Theme: Medical

protozoology
Symbiosis is the living together or close association of two
dissimilar organisms.
Commensalism is symbiosis in which one party
(commensal) is benefited and the other party (host) receives
neither benefit nor harm.
Parasitism [Gr.parasitios eating with another] is symbiosis in
which one party (parasite) benefits at the expense of the other
(host).
Parasitology [Gr. Parasitos parasite-logy] is the science of
parasitism and parasites.
Medical Parasitology is the science or study of parasites of
humans. Medical Parasitology consists of:
Medical Protozoology is the study of human parasites of
Protozoa.
Medical Helminthology is the study of human parasitic
worms of Trematoda, Cestoda, Nematoda.
Medical Arachnoentomology is the study of parasites of
Arthropoda.
Parasite lives upon or within another living organism
(host) at whose expense it obtains some advantage.
External parasite (ectoparasite) lives on skin or hair of host.
Internal parasite (endoparasite) lives in body organs, body
tissues, body cells, body cavities of host.
Host is an organism that harbours or nourishes
another organism (parasite).
Definitive host (final h.) is a host that harbours the adult or
sexually mature parasite.
Intermediate host that harbours the immature or asexual
stages of the parasite.
Reservoir host an animal that harbours the same species of
parasites as man and constitute a source of infection to him.
Vector is an arthropod that carriers a parasite to its
host.
Invasive diseases are caused by animals.
Protozoan diseases are caused by Protozoa.

Anthroponotic diseases are characteristic for humans.

Anthropozoonotic diseases are characteristic for humans
and animals.

The ways of agent transmission of invasive

diseases:
contagion (by skin contact, sexual contact);
alimentary or faecal-oral transmission (ingestion of raw or
undercooked food or use of drinking water containing the
infective stage of the parasite);
by blood (by bite of vector containing the infective stage,
blood transfusion);
congenital (through the placenta)
Kingdom Animalia
Subkingdom Protozoa
Phylum 1. Sarcomastigophora
Subphylum Sarcodina. Class Lobozea. Type
species: Entamoeba histolytica, E. coli, E. gingivalis.
Subphylum Mastigophora (or Flagellates).
Class Zoomastigophorea. Type species:
Trypanosoma brucei gambriense, T. b.rhodesiense, T.
cruzi, Leishmania donovani, L. tropica, Lamblia
intestinalis, Trichomonas vaginalis, T. hominis.
Phylum 2. Apicomplexa. Class Sporozoa. Type
species: Plasmodium vivax, P. malariae, P. falciparum,
P. ovale, Toxoplasma gondii.
Phylum 3. Ciliophora. Class Ciliata. Type species:
Balantidium coli.
 Class Lobozea:
1) Motion is by pseudopodia.
2) Reproduction is by binary fission.
3) The production of a cyst is one of the stages in the
life cycle.
4) The pathogenic species for man is Entamoeba
histolytica, the non-pathogenic (commensal) species
are E. gingivalis, E. coli.
Parasite: Entamoeba histolytica
Disease: Amoebiasis, or amoebic disentery
MMorphology:
1) forma magna;
2) forma minuta;
3) cyst.
 Amebiasis

Entamoeba histolytica Entamoeba histolytica

trophozoite mature cyst
 Life cycle of Entamoeba histolytica
Host: Homo sapiens
Transmission: faecal-oral (alimentary)
Infective stage: mature cyst
Localisation: large intestine
Pathogenicity:
1) Intestinal amoebiasis: formation of ulcers of
the wall of the intestine, acute or chronic diarrhoea,
stool containing blood and mucus; may be
asymptomatic infection.
2) Extra- intestinal amoebiasis: abscess of liver,
lung, brain, skin.
Amebic Colitis:
Severe dysentery with multiple ulcers in the large
bowel, and a bloody diarrhea
 Entamoeba histolytica trophozoites
in section of intestine (H&E)
Gross pathology of liver containing amebic
abscess
Amebic liver abscesses
 Amoebiasis
Laboratory diagnosis: Fresh stools are examined
under the microscope. E. histolytica (forma magna and
cysts with 4 nuclei) can be demonstrated in the stools.
Prevention: Treatment of patients and asymptomatic
cyst carriers; protection of foodstuffs and water from flies
and contamination with faeces, the staff of catering
establishments must be examined for cysts carriage, health
education of the population.
 Class Sporozoa:
1) lack locomotory organelles;
2) complex life cycles (sexual and asexual phases);
3) alternation of hosts;
4) the pathogenic species for man are: Plasmodium vivax,
P. malariae, P. falciparum, P. ovale, Toxoplasma gondii.

