PARASITOLOGY

PROTOZOANS
Group 2
GIARDIA
LAMBLIA
 GIARDIA LAMBLIA
Disease on Human

Mild to severe diarrhea (loose stools/poop),

gas, stomach cramps, nausea (an upset
stomach feeling), or dehydration in susceptible
individuals (loss of water in the body causing
weakness of dizziness).
Some patients show absolutely no symptoms.
Seldom is there a fever.
 GIARDIA LAMBLIA
Morphology
It comes in two types:

Trophozoite Cyst
 GIARDIA LAMBLIA

The trophozoites has a

badminton racket shaped
(dorsoventrally convex)
and are 10-20 μm in length.

Old Man’s Face structure

 GIARDIA LAMBLIA
It has a concave sucking disc
for its adhesion to the intestinal
mucosa and a convex dorsal
shape. It has two nuclei, four
pairs of flagella, one pair of
axostyles that run along the
midline, and two parabasal or
median bodies. It is bilaterally
symmetrical.
 GIARDIA LAMBLIA
The parasite's infectious form is
called a cyst.

The cyst is oval and measures 8-

12 x 7-10 um in size.

Depending on the maturity level, it could

have two or four nuclei. Moreover, it has the
basic axoneme and flagellar structures.
 GIARDIA LAMBLIA
Life Cycle
(1) Cysts are passed out in stool of an
infected human.
(2) Infective cysts are ingested.
(3) The cyst excysts to release trophozoite in
the small intestine.
(4) The trophozoites multiply by binary
fission.
(5) The trophozoite encysts to become cyst
which is passed out in the stool.
 GIARDIA LAMBLIA
Life Cycle

Loose stools are excreted by trophozoites.

In just one host, Giardia completes its life cycle. The
developed cyst is in the infective stage. Cysts found in
polluted food and water cause human illness. Also
susceptible to direct person-to-person transmission
include young people, male homosexuals, and residents of
institutions.
 GIARDIA LAMBLIA
Epidemiology
It can spread widely or sporadic cases of diarrhea.
Is a significant contributor to outbreaks in daycare
centers, foodborne and waterborne illness, and traveler
illness.
Infection rates range from 2 to 67% depending on where
in the world you are.
Man contracts an infection by consuming developed
cysts through tainted food or beverages.
 GIARDIA LAMBLIA
Symptoms
Trophozoite does not enter the tissue; instead, it adheres to
the intestinal epithelium utilizing the sucking disc,
shortening and stunting the villi in the process. Giardiasis
typically leaves patients symptom-free, however it can
occasionally result in flatulence, dull epigastric discomfort,
diarrhoea, and fat malabsorption (steatorrhea). Mucus and fat
in excess are seen in the feces. Children may experience
persistent diarrhea, vitamin A and fat malabsorption
deficiencies, and weight loss. A two-week incubation time is
typical.
 GIARDIA LAMBLIA

Diagnosis
1. Microscopic Examination
cysts and trophozoites in feces can be found
using formal ether, iodine-wet preparations,
and direct saline solutions. It is frequently
necessary to check several stool samples. All
that is visible in asymptomatic carriers are the
cysts. Trichrome staining can be used to
detect cysts and trophozoites in fixed stool
smear.
 GIARDIA LAMBLIA
Diagnosis

2. Enterotest (String test)

a good way to collect duodenal
samples for parasite testing

 GIARDIA LAMBLIA
Protection and Treatment
Control and Prevention
1. Proper feces disposal
2. Personal grooming
3. Boiling water for consumption
4. Water filtration for drinking
5. Before eating, thoroughly rinse
fruits and vegetables with water
6. Proper health education
 GIARDIA LAMBLIA
Protection and Treatment

Treatment

Metronidazole (250 mg 3 times

daily for 5 days) or tinidazole is
the drug of choice. Paromomycin
can be given to symptomatic
pregnant woman.
 GIARDIA LAMBLIA

REFERENCE:
MAHMUD, R., LIAN, L. Y. A., & AMIR, A. (2017). MEDICAL
PARASITOLOGY: A TEXTBOOK. SPRINGER
INTERNATIONAL PUBLISHING.
CHILOMASTIX
MESNILI
BY: JHONA MAE DE GUZMAN
CHILOMASTIX MESNILI
DISEASE ON HUMAN

Chilomastix mesnili is considered nonpathogenic. The presence of cysts and/or

trophozoites in stool specimens can however be an indicator of fecal
contamination of a food or water source, and thus does not rule out other
parasitic infections. Chilomastix mesnili is a nonpathogenic flagellate that is
often described as a commensal organism in the human gastrointestinal tract.

