1. Other intestinal protozoa
Balantidium coli
Cryptosporidium parvum
Isospora belli 1

2. No abscesses in peripheral organs
Balantidium coli
Primarily a zoonotic intestinal parasite:
Horses, cows, pigs
Farm workers at risk
Symptoms similar to amebiasis except,
No abscesses in peripheral organs 2

3. Balantidium coli morphology
Balantidium is the largest protozoan and only ciliate known to parasitize humans 3

4. Balantidium coli life cycle
Contracted by consumption of material contaminated with feces of some farm animals.
Cyst is the infective stage
Trophozoites reside in the lumen of large intestine where they divide by transverse binary fission.
Encystation is triggered by dehydration of intestinal content, it may also occur outside of the host. 4

5. Morphology 50-150 mic Cilliated parasite Phagosome Oval or bag shape
Greenish yellow color
Kidney shapeMacro N
Small micro N
Retractile food vacule
45-55 mic
Cyst wall
No phagosome
Same trophozoite

6. habitate Parasite live in L.I specially cecal region
Invade mucosa and sub M
Feed on mucosal cells, RBC, leukocyte
Multiplicat by binary fission
Cyst formed in large intestine or in outer envirnment

7. Clinical signs and symptomes
Bloody diarrhea
Inter-mitent periods of diarrhea and constipation
Ulceration of large intestine
Tender colon
Cachexia
Gangrenous lesions could occur

8. Balantidium coli Diagnosis
History, symptoms and finding the typical trophozoites and cysts in the stool 5

9. diagnosis Finding parasite (cyst or troph.) in stool by wet mount
Stained smear
Clinical signs could confused by histolytica infection
Looking for characteristic kidney shape N and retractile food vacule

10. Balantidium coli Prevention and treatment
Avoid ingestion of material contaminated with animal feces
Treatment
Tetracycline
Iodoquinol
Metronidazole 6

11. Cryptosporidium parvum
Major cause of epidemic diarrhea
Animal reservoir (domestic animals)
Severe diarrhea and invasive infection in AIDS patients 7

12. morphology Oocyst contain 4 banana shape merozoite
Trophoziote spherical shape(multiply asexually)
Meront (two type 1- reinfect cells 2- form gametocyte to form oocyst again

14. Cryptosporidium parvum8

15. epidemology
Cryptosporidium lives and grows in variety of animals– geese to snakes to cows, sheep and pigs to humans.
Cryptosproridium completes its cycle in a single host.
The Species of Crypto known to infect humans is Cryptosporidium Parvum.

16. Life cycle Infectious agents are the OOCYSTS
In immunocompromised patients ID50 is about 10 to 30 oocysts
Autoinfection takes place in 2 ways-
> Merozoites attach to nearby epithelial cells and spread infection
> thin walled oocysts excyst and continue to spread infection within the body

18. Route of infection Person to person (fecal-oral) Animal to human
Contamination of water supplies (result of waste runoff)
Auto-infection

19. Clinical signs and symptoems
Profuse watery diarrhea
7-20 days periods in immunocompitent self limiting
Last for years in immuncomprimised could invade other organs
Vomiting
Weight loss
Abdominal pain
Low grade fever

20. diagnosis Acid-fast stain ELISA PCR
Sample stool but other tissue biopsy depending on each pt

21. Cryptosporidium parvum Treatment and control
Self limiting in normal individuals
Severe and prolonged disease in AIDS patients
Nitazoxanide
Proper sanitation and clean water supply 9

22. sarcocyst Sarcocysts are coccidia belonging to the phylum Apicomplexa.
coccidia are related to Isospora, Cryptosporidium, Cyclospora, and Toxoplasma
Microscopic demonstration of the oocysts with one sporocyst. Oocysts are thin walled transparent and ovoid in shape 10

23. general
The definitive host of S.hominis and S. suihominis is man, and the intermediate hosts are cattle and swine, Respectively
more than a hundred species of Sarcocystis that infect mammals
only two are known to parasitize the human intestine

24. Morphology
Intestinal phase, The sarcocyst has a wall around it with internal septa that divide the cyst into compartments each contain 4 banna shape spore
Tissue phase filled with hundreds or thousands of slowly dividing fusiform parasites, called bradyzoites

