Trophozoite

active feeding stage of protozoa

Cyst
survival stage of protozoa, organelles double

Trichrome Stain
always use for ID confirmation

Giardia lamblia
Pathogenic flagellate protozoa, known as "Beaver Fever" found
worldwide
-Ingest infective cyst form contaminated food, drink, breakdown in
sanitation
-Excyst in duodenum
-Trophs attach to large intestine
-Encystment in large intestine
-Diagnosed using Trichrome stains, O&Px3, up to 3 stools may be
required, looking for cysts!

Giardia lamblia (Trophozoite Diagram)

Giardia lamblia Trophozoite

Giardia lamblia (Cyst Diagram)


Giardia lamblia Cyst

Trichomonas vaginalis
Pathogenic Flagellate Protozoa
-No Cyst stage
-Diagnosed by "Twitchy motility" if kept warm
-Difficult to recognize on a permanent stain
-Troph in tissue and secretions
-Males asymptomatic

Trichomonas vaginalis (Trophozoite Diagram)

Trichomonas vaginalis Trophozoite

Trichomonas hominis
Non-pathogenic Flagellate Protozoan, found worldwide
-No Cyst stage
-Motile is fresh stools
-Difficult to stain
-Oral-fecal transmission, treatment not recommended


Trichomonas hominis (Trophozoite Diagram)

Trichomonas hominis Trophozoite

Chilomastix mesnili
Non-pathogenic Flagellate Protozoa
-lives in cecal region of large intestine
-fecal-oral transmission
-looks like yeast
-"Pear Shaped"

Chilomastix mesnili (Trophozoite Diagram)

Chilomastix mesnili Trophozoite


Chilomastix mesnili (Cyst Diagram)

Chilomastix mesnili Cyst

Balantidium coli
Pathogenic Ciliate Protozoa
-Causes Dysentary with persistent diarrhea beforehand
-Can't function w/o macronucleus, "kidney bean-shaped"
-Wet preps are best for viewing, can be confused with helmenth egg
-Domestic hogs are reservoir in Subtropics/Tropics
-Ingestion of infective cysts in food, water

Balantidium coli (Trophozoite Diagram)

Balantidium coli Trophozoite


Balantidium coli (Cyst Diagram)

Balantidium coli Cyst

Intestinal Amebae
-Unique cysts, CYSTS ARE DIAGNOSTIC STAGE
-Motile by pseudopodia
-Have Trophozoites & Cysts

Chromatin
-The combination of DNA and proteins that make up the contents of the
nucleus of a cell.
-Stains red/Purple

Peripheral Chromatin
Wavy outerlayer

Karyosome
Chromatin material inside cell nucleus (separate piece in center)

Entamoeba histolytica & E. dyspar

Worldwide Pathogenic Amoeba
Amoebic Lifecycle:
-Asymptomatic=Passing cysts, Negative for Occult Blood, cysts survive
in cold
-Morphologically identical to E. hartman (which is smaller)
-Oral-Fecal Transmission
Histolytica=pathogenic
Dyspar=non-pathogenic
-Ingested RBCs give away diagnosis
-Max 4 nuclei
-Mucosal penetration, ulcers in cecum, appendix, spread to brain, lung,
liver, much Dysentary
-MUST use permanent stain to confirm ID, negative on Occult Blood
-Cysts survive longer in Cold=28-34C
-Have peripheral chromatin and karyosome


Entamoeba histolytica
Nuclear Morphology of:

Entamoeba histolytica & E. dyspar (Trophozoite Diagram)

Entamoeba histolytica & E. dyspar Trophozoite

Entamoeba histolytica & E. dyspar Trophozoite with WBCs


Entamoeba histolytica & E. dyspar (Cyst Diagram)

Entamoeba histolytica & E. dyspar Cyst

Entamoeba histolytica & E. dyspar Cyst with Glycogen vacule

(Unmatured)

Entamoeba hartmanni
NonPathogenic Amoeba
-Oral-Fecal transmission
-No treatment recommended
-SAmoebic Lifecycle, E. histolytica=larger
-Diagnoses on Permanent stain with NO ingested RBCs

Entamoeba hartmanni
L=Entamoeba histolytica
R=Entamoeba hartmanni

Notice Size Difference in Trophozoites, Which is which?

