Introduction (short game)

Definition of Terms
Encystation: Trophozoites become cysts.
Excystation: Cysts become trophozoites.
Infective stage: The stage of entering the host or the source of infection.
Pathogenic stage: The stage that causes organ damage in the host, leading to symptoms.
Trophozoites: are the active, moving form of a parasite that can cause infection.
Cysts: are a dormant (inactive) form of the parasite that can survive outside the host for a while.

General Characteristics of Protozoa (key points)

1. Protozoa are single-celled eukaryotic organisms found in the Kingdom Protozoa.
2. They vary in shape, ranging from spherical to oval or elongated.
3. Protozoa are classified based on their mode of locomotion.
whether they move using cilia, flagella (whip-like structures), or pseudopodia (extend parts of
their cell membrane to move).
4. Not all protozoa are parasites; some are facultative parasites capable of a free-living state.
5. Reproduction in protozoa is primarily through binary fission, with sporozoans undergoing both
sexual and asexual reproduction.
Sporozoans are groups of protozoa
6. Protozoan infections are typically diagnosed through microscopic examination of body fluids,
tissues, or feces.
7. Special stains may be used to demonstrate different protozoa.
8. Parasitic protozoa infections are diagnosed by identifying trophozoite (motile and feeding) or
cyst (dormant and nonmotile) forms.
9. Trophozoites are the pathogenic stage, while cysts are the infective stage for most intestinal
protozoan parasites.
10. Trichomonas vaginalis is an exception, as cyst forms are not found in this parasite.
While most parasitic protozoa have a stage where they create cysts to survive outside the host
or to infect new hosts, Trichomonas vaginalis doesn't have this cyst stage. It doesn't form cysts
to survive outside the body.

Subphylum Mastigophora: Trichomonas vaginalis

- Important Characteristics and Life Cycle

Characteristics:
1. Pear-shaped organism.
2. Contains a central nucleus.
3. Possesses four anterior flagella.
 4. Features an undulating membrane.
Life cycle:
1. Exists only in the trophozoite form.
2. Trophozoite form is both infectious and pathogenic

- Epidemiology and Pathogenesis

1. Trichomonas vaginalis spreads mainly through sexual intercourse.
2. It's found in the urethra and vagina of infected women, and in the urethra and prostate
gland of infected men.
3. Women in their thirties have the highest infection rates; post-menopausal women
have the lowest.
4. Transmission can also occur through shared items like toilet articles and clothing.
5. Infants can get it during birth as they pass through the infected birth canal.
6. In women, it invades the vaginal mucosa and multiplies through binary fission.
7. Trophozoites feed on local bacteria and leukocytes.
8. In men, it commonly affects the prostate gland and urethral epithelium.

- Disease: Trichomoniasis
In men:
❖ Usually asymptomatic but can lead to prostatitis, urethritis, and urinary tract involvement.
Prostatitis - Inflammation of the prostate; Urethritis - inflammation of the urethra

In women:
❖ Often asymptomatic but can cause scant, watery vaginal discharge.
❖ Severe cases may present with foul-smelling, greenish-yellow discharge, itching, burning
sensation in the vagina, and a "strawberry cervix."

❖ Symptoms may include dysuria and increased frequency of urination.

Dysuria refers to pain or discomfort during urination.
In infants:
❖ Infection occurs during passage through the infected birth canal.
❖ Manifestations include conjunctivitis or respiratory infection.
Conjunctivitis—often called “pink eye”—is inflammation of the conjunctiva
Blood and Tissue Protozoa
Subphylum Sarcodina: Acanthamoeba
- Lab Diagnosis
❖ Diagnosis involves finding both trophozoites and cysts in cerebrospinal fluid, brain
tissue, and corneal scrapings.
❖ Histologic examination of corneal scrapings can also be performed.
❖ Calcofluor white stain, typically used for fungi, may be used to highlight the parasite in
corneal scraping specimens.

- Treatment
❖ Pentamidine, ketoconazole, or flucytosine may be effective, but prognosis remains poor
even with treatment.
❖ Topical treatments like miconazole, chlorhexidine, itraconazole, ketoconazole,
rifampicin, or propamidine can be used for eye and skin involvement.
❖ Propamidine shows the best success record among these treatments.

