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ISOSPORA

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9 views

ISOSPORA

Uploaded by

Abdirashid
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Isospora

Isospora
Genus of internal parasites in the
subclass Coccidia responsible for
Isosporiasis, which causes acute,
non-bloody diarrhea in
immunocompromised individuals
EPIDEMIOLOGY
 Cystoisospora belli infections are essentially
cosmopolitan in distribution but are more common
in tropical and subtropical regions especially Haiti,
Mexico, Brazil, El Salvador, tropical Africa, Middle
East and Southeast Asia.
 Infectionsoccur in immunocompromised individuals
and outbreaks have been reported in
institutionalized groups in the US.
Cystoisospora belli
Isospora belli/ Cystoisospora belli
 The name belli (from bellium meaning war) was given
for its association with war, because several cases of
infection with this parasite were seen among troops
stationed in Middle East during the First World War.
 Is an Intestinal parasite that causes intestinal disease
called Cystoisosporiasis (diarrhea in humans.)
 This parasite is opportunistic in immunocompromised
human hosts.
Morphology
 Oocysts of C. belli are
elongated, ovoid and
measure 25 μm × 15 μm.
 Each oocyst is
surrounded by a thin
smooth cyst wall.
 Immature oocyst seen in
the faeces of patients
contains 2 sporoblasts.
 Onmaturation, the
sporoblasts become
sporocysts.
 Eachsporocyst
contains 4
sporozoites.
 The sporulated oocyst
is the infective stage
of the parasite
Life Cycle
LIFE CYCLE
 Undergoes sexual and asexual cycles
 unsporulated oocysts are passed out in faeces of infected person.
 Humans acquire infection by ingesting the mature oocysts
containing sporozoites via contaminated food or water.
 The mature oocyst ruptures in the intestine releasing 8
sporozoites which invade the intestinal epithelial cells.
 In the epithelium, the sporozoites transform into trophozoites,
which multiply asexually (schizogony) to produce merozoites.
The merozoites invade adjacent epithelial cells to repeat the
asexual cycle.
Life cycle…cont
 Some of the trophozoites undergo sexual cycle
(gametogony) in the cytoplasm of enterocytes and
transform into macrogametocytes and
microgametocytes.
 After
fertilization, a zygote is formed and
develops into an immature oocyst. These
immature oocysts are excreted with faeces and
mature in the soil
Infective form
 Oocyst

Pathogenicity
 Transmitted :fecal-oral
 Occurs under poor sanitary condition
 3-14 days incubation period
 After ingestion sporozoites invade small intestine
destroying the enterocytes
 Site of infection is intestinal villus and lamina propria
of the villus
Clinical manifestations
 Watery, non bloody diarrhea
 Abdominal pain
 Anorexia
 Nausea and vomiting
 Low grade fever
 Thediarrhea can be profuse and prolonged particularly in
immunocompromised patients resulting in severe dehydration,
electrolyte imbalance eg. Hypokalemia, weight loss and
malabsorption
 Cholecystitis and reactive arthritis
Diagnosis

1. Microscopic examination
To detect the oocysts in saline preparation of stool. Stool
concentration technique may be required when direct wet
mount is negative. The staining technique used is modified Ziehl
Neelsen stain or Kinyoun acid fast. Pink-coloured acid fast
oocyst can be demonstrated.
 Samples from duodenal aspirates and intestinal biopsy can also
be obtained for diagnosis.
2. Molecular diagnosis
PCR of the stool sample.
Treatment
 No treatment is indicated in self-limiting infection in
immunocompetent persons.
 Immunodeficient patients with diarrhea and excreting
oocysts in the feces should be treated with co-
trimoxazole, (trimethoprim-suIfamethoxazole).
 For patients intolerant to sulfonamides, pyrimethamine
is given.
 Relapses can occur in persons with AIDS and necessitate
maintenance therapy with cotrimoxazole one tablet
thrice a week.
Prevention
 Proper fecal disposal
 Personal hygiene
 Boiling of drinking water
 Avoid oral-anal sexual practice
 Filtration of drinking water
 Wash fruits and vegetables with clean water before
eating
 Health education
Thank
YOU

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