PARASITIC

INFECTIONS
Supervised by: Dr. Hassan Addi

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Outline
• Amebiasis

• Giardiasis

• Cryptosporidiosis

• schistosomiasis.

• ascariasis

• hookworm,

• pinworm (enterobiasis)

• tapeworm
Amebiasis
Entamoeba histolytica ( protozoan) is well recognized as a pathogenic ameba,
associated with intestinal and extraintestinal infections.

Transmission/ life cycle: Fecal oral route, Contaminated water/ food , anal-oral
sexual contact.

Clinical Presentation
The majority of infections restricted to the lumen of the intestine (“luminal amebiasis”)
are asymptomatic.
Amebic colitis, or invasive intestinal amebiasis. Symptoms include severe dysentery
(Bloody diarrhea), tenesmus, abdominal pain

Severe chronic infections may lead to further complications such as peritonitis,

perforations, and the formation of amebic granulomas (ameboma).

Amebic liver abscesses are the most common manifestation of extraintestinal amebiasis.
Pleuropulmonary abscess, brain abscess, and necrotic lesions on the perianal skin and
genitalia have also been observed.
Amebiasis
Cysts and trophozoites are passed in feces .
Cysts are typically found in formed stool, whereas
trophozoites are typically found in diarrheal stool.
1. Infection with Entamoeba histolytica occurs via ingestion
of mature cysts from fecally contaminated food, water, or
hands.
2. Exposure to infectious cysts and trophozoites in fecal
matter during sexual contact may also occur.
2.Excystation occurs in the small intestine and
trophozoites
4.are released, which migrate to the large intestine.
Amebiasis
Trophozoites may remain confined to the intestinal lumen (A:
noninvasive infection) with individuals continuing to pass cysts in
their stool (asymptomatic carriers).

Trophozoites can invade the intestinal mucosa (B: intestinal

disease), or blood vessels, reaching extraintestinal sites such as the
liver, brain, and lungs (C: extraintestinal disease).

Trophozoites multiply by binary fission and produce cysts , and both

stages are passed in the feces . Cysts can survive days to weeks in
the external environment and remain infectious in the environment
due to the protection conferred by their walls. Trophozoites passed in
the stool are rapidly destroyed once outside the body, and if ingested
would not survive exposure to the gastric environment.
Amebiasis
• Diagnosis:
• Microscopic Detection in stool sample: see trophozoites
• Immunodiagnosis: Enzyme immunoassay (EIA)
• Antibody detection: indirect hemagglutination (IHA) test

• Treatment:
The primary therapy: metronidazole and/or tinidazole.
Metronidazole dosing for adults is 500 mg orally every 6 to
8 hours for 7 to 14 days.
Tinidazole adult dosing is 2 g orally each day for 3 days
Giardiasis
• Giardia lamblia( protozoan )
• Transmission/ life cycle: Fecal oral route, hints: daycare,
camping

• Clinical presentation: watery diarrhea, weight loss(chronic

infection)

• Diagnosis: Microscopic Detection in stool sample: see

cysts or trophozoites

• Treatment:
Metronidazole, tinidazole
Cryptosporidiosis
• Cryptosporidium spp (spore forming protozoa )
• Most common :Cryptosporidium hominis,
and Cryptosporidium parvum

• Transmission/ life cycle: Fecal oral route

• Clinical presentation: watery diarrhea, sever diarrhea in

immunocompromised host

• Diagnosis: stool sample: see oocysts

• Treatment: supportive threrapy

Schistosomiasis
Schistosomiasis, also known as bilharzia, is a disease
caused by parasitic worms.

The three main species infecting humans are Schistosoma

haematobium, S. japonicum, and S. mansoni.

Transmission: fresh water

Praziquantel is the recommended treatment against all

forms of schistosomiasis.
Schistosomiasis
Clinical Presentation
• Many infections are asymptomatic.
• A local cutaneous hypersensitivity reaction following skin
penetration by cercariae may occur and appears as small,
itchy maculopapular lesions.
• Acute schistosomiasis (Katayama fever) is a systemic
hypersensitivity reaction that may occur weeks after the initial
infection, especially by S. mansoni and S. japonicum.
• Manifestations include systemic symptoms/signs including
fever, cough, abdominal pain, diarrhea, hepatosplenomegaly,
and eosinophilia.

•
Schistosomiasis
• Occasionally, Schistosoma infections may lead to central
nervous system lesions. Cerebral granulomatous disease.
• Or spinal cord lesions

• fibrosis in the affected organs (e.g., liver and spleen) with

associated signs/symptoms. (liver fibrosis , potral HTN)

• Pathology of S. haematobium schistosomiasis includes

hematuria, scarring, calcification, squamous cell
carcinoma, and occasional embolic egg granulomas in
brain or spinal cord.
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