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Balantidium coli,
Isospora, Cyclospora, Cryptosporidia,
Microsporidia & Sarcocystis
Dr. R. Someshwaran, MD.,Assistant professor,
Dept. of Microbiology,
Karpagam Faculty of Medical Sciences & Research,
OBJECTIVES
 To define etiology, morphology, life cycle,
disease caused, laboratory diagnosis and
treatment of Acid fast Intestinal parasitic
infections caused by Isospora, Cyclospora,
Cryptosporidia, Microsporidia and Sarcocystis
spp.,
 To define etiology, morphology, life cycle,
disease caused, laboratory diagnosis and
treatment of Balantidium coli infections
Balantidium
• Large protozoal parasite
• Phylum: Ciliophora
• Body covered with cilia (hair-like process)
• Two morphologically distinct nuclei
• Balantidium coli - pathogenic to human beings
• World wide in distribution
• Habitat: Large intestine of Humans
• Also seen in Pigs & Monkeys.
Balantidium coli
• Pig is the common
reservoir host
• Morphology:
2 stages
• Trophozoite stage
• Encysted stage
Balantidium coli
• Trophozoite stage:
Found in dysenteric stool
Oval body, variable size
60-70µm X 40-50µm
Body covered with delicate pellicle
Cilia – short and delicate
Adoral cilia – around mouth
Balantidium
• Trophozoite stage:
Peristome – Groove in Anterior end
Cytosome – mouth
Cytopharynx – funnel shaped gullet
No intestine
Cytopyge – Permanent anus
Balantidium coli
• Trophozoite stage:
a) Two nuclei (Large kidney shaped
macronucleus)
b) Two contractile vacuoles
c) Many food vacuoles with RBC,
WBC, tissue debris
Balantidium
• Cystic stage:
Slightly smaller than trophozoite
50-60µm diameter
Granular cytoplasm
Macronucleus and a refractile body
Double layered cyst wall
LIFE CYCLE
• Infective form: Mature Cyst
• Mode: Feco-oral contamination by ingestion
of food, water, among food handlers
• Life cycle in 2 stages (both inside the host)
• Natural host – Man
• Amplifier host / Reservoir host – Pig
• Pig-Pig, Man-Man, Pig-Man, Man-pig
LIFE CYCLE
Pathogenesis
• Cyst – Trophozoite in Large intestine
• Lumen to Submucous coat – where it
multiplies by binary transverse fission
• Micronucleus – 2 macronuclei
• Conjugation between 2 trophozoites
• Starchy food – abundant in Pig’s intestine
• Parasite does not invade liver
Lab Diagnosis & Treatment
Stool Microscopy:
Trophozoites of B. coli
Treatment:
a) Tetracycline 500 mg Q.i.d for 10 days
b) Metronidazole 750 mg TDS for 5 days
c) Iodoquinol 650mg TDS for 20 days
Acid fast Intestinal parasites - size
• Isospora belli 20-30 µm
• Sarcocystis – 50-60µm
• Cyclospora – 40-50µm
• Cryptosporidium – 4-6µm
• Microsporidium – 1-3 µm
MICROSPORA
• Microsporidia
• 7 genera
• Enterocytozoon (E.bieneusi, E.intestinalis),
Encephalitozoon, Nosema, Pleistophora,
Thelohanea, Trachipleistophora & Vittaforma
• Causes microsporidiosis especially in AIDS
cases causing persistent diarrhoea, abdominal
cramps, nausea, malabsorption
MICROSPORA
• Microsporidia – minute unicellular obligate
intracellular spore forming protozoa
• Life cycle: not worked out fully
• 2 developmental stages inside a host cell
• i) Schizogony, ii) sporogony
• Spore –polar tube – sporoplasm – enterocytes –
merogony – several spore formed
• Size of spore less than 10µm in length
• Spores- Oval or cylindrical – Acid fast by MZN
MICROSPORA
• Enterocytozoon hellam-peritonitis, myositis,
keratoconjunctivitis
• Encephalitozoon cuniculi
• Encephalitozoon intestinalis or septatata
intestinalis
• Treatment:
• Albendazole 400mg BD for 4 weeks
MICROSPORA
MICROSPORIDIA
MICROSPORIDIA
MICROSPORIDIA
Cryptosporidiosis
• Disease of birds, reptiles and fishes and also
man
• Cryptosporidium parvum
• Acid fast - MZN
Cryptosporidium parvum LIFE cycle
Cryptosporidium spp., - Acid fast- MZN
Cryptosporidium spp.,
Cystoisospora belli
Isospora
Isospora
Isospora
Cyclospora cayatensis
Cyclospora life cycle
Cyclospora cayatenesis
Cyclospora cayatenesis
Cyclospora cayatenesis
Cyclospora cayatenesis
• Treatment:
• Co-trimoxazole 160/800mg BD for 7 days
Sarcocystis hominis, S. suihominis
• Sarcocystosis
• Intestinal sarcocystosis
• Cyst in the muscle (Muscular cyst)
• Acid fast by MZN
• Man- definitive host
• Pig – intermediate host
Sarcocystis
Sarcocystis
Take home message & Summary
• Acid fast Intestinal parasites
• Persistent diarrhoea – HIV/AIDS
• Cryptosporidium spp., - Oocyst
• Cyclospora spp., - Oocyst
• Isospora spp., - Oocyst
• Sarcocystis spp., - Oocyst
• Microsporidium spp., - Spores
• Balantidium coli- Largest intestinal ciliated
protozoan
Acid fast Intestinal parasites - Parasitology isospora cyclospora - sarcocystis - microsporidium - cryptosporidium -  balantidiumt

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Acid fast Intestinal parasites - Parasitology isospora cyclospora - sarcocystis - microsporidium - cryptosporidium - balantidiumt

  • 1. Balantidium coli, Isospora, Cyclospora, Cryptosporidia, Microsporidia & Sarcocystis Dr. R. Someshwaran, MD.,Assistant professor, Dept. of Microbiology, Karpagam Faculty of Medical Sciences & Research,
  • 2. OBJECTIVES  To define etiology, morphology, life cycle, disease caused, laboratory diagnosis and treatment of Acid fast Intestinal parasitic infections caused by Isospora, Cyclospora, Cryptosporidia, Microsporidia and Sarcocystis spp.,  To define etiology, morphology, life cycle, disease caused, laboratory diagnosis and treatment of Balantidium coli infections
  • 3. Balantidium • Large protozoal parasite • Phylum: Ciliophora • Body covered with cilia (hair-like process) • Two morphologically distinct nuclei • Balantidium coli - pathogenic to human beings • World wide in distribution • Habitat: Large intestine of Humans • Also seen in Pigs & Monkeys.