May indicate dysbiosis or suppressed immunity.

CHILOMASTIX MESNILI
MORPHOLOGY OF THE CYST

The cyst is 6-9μm in diameter and has a single large nucleus with a large karyosome.
It has a prominent side knob which gives it the distinctive lemon shape. The
cytosome is visible as a curved shepherd's Crook fibril.

Figure A: Cyst of C. mesnili in a stool specimen, Figure B: Cyst of C. mesnili in a concentrated wet
stained with trichrome. Image taken at 1000x mount of stool, stained with iodine. Image taken
magnification. at 1000x magnification.
CHILOMASTIX MESNILI
MORPHOLOGY OF THE TROPHOZOITE

The trophozoites of C. mesnili are pear shaped and measure 10-20μm in length. It has a single large
a nucleus with a small karyosome andIt has 4 flagella (3 extend anteriorly, and 1 is associated with
the cytostome) that protrude from the nucleus at the anterior end of the cell. A distinct oral groove
or cytosome can be seen near the nucleus It moves in a directional manner.

Figure C: Trophozoite of C. mesnili from a stool Figure D: Trophozoite of C. mesnili from a stool
specimen, stained with trichrome. Image taken at specimen, stained with trichrome. Image taken at
1000x magnification. 1000x magnification.
CHILOMASTIX MESNILI
CHILOMASTIX MESNILI
LIFECYCLE
CHILOMASTIX MESNILI
DEFINITIVE HOST as nonpathogenic in the human host

Like most nonpathogenic intestinal protozoa, it has a simple one-host life cycle
whereby infection occurs from the ingestion of cysts and trophozoites multiple by
binary fission in the lumen of the intestine.

IT LACKS AN INTERMEDIATE HOST

MODE OF TRANSMISSION
Transmission occurs via the fecal-oral route
when water contaminated with feces that
contain Chilomastix cysts is ingested.
CHILOMASTIX MESNILI
INFECTIVE STAGE
IT LACKS VECTOR
cysts

EPIDEMIOLOGY

It has an infection rate of about 6% of the world population.

Found more frequently in warm climates

SYMPTOMS
Chilomastix mesnili is considered non-pathogenic may not cause
symptoms. The presence of cysts and/or trophozoites in stool specimens
can however be an indicator of fecal contamination of a food or water
source, and thus does not rule-out other parasitic infections.
CHILOMASTIX MESNILI
DIAGNOSIS

Chilomastix mesnili is identified through the detection of cysts and/or trophozoites

in stool specimens, both concentrated wet mounts and permanent stained smears
(e.g., trichrome).
CHILOMASTIX MESNILI
CHILOMASTIX MESNILI
TREATMENT

Treatment with metronidazole is found to be highly effective in eradicating C.

mesnili infection in common marmoset.
CHILOMASTIX MESNILI
REFERENCES

CDC - DPDx - Chilomastix mesnili. (2019, June 5). Www.cdc.gov.

https://www.cdc.gov/dpdx/chilomastix/index.html
‌Chilomastix - an overview | ScienceDirect Topics. (n.d.).
Www.sciencedirect.com. https://www.sciencedirect.com/topics/immunology-
and-microbiology/chilomastix
‌Chilomastix_mesnili.pdf (ukneqasmicro.org.uk)
The Intestinal Protozoa. (n.d.).
https://www.austincc.edu/ddingley/MLAB1331/LectureGuide/IntProt
Trichomonas vaginalis

STD
 Trichomonas vaginalis

Trichomoniasis is a common sexually transmitted

infection caused by a parasite. In women, trichomoniasis
can cause a foul-smelling vaginal discharge, genital
itching and painful urination.

