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HAEMOFLAGELLATES. Dr.Rita Swaminathan Mr.Narayana Kamath. HAEMOFLAGELLATES. Protozoans living in blood &tissue of human Belong to Subphylum Mastigophora Two hosts are needed for completion of life cycle Leishmania & Trypanosoma are important human pathogens.
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HAEMOFLAGELLATES Dr.Rita SwaminathanMr.Narayana Kamath
HAEMOFLAGELLATES • Protozoans living in blood &tissue of human • Belong to Subphylum Mastigophora • Two hosts are needed for completion of life cycle • Leishmania & Trypanosoma are important human pathogens
Morphological characteristics of Haemoflagellates • Haemoflagellates have a single nucleus • A special structure –Kinetoplast (parabasal body &bleperoplast) • Parabasl body contains mitochondrial DNA • Bleperoplast give rise to flagellum
Morphological forms-Haemoflagellates • Amasitogote • Promastigote • Epimastigote • Trypomastigote • Differentiated on basis of 1.size&shape2.position of kinetoplast 3. Point of emergence of external flagella 4. Presence of an undulating membrane
Amastigote stage-Haemoflagellates axoneme kinetoplast nucleus
Promastigote stage -Haemoflagellates kinetoplast nucleus axoneme flagellum
Pathogenicity • Incubation period : 3-6 months • Visceral Leishmaniasis/kala azar • Amstigote forms multiply in Reticuloendothelial system • Spleen, liver, lymph nodes,bone marrow • Hepatospleenomegaly • Stimulation of CMI &AMI • Reversal of Albumin/Globulin ratio
Pathogenicity • Anemia,leucopenia & thrombocytopenia • Fever, malaise,headache • Hepatspleenomegaly &Lymphadenopathy • Skin is dry, rough & Pigmented • 75-95%of untreated cases die within 2 years • Death due to secondary infections
Laboratory diagnosis • Non-specific Lab tests : Blood count,hemoglobin estimation,Serum proteins,A:G ratio Parasitological diagnosis: Peripheral smear(amastogote forms) Lymph node,bone marrow,liver,Spleen :aspiration/needle biopsy(Giemsa-amastigote) Culture :Promastigote form Animal inoculation
Amastigote forms LD bodies LD bodies
Laboratory diagnosis • Immunological tests • Non-specific tests:Aldehyde test Antimony test Complement fixation test with W.K.K antigen(Witebsky,Kleingenstein& Kunh) Specific tests:Direct agglutination(DAT) IHA,Indirect fluorescent antibody test ELISA ,Leishmanin or Montenegro test
POST KALA AZAR DERMAL LEISHMANIASIS(PKDL) • As a result of therapeutic cure from viscereal leishmaniasis,due to reversal of the agent from viscerotropc to dermatotropic • Differentialdiagnosis: Malaria,trypanosomiasis,schistosomiasis,liver abscess,splenomegaly,histoplasmosis,TB,brucellosis…etc.
Treatment • Pentavalent antimonials Sodium stibogluconate Meglucomine anitmoniate Aromatic diamidines: Monomycin Paromycicn Aminosidine Amphotericin B