Entamoeba coli
Worldwide NonPathogenic Amoeba
-Amoebic Lifecycle
-Mature cysts most diagnostic on permanent stains, NO ingestion of
RBCs
-Oral-Fecal transmission
-Off center karyosome, random peripheral chromatin, >4 nuclei

Entamoeba coli
Nuclear Morphology of:

Entamoeba coli (Trophozoite Diagram)

Entamoeba coli Trophozoite

Entamoeba coli (Cyst Diagram)

Entamoeba coli Cyst

Endolomax nana
Worldwide NonPathogenic Amoeba
-Like warm, moist regions
-Amoebic Lifecycle
-If using iodine wet prep instead of trichrome stain, you won't be able
to see nucleus
-Have 4 nuclei with blot-like karyosome

Endolomax nana
Nuclear morphology of:

Endolomax nana (Trophozoite Diagram)

Endolomax nana Trophozoite

Endolomax nana (Cyst Diagram)

Endolomax nana Cyst

Iodamoeba butschii
Worldwide NonPathogenic Amoeba
-Likes tropics

Iodamoeba butschii
Nuclear Morphology of:

Iodamoeba butschii (Trophozoite Diagram)


Iodamoeba butschii Trophozoite

Iodamoeba butschii (Cyst Diagram)

Iodamoeba butschii Cyst

Notice the Glycogen Vacule!

Blastocystis hominis
Amoeba, Sometimes Pathogenic, when numerous
-Usually commensile
-Oral-Fecal Transmission
-Symptoms: diarrhea, cramps, nausea, fever, vomiting, abdominal pain
-Seen in Vacoulated Form, but also exists as granulated form, amoebic
form, and cyst form.

Blastocystis hominis (Vacoulated Form Diagram)


Blastocystis hominis Vacuolated Form

Blastocystis hominis ("Dividing")

Dientamoeba fragilis
Worldwide Pathogenic Flagellate
-FLAGELLATE
-No cyst stage!!
-Asymptomatic carrier state, then diarrhea, abdominal pain,
blood/mucus in stool, gas nausea, vomiting, weight loss, fatigue
-Diagnosis made on Permanent Stains with multiple specimens
Possible association with helminth infections, transmitted via ova?
-Troph looks like "oval with eyes"

Dientamoeba fragilis
Nuclear Morphology of:


Dientamoeba fragilis (Trophozoite Diagram)

Dientamoeba fragilis Trophozoite

Sporozoa
-Infect intestinal mucosa
-Cause diarrheal illness in humans
-Oocysts are diagnostic stage and are spore-like in the fact that they
are resistant
-Sporozoites start inside Oocyst

Cryptosporidium parvum
Pathogenic Sporozoa
-From "Baby Cows"
-Causes Cryptosporidiosis
-Systemic spread with immunocompromised, life threatening with HIV+
-Significant morbidity and mortality
-Look like yeasts, Use modified ACID FAST STAINS->AF=pink
-Fecal-Oral water/food Transmission
-Biggest outbreak in US, in Milwaukee in '92, water treatment plant
from river
-Stages:
Schizonts, Merozoites, Gametocytes, Oocysts, Sporozoites

Cryptosporidium parvum (Diagram)


Cryptosporidium parvum

Cryptosporidium parvum

Cyclospora cayetanensis
Pathogenic
-Larger than parvum, longer duration, and more sever effects
-Diagnosed on wet preps, modified ACID FAST STAIN
-Looks like "Perfectly Round," "Cut Glass"/"Nut Bowl" using trichrome
stain, doesn't stain Oocyst
-Autofluorescent!
-Fecal-OralTransmission

Cyclospora cayetanensis

Cyclospora cayetanensis

Cyclospora cayetanensis

Isospora belli
Pathogenic
-No intermediate hosts, Humans are DEFINITIVE host!
-Use modified ACID FAST STAIN
-Transmission from contaminated food/water, Sexual transmission!!
Stages:
Oocysts, Sporoblasts, Sporocysts, Sporoxoites

Isospora belli (Diagram)

Isospora belli


Isospora belli

Toxoplasma gondii
Pathogenic
-Causes Toxoplasmosis, AKA: Cat Scratch Disease
-MOST SUCCESSFUL Human parasite
-Serologic testing, during preganancy, can cross placenta, part of
TORCH titer
-Transmission=ingest oocysts
-Many intermediate hosts
-Cats are definitive hosts
-Mimics Mono
Stages:
Tachyzoites, Bradyzoites, Oocysts

Toxoplasma gondii (Diagram)

Microsporidia
-Metabolically reduced specialized fungi, mostly in insects
-Obligate, intracellular, spore-forming protists
-7 genera infect humans, Enterocytozoon bienuesi
-Mainly in immunocompromised
-Trichrome, Giemsa stains