- Prevention and Control

❖ Infection prevention involves adequately boiling water.
❖ Regular disinfection of contact lenses is recommended.
❖ Contact lens wearers should avoid homemade non sterile saline solutions.

Leishmania braziliensis complex

- Disease: Mucocutaneous Leishmaniasis
affects skin, cartilage, and mucous membranes.
❖ Spread by sandflies (Lutzomyia and Psychodopigus) through skin bites.

❖ Promastigotes transform into amastigotes in reticuloendothelial cells, leading to tissue

destruction.
Reticuloendothelial cells: immune cells that gobble up harmful substances located in
places like the liver, spleen, and lymph nodes.
❖ Promastigotes:
➢ Stage of the parasite Leishmania that infects sandflies and transforms into
amastigotes after entering the host.
➢ Motile with long flagellum and elongated shape.
❖ Amastigotes:
➢ Stage of the parasite Leishmania that multiplies inside the cells of the host,
causing tissue damage.
➢ Non-motile with short flagellum and spherical shape.
 ❖ Mucocutaneous leishmaniasis starts with a papule, forming ulcerating lesions often on
the nose and mouth mucocutaneous junction.
Papule: Small, raised bump on the skin, early stage of infection
❖ Disfiguring granulomatous lesions can destroy nasal cartilage (tapir nose) but not bone,
sometimes leading to death from secondary infections.

- Lab Diagnosis
❖ Confirmed by finding amastigotes in clinical specimens, typically ulcer biopsy
specimens.
❖ Giemsa-stained ulcer biopsy specimens reveal diagnostic amastigotes.
❖ Culture of infected material may show promastigotes, and serologic testing may be
used.
- Treatment
❖ Sodium stibogluconate is commonly used, but resistance can develop.
❖ Alternatives include liposomal amphotericin B and oral antifungal drugs (fluconazole,
ketoconazole, itraconazole).
- Prevention and Control
❖ Control of insect vectors is crucial.
like the sand flies
❖ Protective measures such as netting, window screens, protective clothing, and insect
repellents can reduce sandfly bites.
protective clothing (long sleeves, pants, hats)
❖ Prompt treatment helps prevent disease spread.

Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense

- Treatment
❖ Drugs for East and West African sleeping sickness include melarsoprol, suramin,
pentamidine, and eflornithine.
❖ Drug choice depends on factors like pregnancy status, patient age, and disease stage.
- Prevention and Control
❖ Preventive measures focus on avoiding fly bites.
using nets and protective clothing (long sleeves, pants, hats)
❖ Fly traps and insecticides.
Sticky traps or UV light traps
❖ Clearing forests around villages.
Summary
1. Protozoa are unicellular organisms, typically spherical or elongated in shape.
2. Classification into phyla is based on mode of locomotion: Sarcodina (pseudopods),
Apicomplexa (no locomotion), Mastigophora (flagella), and Ciliophora (cilia).
3. Significant human pathogens of Subphylum Sarcodina include Entamoeba histolytica,
Acanthamoeba, and Naegleria.
4. subphylum Mastigophora consists of flagellated parasites like Giardia lamblia,
Trichomonas vaginalis, Leishmania, and Trypanosoma.
5. Subphylum Apicomplexa includes Toxoplasma gondii and Plasmodium, the malarial
parasite.
6. Subphylum Ciliophora has one significant human pathogen, Balantidium coli, causing
intestinal infection.
7. Acanthamoeba and Naegleria can cause central nervous system infection despite their
free-living state.
8. Reproduction in protozoa is mainly by binary fission, with some species undergoing
syngamy or sexual reproduction.
9. Transmission modes vary: fecal-oral for intestinal/protozoa, direct contact or vectors for
blood/tissue/protozoa, and congenital for T. gondii and Plasmodium.
10. Trophozoite is the infective stage for most protozoa, while the cyst is the pathogenic
stage, except for T. vaginalis, which exists only as trophozoites.
11. Diagnosis of protozoal infection is typically through microscopic examination of Giemsa-
stained specimens, detecting diagnostic parasite forms.