Kingdom: Protista = (Simplest of eukaryotic microorganisms)

Subkingdom: Protozoa
1-Phylum: Sarcomastigophora
Subphylum:1- Sarcodina ex. Entamoeba histolytica and E.Coli
2- Mastigophora ex. Leishmania Spp.
2-Phylum: Ciliphora (carrying cilia) Ex. Balantidium coli
3-Phylum: Apicomplexa: Like Plasmodium(Malaria).
BOTH ARE UNICELLUAR (PROTOZOA) PROTESITA
Amoeba Paramecium
 The Parameters of this study

We can study for each parasite

- Morphology of the organism.
- Life cycle, hosts and Vectors.
- Disease, symptoms, pathogenesis.
- Diagnosis, Prevention and control.
- Treatment.
Protozoa (PR0TO = PRMITIVE) (ZOA = ANIMAL)
General characters
1-Unicellular microorganism ( just one cell) eukaryotic with
true nucleus, cytoplasm. The nucleus contain karyosome.
2-The most important protozoan size range usually from 10 to
52 microns
3-They are seen by microscope
4-They move by a variety of organs pseudopodia, flagella and
cilia.
5-Perfom all metabolic mechanisms( e.g. movement, digesting,
excretion, reproduce by asexually and sexually…..etc).
6-They are found in different parts of the body intestine ,
blood and tissues, cavities like mouth, Uro-genital system.
7-Most intestinal protozoa have direct life cycle. They have
either:
A- cyst stage
It is non motile, non feeding, non active stage, it is the infective stage if the
parasite has trophozoite and cyst stage in the life cycle. It is diagnostic stage in
case of chronic infection. Transmitted to the human by contamination of food
and water.

B- Trophozoite stage ..
it is active, motile, feeding stage of parasite.
*it is the pathogenic stage of parasite.
*it is the diagnostic stage in case of acute infection.
C- Or It has only Trophozoite without cyst stage (trophozoite stage
will be the pathogenic, diagnostic and infective stage if the parasite has no
cyst stage).
GENERAL LIFE CYCLE OF
INTEST.PROTOZOA
Entamoeba histolytica Morphology
MOROPHOLOGY:
Trophozoite:has no fixed shape small active, motile by pseudopodia.
Cytoplasm divided into two portions ; a clear ectoplasm and a granular
endoplasm.
Movement is directional and pseudopodium is finger shape.
The granular endoplasm may contain ingested RBC by food vacuoles.
The organism has a single nucleus with a distinctive small central
karyosome.
Trophozoite is the only form present in tissues, it is also found in fluid feces
during amebic dysentery.Trophozoite also known active vegetative stage.
Mature Cyst:
It is both infective stage and diagnostic stage, spherical in
shape also contain 1 - 4 nuclei with a central karyosome
Life cycle
Life cycle
Intestinal infection:
Infection occurs orally by ingestion of cysts (Orally
fecally) contaminated food or hands

They passe into small intestine where it (Excystation)

giving four and then eight amoebae which move to the
large intestine.

The majority of the organisms are passed out of the

body with the feces but, with huge infection, some
amoebae attach to and invade the mucosal tissue
forming "flask-shaped" lesions (Intestinal amoebiasis).

Encystation happen in the rectum.

There are no intermediate or reservoir hosts.
 Entamoeba histolytica
Disease: AMEBIASIS (Amebic dysentery, amebic hepatitis).

Epidemiology: worldwide and more in underdeveloped country

50%.
Habitat: trophozoite in 1-large intesine 2-
extraintesinal infection. cyst only in large
intestine
Life cycle: direct no intermediate host.

Infective stage: is mature quadrinucleated cyst.

Pathogenic stage: only Trophozoite which seen in diarrheic acute

dysentery stool.
Diagnostic stage: cyst in chronic infection and trophozoite in
acute diarrhic infection.
Mode of infection: contamination of food and water
Humans are the principal host, although dogs, cats and rodents
 Symptoms
Acute: Frequent dysentery with necrotic mucosa and
abdominal pain. (symptomatic intestinal
amoebiasis).

