Luminal & intestinal flagellates. G iardia lamblia (flagellate). D isease : Giardiasis ( lambliasis ). Epidemiology: It has worldwide distribution. It is the most common protozoan intestinal disease in disease.
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Giardialamblia (flagellate). Disease : Giardiasis (lambliasis).
Epidemiology: It has worldwide distribution.
It is the most common protozoan intestinal disease in disease.
This parasite more prevalence in children under 10 years old.
Habitat→→duodenum and upper jejunum.
Infective stage → → Mature quadrinucleate cyst.
Pathogenic stage → →Active trophozoite.
Diagnostic stage → → Mature cyst and trophozoite in stool sample.
Mode of infection → → Contamination of food and water with cyst.
Route of entry → → is mouth or orally.
There are two stages:
→→ It is 12-15 µ pear shaped with 8 flagella(f) and, 2 axostyles(a) arranged in a bilateral symmetry.
→→ There are two anteriorly located large sucking discs(d).
→→ The cytoplasm contains two 2 nuclei (n) with karyosome (k) and 2 Para basal bodies(p.b).
→→ Giardia cysts are 9-12 microns.
→→ Ovoid in shape with well-defined cyst wall(c.w).
→→ The cytoplasm contains 4 nuclei(n) .
→→ many structures of the trophozoite like 2 axostyles (a) and parabasal bodies(p.b).
→→ Life cycle: Infection occurs by ingestion of cysts, usually in contaminated water.
→→ Ex-cystation occurs in duodenum and trophozoites colonize the duodenum where they may swim freely or attach to the sub-mucosal epithelium via the ventral suction disc.
→→ The free trophozoites encysted in the colon.
→→ The cysts are passed in the stool.
→→ Man is the primary host and some animals(e.g. pigs and monkeys, mice…..etc) are also infected and serve as reservoirs.
→→ Afterrward, person-to-person transmission is possible.
Symptoms: The early symptoms include
→→ abdominal pain and distension, nausea and fatty diarrhea (steatorrhea).
→→ The stool contains excessive lipids but very rarely any blood or necrotic tissue. The more chronic stage is associated with vitamins A and B12 Malabsorption, disaccharides deficiency.
→→ Covering of the epithelium by the trophozoite causing malabsorption of nutrients.
Diagnosis: by Symptoms, history, epidemiology.
→→ Distinct from other dysentery due to lack of mucus, and blood in the stool, lack of increased PMN leukocytes in the stool and lipids droplets & lack of high fever.
→→ Cysts in the stool and trophs in duodenal content obtained using a string device (Enterotest R).
→→ Trophozoite must be distinguished from the nonpathogenic flagellate Trichomona hominis, an asymmetrical flagellate with an undulating membrane.
Keep the child hydrated. If it is dehydrated:
2-Tinidazolea new Giardia alternative drugs
(but it has a shorter treatment course) used for under 3 years children.
→→ Lumen-dwelling F: Flagellates found in the lumen of alimentary canal and UGT.
→→ The genus Trichomonas consists of 3 main species which infect man.
→→ All 3 spps. have direct life cycle .
→→ All Trichomonas posses 3 to 5 anterior flagella, an undulating membrane, and a recurrent flagellum attached to the edge of the undulating membrane.
→→ An axostyle extended along the length of the body and extends from posterior.
→→ reproduce by longitudinal binary division .
→→ A cyst stage is not known for this genus.
There are three species of genus Trichomonas
→→Living in the mouth and teeth pockets.
→→ Moving vigorously by flagellum through saliva, feeding on food debris.
→→ The tissue destruction has been done by toxins produced by this and other pathogens at the site of infection.
→→ Lives in the intestine.
→→ It is cosmopolitan in distribution.
→→ It is thought to be non-pathogenic although it has been associated with diarrheic stools.
$ $→ → Trichomoniasis disease.
$ $→ → It is sexually transmitted disease.
Epidemiology: It has a world-wide.
half pear shaped with a single
nucleus and 4 anterior flagella and
a lateral flagellum attached
by an undulating membrane,
2 axostyles arranged asymmetrically.
The organism does not encysted
→→ Trophozoite infect the squamous epith. Cells.
→→ It is asymptomatic particularly in male.
→→ In females causing severe causing irritation& Inflammation of the vaginal mucosa(vaginitis) or inflammation uterine cervix(cervicitis). →→ In males causing inflammation of urethra and prostate (urithritis and prostatitis).
Clinical symptoms :
→→ majority of infected males without symptoms and ⅓ of infected females without symptoms.
→→ both in male and female genital discharge and pain in urination.
→→ By GUE or males and females UG swab and smear stain with Giemsa stain.
1-Metronidazole(Flagyle) tablets for men and vaginal suppositories for females.
2-Tinidazole alternative drug.it has a shorter treatment course.