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PARASITOLOGY 
(apicomplexa)
Apicomplexa ( Sporozoa) 
-all apicomplexans are obligate intracellular parasites 
and have an apical complex. 
-elongated shape 
APICAL COMPLEX 
micronemes 
Rhoptries 
Polar rings 
-apicomplexans replicate via schizogony.
3 Distinct processes of Apicomplexan Life 
Cycle 
 Sporogony-asexual reproductive phase 
 Gamogony/gametogony-sexual phase 
Female gametes + Male gametes = 
ookinete/sporoblast 
 Merogony-asexual reproduction; cellular 
products are called merozoites.
Parasitology (apicomplexa)
Diseases cause by 
Apicomplexan Organism 
Babesiosis 
Malaria 
Forms of cocciodiosis including 
-Cryptosporidiosis 
-Cyclosporiasis 
-Isosporiasis 
-Toxoplasmosis
CRYPTOSPORIDIUM 
PARVUM
Cryptosporidium parvum is a 
protozoan and an obligate intracellular 
parasite (a parasite that cannot survive 
without a host) that commonly causes 
an opportunistic infection in 
immunocompromised hosts. 
C. parvum is considered to be the most 
important waterborne pathogen in 
developed countries.
Disease cause by C.parvum 
• Cryptosporidiosis (krip-to-spo-rid-e-O-sis), 
is a diarrheal disease caused by 
microscopic parasites, Cryptosporidium, 
that can live in the intestine of humans and 
animals and is passed in the stool of an 
infected person or animal. Both the 
disease and the parasite are commonly 
known as "Crypto"..
Morphology 
Oocysts 
• Size: 4-6 μm. 
• Morphology: round, 
oval 
• They are mainly 
located in the jejunum.
Life cyle
Life Cycle 
•Crypto begins its life cycle as sporulated 
oocysts (1) which enter the environment 
through the feces of the infected host. 
•The infective oocysts reside in food and 
water (2). 
•Infection occurs when the oocysts are 
ingested by a suitable host (3)
Mode of transmission 
Swallowing pool water that has been contaminated 
with the parasite 
In contaminated food or drink (called heteroinfection). 
By faeco-oral route (hand to mouth) in already 
infected patient ( called external autoinfection). 
by touching your mouth after touching the 
stool of infected persons or animals or touching soil or 
objects contaminated with stool.
Pathogenesis 
•Increased intestinal secretion of sodium 
and chloride, water absorption is inhibited 
•Epithelial cells damaged by: 
•Parasite invasion and multiplication 
•May produce up to 10-20 liters of watery 
stools per day
Symptoms 
•The first signs and symptoms of 
cryptosporidium infection usually appear 
within a week after infection and may 
include: 
•Watery diarrhea 
•Dehydration 
•Lack of appetite 
•Weight loss
Stomach cramps or pain 
Fever 
Nausea 
Vomiting 
Symptoms may last for up to: 1-14 days, 
though they may come and go 
sporadically for up to a month, even in 
people with healthy immune systems. 
Some people with cryptosporidium 
infection may have no symptoms
TREATMENT 
• paromomycin, may reduce the symptoms 
of crypto 
• drink plenty of fluids. 
• Nitazoxanide has been FDA-approved for 
treatment of diarrhea caused by 
Cryptosporidium
Treatment 
HIV-positive individuals who suspect they 
have cryptosporidiosis should contact their 
health care provider. For those persons 
with AIDS, anti-retroviral therapy that 
improves the immune status will also 
decrease or eliminate symptoms of 
cryptosporidiosis. However, even if 
symptoms disappear, cryptosporidiosis is 
often not curable and the symptoms may 
return if the immune status worsens.
Prevention 
1. The easiest way to prevent cryptosporidiosis is 
to practice good hygiene, especially after using 
the toilet.. b. After handling animals 
2. After touching dirt 
3. Before preparing food 
4. Avoid drinking untreated water 
5. Peel and rinse fruits and vegetables 
6. Follow water advisories 
7. Boiling and microfiltration of drinking water
CYLOSPORA CAYETONENSIS
General Characteristics 
•is an apicomplexan, cyst-forming 
coccidian protozoan that causes 
a self-limiting diarrhea 
•unicellular parasite that causes an 
intestinal infection called cyclosporiasis. 
• Acid-fast variable, have been found in 
the feces of immunocompetent 
travellers. 