Chronic: Recurrent dysentery with blood and mucus in the

feces. There are gastro-intestinal disturbances &
constipation cyst are found in stool.
Trophozoite may found in acute bloody dysenteric stool.
Cysts found in the chronic formed stool.
The organism may invade the liver, lung and brain
( Extra intestinal amoebiasis) where it produces abscess in
liver, lung brain…etc & this is called systemic infection.
Cysts: found in the chronic formed stool.
PATHOLOGY
Intestinal infection: Severity of the infection(Virulence factors
secreted by the parasite that causing the damage).
Extra-intestinal infection.
Intestinal ulcers /flasks shape ulcer with mouth and neck and
wide broad base: these ulcers are formed by trophozoites due
tissue lytic substances released by amoeba trophozoite which
damage and lysis the mucosal epithelium and then multiply to
form colonies inside the ulcer with abscess.
During multiplication of trophozoite in the intestine, it forming a
granulomatous growth or amoebic granuloma orAmoeboma.
Extra intestinal: (Systematic Infection).When amoebas penetrate
the radical of the portal vein and transport by circulation to the
liver causing Amoebic hepatitis and abscess.
Liver is the most common extra-intestinal organ.
sometimes brain, lung and spleen abscesses can also occur.
 PATHOLOGY
FLASK-SHAPED ULCER LIVER ABSCESS
 CLINICAL MANFESTATION IN SUMMARY
AMOEBIASIS
ASYMPTOMATIC 85-95% SYMPTOMATIC 5-15%

Intestina amoebiasis Extraintestina amoebiasis

*Amoebic dysentery (5% of symptomatic cases)
*Non -dysenteric colitis *Amoebic hepatitis
*Amoebic appendicitis *Amoebic liver abscess
*Posit-dysenteric colitis *Pulmonary amoebiasis
*Complication of all above *Cerebral amoebiasis
*Cutaneous amoebiasis
*Splenic abscess
*Urogenital tract amoebiasis
 LAB. DIAGNOSIS
Symptoms confirmed by finding Trophozoite in blood
diarrhea or cysts in the formed stool.
Distinct from bacillary dysentery due to lack and
absence PMN.
Differentiation must be made from nonpathogenic
intestinal protozoa (EX. Entamoeba coli).
 Prevention and control:
Determine:
 The source of infection by lab. Tests.
 Symptomatic cyst carriers detection.
 Diagnose and treat the cases.
 Improvement water supply and sewages.
 Good health education.
 Treatment
Iodoquinol drug for asymptomatic infections and
metronidazole(FLAGYLE) for symptomatic and chronic
amebiasis including extra intestinal disease are the drugs of
choice
The dose depends on:
1-Severity of the infection
2-Age of patients.
3-Infected organ.
Entamoeba coli :
• This parasite is non- pathogenic and
• live commensally in large intestine of human
• has the same life cycle ofE.histolytica
• but it differ in some properties
Differences between Entamoeba histolytica and E. coli
Entamoeba histolytica Entamoeba coli
Trophziotes Trophziotes
15–20 mm (invasive Eh can be > 20 20–25 mm
mm)
Finger-shaped pseudopodia Broad blunt pseudopodia

Progressive , directional movement Sluggish, non-directional movement

Nucleus with centric Nucleus with eccentric karyosome

karyosome

Mature cysts Mature cysts

12–15 mm 15–25 mm
4 nuclei 8 nuclei
Blunt chromatoid bodies Broad chromatoid bodies
Small amoeba
1-Entamoeba gingivalis
• This parasite live inside the mouth especially in
the gingival pockets,
• unable to form the cyst stage, so it’s direct
transmitted through direct contact or other
personal tools like teeth brushes.
Morphology
The tophozoites: ranges between 10 – 20
microns, highly active. No cyst stage.
Diagnosis
Mouth swab taken from the patient to see the
trophozoite of this parasite
Small amoeba
2-Endolimax nana( nana means dwarf or
small)
• Normal protozoa live in the human large intestine, very
small in size , has direct life cycle, also have two stages
trophozoite and cyst

• The trophozoite characteristic by a large blot-like

karyosome, and the lack of peripheral chromatin.

• The cysts are mature, they contain four nuclei that are
much smaller than the nuclei of the trophozoites and do
not have peripheral chromatin.

• The trophozoites are usually 8-10 µm in size, while the

cysts are usually 6-8 µm
Small amoeba
3.Iodamoeba butschilli
• Normal protozoa nonpathogenic , live in the
human large intestine, small in size , has direct life
cycle ,also have two stages trophozoite and cyst .

• Morphology
• Trophozoite size range between 9 – 13 micron , the
nucleus semispherical , have large karyosome
surrounded by chromatic granules.

• The cyst size is 8 – 13 micron oval or poly morph

, have only one basket shape nucleus in all stages
and a large mass of glycogen pushes the nucleus
aside.