1. NON-PATHOGENIC & OPPORTUNISTIC AMOEBAE

2. NON-PATHOGENIC AMOEBAE Entamoeba dispar Entamoeba hartmanni Entamoeba coli Entamoeba gingivalis Endolimax nana Iodamoeba beutschlii

3. ENTAMOEBA DISPAR Non-invasive,nonpathogenic Earlier it was considered as a nonpathogenic strain of E.histolytica E.histolytica &E.dispar are morphologically identical Cysts of E.histolytica & E.dispar cannot be differentiated microscopically

5. ENTAMOEBA HARTMANNI Earlier considered as small race of E.histolytica Morphologically similar to E.histolytica But trophozoites &cysts are smaller and have a diameter of 4-12µm &5-10µm respectively Trophozoites never contain ingested red blood cells LIFE CYCLE-Similar to E.histolytica Δ is by measurement of size of the trophozoites and cysts & absence of red blood cells in trophozoites

7. ENTAMOEBA COLI World wide parasite Nonpathogenic Habitat-Lumen of large intestine of man It exists in 3 stages-Trophozoite,Precyst and Cyst Life cycle-Similar to E.histolytica

8. TROPHOZOITES Sluggish movement Cytoplasm is not differentiated into ectoplasm and endoplasm They never contain red blood cells But bacteria and cellular debris is present Karyosome is eccentric Nuclear membrane is thick and is lined by coarse chromatin granules

9. CYST Spherical,15-20µm Nuclei-1to8 Chromidial bars are filamentous PRECYST Resembles in shape with that of E.histolytica

10. ENTAMOEBA GINGIVALIS First parasitic amoebae to be recognised Commensal in the gingival tissue around the teeth Described by Gros in 1849 in the soft tartar between the teeth Also found in the diseased tonsils and in the vaginal & cervical smears from women using intrauterine devices

11. ENTAMOEBA GINGIVALIS Only the trophozoite stage has been found Encystation probably does not occur TROPHOZOITE: 10-25µm in diameter; Actively motile by multiple pseudopodia Cytoplasm:Differentiated into clear ectoplasm and granular endoplasm Food vacuoles consists of digested leukocytes and epithelial cells

12. Cont….. Bacteria are seen at times Red blood cells are seen very rarely Nuleus: spherical;central karyosome Chromatin granules are closely packed TRANSMISSION:By close contact like kissing and from contaminated drinking utensils

13. ENDOLIMAX NANA World wide,nonpathogenic,small amoeba Habitat:Lumen of large intestine of humans,primates and pigs It has 3 stages:Trophozoite,precyst and cyst TROPHOZOITES are small in size and cytoplasm is demarcated into ectoplasm and endoplasm

14. Motility: Sluggish Cytoplasmic inclusions:Bacteria, small vegetable cells and crystals No red blood cells NUCLEUS: Large irregular karyosome, arranged eccentrically with Achromatic strands Chromidial bars and glycogen vacuole are absent

15. IODAMOEBA BUETSCHLII Nonpathogenic luminal parasite of large intestine TROPHOZOITES: Active in freshly evacuated unformed stools & sluggish in older stools Ectoplasm is not well differentiated from endoplasm NULEUS relatively large;karyosome surrounded by refractile globules Cytoplasmic inclusions:Bacteria and yeast cells CYST:Uninucleate, Chromidial bars absent.

17. NAEGLERIA FOWLERI MORPHOLOGY 2 stages:Motile trophozoites and non-motile cysts TROPHOZOITE:2 forms→Amoeboid & Flagellate AMOEBOID: Amoebostomes- Distinctive phagocytic structures No peripheral chromatin. Reproduction is by simple binary fission FLAGELLATE:Non-dividing,non-feeding form CYST: Uninucleate;spherical; mucoid-plugged pores or ostioles in cyst wall

18. PATHOGENICITY Amoeboid form is the invasive stage INFECTION:Nasal contamination during swimming or inhalation of dust containing infective forms Flagellate and cyst forms could also enter the nose Flagellate forms revert to amoeboid forms and the amoeboid forms escape from the cysts in the nose

19. Life cycle

20. Amoeboid forms invade nasal mucosa Cribriform plate Olfactory nerve Olfactory bulbs Posterior regions of the brain., leading to Primary amoebic meningoencephalitis

21. ACANTHAMOEBA Sp.. Acanthamoeba culbertosoni A.castellani A.hatchetti A.polyphaga A.rhysodes

22. MORPHOLOGY Acanthamoeba exists as active trophozoites and resistant cysts No flagellate form TROPHOZOITES:24-56µm;larger than that of Naegleria; Irregular in appearance due to acanthopodia- tapering like pseudopodia;Motility-slow CYST:Double walled and so are quite resistant Double wall-Outer wrinkled ectocyst and inner endocyst

23. PATHOGENICITY INFECTION:By inhalation of trophozoites and by direct invasion through broken or ulcerated skin or eye Trophozoites reach lower respiratory tract→ CNS through blood stream It causes Granulomatous amoebic encephalitis(GAE) in immunosupressed patients In healthy persons: Acanthamoeba keratitis and infection occurs by direct contact of cornea with amoebae It releases proteases→cytolysis of corneal epithelium

24. Keratitis

25. Diagnosis: GAE:-Demonstration of Trophozoites in CSF or trophozoites and cysts in brain tissue Keratitis:Trophozoites and cysts in corneal scrapings(wet mount preparation) TREATMENT: GAE:Total excision of the mass and treatment with ketoconazole, penicillin and chloramphenicol Keratitis:Dibromopropamidine+ Propamidine isethionate ointment or drops

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