blood flagellates-haemoflagellates
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Blood Flagellates (Haemoflagellates)
Prepared by:
NOE P. MENDEZCENTRAL MINDANAO UNIVERSITY (CMU)
npolomendez@gmail.com
Different stages of hamoflagellates
• Trypanosoma• Leishmania
Life cycle of Trypanosome
African sleeping sicknessTrypanosoma brucei gambiense: West
and Central Africa, mainly human infection
Trypanosoma brucei rhodesiense: East Africa, wild and domestic animal reservoirs
Trypanosomal chancre
Heamolymphatic stage (Lymph node)
The life cycle of Leishmania
Meningoencephalitis stage
COMA BEFORE DEATH
DIAGNOSIS• 1- Trypomastigotes are more in
the blood. • 2- Laboratory animals (mice and
rats) are more susceptible to infection with posterior nuclear shift.
TREATMENT• Earlier & more intensive
treatment by suramin in the early stage and melarsoprol in the late stage of disease.
PREVENTION AND CONTROL
• 1-Protection by skin repellents.• 2-Treatment of cases.• 3-Control of Glossina (vector).• 4-Chemoprophylaxis in endemic
areas
West AfricaLess plentiful &
Can not live in lab animals
East AfricaMore plentiful &can live in lab
animals
Trypanosoma cruzi
PATHOGENESIS AND CLINICAL PICTURE
• Primary lesion
Romana’s eye
Chronic Chagas’ diseaseParasite attacks:
1. Heart muscle fibers: ECG changes , congestive heart failure.
2. Oesophageal muscle fibers:Megaoesophagus >>>> dysphagia.
3. Colon muscle fibers:Megacolon >>>> constipation.
4. Less commonlyCNS or thyroid gland involvement.
5. Exacerbation of infection in immunosuppressed patients(due to drugs or AIDS).
DIAGNOSIS 1. Blood film >>(C-shaped T.cruzi).2. muscle biopsy by culture or
animal inoculation.3. Xenodiagnosis.4. Serological tests5. Cruzin test (I.D.)6. Molecular techniques:PCR.
TREATMENT • Primaquine orally (destroys
trypomastigotes in blood and decreases tissue invasion).
• Nifurtimox (Lampit): 8-10 mg/kg/day for two months. Or
• Benznidazole (Radanil): 5mg/kg/day for two months.
• Symptomatic treatment.
Different stages of Haemoflagellates
Lesion
Lesion
Clinical types of cutaneous leishmaniasis• Leishmania major:
Zoonotic cutaneous leishmaniasis• Leishmania tropica:
Anthroponotic cutaneous leishmaniasis• Oriental sore (most common)
Uncommon types• Diffuse cutaneous leishmaniasis (DCL):
- Caused by L. aethiopica, diffuse nodular non-ulcerating lesions.
• Leishmaniasis recidiva (Lupoid leishmaniasis) - Severe immunological reaction to leishmania antigen leading to persistent dry skin lesions, few parasites.
Diffuse cutaneous
leishmaniasis
Leishmaniasis recidiva
Cutaneous Leishmaniasis
Diagnosis:
• Smear: Giemsa stain – microscopy for LD bodies (amastigotes)
• Biopsy: microscopy for LD bodies or culture in NNN medium for promastigotes
Visceral leishmaniasis• There are geographical variations.• The diseases is called kala-azar• Leishmania infantum mainly affect
children• Leishmania donovani mainly affects
adults
Presentation• Fever• Splenomegaly, hepatomegaly,
hepatosplenomegaly• Weight loss• Anaemia• Epistaxis• Cough• Diarrhoea
Presentation
Untreated disease can be fatal
After recovery it might produce a condition called post kala-azar dermal leishmaniasis (PKDL)
Hepatosplenomegaly
Mucocutaneous
PKDL
Visceral leishmaniasisDiagnosis
(1) Parasitological diagnosis: METHOD
Bone marrow aspirate 1. microscopy
Splenic aspirate 2. culture in NNN medium
Lymph node Tissue biopsy
Bone marrow aspiration
Bone marrow amastigotes
Immunological Diagnosis:
• Specific serologic tests: Direct Agglutination Test (DAT), ELISA, IFAT
• Skin test (leishmanin test)
DAT test
ELISA test
Formol-gel
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