PARASITOLOGY

Introduction
The most important feature that separates amoeba from the other group of protozoa is the presence of pseudopods in their trophozoite form. Amoebic life cycle require two morphologic forms :

trophozoite and the cyst

Trophozoite
Shape Size Surface

Cyst
Spherical

Oval, pointed at anterior end

50-130 mm long by 20-70 mm wide

Covered in cilia

40-60 mm across
Covered with thick, hard cyst wall with cilia sometimes visible underneath

Motility

Rotary or boring motility, like a thrown football

Non-motile

Infectious Reproduction Nuclei

Not infective
By binary fission or conjugation Macronucleus (spherical, next to macronucleus) visible

Infective
Non-reproductive macronucleus (kidney-shaped) visible; contractile vacuole visible in young cysts; in older cysts, organelle structures look granular (kidney-shaped) and micronucleus Only

Important
structures Diagnosis

cell Funnel-shaped cytostome (cell mouth) near anterior Cyst wall made of one or two layers

end; 2 contractile vacuoles Occasionally found in feces, often found in tissue Diagnostically found in feces of infected biopsies of infected individuals individuals

Entamoeba histolytica

Kingdom: Protista Subkingdom: Protozoa Phylum: Sarcomastigophora Subphylum: Sarcodina Class: Lobosea Order: Amoebida Family: Entamoebidae Genus: Entamoeba Species: histolytica

Entamoeba histolytica
a protozoan parasite responsible for a disease called

amoebiasis.
Universally considered to be a pathogen. Considered a leading cause of parasitic deaths after only malaria and schistosomiasis.

Geographic Distribution

Worldwide, with higher incidence of amoebiasis in developing countries. In industrialized countries, risk groups include male homosexuals, travelers and recent immigrants, and institutionalized populations.

Entamoeba histolytica Trophozoites

Size Motility 8- 65 m Progressive or fingerlike pseudopodia

Number of nuclei
Karyosome Peripheral chromatin

One
Small and central Fine and evenly distributed

Cytoplasm
Cytoplasmic inclusions

Finely granular (ground glass)

Ingested red blood cells (Erythrophagocytosis)

Entamoeba histolytica Cysts

Size
Shape Number of nuclei Karyosome Peripheral chromatin Cytoplasm Cytoplasmic inclusions

8- 22 m
Spherical to round One - four Small and central Fine and evenly distributed Finely granular Chromatoid bars/ rounded ends

Diffuse glycogen mass

L I F E C Y C L E

LABORATORY DIAGNOSIS
Microscopic identification of cysts and trophozoites in the stool is the common method for diagnosing E. histolytica. In addition, E. histolytica trophozoites can also be identified in aspirates or biopsy samples obtained during colonoscopy or surgery.

Laboratory diagnosis:
Saline wet preparationmotility of the amoebic trophozoite

 Iodine wet preparationinternal cytoplasm, nuclear structures

Permanent stains - refractive and invisible structures are clearly visible and easier to identify

When E. histolytica is suspected but not recovered in stool samples, other laboratory tests including serological procedures may be utilized:

Enzyme- linked immunosorbent assay (ELISA) Indirect hemagglutination (IHA) Gel-diffusion precipitin (GDP) Indirect immunofluorescent (IIF)

DISEASE
The range of symptoms varies and depends on two major factors: The location(s) of the parasite in the host The extent of tissue invasion Minor infections (luminal amoebiasis) can cause symptoms that include: gas (flatulence) intermittent constipation loose stools stomach ache Stomach cramping.

TREATMENT
Diloxanide furoate (Furamide)- only cysts in the stool Iodoquinol or Metronidazole (Flagyl) for both cysts and trophozoites Chloroquine plus iodoquinol of Flagyl- amoebic colitis Dehydroemetine dihydrochlorideacute amoebic dysentery Flagyl or dehydroemetine plus chloroquine- amoebic liver abscess

PREVENTION AND CONTROL:

Ensure a safe water supply. Avoid the use of human feces as fertilizer. Properly wash the food products. Good personal hygiene and sanitation practices. (Always wash your hands with soap and water after using the toilet and before eating or preparing food and after eating.) Protection of food from flies and cockroaches. Avoidance of unprotected sexual practices.

Entamoeba coli Kingdom: Protista Subkingdom: Amebozoa Phylum: Sarcomastigophora Subphylum: Sarcodina Family: Entamoebidae Genus: Entamoeba Species: coli

Entamoeba coli
non-pathogenic amoeba with worldwide distribution. Its life cycle is similar to that of E. histolytica but it does not have an invasive stage and does not ingest red blood cells. Single-celled parasites commonly found in the intestinal tract but never associated with illness. They do not harm the body, even in people with weak immune systems.

Entamoeba coli Trophozoite

Size range Motility Number of nuclei Karyosome Peripheral chromatin Cytoplasm Cytoplasmic inclusions 12-55 m Nonprogressive/ blunt pseudopods One Large, irregular shape Coarse and unevenly distributed Coarse and often vacuolated Bacteria, other debris

Entamoeba coli trophozoite with ingested bacteria.

Entamoeba coli Cysts

Size range Shape Number of nuclei Karyosome Peripheral chromatin Cytoplasm 8- 35 m Round to spherical One to eight Large, irregular shape, eccentric Coarse and unevenly distributed Coarse

Cytoplasmic inclusions Thin chromaid bars with pointed to splintered ends Diffuse glycogen mass

Entamoeba coli (larger) and Entamoeba histolytica (smaller) cysts.

L I F E C Y C L E

LABORATORY DIAGNOSIS
Stool examination
The presence of Entamoeba coli suggests ingestion of contaminated food or drink and a presence of pathogenic parasites in addition to the nonpathogenic Entamoeba coli. Where amebic dysentery is suspected, the laboratory should be informed that a "hot stool" is being supplied so that it can be examined within twenty minutes of being passed. Direct microscopy should be done by mixing a small amount of the specimen in 0.9% sodium chloride solution.

Symptoms Infections with Entamoeba coli are usually asymptomatic.

Treatment: Entamoeba coli are considered to be a nonpathogenic. Treatment, therefore, is

usually not indicated.

PREVENTION AND CONTROL:

Adequate disposal of human feces. Proper personal hygiene. Protection of food and drink from flies and cockroaches is also necessary.

Thank you!

Presented by: Gladys Joy Avila