TOPIC 5: Other Protozoans (Coccidians)

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187 Terms

1
  1. Cystoisospora belli

  2. Cyclospora cayetanensis

  3. Cryptosporidium (parvum and hominis)

  4. Toxoplasma gondii

  5. Sarcocystis (hominis and suihominis)

COCCIDIANS:

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Phylum Apicomplexa

What phylum do coccidians belong to?

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Spore-forming, microscopic, single-celled, obligate intracellular protozoans

What type of protozoans are coccidians?

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4

Gastrointestinal (GI) tract

What is the main site of infection for coccidians?

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Coccidiosis

What disease is caused by coccidians infecting the GI tract?

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They are usually asymptomatic in immunocompetent individuals.

How do coccidians affect immunocompetent individuals?

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In immunocompromised hosts

In which type of host do coccidians become opportunistic pathogens?

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It means they can cause severe infections when the immune system is weakened.

What does it mean for coccidians to be "opportunistic" in immunocompromised hosts?

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  1. Gametogony

  2. Sporogony

  3. Schizogony

What are the three main stages in the life cycle of coccidians?

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The development of male (microgametes) and female (macrogametes)

What occurs during gametogony in the coccidian life cycle?

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Microgametes

What type of gamete is developed for males during gametogony?

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Macrogametes

What type of gamete is developed for females during gametogony?

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The production of oocysts

What is the purpose of the sexual cycle (sporogony) in the coccidian life cycle?

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Sporogony

What is the sexual reproductive cycle of coccidians called?

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Schizogony

What is the asexual reproductive cycle of coccidians called?

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The production of merozoites

What occurs during the asexual cycle (schizogony) in the coccidian life cycle?

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Gametogony

Which stage of the coccidian life cycle is responsible for the development of male (micro) and female (macro) gametes?

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Sporogony (Sexual Cycle)

Which stage of the coccidian life cycle is responsible for the formation of infectious oocysts?

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Schizogony (Asexual Cycle)

In which stage do merozoites multiply within the host?

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20

It allows the formation of male (micro) and female (macro) gametes, which fuse to form a zygote before developing into an oocyst

What is the significance of gametogony in the coccidian life cycle?

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Unsporulated oocyst.

What is the diagnostic stage of coccidians?

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Sporulated oocyst

What is the infective stage of coccidians?

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The sporozoites are released and invade host cells

What happens to the zygote after gametogony?

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Schizont formation

What stage follows the invasion of host cells by sporozoites?

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To infect a new host when ingested

What is the function of a sporulated oocyst?

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An unsporulated oocyst is immature and non-infectious, while a sporulated oocyst contains sporozoites and is infectious

What is the difference between an unsporulated and a sporulated oocyst?

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Merozoites are produced through asexual reproduction

What happens inside the schizont?

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They infect new host cells and continue the cycle by forming more schizonts or entering gametogony

What is the function of merozoites in the coccidian life cycle?

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  • Gametogony → Host’s GI Tract

  • Sporogony → Environment

  • Schizogony → Host’s GI Tract

Where does each stage of the life cycle occur?

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In the host’s GI tract

Where does gametogony occur in the host?

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In the environment.

Where does sporogony take place?

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32

In the host’s GI tract.

Where does schizogony occur in the host?

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It undergoes sporogony, developing into a sporulated oocyst

What happens to the unsporulated oocyst in the environment?

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4 sporocysts, each containing 2 sporozoites

What does the sporulated oocyst contain?

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By ingesting a sporulated oocyst from contaminated food, water, or surfaces

How does the host get infected?

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  • Good sanitary practices

  • Adequate water treatment (boiling water)

  • Proper washing of fruits and vegetables

What are the key methods for preventing and controlling coccidian infections?

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Boiling water kills the infective oocysts, preventing transmission.

Why is boiling water recommended for water treatment in coccidian prevention?

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No, chlorination is NOT effective against coccidian oocysts.

Is chlorination effective in killing coccidian oocysts?

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Immature (unsporulated) oocyst

What is the diagnostic stage of Cystoisospora belli?

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Mature (sporulated) oocyst

What is the infective stage of Cystoisospora belli?

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Tropical countries with poor sanitary conditions

In what type of environment is Cystoisospora belli most commonly found?

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Day care centers and mental institutions

Where are common places where Cystoisospora belli infections can occur?

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Severe diarrhea

What symptom is commonly associated with Cystoisospora belli infection, particularly in infants?

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Humans

What is the only known host for Cystoisospora belli?

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Ingestion of sporulated (mature) oocysts

How is Cystoisospora belli transmitted?

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2 sporocysts, each containing 4 sporozoites

How many sporocysts and sporozoites are present in a mature oocyst of Cystoisospora belli?

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8 sporozoites

How many sporozoites does Cystoisospora belli have in total?

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Distal duodenum and proximal ileum

Where does Cystoisospora belli primarily inhabit (habitat) within the human gastrointestinal tract?

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They differentiate into microgametes and macrogametes, which eventually form zygotes.

How do merozoites contribute to the sexual cycle of Cystoisospora belli?

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The oocyst lyses, releasing sporozoites.

What happens when the oocyst reaches the stomach?

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The sporozoites infect the intestinal cells, particularly in the distal duodenum and proximal ileum.

Where do the sporozoites infect the host?

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No, it is generally asymptomatic in immunocompetent individuals.

Is Cystoisospora belli infection always symptomatic?

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Cystoisosporiasis

What disease is caused by Cystoisospora belli?

