PARASITOLOGY REVIEWER

FINAL EXAM

B. LIFE CYCLE
1. ARTHROPODS (MOSQUITOES)
TYPE OF PARASITE: Plasmodium falciparum
A. PARASITE BIOLOGY
 Most virulent parasite in humans
 Obligate parasites
 Its morphology depends on the diagnostic
stage/form:
o TROPHOZOITES – small, range
between 1.25 – 1.5 µm. it has thin
cytoplasm, is vacuolated, and has
a single nucleus. Early
trophozoites may have a signet
ring shape.
o SCHIZONTS – measuring 4.5 – 5
µm, it only occupies two-thirds of The bite of the female Anopheles mosquito
RBCs. They are characterized by introduces sporozoites into the human host, which
having 2-4 merozoites (as they mature as they travel to the liver and ultimately the
mature, they may contain 30 bloodstream. After a blood meal from an infected
merozoites). These are small and person, the malarial gametocytes enter the
immobile representing the mosquito’s midgut, transforming into male
dividing form of the parasite. microgametes and female macrogametes.
o GAMETOCYTES – sexual forms Their union leads to a zygote, which transforms
of the parasite, crescent-shaped into an ookinete, penetrates the intestinal wall of the
cell. It has separate sexes and is mosquito, and is transformed into a circular oocyst.
about the size of 1 ½ of a normal Inside the oocyst, the sporozoites develop from
RBCs. This form is infectious to germinal cells known as sporoblasts. The sporozoites
mosquitoes. emerge from the oocysts and migrate to the salivary
o SPOROZOITES – infective to gland, entering the human hosts during the
humans, has a thick pellicle, mosquito’s blood meal.
mitochondrion, and a sickle-
shaped nucleus. It measures 10
and 15 µm and is capable of C. DISEASE
locomotion because of peripheral
fibers.  Malaria disease is caused by several
Plasmodium spp.; however, Plasmodium
 It has a RING FORM that is found inside
falciparum can cause severe and life-threatening
the red blood cells
Malaria.
 Have delicate cytoplasm and 1 or 2 small
 Severe Malaria occurs when infections are
chromatin dots
complicated by serious organ failures or
 MAIN VECTOR – FEMALE
abnormalities in the patient’s blood or
ANOPHELES
metabolism.
o MANIFESTATIONS OF P. falciparum:
 Cerebral malaria – with
abnormal behavior, impairment
of consciousness, seizures,
coma, or other neurologic
abnormalities.
 Severe anemia due to hemolysis
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 Hemoglobinuria due to  Treat the patient with oral antimalarials while
hemolysis waiting for IV artesunate to arrive. Options
 Acute respiratory distress include artemether-lumefantrine (Coartem®)
syndrome (ARDS) – (preferred), atovaquone-proguanil (Malarone
inflammatory reaction in the TM), or quinine. Once the IV artesunate
lungs that inhibits oxygen arrives, start the IV artesunate and discontinue
exchange. It may occur even the oral antimalarial.
after the parasite is decreased in
response to treatment.
 Abnormalities in blood E. SYMPTOMS
coagulation
 Low blood pressure caused by  SYMPTOMS OF SEVERE MALARIA:
cardiovascular collapse o Fever
 Acute kidney injury o Flu-like illness
 Hyperparasitemia o Shaking chills, muscle aches, headache,
 Metabolic acidosis – excessive and tiredness
acidity in blood and tissue o Nausea, vomiting, and diarrhea may
fluids; can be associated with occur
hypoglycemia. o May cause anemia or jaundice
o If not promptly treated, it may cause
o SYMPTOMS OF SEVERE MALARIA: kidney failure, seizures, mental
 Fever confusion, coma, and death.
 Flu-like illness
 Shaking chills, muscle aches,
headache, and tiredness F. PREVENTION
 Nausea, vomiting, and diarrhea
may occur To lower your chances of getting malaria, you should:
 May cause anemia or jaundice
 If not promptly treated, it may  Apply mosquito repellent with DEET
cause kidney failure, seizures, (diethyltoluamide) to exposed skin.
mental confusion, coma, and  Drape mosquito netting over beds.
death.  Put screens on windows and doors.
 Treat clothing, mosquito nets, tents, sleeping
D. TREATMENT bags, and other fabrics with an insect repellent
called permethrin.
 CDC recommends that the treatment of malaria
should not be initiated until the diagnosis has  Wear long pants and long sleeves to cover your
been confirmed by laboratory testing. Treatment skin.
should be initiated immediately after the  There’s a vaccine for children which was
confirmation of malaria infection. Empirical developed and tested in Ghana, Kenya, and
treatment is, however, reserved only for extreme Malawi in a pilot program. The RTS, S/AS01
cases where there is a strong clinical suspicion vaccine is effective against Plasmodium
with convincing exposure history, the presence falciparum malaria, which causes severe disease
of severe disease, or an inability to diagnose in children.
malaria due to inadequate laboratory facilities.
