Malarial Parasite Flashcards by LUIMER RAMOS

PLASMODIUM
● Normally transmitted by the bite of Plasmodium infected

female mosquito

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Vertebrates: asexual or sexual

asexual cycle (Schizogony)

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Invertebrate: asexual or sexual?

: sexual cylce (Sporogony)

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Stage:
● Feeding or growing stages in the asexual cycle
● Lives within the tissue cells

TROPHOZOITE

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Stage:
Sporozoan body during schizogony

SCHIZONT

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stage: ● Released from the infected cell
● Some will infect other tissue cells going back to the
trophozoite stage
● Others will be differentiated into male and female forms
(gametocytes)

MEROZOITES/ LATE SEGMENTERS

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IMMATURE SEXUAL FORM

. GAMETOCYTES -

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stage:
● Fertilized ovum/ova before cell division
● Union of macrogamete and microgamete

ZYGOTE

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○ Female gametocyte
○ Produce a macrogamete
○ Mature only to be fit for fertilization

MACROGAMETOCYTES

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○ Male gametocyte
○ Produce a group of microgametes

MICROGAMETOCYTES

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Mature sexual form of plasmodium

GAMETES

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○ Female gametocyte
○ Produce a macrogamete
○ Mature only to be fit for fertilization

A. MICROGAMETOCYTES

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○ Male gametocyte
○ Produce a group of microgametes

B. MICROGAMETOCYTES

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Male sex cells in sporozoa

MICROGAMETES

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○ Female sex cells in sporozoa

MACROGAMETES

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stage:
● Encysted zygote

OOCYST

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stage:
● end product of sexual multiplication of malarial parasites in
mosquito

SPOROZOITE

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stage: ● one of a number of bodies in many sporozoa into which the
zygotes divide and from which sporozoites are formed

SPOROBLAST

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stage:
● the separated membrane that surrounds a sporoblast and
subsequently the group of sporozoites formed from this
sporoblast

SPOROCYST

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● Fertilized ovum/ova before cell division
● Union of macrogamete and microgamete

ZYGOTE

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– rapidly multiplying stage in the development of the tissue phase of
certain organisms such as Toxoplasma gondii

Tachyzoites

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P.vivax cause what disease?

Benign Tertian Malaria

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Incubation Period of p.vivax

12-20 days

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Incubation Period:PLASMODIUM OVALE

11-16 days

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prepatent period of p.vivax

11-15 days

PLASMODIUM OVALE Has recently been shown by genetic methods to consist of two species

1) Plasmodium ovale curtisi (2) Plasmodium ovale wallikeri

Intermittent fever every 72 hours

PLASMODIUM MALARIAE

Prepatent period: PLASMODIUM OVALE

14-26 days

Intermittent fever every 48 hours

PLASMODIUM OVALE and p.vivax

The ____ can lead to severe disease and death due to splenomegaly

vivax malaria

P.ova causes what disease

Ovale Tertian Malaria

Incubation Period: PLASMODIUM MALARIAE

18-40 days

Prepatent period:PLASMODIUM MALARIAE

3-4 weeks

p.mala cause what disease

Quartan Malaria

MALARIAL PAROXYSM  3 STAGES:Symptoms would usually diminish at this stage

SWEATING STAGE

Causative agent PLASMODIUM FALCIPARUM

Malignant Tertian Malaria

MALARIAL PAROXYSM  3 STAGES: ● There is a sudden feeling of cold or a feeling of inappropriate convulsion ● characterized by mild shivering, violent teeth chattering ● Vomiting and febrile convulsions

1. COLD STAGE

Intermittent fever every 36-48 hours

PLASMODIUM FALCIPARUM

incubation Period PLASMODIUM FALCIPARUM

8-15 days

Prepatent period: PLASMODIUM FALCIPARUM

11-14 days

MALARIAL PAROXYSM  3 STAGES: Rigors last for 14-60 minutes

COLD STAGE

MALARIAL PAROXYSM  3 STAGES: ● Characterized by very high temperature of 40-41C

. HOT STAGE OR FLUSH PHASE

ERYTHROCYTIC CYCLE: 48 hours

P. FALCIPARUM:

MALARIAL PAROXYSM  3 STAGES: Manifests with headache ● palpitations , tachypnea, epigastric discomfort ● Because of the high temperature, thirst, nausea and vomiting ● Last for 2-6 hours

2. HOT STAGE OR FLUSH PHASE

MALARIAL PAROXYSM  3 STAGES: Temperature lowers over the next 2 to 4 hours because of the sweating

