Atrial flagellates

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1
Originally described as an ameba
-no cystic stage
-related to the trichomonads (flagellate).
-Resembles Trichomonas
DIENTAMOEBA FRAGILIS
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DIENTAMOEBA FRAGILIS
-Co-infection with
Enterobius vermicularis
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DIENTAMOEBA FRAGILIS
-MORPHOLOGY
Rosette shaped nuclei (1 to 2)
-karyosome consists of four to six discrete granules.
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It was first discovered in 1681 by Antoine van Leeuwenhoek
in his own stools
GIARDIA LAMBLIA
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First described in 1859 by French scientist Dr. F. Lambl and
Czechoslovakian scientist Dr. Giard:
Cercomonas intestinalis
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In 1915 Stiles coined
Giardia lamblia
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Giardia lamblia
-MORPHOLOGY
Trophozoite
✓ Pear/tear drop shaped, pyriform
✓ Bilaterally symmetrical
✓ “Old-man with eyeglasses”
✓ 4 pairs of flagella
✓ 2 nuclei with distinct karyosome (symmetrically bilateral)
✓ “Falling leaf motility” - movement
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✓ Ovoidal in shape
✓ Thick shell (double wall)
✓ Nuclei: 2 (young), 4 (mature)
✓ Presence of axonemes
CYSTS
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Cysts looks like
Coffee bean
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Causative agent of Giardiasis
(malabsorption syndrome) or
Lambliasis
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Giardiasis a.k.a.
“Traveler’s diarrhea”
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Giardiasis
-infections
Acute infections: “rotten eggs” odor = due to hydrogen sulfide
➢ Chronic infections:
✓ Steatorrhea → passage of greasy, frothy stools that may
float on toilet water
✓ Malabsorption of electrolyte, glucose, fluid
✓ Gay Bowel Syndrome
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Stool examination

➢ Direct fecal smear: cysts (1 hr-semiform) and trophozoites (30
min-watery) can be seen
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-may demonstrate Giardia trophozoites.
-The patient swallows a gelatin capsule attached to a
nylon string, with one end of the string attached to
the patient’s cheek.
Enterotest
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-If the parasite is not found in the feces,
this aspiration may be done
Duodenal aspirate
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Look at the intestinal villi if it is normal or
experiencing hypertrophy
Biopsy
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it has the highest combination of
sensitivity and specificity.
Direct Fluorescent Antibody –gold standard
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Immunologic and Molecular Test
➢ EIA and ELISA
➢ Western Blot
➢ PCR
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Treatment for intestinal villi
Metronidazole,Nitazoxanide, Tinidazole (approved)
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The only pathogenic Trichomonas
➢ No cyst stage
➢ First observed by Donne in 1836 in purulent secretions of
male and female urogenital tracts.
TRICHOMONAS VAGINALIS
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TRICHOMONAS VAGINALIS Habitat
Urogenital tract
➢ Female: vulva (vagina)
➢ Male: prostate gland
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sexually transmitted disease called
trichomoniasis
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TRICHOMONAS VAGINALIS Morphology
“Rapid jerky tumbling”- movement
➢ Pyriform shape
➢ 4 anterior flagella
➢ Prominent axostyle
➢ Presence of undulating membrane
➢ Single nucleus
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Trichomoniasis Male symptoms
➢ Asymptomatic (less persistent, self-limiting)
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Trichomoniasis Female symptoms
➢ Greenish-yellow discharge
➢ Edema, itching, burning sensation
➢ vaginal pruritus
➢ “Strawberry cervix"
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Largest flagellate in man
CHILOMASTIX MESNILI
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CHILOMASTIX MESNILI Habitat:
Cecal region of the large intestine
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CHILOMASTIX MESNILI Morphology
✓ Asymmetrical
✓ Pear-shaped
✓ Spiral groove on midportion
✓ 3 anterior flagella
✓ 1 flagellum within the cytostome → Cystostomal fibril
(shepherds crook)
✓ “Boring/spiral movement or Cork-screw movement”
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Usually found in the intestines
➢ Commensal
➢ Relatively smaller than T. vaginalis
➢ Specimen: Stool (only this)
➢ occurs only as a trophozoite
➢ noninvasive
TRICHOMONAS HOMINIS
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TRICHOMONAS HOMINIS
-Mode of Transmission
fecal contamination of food and drinks
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Also known as Trichomonas buccalis
➢ Usually found in the mouth
➢ No cyst stage, only trophozoites
TRICHOMONAS TENAX
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Specimen for TRICHOMONAS TENAX
Mouth Scrapings
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Mouth Scrapings
-Mode of transmission
contaminated dishes and utensils, kissing
➢ Trophozoites appear to durable: surviving several hours in
drinking water
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