FT 0297

MICROBIOLOGY
WITH DISEASES BY TAXONOMY, THIRD EDITION
Chapter 23
Parasitic Protozoa, Helminths, and Arthropod Vectors

Lecture prepared by Mindy Miller-Kittrell, University of Tennessee, Knoxville
Copyright 2011 Pearson Education Inc.
Parasitic Diseases
Protozoan and helminthic parasites exist worldwide

Occur among people in rural, undeveloped, or overcrowded places
Emerging as serious threats in developed nations
Parasitic infections often involve several hosts
Definitive host
Intermediate host
Parasites can infect humans in one of three ways
Routes by which humans acquire parasitic infections
Figure 23.1
Protozoan Parasites of Humans

Protozoa that enter the body via ingestion have two morphological forms
Trophozoite
Feeding and reproducing stage that lives within the host
Cyst
Infective form that survives in the environment
Undergo excystment when ingested developing into trophozoites
Trophozoites undergo encystment before leaving the host in feces
Parasites presented based primarily on their mode of locomotion
Ciliates, amoebae, flagellates, and apicomplexans

Ciliates
Protozoa that use cilia in their trophozoite stage
Balantidium coli
Only ciliate known to cause disease in humans
Commonly found in animal intestinal tracts
Humans infected by food or water contaminated with feces
containing cysts
Trophozoites attach to mucosal epithelium lining the intestine
Infections generally asymptomatic in healthy adults
Balantidiasis occurs in those with poor health
Persistent diarrhea, abdominal pain, and weight loss

Amoebae
Protozoa with no truly defined shape
Move and acquire food through the use of pseudopodia
Found in water sources throughout the world
Few cause disease

Amoebae
Entamoeba
Carried asymptomatically in the digestive tracts of humans
No animal reservoir exists
Infection occurs by drinking water contaminated with feces
containing cysts
Three types of amebiasis can result from infection
Luminal amebiasis
Invasive amebic dysentery
Invasive extraintestinal amebiasis
Maintaining clean water is important in prevention
Trophozoite of Entamoeba histolytica
Figure 23.2

Amoebae
Acanthamoeba and Naegleria
Cause rare and usually fatal brain infections
Common inhabitants of natural and artificial water systems
Individuals who wash their contact lenses with tap water can
become infected

Amoebae
Acanthamoeba and Naegleria
Acanthamoeba disease
Occurs through cuts, scrapes, the conjunctiva, or inhalation
Acanthamoeba keratitis due to conjunctival inoculation
Amebic encephalitis is the more common disease
Naegleria disease
Infection occurs when swimmers inhale contaminated water
Amoebic meningoencephalitis can result
Prevention difficult since organisms are environmentally hardy

Flagellates
Protozoa that possess at least one flagellum
Number and arrangement of flagella important to determining the
species
The flagellates include members of the genera Trypanosoma,
Leishmania, Giardi, and Trichomonas

Flagellates
Trypanosoma cruzi
Causes Chagas disease
Endemic in Central and South America
Opossums and armadillos are the primary reservoir
Transmission occurs through bite of insects in genus Triatoma
Kissing bugs feed preferentially from blood vessels in the
lips
The life cycle of Trypanasoma cruzi
Figure 23.3

Flagellates
Trypanasoma cruzi
Chagas disease
Progresses through four stages
Acute stage characterized by chagomas
Generalized stage
An asymptomatic chronic stage
Symptomatic stage characterized by congestive heart
failure following formation of pseudocysts
Parasite-induced heart disease is a leading cause of death in
Latin America
Mature trypomastigotes of Trypanasoma cruzi
Figure 23.4

Flagellates
Trypanosoma brucei
Causes African sleeping sickness
The insect vector is the tsetse fly
Humans usually infected when bitten by infected tsetse flies
The life cycle of T. brucei
Figure 23.5

