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Intestinal

BY: Hanan

Coccidia
Mahmoud

Phylum Apicomplexa
-Single-celled organisms -All are parasitic
-Almost all are intracellular parasites

-Anterior end has apical complex
i.e:Set of organelles that allow the parasite to invade host cells

Phylum Apicomplexa -Most have a complex two host life cycle -Involves several stages that are morphologically similar -Asexual and Sexual reproduction occur in all species -Zygotes are diploid but all other stages are haploid

Generalized Coccidian Life Cycle
Meronts (1N) Schizonts Gametogony

microgamete (1N) Merogony Schizogony

macrogamete (1N)

Microgamete finds and invades cell containing macrogamete Zygote (2N) Ookinete

Sporozoites (1N) in oocyst

Sporogony (Meiosis)

CRYPTOSPORIDIUM .

TAXONOMY KINGDOM:Animalia Sub-KINGDOM:Protozoa. . PHYLUM:Apicomplexa CLASS:Conoidasida(sporoz oa). GENUS:Cryptosporidium. SUB-CLASS:Coccidiasina ORDER:Eucoccidiida. SUB-ORDER:Eimeriorina FAMILY:Cryptosporidae.

C.parvum.parvum apart from many of other coccidia .C.nasorum).wrairi). birds (C.baileyi.muris.C.C.Family:Cryptosporiidae -This family contains the single genus Cryptosporidium of many species of mammals ( C. -most human isolates are now referred to as Cryptosporidium parvum. -Lack of host specificity is one major characteristic that sets C.felis.serpentis).meleagridis) Reptiles(C.and fishes(C.

Geographic distribution: Cosmopolitan. Intermediate Host: None. Mode of Transmission: .Cryptosporidium parvum Definitive Host: Humans. food less frequently -Oocysts are too small to be filtered out by normal water treatment facilities -auto-infection -mechanical transmission by house flies -associated with epidemic diarrhea in institutions and hospitals.Ingestion of oocysts in contaminated water. most mammals Reported from 150 different mammals species Has also been reported in chickens and turkeys First reported as human parasite in 1975. .

particularly the ileum. -In young and elderly. and weight loss. -in developing countries Cryptosporidium is considered a cause of diarrhea especially in children below the age of 5 years . infections last longer and are more severe. Causes severe watery diarrhea. lasting 1-10 days. Pathology: Invades and lyses intestinal epithelium cells.Location in Definitive Host: Invades cells lining the small intestines.Can be deadly. abdominal cramping. . In immunocompetent patients. the infection is self-limiting. Symptoms: Causes Cryptosporidiosis.

hepatitis and pancreatitis.N. electrolyte imbalance.b:it should be noted that C. -1-17 liters of feces per day. -Most severe in AIDS patients: -Can¶t fight infection (cell mediated immunity is thought to be the corner stone of immunity against Cryptosporidium particularly CD4+cells). -6-25 bowel movements per day.felis (isolated from cats )has been reported in AIDS patients. -Parasite may invade other organs causing respiratory infections . . -Eventually leads to dehydration.cholecystitis . and death.

Morphology: = oocyst round or slightly oval-shaped. 4 ovalenclosing 4 spindle shaped sporozoites 6um .

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molecular methods are mainly research tools.can also be found in doudenal aspirates and doudenal biopsies. b) Direct exam. 2)Micro-scopic: a)Examination of direct smears or after Formol ether concentration Technique are specially stained by Modified Ziehl Neelsen Staining demonstrate oocyst (red color round or oval bodies Acid fast )against green background in feces . . of fresh fecal specimen by immuno-flourescence Technique(using flourescein labeled polyclonal or monoclonal Ab) is the method of choice (followed by enzyme immunoassay).Diagnosis:1)Macro-scopic:stool is loose and may be watery.