 Severe malaria should be treated with
intravenous (IV) antimalarial medications. IV
ARTESUNATE is the first-line drug for the
treatment of severe malaria in the United
States. Artesunate for injections was approved
by FDA.
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 METAZOONOSES – requires both
vertebrate and invertebrate species to
complete the life cycle.
2. SPECIAL TOPICS IN PARASITOLOGY  4 types:
 Type I – 1 vertebrate
A. PARASITIC ZOONOSIS and invertebrate e.g.,
ZOONOSIS – those diseases and infections which are Dipylidium caninum
naturally transmitted between vertebrate animals and  Type II – 2
man. invertebrates and 1
vertebrate host e.g,
CLASSIFICATIONS OF PARASITIC ZOONOSIS paragonomiasis
o BASED ON ETIOLOGICAL AGENTS  Type III – 1
invertebrate and two
vertebrate host e.g.,
clonorchiasis
 Type IV – transovarian
transmission e.g.,
Babesia divergens
(babesiosis)
 SAPROZOONOSES – requires non-
animate material in addition to their host
for completion of life cycle.
 3 categories:
 Saproanthropozoonoses
– animals act as
reservoir host and
o BASED ON THE TRANSMISSION CYCLE
transmitted from
 DIRECT PARASITIC ZOONOSIS – animals to man through
transmitted by direct contact or inanimate material e.g.,
indirectly through food e.g., scabies, larva migrans, myiasis.
trichinellosis, giardiasis, etc.
 Saproamphixenoses –
 CYCLOZOONOSES – requires two or
both animals and
more vertebrate host to complete life
humans could act as
cycle of the parasite
reservoir hosts and
 2 categories:
transmitted through
 Obligatory inanimate objects e.g.,
cyclozoonoses – micronemosis
humans must act as host
 Saprometanthropozoono
to complete the
ses – requires vertebrate
parasite’s life cycle.
host, invertebrate host
e.g., Taenia solium
and inanimate substance
 Non-obligatory for transmission of
cyclozoonoses – disease e.g., fasciolosis
humans are not required
to complete life cycle o BASED ON RESERVOIR HOST
but can act as accidental
host. e.g., human
hydatidosis.
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o Transmitted to animals and people by
insect vectors and is found only in Latin
America
 Cysticercosis
o Parasitic tissue infection caused by
larval cysts of tapeworm Taenia solium.
o Can infect brain, muscle or other tissue,
o BASED ON PRINCIPAL HOST INVOLVED and other onset seizures in most low-
income countries.
 Dengue fever
o Spreads to people through the bite of an
infected Aedes species
o Almost all people were at risk of dengue
o It is the leading cause of illness in areas
with risk
 Dracunculiasis (guinea worm disease)
o Caused by Dracunculus medinensis
o Affects poor communities in remote
parts of Africa that do not have safe
water to drink
 Echinococcosis
o Caused by tiny tapeworms of the genus
Echinococcus and is classified either
cystic echinococcosis or alveolar
echinococcosis
B. NEGLECTED TROPICAL DISEASES
o Cystic echinococcosis – also hydatid
(NTDs)
disease, caused by infection with larval
stage of Echinococcus granulosus
 These are the diverse groups of 20 condition
o Alveolar echinococcosis – caused by the
that are prevalent in tropical areas like
Africa, Asia, and Latin America where infection with larval stage of
people do not have access to clean water or Echinococcus multilocularis.
safe ways to dispose human waste.  Fascioliasis
o
 These conditions were mainly related to
environmental conditions. Many of them are  Human African trypanosomiasis (African
vector-borne, have animal reservoir and are Sleeping sickness)
associated with complex life cycle.  Leishmaniasis
 Leprosy (Hansen’s Disease)
LIST OF NTDs:  Lymphatic Filariasis
 Mycetoma
 Buruli ulcer –
 Onchocerciasis
o caused by Mycobacterium ulcerans
 Rabies
o mainly affects skin, also bone  Schistosomiasis
o infection leads to ulcers on arms or legs,  Soil-transmitted Helminths (STH – Ascaris,
which can destroy skin or soft tissue Hookworm, and whipworm)
o can cause irreversible deformity or long-  Trachoma
term functional disability
 Chagas disease
o Named after Carlos Chagas (1909) In the Philippines:
o Caused by the parasite Trypanosoma
cruzi  Leprosy
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FINAL EXAM
 Rabies
 Schistosomiasis
 Filariasis
 Soil-transmitted Helminths
 Food and water borne diseases