Protozoa

The Parasites Troph ⇔ Cyst

of Life cycle

Medical
Importance

Ameba Acanthamoeba

Entamoeba histolytica Meningoencephalitis

• “Montezuma’s revenge”
Nagleria fowleri
• Occasional fatal infection of brain
• Advances rapidly—treatment futile
• Swimming in natural waters
Enters through broken skin,
conjunctiva, lungs, urinary epithelia
Course of infection lengthy
At risk—traumatic eye injuries,
contact lens wearers, AIDS

Ciliates Flagellates
Balantidium coli Trichomonas vaginalis
• Gastrointestinal disease • Sexual transmission
• Normal flora in animals
Trichomonas tenax
• Normal oral flora
• Opportunist in gingival disease

Trichomonas hominis
• Normal intestinal flora

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 Giardia lamblia
• Contaminated water
• Diarrhea with flatulence
• Associated with camping

No cyst form

T. cruzi—Chagas disease
Trypanosoma

• Blood parasites
hemoflagellates
T. brucei—
Sleeping sickness

Leshmania

• Blood and tissue parasite

• Three species—Oriental sore or

visceral leshmaniasis
• Asia, Middle East

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 Apicomplexans
no organelle for motility
Plasmodium
• Blood parasite—malaria
• Four species—varying symptoms
and pathology
Pathology
• Cyclic fever when RBCs rupture
• Anemia from loss of RBCs
• Liver damage
• Kidney damage
Toxoplasma gondii
• Toxoplasmosis
• Mild disease in adults
• Severe to fatal disease in fetus and
individuals with AIDS
• Cats ⇔ Rats
• Humans ingest oocysts from cat
feces or pseudocysts from meat
• Dx—serology, symptoms, history
Coccidians
no organelle for motility
• Live intracellularly
• Order (Coccidiorida) of the
Apicomplexa
Sarcocystis
• Common in animals
• Rare in humans—ingest infected
meat
Cryptosporidium
• Infects variety of animals
• Contaminated food and water
• Mild to asymptomatic “stomach flu”
• Severe, chronic disease in AIDS
• Immunofluorescent stain
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Helminths
Hermaphroditic
Male and female sex organs in
same worm
Definitive host
Harbors sexual cycle
Intermediate host
Harbors asexual cycle
Transport host
No development—link in life cycle
Pathology of Helminth Infestation
Mouth parts adapted for attachment
and feeding
Process food and reproduce
Many migrate through tissues—
inflammation
Set up housekeeping in various
tissues—trauma due to feeding,
toxins, blockages
Isospora
• Contaminated food and water
• Self-limiting diarrhea, asymptomatic
Cyclospora
• Emerging pathogen, Isospora
• Fresh produce, water with fecal
contamination
Babesia
• Historical significance
• Rare in humans, zoonosis
Epidemiology of Helminth Diseases
World-wide—3.8 million infections
Highest—children, rural areas,
tropics and subtropics
Fecal-soil contamination
Bare feet
Raw or undercooked meat
Eosinophils produced in response
to infestation
Capable of destroying worms
Antibodies and T-cells also
produced—limited ability to control
Immune system unable to eliminate
worms completely—size, migration,
inaccessibility
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 Helminth life
Diagnosis
and
Eosinophils and serology transmission
History of travel—even years ago cycles
Evidence of worms or eggs in
various body fluids
Rx—antihelminthic drugs
Prevention—limit parasite-human
contact

Helminth life Roundworms—Nematodes

and
transmission
cycles Intestinal Nematodes
Some development in intestine

Tissue Nematodes
Live in soft tissues

Intestinal Nematodes Adults do not

attach and
Ascaris lumbricoides
may migrate
• Large intestinal roundworm to liver, gall
• Ingest eggs bladder or
• Larvae burrow through intestine emerge from
• Travel in blood to lungs mouth or nose
• Swallow to intestine Allergic
• Humans only host reactions can
occur

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Trichuris trichiura Enterobius vermicularis

• Pinworm, seatworm
• Whipworm
• Lives in appendix
• Large intestine—rectal prolapse • Female lays eggs in perianal area
• Ingest eggs • Ingest eggs
• Humans only host
• Humans only host

Hookworms
• Necator americanus Strongyloides stercoralis
• Ancylostoma duodenale
• Thread worm
• Can complete life cycle in human
or in soil
• Eggs hatch in large intestine
• Larvae penetrate skin
• Eggs hatch in soil, larvae penetrate • Can disseminate in
skin immunocompromised host

Trichinella spiralis

• Larva encysts in muscle

• Ingest cyst

• Associated with pork

disseminated Strongyloides infection

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 Tissue Nematodes
Require arthropod vector

Wuchereria bancrofti
• Elephantiasis
• Worms block lymphatics

Onchocerca volvulus
• Skin or eye—river blindness

Loa loa
• Skin or eye—nos blindness
• Calabar swellings

Dracunculus medinensis
• Longest—1 meter
• Pregnant female coils up under skin
• Releases eggs into water
• Eggs ingested by a copepod
• Humans ingest copepod
Trematodes—flukes
Schistosoma
• Blood flukes
• Invade blood vessels walls
• Deposit eggs in intestine or bladder
• Eggs hatch in water
• Larva infects snail
• Snails release infective larva—
penetrate skin

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Opisthorchis (Clonorchis) sinensis
• Chinese liver fluke Fasciola hepatica

• Larva infect snail

• Larva from snail infect fish • Giant liver fluke

• Humans eat fish

• Fluke migrates to liver

• Larva from snail encysts on plant
• Eggs in common bile duct

Paragonimus westermani
• Oriental lung fluke
• Second host (after snail) is crab
or crayfish
• Humans ingest infected crab or
crayfish
• Fluke migrates to lung
Cestodes—tapeworms
Head—scolex
Hooks or suckers for attachment
Body segments—proglottids
Uterus full of eggs
Further from scolex—more mature

scolex Tapeworm Life Cycle

Eggs ingested by meat animal

Larva encyst in muscle

chain of
proglottids
Humans ingest cyst

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 Taenia saginata
• Cows

Taenia solium
• Pigs

Diphyllobothrium latum
• Fish—Jewish mother’s disease
• Pernicious anemia

Cystocercosis
• Human intermediate host for Arthropods as Disease Vectors
T. solium Ectoparasites—feed on blood and
tissue fluids

Biological vectors—part of disease

transmission cycle
Many diseases vector specific—
distribution of vector determines
disease distribution

Mosquitos—only female—spread
disease through anticoagulant
Fleas—spread from species to
species easily—regurgitate blood
Lice—infection through louse or
feces being crushed into wound
Ticks—broadest host range—
every vertebrate except fish