Parasitic Infections

ROSE A BAUTISTA RN
Definitions
 Parasites are defined as organisms that live
on or in other living organisms (hosts), at
whose expense they gain some advantage
(usually by depriving the host of nutrients).
 Of the three categories of organisms (parasitic
protozoa, helminths, and arthropods) that are
studied in a parasitology course, only one
category (parasitic protozoa) contains
microorganisms.
Definitions
 Parasites that live on the outside of the host’s
body are referred to as ectoparasites,
whereas those that live inside are called
endoparasites.
 The definitive host is defined as the host
that harbors the adult or sexual stage of the
parasite or the sexual phase of the life cycle.
The intermediate host is the host that
harbors the larval or asexual stage of the
parasite or the asexual phase of the life cycle.
Definitions

 An accidental host is a living organism

that can serve as a host in a particular
parasite’s life cycle, but is not a usual
host in that life cycle. Some accidental
hosts are dead-end hosts, from which
the parasite cannot continue its life cycle.
Definitions

 A facultative parasite is an organism

that can be parasitic but does not have to
live as a parasite. It is capable of living
an independent life (apart from a host).
An obligate parasite has no choice. To
survive, it must be parasitic.
Key points
 In general, parasitic infections are
diagnosed by observing and recognizing
various parasite life cycle stages in clinical
specimens.
 Protozoa are classified taxonomically by
their mode of locomotion. Amebas move
by pseudopodia, flagellates move by
flagella, ciliates move by cilia, and
sporozoans are nonmotile.
Key points
 The trophozoite is the motile, feeding,
diving stage in the protozoal life cycle, and
the cyst, oocyst, and spore are dormant
stages. Protozoal infections are most often
acquired by ingestion or inhalation of
dormant stages.
 Leishmaniasis is caused by various
species of flagellated protozoa in the genus
Leishmania, and is usually transmitted via
the bite of an infected sand fly.
Key points

 Trichomoniasis is caused by a
flagellated protozoan named
Trichomonas vaginalis, and is
transmitted by direct contact with vaginal
and urethral discharges of infected
people.
 Primary amebic meningoencephalitis
is caused by an ameboflagellate named
Naegleria fowleri.
Key points

 Helminths – parasitic worms – are

divided into roundworms (nematodes)
and flatworms. Flatworms are further
divided into tapeworms (cestodes) and
flukes (trematodes).
 The typical helminth life cycle consists of
three stages: the egg, the larva, and the
adult worm.
Key points

 Helminth infections are usually

diagnosed by observing (1) whole worms
or segments of worms in clinical
specimens – most often, fecal
specimens, or (2) larvae or eggs in
stained or unstained clinical specimens.
Key points

 Arthropods may be involved in human

diseases in several ways: (1) they may
be the actual cause of the disease, (2)
they may serve as an intermediate or
definitive host in a parasite’s life cycle, or
(3) they may serve as a mechanical or
biological vector in the transmission of an
infectious disease.
Helminths
 Intestinal Nematodes (roundworms)
o Ascariasis: Ascaris lumbricoides
o large intestinal roundworm of humans
o Humans are the only hosts.
o Ascariasis is most common in areas where human
feces (“night soil”) is used to fertilize crops.
o Pinworm infection: Enterobius vermicularis
o the most common helminth infection in the world
o Humans are the only hosts.
o Hookworm infection: Necator americanus
o lives in the small intestine
o Humans become infected by penetration of the
skin (usually the soles of the feet) by the infective
larvae.
o Humans are the only hosts.
 Tissue Nematode
o Dracunculiasis: The adult Dracunculus
medinensis (guinea worm)
o which can be up to a meter in length, migrates in
the deep connective tissues and subcutaneous
tissues of the body.
o Humans become infected by drinking water that
contains the infected Cyclops.
o In this life cycle, the human is the definitive host
and the Cyclops is the intermediate host.
 Filarial Nematodes
o Filariasis: The adult worms (such as Brugia
malayi and Wuchereria bancrofti) that cause
filariasis live in lymph nodes, where they can
block the flow of lymph (leading to
elephantiasis).
o Female worms release tiny, microscopic,
prelarval stages called microfilariae, which
get into the bloodstream.
o When a mosquito takes a blood meal, it
ingests the microfilariae. Within the
mosquito, the microfilariae mature into
infective larvae. When the mosquito again
takes a blood meal, it injects the infective
larvae into the human. In the human body, a
larva matures into an adult worm. In this life
cycle, the human is the definitive host and
the mosquito is the intermediate host.
 Onchocerciasis (river blindness): Adult
Onchocerca volvulus worms live within
fibrous tissue nodules.
o In this life cycle, the human is the definitive
host and the black fly is the intermediate
host.
 Cestodes (tapeworms) (Note:
tapeworms are hermaphroditic, meaning
that each tapeworm contains both male
and female reproductive organs; thus, it
only takes one worm to produce fertile
eggs.)
Intestinal Cestodes
 Fish tapeworm infection: The adult
Diphyllobothrium latum tapeworm lives in
the human small intestine
o the human is the definitive host, the Cyclops
is the first intermediate host, and the fish is
the second intermediate host.
 Dog tapeworm infection: The adult
Dipylidium caninum tapeworm lives in the
dog’s small intestine
o the dog is the usual definitive host and the
flea is the intermediate host. Humans are
considered accidental hosts.
 Rat tapeworm infection: In nature, the
life cycle of Hymenolepis diminuta usually
involves a rodent (the definitive host) and
a beetle (the intermediate host).
o Humans are considered accidental hosts.
 Dwarf tapeworm infection: Adult
Hymenolepis nana tapeworms live in the
human small intestine
o humans are the only hosts
 Beef tapeworm infection: The adult
Taenia saginata tapeworm lives in the
human small intestine
o the human is the definitive host and the cow
or bull is the intermediate host.
 Pork tapeworm infection: The adult
Taenia solium tapeworm lives in the
human small intestine
o the human is the definitive host and the pig is
the intermediate host.
Tissue cestode

 Echinococcus granulosus usually

involves a dog (the definitive host) and a
sheep (the intermediate host).
Trematodes (flukes)

 Blood Flukes: The blood flukes—

Schistosoma haematobium, Schistosoma
mansoni, and Schistosoma japonicum—
cause the disease known as
schistosomiasis.
 The human is the definitive host and the
freshwater snail is the intermediate host.
 Adult male and female worms, which are
between 1 and 2 cm in length, live
together in pairs within the human body
in blood vessels that surround either the
urinary bladder (in the case of S.
haematobium) or the intestine (in the
case of S. mansoni and S. japonicum).
 The eggs that are released by the female
worms can penetrate through the blood
vessel walls and migrate through tissues.
Eggs of S. haematobium gain access to
the lumen of the urinary bladder, and
eggs of the other two species gain
access to the lumen of the intestine.
 Eggs passed either in urine or feces must
reach fresh water. In the water, a ciliated
organism called a miracidium emerges
from the egg. The miracidium penetrates
into a snail, where it matures into a
mother sporocyst. The mother sporocyst
produces daughter sporocysts, each of
which matures into a cercaria.
 The mature cercariae are released from
the snail into the water. Humans become
infected by penetration of the skin by a
cercaria. Within the human body, the
cercaria matures into an adult worm.
Adult worms may live throughout the
lifetime of the infected human.