Pathogenic Intestinal Amebae

Figure 1 Figure 2
Entamoeba histolytica
• Pseudopod-forming, non flagellated
protozoan parasite
• Only pathogenic amoeba
• Two stages: Infective stage- cyst and
Invasive stage- trophozoite
• MOT: ingestion of mature/
quadrinucleated cysts from fecally-
contaminated material, venereal contact
through fecal-oral contact, direct colonic
inoculation through contaminated Figure 1: Cyst of E. histolytica/E. dispar in an
enema equipment
unstained concentrated wet mount of stool.
• Cause amebiasis, intestinal (amebic Notice the chromatic bodies with blunt,
colitis peritonitis, perforations, rounded ends(arrow).
ameboma) and extaintestinal infections
(amebic liver abscess, pleuropulmonary Figure 2: Cyst of E. histolytica/E. dispar in a
abscess, brain abscess, and necrotic concentrated wet mount stained with iodine.
lesions on the perianal skin and Notice the chromatic body with blunt,
genitalia) rounded ends (arrow).

CYST STAGE Figure 3 Figure 4

• Usually spherical
• Size: usually measure 12 to 15 um
• Highly refractive hyaline cyst wall
• One to four nuclei
• Centrally-located karyosomes
• Fine, uniformly distributed peripheral
chromatin
• Rod- shaped/cigar-shaped chromatoidal
bars

Figure 3: Cyst of E. histolytica/E. dispar

stained with trichrome. Two nuclei are
visible in the focal plane (black arrows), and
the cyst contains a chromatoid body with
typically blunted ends (red arrow)

Jam Ariane A. Evangelista BSMT 2E

Figure 4: Cyst of E. histolytica/E. dispar • Presence of trophozoites or cysts of non
stained with trichome. Note the chromatic pathogenic amebae in stool indicates
body with blunt ends (red arrow). that the person from whom the
specimen was collected had fecal
TROPHOZOITE STAGE exposure
• Highly motile
• Possess pseudopods Entamoeba coli
• Size: 12-60 um in diameter (20 um in
average) CYST STAGE
• Single nucleus with centrally located • Usually spherical but may be elongated
karyosomes with uniformly distributed • Measures 10-35 um
peripheral chromatin
• Mature cyst typically have 8 nuclei but
• Cytoplasm has a granular or “ground- may have as many as 16 or more
glass” appearance
• Karyosome may be compact or diffuse
• Progressive and directional movement and are usually eccentrically located
• Occasionally with ingested erythrocytes
• Peripheral chromatin is course, granular
(erythrophagocytosis)
and irregular arranged along the nuclear
membrane
Figure 5:
• Chromatoidal bodies are usually splinter
like with pointed ends
Figure 5:
Trophozoite of
E. hystolytica/E.
dispar in a
direct wet
mount stained
with iodine.

Intestinal Amebae (Nonpathogenic)

• Reside in the lumen of the large
intestine in the human host
• MOT: ingestion of mature cysts in fecally
contaminated food, water and formites
• Main host: humans (except: Entamoeba
polecki- usually associated with primates
and swine)
• Cause noninvasive colonization

Jam Ariane A. Evangelista BSMT 2E

TROPHOZOITE STAGE
• Usually measures 15-50 um
• Single nucleus with a characteristically
large, eccentric karyosome and course,
irregular peripheral chromatin
• Nondirectional movement
Iodamoeba butschlii
CYST STAGE
Endolimax nana
CYST STAGE
• Spherical to ellipsoidal in shape and
measure 5-10 um
• Mature cysts have four small nuclei with
large, usually centrally located
karyosomes and no peripheral
chromatin
• Cytoplasm may contain diffuse glycogen
but lacks chromatic bodies
• Nuclei are not visible unstained wet
mounts
Jam Ariane A. Evangelista BSMT 2E
TROPHOZOITE STAGE
• Measures 6-12 um
• Single nucleus with characteristically
large, irregularly shaped, blot-like
karyosome
• Nucleus lacks peripheral chromatin
• Cytoplasm is granular and often highly
vacuolated and may contain inclusions of
bacteria
• Nearly spherical to ellipsoidal in shape
and measure 5-20 um
• Cyst contain a single nucleus (not visible
in wet mounts)
• Nucleus contains a large, usually
eccentrically located karyosome
(permanent stains ex. Trichrome)
• Presence pot a large compact mass
(vacuole) of glycogen in the cyst stage
important diagnostic feature in iodine-
stained wet mounts: darker, reddish-
brown color
TROPHOZOITE STAGE
• Measures 8-20 um
• Single nucleus with a large, usually
centrally located karyosome surrounded
by refractile, achromatic granules
• Cytoplasm is coarsely granular and
vacuolated and can contain bacteria,
yeast, or other materials
• Sluggish and nonprogressive movement
• Difficult to distinguish from those of
Endolimax nana
Jam Ariane A. Evangelista BSMT 2E
Dientamoeba fragilis
TROPHOZOITE STAGE
• Intestinal flagellate, not an amoeba
• Irregularly in shaped
• Size: 5-15 um
• Have one or two nuclei (mostly
binucleate)
• Nucleus has fragmented karyosome with
discrete chromatin granules
• No peripheral chromatin in the nuclear
membrane
• Pseudopods may be loose, triangular or
serrated edges
• Cytoplasm is usually vacuolated and may
contain ingested debris and large
uniform granules