Men who have trichomoniasis typically have no

symptoms. Pregnant women who have trichomoniasis
might be at higher risk of delivering their babies
prematurely.
 Trichomonas vaginalis

Causes
An infection caused by protozoa, Trichomonas vaginalis
It is transmitted through sexual contact
In women, it causes infection in urethra (a tube which empties urine
from the bladder), vagina or both
In men, infection occurs only in urethra

Risk factors include:

Multiple sexual partners
Unprotected sex
Other sexually transmitted infections
 Trichomonas vaginalis
How do you get trichomoniasis?
Trich is caused by a really tiny parasite called a trichomona (you can’t see it with the
naked eye). People get trich from having unprotected sexual contact with someone who
has the infection. It’s spread when semen (cum), pre-cum, and vaginal fluids get on or
inside your penis, vulva, or vagina.

Trich is often passed during vaginal sex. It’s also spread by vulva-to-vulva contact,
sharing sex toys, and touching your own or your partner’s genitals if you have infected
fluids on your hand. Trich can easily infect the vulva, vagina, penis, and urethra, but it
usually doesn’t infect other body parts (like the mouth or anus).

Trichomoniasis isn’t spread through casual contact, so you can’t get it from sharing food
or drinks, kissing, hugging, holding hands, coughing, sneezing, or sitting on toilet seats.

Many people with trich don’t have any symptoms, but they can still spread the infection to
others. So using condoms and having safer sex is the best way to prevent trichomoniasis
— even if you and your partner seem totally healthy.
 Trichomonas vaginalis

Symptoms
Common symptoms in women include: Common symptoms in men include:

White, grey or yellow vaginal Urge to urinate frequently

discharge, with an unpleasant smell Burning during urination or after
Vaginal spotting or bleeding ejaculation
Genital burning or itching Discharge from the urethra
Genital redness or swelling
Frequent urge to urinate
Pain during urination or sexual
intercourse
 Trichomonas vaginalis
Complications

If untreated, it can lead to:

High risk of getting HIV infection and other STIs

Chronic abdominal pain
Infertility
Fallopian tube blockage due to scars
 Trichomonas vaginalis
Diagnosis
Your health care provider may diagnose trichomoniasis by doing an exam of the genitals and
lab tests.

Your health care provider may also look at a sample of vaginal fluid for women or a swab from
inside the penis (urethra) for men under a microscope. If the parasite can be seen under the
microscope, no further tests are needed.

If the test doesn't show the parasite, but your provider thinks you may have trichomoniasis,
other tests may be done. Your provider may order tests done on a sample of vaginal fluid, a
penis uretheral swab or sometimes urine. Tests include a rapid antigen test and nucleic acid
amplification test.

If you have trichomoniasis, your provider may also do tests for other sexually transmitted
infections (STIs) so they can also be treated.
 Trichomonas vaginalis
Treatment
Treatment of trichomoniasis requires an oral antibiotic that is effective against
infections caused by this parasite. Treatment can be given during pregnancy. Options
may include:

Megadose. Your health care provider may recommend one large dose (megadose)
of either metronidazole (Flagyl), tinidazole (Tindamax) or secnidazole (Solosec).
You only take these oral medications one time.

Multiple doses. Your provider might recommend several lower doses of

metronidazole or tinidazole. You take the pills two times a day for seven days. To
help clear up the infection completely, keep taking this medicine for the full time
your provider prescribed the drug, even if you begin to feel better after a few days.
If you stop using this medicine too soon, your infection may not go away
completely.
 Enteromonas hominis

Disease on Human:

– it's considered as non-pathogenic

flagellate
 Enteromonas hominis
Morphology:
Trophozoites.
– Enteromonas hominis trophozoites typically

range from 3 to 10 µm long by 3 to 7 µm wide,

with an average length of 7 to 9 µm.

– The typical E. hominis trophozoite is oval in

shape. This organism may also be seen in the

form of a half-circle. In this case, the body is

flattened on one side.

– Enteromonas hominis trophozoites usually

exhibit jerky motility.

 Enteromonas hominis

– The single nucleus, visible only in stained

preparations, consists of a large central
karyosome surrounded by a well-defined
nuclear membrane. Peripheral chromatin is
absent.
– The nucleus is located in the anterior end of
the trophozoite.
– Four flagella originate from the organism's
anterior end. Three of these flagella are directed
anteriorly; the fourth is directed posteriorly. The
posterior end of the organism comes together to
form a structure resembling a small tail.
 Enteromonas hominis
Morphology:
Cyst.
– The typical oval to elongated E. hominis cyst

measures 3 to 10 µm long by 4 to 7 µm wide,

with an average length of 5 to 8 µm.