MALARIA PARASITES OF MAN

PARASITES DISEASES
Plasmodium vivax tertian malaria
Plasmodium malariae quartan malaria
Plasmodium falciparum tropical (falciparum) malaria
Plasmodium ovale tertian ovale-malaria
Geographical distribution of malaria:
in parts of Africa, Asia, Turkey, the West Indies, Central
and South America, and Oceania
 MALARIA PARASITES OF MAN

Intermediate host: Homo sapiens

Definitive host: Anopheles mosquito
Transmission: by bite of female Anopheles
mosquito
Infective stage for man: sporozoite
Infective stage for mosquito: gametocyte
Localisation: liver, blood
Prevention: chemoprophylaxis and personal
protective measures against the mosquito vector
(Anopheles).
 Blood stages of
Plasmodium:
1) young trophozoites
(ring forms);
2) growing
trophozoites;
3) mature trophozoites;
4) mature shizonts;
5)macrogametocytes;

6) microgametocytes
Patient with malaria. Clinical manifestations: fever, anemia,
splenomegaly, hepatomegaly
Laboratory diagnosis
of malaria:
Microscopy of thin and
thick films blood
smears. Different
stages of the parasite
(trophozoites,
schizonts, and
gametocytes) can be
demonstrated in the
blood.
Parasite: Toxoplasma gondii
Disease: toxoplasmosis

Intermediate hosts: birds and mammals,

including humans
Definitive hosts: cats
Localisation: brain, eyes, skeletal and cardiac
muscles, liver, and lungs
Transmitted to humans by:
1) ingestion of undercooked infected meat (cysts
and pseudocysts);
2) contamination of food or drink with infected cat
faeces (oocyts);
3) transplacental (congenital)
Toxoplasma gondii 1) pseudocysts;
2) trophozoites; 3) cysts; 4) oocysts
T.g. human liver
lung heart
 Congenital toxoplasmosis

Clinical manifestations. Hydrocephalus, lesions in

the organs of the vision (chorioretinitis), cirrosis of the
liver and enlargement of the spleen.
Prevention of toxoplasmosis:
washing of hands before meals and after handling animals and
animal products, and the prohibition of preparing food from
insufficiently cooked meat products, in particular liver. All women
with a history of spontaneous abortion must be examined by
laboratory methods for prevention of congenital toxoplasmosis.
 Class Zoomastigophorea:

1) Motion is by flagella.
2) Reproduction is by longitudinal binary fission.
3) Complex life cycles include alternation of hosts.

Parasitical species parasites of tissues and blood:

a) Trypanosoma
b) Leishmania
Their transmission requires a biological vector.
Species living in the digestive tract and genitals:
a) Lamblia intestinalis
b) Trichomonas vaginalis
c) Trichomonas hominis
Their transmission does not require a biological vector.
Parasites: Trypanosoma brucei gambiense and
Trypanosoma brucei rhodesiense
Disease: African trypanosomiasis, or sleeping
sickness
Geographical distribution: West and Central Africa
Transmission: by bite of infected tsetse flies (Glossina
palpalis)
Reservoir hosts of T.b.gambiense are: man,
domestic pig, cattle, dog, antelope.
Reservoir hosts of T.b.rhodesiense are: hartebeest,
lion, hyena.
Localisation: blood, lymph nodes, cerebrospinal fluid,
brain, muscles.
Morphology of trypanosoma:
spindle-shaped cells with an undulatory membrane
and pointed flagella at the ends. The organisms are
motile, 25-40 micro;m in length.
Scanning electron micrograph (5.500 magnification)
of African trypanosome (Trypanosoma brucei
gambiense ) among host red blood cells
Tsetse fly (Glossina palpalis) is vector of
Trypanosoma
 Pathogenicity:
1) From the site of bite trypanosomes reach the blood
and lymphatics where they multiply.
2) There is perivascular infiltration with chronic
inflammation, leading to meningoencephalitis.
3) The patient suffers from fever, rash, headache,
lymphadenopathy, oedema of the brain. There are
alternating periods of fever and apparent recovery.
This is followed by depression and progressive
lethargy.
4) Rhodesien form develops within weeks to months,
Gambian form develops within years. The disease
becomes chronic and persists for months and even
years.
Parasite: Trypanosoma cruzi
Disease: American trypanosomiasis, or
Chagas disease
Geographical distribution: South and Central
America
Transmission: 1) by bite of infected bug
species of the family Triatomidae ;
2) congenital; 3) by blood transfusion.
Reservoir hosts: armadillos, opossums,
rodents, monkeys, dogs, cats.
Localisation: blood (in acute phase), cells of
lymph nodes, spleen, liver, brain, muscles.
Trypanosoma cruzi was discovered in 1909 by C.
Chagas in Brazil
Bug of family Triatomidae is vector of
Trypanosoma cruzi
T. cruzi cardiac muscle
Clinical
manifestation:

