-> Flagella

Nuclcus
Cytostome
NON-PATHOGENIC
-> Food vacuole
FLAGELLATES

I.TRICHOMONAS HOMINIS

2.TRICHOMONAS TENAX

3.CHILOMASTIX MESNILI
 TRICHOMONAS HOMINIS
(PENTATRICHOMONAS HOMINIS)

This flagellate is of cosmopolitan distribution. It is thought to be non-pathogenic

although it has been associated with diarrheic stools.
the most commonly found flagellate next to Giardia lamblia and Dientamoeba fragilis.
a harmless commensal found in the caecum and colon of man, other primates, dogs
and cats.
Does not invade the mucosa, in general it does not cause pathology. However, when
for some reason it begins to reproduce in an uncontrolled way. Considerably,
increasing its number. In the intestine willgenerate intestinal problems.
•
less common in temperate climates; prevalence in the Philippines is less
than I%.
Transmission: occurs rapidly through fecal contarnination of food and drinks.
associated with Entanoeba histolytica.
Trichomoniasis =Infective stage
Trichomonas vaginalis
=Diagnostic stage
Sexual intercourse

Trichomonas vaginalis

1)
2) Multiplication by 3) Trophozoite in
Trophozoites in vaginal vagina or orifice
DPDx and prostatic secroations
longitudinal binary
fissior of urothra
DC and urine Dr Amer Al-l5watbre
22
 Morphology
Troph Troph
<ichrome
Flagella
Krichrome

Axostyle

Stain Nucleus Stai

X000 X0001

Troph
Hemaatoxylin

Stain

xO005

12
 Describe Morphology
P(T). hominis
Troph Troph
Brložnik el al., 2016

SEM
Nucleus, SEM
centric karyosome
no chromatin
Flagella
Axostyle
Undulating membrane
and costa
Troph

cichrome

Stain

xO00

13
 Stage: Trophozoite
T tenaX Troph

Giemsa
4-6 Flagella
Stain
Undulating Cytosome
membrane
(2/3 body
Nucleus
length) X0005
Costa
1 Posterior Axostyle
flagellum

Posterior axostyle

Size: 6-9um

Pyriform/pear shape

Axostyle: Anchor and support No cyst

Dr. AmerA iwabreh 17
 Describe Morphology
Troph
L tenaX
Troph
ANet
We Giemsa
mount Nucleus
Stain

xO001

xO0%

Troph
Mark Bonner dmd Giemsa

Stain

XO00T

18
 MORPHOLOGY

-
has no cystic stage.
-
trophozoite measures from 5-15um in
length by 7-10um in width.
-
shape is pyriform and has an axostyle
which runs from the nucleus down the
centre of the body and extends from the
end of the body
undulating membrane which extends the
entire length of the body and projects from
the body like a free flagellum.
-
has 4 free flagellae and a single nucleus
at the anterior end.
 CLINICAL MANIFESTATIONS

Individual can be infected with this parasite without any type of

symptoms; happens most frequently since this is non-pathogenic
protozoans to humans.
May have symptoms when the number is very abundant,tend to
erode and inflame the intestinal mnucosa with consequent
symptoms: diarrhea, colic, abdominal cramps, and irritated colon.
 DIAGNOSIS

FRESH STOOL:
flagellates move very rapidly in ajerky,
non-directional manner.
axostyle and undulating membrane are diagnostic.
The flagellates are difficult to stain, however, the axostyle can be seen on a
stained preparation and is diagnostic.
Finding the parasite in the stool may be accidental in some routine examination.
 TREATMENT

No treatment if no symptoms.
Metronidazole if in case symptomatic.
 TRICHOMONAS TENAX

also known as oral trichomonas; species commonly found in oral cavity of

humans.
a commensal in human mouth; tartar around the teeth or defects of carious
teeth; not found on the gums of healthy patients.
no evidence of direct pathogenesis, but it is frequently associated with pyogenic
organisms in puspockets or at the base of teeth.
innecrotizing ulcerative gingivitis and necrotizing ulcerative periodontitis, worsening
preexisting periodontal disease.
also implicated in some chronic lung diseases.
Transmission : through saliva, droplet spray, and kissing or use of contaminated dishes or
drinking water; divide by binary fission.
patients with poor oral hygiene andadvanced periodontal disease.
 MORPHOLOGY

pyriform flagellate; only in trophozoite for

measures 5 to l2 um, and is smaller and more
slender than T. vaginalis.
smallest of the 3 genus Trichomonas
has four free equal flagella and a fifth one onthe
margin of an undulating membrane which does not
reach the posterior end of the body, and lacks a free
posterior extension.
> has a single nucleus and a cytostome.

3
 SCHEMATIC DRAWING OF T.TENAX

fg.
Fg=flagella bb
•
Bb=basal body
Nu=nucleus
Ax=axostyle Um
um=undulating
membrane G5
Cy=cytostomal ax
groove
Cs=costa
 Life cycle
*Trichomonas tenax trophozoites survive in the body as mouth

scavengers that feed on local microorganisms.