– Reveals one to four nuclei. When more than

one nucleus is present, these structures are

typically located at opposite ends of the cell.

 Enteromonas hominis
– The nuclei resemble those of the trophozoites

in that each consists of a well-defined nuclear

membrane surrounding a central karyosome.

Peripheral chromatin is again absent.

– The cysts of E. hominis are protected by a

well-defined cell wall. Fibrils and internal

flagellate structures are also not seen in the

cyst form.
 Enteromonas hominis

Life Cycle:
 Enteromonas hominis

Definitive Host
Humans are the primary host for E. hominis.

Occasionally these species are found in apes and

monkeys.

Mode of Transmission:
Fecal-Oral Transmission
—Ingestion of infected cysts appears to be the

primary cause of E. hominis transmission.

 Enteromonas hominis

Infective Stage:
Both trophozoites and cysts may

be passed in the feces and both

are considered diagnostic stages.

Since the trophozoites are fragile

and disintegrate soon after

leaving the body, only the cyst is

the infective stage.

 Enteromonas hominis
Epidemiology:
E. hominis is distributed worldwide in warm

and temperate climates.

Symptoms:
Infections with E. hominis are characteristically

asymptomatic.
 Enteromonas hominis

Diagnosis:
Examination of stool samples is the laboratory

diagnostic technique of choice for identifying E.

hominis trophozoites and cysts.

Unfortunately, this organism is difficult to identify

accurately because of its small size. Careful screening

of samples is recommended to prevent missing an E.

hominis organism.
 Enteromonas hominis
Diagnosis:
– Enteromonas hominis are identified through the

detection of cysts and/or trophozoites in stool

specimens.
– Identification is best accomplished by direct wet

mounts of freshly produced stool that reveal the

characteristic motility of the organisms.

☆ Enteromonas hominis trophozoites present with a

distinctive “jerky” slowly directional motility in fresh stool

specimens.
 Enteromonas hominis

Diagnosis:
– They may also be identified in permanent stained

smears, although their affinities for stain are

inconsistent and individual flagella may not be readily

visible.
 Enteromonas hominis
Treatment:
Treatment with metronidazole resulted in

resolution of the patient's symptoms and

eradication of E. hominis from the stool,

suggesting E. hominis as the causal organism.

Although this flagellate has been classified as a

non-pathogen, this case suggests that it should be

considered as an occasional pathogen.

 Enteromonas hominis

Prevention and Control:

The observance of proper personal hygiene
and public sanitation practices will

undoubtedly result in the prevention and

control of future infections with E. hominis.

References:

Gockel-Blessing, E.A., 1997. Clinical Parasitology, A Practical Approach,

Second Edition, p.92.

DPDX - Laboratory Identification of Parasites of Public Health Concern.

Non-pathogenic Flagellates.

https://www.cdc.gov/dpdx/nonpathogenic_flagellates/index.html

J R Spriegel et al. Am J Gastroenterol. 1989. Infectious diarrhea secondary

to Enteromonas hominis. https://pubmed.ncbi.nlm.nih.gov/2801685/

 TOXOPLASMA
GONDII

is a protozoan parasite that causes the illness

toxoplasmosis in most warm-blooded animal species, including humans.
 DISEASE IN HUMAN:

TOXOPLASMOSIS

Toxoplasma gondii, a parasite with only one cell, is the

source of the infection known as toxoplasmosis.

Eating undercooked meat frequently causes illness in humans. .

Moreover, it can spread by contact with cat excrement. .

 TOXOPLASMA GONDII
LIFE CYCLE:

The life cycle of Toxoplasma gondii is dependent on both definitive and

intermediate hosts, as is the case with a number of other parasites. A wide range of
domestic and wild animals, including birds, act as intermediate hosts for
Toxoplasma, with felids (domestic and wild cats) serving as definitive hosts.
 3 INFECTIOUS STAGES OF
TOXOPLASMA GONDII
Tachyzoites
Tachyzoites, which measure
around 2 um in width and 6 um
in length, frequently multiply in
different host cells.
bradyzoites
Also known as cystozoites,
bradyzoites multiply within the
tissue host. Compared to
tachyzoites, bradyzoites have
been shown to multiply at a
slow rate. new tissue cysts are
small in size, measuring about
5um in diameter. This is
because they contain very few
bradyzoites
sporozoites
isporozoites resemble
tachyzoites in many ways at the
ultrastructure level.
Nonetheless, sporozoites have
a higher concentration of
granules in the micronemes,
rhopties, and amylopectin than
tachyzoites do. The dimensions
of sporozoites are 2um in width
and 8um in length, making
them comparable in size to
tachyzoites.
 EPIDEMIOLOGY