fever, oedema of the

face, and
enlargement of the
thyroid gland, lymph
nodes, spleen, and
liver, heart alterations
Parasite: Leishmania tropica
Disease: Cutaneus leishmaniasis
Geographical distribution: Asia, Africa,
Europe
Transmission: by sand fly vector -
Phlebotomus sergenti (in Iran, Iraq, and
India); Phlebotomus papatasi (in southern
France, Italy, and certain Mediterranean
islands)
Hosts: man, dogs, wild rodents
Localisation: cells of skin
Morphology of
leishmania
Intracellular
amastigotes (without
flagellum)2 - 6
micro;m; live in men

Promastigotes (with
flagellum) develop in
the intestine of the
sand fly
Phlebotomus sandfly is vector
of Leishmania tropica
Clinical manifestation: development of a
cutaneous papule that evolves into a nodule,
breaks down to form an indolent ulcer, and
heals, leaving a depressed scar.

Laboratory diagnosis: detection of the

Leishmania parasites in cells of skin.

Prevention: early diagnosis, extermination

of sandflies and dogs and rodents infected
with leishmaniasis, and vaccination.
Parasite: Lamblia intestinalis
Disease: lambliosis
Geographical distribution:
cosmopolitan
Host: man
Transmission: faecal-oral
(alimentary)
Infective stage: cyst
Localisation: the small intestine
(duodenum) and gall-bladder
 Life cycle
of Lamblia
intestinalis
 Lamblia
intestinalis

Morphology: Trophozoites are symmetrical, pear-shaped

organisms with two nuclei. The body is 10 - 18 micro;m with
four pairs of flagella. Cysts are oval-shaped which are 10 -
14 micro;m and have four nuclei.
Scanning electron micrograph (5.500 magnification)
of Lamblia intestinalis in duodenum.
Pathogenicity: chronic duodenitis,
enterocolitis;. cholecystitis and hepatitis.
Laboratory diagnosis: microscopic
examination of the duodenal contents or
faeces.
Prophylaxis: Treatment of patients and
asymptomatic cyst passers; protection of
foodstuffs and water from flies and
contamination with faeces, the staff of
catering establishments must be examined
for cysts carriage, health education of the
population.
Parasite: Trichomonas vaginalis
Disease: Urogenital trichomoniasis
Geographical distribution: cosmopolitan.
Morphology: Trophozoite is a pear-shaped (7-23 micro;m long)
with four anterior flagella and a fifth forming the edge of an
undularing membrane. The axostyle extends of the body.
Host: man
Transmission: by sexual contact; otherwise (through contact with
toilet seats and towels, for example).
Localisation: vagina, urethra, prostate.
Clinical Manifestations: vaginitis in women, more commonly
asymptomatic in men, but may lead to prostatitis or urethritis. The
main symptoms are dysuria, pruritis, yellow and frothy discharge.
Laboratory diagnosis: microscopic examination of the vaginal
fluid, scrapings, or washing.
Trichomonas vaginalis
 Class Ciliata
1) Move by cilia, which are numerous
and cover most of the body.
2) Have 2 nuclei, macronucleus
containing vegetative chromatin and
micronucleus containing generative
chromatin.
3) Reproduce by transverse binary
fission, and sometimes by conjugation.
Parasite: Balantidium coli
Disease: Balantidiasis
Geographical distribution: cosmopolitan.
Morphology: The trophozoite is 75-200 micro;m, oval, with
cilia. Cyst is 30-60 micro;m.
Hosts: man, domestic swine
Transmission: faecal-oral (alimentary)
Localisation: large intestine
Clinical Manifestations: colitis, ulcers and abscesses of
colon, diarrhoea, blood and mucus in the stool.
Laboratory diagnosis: microscopic examination of the
faeces.
Prevention: protection of foodstuffs and water from
contamination with swine faeces and observation of
individual hygiene when talking care of the domestic swine.