*Located in the tartar between the tonsillar crypts, and

gingival margin around the gums.

*T. tenax trophozoites multiply by longitudinal binary fission.

*These trophozoites are unable to survive the digestive process.

 Pathogenesis
* Trichomonas tenax is knownto play a pathogenic role in necrotizing
ulcerative gingivitis and necrotizing ulcerative periodontitis. (Fekiet al.
1981,Honigberg, 1990)

NUP NUG
 CLINICAL MANIFESTATIONS

The typical Trichomonas tenax infection does not produce any notable
symptoms. On a rare occasion, T.tenax has been known to invade the respiratory
tract, but this appears to have mainly occurred in patients with underlying
thoracic or lung abscesses of pleural exudates.
 LIFE CYCLE

T.tenax trophozoites survive in the body as mouth

scavengers that feed primarily on local microorganisms
located between the teeth, tonsillar crypts, pyorrheal pockets,
and the gingival margin around the gums. T.
tenax trophozoites multiply by longitudinal binary fission.
These trophozoites are unable to survive the digestive
process
 DIAGNOSIS

The specimen of choice for diagnosing Trichonmonas tenax trophozoite is mouth

scrapings. Microscopic examination of tonsillar crypts and pyorrheal pockets of
patients suffering from T. tenax infections often yields the typical trophozoites.
Tartar between the teeth and the gingival margin of the gums are the primary
areas of the mouth that may also potentially harbor this organism.T. tenax may
.
also be cultured onto appropriate media
CHILOMASTIX MESNILI
 Describe Morphology: Trophozoite Dr.
Amer,Al-lawabreh

Troph Troph
2 anterior flagella, 1 not seen
Trichroome:
Trichrome
1
short posterior flagellun
Single anterior nucleus
stain-stoo
staln-stoo,

No/slight chromatin
X000
Eccentric karyosome XO005

Troph

1odine
Single anterior nucieus Single anterior nucleus
No/slight chromatin mount-stool No chromatin
Centric karyosome No karyosome, but granules
XO0

Dr. Amer Al-Jawabreh

14
 Describe Morphology:Trophozoite
Troph Troph
3 anterior flageila
adine Giemsa
msa
mount
Cytosomne
stain-stoo

1 short posterior flagellum

-stool

X0001 x000T
!

Troph

Single anterior nucleus \odine

No chromatin Spiral groove

mount-stool

Centric karyosome X00

Dr. Amer Al-Jawabreh 15

 Describe Morphology: Trophozoite
Dr. Aner AElawabren
Troph
Troph
3
anterior flagella

<richrome
1
short posterior flagellum Wet

mount-Stool

staint-stoo x000
XO00

Troph

Maye

HematoXylin

No flagella seen
Single anterior nucleus
Slight peripheral chromatin X000
stainstoo/
Eccentric karyosome

Dr. Amer Al-Jawabreh 17

 Describe Morphology: Cyst Dr.
Amer/Al-Jawatbreh

Cyst Cyst

Trichrome
Lemon-shaped
Hyaline knob Wet

stain-stoo/
Nipple-like protuberance mount-Stool

Large single nucleus

XO00

Large centric karyosome

Nofslight chromatin
Cyst

Tricchrome

stain-stoo/

X000

Dr. Amer Al-Jawabreh 18

 Describe Morphology: Cyst Dr. Aner Ai Jawabret:

Troph Cyst

Mayer Lemon-shaped
, Irregular shape odine
Hemato

Hyaline lknob mount-

Nipple-like protuberance
ylinstain-st t-stool
X0001 XO001

Troph

odine

n mount-Stoo!

Large single anterior nucleus Cytosome:

Shepard's crook
Large centric karyosome
X000t
(or open safety pin)
No/slight chromatin

19
Dr. Amer Al-Jawabreh
 CHILOMASTIX MESNILI

• is a flagellated protozoan generally regarded as nonpathogenic in the human host.

inhabits the cecal region of the large intestine.
exist in 2 forms:
Trophozoite stage
Cystic stage
 MORPHOLOGY
TROPHPZOITE
asymmetrically pear-shaped; spiral groove
extending through the middle half of the body. Size 12-24u
The trophozoites are 20-30 um in Blepharoplast
diameter and contain a vesicular nucleus with a
central endosome, peripherat chromatin and radial Nucleus
achromatic fibrils (imparting a 'art-wheel'
appearance). Cytostome
= single nucleus usually has a prominent
karyosome. Food Vacuole
There are no undulating mnembrane and
axostyle
movement: boring and spiral forward by 3
anterior free flagellae and a more delicate one within the
prominent cytostome.
 MORPHOLOGY Chilomastix mesnili

Cyst

CYST slear knob on nucleu

-
:yst
pear- or lemon-shaped; single
large vestibular-nucleus and the
cytostome by hematoxylin and eosin
stained film. cytosome
a
single nucleus and a curved
cytostomal fibril called the shepherd's
crook.
 Life cycle similar to Giardia lamblia.. Both trophozoites and cysts are passed in the feces; only cysts
can survive outside of the host.
Transmission: ingestion of cysts ( the infective stage) in food and drinks.
Prevalence: < 1% in the Philippines; more prevalent in areas with inadequate sanitation.
CLINICAL MANIFESTATIONS:
Non-pathogenic
- an
The presence of cysts and/or trophozoites in stool specimens indicator of fecal contamination
of a food or water sOurce,
No treatment is indicated.
Preventive and control measures include improved sanitation and personal
hygiene.
 COMPARISON OF 3 TRICHOMONAS SPP.

