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PARASITIC INFECTIONS IN CENTRAL

NERVOUS SYSTEM

PARASITOLOGY DEPARTMENT MEDICALFACULTY of

SUMATERA UTARA UNIVERSITY

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PARASITIC INFECTIONS IN CNS

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CESTODE
NEUROCYSTICERCOSIS

FREE LIVING AMOEBA

- PRIMARY AMOEBIC
MENINGOENCEPHALITIS
-GRANULOMATOUS
AMOEBIC ENCEPHALITIS

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Caused by the infestation of T. solium

larvae (Cysticercus cellulosae)
Human is the definitive host
In Indonesia, Bali and Papua have many
cases reported

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NEUROCYSTICERCOSIS

Cyst produces paramiosin and taeniastatin

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Neurologic symptom arises when the

Cysticercus cellulose dies and the host (human)
mounts anassociated inflammatory response.

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PATHOGENESIS

(inhibitor protease serin) enzymes that bind

alternative.

Cyst wall is covered by polysaccharide sulfa

activating complement to avoid the parasite
interfering .

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C1q and blocking its classic pathway or

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Primary Amoebic Meningoencephalitis (PAM)

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FREE LIVING AMOEBA INFECTION

Primary Amoebic Meningoencephalitis (PAM)

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General

Etiology : Naegleria fowleri

Thermophilic, temp tolerance :40-450C.

Sources: soil, sewage sludge, nasal & throat
swabs, tap water, lakes , stream, ponds,
swimming pool, thermal spring.
temp tolerance :40-450C.

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Inhalation
Contaminated dust
Nasal instillation

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Transmission

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Pathology & Pathogenesis

N. fowleri injures nerve cells by 2 mechanism :
1. Ingestion of cytoplasma through a feeding
cup
2. Contact dependent lysis due to alteration of
the permeability of the target cell by lytic
proteins.
Cell death is due to the release of ions,
followed later by the loss of large
macromolecules.

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An inflamatory reaction develops in the meninges

& the cellular influx leads to damage of the cellular
functions of the blood brain barrier.
The integrity of the barrier due to direct invasion
of amoeba into the brain tissue

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Pathology & Pathogenesis

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Motile trophozoite seen in CSF

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Diagnosis

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Granulomatous Amoebic Encephalitis

Etiology : Acanthamoeba sp.
Pathology :
Probably injuries by 2 mechanism :
1. Ingestion of cytoplasma
2. Contact mediated lysis of cellular components
due to secreted enzymes.
Pathology is probably related to attraction of a
granulomatous cellular response.

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REFERENCES

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Ahmad MF, Gandahusada S. Ameba hidup bebas. Dalam : Sutanto I,

Ismid IS, Sjarifuddin PK, Sungkar S (eds.). Buku Ajar Parasitologi
Kedokteran. Edisi ke-4. Jakarta:FK-UI;2008.p.126-27
Warhust, DC. Pottentialy Pathgenic Free Living Amoeba. In:
MansonsTropical Diseases. Ed 22. Saunders. 2009.p. 1407-1417
Sandjaja B. Sarcodina. Parasitologi Kedokteran Buku I Protozoologi
Kedokteran. Ed.1. Jakarta:Prestasi Pustaka. 2007. p. 111-13
Schmidt GD, Robert LS. Foundations of parasitology. 7th ed. New
York:Mc Graw Hill;2005.p.118-19
Acanthamoeba sp. Available from
http://images.loverhythm.multiply.com/image (accessed on 21st of
July, 2010)
Trophozoit Acanthamoeba sp. Available from http://atlas.or.kr
(accessed on 26t hof July, 2010)

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