı
, p

Pı
ņ lu m PR O T 0 70 4 G o lt llu ųs ı9 ı8 e m c n Lı v o n S ic h o ı
d ı8 4 5

S u b p h y lu m 1Sa rco m ig b e r8 & B a la m u th 19 6 3 It is d iv id e d in to 3

a s tig o p h o ra H o n su rc ı
pe a s se s

S u p e r c la s s I M A S T IG O P H O R A D ie s in g 18 6 6 It h a s 2 c la s s e s
C la s s 1 p n v r o M A m c o p H o R E A C a lk in s ı 9 0 9 (n o h u m a n re p re s e n ta tiv e )
,

C la s s 2 Z o o M A s u G o p H o R E A C a ı
k in s ı9 0 9 It h a s 9 o r d e rs
O rd e r 4 N E Ro p L A s u D A
Kı H o n ig b e rg 19 6 3 It h a s 2 su b o r d e rs
S u b o r d e r 1 B o tio n iım H o lla n d e ı9 5 2
S u b o r d e r 2 T ņ p a rra s o m ťu ilıa K e n t 18 80
r

.
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O ru e r 5 T O R r A m O N A n ln A
Rı G r \s x ć I9 5 2

O rd e r 6 D Ip I o M o N A D ıD A W c n yo n 9 26
ı

O ru c r 8 x ıC l ıO h l O N A I J l n A K ir b y 19 4 7

O rc ı
e r 9 ılY ıF R H ı (I ı
A sT ı D A G ra s s i& F o ii 19 l l

Su ı
x rc ı
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is s & B a l a m u l ı 19 6 3 (n o hu m an re p r e s e n ta tiv e )
l S A R C O D IN A H e r tw ig & L e s s e r 18 7 4 It is d iv id e d in to 3
S u p e r c la s s lı c ı
a s se s

C la s s 1 R ıIIz o p o D E A v o n S ie b o ld 18 4 5 It h a s 5 s u b c la s s e s
S u bc ı
a s s ıL o sı
o lł A C a r p e n te r 18 6 ı It h a s 2 o rd e rs

O rd e r A M o E u ID A K e n t 18 8 0
C la s s 2 P ı
R o pL A s M E A L e v in e 19 6 1
C la s s 3 A c I7 N o p o D E A C a lk in s 19 0 9 (n o hu m a n re p r e s e n ta tiv e )
S u b p h y lu m II S p o ro z o a L e u c k a r t 1 8 7 9 It is d iv id e d in to 3 c la s s e s

C la s s 1 T E Lo spo R E A S c h a u d in n 19 0 0 It h a s 2 su b c la s s e s

S u b c la s s I G R E G A R IN IA D u fo u r 18 2 8 (n o h u m a n re p re s e n ta tiv e )
Su bı
c a ss 2 C o cc ı
D IA L e u c k a r t 1 8 7 9 It h a s 2 o rd e r s

O rd e r p R o T o c o c c ID A C h e is s in 19 5 6 ( n o hu m an re p r e s e n ta tiv e )
O rd e r 2 E u c o c c ïD A U ge r & D u bo se q 19 10 It h a s 3 su b o rd e rs
S u b o r d e r 1 A d e te in a L ég e r 1 9 1 1 (n o hu m a n re p r e s e n ta tiv e )
S u b o r d e r 2 E im e r iin a U ge r 19 1 1
S u b o rd e r 3 H a em o s p o r in a D an ile w sky 18 8 5
C la s s 2 T o x o pLA sM E A B io cca 1 9 5 7 It h a s o n e o rd e r

O rd e r T o x o pm sM ı
D A B io c c a 19 5 7
C la s s 3 H A p L o s ĦD R E A C au lle r y 1 9 5 3 (n o h u m an re p re se n ta tiv e )

S u b p h y lu m III C n ld o s p o ra D o fle in 1 9 0 1 (n o hu m an re p re s e n ta tiv e )

S u b p h y lu m IV C ilio p h o ra D o fle in 1 9 0 1 It h a s o n e c la s s

C la s s 1 C u ATEA
ı P e r ty , 1 8 5 2 It is su b d iv id e d in to 4 su b c la s s e s

