Hemoflagellates

• Hemoflagellates are transmitted through...

  vectors
• Trypanosoma


  • present in circulating blood
  • resides in peripheral blood and tissues
• Trypanosoma brucei gambiense


  • West African sleeping sickness
  • Central and West Africa
  • Glossina palpalis (tsetse fly)
• G - gambiese

  G - glossina

  W - west african

  P - palpalis
• Trypanosoma brucei rhodesiense


  • East African sleeping sickness
  • East Africa
  • Glossina morsitans (tsetse fly)
• M - morsitans

  E - east africa

  R - rhodesiense

  G - glossina
• Trypanosoma cruzi


  • Carlos Chagas
  • Chaga's disease (American trypanosomiasis)
  • Central and South America
  • Reduviid bug (Assassin bugs or kissing bugs / triatoma)
• Glossina palpalis


  vector of Trypanosoma brucei gambiense
• Glossina morsitans


  vector of Trypanosoma brucei rhodesiense
• Reduviid bug


  vector of Trypanosoma cruzi
• Trypanosoma brucei gambiense

  
  

  causes West African Sleeping sickness
• Trypanosoma brucei rhodesiense


  causes East African sleeping sickness
• Trypanosoma cruzi


  causes Chaga's disease
• Leishmania


  causes Leishmaniasis
• Leishmania tropica


  • oriental sore/ Old world cutaneous leishmaniasis
  • Phlebotomous (sand fly)
  • Baghdad boils
• Leishmania brazillensis


  • Espundia / Mucocutaneous leishmaniasis
  • Chiclero Ulcer / New world cutaneous leishmaniasis
  • Lutzomyia (vector)
• Leishmania donovani


  • Kala-azar / visceral leishmaniasis
  • Phlebotomous specie (Sandfly)
• Leishmania tropica

  T - tropica

  O - oriental sore

  O - old world

  P - phlebotomous

  B - baghdad boils
• Leishmania brazillensis

  B - brazillensis

  E - espundia

  C - chiclero ulcer

  M - mucocutaneous

  N - new world

  L - lutzomyia
• Leishmania donovani

  D - donovani

  K - Kala-azar

  V - visceral

  P - phlebotomous
• 4 morphological stages of Hemoflagellates

  • Amastigote
  • Promastigote
  • Epimastigote
  • Trypomastigote
• Amastigote


  • ovoid
  • lacks flagellum
• Promastigote


  • elongated and spindled shape
  • has arising flagellum (antinuclear kinetoplast)
  • infective stage of Leishmania
• Epimastigote


  • elongated
  • juxtanuclear kinetoplast (closed to nucleus)
• Trypomastigote


  • flagellated form of Trypanosomes
  • infective stage of Trypanosoma
• What morphological stages does Leishmania have?

  • Amastigote
  • Promastigote
• What morphological stages does Trypanosoma brucei have?

  • Epimastigote
  • Trypomastigote
• What morphological stages does Trypanosoma cruzi have?

  • Amastigote
  • Promastigote
  • Epimastigote
  • Trypomastigote
• Trypanosoma cruzi


  what flagellate is associated with this?

  • Chagoma (slightly painful nodules)
  • Romaña sign
• Diagnosis for Trypanosoma brucei


  • stained blood prep
  • lymph aspirates
• Diagnosis for Trypanosoma cruzi


  • thick blood smear
• Treatment for T. brucei

  • Pentamidine (this do not enter CSF)
  • Suramin (this do not enter CSF)

  
  

  • Melarsoprol ( for late stages of disease, with CNS involvement)
• Treatment for T. cruzi

  • nifurtimox (partially effective in acute disease)
  • bezuidazole
• Diagnosis for Leishmania


  • Culture in NNN medium ( Nicole, Novy, Mc Neal)
  • Montenegro skin test (intradermal injection)
  • Formol gel test (screening test)
• Treatment for Leishmania


  Primary drug

  • Pentavalent antimonials
  • Sodium atiboglucolate
  • N-methyl-glucamine antimonate (meglumine)

  Secondary line

  • antimicrobial Amphotericin B
  • Pentamidine ( for kala-azar)
  • Metronidazole
  • Nifurtimox