25. Life cycle
The definitive host acquires them upon ingesting meat infected with the parasite
The infected striated muscle contains mature, whitish-colored cysts (sarcocysts)
which are usually oval and range in size from microscopic to clearly visible by direct observation
Once the cyst is ingested, the bradyzoites are released into the intestine and invade the cells of the lamina propia,

26. Life cycle
where they are immediately transformed by gametogony into sexuated parasites
which in turn fuse and form oocysts by Sporogony
The oocysts mature in the intestine, destroy the host cell, and then exit the body in the feces.
When they are eliminated they already contain two sporocysts, each with four sporozoites.

27. Life cycle
The intermediate host acquires the infection upon consuming oocysts or mature sporocysts.
The sporozoites are released into the intestine, penetrate the intestinal mucosa, invade the bloodstream, and multiply asexually by merogony in the endothelial cells of the small blood vessels for one or two generations.

28. Life cycle
These forms, called tachyzoites, do not form cysts; instead, they multiply rapidly, invade the fibers of striated muscle, form the sarcocyst wall, and multiply asexually by merogony for several generations into intermediate forms known as merozoites
these forms that generate the infective bradyzoites

29. Epidemiology
Human intestinal sarcocystosis appears to occur worldwide.
Muscular sarcocystosis has been reported only in Egypt, India,Malaysia, and Thailand.

30. Clinical signs Intestinal sarcocystosis is usually asymptomatic.
nausea, abdominal pain, and diarrhea
3 to 6 hours after eating raw or undercooked beef containing parasite
Human muscular sarcocystosis is usually discovered during examination of muscle tissue for other reasons
muscular weakness, muscular pain, myositis

31. Route of infection Eating raw beef or hamp
The epidemiology of human muscular sarcocystosis has not yet been clarified
Not fully understood

32. Diagnosis
diagnose by confirming the presence of oocysts or mature sporocysts in feces starting on day 9 or 10 following the ingestion of infected meat
Serologic tests (indirect immunofluorescence and ELISA for muscle phase

33. Isospora belli Causes giardiasis-like but milder symptoms
Self limiting in normal individuals
Severe and prolonged disease in AIDS patients 11

34. Isospora belli
Diagnostic stage of I. Belli in fresh stool oocyst with 1 sporocysts
Treatment:
Trimethoprim Sulphamethoxazole 12

35. Microsporidium Microsporidia are small intracellular protozoa
undergo a phase of asexual multiplication—
merogony—followed by a phase of sexual multiplication

36. Morphology small, double-walled bodies measuring 1
μm to 3 μm which contain a parasitic cell
Oval in shape with one or two nuclei At
their anterior end, they have an extrusion apparatus, the polaroplast
Infection takes place when the polar tube is extruded and penetrates the host
cell, allowing the sporoplasm to pass through it and enter the host.

37. Epidemiology Apparently worldwide
Microsporidiosis is one of the most frequent complications
occurring in immunodeficient patients
It has also been reported in transplant patients
Rarely affect immunocompetent
Parasite almost affect all warm and cold blood animal

38. Clinical signs and symptomes
infects the small intestine and, sometimes, thehepatobiliary tract in immunodeficient individuals
chronic diarrhea with passage of watery or semi-watery stools numerous
times (2–8) a day, but without evidence of intestinal hemorrhage
malabsorption
with atrophy of the microvilli, which is aggravated by the ingestion of food; and
subsequent progressive and irreversible weight loss

39. continue it may spread to the nasal sinuses and the kidneys
corneal epithelium and the conjunctiva involved has been found in generalized infections
systemic invasion mainly the brain and the kidneys
skeletal musculatur, and respiratory system

40. Route of infection Feco-oral route Spores contaminate environment
Systemic infection could occurthrough dropletes, instruments blood infusion

41. Diagnosis Specimen body fluids, feces, duodenal
aspirates, urinary sediment, and corneal scrapings
In biopsies, the parasites can be detected by means
of Gram or Giemsa stains or fluorescent antibodies
PCR is the most sensitve route

42. Treatment
Triomethprime
Clarthrimycine
Nitazoxanide