3. SWEATING STAGE:

MALARIAL PAROXYSM  3 STAGES: In this stage, there is also convulsion and the patient can become delirious because of the very high temperature and the skin is usually flushed and very hot

HOT STAGE OR FLUSH PHASE

ERYTHROCYTIC CYCLE: paroxysms occur on alternate days hence causing Tertian malaria

P. OVALE AND P VIVAX

MALARIAL PAROXYSM  3 STAGES: Total Duration: 8-12 hours

SWEATING STAGE:

ERYTHROCYTIC CYCLE: paroxysms 72 hours (on 1 and 4 days) ❖ Quartan malaria PICTURE: DISSEMINATED INTRAVAS

P. MALARIAE:

DIAGNOSIS: ❖ In P. falciparum only the____can be found which would usually be done 10 days after symptoms begin, gametocytes may be found.

ring form ; THICK AND THIN BLOOD FILM EXAMINATION

s Disseminated Intravascular Coagulation that can be seen in

P. falciparum

DIAGNOSIS: Malarial parasites: bright green and yellow under fluorescent microscope

QUANTITATIVE BUFFY COAT (QBC)

DIAGNOSIS: ❖❖ Special capillary tube coated with Acridine orange

QUANTITATIVE BUFFY COAT (QBC)

DIAGNOSIS:❖ Giemsa and Wright’s stain ❖ Specimen collection which can be done anytime every 6-8 hrs is appropriate)

THICK AND THIN BLOOD FILM EXAMINATIO

DIAGNOSIS: ❖ Only used for screening and needs thick, thin films

QUANTITATIVE BUFFY COAT (QBC)

DIAGNOSIS:Antigen capture test

PARASIGHT F TEST

DIAGNOSIS: High sensitivity and good specificity

PARASIGHT F TEST

DIAGNOSIS: This is a dip stick test for simple and rapid diagnosis of P. falciparum

PARASIGHT F TEST

DIAGNOSIS: PARASIGHT F TEST antigen

Ag: trophozoite-derived histidine-rich protein II (HRP-II)

TREATMENT To prevent establishment of the parasite in the liver

CAUSAL PROPHYLACTIC DRUGS

TREATMENT destroy the sexual form of parasite in the blood

GAMETOCYTOCIDAL DRUGS

MORPHOLOGY:  Ovoidal, pyriform or cresentic

TOXOPLASMA GONDII

TREATMENT attacks the parasite in red blood cells

BLOOD SCHIZONTICIDAL DRUGS

TREATMENT prevents the occurrence of the disease

HYPNOZOITICIDAL OR ANTI-RELAPSE

MODE OF TRANSMISSIONTOXOPLASMA GONDII

Ingestion of uncooked meat, fecal contamination, nasal route, transplacental

Drug of choice for malaria

CHLOROQUINE

TREATMENT it inhibits the development of the oocysts in the gut of the mosquitoes.

SPORONTICIDAL DRUGS:

MAIN USES OF ANTIMALARIAL DRUGS: MAIN USES OF ANTIMALARIAL DRUGS:

Curative-

MAIN USES OF ANTIMALARIAL DRUGS: prophylactic

Protective-

CHLOROQUINE combination

Pyrimethamine/sulfadoxine

So there is an exogenous asexual phase in the mosquito called the

sporogony

MODE OF REPRODUCTION TOXOPLASMA GONDII

longitudinal binary fission

drug for severe falciparum malaria

Quinine or quinidine:

TOXOPLASMA GONdii HOST:

cats

OPPORTUNISTIC SPOROZOANS:

1. Toxoplasma gondii 2. Cryptosporidium specie 3. Pneumocystis carinii 4. Isospora belli

TOXOPLASMA GONDII DISEASE:

Toxoplasmosis

T,gon infective stage

oocyst

ONE OF THE MOST COMMON HUMAN INFECTIONS THROUGHOUT THE WORLD

TOXOPLASMOSIS

IS A PROTOZOAN PARASITE THAT INFECTS MOST SPECIES OF WARM BLOODED ANIMALS INCLUDING MAN AND CAN CAUSE THE DISEASE

TOXOPLASMA GONDI

a high prevalence of infection in ___ has been related to a prevalence for eating raw or undercooked meat