Flagellates
Trypanasoma brucei
African sleeping sickness
Progresses through three stages if left untreated
Site of the fly bite becomes a lesion with dead tissue
Fever, lymph node swelling, and headaches
Meningoencephalitis
Infections characterized by cyclical waves of parasitemia
Clearing tsetse fly habitats reduce the cases of disease

Flagellates
Leishmania
Causes leishmaniasis
Endemic in parts of the tropics and subtropics
Wild and domestic dogs and small rodents are common hosts
Leishmania have two developmental stages
Amastigotes
Multiply in hosts macrophages and monocytes
Promastigotes
Develop extracellularly within a vectors gut
The life cycle of Leishmania
Figure 23.6

Flagellates
Leishmania
Three clinical forms of leishmaniasis often observed
Cutaneous leishmaniasis
Mucocutaneous leishmaniasis
Visceral leishmaniasis
Most cases of leishmaniasis heal without treatment
Prevention limited to reducing exposure to reservoir and vector
Mucocutaneous leishmaniasis
Figure 23.7

Flagellates
Giardia intestinalis
Found in intestinal tracts of animals and in the environment
Causative agent of giardiasis
Common gastrointestinal disease in the United States
Ingest cysts in contaminated water or when swimming
Range from asymptomatic infection to gastrointestinal
disease
Giardia have a life cycle similar to that of Entamoeba
Trophozoites multiply in the small intestines
Prevent infections in endemic areas by use of filtered water
Trophozoite of Giardia intestinalis
Figure 23.8

Flagellates
Trichomonas vaginalis
Most common protozoan causing human disease in
industrialized nations
Lives in the genitourinary system of men and women
Transmitted almost exclusively via sex
Occurs in people with preexisting STD or multiple sex partners
Infection of women results in vaginitis
Infection of men is typically asymptomatic
Prevention involves abstinence and safe sex
Trophozoite of Trichomonas vaginalis
Figure 23.9

Apicomplexans
Alveolate protozoa
Infective form characterized by ornate complex of organelles at
their apical end
Parasites of animals
Life cycles involve at least two types of hosts
Schizogony is major feature of apicomplexan life cycles
Multinucleate schizonts form before the cells divide
Four important apicomplexan parasites
Plasmodium, Toxoplasma, Cryptosporidium, and Cyclospora

Apicomplexans
Plasmodium
Causative agent of malaria
Four species cause malaria
P. falciparum, P. vivax, P. ovale, and P. malariae
Malaria is endemic throughout the tropics and subtropics
Mosquitoes are vector for Plasmodium
The Plasmodium life cycle has three prominent stages
Geographical distribution and incidence of malaria
Figure 23.10
The life cycle of Plasmodium
Figure 23.11
Trophozoites of Plasmodium falciparum in erythrocytes
Figure 23.12

Apicomplexans
Plasmodium
Genetic traits increase malaria resistance in endemic areas
Sickle-cell trait
Sickle-shaped cells resist penetration by Plasmodium
Hemoglobin C
Two genes for hemoglobin C protect against malaria
Glucose-6-phosphate-dehydrogenase deficiency
Needed by the trophozoites to synthesize DNA
Lack of Duffy antigens on erythrocytes
P. vivax requires Duffy antigen to infect erythrocytes

Apicomplexans
Plasmodium
Symptoms of malaria associated with cycles of erythrocyte lysis
P. falciparum can cause blackwater fever
High fever, erythrocyte lysis, renal failure, and dark urine
Cerebral malaria results in tissue death in the brain
Immunity develops if victim survives acute stage
Periodic episodes become less severe over time
Prevent malaria by limiting contact with mosquitoes

Apicomplexans
Toxoplasma
T. gondii is causative agent of toxoplasmosis
One of the worlds most widely distributed parasites
Wild and domestic mammals and birds are major reservoir
Cats are the definitive host
Infection due to consumption of undercooked meat containing
the parasite
Ingestion or inhalation of contaminated soil can also occur
The protozoan can cross the placenta and infect the fetus
The life cycle of Toxoplasma gondii
Figure 23.13