Pathogenic
Morphology 
•has sphericaloocysts that are between 7.5 
and 10 micrometers in diameter. 
•a 50-nanometer-thick wall with an outer 
threadlike coat called a wrinkle
Mode of Transmission: 
• By drinking water or eating food that's been 
contaminated by an infected person. 
• type of sanitation and contact with soil 
• direct person to person transmission 
• through the fecal-oral 
• visiting regions where the species is 
endemic.
Life Cycle
Sign and Symptoms 
•Nausea 
•Vomiting 
•Muscle aches 
•Low-grade fever 
•Fatigue 
•General feeling of 
unwellness 
•Burping 
•Stomach cramps 
• Watery diarrhea 
• Frequent and 
sometimes 
explosive bowel 
movements 
• Bouts of diarrhea 
alternating with 
bouts of constipation 
• Loss of appetite
25 
Prevention 
• The simplest one is to warn travelers 
not to visit regions where the protozoan 
is endemic. 
•Individuals in endemic areas should 
wear gloves when gardening to prevent 
exposure to oocysts. 
•Thorough washing may help remove 
oocysts.
Therapy 
•Patients have been treated symptomically 
with antidiarrheal preparations and have 
obtained some relief; 
•Trimethoprin(TMP-SMX) 
•orally twice daily for seven days. 
Elimination of parasites a decrease in 
diarrhea. 
diminished abdominal pain occur 
within 2-3 days after treatment. 
•Patients with AIDS needs higher dose and 
long term
Sarcocystis 
spp.
Sarcocystis spp. 
General Characteristics: 
-Two well described Sarcocystis spp. include 
S. bovihominis(cattle) and S. suihominis (pig). 
When uncooked meat from this infected 
animals ingested by humans, 
gamogony(fission resulting in the production 
sporozoan gametes) can occur in the 
intestinal cells, with eventual production 
sporocysts in stool.
-Sarcocystis spp. Have an obligatory 2 
hosts life cycle. 
Intermediate host(herbivores and 
omnivores)- infected through ingestion 
of sporocysts secrete in the feces of the 
definitive host. 
Definitive host (carnivores and 
omnivores)-Human who have ingested 
meat containing the mature sarcocysts 
serve as the definitive host.
For immunocompromised hosts: 
-fever 
-sever diarrhea 
-abdominal pain 
-weight loss. 
-Sporocysts found in the stool are broadly 
oval and slightly tapered at the ends. 
- 9-16 um long
Pathogenesis and Spectrum of Disease 
-when human ingests oocysts from other 
animal stool sources, the sarcocysts that 
develop in human muscle are 7-16 um long 
and cause few problems. Basically, no 
inflammatory response, no evidence of 
pathogenicity is seen. 
CORTICOSTEROIDs- reduce allergic 
inflammatory reactions.
Ingestion of Infected meat manifests 
primarily intestinal disease within few 
hours after consumption, characterized 
by; 
Nausea 
Abdominal pain 
Diarrhea 
However, patients may be 
asymptomatic.
Prevention 
Cooking meat to an internal temperature higher than 
67degree kills taxoplasma gondii tissue cysts in meat. 
Preventing cattle, buffalos, and swine from 
consuming human feces shedding infective oocysts 
also prevents animal infection. 
When human are intermediate hosts, preventive 
measures involve careful disposal of animal feces 
that may contain the infective sporocysts.
Treatment 
•no known treatment or prophylaxis is 
available for intestinal infection, myositis, 
vasculitis, or related lesions caused by 
human sarcocystosis. 
•Supportive therapy for patients with 
severe diarrhea is indicated.
MICROSPORIDIA
 MiCROSPORIDIA 
= intracellular spore - forming parasites; 
=clinical manifestations of 
microsporidiosis include intestinal, 
pulmonary, ocular, muscular, and renal 
disease. Microsporidiosis has been 
identified in immunosuppressed 
hosts ,travelers, children, and the elderly. 
=shared the same features with fungi
Morphology 
-spores are all round and oblong, and those 
associated with human infection tend to be 
about 1-4 um size.
THE LIFE CYCLE
Transmission: 
• human-to-human 
• animal-to-human 
• water transmission 
• inhalation or ingestion
DIAGNOSTIC TESTS 
Fecalysis 
Urinalysis 
Other body fluid or tissues 
Transmission electron microscopy-gold 
standard for identifying specific spp.