-This is another organism that has only become known due to AIDS research.B:Commercially available diagnostic Kits are used for detection of cryptosporidial Ag in stool specimen . .including that in AIDS patients.even in specimens that are preserved . -Outbreaks have occurred in many areas Particularly in the spring. Prevention: -ordinary water systems can¶t filter out the oocysts and chlorine does not kill oocysts. Treatment: Nitazoxamide is effective against cryptosporidial diarrhea.N. -Boiling and freezing below -10oF does kill it.it also offers a highly sensitive method .

CYCLOSPORA .

SUB-ORDER:Eimeriorina FAMILY:Eimeriidae GENUS:Cyclospora .TAXONOMY KINGDOM:Animalia Sub-KINGDOM:Protozoa PHYLUM:Apicomplexa CLASS: Conoidasida (Sporozoa). SUB-CLASS:Coccidiasina ORDER:Eucoccidiida.

insect &rodents. -direct human to human transmission is un-likely. -1st infection in human was diagnosed in 1977. -1986 cases of prolonged watery diarrhea among immunocompromised (AIDS) patient has been reported worldwide -parasite infect vertebrates including reptiles.Cyclospora Specie: C. -recent outbreaks has been blamed on contaminated fresh fruits Such as raspberries.typically served at social events. cayetanensis -one of the medically important parasite recognized today. .

villous atrophy and hyperplasia of the jejunal tissue. Sporocyt Sporozoite Acid Fast s .(di-sporocystic. Morphology: . By inflammatory changes.di-sporozoic).infection typically confined to the jejunum charac.mature oocysts contains 2 sporocyst with 2 cresentshaped sporozoites.Pathogenesis: .oocyst spherical-shaped 8-10um .

Disease: Cyclosporiasis .disease is clinically indistinguishable from Cryptosporidiosis and Isosporiasis . . low grade fever. associated with abdominal cramps.charac. vomiting.The diarrhea is usually self limiting in immunocomptent hosts but prolonged in AIDS patients. by persistent watery diarrhea that tends to recur in a relapsing pattern and last for 3-4 weeks. weight loss and anorexia -Infection is typically concentrated in the jejunum .although in people with AIDS the bile duct may also be involved . nausea.

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unlike Cryptosporidium oocysts) Acid fast stain of oocyst Treatment: Trimethoprim 160mg + Sulfamethoxazole 800mg 2X daily for 7 days .Lab. Diag: -Microscopy of fecal material by modified acid fast staining or safranin stain(concentration methods should be used prior to the staining to maximize recovery of oocysts) = demonstrate spherical-shaped body of oocyst -N.B:oocyst autofluoresce under ultra-violet light .(like Isospora .

ISOSPORA .

SUB-CLASS:Coccidiasina ORDER:Eucoccidiida SUB-ORDER:Eimeriorina FAMILY:Eimeriidae GENUS:Isospora .TAXONOMY KINGDOM:Animalia SUB-KINGDOM:Protozoa PHYLUM:Apicomplexa CLASS:Conoidasida(Sporoz oa).

ISOSPORA: -Closely related to Eimeria. now known to be cosmopolitan in distribution. -previously considered a rare parasite. . -Mostly parasites of birds. -Isospora belli is the one of the few that is parasitic in humans. -Smaller genus than Eimeria.

-No intermediate or reservoir hosts. -Most cases are reported from tropics. causing fever. -Located in small intestines. persistent diarrhea -Can cause death in AIDS patients .Isospora canis in dogs and Isospora felis in cats though more commonly distributed are not infectious to man . malaise.

Oocyst elongate ovoidal-shape . .Morphology: .unsegmented oocyst contains spherical mass of granule with visible nucleus .20 33 um X10 19 u m.cyst wall double-layered.mature oocyst has 2 sporocyst and each contains 4 cresent-shaped sporozoites (disporocystic tetrasporozoic). . thin & colorless . smooth.

intestinal tract probably in the ileum and cecum Disease: Isosporosis/Intestinal coccidiosis . by fever. steatorrhea (fatty stool) and weight loss.Habitat: . low grade fever .mild self-limiting infection charac. chronic diarrhea (months to years) abdominal discomfort. indiacating the inability of patient to absorb Fat adequately( as in Giardiasis ). severe diarrhea.seen most often in patient with AIDS .intracellular development occurs in the intestinal mucosa (lamina propria)p mucosal atrophy .charac. .transmitted fecally in contaminated food and drink with oocyst Pathology and Symptomatology: . colicky abdominal pain.