Apicomplexans
Toxoplasma
Most infections are asymptomatic
Toxoplasmosis develops in a small number of people
Fever-producing illness combined with other symptoms
Usually is a self-limited infection
Toxoplasmosis is more severe in two populations
AIDS patients
Fetuses
Prevent by cooking meats and avoiding contaminated soil
Pseudocysts of Toxoplasma gondii
Figure 23.14

Apicomplexans
Cryptosporidium parvum
Causative agent of cryptosporidiosis (Cryptosporidum enteritis)
Once thought to only infect livestock and poultry
Humans can carry the parasite asymptomatically
Infection usually results from drinking contaminated water
Fecal-oral transmission can occur
Causes severe diarrhea that can last up to two weeks
Chronic Cryptosporidum enteritis indicator a person has AIDS
Infection of AIDS patients can be life threatening
Oocysts of Cryptosporidium parvum
Figure 23.15

Apicomlexans
Cyclospora cayetanensis
Water borne apicomplexan
Linked to raspberries imported from Central and South America
Infection occurs from ingestion of oocysts in contaminated food
or drink
Environmental reservoir is unknown
Symptoms include cramps, watery diarrhea, myalgia, and fever
AIDS patients can experience more severe disease
Thoroughly washing fruits and vegetables can prevent infection
Helminthic Parasites of Humans
Helminths are macroscopic, multicellular, eukaryotic worms

Life cycles are complex
Intermediate hosts are often needed to support larval stages
Adult worms are either dioecious or monoecious
Three groups of helminthes
Cestodes (tapeworm)
Trematodes (fluke)
Nematodes (roundworm)

Cestodes
Flat, segmented intestinal parasites
All tapeworms lack digestive systems
All possess the same general body plan
Features of tapeworm morphology
Figure 23.16
Generalized life cycle of some tapeworms of humans
Figure 23.17

Cestodes
Taenia
Taenia saginata is the beef tapeworm
Taenia solium is the pork tapeworm
Cattle and swine serve as the intermediate hosts
Humans living close to livestock have highest incidence of
infection
Adults attach to the intestinal epithelium
Most individuals shed strobila without having symptoms
Intestinal blockage can occur if the tapeworm is large

Cestodes
Echinococcus
Echinococcus granulosus is the canine tapeworm
Canines infected by eating cysticerci in various herbivore hosts
Humans are accidental intermediate hosts
Consume food or water contaminated from dog feces
Causes hydatid disease
Larvae travel throughout body and form hydatid cysts
Symptoms follow enlargement of cysts in infected tissue
Prevent with good hygiene practices
X ray of hydatid cyst
Figure 23.18

Trematodes
Flukes are flat, leaf-shaped worms
Lack complete digestive tract
Attach to host tissues via a ventral sucker to obtain nutrients
Geographical distribution limited because the intermediate host is
limited
Grouped according to the site in the body they parasitize
Some features of fluke morphology
Figure 23.19
Representations of fluke life cycles
Figure 23.20
Representative Liver Fluke: Fasciola

Trematodes
Representative liver fluke: Fasciola
Fasciola hepatica and F. gigantica
Infect sheep and cattle worldwide
Humans are accidental definitive hosts
Ingest metacercariae from aquatic vegetation
Parasite migrates from the intestine to the liver
Chronic infections occur when flukes reside in the bile ducts
Symptoms coincide with episodes of bile duct obstruction
and inflammation

Trematodes
Blood flukes: Schistosoma
Dioecious blood flukes
Causative agent of schistosomiasis
Humans are the principal definitive host
Three geographically limited species infect humans
S. mansoni
S. haemotobium
S. japonicum

