Hemoflagellates-parasitologiiiijjjy.pptx

Hemoflagellates for parasitology

1. HEMOFLAGELLATES Jenny-Rose G. Masocol MPH Student

2. HEMOFLAGELLATES may infect the blood, lymph nodes, muscles and RES Common MOT: bite of a vector Trypanosoma Leishmania L. tropica L. braziliensis L. donovani T. brucei gambiense T. brucei rhodesiense **T. cruzi Four morphologies or stages: AP ET A mastigote (Leishman-Donovan body) or leishmanial form P romastigote ( Leptomonal form) E pimastigote ( crithidial form) T rypomastigote ( trypanosomal form) Trypomastigote Trypomastigote Amastigote Major difference: Diagnostic stage Amastigote **AET

3. MORPHOLOGIES/STAGES A mastigote P romastigote

4. MORPHOLOGIES/STAGES E pimastigote T rypomastigote

5. Appearance? Nucleus? Feature? E pimastigote A mastigote P romastigote T rypomastigote

6. General Morphology and Life Cycle Notes Amastigotes and Trypomastigotes : 2 forms routinely found in human specimen Amastigotes : found primarily in tissue and muscle as well as the CNS withing macrophages where they multiply Trypomastigotes : reproduce and visible in peripheral blood Promastigote : seen only if a blood sample is collected immediately after transmission Epimastigote : found primarily in the arthropod vector Specimen of choice: Blood, lymph node and ulcer aspirations, biopsies, CSF Available serologic and molecular test

7. QUICK QUIZ This is the only hemoflagellate morphologic form that does not have an external flagellum A. Leishman-Donovan body B. Leptomonal form C. Crithidial form D. Trypanosomal form A (or Amastigote)

8. Leishmania Vector: Sandfly ( Phelotomus spp.) Infective Stage to Man: Promastigote Infective Stage to Sandfly: Amastigote Diagnostic Stage: Amastigote Culture Media: Novy-Nicole-McNeal (NNN) Montenegro Skin Test: screening test similar to tuberculin test for screening large populations at risk for infections caused by Leishmaniasis, but not good in active diesease AP ET

9. Status of Endemicity, WHO 2023 99 out of 195 countries endemic of leishmaniasis An estimated 700 000 to 1 million new cases occur annually

10. Blood and Tissue Flagellates Habitat Vector Pathology Leishmania tropica Dry lesions Old World cutaneous leishmaniasis Dry or urban cutaneous leishmaniasis Oriental sore Bay Sore Baghdad Boil Jericho Boil Dehli Boil Endothelial cells of infected skin capillaries and within the cytoplasm of large monocytes Phlebotomus papatasii Phlebotomus sergenti Localized cutaneous infection which give rise to macule to papule, a raised lesion with depressed ulcerated center Diffuse Cutaneous Leishmaniasis Lupoid leishmaniasis- persistent dry lesions

11. Blood and Tissue Flagellates Habitat Vector Pathology Leishmania braziliensis Weeping lesions American mucocutaneous leishmaniasis Espundia Bubas Chichlero ulcer Forest yaws Plan Bois Uta Mucocutaneous junctions, particularly the nasal septum, mouth, pharynx Phlebotomus peruensis Phlebotomus verrucanum Primary lesion is similar to that of L. tropica except that ulcer produced is a weeping lesion with granular base Spx : biopsy of the infected ulcer. Giemsa-stained = typical amastigotes

12. Blood and Tissue Flagellates Habitat Vector Pathology Leishmania donovani Visceral leishmaniasis Kala-azar Dum-dum fever Black Fever Epithelial cells of RES: liver, spleen, BM, & visceral lymph nodes, and fixed tissue macrophages Phlebotomus argentipes Splenomegaly with severe anemia darkening of the skin “black fever” Post Kala-Azar Dermal Leishmaniasis (PKDL) Can be pass through blood transfusion -up to 12 months deferment (travel history)

13. QUICK QUIZ The most common morphologic form seen in   samples positive for L. tropica is:  A. Trypomastigote B. Promastigote C.  Epimastigote D. Amastigote D