S u b c la s s 4 S p ıR o T R Ic H IA B ū ts c h li 18 8 9 It h a s 6 o rd e r s

O rd e r H E 丁E R o IT R IC H ID A S te in 185 9

It is to b e n o te d th a t th e su ffix e s hav e a ls o b e e n a lte r e d as w iı

l be se e n fr o m th e fo llo w in g
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m to zoa lP a r a s ite s P a th o g e n ic to M a ıı

PH Y LUM G EN U S S P E C IE S H A B IT A T P A T H O G E N IC E F F E C T S

S arco m a s tig o p h o ra E n ta m o e ba E M sıo ly tic a L m g e in te s tin e D y s e n te ry L iv e r a bsc e s s

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c y s t w a ll is re s is ta n t to th e a c tio n o f th e g a s tr ic ju ic e b u t is d ig e s te d b y th e a c tio n o f tr y p s in in th e in te s tin e T h e

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y
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o f th e la r g e g u t th e ir n o r m a l h a b ita t H e r e th e y g r o w a n d m u ltip ly b y b in a r y fis s io n It is to b e n o te d th a t th e tr o h o
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n a tu r e o f h is to ly s in w h ic h b r in g s a b o u t d e

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o
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p h ic fo r m s m a y fo r a tim e g r o w a n
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y p o n a s a n a c c id e n t o n th e p a r r
o f th e p a r a s ite b e c a u s e s o fa r a s its b io lo g ic a l a s p e c t is c o n c e r n e d it h a s r e a c h e d a d e a d e n d

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p ,
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Șf :
tra n s fo r m e d in to s m a ll p r e c y s tic fo r m s fr o m w h ic h th e c y s ts a r e d e v e lo p e d
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y ) In s u c H
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rs
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h o s t a n d th e p a r a s ite B u t th e c y s ts p r o d u c e d
in a n in k c [e d in d iv id Įı
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tr a n s fe re n e c to a n o th e r su sc e p tib le h o s t h e r e th e y u in g m w d c o n tin u e th e ir lik
w an c y c le a s s ta te d a bo v e

/ Řıs c r v o ir s o f I n fe c tio n N a tu r a ıin lb c tio n o fE /lis tn lj tic a is ly d keys H

se e n o n
arrET an m o n en ce w is
th c c u ı11 m o n e s t s o u r c e Q f jntction
In C h in a T lo gs a re su ppo se d Io b e th e p o s s ib le s o u r c e o f in fe c tio n to It h a s b e e n sho w n th a t ild
m a n w r a ts a lth o u gh n o t an
s p re a d o f th e d is e a s e to m a n m a y b e r e g a rd e d a s re s e rv o ir s o fE /ıis ıo tľ tic a

o n T ra n s m is s io n o fE /ıis to ly ï ic a fr o
fr e c te d th r o u g h its e n c y s te d s ta g e a n d m m an to m a n is e

r o u g h th e in \ s tio n o f th e s e e ls ts M a tu r e
q u a d r in u c le a te c y s ts a r e th e in fe c tiv e fo r m s o f th is
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e s m d fr u its w h ic h h a r e B e e n fe r tilis e d w ith in fe c te d h u m a n fa e c e s h a s o fte n ı

v e g e ta b ı e d to th e o c c u r r e n c e o f th e
d is e a s e O c c a s io n a ıly d r in k in g w a te r s u p p Iy c o n ta m in a te d w ith in fe c te d fa e c e s g iv e s r is e to e id e m ic s
, p
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co m m o n m e th o d T he re a rc tw o ty p e s o f c a rr ie rs : c o n ta c t a n d c o n v a le s c e n t T h e fo r m e r a r e s u p p o s e d to b e s o
"

ca lı
ed h e a lth y c a r r ie r s w h o h a v e n e v e r s u ffe r e d fr o m a m o e b ic d y s e n te r y a n d w h o s e h e a lth a p p e a r s to r e m a in u n

im p a ire d T h e la tte r a r e th o s e w h o h a v e r e c o v e re d fr o m a c lin ic a l a tta c k o f a c u te a m o e b ic d y s e n te r y