France; t,gondi

high prevalence in ____ has been related to the frequency of stray cats in a climate favoring survival of OOCYST and soil exposure

central America; t.gondii

TISSUE STAGES IN MAN of T.gondi; fast rapid, multiplication, acute phase

TACHYZOITEs

TISSUE STAGES IN MAN of T.gondi ; slow proliferation during this stage, chronic phase

BADYZOITES

TISSUE STAGES IN MAN of T.gondi; Female who first to acquire the infection during pregnancy may transmit the infection to embryo resulting in fetal death, or mental retardation on newborn, or blindness in later life

TACHYZOITES

TISSUE STAGES IN MAN of T.gondi ; Major cause of encephalitis in AIDS patients

TACHYZOITES

congenital or acquires toxoplasmosis? Regional lymph node invasion o Intracellular multiplication in various organ

ACQUIRED TOXOPLASMOSIS

TISSUE STAGES IN MAN of T.gondi  Toxoplasma divide in tissues of man as tachyzoites  Associated with RES, or endothelium of the circulatory system  Serous fluids in body cavities  Necrosis of the invaded area  Pseudocysts (group of bradyzoites) are also formed

TACHYZOITES

congenital or acquires toxoplasmosis? o Occurs in 1-2% per 1000 pregnancies o Severe and fatal

CONGENITAL TOXOPLASMOSI

congenital or acquires toxoplasmosis? Hydrocephaly, choiretinitis, microcephaly, psychomotor disturbances and convulsions

CONGENITAL TOXOPLASMOSIS

 Appears after the infection and regional lymph node invasion  Parasite is blood borne to many organs where intracellular multiplication takes place

Acquired toxoplasmosis:

congenital or acquired toxoplasmosis? Clinical course: Usually benign and self-limited o Symptoms usually resolve in a few weeks to months

ACQUIRED TOXOPLASMOSIS

congenital or acquires toxoplasmosis? , 10-20% of patients with acute infection may develop cervical lymphadenopathy and flu-like illness

ACQUIRED TOXOPLASMOSIS

congenital or acquired toxoplasmosis? o Rare cases: ocular infection with visual loss can occur o Immunodeficient patients often have central nervous system disease that may have retinochoroiditis pneumonitis or other systemic disease

acquired toxoplasmosis

In patients with AIDS,____ is the most common cause of intracerebral mass lesions and is thought to usually because by the activation of chronic infection

toxoplasmic encephalitis

Toxoplasmosis in patients being treated with immunosuppressive drugs may be due to either

newly acquired or reactivated latent infection

CRYPTOSPORIDIUM SPECIES DIAGNOSTIC STAGE:

oocyst with 4 naked sporozoites

CRYPTOSPORIDIUM SPECIES INFECTIVE STAGE:

sporozoites

PATHOGENESIS ● acute , self-limiting diarrhea of 1-2 weeks duration ● Intense abdominal pain and bloating, anorexia, weakness

CRYPTOSPORIDIUM SPECIES

CRYPTOSPORIDIUM SPECIES DIAGNOSIS \● observe for mucosal changes and partial villous atrophy ● Trophozoites, schizonts, and merozoites can be found in the microvilli

. BIOPSIES OF ILEUM AND JEJUNUM:

CRYPTOSPORIDIUM SPECIES DIAGNOSIS; ● Perform DFS and concentration techniques

2. CRYPTOSPORIDIUM OOCYSTS IN STOOL

PNEUMOCYSTIS JEROVECI (CARINII) / PNEUMOCYSTIS JEROVECI PNEUMONIA DISEASE

● Interstitial plasmacellular pneumonia or pneumocytosi

Most common opportunistic infection in patients with HIV infection

pNEUMOCYSTIS JEROVECI (CARINII) /

Organism is a rare cause of infection in the general population

PNEUMOCYSTIS JEROVECI (CARINII)

Frequent cause of morbidity and mortality in persons who are immunocompromised especially patients with acquired immunodeficiency syndrome (AIDS)

PNEUMOCYSTIS JEROVECI (CARINII)

is classified as a fungal pneumonia but does not respond to antifungal therapy

PCP (PNEUMOCYSTIS JEROVECI PNEUMONIA)

Incidence has decreased as a result of a highly active antiretroviral drugs

PCP (PNEUMOCYSTIS JEROVECI PNEUMONIA

PNEUMOCYSTIS JEROVECI HABITAT:

lungs

P.jiro MOT

airborne

○ small, round, with 8 uninucleated bodies

P.jiro cyst

crescent, sickle or pear-shaped with amoeboid movement

P.jiro troph

Alveolar septal infiltration with plasma cells

P.jiro

● In the lungs: honeycombed masses of parasites within the alveoli

P.jiro

P.jiro death due to

Asphyxia

a condition where the body does not get enough oxygen, if left untreated it can cause coma or death

ASPHYXIA; p.jiro

treatment for P.jiro

Trimethoprim- sulfamethoxazole is the drug of choice.

