PROTOZOA

• Unicellular organism
• Eukaryotic (having a nuclear membrane), plasma membrane,
cytoplasm, mitochondria
• Heterotrophs
• Living free, saprophyte or parasite
• Proliferation generally by dividing
• Forming cysts to survive
• Move using cilia, flagella, pseudopodia, but some didn’t move
actively
Cryptosporodium
Toxoplasma gondii
 A B. MOUTH
LOCATION OF A . BRAIN
- T. tenax
- P.falciparum
PROTOZOA IN - T.cruzi B - E. ginggivalis
HUMAN BODY - T. brucei
C. CARDIAC
- Naegleria D
C MUSCLE
- Acanthamoeba
- T. cruzi
- T.gondii F G
E. INTESTINAL D. LUNGS
- E. histolytica CS F. HEPAR
E - Pneumocystis
- G. lamblia - E.histolityca
- E. histolytica
- B. coli - Plasmodium H
- T. hominis - Leishmania M J. BONE MARROW
- Cryptosporidium I - L. donovani
- I. belli & I. hominis H.
- D. fragillis UROGENITAL L K. BLOOD
- T. vaginalis - Tripanosoma sp
G. SPLEEN - Plasmodium sp
- L. donovani I. RES - Leishmania sp
- Plasmodium - Toxoplasma J - Babesia
- E. histolytica - L. donovani K
L. SKIN
M. LYMPH NODE - L. donovani
- T. brucei - L. tropica
• Entamoeba histolytica
• Giardia lamblia
• Balantidium coli
• Plasmodium
 Entamoeba histolytica
• Causing disease called “Amoebiasis”
• 50 million symptomatic cases
worldwide
• 110,000 death annually
• developing countries,
due to poor sanitary conditions
 MORPHOLOGY
Trophozoite

20 – 40 μm diameter
Granulated cytoplasm containing erythrocyte
Have 1 nucleus with central karyosome
Minuta

10-20 µm diameter
Ectoplasm appears to be pseupodine-shaped and not clearly visible
Rough-grained endoplasm, containing bacteria / food waste, contains
entamoeba core but does not contain erythrocyte
Cyst
Oval, diameter 10-20 μm
Matured cyst have 4 nucleus
No erythrocyte can be seen in cytoplasm
Unmatured cyst have chromatoidal bodies

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 Ameobiasis Life Cycle

• Trophozoite: motile form

– multiplies and differentiates into
the cyst in the large intestine

• Cyst: resistant form

– responsible for the transmission
of the infection

• Cysts excreted in stools,

then ingested by a new host via
contaminated food or water.
10
 Clinical manifestations

• Asymptomatic colonization
– public health risk through the shedding of
infectious cysts
• Intestinal amoebiasis
– Amoebic colitis: abdominal pain, tenderness,
diarrhea, and mucous and bloody stool, weight loss, seldom fever
• Extraintestinal amoebiasis
– Amoebic liver abscess: fever, right upper abdominal
tenderness and pain
Extraintestinal
Amebiasis

12
 Diagnosis
• Microscopic
• Culture of stool samples,
followed by isoenzyme analysis
• Serological testing
• Molecular-based Diagnosis
 Giardia lamblia
Inhabits the upper part of small intestine
It has direct life cycle
The cyst is the infective stage. They can survive in water
4°C for at least 3 months. Ten cysts are sufficient to
infect humans
After ingestion of the cyst, two trophozoites imerge in
the duodenum and attach to the host intestinal’s mucosa
They undergo mitotic division in the intracellular lumen.
They colonize the small bowel
Some of the trophozoites will encyst and are released
with the fecal materials.
Life cycle
MORFOLOGY TROFOZOITE
 Cyst…
• Resist to chlorine
• Dimention 8-10 µm
• Elliptically shape
• The cyst wall is composed of fibrous component
containing polymers of galactosamine and proteins
 Symptoms

• Symptoms include
– diarrhea
– loose or watery stool
– foul-smelling stool
– stomach cramps
– upset stomach
– weight loss
– dehydration
• Some may be asymptomatic
 Incubation Period & Duration
Incubation period
– Symptoms generally begin 1-2 weeks after being
infected

Duration
– Healthy persons, symptoms may last 2-6 weeks
 How is Giardia spread?

