PRELIM LEC 3: CILIATES AND FLAGELLATES

Question 1

● Causes BALANTIDIASIS
● LARGEST PROTOZOAN
PARASITE affecting humans
● ONLY CILIATE capable of causing
DISEASE to HUMANS
● Normal host: PIGS
● HUMANS - accidental host

Answer 1

Balantidium Coli

Question 2

INFECTIVE STAGE OF Balantidium
Coli

Answer 2

Balantidium Coli MATURE CYST

Question 3

Balantidium Coli will inhabits the ______________

Answer 3

LARGE INTESTINE

Question 4

MOT of Balantidium Coli

Answer 4

ingestion of contaminated food or water

Question 5

Balantidium Coli TROPHOZOITE motility

Answer 5

football/throwball motility

Question 6

● use for movement/locomotion
● Longitudinal pattern cilia
● CYTOSTOME - food acquisition
(mouth of the parasite)
● CYTOPYGE - waste excretion (anus
of the parasite)
● 2 nuclei
○ MACRONUCLEUS: bean -
shaped (vegetation)
○ MICRONUCLEUS - round -
shaped (reproduction)
● 2 contractile vacuoles
● Mucocysts - located beneath the
membrane
● football/throwball motility

Answer 6

Balantidium Coli TROPHOZOITE

Question 7

● spherical /ovoid
● Covered with thick cell walls or
refractive double wall

Answer 7

Balantidium Coli CYST

Question 8

BALANTIDIASIS
● Intestinal Ulceration is caused by __________
- ulcer is ROUND BASE and WIDE NECK

Answer 8

HYALURONIDASE

Question 9

3 forms of BALANTIDIASIS
- DO NOT PRESENT WITH DIARRHEA or dysentery, but may serve as a parasite reservoir in the community.

Answer 9

ASYMPTOMATIC CARRIER

Question 10

SUDDEN ONSET OF BALANTIDIASIS; involves diarrhea with bloody mucoid stools

Answer 10

Fulminant or balantidial dysentery

Question 11

wherein diarrhea is alternate with constipation and results in abdominal pain and anemia.

Answer 11

Chronic form

Question 12

DIAGNOSTIC TESTS OF Balantidium coli

Answer 12

• Direct Fecal Smear (DFS) & Concentration Techniques - (sedimentation or flotation) : microscopic demonstration of Trophozoites and Cysts
• Lesions from sigmoidoscopy
• bronchoalveolar washings

Question 13

TREATMENTS
contraindicated in children <8 years of age
ADULTS & OLDER CHILDREN: 500 mg or 40 mg/kg/dose divided in 4 doses for 10 days

Answer 13

TETRACYCLINE

Question 14

contraindicated in early pregnancy

Answer 14

Metronidazole

Question 15

• MOST COMMON cause of DIARRHEA WORLDWIDE
• Known to cause epidemic and endemic diarrhea
• Can grow and live in duodenum, jejunum and upper ileum of intestine
• Causes GIARDIASIS
• Only protozoan that is BILATERALLY SIMILAR
• Other terms: Giardia intestinalis and Giardia lamblia

Answer 15

Giardia duodenalis

Question 16

1st discovered by _________in his own stool

Answer 16

Anton van Leeuwenhoek

Question 17

1st described by Lambl in 1859 who called it?

Answer 17

Cercomonas intestinalis

Question 18

It was later renamed Giardia lamblia by ________ in 1915.

Answer 18

Stiles

Question 19

DIAGNOSTIC STAGE: cyst and trophozoite in stool
● INFECTIE STAGE: MATURE CYST
○ Can survive in cold water
○ Responsible for the transmission of
Giardiasis
○ MOT: ingestion of contaminated food or water and fecal - oral route (on the
hands)
○ will multiply by longitudinal binary fission
○ Note: Each cyst produces 2
trophozoite

Answer 19

Giardia duodenalis

Question 20

● Pyriform or teardrop shaped
● Nucleus
○ 2 ovoidal nuclei each with large karyosome “old man with eyeglasses”
● Dorsal: convex
● Ventral: concave with sucking disk
(large adhesive disk that is used by
the parasite to attach in the
intestine.)
● Axostyle (medial line)
○ Can be seen if stool and smear are fresh
● 4 pairs of flagella
○ Floating leaf-like motility

Answer 20

Giardia duodenalis TROPHOZOITE

Question 21

● Nucleus
○ Immature: 2
○ Mature: 4
○ Shape: Ovoid
● 1 mature cyst give rise to 2
trophozoite
○ If the cyst is immature, flagella is retracted to the axonemes
○ if it transforms to trophozoite, flagella will come out.