Recognized as a opportunistic small bowel pathogen in patients with HIV infection

ISOSPORA BELLI

P.jiro: The samples that we get will be stained ___ to demonstrate cyst and trophozoites

methenamine silver

diagnosis P.jiro

Percutaneous needle biopsy of the lungs and lung aspirates

I.bel disease

human coccidiosis

ISOSPORA BELLI INFECTIVE STAGE:

sporulated oocyst

Acute diarrhea with abdominal pain, it can be severe in immunocompromised patients and children, eosinophilia has also been reported

I.belli

Most commonly found in tropical and subtropical climates ● Can be diagnosed by identification of the oocyst in the stool or biopsy, stools through DFS

I.belli

MORPHOLOGY: ● Immature oocyst: ○ Elongate ovoidal ● Mature oocyst: ○ Contains 2 sporocyst, each containing 4 sporozoites

ISOSPORA BELLI

ISOSPORA BELLI habitat

small intestine of man

Infects epithelial cells in the small intestines ● Symptoms which can last for weeks and results in malabsorption and weight loss

I.belli

● Mild cases - mild abdominal pain and mucoid diarrhea

I.belli

Principal vector of plasmodium spp

Anopheles minismus var. flavirostris

what parasite: ➢ Single large compact ring or band forms

Plasmodium malariae

what parasite?Invades old RBCs

Plasmodium malariae

Schizont with merozoites arranges around central pigment (resembles fruit pie)

p.malariae

ovoid gametocyte

p.malar

Small ring forms (1/6 diameter red cell), applique forms, double nuclear dots

Plasmodium falciparum

Organisms invades all ages of red blood cells (most severe)

Plasmodium falciparum

arge pale red cells with Schuffner’s dots which may be oval and fimbriated

Plasmodium ovale

Single compact ring

Plasmodium ovale

Only reticulocytes are invaded

. Plasmodium vivax

remains the gold standard method for plasmodium spp identification

. Microscopic identification of the malarial parasites in thick and thin blood smears stained with Giemsa or Wright’s stain is still important in making the definitive diagnosis

produced by both sexual and asexual stages and can distinguish between P. falciparum and non-P. falciparum specie

Plasmodium LDH

Crescent/banana-shaped gametocytes

Plasmodium falciparum

Single large ring succeeded by amoeboid form in pale large red cel

Plasmodium vivax

Round gametocyte

. Plasmodium vivax

disease? sudden massive intravascular hemolysis resulting to hemoglobinuria

o Blackwater fever:

– detects Plasmodium-specific antigens; these target antigens are called HRP II (Histidine-rich protein

Immunochromatography

disease? red cells, organisms and pigment can block the brain vessels

Cerebral malaria

Plasmodium____ infection is most likely fatal

Plasmodium falciparum

36- 48 hours Paroxysm cycle

p.falci

72 hours

P.malariae

48 hours

p.ovale and p.vivax

appearance of RBC size: Normal

lasmodium malariae

infected rbc: Sometimes enlarged; frequently oval with ragged margins

p.ovale

Appearance of RBC size: Normal; multiply infected red blood cells are common

p.falci

infected rbc not enlarged

p.falci, malar, vivac

Appearance of RBC size; Enrlaged; maximum size may be 1 – 2 times normal RBC diameter

Plasmodium

Appearance of RBC size; Enlarged; approximately 20% or more of infected RBCs are oval and/or fimbriated (border has irregular projections)

Plasmodium ovale

Number of merozoites; 6 – 14; average is 8

p.oval

Number of merozoites; 12 – 24; average is 16

p.vivax

Number of merozoites; 6 – 32 (average is 20 – 24)

p. fal

Schuffner’s stippling (precipitated Hb): Maurer’s dots occasionally seen)

p. fal

Number of merozoites; 6 – 12 (average is 8); “rosette” schizonts

p,mal

Schuffner’s stippling (precipitated Hb): + (James’ dots; present in all stages except early ring forms)

