blood flagellates-haemoflagellates
TRANSCRIPT
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Blood Flagellates (Haemoflagellates)
Prepared by:
NOE P. MENDEZCENTRAL MINDANAO UNIVERSITY (CMU)
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Different stages of hamoflagellates
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• Trypanosoma• Leishmania
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Life cycle of Trypanosome
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African sleeping sicknessTrypanosoma brucei gambiense: West
and Central Africa, mainly human infection
Trypanosoma brucei rhodesiense: East Africa, wild and domestic animal reservoirs
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Trypanosomal chancre
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Heamolymphatic stage (Lymph node)
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The life cycle of Leishmania
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Meningoencephalitis stage
COMA BEFORE DEATH
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DIAGNOSIS• 1- Trypomastigotes are more in
the blood. • 2- Laboratory animals (mice and
rats) are more susceptible to infection with posterior nuclear shift.
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TREATMENT• Earlier & more intensive
treatment by suramin in the early stage and melarsoprol in the late stage of disease.
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PREVENTION AND CONTROL
• 1-Protection by skin repellents.• 2-Treatment of cases.• 3-Control of Glossina (vector).• 4-Chemoprophylaxis in endemic
areas
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West AfricaLess plentiful &
Can not live in lab animals
East AfricaMore plentiful &can live in lab
animals
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Trypanosoma cruzi
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PATHOGENESIS AND CLINICAL PICTURE
• Primary lesion
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Romana’s eye
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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).
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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.
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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.
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Different stages of Haemoflagellates
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Lesion
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Lesion
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Clinical types of cutaneous leishmaniasis• Leishmania major:
Zoonotic cutaneous leishmaniasis• Leishmania tropica:
Anthroponotic cutaneous leishmaniasis• Oriental sore (most common)
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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.
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Diffuse cutaneous
leishmaniasis
Leishmaniasis recidiva
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Cutaneous Leishmaniasis
Diagnosis:
• Smear: Giemsa stain – microscopy for LD bodies (amastigotes)
• Biopsy: microscopy for LD bodies or culture in NNN medium for promastigotes
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Visceral leishmaniasis• There are geographical variations.• The diseases is called kala-azar• Leishmania infantum mainly affect
children• Leishmania donovani mainly affects
adults
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Presentation• Fever• Splenomegaly, hepatomegaly,
hepatosplenomegaly• Weight loss• Anaemia• Epistaxis• Cough• Diarrhoea
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Presentation
Untreated disease can be fatal
After recovery it might produce a condition called post kala-azar dermal leishmaniasis (PKDL)
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Hepatosplenomegaly
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Mucocutaneous
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PKDL
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Visceral leishmaniasisDiagnosis
(1) Parasitological diagnosis: METHOD
Bone marrow aspirate 1. microscopy
Splenic aspirate 2. culture in NNN medium
Lymph node Tissue biopsy
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Bone marrow aspiration
Bone marrow amastigotes
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Immunological Diagnosis:
• Specific serologic tests: Direct Agglutination Test (DAT), ELISA, IFAT
• Skin test (leishmanin test)
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DAT test
ELISA test
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Formol-gel