Answer 21

Giardia duodenalis CYST

Question 22

CLINICAL MANIFESTATION

Answer 22

1. Maximal at body temperature and stable at a pH of 7.8 - 8.2
2. Production of lectin
3. Decreased maltase and sucrase activities
4. Rearrange the cytoskeleton in human colonic and duodenal monolayers
5. Disrupt the cellular tight junctions and increase epithelial permeability

Question 23

DIAGNOSIS of Giardia duodenalis

Answer 23

• PARASITIC DIAGNOSIS
  Specimen: Stool, duodeno-jejunal Aspirates
• Stool Microscopy
• Direct Wet Mount Examination
• Concentration Techniques (FECT,
• ENTERO - TEST/STRING TEST
• Immunochromatographic assays - detect CWP1(Cyst Wall Protein 1)

Question 24

TREATMENT

Answer 24

METRONIDAZOLE - oral, 250 mg 3x a
day for 5-7 days

Question 25

alternative drugs of Giardia lamblia

Answer 25

TINIDAZOLE FURAZOLIDONE ALBENDAZOLE

Question 26

- MOT: sexually transmitted - Habitat: Genitalia/Gut - Women - in vagina but may ascend as far as the renal pelvis. - Parasite can be isolated from the urethra, prostate, and less frequently, in the epididymis in men. trophozoites multiply by binary fission, - - DOES NOT HAVE CYST FORM & trophozoite cannot live or survive well in external environment transferred passively from person to person - Usual MOT: sexual intercourse.

Answer 26

Trichomonas vaginalis (Ping - Pong’s Disease)

Question 27

DIAGNOSTIC STAGE: trophozoite INFECTIVE STAGE: Trichomonas vaginaliS TROPHOZOITE - Multiply by ____________

Answer 27

LONGITUDINAL BINARY FISSION

Question 28

● Pyriform shape ● Single nucleus ● Undulating membrane: 1⁄2 of the body ○ JERKY MOTILITY ● Median axostyle ● 5 flagella

Answer 28

Trichomonas vaginalis TROPHOZOITE

Question 29

CLINICAL MANIFESTATION - Speculum examination: ____________(due to the hemorrhage of genitals)

Answer 29

STRAWBERRY CERVIX

Question 30

- Trichomonas infection in males may be latent and essentially asymptomatic. ___________: most common complication

Answer 30

PROSTATITIS

Question 31

TREATMENTS

Answer 31

Metronidazole & Tinidazole

Question 32

HABITAT: intestines SIZE: 7-13 um NUCLEUS: ovoidal UNDULATING MEMBRANE: as long as the body INCLUSION BODIES: none - detected to differentiate from the Trichomonas vaginalis - MOT: fecal contamination of food and water

Answer 32

Trichomonas hominis

Question 33

HABITAT: oral cavity SIZE: 5-12 um NUCLEUS: rounded UNDULATING MEMBRANE: 2/3 of the body INCLUSION BODIES: none - MOT: Kissing, droplets from the mouth, sharing of contaminated dishes and drinking glasses. - Can be a commensal of human mouth

Answer 33

Trichomonas tenax

Question 34

HABITAT: gut/genitalia SIZE: 7-23 um NUCLEUS: ovoidal UNDULATING MEMBRANE: 1/2 of the body INCLUSION BODIES: siderophil granules

Answer 34

Trichomonas vaginalis

Question 35

● Habitat: cecal region of the large intestine ● MOT: ingestion of cysts in food and drinks ● HARMLESS COMMENSAL PARASITE ● Can be diagnosed with microscopic examinations of feces ● No treatment is indicated

Answer 35

Chilomastix mesnili

Question 36

○ Asymmetrically pear - shaped ○ Boring and spiral forward movement ○ 3 anterior free flagella and 1 within the prominent cytostome

Answer 36

Chilomastix mesnili TROPHOZOITE

Question 37

○ Pear or lemon-shaped ○ Hematoxylin and eosin: single large vestibular nucleus, cytostome and fibril on either side of the cytostome

Answer 37

Chilomastix mesnili CYST