Trematodes
Blood flukes: Schistosoma
Cercariae burrow through skin of humans who contact
contaminated water
Larvae mature and mate in the circulatory system
Eggs move to the intestines or the urinary bladder and ureters
Dermatitis may occur at the site where cercariae entered
Infections can become chronic and can be fatal
Prevention relies on improved sanitation and avoiding
contaminated water
An egg of Schistosoma mansoni
Figure 23.21

Nematodes
Roundworms are long, cylindrical worms that taper at each end
Possess complete digestive tracts
Have a protective outer cuticle
Parasites of almost all vertebrates

Nematodes
Features of the life cycle of roundworms
Number of reproduction strategies
Intestinal nematodes shed eggs into lumen of the intestine
Eggs are consumed in contaminated food or water
Larvae of some intestinal nematodes hatch in the soil
Larvae actively penetrate the skin of a host
Some nematodes encyst in muscle tissue
Consumed in raw or undercooked meat
Mosquitoes transmit a few species of filarial nematodes
Adult sexually mature stages are found only in definitive hosts
Ascaris lumbricoides
Figure 23.22

Nematodes
Ascaris
Ascaris lumbricoides
Endemic in the rural southeastern United States
Causative agent of ascariasis
Most common nematode infection of humans worldwide
Eggs are ingested in water or on vegetables
Adult worms grow and reproduce in the small intestine
Most infections are asymptomatic
Proper sanitation and hygiene are important for prevention

Nematodes
Ancylostoma and Necator
Two hookworms infect humans
Ancylostoma duodenale
Necator americanus
Larvae burrow through skin
Travel to the heart, lungs, and eventually the small intestine
Adult worms suck the blood of their hosts
Causes chronic anemia, iron and protein deficiencies
Ground itch occurs at the site of larvae penetration
Wearing shoes in endemic areas helps prevent exposure
Mouth of Ancylostoma duodenale
Figure 23.23

Nematodes
Enterobius vermicularis
Commonly known as the pinworm
Most common parasitic worm found in the United States
Humans are the only host for Enterobius
Female pinworms deposit their eggs in the anus
Infections are often asymptomatic
Intense perianal itching occurs if symptomatic
Preventing fecal-oral spread from infected individuals limits
disease
Eggs of Enterobius vermicularis
Figure 23.24

Nematodes
Wuchereria bancrofti
Filarial nematode
Infects the lymphatic system
Causative agent of filariasis
Transmitted by various genera of female mosquitoes
Mosquitoes ingest microfilariae when feeding on human
Mosquitoes then transmit the parasite to new individual
Remains asymptomatic for years
Lymphatic damage can result in elephantiasis
Prevention relies on avoiding infected mosquitoes
A microfilaria of Wuchereria bancrofti in blood
Figure 23.25
Elephantiasis in a leg
Figure 23.26
Arthropod Vectors
Vectors are animals that carry microbial pathogens
Arthropods are common vectors
Some arthropods are biological vectors
Serve as hosts for the pathogens they transmit
Disease vectors belong to two classes of arthropods
Arachnida
Insecta

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MICROBIOLOGY

WITH DISEASES BY TAXONOMY, THIRD EDITION

Parasitic Protozoa, Helminths, and Arthropod Vectors

Copyright 2011 Pearson Education Inc.

Protozoan and helminthic parasites exist worldwide

Copyright 2011 Pearson Education Inc.

Routes by which humans acquire parasitic infections

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Trophozoite of Entamoeba histolytica

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

The life cycle of Trypanasoma cruzi

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Mature trypomastigotes of Trypanasoma cruzi

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

The life cycle of T. brucei

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

The life cycle of Leishmania

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Trophozoite of Giardia intestinalis

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

Trophozoite of Trichomonas vaginalis

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

Geographical distribution and incidence of malaria

Copyright 2011 Pearson Education Inc.

The life cycle of Plasmodium

Copyright 2011 Pearson Education Inc.

Trophozoites of Plasmodium falciparum in erythrocytes

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans

Copyright 2011 Pearson Education Inc.

Protozoan Parasites of Humans