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  • Fever

  • anorexia

  • diarrhea

  • vomiting

  • body malaise

  • weight loss

What are common symptoms of cystoisosporiasis?

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  • Prolonged diarrhea

  • fat malabsorption

  • potential dissemination to other organs.

What are complications of severe Cystoisospora belli infections?

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fat malabsorption

What specific type of malabsorption is associated with severe Cystoisospora belli infection?

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  1. DFS (Direct Fecal Smear) / concentration techniques

  2. acid-fast staining

  3. phenol-auramine staining

  4. iodine staining.

What laboratory techniques are used to diagnose Cystoisospora belli?

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Eosinophilia and Charcot-Leyden crystals.

What additional findings may be seen in the stool of infected individuals?

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Charcot-Leyden crystals

What characteristic crystals may be seen in the stools of individuals infected with Cystoisospora belli?

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Entero-test (String Capsule) and Duodenal Aspirate.

What alternative tests can be used to detect Cystoisospora belli?

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They appear as translucent, oval structures measuring 20-33 µm x 10-19 µm.

How do Cystoisospora belli oocysts appear under a microscope, and what are their typical dimensions?

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Trimethoprim-Sulfamethoxazole (160/800 mg QID for 10 days).

What is the first-line treatment for Cystoisospora belli infection?

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Pyrimethamine and sulfadiazine for 7 weeks.

What is an alternative treatment option for Cystoisospora belli?

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  • Nepal

  • Peru

  • Haiti

  • United States

In which countries is Cyclospora cayetanensis commonly found?

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Children

Which population group is commonly affected by Cyclospora cayetanensis in Peru?

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Homosexual males

Which population group is commonly affected by Cyclospora cayetanensis in Haiti?

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Raspberries, lettuce, and basil pesto salad.

What are some food sources associated with Cyclospora cayetanensis outbreaks?

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It was originally called a Cyanobacterium-like body (CLB).

What was Cyclospora cayetanensis originally called?

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Cyclospora cayetanensis

It was originally called a Cyanobacterium-like body (CLB).

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4 sporozoites

What is the total number of sporozoites in a sporulated Cyclospora cayetanensis oocyst?

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By ingestion of a sporulated (mature) oocyst.

How is Cyclospora cayetanensis transmitted?

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  • 2 sporocysts, each with 2 sporozoites, making a total of 4 sporozoites.

How many sporocysts and sporozoites are present in a sporulated oocyst? (Cyclospora cayetanensis)

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Jejunum

Where does Cyclospora cayetanensis reside in the human body?

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Two cycles.

How many cycles of schizogony occur in the host’s GI tract?

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8–12 merozoites

How many merozoites are produced in the first generation of schizogony?

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4 merozoites

How many merozoites are produced in the second generation of schizogony?

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Cyclosporiasis

What disease is caused by Cyclospora cayetanensis?

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Yes, it is generally self-limiting.

Is Cyclosporiasis self-limiting?

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  • chronic,

  • intermittent alternating bouts of diarrhea and constipation,

  • malaise,

  • low-grade fever,

  • fatigue,

  • anorexia,

  • weight loss,

  • nausea, and

  • vomiting.

What are the symptoms of Cyclosporiasis?

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D-xylose malabsorption

What is a specific malabsorption issue associated with Cyclosporiasis?

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Diagnosis is made through visualization of oocysts in fecal specimens using:

  • direct fecal smear (DFS) / concentration techniques

  • acid-fast staining.

How can Cyclospora cayetanensis be diagnosed?

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Polymerase Chain Reaction (PCR).

What molecular technique can differentiate Cyclospora from Eimeria spp.?

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Fluorescent microscopy

What microscopy technique is used to detect Cyclospora oocysts?

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They appear as blue or green autofluorescent circles.

How do Cyclospora oocysts appear under fluorescent microscopy?

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No, it is self-limiting, and treatment may not always be necessary.

Is treatment always necessary for Cyclosporiasis?

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Trimethoprim-sulfamethoxazole (160/800 mg) twice daily for 7 days.

What is the first-line treatment for severe cases of Cyclosporiasis?

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  1. Cryptosporidium parvum

  2. Cryptosporidium hominis

What are the two main species of Cryptosporidium?

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Water contaminated with calf feces.

What is a common source of Cryptosporidium outbreaks?

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Person-to-person transmission.

What is the most common mode of Cryptosporidium transmission?

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Yes, nosocomial infections have been reported.

Can Cryptosporidium cause hospital-acquired infections?

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Cryptosporidium parvum.

Which Cryptosporidium species from calves can infect veterinary attendants and visitors in dairy farms and zoos?

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Cryptosporidium parvum.

Which Cryptosporidium species infects both humans and calves?

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Cryptosporidium hominis.

Which Cryptosporidium species mainly infects humans?

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By ingestion of thick-walled oocysts.

How is Cryptosporidium spp. transmitted?

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Yes, they are already infective.

When Cryptosporidium oocysts are passed out, are they immediately infectious?

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Four sporozoites.

How many sporozoites does each Cryptosporidium oocyst contain?

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No, it does not contain a sporocyst.

Does Cryptosporidium oocyst contain a sporocyst?

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Thick-walled oocysts and thin-walled oocysts.

What are the two types of Cryptosporidium oocysts?

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They are passed out in feces and serve as the infective form for new hosts.

What is the function of thick-walled oocysts?

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They remain inside the intestine and cause autoinfection, contributing to chronic infection.

What is the function of thin-walled oocysts?

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