Many Southeast Asian nations have reported cases of toxoplasmosis. Studies that have identified
toxoplasmosis in the Philippines have primarily employed serological techniques, with several
findings in pigs, rats, and cats as well as a few histological studies in rats and cats.

SIGNS AND SYMPTOMS

Headache
eye pain
Muscle pain
Abdominal Pain
Rashes
Sore throat
Nausea
Fever
Convulsions
 DIAGNOSIS

Blood tests are used to determine the presence of

toxoplasmosis. Two categories of antibodies are
detectable in laboratories. One antibody is a
component of the immune system that is present when
the parasite is newly and actively infected. If you've
ever had an illness, the other antibody is already there.
Your doctor might repeat a test after two weeks,
depending on the findings.
 TREATMENT

When symptoms of toxoplasmosis become

severe and chronic and there is visceral illness,
treatment is frequently advised. Patients with
weakened immune systems, newborns, and
expectant mothers with acute infections can
all receive treatment.

For patients with a compromised immune system and persistent symptoms, the
following treatment options are recommended:

Pyrimethamine

Sulfadiazine
Leucovorin

 REFERENCES:

HTTPS://WWW.NCBI.NLM.NIH.GOV/BOOKS/NBK7752/#:~:TEXT=TOXOP
LASMA%20GONDII%20IS%20AN%20INTESTINAL,BUT%20DEVASTATING
%20DISEASE%20CAN%20OCCUR.

HTTPS://WWW.CDC.GOV/PARASITES/TOXOPLASMOSIS/GEN_INFO/FAQ
S.HTML
Cystoisospora belli
 Disease on Human
Cystoisospora (formerly Isospora) belli is a coccidian intestinal
protozoa. Isospora belli is found worldwide, but infects only
humans and is almost always in individuals with an immuno-
compromised status. Infection leads to diarrhea and
malabsorption, and isospora belli may be present along with other
co-infecting parasites.
 Morphology
A fully mature (sporulated) oocyst of
Isospora genus is a spindle-shaped body
that has two sporocysts that contain four
sporozoites each. The oocysts of
Cystoisospora belli are long and oval
shaped. They measure between 20 and 33
micrometers in length and between 10 and
19 micrometers wide.
The Life Cycle
 Definitive host
Humans are the only known hosts for C belli,
which has no known animal reservoir.
Cystoisosporiasis has a worldwide distribution,
although it is more common in tropical and
subtropical climates.

Mode of transmission
The parasite can be spread by
ingesting food or water that was
contaminated with feces (stool) from
an infected person.
 Infective stage
The infective stage is the sporulated oocyst
containing two sporocysts, each with four
sporozoites. The apicomplexan attacks the columnar
epithelium of the small intestine, causing diarrhea,
which is usually mild in normally healthy patients.
 epidemiology
Isospora belli infections are essentially
cosmopolitan in distribution but are more
common in tropical and subtropical regions,
especially Haiti, Mexico, Brazil, El Salvador,
tropical Africa, Middle East, and Southeast Asia.

Symptoms
The most common symptom is watery diarrhea. Other
symptoms can include abdominal pain, cramps, loss of
appetite, nausea, vomiting, and fever. If untreated,
people with weak immune systems, such as people with
AIDS, may be at higher risk for severe or prolonged
illness.
 diagnosis
Diagnosis is by detection of characteristic
oocysts in stool or intestinal biopsy specimens.
More than one specimen may need to be
examined to find the parasite and they can also
be stained by modified acid-fast stain.

Treatment
The infection is treated with prescription antibiotics. The
usual treatment is with trimethoprim-sulfamethoxazole,
which is also known as Bactrim*, Septra*, or Cotrim*.
People who have diarrhea should also rest and drink
plenty of fluids.
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