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d y s e n te ry c a n n o t s u rv iv e fo r m o r e th a n a c o u p le o F h o u rs a n d s o a r e a n u n lik e ly s o u rc e o f in fe c tio n E v e n if th e y a re in g e s te d
d u r in g th is s h o rt p e r io d o f e x is te n ce th e y a r e d ig e s te d b y th e a c tio n o f th e g a s tr ic ju ic e
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r e la tiv e ly little im p o r ta n c e T h e c y s ts o f E /jis ï o ly lic a h a v e b e e n fo u n d in th e d r o p p in g s o f c o c k r o ac he s w h ic h a ls o

se rv e a s a s o u r c e o f in fe c tio n

P a

In cu b a tio n P e r io d In m an th e in c u b a tio n p e r io d v a r ie s a g r e a t d e a l b u t is g e n e ra y fo
lı u r o r fiw Da Y s

in ic a ıF
C ı ea tu res o r S y m p to a to ı
m o g y T h e te r m a m o e b ia s is is u s e d c lin ic a lly to d e n o te a ll th o s e c o n d itio n s
"

w h ic h a r e p ro d u c e d in th e h u m a n h o s t b i f
y n ec o ti n w ith E h is o y ic a a t d iffe r e n t a r e a s o f its in v a s io n
t l ı T h c te r m
b ic t tV S e n l e ig n ifie s c o n d itio n in w h ic h th e in fe c tio n is c o n fin e d to th e in te s tin a l c a n a l a n d is c h a r a c te r is e d
"
a ı?to e s a

by th e pa ssa ge o f b lo o d a n d m u cu s in th e s to o ı It is to b e n o te d th a t a ln o e b ic tlv s e n ı
e ņ is n o t a sy n o n ym o f
a m u e b ia s is "
an d n e ith e r do e s th e te rm b ic d j S e n t e / g iv e th e fu 1ıp ic tu r e o f th e m a n ife s ta tio
a n zo e n s o f iııï e s ıiım t
a m t re b ia s if D y s e n te r y is a s y m p to m c a r a c te r is tic o f e x te n s iv e in te s tin a l u lc e ra tio n s r e p re s e n tin g o
h n ly a p a r t o f th e

c lin ic a l p ic tu re o f in te s tin a ıa m o e b ia s is b u t th e r e a re a la r g e n u m be r o f c a se s w h ic h a re n o t a c c o m p a n ie d b y d y s e n
te r ic sy m p to m C ı
in ic a l fe a tu r e s v a ry fr o m a c u te c o litis to c h ro n ic c o litis a n d a sy m p to m a tic c a r r ie r s ta le A s y m p to m
a tic c a r r ie r c a n pa ss c y s ts o f b o th n o n p a th o g e n ic a n d p a th o g e n ic s tr a in s o f E h is to lj tic a
・

P ņ t h o g e n ic L e s io n s T he se m a y be c o n s id e r e d u n d e r tw o he a ds

1 P r ln a ry o r
ı In te s tin a t L e s io n s Th e in fe c tio n is lim ite d e n tire ly to th e la rg e in te s tin e th e in itia l s ite o o c a tio
fı n ot

th e p a n ßite

2 Secdary o r M e ta M a lic L e s io n s T h e e x tr a c o lo n ie a r e a s w h e r e th e tn o p h o z o ite s o fE llis to ly tic a can m ig r a te

an d p ro d u ce le s io n s in c lu d e (i ) liv e r (b ) ı u n gs an d (c ) b r a in

甯認
毽胃畢多 司园
囑 거 戻떻露司舁睡犷가望日里粵 ・

，
イ 卣
 G O pH O RA G EN U S EN T A M O EBA
25
PH Y LU M S A R C O M A ST ı

f v N I N T E S T IN A L L E S IO N S

ib e r a te d a fte r e x c y s ta tio n e n te r th ro u g h th c c r y p s
f I n te s tin t
o a ıL e s io n s
y s tic tr o p h o z o ite s ı
T he *
m e ta c
id
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t T he y th b
y tic fe r m e n t th e y s e c re e
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1 ı)
th e ir w a y d e e p e r a n d d e e p e r b y c o n t in u o u s Iy s is o f tis s u e c e lls t iııth e y r e a c h th c s u b m u c o u s c o a t (F ig s 10 &
H e re th e a m o e b a e r a p id ly m u ltip ly a n d in c r e a s e in n u m b e r Fo r m c o lo n ie s destmy th c tis s u e s n i t h e ir v ic i n i ty nda

u tilis e th e c y to ly s e d m a te r ia l a s th e ir fo o d T h e a m o e b a e th e n b e g in to p a s s
in v a r io u s d ir e c tio n s d is s o lv in g a ı l
i i th e m u c o u s
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i i t in c o a g u la tiv e n e c r o s is a n d th e
m e m b ra n e a b o v e T h e in v a s io n o f th e tis s u e s b y th is p ro to z o a l p a r a s ite b r in g s n ts r a

