Microbiology

Trypanosoma (Jawetts/ reading assignment)

07 February 2008

Guys. Part 1 lang to. Meron pang , b. coli, n. fowleri, a. castellani at

arthropods n nksked na reading assignment di kasma ditto. Anatay
antayin ni nlng… to follow.. Sinusundan namin yung sked ng micro
department coinciding w/ trans date. And sabi dun reading assignment
tayo ng feb 7. so eto. Enjoy. 4 units of Micro.. -brim

TRYPANOSOMA
 occur in blood of mammals as mature elongated
trypomastigotes
 multiplying epimastigotes precedes the foremation of
infective trypomastigotes in the intermediate host in all
species of trypanosomes that infect humans
 Expressed as:
o African spleeing sickness
o Chaga’s Disease
o Asymptomatic trypanosomiasis

Trypanosoma brucei brucei

 parent form in Africa
 causes nagana in livestock and game animalas
T. brucei rhodesiense and T. brucei gambiense
 human forms

MORPHOLOGY

A. TYPICAL ORGANISM
T.b. gambiense and T. b. rhodesiense
 vary in shape of the body and length of flagellum(
15-30μm)
i. Stumpy short form
 Infective to the insect host and possess a full
battery of enzymes for energy metabolism
ii. Elongated form
 Requires host metabolic assistance and is
specialized for rapid multiplication in the richly
nutritious vertebrate bloodstream
 Seen in blood as in lymph node aspirates
iii. Blood form of T. cruzi
 present during the early acute stage and at
intervals thereafter in smaller numbers
 typical trypomastigotes, mean size 20 μm
 frequently curved in a C shape when fixed and
stained
iv. Tissue forms
 common in heart muscle, liver, brain
 develop from amstigotes that multiply to form an
intracellular colony after invasion of the host cell
or phagocytosis of the parasite
Trypanosome rangeli
 infects humans w/o causing disease
B. CULTURE
T. cruzi & T. rangeli
 cultivated (3-6 weeks) in the epimastigote form in
fluid or diphasic media
C. VARIATION
T. brucei complex
 undergo development of a series of genetically
controlled glycoprotein antigenic coats (variant
surface glycoproteins)
 VSGs – means of escaping the host’s antibody
response by producing different antigenic membranes
 each trypanosome – thought to possess 1000 VSG
gene – mosaic gene formation

Leu, Brim, Virns 1 of 3

 Microbiology – TRYPANOSOMA by Jawetts (reading assignment) Page 2 of 3

PATHOGENESIS • Tobie’s
• Wenyon’s semisolid
T. b. gambiense and T b. rhodesiense • Growth at 22-24 °C
 introduced through the bite of the tsetse fly • Subcultured every 1-2 weeks
 indurationa and swelling  progress to trypanosomal ANIMAL INOCULATION
chancre • detected by inoculating blood intraperitoneally in mice
 spread to lymph nodes, bloodstream, and to CNS • T. b rhodesiense  often detectable
(terminals stage)
• T b. gambiense  sometimes detectable
 sleeping sickness syndrome: lassitude, inability to SEROLOGY
eat, tissue wasting, unconsciousness and death • confirmatory test
o positive IHA, IFA, CF (Machado’s) tests
T b rhodesiense T b gambiense • ELISA
Appears in CSF in 1 month Several months
• Useful in blood blank screening
Rapidly fatal produces Chronic and leads to
somnolence and coma only progressive diffuse • African forms cause IFA rxns after 12 days of infxn
during the final weeks of meningoencephalitis, w/ XENODIAGNOSIS
terminal infection death from sleeping • Method of choice in Chaga’s Dse
syndrome usually ff 1-2 yrs • For trained workers only!
• Impractical for African forms
T. cruzi
 introduced when infected bug feces are rubbed into DIFFERENTIAL DIAGNOSIS
the conjunctiva, the bite site or a break in the skin
 subcutaneous inflammatory nodule or chagoma • Presence of specific IgM- pathognomonic for the
 Chaga’s disease encephalitic stage of African trypanosomiasis
• Differentiation of 2 specie based on total parasite DNA
 Insterstitial myocarditis – most serious
element digestant electrophoresed on agarose gels which are
then stained w/ ethidium bromide
 Romañas sign – unilateral swelling of the eyelids, a
characteristic at onset. T. cruzi T. rangeli
 fever, acute lymphadenitis, dissemination to blood and
tissues Blood forms
Size 20μm Over 30 μm
 detected 1-2 weeks as trypomastigotes in blood
Shape Often c-shaped in Rarely c-shaped
 multiplies mostly w/in reticuloendothelial cells fixed preparations
Posterior Terminal, large Distinctly
• African forms  multiply extracellularly as Kinetoplast subterminal, small
trypomastigotes in blood & lymphoid tissues
• Parasitimia Developmental Amastigote to Not found (only
stages in tissues epimastigote trypomastigotes)
 punctuates multiplication
 w/ later destruction by the host of blood forms, Triatomine bugs
accompanied by bouts of intermittent fever gradually In salivary gland Always absent Usually present
decreasing in intensity or proboscis
 T.b rhodesiense –common In hindgut or Present Present
feces
 T. cruzi – intermittent & scant
• Toxin relase explains systemic and local reactions.
• Brazilian Chaga’s Disease
IMMUNITY
 causes megaesophagus and megacolon