Swallowing recreational water

contaminated with Giardia

Eating uncooked food contaminated

with Giardia

Possibly found in soil, food, water, or

surfaces contaminated with Giardia
 Prevention
Wash and/or peel all raw vegetables and fruits before
eating
Use uncontaminated water to wash all food that is to be
eaten raw
Avoid eating uncooked foods when traveling in
countries with minimal water treatment and sanitation
systems 
Avoid swallowing recreational water
Avoid drinking untreated water from ponds and streams
Avoid using ice or drinking untreated water when
traveling in countries where the water supply might be
unsafe
 Balantidium coli
• Caused disease called “Balantidiasis”  largest protozoan parasite in
humans  living in large intestine
• About 1 % of the world's population is infected with balantidiasis.
• Most infections occur in developing countries where feces are more likely
to get in contact with food and drinking water. In addition to humans, pigs
and other animals carry the disease.
• Morphology:
 Cyst
- spherical and 0.04–0.06 mm in diameter
- have a tough multilayered shell which
protects them against stomach acid of the
host, when ingested
- cysts cannot reproduce and do not have any
cilia for moving.
 Trophozoite
0.03–0.15 mm x 0.025–0.12 mm wide.
spherical or oblong.
trophozoites have both a micronucleus and a macronucleus,
which both are normally visible. The macronucleus is bigger
and sausage-shaped whereas the micronucleus is less
notable.
• Clinical Manifestation: often asymptomatic. But in
some cases the patient might have diarrhea, weight
loss and dysentery (severe diarrhea containing blood
and/or mucus in the feces) with stomach pain and
fever.
• Diagnosis can be made by finding trophozoites from
a stool
• Treatment:
Tetracycline (contradicted in pregnant woman and child <8yrs
old)
Iodoquinol
Metronidazole

• Prevention:
- proper hygiene practices.
- Do not use human feces as fertilizer in agriculture.
- Wash your hands after going to the toilet and before meal.
- Only drink pure water.
- Wash vegetables and cook meat properly. Infective
Balantidium coli cysts are killed by heat.
 Plasmodium sp.
 Plasmodium falciparum (malaria tropika)
 Plasmodium vivax (malaria tertiana)
 Plasmodium malarie (malaria malariae/ kuartana)
 Plasmodium ovale (malaria ovale)
 Plasmodium knowlesi
Vector: female anopheles mosquito
Transmission route:
- mosquito bite
- intrauterine infection (malaria congenital)
- transfusion
 Differences between Plasmodium sp.

• P. falciparum P. vivax P. ovale P. malariae

Hypnozoite -- + + --
Size of RBC normal normal normal normal
Parasite size 1/3 1/3 1/3 1/6
Multi parasite + -- -- --
Schuffners dots -- -- + --
*Trophozoite:
Size of RBC normal enlarge enlarge normal
Parasite size 67% 100% 67% 100%
Parasite shape ameboid ameboid ameboid band
Schuffner dots -- + + --
Maure dots + -- -- --
not seen in
P.B
malaria pigment
 continue

• P. falciparum P. vivax P. ovale P. malariae

Schizont :
size of RBC normal enlarge enlarge normal
Parasite size 67% 100% 67% 100%
Schuffner dots -- + + --
# of merozoite 16-24 12-24 6-12 6-12(rosette shape

not seen inP.B

Gametosite:
Size of RBC crescent shape enlarge enlarge normal
Parasite size hall cell 100% 67% 100%
Age of cell any young young old
Disease malignant benign benign benign
 Clinical Manifestation
• Clinical appearance depend on species, strains, number of
parasites, & immune status

• Fever: Associated with the rupture of erythrocytes

containing schizont and the release of merozoites that enter
the bloodstream (sporulation)
     -------- periodicity of fever
Chills (15 minutes - 1 hour)
Peak fever (2-6 hours)
Sweating (2-4 hours).
Periodicity depends on species
- Cephalgia, athralgia, myalgia, pain on right
subcostal region
- Gastro intestinal disorder: diarrhea, vomiting,
abdominal pain
- Splenomegaly
- Anemia
Diagnosis
Microscopic: Thin & thick blood smear
PCR
Dipstcik