14. Trypanosoma Trypanosoma brucei Agent of trypanosomal disease called Nagana (cattle dse ) and Sleeping Sickness Animal parasite Trypanosoma brucei rhodesiense and T.b gambiense vector: tsetse fly (Glossina spp.) acute phase : peripheral blood and lymph nodes are invaded chronic phase : CNS is invaded--- meningoencephalitis; comatose state develops “sleeping sickness” T.b rhodesiense : East African Sleeping Sickness (more virulent) T.b gambiense: West African Sleeping Sickness

15. Infective Stage to Man: Trypomastigote Infective Stage to Tsetse fly: Trypomastigote Diagnostic Stage: Trypomastigote

16. Blood and Tissue Flagellates Habitat Vector Animal Reservoir Trypanosoma rhodesiense East African Sleeping Sickness **symptoms appear just weeks after infection Febrile Period: circulating blood and lymph node Sleeping period: CSF Glossina morsitans Glossina swynnertoni Cattle Sheep wild animals Trypanosoma gambiense West African Sleeping Sickness **manifest months/years after initial infection Glossina palpalis Glossina tachinodes No known animal reservoir ** blood transfusion, organ trans plantation, and congenital transmission Pathology: Winterbottom’s Sign Kerandal’s Sign- a delayed sensation to pain Comatose/ Somnolence Painful chancre

17. QUICK QUIZ Which of the following  trypanosomal  parasites that  causes sleeping sicknesses is the more aggressive  form?  A. Trypanosoma brucei gambiense B. Trypanosoma brucei rhodesiense C. Trypanosoma cruzi D. Trypanosoma rangeli B

18. Trypanosoma Trypanosoma cruzi American trypanosomiasis , Chagas Disease Described by young medicine student in Brazil named Carlos Chagas Vector: reduviid bug, kissing bug, assassin bug, triatomine bug, conenose bug Laboratory Diagnosis trypomastigote in thin and thick smear prepared from PB/ CSF (C-shaped) xenodiagnoses (TC, TS)- test animal: reduviid bug (stool exam of bug – trypomastigote)

19. About 6–7 million people worldwide , mostly in Latin America, are estimated to be infected with  Trypanosoma cruzi , the parasite that causes Chagas disease (WHO, 2024)

20. Infective Stage to Man: Trypomastigote Infective Stage to Tsetse fly: Trypomastigote Diagnostic Stage: Trypomastigote Amastigote

21. Blood and Tissue Flagellates Habitat Vector Remarks Trypanosoma cruzi American trypanosomiasis Chagas Disease RES Cardiac Muscle CNS Triatoma infestans Rhodnius prollixus Panstrongylus megistus Other MOT: blood transfusions, sexual intercourse, transplacental transmission, entry mucous membranes when the bug bite is near the eye or mouth Pathology: Chagoma - erythamotous nodule at infection site Romana’s Sign: unilateral edema of the eyelids Myocarditis Megacolon Megaesophagus Hepatosplenomegaly cardiomegaly

22. QUICK QUIZ Which of the following is not a characteristic finding  in Chagas’ disease?  A.  Romaña’s  sign B. Megacolon C. Cardiomegaly D. Somnolence D

23. Hemoflagellates Prevention and Control Public Awareness - Education Programs Personal Protection ( e.g protective clothing, repellants, screening) Prompt treatment/eradication of ulcers Vector population/reservoir host control Vaccination, if available prompt medical treatment of infected domestic animals - ** T.b rhodesiense

24. QUICK QUIZ 1.Reduviid Bug ( stercoraria vector) 2.Sandfly ( salivaria vector) 3.Tsetse Fly ( salivaria vector) A. Leishmaniasis B. American Trypanosomiasis C. African Sleeping Sickness B A C

25. Trypanosoma Leishmania L. tropica L. braziliensis L. donovani T. brucei gambiense T. brucei rhodesiense **T. cruzi Morphologies/ or stages: E pimastigote T rypomastigote **AET A mastigote P romastigote

26. THANK YOU!