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Giardia and trichomonas

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Giardia and trichomonas

  1. 1. FLAGELLATES – GIARDIA LAMBLIA AND TRICHOMONAS VAGINALIS -DR.M.JANE ESTHER MD (Microbiology)
  2. 2. FLAGELLATES  Intestinal flagellates  Haemoflagellates INTESTINAL FLAGELLATES:  Giardia lamblia  Genital flagellate-Trichomonas vaginalis
  3. 3. GIARDIA LAMBLIA  First observed by Leeuwenhoek  Prof Giard and Prof Lambl – detailed description  Most common intestinal protozoan pathogen  Distribution : Worldwide  Habitat: duodenum & upper part of jejunum  2 forms : Trophozoite & cyst forms  IgA deficient individuals
  4. 4. TROPHOZOITE PHASE:  Rounded anteriorly and pointed posteriorly  Pyriform, heart or tennis racket shaped  15µm long and 7µm wide  B/L symmetrical  Axostyle  2 nuclei  4 pairs of flagella
  5. 5. FALLING LEAF MOTILITY  2 sausage shaped para median bodies posterior to sucking disc  Motility: Falling leaf  Division: Longitudinal binary fission
  6. 6. CYST  Oval; 12µm long and 7µm broad  4 nuclei  Acid environment  Encyst
  7. 7. LIFE CYCLE  Trophozoite (multiply in duodenum)  Unfavourable conditions – encystment(LI)  Ingestion of cysts - infection  Hatch out in duodenum  Trophozoites released  Colonise duedenum & biliary tract
  8. 8. PATHOGENICITY  Parasite attaches to the epithelial cell surface  malabsorption & steatorrhoea  Toxic (allergic) effect  Traumatic & irritative effect
  9. 9. CLINICAL FEATURES  Giardiasis  Intestinal : Enteritis & enterocolitis  General : fever, anaemia, allergic manifestations  Chronic cholecystopathy
  10. 10. LAB DIAGNOSIS  Stool examination – giardia cyst & trophozoite  Enterotest  ELISA  Immunochromatographic strip tests
  11. 11. ENTEROTEST
  12. 12. TREATMENT  Metronidazole (250 mg tds for 5 days)  Trimidazole (2 g once)  Furazolidone (100 mg 4 times a day for 7-10 days)
  13. 13. TRICHOMONAS VAGINALIS  First observed by Donne in vaginal secretion  Occurs only as the trophozoite  No cystic form  Habitat  Females : vagina, urethra, bartholin’s gland  Males : urethra, prostate anterior preputial sac
  14. 14. MORPHOLOGY  Ovoid or pear shaped  10 to 30µm long and 5 to 10µm broad  Undulating membrane  Costa  4 ant flagella & 5th running along undulating membrane  Axostyle
  15. 15. Continued….  Jerky motility  Binary fission  Infetive form : trophozoite  Culture : CPLM madium (cysteine,peptone,liver,maltose)
  16. 16. LIFE CYCLE
  17. 17. PATHOGENESIS  IP:4 days to 4 weeks  Squamous epithelium & not columnar  Disruption of glycogen levels & bacterial flora  Rise in pH level(exceeds 4.9)
  18. 18. CLINICAL FEATURES Trichomoniasis WOMEN:  Vulvo-vaginitis  Urethritis  Purulent abnormal vaginal discharge(yellow greenish)  Vulval & vaginal epithelium – Fiery red  Ectocervix : punctate hemorrhages (strawberry mucosa) – colpitis macularis
  19. 19. MALES:  Urethritis  Epididymitis  Prostatitis  Prepuce ulceration
  20. 20. LAB DIAGNOSIS  Microscopy :urine wet mount  Trophozoite  Giemsa stain  Culture – CPLM  Indirect haemagglutination  PCR TREATMENT  Metronidazole 250 mg oral tds for 5-7 days
  21. 21. SUMMARY  Giardia lamblia : Trophozoite & cyst – falling leaf motility – giardiasis  Trichomonas vaginalis : only trophozoite, no cyst form, jerky moltility, trichomoniasis

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