PROTOZOOLO

GY
Medical Parasitology – deals with
parasites which infects man and
the disease they produce
Parasites – organisms that infect
other living organisms
Host – an organism that harbors the
parasite
Types of hosts:
 Definitive hosts – harbors the

adult stage of the parasite or

where sexual stage of
reproduction takes place
 Intermediate host – harbors the

larval stage of the parasite or

where asexual stage of
reproduction takes place
Paratenic host – a host where the
parasite merely remains viable
without development or multiplication
Reservoir host – harbors the parasite
and where it can reproduce
Protozoa – single celled
microorganisms
 Amoebas

 Entamoeba histolytica –

causes amoebiasis
- With a large centrally

located karyosome
- The cyst (dormant) is the

infective stage
- Trophozoites are motile, metabolically
active, and capable of reproduction
- Transmission through ingestion of fecally
contaminated water or food, flies on food,
soiled hands of infected food handlers,
oral-anal sexual contact
- S/Sx: abdominal
cramps, watery stool
usually mucoid or
blood streaked
- Amoebae may invade

mucus membranes of
the colon forming
abscesses
- May also be
disseminated via the
bloodstream leading to
abscess in the liver,
lung, brain, and other
organs
- Dx: stool exam
- Treatment: Metronidazole
for symptomatic patients
Iodoquinol for
asymptomatic carriers
Enatamoeba histolytica cyst
Entamoeba histolytica
trophozoite
 Entamoeba coli –
commensals but may
produce amoebiasis
in multiple infections
- With 4-8 nuclei with
large eccentrically
placed nucleus
Entamoeba coli cyst
Entamoeba coli trophozoite
Entamoeba gingivalis –
only amoeba in the oral
cavity
- Causes halithosis

- Transmitted through

saliva
 Naegleria fowleri and
Acanthamoeba acanthusis
– free living amoeba w/c
inhabits fresh water
lakes and streams
- May accidentally infect

bathers
- Parasite invades the nasal mucosa and
destroys the olfactory nerves which is a
point of entry into the brain
- May cause meningoencephalitis (fatal)
- Treatment: Amphotericin B and
Rifampicin
Naegleria fowleri
Naegleria fowleri cyst
Acanthamoeba cyst
Ciliates
 Balantidium coli – only ciliate
known to parasitize man
- largest of the protozoans
- cyst is the infective stage
acquired by ingestion of
contaminated food or water
- trophozoites colonize in the
ileum and colon of infected
humans
- w/ a prominent cytostome (cell
mouth) and cytopyge ( cell anus)
- reproduce by binary fission

- pig is the reservoir host

- with 2 nuclei: macronucleus and

micronucleus
- causes Balantidial dysentery/
Balantidiasis/ Ciliary dysentery
- Diagnostic exam: cysts in the stool
exam
- Treatment: Tetracycline
Balantidium coli trophozoite
Balantidium coli cyst
 Flagellates
 Giardia lamblia – only
flagellate in the small
intestine (duodenum)
- Also known as Giardia
duodenalis
- reproduce by binary
fission
 - causes Giardiasis
 - infection is caused by
consuming contaminated food or
water
 - cyst is the infective stage
- S/Sx: dull epigastric
pain, flatulence,
diarrhea, steatorrhea
- some do not manifest

symptoms but are

carriers of the parasite
- Diagnostic exam: stool exam
- under the light microscope it looks like a “clown
face” w/ 2 nuclei outlined by adhesive discs
above dark median bodies that form the mouth
- Cysts have 4 nuclei
- Treatment: Quinacrine or Metronidazole
Giardia lamblia trophozoite
Giardia lamblia trophozoite
Giardia lamblia
Giardia lamblia
cyst
Giardia lamblia cyst
 Trichomonas vaginalis –
sexually transmitted
- causes cervicitis in
females and urethritis in
males
- S/Sx: profuse, thin,
foamy, malodorous (fishy
odor) vaginal discharge
- often asymptomatic
 - largest flagellate
- Dx: wet mount examination of the
discharge, sometimes trophozoites can be
seen in urine and Papanicolau smears
- Treatment: Metronidazole
Trichomonas vaginalis
Trichomonas vaginalis
Trichomonas vaginalis
trophozoite
 Trichomonas tenax – only
flagellate found in the oral
cavity
- causes dental caries and
tartar formation
Trichomonas tenax
 Leishmania sp. - a blood
flagellate, can be transmitted
intravenously
- transmitted by a sandfly w/ 2
different vectors:
1. Phlebotomus – Old World