PREVENTION 
•NO vaccine available 
•Filtrating water supply 
•Taking precaution when handling body 
fluids 
•Improving personal hygiene(e.g 
handwashing)
THERAPY,TREATMENT 
Albendazole- Gastro, muscle, 
disseminated and ocular infections. 
Metronidazole- E. bieneusi and others. 
Fumagillin- Keratoconjunctivitis and ocular 
lesions (Encephalitozoon spp. B. algarae, E. 
hellum, E. cuniculi, V. corneae); Not 
approved by FDA for microsporidiosis.
Parasitology (apicomplexa)

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Parasitology (apicomplexa)

  • 2. Apicomplexa ( Sporozoa) -all apicomplexans are obligate intracellular parasites and have an apical complex. -elongated shape APICAL COMPLEX micronemes Rhoptries Polar rings -apicomplexans replicate via schizogony.
  • 3. 3 Distinct processes of Apicomplexan Life Cycle  Sporogony-asexual reproductive phase  Gamogony/gametogony-sexual phase Female gametes + Male gametes = ookinete/sporoblast  Merogony-asexual reproduction; cellular products are called merozoites.
  • 5. Diseases cause by Apicomplexan Organism Babesiosis Malaria Forms of cocciodiosis including -Cryptosporidiosis -Cyclosporiasis -Isosporiasis -Toxoplasmosis
  • 7. Cryptosporidium parvum is a protozoan and an obligate intracellular parasite (a parasite that cannot survive without a host) that commonly causes an opportunistic infection in immunocompromised hosts. C. parvum is considered to be the most important waterborne pathogen in developed countries.
  • 8. Disease cause by C.parvum • Cryptosporidiosis (krip-to-spo-rid-e-O-sis), is a diarrheal disease caused by microscopic parasites, Cryptosporidium, that can live in the intestine of humans and animals and is passed in the stool of an infected person or animal. Both the disease and the parasite are commonly known as "Crypto"..
  • 9. Morphology Oocysts • Size: 4-6 μm. • Morphology: round, oval • They are mainly located in the jejunum.
  • 11. Life Cycle •Crypto begins its life cycle as sporulated oocysts (1) which enter the environment through the feces of the infected host. •The infective oocysts reside in food and water (2). •Infection occurs when the oocysts are ingested by a suitable host (3)
  • 12. Mode of transmission Swallowing pool water that has been contaminated with the parasite In contaminated food or drink (called heteroinfection). By faeco-oral route (hand to mouth) in already infected patient ( called external autoinfection). by touching your mouth after touching the stool of infected persons or animals or touching soil or objects contaminated with stool.
  • 13. Pathogenesis •Increased intestinal secretion of sodium and chloride, water absorption is inhibited •Epithelial cells damaged by: •Parasite invasion and multiplication •May produce up to 10-20 liters of watery stools per day
  • 14. Symptoms •The first signs and symptoms of cryptosporidium infection usually appear within a week after infection and may include: •Watery diarrhea •Dehydration •Lack of appetite •Weight loss
  • 15. Stomach cramps or pain Fever Nausea Vomiting Symptoms may last for up to: 1-14 days, though they may come and go sporadically for up to a month, even in people with healthy immune systems. Some people with cryptosporidium infection may have no symptoms
  • 16. TREATMENT • paromomycin, may reduce the symptoms of crypto • drink plenty of fluids. • Nitazoxanide has been FDA-approved for treatment of diarrhea caused by Cryptosporidium
  • 17. Treatment HIV-positive individuals who suspect they have cryptosporidiosis should contact their health care provider. For those persons with AIDS, anti-retroviral therapy that improves the immune status will also decrease or eliminate symptoms of cryptosporidiosis. However, even if symptoms disappear, cryptosporidiosis is often not curable and the symptoms may return if the immune status worsens.
  • 18. Prevention 1. The easiest way to prevent cryptosporidiosis is to practice good hygiene, especially after using the toilet.. b. After handling animals 2. After touching dirt 3. Before preparing food 4. Avoid drinking untreated water 5. Peel and rinse fruits and vegetables 6. Follow water advisories 7. Boiling and microfiltration of drinking water
  • 20. General Characteristics •is an apicomplexan, cyst-forming coccidian protozoan that causes a self-limiting diarrhea •unicellular parasite that causes an intestinal infection called cyclosporiasis. • Acid-fast variable, have been found in the feces of immunocompetent travellers. Pathogenic
  • 21. Morphology •has sphericaloocysts that are between 7.5 and 10 micrometers in diameter. •a 50-nanometer-thick wall with an outer threadlike coat called a wrinkle
  • 22. Mode of Transmission: • By drinking water or eating food that's been contaminated by an infected person. • type of sanitation and contact with soil • direct person to person transmission • through the fecal-oral • visiting regions where the species is endemic.
