Of the three microbes that can cause hemolytic infections, which one is a flagellated protozoan?
Leishmania species (infectious stage is promastigotes)
The other two are apicomplexan protozoans: Plasmodium and Babesia (infectious stage is sporozoite)
Which protozoan has female anopheles mosquito as a vector? Sandfly? Tick?
Anophele mosquito: Plasmodium species
Which is the infective stage of plasmodium?
Sporozoite in mosquito saliva
Which is the infective stage of Leishmania?
Promastigotes in fly saliva
Which is the infective stage of Babesia?
Sporozoite in tick saliva
Plasmodium and Babesia both have _____ as infective stages, while Leishmania has_____ as its infective stage.
Stages in humans most associated with disease for Plasmodium, Leishmania, and Babesia?
Plasmodium: trophozoite and mereozoites in RBC
Leishmania: Amastigotes in macrophages (in L. donovani, the amastigotes in macrophages can be foudn in spleen, liver and bone = visceral leishmania, vs other species just in skin = cutaneous)
Babesia: trophozoites and merozoites in RBC like plasmodium
What is Kala-azar and what is it associated with?
Kala-azar is blackening of the skin due to Leishmania donovani infection.
This is a symptom of visceral leishmaniasis
What are signs and symptoms of L. donovani infection?
Kala-azar, liver and spleen swelling.
L. donovani infects reticuloendothelial cells and the bone marrow too
T/F: L. tropica, L. Mexicana, and L brazailiensis are causes of visceral leishmaniasis, while L. donovani causes the less severe cutaneous leishmaniasis
False; L. Mexicana, L. brazailiensis, and L tropica are causes for the less severe cutaneous infections with no organ involvement; L. donovani is a lot more serious as this is a visceral infection, affecting the liver and spleen.
Flagellated leishmania are known as ____ and this is the ____ stage. ______ are found inside macrophages inside our body
Amastigotes (non-flagellated, absent flagella)
Infectious stage of leishmania/ diagnostic stage of leishmania?
Infectious- promastigote in sandfly
T/f: visceral leishmaniasis usually results in pancytopenia and pt typically dies from secondary infection
True. Anemia, leukopenia and thrombocytopenia are often seen and pt die from secondary infections/ GI bleeding as a result of decreased immune cells
Pt with h/o splenectomy currently taking Rituximab, who recently traveled to Northeastern coast of the US, presenting with flu like symptoms. Pt has jaundice and hepatosplenomegaly and CBC suggests anemia; What is a fair assumption as to what is causing her symptoms:
Babesia, given recent travel history
Asplenic pt on rituximab even more so affected
T/F: both plasmodium and babesia have exoerythrocytic phase that takes place in the liver
False; only plasmodium has life cycle that takes place in the liver prior to infecting the erythrocyte, babesia only affects RBC, no other cells
Infectious and diagnostic stages of babesia?
Diagnostic- merozoite/ trophozoite
What is characteristic of the babesia in smears? What type of smear?
Looks like an X, or an intraeryhrocytic ring-shaped trophozoites seen in tetrads in the form of a Maltese cross.
Giemsa-stained blood smears (also the same smear for plasmodium)
Most severe plasmodium species:
T/F: humans are definitive host for plasmodium
False; humans are intermediate host, as in only asexual cycle happens in us. Definitive host for plasmodium is Anophele mosquito, this is where the sexual cycle occurs
Diagnostic/ infectious stages of plasmodium?
Diagnostic: trophozoite in rbc
What is the life cycle of plasmodium, aka: put these words in sequence: merozoite, sporozoite, trophozoite, schizont
Start with sporozoite (infective stage) from mosquito, then sporozoite travels to the liver and infect liver cell, forming schizont, and schizont ruptures and releases merozoite, then infects RBC and merozoite matures into Trophozoite -> schizont (ruptures) -> merozoite cycle continues again or develop into gametocyte
What is hypnozoite, when does it occur and in which species?
Hypnozoite can form when sporozoite enters hepatocyte and forms schizont. These remain dormant in the LIVER for months to years.
Only P. ovale and P. vivax have hypnozoites
Exoerythrocyte stage of plasmodium occurs in the _____
T/f: mosquito is infected when mosquito ingests gametocytes in human blood
T/F: the periodic release of merozoite causes the typical recurrent symptoms of fevers, child and sweats in patient
True; cyclic fevers (depending on species, could be every 3 days or so), think malaria/ plasmodium species
Patients feel well in between febrile episodes because healthy RBCs are formed during those times, i.e no merozoites released / lysing RBC
T/F: because P vivax and P ovale form dormant hypnozoites, pts who visited malarious areas should always seek medical attention for any fever symptoms up to 3 years after leaving that place
Which plasmodium species can cause cerebral malaria and kidney damage?
P falciparum, again, this is the most severe one because they affect way more RBCs (at all ages) and capillaries get blocked by parasitized RBCs and this can be in the brain and kidneys.
Which plasmodium species as a Quartan release cycle (every 4th day, i.e. fever on Monday, get it again on Thursday: 72 hours)? Which have tertian cycles (every 3rd day. Ie fever on Monday, get it again on Wednesday: 48 hours)?
P malariae – quartan
P vivax, P ovale, P falciparum – tertian
Pt with homozygous recessive gene for Duffy Blood group (aka, they lack Duffy blood group), have protection against _____. While patients with sickle cell hemoglobin have protection against ______
P. vivax (no duffy protection)
P. palciparum (Sickle cell protection)
Primaquine is a medication that is needed for these plasmodium species _____, but needs to be avoided if the patient has a _______.
P vivax and P ovale (because they have hypnozoites)
What is Schuffner’s dot? Where do you see it?
Schuffner’s dots are intracytoplasmic granules seen in rbc that are infected with P vivax or P ovale
If greater than 5% of red cells contain trophozoites on Giemsa-stained smears, think _____
Banana shaped Giemsa-stained smear?
Trophozoites that are amoeboid in shape on Giemsa-stained smear?
Oval, jagged infected RBCs on Giemsa-stained blood smear?
Bar and rectangle inside RBC on Giemsa- stained blood smear?