***all three trypanosomes are transmissible through the • Strain-specific CF and protecting antibodies detected
placenta, and congenital infections occur in hyperendemic in human plasma
areas***
TREATMENT
DIAGNOSIS
• Nifurtimox (Bayer 2505) – shorten acute phase
SPECIMENS • Gamma-interferon –temporary relief
• blood • Suramin Sodium/ pentamidine isethionate – for
• CSF African trypanosomiasis
• Lymph node or primary lesion aspirates • Melarsoprol / Suramin/ Tryparsamide– late dse w/
• Specimes obtaine by iliac crest, sternal bone marrow CNS involve
or spleen punctured • Eflornithine – (DFbIO)  for blood and CNS phases of
MICROSCOPIC EXAM T. gambiense and hemolytic stages of T. rhobdesiense
• Thick films – by Giemsa’s stain
• Most reliable
o Smears of blood by T b rhodesiense
o Lymph gland puncture for Tb gambiense
o CSF – tb rhodiense & advanced Tb
gambiense
CULTURE
 Microbiology – TRYPANOSOMA by Jawetts (reading assignment) Page 3 of 3

EPIDEMIOLOGY
To follow nlng yung iba.. peace ;)
• Tb gambiense
 transmitted by the streamside tsetse
Glossina palpalis
 West to central Africa
 Produce chronic infxn w/ progressive CNS
involvement
 Human reservoir
• T. rhodiense
 Transmitted by woodland –savanna Glossina
morsitans, Glossina pallidipes and Glossina
fuscipes
 Eastern and southeastern savannas of Africa,
w/ foci West of Lake Victoria
 Bushbuck & other antelopes – serves as
reservoir
• American trypanosomiasis
 Important in Central & south America
extends widely to Maryland & southern
California
• Certain triatomine bugs become as domiciliated as
bedbugs & infextion may be brought in by rats,
opossums or armadillos  w/c may spread the
infection to domestic animals such as dogs and cats
• Largely among poor economic circumstances

PREVENTION AND CONTROL

• Control depends upon searching for and then isolating

and treating pxs w/ disease
• Controlling movements of people in & out of fly belts
• Using insecticides and by altering habitatas
• Control vectors w/ residual insectidies and habitat
modification
• Short-lived – chemoprophylaxis w/ suramin sodium

EIGHT GIFTS THAT DO NOT COST A CENT . . .

1) THE GIFT OF LISTENING . . .

But you must REALLY listen. No interrupting, no daydreaming, no
planning your response. Just listening.
2) THE GIFT OF AFFECTION . . .
Be generous with appropriate hugs, kisses, pats on the back and
handholds. Let these small actions demonstrate the love you have
for family and friends.
3) THE GIFT OF LAUGHTER . . .
Clip cartoons. Share articles and funny stories. Your gift will say, "I
love to laugh with you."
4) THE GIFT OF A WRITTEN NOTE . . .
It can be a simple "Thanks for the help" note or a full sonnet. A
brief,
handwritten note may be remembered for a lifetime, and may even
change a life.
5) THE GIFT OF A COMPLIMENT . . .
A simple and sincere, "You look great in red," "You did a super job"
or "That was a wonderful meal" can make someone's day.
6) THE GIFT OF A FAVOR . . .
Every day, go out of your way to do something kind.
7) THE GIFT OF SOLITUDE . . .
There are times when we want nothing better than to be left alone.
Be sensitive to those times and give the gift of solitude to others.
8) THE GIFT OF A CHEERFUL DISPOSITION . .
The easiest way to feel good is to extend a kind word to someone,
really it's not that hard to say, Hello or Thank You. Friends are a
very rare jewel, indeed. They make you smile and encourage you
to succeed. They lend an ear, they share a word of praise, and they
always want to open their hearts to us . . .