CRYPTOSPORIDIUM ISOSPORA CYCLOSPORA MICROSPORIDIA · Life cycle Clinical features ... Isospora...
Transcript of CRYPTOSPORIDIUM ISOSPORA CYCLOSPORA MICROSPORIDIA · Life cycle Clinical features ... Isospora...
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CRYPTOSPORIDIUM
ISOSPORACYCLOSPORA
MICROSPORIDIA
ANKUR VASHISHTHA
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Lesson Plan
Introduction
Morphology
Life cycle
Clinical features
Lab diagnosis
Treatment
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Introduction
Phylum: Apicomplexa
Class : Sporozoa
Subclass : Coccidea
Order : Eimeriida
Genus : Isospora
Cyclospora
Cryptosporidium
Sarcocysti
Toxoplasma
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Cryptosporidium parvum causes cryptosporidiosis.
Amongst several species of cryptosporidium only C. parvum infects human.
Cryptosporidium parvum is an obligate intracellular parasite that causes an opportunistic infection in immunocompromised hosts.
Isospora belli, a parasite causing isosporiasis is reported
from man particularly patient with AIDS disease.
The organisms can infect both adult and children .
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Cyclospora Cayetanensis produces prolonged diarrhoea in
human.
In recent years, human cyclosporiasis has emerged as an
important infection.
All are transmitted by faecal oral route.
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Morphology of oocyst
Size: 1.5-5μm in diameter
Morphology: round, oval
They are mainly located in the jejunum of the host.
The infective form of parasite is oocyst exist in two forms-
Cryptosporidium parvum
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Z-N staining Wet mount
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Morphology of oocyst
22µm long and 15µm wide.
Mature oocyst contains 2 sporocysts with 4 sporozoites
each; usual diagnostic stage in feces is immature Oocyst
containing spherical mass of protoplasm.
They mainly located in small intestine(lower part of ileum)
of host.
Isospora belli
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The oocyst of isospora belli is surrounded by a cyst-wall
having two layers.
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Wet mount of isospora belliZ-N Staining
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Morphology of oocyst
C.cayetanensis are nonrefractile, spherical to oval, slightly
wrinkled bodies
Size of oocysts that are between 8 -10 micrometers in
diameter.
Oocyst contains 2 sporocysts, each containing 2 sporozoites.
Sporozoites are semilunar in shape & 9µm by 1.2µm in size
They are located within epithelial cells of gastrointestinal
tract of host.
Cyclospora cayetanensis
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Wet mount of C.cayetanensis
Z-N Staining
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LIFE CYCLE OF
CRYPTOSPORIDIUM
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LIFE CYCLE OF ISOSPORA
BELLI
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clinical feature lab diagnosis Treatment
Cryptosporadium
parvum
Incubation period one week
Gastrointestinal infection (acute watery
diarrhoea, anorexia, nausea, vomiting and
abdominal pain).
Extra- intestinal infection of respiratory tract
(respiratory cryptosporidiosis), cholecystitis and
hepatitis have been reported in severely
immunocompromised patient.
Specimen- Stool, Sputum
Wet mount
Modified Z-N staining
Serology:-
IFA and ELISA test have been
developed for detection of
serum antibody to oocyst
antigen but are not used
routinely.
Spiramycin,
Azithromycin,
Paromycin and
Nitazoxanide.
Isospora belli Incubation period is 7to 11 days.
Mild, self-limited diarrhoea. May be produce
severe inection in AIDS patients.
Several deaths have been reported in case of
isosporiasis in AIDS patient.
Watery diarrhoea without blood, abdominal
cramps, fever, malaise and weight loss.
Direct microscopy : Wet
mount
.Normal saline mount
Modified Z-N staining
co-trimoxazole.
Cyclospora
cayetanensis
Incubation period is around one week.
Man acquires infection by ingestion of food and
water contaminated with faeces containing
oocysts.
It causeswatery diarrhoea, fever, fatigue,
abdominal cramps and its associated with poor
sanitation.
Direct microscopy : Wet
mount
.Normal saline mount
Modified Z-N staining
Co-trimoxazole
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MICROSPORIDIA
Microsporidia belong to
Phylum – Microspora
Order – Microsporida
They are obligate intracellular parasites
Eight genera have been reported to cause disease in human.
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• Spores are all oval or
cylendrical in shape &
measure 0.5-4 µm size
thick double layered wall.
• Within the cytoplasm
spore posseses a coiled
polar tube.
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Microsporidia causing human diseaseGenus Species Main sites of infection
Enterocytozoon bieneusi Small intestine epithelium, bile duct
epithelium and rarely nasal polyps and
bronchial epithelium
encephalitozoon Hellem
intestinallis
Corneal and conjuntival epithelial, nasal
polyps, kidney, tracheobronchial tree epithelia
of the gut from small intestine to colon,
macrophase in the lamina propria,eyes and
gall bladder
Trachipleistophora Cuniculi
Hominis
anthropophthera
Liver, peritoneum, kidney, intestine, eyes
Skeletal muscle, heart muscle, corneal
epithelium, kidney, nasopharynx Brain,
kidney, heart, pancreas, thyroid, parathroid,
liver, spleen, bone marrow
Pleistophora spp. Skeletal muscle
Brachiola Vesicularum
Conori (synonym
Nosemaconori)
Smooth and cardiac muscle, kidney, liver,
lungs, adrenal cortex
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Vittaforma Corneae (synonym nosema corneum)
Corneal stroma of the eye
Nosema ocularum Corneal stroma of the eye
Microsporidium Cewylonensisafricanum
Corneal stroma of the eyeCorneal stroma of the eye
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Life cycle has not fully worked out
They have two stages of development inside a host’s cell
1. Schizogony
2. Sporogony
LIFE CYCLE
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Transmission:
• Human-to-human
• Animal-to-human
• Water transmission
• Inhalation or ingestion
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Microsporidia can cause persistent diarrhoea
with wasting.
Keratoconjunctivitis
Myositis
Clinical features
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Laboratory diagnosis
Sample collection:- three consecutive specimens of stool be
examined.
Processing :-
Direct microscopy :1 Wet mount
2 . Enterotest method can be
detected by staining
. Modified trichrome stain
. Giemsa or fluorescent dyes
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Indirect immunofluorescence antibody stains using
polyclonal antisera.
Culture of microsporidia: spore can be cultured in cell
lines.
Microsporidian DNA can be amplified by PCR.
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Small-intestinal biopsy :
Tiny intracytoplasmic spores are best demonstrated
using:
1. Brown-brenn
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TREATMENT
Albendazole- Gastro, muscle, disseminated and
ocular infections.
Metronidazole- E. bieneusi and others.
Fumagillin- Keratoconjunctivitis and ocular
lesions
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THANK YOU