Microsporidia

Plasmodium
Protozoa
-Worldwide cause of mosquito-acquired malaria if traveled recently
-Complex lifecycles- Stages: Ring forms (early torphozoites),
Developing trophozoites, Immature schizonts, Mature schizonts (with
merozoites), Microgametocytes, Macrogametocytes
-First week=asymptomatic, asynchronous division, Rupturing RBC's at
different times. Symptoms most prominent when they are
synchronized.
-Used to control Syphilis with plasmodium
-Fever spikes in cycles

Plasmodium vivax
Fever spikes at 48 hrs

Plasmodium vivax


Plasmodium ovale
Fever spikes at 48 hrs

Plasmodium ovale

Plasmodium malariae
Fever spikes at 72 hrs

Plasmodium malariae


Plasmodium falciparum
Fever spikes at 36-48 hrs
-Affects the brain
-Only parasite that can be potentially immediately fatal

Plasmodium falciparum

Plasmodium knowlasi
-Newest, only in a small area

"Signet Ring"
Appears on Early Trophozoite. Forms before Hepatic stage- when
plasmodium enters liver and sets up camp. Reproduces and breaks out
of liver, into RBC's, this is where its diagnosed. Busts out of cell and
starts over. Classic signs start when it keeps reproducing/cycling.

Recrudescence
Erythrocytic cycle not eliminated, Symptoms return quickly

Relapse
Erythrocytic cycle eliminated, Reinfection of RBC's from liver, Return of
symptoms much delayed >20 yrs.

Babesia
Worldwide Protozoa
-Rodent is intermediate host
-TX by ticks
-General malaise, fever, chills
-Self-limiting infection
-Mimics P. falciparum ring forms with "Maltese cross" instead of signet
ring


Babesia

Hemoflagellate
Protozoa
-Stages: Amasitgote, Promastigote, Epimastigote, Trypomastigote
-Amastigote is non flagellated stage where it grows and eventually kills
macrophage that ate it

Hemoflagellate Stages
"Looks like Platelets"
Mostly will see with flagella in mature stage

Hemoflagellate with Epimastigotes

Burst Macrophage

Trypomastigote Stage

Trypanosoma brucei gambesiense

West African Sleeping Sickness
-West/Central Africa
-Tsetse fly is insect host/vector
-Chancer at bite site, swollen lymph nodes, apathy, fatigue, death
-Diagnosis from blood smears, pt history, both amastigotes and
trypomastigotes present

Trypanosoma brucei rhodesiense

East African Sleeping Sickness
-East/Central Africa
-Tsetse fly is insect host/vector
-Early CNS involvement, more aggressive
-Diagnosis from blood smears, pt history, both amastigotes and
trypomastigotes present, highly infectious- can go through skin if not
covered!
-Many ANIMAL reservoirs

Trypanosoma cruzi
Chaga's Disease
-South/Central America
-Reduvid bugs are insect host/vector
-Invades many organs, especially heart
-Painful nodule on face, rash around eyes
-Death as early as several weeks after attack
Diagnosis from blood smears, pt history, both amastigotes and
trypomastigotes present

Leishmania
-Worldwide
-Sandfly is insect host/vector
-Obligate intracellular (macrophage) parasites
-Painless papule at bite site, secondary bacterial/fungal infections, Eats
away at tissue like cancer and spread throughout body with
macrophages- DEADLY
-No flagellated forms in humans, only amastigotes (in macrophages)
TABLE 5-5 Diseases and Conditions Associated with Leishmaniasis
Disease or
Condition Description
Baghdad boils A common name for an infection with Leishmania tropica; it is a cutaneous form of leishmaniasis
presenting with pus-containing ulcers
Bay sore A common name for a cutaneous form of infection caused by Leishmania mexicana
Chiclero ulcer A form of cutaneous leishmaniasis cased by L. mexicana; it is commonly found in Belize, Guatemala,
and the Yucatan peninsula in areas where chicle sap is harvested for making chewing gum
Dum dum fever A common name for the visceral leishmaniasis caused by Leishmania donovani
Espundia Another name for an infection resulting from Leishmania braziliensis, the principle cause of
mucocutaneous disease in Central and South America, particularly in Brazil
Forest yaws Another name for an infection with Leishmania guyanensis, the principle cause of mucocutaneous
leishmaniasis in the Guianas, parts of Brazil and Venezuela; also known as pian bois

Kala-azar Another name for the most severe form of visceral leishmaniasis caused by members of the
Leishmania donovani complex
Oriental sore A common reference for the cutaneous leishmaniasis caused by the infecting agents comprising the
Leishmania tropic complex
Pian bois Another name for infection with L. guyanensis; also known as forest yaws
Uta A reference to mucocutaneous leishmaniasis in the Peruvian Andes