Trichomonas vaginalis:
a pear-shaped trophozoite and Characteristic jerky motility, (7 to 23 um long) with four anterior
flagella and a fifth forming the outer edge of a short undulating membrane (1/2 of the body length).
Costa,a rigid cord attaches theundulating membranc to the cell membrane and gives the ndulating
membrane support. Axostyle runs down the middle of the body & ends in a pointed tail like barb.
Round nucleus in the anterior Portion.

Trichononas hominis
-
trophozoite measures from 5-15 um in length by 7-10 um in width. The shape is pyriform, Characteristic
jerky motility and has an axostyle which runs from the nucleus down the centre of the body and
extends from the end of the body. undulating membrane which extends the entire length of the body
and projects from the body !like a free flagellum. It has 4 free flagella and asingle nucleus at the anterior
end.
Trichomonas tenax
parasite Size range 5 to 14 jum long ,Shape Oval to pear ,Characteristic jerky motility .Nuclei One,
vesicular filled with chromatin granules. Flagella Five total, all originating anteriorly : four
extends anteriorly .One .extends posteriorly .An undulating membrane that extends twothirds
(2/3)of thebody length A thick axostyle runs along the entire body length, curving around the
nucleus, and extends posteriorly beyondthe body of the organism a smallanterior cytostomal
groove is locnted opposite the undulating membran.
 SUMMARY
TRICHOMONAS VAGINALIS
1.Characteristic jerky motility
2. four anterior flagella and a fifth forming the outer edge of a shortundulating membrane (1/2
of the body
length).
,
3. Costa a rigid cord attaches the undulating membrane to the cell membrane and gives tlhe
undulating membrane support.
4. Axostyle runs down the middle of the body & ends in a pointed tail like barb.
5. Roundnucleus in the anterior Portion.
 Trichononas hominis
1. Characteristic jerky motility
2. axostyle which runs from the nucleus down the center of the body and extends from the end of
the body
3. undulating membrane which extends the entire length of the body and projects from the body
like a free flagellum.
4. has 4 free flagella and a single nucleus at the anterior end.
 TRICHOMONAS VAGINALIS, TRICHOMONAS
HOMINIS, T. TENAX

T tel
Anterior Flagella
Trichomonas vaginals

4-6 Flagella

4 anterior
-Conical Cyto
flagella
Undulating Cytosome
nucleus -Nucleus
membrane
(2/3 body
undulating membrane Nucleus
(one hall otf body) length)
Axostyl4
Costa
cosla
1 Posterior Axostyle

axostyto Costa flagellum

posterior
axostyle
Posterior axostyle
Undulating Membrane
Trophozoto (00 cyst stago f (foll body length)
15 am Traling Flagelum Size: 6-9um
esnili

Differential Morphologic Characteristics

Nucleus- Shape of karyosome chromatin Flagella Site Motility
cyst troph (cyst) peripheral(undulating
(troph) membrane)
G. lamblia 4 (2) Pear or tear Eccentric, No 8( No) Duodenum, Falling leaf
(rugby, oval) large jejunum
C. mesnili 1 (1) Pear (lemon) Centric No-slight 3+1 (No) Intestine Rotary-stiff
eccentric
D.
fragilis 1-2 Irregular granules No No (No) Colon, cecum Progressive
E.
hominis 1 (1-4) Oval (Oval) Centric No 3+1 (No) Large Intestine Jerky

-R. intestipalis 1
(1) Ovoid Centric Fine ring 2 (No) Large Intestine Jerky
(Lemon-pear)
T Vaginalis 1 Pear (no cyst) Fine No 4+1 (yes) Vagina, Jerky
granules urethra twitching
T hominis 1 Pear (no cyst) Centric No 4+1 (yes) lleoceal region Jerky
in Intestine
T tenaX 1 Pear (no cyst) Coarse No 4+1 (yes) Mouth Jerky, rapid
granules
esnili

Morphology-Panoramic view
G. lamblia C. mesnili F fragilis I tenax R. E.
vaginalis hominis intestinalis honminis

Trohozoite

10 x 15 um 8x 15jm 3-20um 8-15um 10-12um6-9um 3-5um 7-94m

Nocyst No cyst No cyst No cyst
stage stage stage stage

Cyst 10 x 12 umi 5 x
1um 5-7m 5-8um
No cyst No cyst No cyst No cyst
stage stage stage stage