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Cryptosporidium Isospora Cyclospora Microsporidia

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Cryptosporidium Isospora Cyclospora Microsporidia CRYPTOSPORIDIUM ISOSPORA CYCLOSPORA MICROSPORIDIA ANKUR VASHISHTHA Lesson Plan Introduction Morphology Life cycle Clinical features Lab diagnosis Treatment Introduction Phylum: Apicomplexa Class : Sporozoa Subclass : Coccidea Order : Eimeriida Genus : Isospora Cyclospora Cryptosporidium Sarcocysti Toxoplasma Cryptosporidium parvum causes cryptosporidiosis. Amongst several species of cryptosporidium only C. parvum infects human. Cryptosporidium parvum is an obligate intracellular parasite that causes an opportunistic infection in immunocompromised hosts. Isospora belli, a parasite causing isosporiasis is reported from man particularly patient with AIDS disease. The organisms can infect both adult and children . Cyclospora Cayetanensis produces prolonged diarrhoea in human. In recent years, human cyclosporiasis has emerged as an important infection. All are transmitted by faecal oral route. Cryptosporidium parvum Morphology of oocyst Size: 1.5-5μm in diameter Morphology: round, oval They are mainly located in the jejunum of the host. The infective form of parasite is oocyst exist in two forms- Z-N staining Wet mount Isospora belli Morphology of oocyst 22µm long and 15µm wide. Mature oocyst contains 2 sporocysts with 4 sporozoites each; usual diagnostic stage in feces is immature Oocyst containing spherical mass of protoplasm. They mainly located in small intestine(lower part of ileum) of host. The oocyst of isospora belli is surrounded by a cyst-wall having two layers. Z-N Staining Wet mount of isospora belli Cyclospora cayetanensis Morphology of oocyst C.cayetanensis are nonrefractile, spherical to oval, slightly wrinkled bodies Size of oocysts that are between 8 -10 micrometers in diameter. Oocyst contains 2 sporocysts, each containing 2 sporozoites. Sporozoites are semilunar in shape & 9µm by 1.2µm in size They are located within epithelial cells of gastrointestinal tract of host. Z-N Staining Wet mount of C.cayetanensis LIFE CYCLE OF CRYPTOSPORIDIUM LIFE CYCLE OF ISOSPORA BELLI clinical feature lab diagnosis Treatment Cryptosporadium Incubation period one week Specimen- Stool, Sputum Spiramycin , parvum Gastrointestinal infection (acute watery Wet mount Azithromycin, diarrhoea, anorexia, nausea, vomiting and Modified Z-N staining Paromycin and abdominal pain). Serology:- Nitazoxanide. Extra- intestinal infection of respiratory tract IFA and ELISA test have been (respiratory cryptosporidiosis), cholecystitis and developed for detection of hepatitis have been reported in severely serum antibody to oocyst immunocompromised patient. antigen but are not used routinely. Isospora belli Incubation period is 7to 11 days. Direct microscopy : Wet co-trimoxazole. Mild, self-limited diarrhoea. May be produce mount severe inection in AIDS patients. Several deaths have been reported in case of .Normal saline mount isosporiasis in AIDS patient. Watery diarrhoea without blood, abdominal cramps, fever, malaise and weight loss. Modified Z-N staining Cyclospora Incubation period is around one week. Direct microscopy : Wet Co-trimoxazole cayetanensis Man acquires infection by ingestion of food and mount water contaminated with faeces containing oocysts. .Normal saline mount It causeswatery diarrhoea, fever, fatigue, abdominal cramps and its associated with poor sanitation. Modified Z-N staining MICROSPORIDIA Microsporidia belong to Phylum – Microspora Order – Microsporida They are obligate intracellular parasites Eight genera have been reported to cause disease in human. • Spores are all oval or cylendrical in shape & measure 0.5-4 µm size thick double layered wall. • Within the cytoplasm spore posseses a coiled polar tube. Microsporidia causing human disease Genus Species Main sites of infection Enterocytozoon bieneusi Small intestine epithelium, bile duct epithelium and rarely nasal polyps and bronchial epithelium encephalitozoon Hellem Corneal and conjuntival epithelial, nasal intestinallis polyps, kidney, tracheobronchial tree epithelia of the gut from small intestine to colon, macrophase in the lamina propria,eyes and gall bladder Trachipleistophora Cuniculi Liver, peritoneum, kidney, intestine, eyes Hominis Skeletal muscle, heart muscle, corneal anthropophthera epithelium, kidney, nasopharynx Brain, kidney, heart, pancreas, thyroid, parathroid, liver, spleen, bone marrow Pleistophora spp. Skeletal muscle Brachiola Vesicularum Smooth and cardiac muscle, kidney, liver, Conori (synonym lungs, adrenal cortex Nosemaconori) Vittaforma Corneae (synonym nosema Corneal stroma of the eye corneum) Nosema ocularum Corneal stroma of the eye Microsporidium Cewylonensis Corneal stroma of the eye africanum Corneal stroma of the eye LIFE CYCLE Life cycle has not fully worked out They have two stages of development inside a host’s cell 1. Schizogony 2. Sporogony Transmission: • Human-to-human • Animal-to-human • Water transmission • Inhalation or ingestion Clinical features Microsporidia can cause persistent diarrhoea with wasting. Keratoconjunctivitis Myositis Laboratory diagnosis Sample collection:- three consecutive specimens of stool be examined. Processing :- Direct microscopy :1 Wet mount 2 . Enterotest method can be detected by staining . Modified trichrome stain . Giemsa or fluorescent dyes Indirect immunofluorescence antibody stains using polyclonal antisera. Culture of microsporidia: spore can be cultured in cell lines. Microsporidian DNA can be amplified by PCR. Small-intestinal biopsy : Tiny intracytoplasmic spores are best demonstrated using: 1. Brown-brenn TREATMENT Albendazole- Gastro, muscle, disseminated and ocular infections. Metronidazole- E. bieneusi and others. Fumagillin- Keratoconjunctivitis and ocular lesions THANK YOU.
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