  • 4. Balantidium coli • Pig is the common reservoir host • Morphology: 2 stages • Trophozoite stage • Encysted stage
  • 5. Balantidium coli • Trophozoite stage: Found in dysenteric stool Oval body, variable size 60-70µm X 40-50µm Body covered with delicate pellicle Cilia – short and delicate Adoral cilia – around mouth
  • 6. Balantidium • Trophozoite stage: Peristome – Groove in Anterior end Cytosome – mouth Cytopharynx – funnel shaped gullet No intestine Cytopyge – Permanent anus
  • 7. Balantidium coli • Trophozoite stage: a) Two nuclei (Large kidney shaped macronucleus) b) Two contractile vacuoles c) Many food vacuoles with RBC, WBC, tissue debris
  • 8. Balantidium • Cystic stage: Slightly smaller than trophozoite 50-60µm diameter Granular cytoplasm Macronucleus and a refractile body Double layered cyst wall
  • 9. LIFE CYCLE • Infective form: Mature Cyst • Mode: Feco-oral contamination by ingestion of food, water, among food handlers • Life cycle in 2 stages (both inside the host) • Natural host – Man • Amplifier host / Reservoir host – Pig • Pig-Pig, Man-Man, Pig-Man, Man-pig
  • 11. Pathogenesis • Cyst – Trophozoite in Large intestine • Lumen to Submucous coat – where it multiplies by binary transverse fission • Micronucleus – 2 macronuclei • Conjugation between 2 trophozoites • Starchy food – abundant in Pig’s intestine • Parasite does not invade liver
  • 12. Lab Diagnosis & Treatment Stool Microscopy: Trophozoites of B. coli Treatment: a) Tetracycline 500 mg Q.i.d for 10 days b) Metronidazole 750 mg TDS for 5 days c) Iodoquinol 650mg TDS for 20 days
  • 13. Acid fast Intestinal parasites - size • Isospora belli 20-30 µm • Sarcocystis – 50-60µm • Cyclospora – 40-50µm • Cryptosporidium – 4-6µm • Microsporidium – 1-3 µm
  • 14. MICROSPORA • Microsporidia • 7 genera • Enterocytozoon (E.bieneusi, E.intestinalis), Encephalitozoon, Nosema, Pleistophora, Thelohanea, Trachipleistophora & Vittaforma • Causes microsporidiosis especially in AIDS cases causing persistent diarrhoea, abdominal cramps, nausea, malabsorption
  • 15. MICROSPORA • Microsporidia – minute unicellular obligate intracellular spore forming protozoa • Life cycle: not worked out fully • 2 developmental stages inside a host cell • i) Schizogony, ii) sporogony • Spore –polar tube – sporoplasm – enterocytes – merogony – several spore formed • Size of spore less than 10µm in length • Spores- Oval or cylindrical – Acid fast by MZN
  • 16. MICROSPORA • Enterocytozoon hellam-peritonitis, myositis, keratoconjunctivitis • Encephalitozoon cuniculi • Encephalitozoon intestinalis or septatata intestinalis • Treatment: • Albendazole 400mg BD for 4 weeks
  • 21. Cryptosporidiosis • Disease of birds, reptiles and fishes and also man • Cryptosporidium parvum • Acid fast - MZN
  • 23. Cryptosporidium spp., - Acid fast- MZN
  • 34. Cyclospora cayatenesis • Treatment: • Co-trimoxazole 160/800mg BD for 7 days
  • 35. Sarcocystis hominis, S. suihominis • Sarcocystosis • Intestinal sarcocystosis • Cyst in the muscle (Muscular cyst) • Acid fast by MZN • Man- definitive host • Pig – intermediate host
  • 38.
  • 39. Take home message & Summary • Acid fast Intestinal parasites • Persistent diarrhoea – HIV/AIDS • Cryptosporidium spp., - Oocyst • Cyclospora spp., - Oocyst • Isospora spp., - Oocyst • Sarcocystis spp., - Oocyst • Microsporidium spp., - Spores • Balantidium coli- Largest intestinal ciliated protozoan