Protozoa

General characteristics
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Unicellular Variation in size shape, locomotor apparatus Majority are free living Some are parasitic

Morphology

Ectoplasm

Locomotor apparatus
– – – – Pseudopods Flagella Cilia Undulating membrane

Procurement of food
– periostome

Discharge of metabolic waste
– cytophage

ENDOPLASM

Contractile vacuole
– Regulating osmotic pressure

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Organelles Nucleus
– karyosome

Stages of development

Trophozoite
– – – – Vegetative Motile Infective stage Obtained from semi formed stool

Cyst
– Non motile stage – Resistant stage – Sexual reproduction

Mitotic or amitotic Temporary union or conjugation

– Sexual union of two cells

Amoeba

General rule

Inhabits the large intestine ex. Entamoeba gingivalis Most develops into cystic stage ex. Entamoeba gingivalis ad dieentamoeba fragilis Commensals except entamoeba histolytica Amoebiasis- entamoeba histolytica

Entamoeba
– – – – Histolytica Coli Hartmanii gingivalis

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Endolimax Iodamoeba Dientamoeba

Entamoeba histolytica

Trophozoite
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Elongated Changes shape when staionary Clean looking cytoplasm with RBC Small centrally located karyosome

cyst
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Round With sausage shaped/cigar shaped chromatoidal bar 1-2 nuclei Small karyosome

Life cycle
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Large intestine Feces Ingestion of mature cyst Cyst in the G.I. tract Encyst in the S.I. trophozoite reach the colon Invades intestinal wall encystation in the large intestine

Disease associated

Asymptomatic amoebiasis
– Carrier

Acute symptomatic amoebiasis
– Amoebic diarrhea

Soft stool and extensive ulcer

– Acute amoebic dysentery
Stool with blood and mucus  tenesmus

Chronic amoebic dysentery

Tumor like mass called amoebomas

Extraintestinal
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Hepatic Pulmonary Cerebral Amoebic pericarditis Cutaneous amoebiasis Genital amoebiasis

Diagnosis and treatment

DFS
– Quensel’s solution – Lugol’s solution

Cuture
– Locke’s egg serum – NA saline

Serum
– ELISA

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Rectal biopsy Extra intestinal
– Liver aspirate/scan – Serological test

Treatment
– Metronidazole – Tinidazole – Diloxanide furoate

Cyst

Trophozoite

Non pathologic amoeba

Entamoeba coli
– Trophozoite
Sluggish movement  Dirty looking cytoplsma  Large eccentric karyosome

– Cyst
1-8 nuclei  Broomstick chromatoidal barr

cyst

Endolimax nana- smallest
– Trophozoite
Central or eccentric karyosome  Plenty of pseudopodia  sluggish

– Cyst
Oval with 1-4 nuclei  Large karyosome  Cross eyed cyst

Trophozoite

Cyst

Iodamoeba butschii
– Trophozoite
Leaf like  Round pseudopodia  Slow moving  Cytoplasm with glycogen vacoule

– Cyst
With single nucleus  With glycogen vacoule

Trophozoite

Cyst

Dientamoeba fragilis
– Trophozoite
Small rounded with nuclei  Blunt leaf like pseudopodia  Sluggish movement

Entamoeba gingivalis
– Trophozoite
Oral parasite  Fast and vigorous movement  Multiple pseudopodia

Free-living pathogenic amoeba

Naegreria
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Naegleria fowleri Amoeboid/flagellated Portal of entry is the nasal passage going to the meninges and brain Agent of PAM- primary amoebic meningoencephalitis Fever Headache

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Vomiting Death Amphotericin B for PAM

Acanthamoeba

Active trophozoite stage
– Broad pseudopodia – sluggish

Dormant cystic stage
– Uninucleated – Double wall

Not well defined life cycle

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Infects the CNS GAE- granulomatous amoebic encephalitis
– – – – Seizure Stiff neck Nausea vomitting

Acanthamoeba keratitis
– Corneal ulceration – blindness

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5- flourocytosine Ketoconazole Itraconazole Amphotericin B

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