Naegleria Acanthamoeba Balantidium Coli

Amoeba-flagellate-cyst stages
Infective stage: trophozoite
Binary fission
Preferred habitat: soil and fresh water
Species: gruberi, fowleri, philppinensis
Trophozoite: finely granular numerous
vacuoles of cytoplasm, dense central
nucleolus, transform to cyst in presence of
water, with blunt lobose pseudopod and
directional motility
Cyst: single layered with mucus plugged
pores
Inhabitants of soil, freshwater, thermal
hotsprings
Pathogensis: sustentacular cells
phagocytosis (olfactory epithelium);
penetrate nasal tissue
MOT: inhalation
PAM
- s/sx: gastritis, diarrhea, inflame of
brain and brain tissue destruction,
onset of headache, fever, stiffneck
lead to coma and death
- brain only affected
- DOC: amphotericin B
- Dx; PCR and ELISA, Culture in CSF
and brain, Ct Scan: obliterated
cisternae and subarachnoid space
- Prevention: avoid swimming in
warm stagnant water,
unchlorinated pools

Active trophozoite stage, dormant cyst stage
Trophozoite: infective stage but both cyst and
trophozoite enter the body.
Ubiquitous
Opportunistic infection: AIDs with love CD4
count, immunosuppressed
Trophozoite: nucleus: large centrally located.
F.g. ctoplasm, large vacuole, feed on gram (-)
bac; acanthapodia
Cyst: star shaped, double walled, with pores or
ostilioles, large central nucleus
Life cycle: free living, found in soil, binary
fission
MOT: inhalation vis dust/aerosols
Pathogensis: affect lower respi tract
GAE
- Enter the respi tract, eyes, skin,
spread hematogenously in CNS
- Cerebral affectation: edematous,
hemorrages, abscess w/ opaque and
with purulent leptomeninges
- Onset: headache, fever
- Skin lesion impt dx feature
- Tx: 5-flurocytosine, ketoconazole,
amphotericin B
Amoebic Keratitis
- breaks in ocular tissue abrasion of soft
contact lenses; s/sx: corneal
ulcerations
- tx: clotrimazole + petamidine; corneal
grafts
Dx: after death, isolated in CSF, PCR
Prevention: disinfect contact lenses, mask in
cleaning with dust, avoid fresh wtaer
Causative agent for balantindiasis or
balantidial dysentery
Largest protozoa
Only pathogenic ciliate
Binary fion
Attacks intestinal epithelium ulcer
bloody diarrhea with mucus
Associated with pigs
Trophozite: pathogenic stage; cytosome:
food acquisition, cytopyge: excretion, 2
nuclei, macronucleus bean shaped; 2
contractile vacuolues, mucoysts: for
adhesion
Cyst: infective stage
Lifecycle: cyst parasite stage, ingested
through contaminated food and water,
encystation in SI, trophozoite in LI the
encystation again, some invade tissues,
others pass as mature cysts in feces
Balantidial Dysentery
- Round based wide necked ulcer
- Inc hyaluronidase causing ulcer
- Inc exudates
- Bloody diarrhea with mucus
Acute Infxn: adl pain, asymptomatic
Chronic Infxn: D alternate with constipation,
cachexia, intestinal appendix
Dx; stool exam
Tx: Tetracyclin, Meconazole, Iodoquinol
Prevent: proper food handling, water
sanitation
Cyst inactivated by NaHCL3











Entamoeba Histolytica Dientamoeba Fragilis
E. dispar morphologically similar
Most invasive of all entamoeba family
Ensytations happen in the ILEUM; forming
8 trophozoites
Unsual features: mitochondrial genes of
pyridine nucleotide transhydrogenase and
hsp 60, lac of organelles, tunicamycon, lack
of gluta metab, use of pyrophosphate
instead of atp, inability to synthesize
purine
Life cycle: CYST: infective stage,
quadrinuclueated, resistant to gastric
acidity and dessication, present in formed
stool TROPHOZOITE: invasive pathologic
state; invade and colonize LI, ingest RBC
binary fission, present in diarrheic stool,
unidirectional movt
Pathogenesis: VIRULENCE FACTORS: Gal/
GAlnac Lectin adherence to host cells,
Amebapores form spores to human,
Csyteine Protease cytopathotic/detroy
tissues
SITES: cecum, a.colon, liver (CAL)
Aymptomatic cyst carrier state DOC:
diloxanide furoate
Amebic Colitis/ Dysentery most common
form, diarrhea w/wo blood, and mucus;
flask shaped ulcer DOC: Metronidazole
Ameboma mass like lesion with abl pain
ALA -most common extra-intestinal pain
DOC: tinidazole
Dx: Charcot Leyden Crystals in stool exam:
3 consecutive days stool exam
Liver ultrasound: RUL of liver most infect
with trophozoitel dont aspirate in the
middle
Prevention: boil drinking water (20-30m)

Flagellated trophozoite stage
NO CYST STAGE!
Rosette nucleus
Habitat: large intestine (cecum)
Pathogensis: irritates the colon
Tx: metronidazole





GIARDIA LAMBLIA TRICHOMONAS VAGINALIS Trichomonas Hominis
TROPHOZITE: binucleated flagellated, ptriform
tear drop shaped, pair of ovoid nuclei on each
side, dorsal side convex, ventral side
concave with adhesive disc; bilaterraly
symmetrical with distinct medial line:
AXOSTYLE, propelled in erratic tumbling
motion, with 4 pair of flagella, entires surface
with VSP (variant specific surface CHON
resistant to intestinal proteases to survive in
the intestine; reporodce by longitudinal binary
fission
CYST: quadrinucleated infective, ovoid, young
cysts 2 nuc, mature cyst 4, flagella retracted
into axonemes, surrounded by tough hyaline
cysts
Mature cyst: infective stage exycts in
duodenum > TROPHOZOITE in jejunum
mature cysts passed out in feces
CHITIN: responsible for the durability of wall
of protozoan cyst
GIARDIASIS
Pathogenisis:
- oral fecal route
- Attachment rt to adhesive disc, temp
and pH (7.2-8.2), lectin
- Avoid peristalsis trap itself in between
villim crypts hypertrophy, dec
absorption of nutrients
- Entocyte apoptosis reaarange
cytoskeleton of colonic and deuodenal
layer
- Acute: adbl pain, rotten egs smell flatus
- Diarrhea common
- Chronic: steatorrhea, D alternate with C
- Failure to thrive syndrome
- Dx: fecal smear: troph: floating leaf like
motility, Cyst: spotty shedding req 3 days
(3 specimens), entero test, direct
fluoresecent ab assay gold standard
- Tx: metronidazole
- Gay bowel syndrome

From phylum parabasalia
No cyst stage!!!!
Trophozoite: colorless, pyrifirm flagellate,
undulating membrane, axostyle visisble,
single nucleus anterior, rotating movent ,
3-5 flagella
Sites: Vagina, Prostate, Urethra
Trichomonas Vaginitis
Prostatovesiculitis
Male asymptomatic, discharge, pruritis
Female discharhe, pain, pruritus
DX: presence in trophozoite urine
Tx: Metronidazole

Habitat: intestine
Commensal organism, does not cause
disease
Oro-fecal route
Sites: colon
4 flagella anteriorly with 5
th
flagella
altered to form undulated membrane, ant
ovoid nucleus, with axostyle.
No s/sx