Multicellular Pathogens

Dr Karen Fildes
 Learning Objectives
• Give at least three examples of medically
important multicellular pathogens and the
diseases they cause
• Summarise the broad categories of fungal
diseases
• Describe the generalised protozoan life cycle
and the significance it has on the disease
process and the spread of infection
• Describe the major groups of macro parasites
that cause disease
 Outline
• Introduction to Fungi
– Fungal infections

• Protozoans
– Giardia
– Sleeping sickness
– Toxoplasma gondii
– Amoebic infection
– Malaria

• Macroparasites
– Arthropods
• Scabies & lice
– Worms
• Tapeworm infection
 Fungi

http://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/
articles/health_tools/ringworm_slideshow/
phototake_photo_of_ringworm_on_forehead.jpg
https://upload.wikimedia.org/wikipedia/commons/2/23/Mikrofoto.de-Blepharisma_japonicum_15.jpg;
http://www.medicalnewstoday.com/content/images/articles/286/286166/tapeworm-scolex.jpg; http://
www.microbiologyonline.org.uk/themed/sgm/img/slideshows/3.1.5_protozoa_3.png
 Funky facts about Fungi…..
Who are their closest relatives? Animalia
They are heteroptrophs (can’’t make their own food like plants need
to consume food like animals)
Very important for food & drink
– beer & bread
– cheese manufacture
– soy sauce
Important for biotechnological research
– Easily cultured on a range of inexpensive substrates
– Naturally secrete enzymes: “industrial mycology”
Fungi are found in ALL environments
– important degraders of organic matter
 Fungal structures
• Can be unicellular, e.g. yeast

Single hyphae

• Or multicellular

Hyphae are structural

components of fungus and Filamentous hyphae
release enzymes to absorb
nutrients from food sources
 Pathogenic fungi….
Hyphae growing through
and penetrating host cells

 Many parasitic fungi

have specialised
feeding structure
which allows fungal
hyphae to penetrate
host cells without
killing them
5 µm
 Fungal Infections

• Systemic mycoses: Deep within body

• Subcutaneous mycoses: Beneath the skin
• Cutaneous mycoses: Affect hair, skin, and
nails
• Superficial mycoses: Localized, e.g., hair
shafts
• Opportunistic mycoses: Caused by normal
microbiota or environmental fungi
 Pathogenic Fungi
Cutaneous mycoses
Dermatophytosis - Ringworm or Tinea
• Ringworm of scalp, glabrous skin, and nails
• caused by a closely related group of fungi known
as dermatophytes
• have the ability to utilise keratin as a nutrient
source, i.e. they have a unique enzymatic
capacity – keratinase (breaks down ketatin).
 Systemic Mycoses Caused by
Pathogenic Fungi

Histoplasmosis (Histoplasma capsulatum)

– Most common systemic fungal pathogen affecting humans in the
eastern United States, Africa and Asia
– Found in moist soils containing high nitrogen levels (Australian
soils have low nitrogen)
– Most common infection route is inhalation of spores into the
lungs
– Phagocytosed by alveolar macrophages to live inside these cells =
virulence factor
 Deliver the fungus throughout the body
 Dispersed beyond the lungs via the blood and lymph
 Cutaneous blastomycosis
resulting from the spread of
Blastomyces dermatitidis from
the lungs to the skin
(North America originally, now in
Europe and Africa

Mims Medical Microbiology 4th Ed, pp 357 -374

 Systemic Mycoses Caused by Opportunistic
Fungi
• Candidiasis (Candida albicans)
– Includes various opportunistic infections and diseases
– Common members of microbiota of skin and mucous
membranes
– Candida is one of the few fungi transmitted between
individuals
– All cases of systemic disease result from an opportunist
infection (immunosupressed individuals are vulnerable)
– Can produce a wide range of diseases

https://www.youtube.com/
watch?v=kCJupByzAhI
Oropharyngeal candidiasis (thrush) Nappy rash

