1 / 84

GAB 23 october 2007

GAB 23 october 2007. Parasitology, 2007?. M. Lontie MCH, Leuven. Ocular micrometer disk. each objective must be calibrated with reference material can be roughly checked with a counting chamber, with RBCs. Eosinophilia > 10%. With helminths, insects (myasis),

fynn
Download Presentation

GAB 23 october 2007

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. GAB 23 october 2007

  2. Parasitology, 2007? • M. Lontie • MCH, Leuven

  3. Ocular micrometer disk • each objective must be calibrated with reference material • can be roughly checked with a counting chamber, with RBCs ...

  4. Eosinophilia > 10% With helminths, insects (myasis), not with protozoa excepting Isosporabelli and Dientamoebafragilis (with pinworms?)

  5. Auto-infectious Enterobius vermicularis Hymenolepis nana Strongyloides stercoralis

  6. Threats • Global warming • El Nino(little child in Spanish, arriving around Christmas). • Dams • Diama dam in Senegal and large outbreak of Schistosoma mansoni infections. 1996. Kongs et al. Trop Med Int Health. 191-8. • The Lancet. 2001. 570-1.

  7. IatrogenicHepatitis C in Egypt and mass treatment of schistosomiasis • Rao M. et al. 2002. BMC Infect Dis: 29. Nile delta of Egypt: 1950-1980. Injections of tartar emetic (antimony potassium tartrate) with inadequately sterilized needles and syringes.

  8. M. Wéry, 1995.

  9. Kovats R. et al. 2003. The Lancet . El Nino and health

  10. Kovats R. et al. 2003. The Lancet . El Nino and health

  11. Specific gravities • S.G. of Zn-sulfate 33 %: 1.180 • S.G. of formol-solution 10 %: 1.019 • S.G. of ether: 0.714 • S.G.of parasites: Ancylostoma 1.055; Giardia 1.060; Entamoebahistolytica (coli) and Endolimaxnana 1.065 - 1.070; Ascaris 1.110; Trichuris 1.150, Chilomastixmesnili 1.180; Ascaris (unfertilized) 1.200 (Bailenger, 1965).

  12. Entamoeba histolytica • Trophozoite (magna variety) in faeces. Diameter approximately 30 m. Nucleus with typical fine chromatin picture (iron-hematoxylin stain).

  13. Entamoeba histolytica • Trophozoite (magna variety) in faeces. Diameter approximately 30 m. Nucleus with typical fine chromatin picture and central karyosome (Lugol stain).

  14. Entamoeba histolytica • Trophozoite (minuta variety) in faeces. Diameter approximately 15 m. Nucleus with typical fine chromatin picture (iron-hematoxylin stain).

  15. Entamoeba histolytica immature cyst mature cyst trophozoite

  16. Entamoeba histolytica • Cyst in faeces with three visible nuclei. In the nucleus at the right we clearly see the central karyosome (Lugol stain).

  17. Entamoeba histolytica • Cyst in faeces with two visible nuclei. In the nucleus at the left we clearly see the central karyosome (Lugol stain).

  18. Entamoeba histolytica • Cyst in faeces with one visible nucleus with a central karyosome (Lugol stain).

  19. Entamoeba histolytica • Cyst in faeces with one visible nucleus with a central karyosome (Lugol stain).

  20. Entamoeba histolytica • Cyst in faeces with one visible nucleus with a central karyosome (Lugol stain).

  21. Entamoeba histolytica • Cyst in faeces with one visible nucleus with a central karyosome (Lugol stain).

  22. Entamoeba histolytica • Cyst with one visible nucleus and one cylindrical chromatoidal body (Lugol stain).

  23. Entamoeba histolytica • Cyst with two nuclei and one cylindrical chromatoidal body (Lugol stain).

  24. Entamoeba histolytica • Cyst with one visible nucleus and one cylindrical chromatoidal body (Lugol stain).

  25. Entamoebahistolytica - dispar • Entamoebapolecki • Entamoebahartmanni (small race E.histolytica) • Entamoebahistolytica Laredo strain • Entamoebadispar • non pathogenic strains grow betweeen 20 and 37°C, pathogenic only at 37°C • isoenzyme analysis: only 9 zymodemes are pathogenic

  26. Entamoebahistolytica - dispar • PCR, isoenzyme analysis, and antigen detection (JCM, 1998, 449). • Monoclonal antibodies (JCM, 2001, 716). • ITG-Antwerp: PCR under evaluation (T. Vervoort): fecal material in 3.5% formalin.

  27. Entamoeba coli • Large cyst (> 20m) in faeces with four visible nuclei (Lugol stain).

  28. Dientamoeba fragilis • Two nuclei. • “The unflagellated human flagellate “. • Only (very labile) trophozoites, no cysts. • Questionable enteric pathogen. • Doxycycline, paromomycin, metronidazole (Sanford et al., 2005).

  29. Courtesy CDC

  30. Dientamoeba fragilis • SAF fixative (sodium acetate acetic acid formalin) and iron hematoxylin stain have replaced the PVA (polyvinyl alcohol fixative with HgCl2) and trichrome stain.

  31. Sodium acetate acetic acid formalin (SAF) • Sodium acetate 1.5 g • Acetic acid, glacial 2.0 ml • Formaldehyde, 37-40 % 4.0 ml • Distilled water 92.0 ml

  32. Dientamoeba fragilisIn saline (unstained).

  33. Dientamoeba fragilisIn saline (unstained).

  34. Dientamoeba fragilisIn saline (unstained).

  35. Dientamoeba fragilis • In The Netherlands. • In 247 unpreserved stool specimens: none. • In 247 SAF-preserved stool specimens: 24. • (Mank T. 1997. Thesis) Stained with hematoxylin.

  36. Dientamoeba fragilis • In Brussels, Belgium. • SAF-preserved stool specimens used. • D. fragilis (6.3%) and G. lamblia (7.1%) in 448 patients. Stained with hematoxylin. Vandenberg O. et al. 2006. Int J Infect Dis:221, 2.

  37. Dientamoeba fragilis MCH, Leuven • (2005-2007) • 6 + / 160 SAF Stained with hematoxylin.

  38. Blastocystis hominis • Cyst in faeces (Hematoxylin stain).

  39. AntoonvanLeeuwenhoekGiardialamblia1681

  40. Giardia lamblia • Trophozoite with two nuclei and several flagella (May-Grünwald-Giemsa stain)

  41. Giardia lamblia: antigen detection by IF and ELISA • monoclonal antibodies: Merifluor (MERIDIAN) (Cryptosporidium and Giardia). • 8/9 Giardia ELISAs are OK. (JCM, 1998, 1338). • Triage parasite panel (BIOSITE) useful. (JCM, 2000, 3337; JCM, 2001, 334). • one ELISA almost as sensitive as two microscopic examinations. (Mank T. 1997).

  42. Antigen detection • Good sensitivity and specificity • In combination with conventional tests • Problem = COST (Triage = $ 19.44/test)

  43. Leishmaniasis • Leishmaniainfantum, Leishmaniadonovani, … in macrophages of man. • Female sandflies: Phlebotomus spp., Lutzomia spp.,... • Cutanous, visceral leishmaniasis (Kala-azar). • Fever, hepatosplenomegaly, pancytopenia. • Serology - parasitological examination of bone marrow aspiration. • (A. Van Gompel et al., T v G, 1997)

  44. Leishmania sp. • Ovoid small (2-6m) intracellular parasite in a bone marrow aspirate. The typical rod shaped kinetoplast is seen besides the nucleus (May-Grünwald-Giemsa stain).

More Related