INTESTINAL AND GENITAL FLAGELLETES
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INTESTINAL AND GENITAL FLAGELLETES. Intestinal and Reproductive Track Flagellates. Giardia lamblia (pathogenic)- small intestine . Trichomonas vaginalis (pathogenic)- occurs in reproductive and urinary system of people . Trichomonas tenax - endocommensal in mouth (tooth sockets).

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INTESTINAL AND GENITAL FLAGELLETES

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Intestinal and genital flagelletes

INTESTINAL AND GENITAL FLAGELLETES


Intestinal and reproductive track flagellates

Intestinal and Reproductive Track Flagellates

  • Giardialamblia(pathogenic)- small intestine.

  • Trichomonasvaginalis(pathogenic)- occurs in reproductive and urinary system of people.

  • Trichomonastenax- endocommensal in mouth (tooth sockets).

  • Pentatrichomonashominis- endocommensal in large intestine and cecum.

  • Chilomastixmesnili(endocommensal)- lives in the large intestine.


Intestinal and genital flagelletes

CLASS- ZOOMASTIGOPHERA

The parasites belonging to this group of protozoa possess one or more flagella giving them the power of motility.


Intestinal and genital flagelletes

These are classified according to their habitat into TWO groups:

1.Intestinal,oral & genital flagellates.

2.Blood & tissue flagllates.


Intestinal oral flagellates giardia lamblia

Intestinal & oral flagellatesGIARDIA LAMBLIA


Geographical distribution

World wide

Habitat: Duodenum and the upper part of the jejunum of the man.

Geographical distribution


Morphology

Exits in two phases:

A) Trophozoite

B) Cyst

Morphology


Trophozite

When viewed flat,the shape of the trophozoite is like that of badminton racket.

The dorsal surface is convex & the ventral surface is concave like a sucking disc.

The size of the trophpzoite is 14 micrometer long & 7 micrometer broad.

All organs of the body are paired. Thus there are two axostyles,two nuclei and four pairs of flagella.

TROPHOZITE


Giardi trophozoite with trichome stain

GIARDI TROPHOZOITE WITH TRICHOME STAIN


Intestinal and genital flagelletes

CYST

  • It is oval in shape and measures 12 micrometer long and 7 micrometer.

Giardia intestinalis


Giardi cyst stained with trichome stain

GIARDI CYST STAINED WITH TRICHOME STAIN


Life cycle

In the trophozoite stage the parasites multiplies in the intestine of manby binary fission.

When conditions in the duodenum are unfavourable,encystment occurs,usually in large intestine.

During encystment the cell divides into two cyst.

Infection of man is brought by ingestion of cyst.

Within 30 min. of ingestion the cyst hatches out two trophozoites which then miltiply in enormous numbers and colonise in the duodenum.

LIFE CYCLE


Pathogenicity

With the help of the sucking disc the parasites attach itself on the epithelial cells of the intestine and may cause disturbance, leading to malabsorption of fat.

The patient may complain of persistent looseness of bowels , and mild steatorrhoea.

PATHOGENICITY


Lab diagnosis

A microscopic examination of freshly passed stools for demonstration of trophpzoites and cyst.

Giardiatrophozoites may be seen in the bile.

LAB DIAGNOSIS


Intestinal and genital flagelletes

TRICHOMONAS


Introduction

  • These are the common flagellates of the tropics and are frequently observed in diarrhoeic stools.

  • They exist only in the trophozoite phase & there is no cystic phase.

  • These are pear shaped bodies & measure 10 to 12 micrometer in length.

  • There are 3 to 5 anterior flagella that are free.

INTRODUCTION


Trichomonas vaginalis

TRICHOMONAS VAGINALIS


Intestinal and genital flagelletes

  • There are single oval nucleus at the round anterior end

  • The base is supported by a rod like structure, the costa.

  • The axostyleruns down the middle of the body & ends in the pointed tail like extremity.


Life cycle1

LIFE CYCLE


Classification

  • According to their habitat it ts classified into the following species:

  • A) Trichomonas hominis

  • B) Trichomonas tenax

  • C) Trichomonas vaginalis

CLASSIFICATION


Pathogenicity1

  • These flagellates are of no pathogenic importance except for T. vaginalis which is found in large numbers in leucorrhoeic discharge of females.

  • In case of man , T. vaginalis infection is sexually transmitted disease causingUrethritis.

PATHOGENICITY


Trichomonas vaginalis1

Trichomonasvaginalis

  • It lives in the reproductive and urinary system of people.

  • More specifically it is found in the vagina and urethra of women, and in the prostate, seminal vesicles, and urethra of men.

  • It is more common in women, and hard to find in men because most are asymptomatic.

  • It is cosmopolitan in distribution, however prevalence is not uniform because of sanitary and hygiene habits (depends on surroundings).

    • 20-40% in Women

    • 15% in Men


Intestinal and genital flagelletes

  • It is pathogenic and causes Vaginitis.

  • Suffix means “inflamed” or “inflammation of “

  • So inflammation of the vagina.

  • Also can be called Trichomoniasis.

  • Emphasis on a organism.

  • Etiological agent organism that causes something.


Symptoms

Symptoms

  • Usually none.

  • Particularly in males. They don’t show symptoms.

  • In females it ranges from: chaffing, itching, frothing/clear/creamy discharge that is profuse from vagina (leukorrhea).


Pathology

Pathology

  • Eventually females get a disintegration of vaginal epithelial lining.

  • Natural flora (bacteria ) keep the pH of the vagina at 4-4.5 and ordinarily this discourages infections.

  • T. vaginaliscan survive at a low pH.

  • Once established it causes a shift toward alkalinity (pH 5-6) which further encourages its growth.

  • There is a tendency to explain stillbirths, spontaneous abortions, morbidity to women who have vaginitis.


Trichomonas vaginalis epidemiology

Trichomonasvaginalis Epidemiology

  • Sexual contact.

  • Soiled clothing/linens; sharing of wash cloth, clothing, etc.

  • T. vaginalis can live in moist clothing for one day!

  • Also seems to show up in small children: so probably not transmitted sexually.

  • The role of toilets? Feasible but no real evidence.


Diagnosis

Diagnosis

  • Motiletrichomonads seen on saline wet mount

  • Vaginal pH >4.5 often present

  • Positive amine test

  • Culture is the “gold standard”

  • Pap smear has limited sensitivity and low specificity

  • DNA probes

  • Male diagnosis - Culture

    • First void urine concentrated

    • Urethral swab


Wet prep trichomoniasis

PMN

Yeast buds

Trichomonas*

Trichomonas*

Squamous epithelial cells

PMN

Wet Prep: Trichomoniasis

Saline: 40X objective


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