  • 24. Sign and Symptoms •Nausea •Vomiting •Muscle aches •Low-grade fever •Fatigue •General feeling of unwellness •Burping •Stomach cramps • Watery diarrhea • Frequent and sometimes explosive bowel movements • Bouts of diarrhea alternating with bouts of constipation • Loss of appetite
  • 25. 25 Prevention • The simplest one is to warn travelers not to visit regions where the protozoan is endemic. •Individuals in endemic areas should wear gloves when gardening to prevent exposure to oocysts. •Thorough washing may help remove oocysts.
  • 26. Therapy •Patients have been treated symptomically with antidiarrheal preparations and have obtained some relief; •Trimethoprin(TMP-SMX) •orally twice daily for seven days. Elimination of parasites a decrease in diarrhea. diminished abdominal pain occur within 2-3 days after treatment. •Patients with AIDS needs higher dose and long term
  • 28. Sarcocystis spp. General Characteristics: -Two well described Sarcocystis spp. include S. bovihominis(cattle) and S. suihominis (pig). When uncooked meat from this infected animals ingested by humans, gamogony(fission resulting in the production sporozoan gametes) can occur in the intestinal cells, with eventual production sporocysts in stool.
  • 29. -Sarcocystis spp. Have an obligatory 2 hosts life cycle. Intermediate host(herbivores and omnivores)- infected through ingestion of sporocysts secrete in the feces of the definitive host. Definitive host (carnivores and omnivores)-Human who have ingested meat containing the mature sarcocysts serve as the definitive host.
  • 30. For immunocompromised hosts: -fever -sever diarrhea -abdominal pain -weight loss. -Sporocysts found in the stool are broadly oval and slightly tapered at the ends. - 9-16 um long
  • 31. Pathogenesis and Spectrum of Disease -when human ingests oocysts from other animal stool sources, the sarcocysts that develop in human muscle are 7-16 um long and cause few problems. Basically, no inflammatory response, no evidence of pathogenicity is seen. CORTICOSTEROIDs- reduce allergic inflammatory reactions.
  • 32. Ingestion of Infected meat manifests primarily intestinal disease within few hours after consumption, characterized by; Nausea Abdominal pain Diarrhea However, patients may be asymptomatic.
  • 33. Prevention Cooking meat to an internal temperature higher than 67degree kills taxoplasma gondii tissue cysts in meat. Preventing cattle, buffalos, and swine from consuming human feces shedding infective oocysts also prevents animal infection. When human are intermediate hosts, preventive measures involve careful disposal of animal feces that may contain the infective sporocysts.
  • 34. Treatment •no known treatment or prophylaxis is available for intestinal infection, myositis, vasculitis, or related lesions caused by human sarcocystosis. •Supportive therapy for patients with severe diarrhea is indicated.
  • 36.  MiCROSPORIDIA = intracellular spore - forming parasites; =clinical manifestations of microsporidiosis include intestinal, pulmonary, ocular, muscular, and renal disease. Microsporidiosis has been identified in immunosuppressed hosts ,travelers, children, and the elderly. =shared the same features with fungi
  • 37. Morphology -spores are all round and oblong, and those associated with human infection tend to be about 1-4 um size.
  • 39. Transmission: • human-to-human • animal-to-human • water transmission • inhalation or ingestion
  • 40. DIAGNOSTIC TESTS Fecalysis Urinalysis Other body fluid or tissues Transmission electron microscopy-gold standard for identifying specific spp.
  • 41. PREVENTION •NO vaccine available •Filtrating water supply •Taking precaution when handling body fluids •Improving personal hygiene(e.g handwashing)
  • 42. THERAPY,TREATMENT Albendazole- Gastro, muscle, disseminated and ocular infections. Metronidazole- E. bieneusi and others. Fumagillin- Keratoconjunctivitis and ocular lesions (Encephalitozoon spp. B. algarae, E. hellum, E. cuniculi, V. corneae); Not approved by FDA for microsporidiosis.