P.oval

Parasite cytoplasm; Young rings are small, delicate, often with double chromatin dots; gametocytes are crescentshaped or elongated

p.fal

Schuffner’s stippling (precipitated Hb): (Ziemann’s dots rarely seen

P,mal

Schuffner’s stippling (precipitated Hb): + (Schuffner’s dots; present with all stages except in early ring forms)

P.vivax

Parasite cytoplasm Rounded, compact trophozoites with dense cytoplasm; band-form trophozoites

P.mal

Parasite cytoplasm Rounded, compact trophozoites; occasionally slightly amoeboid; growing trophozoites have large chromatin mass

P.oval

Parasite cytoplasm Irregular, ameboid trophozoites; has “spread out” appearance

P. vivax

Trophozoite: Amoeboid

P.vivax

Trophozoite: Accole or Applique forms May have multiple rings

p.falc

Appearance of parasite pigment: Black; coarse and conspicuous in gametocytes

P.fal

Least common Rarely fatal May cause relapses

P, oval

Appearance of parasite pigment: Dark brown, coarse, conspicuous

P.malar

Trophozoite; Band

P.malar

Appearance of parasite pigment: Golden brown, inconspicuous

P.vivax

Trophozoite: Red cell containing trophozoite may have fimbriated edges

P. oval

Appearance of parasite pigment: Dark brown, conspicuous

P.oval

Shape of gametocyte: Sausage or crescentshaped

P.falc

Stages seen in circulating peripheral blood: Rings and/or gametocytes; other stages develop in blood vessels of internal organs but are not seen in peripheral blood EXCEPT in severe infection

p.falc

Shape of gametocyte: round

P. mal, oval, vivac

Stages seen in circulating peripheral blood:All stages

P.oval

Stages seen in circulating peripheral blood: All stages; wide range of stages may be seen on any given film

p.vivax

Stages seen in circulating peripheral blood: All stages; wide variety of stages usually not seen; relatively few rings or gametocytes generally present

P,malar

Highy mortality

p,falc

Rarely fatal

p. malar

slowly multiplying trophozoite contained in the cyst of T. gondii

Bradyzoites

Most common Rarely fatal May cause relapses

p,vivax

extrusion of rapidly waving flagellum-like mircogametes from microgametocytes

Exflagellation

mature sex cell of plasmodia

▪ Gamete –

– immature sexual form of plasmodia (male microgametocyteor female microgametocyte) that is present in peripheral blood

Gametocyte

– development phase in the life cycle of malaria and coccidian parasites in humans in which male and female gametes are formed

Gametogony

– exoerythrocytic schizont of P. vivax and P. ovale in the human liver, characterized by delayed primary development; responsible for true relapse in malaria

Hypnozoite –

also known as schizogony; leading to the production of merozoites in some intestinal coccidians

Merogony –

– product of schizogonic cycle in malaria; produced in the liver (preerythrocytic cycle) and in the red blood cells (erythrocytic cycle); motile and infects the red blood cells

▪ Merozoite –

– encysted form of the ookinete that occurs in the stomach wall of Anopheles spp.

Oocyst

motile zygote of Plasmodium spp; formed by microgamete fertilization of macrogamete

▪ Ookinete –

ever, chills, sweats syndrome in malaria; spiking fever corresponds to the release of merozoites and toxic material from the rupturing parasitized red blood cells, and shaking chills occur during subsequent schizont development

Paroxysm

– increased severity of a disease after a remission or following treatment as a result of an inadequate immune response by the host or inadequate response to treatment

▪ Recrudescence –

a recurrence of illness/signs and symptoms of a disease after a period of improvement; In malaria, it is caused by the reactivation of hypnozoites in the liver that begins a new cycle in red blood cells; occurs only in Plasmodium vivax and P. ovale infections

▪ Relapse -

(Asexual cycle) occurs on the epithelial cells of the intestinal mucosa producing schizonts

Schizogony

developed stage of asexual division of the sporozoa; ruptures to produce merozoites

Schizont

occurs within the intestinal lumen of the invertebrate host. End product → sporozoite

Sporogony

slender, spindle-shaped organism; infective stage of malaria parasites; inoculated into humans by the bite of an infected female mosquito; It is the result of the sexual cycle in the Anopheles mosquito

Sporozoite

– rapidly multiplying stage in the development of the tissue phase of certain organisms such as Toxoplasma gondii

Tachyzoites

feeding or growing stage in the asexual cycle

Trophozoite

union of the macrogamete and microgamete; fertilized ovum/ova before cell division

Zygote

Malarial Parasite Flashcards

(215 cards)