D is tr ib ıłıio n o fU lc e rs A m o e b ic u lc e r a tio n s a r e s tr ic tly c o n fin e d to th e la rg e g u t T h e le s io n s m a y b e g e n e r a lis e d

o r lo ca lis e d
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(ii) L o c a lis e d T he re a re tw o le v e ls o f in v o lv e m e n t

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v e d
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th e s ig m o id c o lo n d r e c tu m in lv e d
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f b ic lc e F s t e a s ily d e te c te d externally (fr o m th e p e r ito n ea l s u r fa c e )

C /ıa ra c ı
e r o fU lc e r s T h e s ite s o a m o e u a re n o

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u n le s s th e y a re de ep a n d e x te n s iv e c a p pe a ra n c e o u rs

b ra n e a ıw a y s in te b e tw th e u ı
c e rs e v e n w he n th e y a re
T he u ı
c e rs a re d is c r e te a n d a h e a lth y m u co u s m e m rv e n e s ee n

L N

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g 10
Fı M ı
c pı o

sa e : 3 su b m u c o R a s k s h a p e d c le a r h f i l
l c r y p ts o f L ie b e r k ū h n 2 M u s c u la ń s m u c o
sa a r e a r e p re s e n ts t e p r o c e s s o t s s u e n e e n ) s s

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4 c ir c u la r m u s c ı e s 5 Io n g u t n a m u s c e es

L N s o lita r y ly m p h n o d e o c c a s io n a l a p p ro ac h

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p e r fic ia lı u ï e

r fa c e d u tilis in
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in te s tin e E ro d in g th e m u c o u s su a n

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liv e s in a s s o c ia tio n w ith c e r ta in

M o g e n ic in 8 x
 20 P A R A S IT O L O G Y

c x tc n s iv c T hc c ・u r liť ť / /￠ ť irtn ix Ľ h a r iıc tc r is c d b y th e ı a r e le v a tio n s (F ig

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T v n
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o w m a le r ia ıo f n e c ro tic tis s u e co m e s o u t in w h ic h am o e b ic tr o p ho zo ite s m a y b e fo u n d W ith th e
ı
ib c r u tio n u l t y to ı
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To m th e s e n o d u la r a re a s sm a ll s u p e r lic ia ıu lc e rs a re p ro d u c e d
ty p ic ı\l ￠iıılt l f b ir ıl /r er h ıs th c Ib ı
lo w in g p e c u lia r itie s

S iz e V a r y in g lr o 11 \
ı p in s he a d to o n e in c h o r m o re in d ia m e te r
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Č y g g m u co u s m e m a n o n
v c r tic a ıs c c tit»n h a s th c a p p e a r a n c e o f a fı
a s k (fla s k s h a p e d u lc e r )
4
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p b y th e Y e lı
o w is h b la c k is h
u se c n c ra n n e u n e c ro o r
1
į s lo u g h (ıig 13 )
E r re n s in n c fU /( e r s S u p e r fic ia l u ı
c e rs d o n o t e x te n d be y o n d th e u s c u la r is m u c o s a e D u ı
c e rs lim ite d to
m e e p a re
U th c s u b m u c o u s c o a t a n d m a y e x te n d la tc
r a lı
y t[» c o m m u n ic a te w ith a d ja c e n t u lc e rs W h e n th e d e s tr u c tio n is n o t
ıim itc d to th c s u b m u c o s a b u t e x tc n c ıs d e e p e r in to th c m u s c u la r a n d e v e n th e s e r o u s ı a y e r s th e fo ı ıo w in g c o m p lic a
tio n s m a y a r is e ıo c a ıp e r ito n itis h a e m o r r h a e
g p e r fo r a tio n a n d g e n e r a lis e d p e r ito n itis p e r ic a e c a l o r p e r ic o lic a b

