Ppt on Giardia and Trichomonas

1. FLAGELLATES – GIARDIA
LAMBLIA AND
TRICHOMONAS VAGINALIS
-DR.M.JANE ESTHER
MD (Microbiology)

2. FLAGELLATES
 Intestinal flagellates
 Haemoflagellates
INTESTINAL FLAGELLATES:
 Giardia lamblia
 Genital flagellate-Trichomonas vaginalis

3. GIARDIA LAMBLIA
 First observed by Leeuwenhoek
 Prof Giard and Prof Lambl – detailed description
 Most common intestinal protozoan pathogen
 Distribution : Worldwide
 Habitat: duodenum & upper part of jejunum
 2 forms : Trophozoite & cyst forms
 IgA deficient individuals

4. TROPHOZOITE PHASE:
 Rounded anteriorly and pointed posteriorly
 Pyriform, heart or tennis racket shaped
 15µm long and 7µm wide
 B/L symmetrical
 Axostyle
 2 nuclei
 4 pairs of flagella

5. FALLING LEAF MOTILITY
 2 sausage shaped para median bodies posterior
to sucking disc
 Motility: Falling leaf
 Division: Longitudinal binary fission

6. CYST
 Oval; 12µm long and 7µm broad
 4 nuclei
 Acid environment  Encyst

7. LIFE CYCLE
 Trophozoite (multiply in duodenum)
 Unfavourable conditions –
encystment(LI)
 Ingestion of cysts - infection
 Hatch out in duodenum 
Trophozoites released
 Colonise duedenum & biliary tract

8. PATHOGENICITY
 Parasite attaches to the epithelial cell surface
 malabsorption & steatorrhoea
 Toxic (allergic) effect
 Traumatic & irritative effect

9. CLINICAL FEATURES
 Giardiasis
 Intestinal : Enteritis & enterocolitis
 General : fever, anaemia, allergic
manifestations
 Chronic cholecystopathy

10. LAB DIAGNOSIS
 Stool examination – giardia cyst & trophozoite
 Enterotest
 ELISA
 Immunochromatographic strip tests

11. ENTEROTEST

12. TREATMENT
 Metronidazole (250 mg tds for 5 days)
 Trimidazole (2 g once)
 Furazolidone (100 mg 4 times a day for 7-10
days)

13. TRICHOMONAS VAGINALIS
 First observed by Donne in vaginal secretion
 Occurs only as the trophozoite
 No cystic form
 Habitat
 Females : vagina, urethra, bartholin’s gland
 Males : urethra, prostate anterior preputial
sac

14. MORPHOLOGY
 Ovoid or pear shaped
 10 to 30µm long and 5 to 10µm broad
 Undulating membrane
 Costa
 4 ant flagella & 5th running along undulating
membrane
 Axostyle

15. Continued….
 Jerky motility
 Binary fission
 Infetive form : trophozoite
 Culture : CPLM madium
(cysteine,peptone,liver,maltose)

16. LIFE CYCLE

17. PATHOGENESIS
 IP:4 days to 4 weeks
 Squamous epithelium & not columnar
 Disruption of glycogen levels & bacterial flora
 Rise in pH level(exceeds 4.9)

18. CLINICAL FEATURES
Trichomoniasis
WOMEN:
 Vulvo-vaginitis
 Urethritis
 Purulent abnormal vaginal discharge(yellow
greenish)
 Vulval & vaginal epithelium – Fiery red
 Ectocervix : punctate hemorrhages (strawberry
mucosa) – colpitis macularis

19. MALES:
 Urethritis
 Epididymitis
 Prostatitis
 Prepuce ulceration

20. LAB DIAGNOSIS
 Microscopy :urine wet mount  Trophozoite
 Giemsa stain
 Culture – CPLM
 Indirect haemagglutination
 PCR
TREATMENT
 Metronidazole 250 mg oral tds for 5-7 days

21. SUMMARY
 Giardia lamblia : Trophozoite & cyst – falling leaf
motility – giardiasis
 Trichomonas vaginalis : only trophozoite, no cyst
form, jerky moltility, trichomoniasis