Nail infection Ocular candidiasis

 Protozoa

http://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/
articles/health_tools/ringworm_slideshow/
phototake_photo_of_ringworm_on_forehead.jpg
https://upload.wikimedia.org/wikipedia/commons/2/23/Mikrofoto.de-Blepharisma_japonicum_15.jpg;
http://www.medicalnewstoday.com/content/images/articles/286/286166/tapeworm-scolex.jpg; http://
www.microbiologyonline.org.uk/themed/sgm/img/slideshows/3.1.5_protozoa_3.png
 PROTISTS
Protists: are unicellular, colonial or simple multicellular
organisms that possess a eukaryote cell structure (protist =
“the very first” from Greek).

Protozoans: are “animal-like” (non-photosynthetic) unicellular

protists.

They are eukaryotes: possess a nuclear membrane and

organelles.

Parasite: is an organism that lives on or inside another host

organism and is metabolically dependent on the host for
survival.

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 INFECTIONS IN HUMANS
Protozoans cause some important
human diseases

Mode of transmission:

1. Ingestion of parasite – via

contaminated food or water

2. Bite of blood sucking insects

• Insects – only vector
• Insects – development
stage

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19
 PROTOZOAN INFECTIONS IN
HUMANS

Organism Disease Habitat/Source/

Vector
Entamoeba histolytica Amoebic Contaminated water
dysentery
Giardia intestinalis Giardiasis Contaminated water

Trypanosoma brucei Sleeping Tsetse fly

gambiense sickness
Toxoplasma gondii Toxoplasmosis Cat faeces

Plasmodium spp. Malaria Anopheles

mosquito

20

Generalised Protozoan life Cycle
As a cyst, a protozoan can survive for
lengthy periods outside a host. It can
also resist many common disinfectants.
After being ingested, or injected into
blood stream moisture and nutrients
are restored .
The protozoan then releases
sporozoites that attach for example to
the microvilli of the epithelial cells of
the small intestine. These develop into
cysts of two types. 1. have thin walls
and so can reinfect the host by
rupturing and releasing sporozoites that
start the process over again having
never left the host. 2. become thick-
walled cysts which are excreted into the
environment and survive for months;
sporozoites are not released until it is
ingested by another host.
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 Giardia (digestive organ flagellate)

 One of the first protists on record

 Intestinal flagellate lives in mucosa
of bowel.
Attach to gut of host with sucker
like central disc
Causes severe diarrhea and
impaired absorption

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 TRYPANOSOMIASIS – Trypanasoma brucei gambiense
(blood and tissue flagellate)

Human African trypanosomiasis or sleeping sickness is a widespread tropical disease that

can be fatal if not treated. It is spread by the bite of an infected tsetse fly (Glossina
Genus). 23
 Trypanasoma brucei gambiense

• Symptoms: fever, swollen lymph glands, aching muscles and joints,

headaches and irritability.

• Advanced stage: attacks the central nervous system, causing changes

in personality, alteration of the biological clock (the circadian

rhythm), confusion, slurred speech, seizures, and difficulty walking

and talking.

• During a blood meal on the mammalian host, an infected tsetse fly

(genus Glossina) injects metacyclic trypomastigotes into skin tissue. 

The parasites enter the lymphatic system and pass into the
 Amoebae (having pseudopods)
Have “false feet” called pseudopods

 First appeared 900 MYA

 Common in aquatic habitats

 Surround tiny particles of food with

pseudopods and engulf food by
endocytosis forming a food vacuole

 Can be parasitic hence amoebic

dysentry

25
 Entamoeba histolytica

• An enteric protozoan causes amoebiasis

• Infects 10% of the world’s population
• 100 000 deaths per year
• Worldwide distribution endemic in
tropical countries
• At risk groups in Australia include
immigrants and indigenous Australians
 ANIMATION
Entamoeba histolytica
HTTPS://WWW.YOUTUBE.COM/WATCH?V=DYASBEWR6NQ

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 Plasmodium
The genus Plasmodium is a member
of the parasitic phylum Apicomplexa

Members of this phyla possess an

apical complex that attaches the
parasite to the host cell.

