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Chapter 3 : Intestinal Protozoa: Flagellates and Ciliates

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Abstract:

This chapter begins with a discussion on . Recent studies document antigenic variation with surface antigen changes during human infections with ; although the biological importance of this work is not clear, it suggests that this variation may provide a mechanism for the organism to escape the host immune response. Routine stool examinations are normally recommended for the recovery and identification of intestinal protozoa. A new and simple colorimetric method has been determined for determining in vitro activity against . Most experts agree that the single most effective practice that prevents the spread of infection in the child care setting is thorough handwashing by the children, staff, and visitors. Currently, the most commonly used method for examining purified material for protozoa is an antibody-based immunofluorescence assay. Isolates from asymptomatic individuals were found in the same zymodemes (isoenzyme groups) as were isolates from symptomatic hosts. The chapter next focuses on . Since there is no known cyst stage, this organism will not be seen on a wet preparation. Consequently, it is mandatory that a permanent stained smear be included in the ova and parasite examination. Current recommendations include iodoquinol, paromomycin, or tetracycline. Since symptomatic relief has been observed to follow appropriate therapy, is probably pathogenic in infected individuals who are symptomatic. Finally, the chapter focuses on , , , , and .

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3

Key Concept Ranking

Infectious Diseases
0.5411043
Giardia lamblia
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Acetyl Coenzyme A
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Figures

Image of Figure 3.1
Figure 3.1

Life cycle of .

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Figure 3.2
Figure 3.2

trophozoites on the mucosal surface. (Scanning electron micrographs courtesy of Marietta Voge.)

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Figure 3.3
Figure 3.3

(1) Trophozoite of (front view); (2) trophozoite of (side view); (3) cyst of ; (4) trophozoite of ; (5) trophozoite of (two fragmented nuclei); (6) trophozoite of (one fragmented nucleus); (7) trophozoite of ; (8) cyst of ; (9) trophozoite of ; (10–12) cysts of ; (13) trophozoite of ; (14 and 15) cysts of . (Illustrations by Sharon Belkin.)

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Figure 3.4
Figure 3.4

(A to D) Trophozoites of ; (E and F) cysts of .

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Algorithm 3.1
Algorithm 3.1

Giardiasis. Fecal immunoassay kits can be used on human stool specimens to confirm the presence of spp. Currently available reagents can be used with fresh, frozen, or preserved specimens (not those containing polyvinyl alcohol). If fluorescent testing is performed, the specimen should not be frozen (the actual organisms are disrupted during the freeze-thaw cycle); however, fresh or preserved specimens are acceptable. Check with each manufacturer for compatibility of the fixative with the proposed test; not all fixatives are compatible with all types of fecal immunoassays.

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Figure 3.5
Figure 3.5

Life cycle of .

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Figure 3.6
Figure 3.6

Trophozoites of . (Illustration by Sharon Belkin.)

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Figure 3.7
Figure 3.7

(A, B) Trophozoites of . (A) The trophozoite contains a single nucleus fragmented into four parts; (B) the trophozoite contains two nuclei, both of which are also fragmented.

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Figure 3.8
Figure 3.8

Life cycle of .

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Figure 3.9
Figure 3.9

Life cycle of .

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Figure 3.10
Figure 3.10

Life cycle of , and .

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Figure 3.11
Figure 3.11

(A) Trophozoite of (note the feeding groove; flagella are not visible); (B) cyst of (note the “lemon or pear” shape and the curved fibril, the shepherd’s crook).

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Figure 3.12
Figure 3.12

Life cycle of .

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Figure 3.13
Figure 3.13

(1) Trophozoite of ; (2) cyst of . (Illustration by Sharon Belkin.)

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Figure 3.14
Figure 3.14

(A) Trophozoite of (note the large bean-shaped macronucleus and evidence of cilia around the organism); (B) cyst of (note the large bean-shaped macronucleus).

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Image of Figure 3.15
Figure 3.15

Trophozoite of in tissue. Note the cytostome (oral groove) and a portion of the macronucleus. The cilia are not clearly visible.

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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References

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Tables

Generic image for table
Table 3.1

species

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
Generic image for table
Table 3.2

genotypes

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
Generic image for table
Table 3.3

Intestinal protozoa: trophozoites of flagellates

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
Generic image for table
Table 3.4

Intestinal protozoa: cysts of flagellates

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
Generic image for table
Table 3.5

Representative commercially available kits for immunodetection of

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
Generic image for table
Table 3.6

Recommendations for therapy for giardiasis

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
Generic image for table
Table 3.7

Guidelines for hand washing

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
Generic image for table
Table 3.8

Questions for consideration when testing well water

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
Generic image for table
Table 3.9

Intestinal protozoa: ciliate

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3
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Table 3.10

Intestinal flagellates and ciliates: recommended diagnostic procedures

Citation: Garcia L. 2007. Intestinal Protozoa: Flagellates and Ciliates, p 33-56. In Diagnostic Medical Parasitology, Fifth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816018.ch3

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