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3 Intestinal Amebae
- Endolimax nana
- Iodamoeba butschlii
Pathogenesis of Amebiasis
- Trophozoites attach to mucosal epithelial cells (MEC)
- Lyse MEC
- Ulcerate and invade mucosa
- Cause dysentery (diarrhea + blood)
- Metastasize via blood &/or lymph to form abscesses in extraintestinal sites
Symptomatic Infections of Amebiasis: Intestinal amebiasis (colon and rectum) presentations
- Acute Dysenteric (Dysentery)
- Chronic Non-Dysenteric ("self-cured")
Symptomatic Infections of Amebiasis: Extra-Intestinal amebiasis (colon and rectum) presentations
- Amebic Liver Abscess (ALA)
- Amebic Pulmonary Abscess
Symptoms of Acute Dysenteric Amebiasis
- Bloody mucoid diarrhea (RBCs and few WBCs in stool)
- Stools positive for trophozoites (NO cysts in loose stools)
Classic-flaskshaped ulcer is myth. Ulcerations with overlying pseudomembrane is more accurate
History of dysentery (1 yr), wt loss, RUQ abdominal pain, rt. chest or shoulder pain
Extra-Intestinal Amebiasis, Amebic Liver Abscess (ALA)
Tx of Amebiasis
Name a flagellate and a ciliate
Giardia, Balantidium (ciliate)
Giardia lamblia (G. intestinalis): Trophozoite has
How does it move?
2 nuclei, 9 flagella.
Locomotion is falling leaf-like
Infective form of Giardia lamblia (G. intesinalis)? How does this differ from the trophozoite form?
Cyst, twice the "stuff" of trophzoites (4 nuclei, 16 flagella)
Most common intestinal parasitic disease in humans in US
Day Care Diarrhea is caused by?
Who is at risk
- Diaper changers and siblings
Tx of Giardiasis
Totally ciliated giant
Cyst with kidney bean shaped macronucleus and thick resisitant wall with cilia inside?
Common in south american hog/ guinea pig farmers
Diagnosis of Balantidiasis?
- Ova and parasite exam of stool specimen
Coccidia: Phylum, Class, Subclass
- Phylum Apicomplexa
- Class Sporozoea
- Subclass Coccidia
How many sporozoites does a Cryptosporidium parfum's infective oocysts have as it passes in the feces?
4 to 8- sporozoites
Cryptosporidium parvum development:
- Asexual--> Merozoite
- Sexual --> Zygote
- Caused by Intestinal Cryptosporidiosis
- Tx is Nitazoxanide
Unsporoulated oocysts of _____ pass in human feces (2-4 um larger that Cryprosporidium- 8 to 10 um)
Cyclospora cayetanensis and Cryptosporidium parfum stain with
Acid Fast Stain
Oocysts of Cyclospora are NOT fully developed and don't contain any sporocysts when passed through stool.
Endemic diarrhea of little Peruvian children
Treatment for Peruvian children (Cyclospora cayetensis)
May cause life-threatening diarrheal illness in persons with AIDS. Treat prophylactically with?
Large football oocysts with sporoblasts. Infective oocysts contain __ sporocysts.
Asexual and sexual development in MEC
Presents with abdominal pain, chronic diarrhea, and eosinophilia!!!! (Exam question!!!)
Tx of Isosporosis
Blastocystis hominis is not a protozoan. It's ____
algae (due to rRNA gene analysis)
- Ova & parasite exam of stool specimin
- Metronidazole, iodoquinol, or nitazoxanide