-
sc e ss s ıo u g h in g a n d g a n g r e n e o l th c ı
, a rg e g u t

Healilt ų í U k ers A fte r th c se p a r a tio n o f s lo u g h g r a n u la tio n tis s u e b e g in s to fo r m o n th e no o r o f th c u ı

c t r a te d
a rc a /ıi {ı
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s c a r tis s u e is n o t fo r m e d a n d th e m u c o u s m e m b r a n e is co m pı c [c ıy r e s to r e d o v e r th c
a rc a In th e se c a se s re g e n e r a tio n is s o e ffe c tiv e th a t th e ite s f th e h e a le d lc e rs c a n h a rd ı b c o g n is e d la te r In
, s o u y e re
3 /t łtw ť cm t/ d e ť p u /Ĺ e r s ,
he a ı in g is a s s o c ia te d w ith th e fo r m a tio n o f s c a r tis s u e o v e r w h ic h th e e p ith e ı
iu m o l th c m uco us
m e m b ra n e d o e s n o t g ro w a n d th e s e a re a s c a n la te r b c d e te c te d as sm o o th d e p re s s e d s c a rs th e c e n tre s t w h ic h
o m a y o r
/ b e p ig m e n te d E x c e s s iv e fo r m
m ay n o t a tio n o f sc ar tis s u e m a y le a d to s tr ic tu r e s a n d p a r tia l o b s tr u c tio n to rh c pa s sa ge
q o l th e fa e c a l m a tte r o r it m a y p r o d u c e
,
a ge n e ra lis e d th ic k e n in g o f th e in te s t in a lw a ll

M ı
c R o s c o p Ic PA ĽH O Lo G Y (H ıs T o p A T ıIo Lo G Y ) In e a rı
an y u lc e r th e le s io n w ill b e fo u n d to b e lim ite d a b o v th e
m u s c u la r is m u c o s a e (F ig 14 ) a n d th e a m o e bae m y b
a e s e e n m a r c h in g a lo n g th e in te r g ı
a n d u la r s p a c e s c a u s in g c y tn ly

s is A t th is s ta g e th e e p ith e lia l c e lls o f th e c r y p ts o F L ie b e r k ü h n w iı l s h o w v a ry in g d e g r e e s o f n e c ro s is a n d w itı ıth c

d e s tr u c t io n o F its b a s e m e n t m e m b r a n e th e am o e ba e w ill b e fo u n d to p e n e tr a te d e e p e r (F ig 15 ) If a se c ıio n is m a L Ie

th r o u g h th e m id d le o fan e a r ly u lc e r o n e w o u ı
d fin d th e fo lı
o w in g

1 In th e c e n tr e a n a re a o fn e c ro s e d tis s u e in w h ic h th e cc ı
ls a re in v a r io u s s ta ge s o f de ge n e ra tio n H a r c lly a n y
am o e ba ca n be se e n in th is ce n tr a ıd e g e n e r a te d a r e a

2 To w a rd s th e p e r ip lıe rr a m o e b a e (tro p h o zo itc fo rm s ) a r e to b e fo u n d in la rg e n u m b e r s ly in g s in g ly o r :rı

g ro u p s ,
w ith n o ce llu la r in filtr a tio n

In a fa ir ly adv an ce p h o z o ite s o f E ìıis ıť ı/Y ıic a m a y b e s e e n m ig r a tin g a c o n s id e ra b le d is ta n c e a w fı

d le s io n th e tr o
fro m th e a c tu a l u ı c e r a n d in v a d in g th e in te r m u s c u ıa r s p a c e s to r e a c h th e p e r ito n e a l c o a t T h e p a r a s ite s m a y a ı s u bť

o b s e r v e d b u r r o w in g in to th e s m a ll v e n u le s o r ly in g w ith in th e lu m in a o f d ila te d v e n o u s ra d ic ı e s a s lr e e c e ı x a lo n g s it ļ c
ı
th e re d b lo o d c e ı
ıs an d le u co c y te s H y p e r p la s ia o f th e e n d o th e lia l c e ı
ıs o f m a n y s m a ll b lo o d v e s s e ls c a u s in g th e ir

th ro m b o s is m a y a ls o b e s e e n In th e s e th r o m b i th e tro p h ic fo r m s o f E liis to ty tic a h a v e o fte n b e e n d e te c te d