2. Lutzomyia – New World

- causes Leishmaniasis
- mucocutaneous (espundia)
infections will start off as a
reaction at the bite and
metastasize into mucus
membranes and be fatal
- visceral infections appear w/
fever, weight loss,
hepatosplenomegaly and
anemia
- it has 2 different morphological states:
1. Promastigote (leptimonad) – lives in the digestive
tract of the fly
2. Amastigote – found in the lysosomes of the
macrophages of vertebrates
- Treatment: a solution containing Antimony
Leishmania amastigote
Leishmania sp.
promastigote
 Trypanosoma brucei – a
blood flagellate
- transmitted by a tsetse
fly
- causes African sleeping
sickness (African
Trypanosomiasis)
- S/Sx:
- early stage

- painful chancre at the site of the bite,

fever, headache, insomnia,
lymphadenitis, anemia, edema, rash;
- late stage

- body wasting, falling asleep, coma,

death
 - 2 types:
 T. Brucei gambiense

 T. Brucei rhodesiense

 - Dx: observations of trypomastigote in

blood, lymph or CSF
T. Brucei gambiense
T. Brucei rhodesiense
 Trypanosoma cruzi – a
hemoflagellate (trypomastigote
form) and an intracellular
parasite (amastigote)
- transmitted by a reduviid
bug/kissing bugs/assassin bugs
- can also be transmitted by
blood transfusion
- the bugs become infected when they take
blood meals from an infected animal
- the bugs defecate as they take a blood meal
or feed at the corner of a sleeping person’s
eye, the feces containing the parasite are
rubbed into the bite or the eye
- causes Chaga’s Disease. (American
Trypanosomiasis)
- S/Sx: inflammatory response at the
site of the bite, fever, malaise,
lymphadenopathy,
hepatosplenomegaly (at times may
be asymptomatic)
Trypanosoma amastigote
Trypomastigote in blood
 Sporozoa

 Plasmodium sp. – causes malaria

- transmitted by a female
Anopheles mosquito
- S/Sx: intermittent chills, fever,
sweat
- with alternating generations of
sexual stage (sporogony) in the
mosquito and asexual stage
(schizogony) in man
Dx: 6 consecutive positive malarial blood smear
- Treatment: Chloroquine
- Types of malaria:
1. Plasmodium malariae – quartan malaria

2. Plasmodium vivax – benign tertian malaria,

most widely distributed
3. Plasmodium ovale – ovale tertian malaria,
sporadic
4. Plasmodium falciparum – malignant tertian
malaria
Plasmodium malariae
Plasmodium malariae ring
stage
Plasmodium vivax
gametocyte
Plasmodium vivax ring
stage
Plasmodium vivax schizont
stage
Plasmodium vivax trophozoite
Plasmodium ovale
Plasmodium ovale trophozoite
Plasmodium falciparum
gametocyte
Plasmodium falciparum ring
stage
 Toxoplasma gondii – causes
Toxoplasmosis
- definitive hosts are cats
that acquires infection by
eating infected rodents or
birds
- intermediate hosts are
birds, rodents, sheep, goats,
swine, cattle
- humans become infected by eating infected raw or
undercooked meat containing the cyst form of the
pathogen or ingesting food or water contaminated w/
oocysts shed from the feces of infected cats
- can be transmitted transplacentally, blood transfusion,
organ transplantation
 - in immunocompetent people
it may be asymptomatic or
may resemble Infectious
Mononucleosis
- in immunocompromised
people, it involves the CNS,
lungs, muscles, heart
- cerebral toxoplasmosis is common in
AIDS patients
- infection during early pregnancy
may lead to fetal infection causing
death of the fetus or serious birth
defects
- Treatment: Pyrimethamine and
Sulfadiazine w/ Folinic acid
Toxoplasma gondii cyst
Toxoplasma gondii
tachyzoites