Test Four

Hematophagous Trophozoites

Trophozoites of Entamoeba histolytica shown with engulfed red blood cells.

1-3mm

Colonic ulcers caused by Entamoeba histolytica

Flask Shaped Ulcer

Characteristic of intestinal amebiasis caused by Entamoeba histolytica

“Anchovy Paste” pus

Amebic liver abscess comprised of reddish brown pus, necrotic tissue, immune cells, and parasites. Characteristic of Entamoeba histolytica.

Trophozoite and Cyst

Balantidium coli

Cilia and Cytosome

Balantidium coli. Only ciliate known to infect humans.

Large and Ovoid Intestinal Cocci

Cystoisospora belli

Mid sized intestinal cocci

Cyclospora cayetanensis

Tiny Intestinal Cocci

Cryptospridium hominis (most medically relevant)

Basophilic Stippling “knobs”

On the surface of P. Falciparum infected erythrocytes

Cellular “knobs”

Occur on P. falciparum infected red blood cells. Promoted agglutination of red blood cells.

Male and Female Ganetophytes

P. Falciparum reproductive phase. Occurs within the mosquito

Volcano Sign

Characteristic painless lesion with rolled edges. Characteristic of leishmaniasis major

Maltese Crosses

Charateric of babesiosis

Giemsa Stain

Thick blood smear detects parasites. Thin blood smears identify species. Gold standard for detection of P. falciparum

Ring forms

Trophozoites of F. falciparum within red blood cells

Blood Smear

Numerous ring form P. falciparum

Microscopy

P. falciparum. Shows the large gametophyte, basophilic Stippling (top left), and rings (bottom)

Lung X-Ray of 9 year old boy

Hilar lynphadenopathy characteristic of Tuberculosis in children.

Lung X-ray of a 5 month old

White spots are miliary tuberculosis lesions

Lungs from a cadaver

Yellow arrows show millet granulomas

What is this?

Primary granuloma formed from a chain reaction macrophages and other phagocytic cells undergoing Tuberculosis induced apoptosis and being engulfed by other phagocytic cells. Forms a “jail” around the tuberculosis organisms and renders them dormant

Cadaver lung

Blue arrows indicate calcified lymph nodes and the green arrows indicate calcified periferal lung lesions. The infection travels from the peripheral lesion and spreads to the node. These combined form the Ranke Complex.

X-ray of lungs

Shows a Ranke Complex. Indicates past, spontaneously resolved tuberculosis infection.

X-ray and Cadaver lung

Shows liquified granulomas consistent with reactivated (cavitary) tuberculosis

Patient’s back

Deformation of the back, consistent with extrapulmonary tuberculosis consistent with Pott Disease. Pott Disease is a form of extrapulmonary Tuberculosis that infects the bones and joints

What is this?

Swelling of the skin as a result of Tuberculosis skin testing

What is this?

Growth of Tuberculosis on Lowensten-Jensen (LJ) agar. Highly selective for TB but organism takes around 4 weeks to form visible colonies. Brown, granular appearance

What is this?

Acid fast stain on mycobacterium tuberculosis

What is this?

Auramine-Rhodamine stain of Mycobacterium tuberculosis. Bacteria flouresce and show up as a bright orange or yellow stain. Cheaper but less specific than acid fast/Ziehl-Neelsen

What is this?

Shows M. Leprae next to Shwann cell membrane. M. Leprae replicates in macrophages and Shwann cells. It results in demylination of the Shwann cell resulting in cell death and permanent nerve damage.

Skin lesion

Superficial pale, flat lesion characteristic of Tuberculoid leprosy.

Patient

Patient shows hair loss in eyebrows and earlobe nodules consistent with Lepromatous leprosy

Patient

Severe, chronic M. Leprae infection has led to permanent neuropathy and resorption of distal phalanges leading to multiple distl amputations

Patient

Leprosy lesions highlighted by healthy skin that is stained dark from anti-leprosy drug clofazimine

1

Active hypopigmented anesthetic plaque

2

Drug staining of healthy skin (light staining)

3

Heavy staining of the border of the lesion

4

Central healed “punched out” lesion

Patient

Buruli ulcer

Patient

Buruli ulcer

Patient

Buruli ulcer

Microscopy

Cell cycle arrest, apoptosis, necrosis caused by micobacterium ulcerans

Stain

Acid fast bacalli: mycobacterium ulcerans

X-ray and CT scan

Well defined, no calcified nodules, tissue necrosis (cavitation) caused by cryptospridium neoformans

Agar plate

Sabourad agar plate of cryptospridium neoformans

Stain

H&E stain showing capule of cryptospridium neoformans

Stain

India ink stain show capsule (white halo) of cryptospridium neoformans

What organism is this?

Top: candida albicans

Botton: candida albicans stains gram positive

What form of what organism is this?

Yeast form of candida albicans, least virulent

What form of what organism is this

Psuedohyphae of candida albicans. Medium virulence

What form of what organism is this?

Hyphae form of candida albicans. Most virulent

Patient

Diaper rash caused by candida albicans

Patient

Oral candidiasis

Patient

Candida esopagitis in recipient of cadaveric renal transplant

Chest X-ray

Pulmonary histoplasmosis caused by histoplasma capsulatum

Patient

Rash from disseminated histoplasmosis

Patient

Rash from disseminated histoplasmosis

Stain

Intracellular yeast of histoplasma capsulatum