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Haemoflagellates Leishmaniasis & Trypanosomiasis

Haemoflagellates Leishmaniasis & Trypanosomiasis. Different stages of Haemoflagellates. Promastigotes of Leishmania . Amastigote of Leishmania. The life cycle of Leishmania. Leishmania Parasites and Diseases. World distribution of Visceral Leishmaniasis. Sand fly.

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Haemoflagellates Leishmaniasis & Trypanosomiasis

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  1. Haemoflagellates Leishmaniasis & Trypanosomiasis

  2. Different stages of Haemoflagellates

  3. Promastigotes of Leishmania Amastigote of Leishmania

  4. The life cycle of Leishmania

  5. Leishmania Parasites and Diseases

  6. World distribution of Visceral Leishmaniasis

  7. Sand fly

  8. Amastigotes of Leishmania

  9. Promastigotes of Leishmania

  10. lesion

  11. lesion

  12. lesion

  13. Clinical types of cutaneous leishmaniasis • Leishmania major:Zoonotic cutaneous leishmaniasis: wet lesions with severe reaction • Leishmania tropica:Anthroponotic cutaneous leishmaniasis: Dry lesions with minimal ulceration Oriental sore (most common) classical self-limited ulcer

  14. Uncommon types • Diffuse cutaneous leishmaniasis (DCL): Caused by L. aethiopica, diffuse nodular non-ulcerating lesions. Low immunity to Leishmania antigens, numerous parasites. • Leishmaniasis recidiva (lupoid leishmaniasis): Severe immunological reaction to leishmania antigen leading to persistent dry skin lesions, few parasites.

  15. Diffuse cutaneous leishmaniasis Leishmaniasis recidiva

  16. cutaneous leishmaniasis Diagnosis: • Smear: Giemsa stain – microscopy for LD bodies (amastigotes) • Biopsy: microscopy for LD bodies or culture in NNN medium for promastigotes

  17. NNN medium

  18. Treatment • No treatment – self-healing lesions • Medical: • Pentavalent antimony (Pentostam), Amphotericin B • +/- Antibiotics for secondary bacterial infection. • Surgical: • Cryosurgery • Excision • Curettage

  19. Pentostam ( sodium stibogluconate) for treatment of all types of leishmaniasis

  20. Visceral leishmaniasis • There are geographical variations. • The diseases is called kala-azar • Leishmania infantum mainly affect children • Leishmania donovani mainly affects adults

  21. Presentation • Fever • Splenomegaly, hepatomegaly, hepatosplenomegaly • Weight loss • Anaemia • Epistaxis • Cough • Diarrhoea

  22. Untreated disease can be fatal After recovery it might produce a condition called post kala-azar dermal leishmaniasis (PKDL)

  23. Fever 2 times a day due to kala-azar

  24. Hepatosplenomegaly in visceral leishmaniasis

  25. Mucocutaneous leishmaniasis

  26. Visceral leishmaniasis Diagnosis • Parasitological diagnosis: METHOD Bone marrow aspirate 1. microscopy Splenic aspirate 2. culture in NNNmedium Lymph node Tissue biopsy

  27. Bone marrow aspiration Bone marrow amastigotes

  28. (2) Immunological Diagnosis: • Specific serologic tests: Direct Agglutination Test (DAT), ELISA, IFAT • Skin test (leishmanin test) for survey of populations and follow-up after treatment. • Non specific detection of hypergammaglobulinaem by formaldehyde (formol-gel) test or by electrophoresis.

  29. DAT test ELISA test

  30. Formol-gel

  31. Treatment: • Pentavalent antimony- sodium stibogluconate (Pentostam) • Amphotericin B Treatment of complications: • Anaemia • Bleeding • Infections etc.

  32. Post-kalazar dermal leishmaniasis (PKDL)

  33. Trypanosomiases

  34. African Trypanosomiasis Life cycle of Trypanosoma brucei gambiense & T. b. rhodesiense

  35. African sleeping sickness Trypanosoma brucei rhodesiense: East Africa, wild and domestic animal reservoirs Trypanosoma brucei gambiense: West and Central Africa, mainly human infection

  36. Animal reservoir hosts for African sleeping sickness

  37. Tsetse fly

  38. Pathology and clinical picture • Skin stage: chancre. • Haematolymphatic stage: generalized lymphadenopathy, anaemia, generalized organ involvement. • Central nervous system stage (CNS): Meningoencephalitis. (Development of the disease more rapid in Trypanosoma brucei rhodesiense)

  39. chancre

  40. Winterbottom’s stage

  41. 3rd stage CNS

  42. Lymph node aspirate

  43. trypanosoma

  44. CSF

  45. AMERICAN TRYPANOSOMIASIS LIFE CYCLE OF Trypanosoma cruzi

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