The apical complex is a conical

arrangement of microtubules and
secretory structures

The parasite attaches to the host at

the apical complex and then forces its
way into the host

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TOXOPLASMOSIS – Toxoplasma gondi

The natural life

cycle of T. gondii
occurs in cats
and small
rodents,
although the
parasite can
grow in the
organs (brain,
eye, skeletal
muscle, etc.) of
any mammal or
birds.
Cats gets
infected by
ingestion of
cysts in flesh.
LIFE CYCLE

29
 TOXOPLASMOSIS – Toxoplasma gondi

• In adults causes mild infuenza-like disease

• Lymph may be enlarged
• Infection during pregnancy can cause foetal
malformation
• Congenital infections can cause eye or neural
damage
 WHAT IS MALARIA ? THE WORST KIND OF
APICOMPLEXA!

• Causative agent Plasmodium (protozoan – Apicomplexa)

discovered in human blood by - Charles Laveran (a
French army surgeon) in 1880- For his discovery he was
awarded the 1907 Nobel prize for medicine.

• Is a disease that can be transmitted to persons of all

ages, spread from person to person through the bites of
infected mosquitoes

• Genus Plasmodium is the protozoan parasite that causes

malaria

•Species: P. falciparum, P. vivax, P. ovale and P. malariae.

•P. falciparum causes most malaria related deaths

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MALARIA LIFE CYCLE

32
 INCIDENCE OF MALARIA

• About 3.3 billion (half of the world’s population) is at risk of malaria

• Every year this leads to about 250 million malaria cases – and nearly
one million deaths

• People living in the poorest countries are the most vulnerable

• One in five (20%) of all childhood deaths in Africa are due to malaria.
(Every 30 seconds a child dies from malaria in Africa)

33
 INCIDENCE OF MALARIA

Malaria occurs mainly in the tropics because the Anopheles

mosquito vector cannot survive in more temperate climates

34
 SYMPTOMS OF MALARIA
Malaria symptoms oscillate
between:
• Fever
• Chills
• Drenching sweats

Complications include:
• Anemia
• Hypoglycemia
• Lactic acidosis
• Glomerulonephritis
• Cerebral disease

Most deaths caused by

Plasmodium falciparum,
often preceded by coma,
severe anemia and cerebral
malaria
35
 Macroparasites

http://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/
articles/health_tools/ringworm_slideshow/
phototake_photo_of_ringworm_on_forehead.jpg
https://upload.wikimedia.org/wikipedia/commons/2/23/Mikrofoto.de-Blepharisma_japonicum_15.jpg;
http://www.medicalnewstoday.com/content/images/articles/286/286166/tapeworm-scolex.jpg; http://
www.microbiologyonline.org.uk/themed/sgm/img/slideshows/3.1.5_protozoa_3.png
Macroparasites
Arthropods, (fleas & mites) & Arachnids
(ticks)
Scabies and lice can cause
severe skin conditions arising
from:
• Production of insect excreta
• Oozing of blood and tissue
fluids from feeding sites
• Host inflammatory reaction
Myiasis: associated with
invasion of the body by the
larvae of flies primarily in
tropical and sub tropical areas;
painful lesions may develop
Helminths: there are many different
infectious worms
• Some tapeworms are
associated with vitamin B12
deficiency
• Cysts or larval stages rather
than the worms themselves can
result in pathogenesis
• Cyst fluid can cause anaphylaxis
• Cysts in brain can result in
neurologic symptoms
• Larval stages can damage liver
 Parasitic infections

• Children from Aboriginal communities in the

west Kimberley region of Western Australia,
infected with dwarf tape worm (Hymenolepis
nana) 20.5%

Western Pac Surveill Response J. 2015 Jan-Mar; 6(1): 44–51.

Published online 2015 Mar 6. doi: 
10.2471/WPSAR.2015.6.1.008