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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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Luminal intestinal flagellates
Luminal & intestinal flagellates

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:

Trophozoite: Morphology:

→→ 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 of g lamblia
Life cycle of G. Lamblia

→→ 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.

Life cycle of giardia lambelia
Life cycle of Giardia lambelia

Symptoms pathology
Symptoms & Pathology:

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.

: Pathology

→→ 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.

Giardia treatment
GIARDIA Treatment


Keep the child hydrated. If it is dehydrated:

Using drugs


2-Tinidazolea new Giardia alternative drugs

(but it has a shorter treatment course) used for under 3 years children.

Luminal flagellates
LUMINAL flagellates

→→ Lumen-dwelling F: Flagellates found in the lumen of alimentary canal and UGT.

Genus :Trichomonas.

General characters.

→→ 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

1-Trichomonas tenax

→→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.

2-Trichomonas hominis.

→→ Lives in the intestine.

→→ It is cosmopolitan in distribution. 

→→ It is thought to be non-pathogenic although it has been associated with diarrheic stools. 

3 trichomonas vaginalis
3-Trichomonas vaginalis

$ $→ → 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

Trichomonas vaginalis
Trichomonas vaginalis


→→ 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.

Diagnosis and treatment

Diagnosis and treatment


→→ 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 has a shorter treatment course.