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Chapter 2 : Intestinal Protozoa: Amebae

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Abstract:

was first described by Losch after being isolated in Russia from a patient with dysenteric stools. This organism was eventually more fully investigated and differentiated from and with respect to both morphology and pathogenesis. At least 10 amebae are found in the mouth or intestinal lumen (, , , , , , , , , and ). However, of these, only and have been considered to be pathogenic. Individuals harboring may have either a negative or weak antibody titer and negative stools for occult blood and may be passing cysts that can be detected if the routine ova and parasite examination is performed. The amebic cysteine proteinases are homologous to proteinases released by transformed cells and probably represent a common mechanism of tissue invasion. In one recent study of patients with irritable bowel syndrome, there was a set of patients in whom the presence of did not appear to be incidental. Both enzyme-linked immunosorbent assay (ELISA) and fluorescent-antibody tests have been developed for detection of serum antibody to infections. At present, metronidazole (Flagyl) appears to be the most appropriate drug. Diiodohydroxyquin (Yodoxin) has also been effective, and dosage schedules for these two drugs are as recommended for other intestinal protozoa. The development of a new drug sensitivity assay may improve our ability to scientifically evaluate the activities of various drugs against this organism.

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2

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Figures

Image of Figure 2.1
Figure 2.1

Life cycle of

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Figure 2.2
Figure 2.2

(1) Trophozoite of ; (2) trophozoite of ; (3 and 4) early cysts of ; (5 to 7) cysts of ; (8 and 9) trophozoites of ; (10 and 11) early cysts of ; (12 to 14) cysts of ; (15 and 16) trophozoites of ; (17 and 18) cysts of

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Figure 2.3
Figure 2.3

(A) Trophozoite of ; (B) trophozoite of ; (C and D) cysts of ; (E and F) trophozoites of ; (G to J) cysts of Note the chromatoidal bars in panels H and I and the shrunken cyst (which is often seen in permanent stained smears) in panel J.

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Figure 2.4
Figure 2.4

Liver containing multiple amebic abscesses. The necrotic tissue has been removed from one portion, leaving a cavity. ×0.4. (Armed Forces Institute of Pathology photograph.)

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Algorithm 2.1
Algorithm 2.1

Intestinal amebiasis. Fecal immunoassay kits can be used on human stool specimens to identify organisms in the group or to differentiate from Currently available reagents require fresh or frozen specimens only. *, trophozoites containing RBCs confirmatory for ; trophozoites with no ingested RBCs and/or cysts confirm only the group.

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Algorithm 2.2
Algorithm 2.2

Amebic liver abscess. *, trophozoites containing RBCs confirmatory for ; trophozoites with no ingested RBCs and/or cysts confirm only the group.

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Figure 2.5
Figure 2.5

Life cycle of (and ).

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Figure 2.6
Figure 2.6

Life cycle of , and

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Figure 2.7
Figure 2.7

(A and B) Trophozoites of ; (C and D) cysts of

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Figure 2.8
Figure 2.8

(Upper) Cyst of (illustration); (lower) cyst of (note the large inclusion in the cytoplasm as seen in the drawing).

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Figure 2.9
Figure 2.9

(Upper) Trophozoite of (illustration by Sharon Belkin); (lower three images) trophozoites of (note the ingested polymorphonuclear leukocytes).

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Figure 2.10
Figure 2.10

(1 to 5) Trophozoites of ; (6 to 10) cysts of ; (11 to 13) trophozoites of ; (14 to 16) cysts of

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Figure 2.11
Figure 2.11

(A and B) Trophozoites of (note the nuclear variation in panel B); (C and D) cysts of

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Figure 2.12
Figure 2.12

(A) Trophozoite of ; (B) cyst of (note the large glycogen vacuole).

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Figure 2.13
Figure 2.13

Life cycle of The central-body forms (or vacuolar forms) can be seen at the bottom of the life cycle (generally seen in clinical specimens); the development of the granular forms can be seen in the left portion of the life cycle; the ameboid forms can be seen in the right portion of the life cycle. Both the granular and ameboid forms can arise from the vacuolated forms (central-body forms); multiplication can occur through binary fission (vacuolar and granular forms), budding (ameboid forms), schizogony (central-body form), and sporulation (less common in the vacuolated form). Modified from reference .

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Figure 2.14
Figure 2.14

(A and B) Central-body forms of (note the multiple nuclei around the edges, outside the central-body area).

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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Image of Figure 2.15
Figure 2.15

classical shape showing binary fission and the large central “vacuole.”

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
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References

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Tables

Generic image for table
Table 2.1

Intestinal protozoa: trophozoites of common amebae

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
Generic image for table
Table 2.2

Intestinal protozoa: cysts of common amebae

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
Generic image for table
Table 2.3

Intestinal amebae: recommended diagnostic procedures

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
Generic image for table
Table 2.4

Commercial assays used to identify

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
Generic image for table
Table 2.5

Intestinal protozoa: trophozoites of less common amebae

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
Generic image for table
Table 2.6

Intestinal protozoa: cysts of less common amebae

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
Generic image for table
Table 2.7

Morphological criteria used to identify

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2
Generic image for table
Table 2.8

Measures for the prevention of infection with intestinal protozoa

Citation: Garcia L. 2007. Intestinal Protozoa: Amebae, p 6-32. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch2

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