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Technique (Unstained or Iodine stained) -Modified Ziehl Neelsen staining of fecal smear. Diagnosis: -Demonstration of oocyst in feces by Formalin Ether Conc. TREATMENT. .Combination of Sulfadiazine + Pyrimethamine (very effective).Lab. .Combiantion of Cotrimoxazole (Trimethroprim) + Sulfamethoxazole (alternate drug) Prevention: = Avoid drinking and eating contaminated food.

EIMERIA .

000 species in the genus Eimeria alone. -Many are of veterinary and medicinal importance.Family Eimeriidae -Very large family with several large genera.Its medical importance that : It may be found in faeces of man as a spurious (coprozoic)parasite passing unchanged through the human intestine after ingestion of infected flesh.also a parasite of fish. . . - -parasite of domestic animals and rabbits in which it causes Coccidiosis . There may be as many as 34.

-the oocysts are( tetra-sporocystic dizoic). -Eimeria tenella infects intestine of chickens -Eimeria perforans infects intestine and Eimeria stiedae Infects the liver of rabbits . -Eimeria gubleri has been reported in human Liver. . -Eimeria sardiane infects fish .-Some hosts have several species at same time.

SARCOCYSTIS .

SUB-ORDER:Eimeriorina FAMILY:Sarcocystidae GENUS:Sarcocystis .TAXONOMY KINGDOM:Animalia Sub-Kingdom:Protozoa. SUB-CLASS:Coccidiasina ORDER:Eucoccidiida. CLASS:Conoidasida(sporoz oa). PHYLUM:Apicomplexa.

Genus Sarcocystis Speices: S.: Cosmopolitan Definitive Host: Carnivores. Dist. .H(cattles and pigs) ingests oocysts in environment. lindemanni Geog. Suihominis(pigs) S. including dogs and humans (rarely) Intermediate Host: Herbivores. including cattle and ducks. bovihominis(cattle) S..H. Mode of Transmission: Ingestion of muscle with sarcocyst of D. I.

lamb) or contaminated food and drink containing the infected sarcocyst .human infection are acquired through ingestion of uncooked meat (beef.symptoms includes diarrhea. vomiting. nausea.disease uncommon and rare in human . .considered as zoonotic . abdominal pain which occurs 1 2 days after ingestion and may last for 2 weeks .domestic animals are intermediate host of the parasite that pick up infective cyst while grazing on grasses contaminated with human excreta . pork.Disease: Sarcocystosis .

. the infections are not intestinal but rather result in muscle cysts.symptoms such as myalgia. In these cases. muscle weakness and transitory edema may occur. humans are dead-end intermediate hosts e.When humans become infected with sarcocysts of non-human species.g Sarcocyst lindemanni .

hyaline appearance and enclosed in a membrane .contains 2 large sporocyst inside tubular mass (Meischer tube) filled up with 4 mature cresent-shaped sporozoites and a refractile residual body.Morphology: -Oocyst broadly oval lying along infected muscle fibers. . .

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Biopsy of tissue demonstrate Meischer tube (Sarcocyst). .Adequate cooking of all meat .For intestinal infection: Trimethoprim + Sulfamethoxazole Pyrimethamine + Sulfadiazine (alternate drug) Prevention: .None for tissue infection (Supportive self-limiting) . Treatment: .Lab. Diag.: -Demonstration of oocyst in feces / duodenal aspirate.Avoid contact with infected animal host .

No sporocysts are present. .Species Isospora belli Shape Size Other features Cryptospori dium parvum Mature oocyst contains 4"sporozoites´.