In te s tin a l L e s io n s in C h r o a l A m o e b ia s is T h e p a th o lo g ic a l p ic tu r e o f in d iv id u a ls s u ffe r in g fm m
n ic In te s tin
c h ro n ic in te s tin a l a m o e b ia s is
ffe ń n g fr o m a c u te d y s e n te r y v a r ie s o n ly in d e g r e e T h e c o u r s e a n d p ro g ıe s s
an d th o se s u

o f s u c h le s io n s a r e e n t ire ly g u id e d b y th e r e s is tin g p o w e r o f th e h o s t T h e le s io n s w h ic h a r e o b s e r v e d in th is g ro u p o f

c a s e s a ie c h a ra c te r is e d b y u lc e r a tio n s a n d r e g e n e ra tiv e tis s u e c h a n g e s a n d h e n c e a c o m b in a tio n o f th e lb ı lo w in 吕 i$

o b se rv e d
ı S m a ll u lc e rs in v o lv in g o n ı y th e m u c o s a
fi i
2 E x be n s iv e s u p e r c a u l lc e r s w ith h y p e r a e m ia

3 M a r k e d s c a rr in g o f in te s tin a l w a ll w ith th in n in g d iı a ta tio n a n d s a c c u la tio n

4 E x te n s iv e a d h e s io n s w ith th e n e ig h b o u r in g v is c e n ı
5 L Jo c a lis e d th ic k e n in g o f th e in te s tin a l w a ll le a d in g to a n a r m w in g o f th e ı
u m en o f th e ı
x »w e l
 P H Y LU M SA R C O M A ST ı
G O p H O R A G E N U S EN T A M O E B A 27

i
F ig 12 E arı in te s t in ıle s io n s in a cu te a m oe bı
c
y a

d y s e n te r y
S ho w in g th e n o d u la r e le v a tio n s a n d u lc e r a tio n s

6 G lis e d th ic k e n in g o f th e b o w e l w a ll r e n d e ń n g it p a lp a b le In e m a c ia te d p a tie n ts th e c o u r s e o f th e e n tir e

e n e ra

th ic k e n e d c o lo n m a y b e c o m e e a s ily v is
ib le a n d p a lp a b le

7 F o r m a tio n o f tu m o u r lik e m a s s e s o g ra n u la tio n tis s u e (a m o e b ic g r a n u lo m a o r a n ıo e b o tm ) C lin ic a ı

f ly it iı
d iff i b f i d e d i i h i f
d iflic u lt to e r e n t a te a m o e o m a r o m c a r c n o m a a n a g n o s s r e s ts u p o n t e 0 n ı t
m o s ra o n o trop
zo ite s o fE h is ıtıty ıic a in s e c tio n s o f tis s u e s o b ta in e d b y b io p s y o r a t a u to p sy
 28 P A R A S IT O L O G Y

F ig M S e c tio n fr o m th e m a r g in o f a n a m o e b ic u lc e r o f th e ca ecu m

Sho w in g a co lle c tio n o fE h is to ly tic a (tr o p h o z o ite fo rm s ) ly in g a lo n g th e in te r g la n d u ı

ar spa c e s

Fı p h o to m ic r o g r a p h fr o m a n e a r ı y a m o e b ic u ı c e r o f th e c a e c u m
g 15
h is to ly tic a a r e s e e n m a r c h in g a ıo n g th e c r y p ts o f L ie b e r k ū h n (4 o f th e m a re s h o w n 2 in ta c t a n d 2 d e s tr o y e d ) e ro d in g
Tophozoites o fE
h i i r)
c a n b e s e e n p a s s in g th e b a r r e
th e b a s e m e n t m e m b r a n e o f th e e p ith e lia l lin in g a n d p e n e tr a t in g d e e p e r in to th e t s s u e s (o n e ro p
i t o z o te

in h e re
D e fin ite u lc e r s in v o lv in g th e m u sc u la r c o a t o r e v e n e x te n d in g u p to th e p e ń to n e a lc o a t m a y be se e n c a se s w

a c u te e x a c e r b a tio n has o c c u rr e d

"
fo d ith ith o u t a d h e r e n t tra c e s f d lo b lo o d T ix a m ın a u w ıu ı

flu id (d ia rr h o e ic ) ,
se m i flu id o r e ven rm e ,
w o r w o m u cu s an r