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Chapter 6 : Protozoa from Other Body Sites
Editor:
Lynne S. Garcia1
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Affiliations:
1: LSG & Associates, Santa Monica, California
Content Type: Reference
Publication Year:
2007
Category: Clinical Microbiology
Book DOI:
10.1128/9781555816018
Chapter DOI:
10.1128/9781555816018.ch6
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Abstract:
Trichomoniasis is the primary nonviral sexually transmitted disease worldwide. Infection with Trichomonas vaginalis has major health consequences for women, including complications in pregnancy, association with cervical cancer, and predisposition to human immunodeficiency virus (HIV) infection. About 20% of women with vaginal trichomoniasis have dysuria, a symptom that may occur before any additional symptoms appear. Toxoplasmosis can be categorized into four groups: (i) disease acquired in immunocompetent patients, (ii) disease acquired or reactivated in immunosuppressed or immunodeficient patients, (iii) congenital disease, and (iv) ocular disease. In genotyping studies, it appears that the type of Toxoplasma gondii strain does not predominantly influence the pathogenesis of toxoplasmosis in immunocompromised patients. Thus, regardless of the strain genotype, there remains the need for specific prophylaxis in these patients infected by T. gondii. Congenital infections result from the transfer of parasites from the mother to the fetus when she acquires a primary infection during pregnancy. The characteristic symptoms of hydrocephalus, cerebral calcifications, and chorioretinitis resulting in mental retardation, epilepsy, and impaired vision represent the most severe form of the disease. Therapy for pregnant patients who acquire the infection and for newborns with Toxoplasma antibody is somewhat controversial. However, prophylactic therapy is often recommended for the newborn until it can be demonstrated that IgM antibody is not present. Since primary infection with T. gondii leads to specific and definitive protection against reinfection, the feasibility of developing a vaccine is now being investigated.
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
Figures
Protozoa from Other Body Sites
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06fig01
Figure 6.1
Life cycle of Trichomonas vaginalis.
10.1128/9781555816018/ch6fig1_thmb.gif
10.1128/9781555816018/ch6fig1.gif
Figure 6.1
Life cycle of Trichomonas vaginalis.
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06fig02
Figure 6.2
Trichomonas vaginalis trophozoite. (Illustration by Sharon Belkin.)
10.1128/9781555816018/ch6fig2_thmb.gif
10.1128/9781555816018/ch6fig2.gif
Figure 6.2
Trichomonas vaginalis trophozoite. (Illustration by Sharon Belkin.)
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06fig03
Figure 6.3
InPouch TV diagnostic system for culturing Trichomonas vaginalis. (A) The swab containing a specimen from the patient is being inserted into the liquid medium within the plastic pouch; (B) the top of the plastic pouch is folded over and sealed with the tabs; (C) the pouch is inserted into the plastic holder; (D) the pouch (in the holder) is placed onto the microscope stage for examination (organism motility). (Photographs courtesy of BIOMED Diagnostics.) See also chapter 32.
10.1128/9781555816018/ch6fig3_thmb.gif
10.1128/9781555816018/ch6fig3.gif
Figure 6.3
InPouch TV diagnostic system for culturing Trichomonas vaginalis. (A) The swab containing a specimen from the patient is being inserted into the liquid medium within the plastic pouch; (B) the top of the plastic pouch is folded over and sealed with the tabs; (C) the pouch is inserted into the plastic holder; (D) the pouch (in the holder) is placed onto the microscope stage for examination (organism motility). (Photographs courtesy of BIOMED Diagnostics.) See also chapter 32.
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06fig04
Figure 6.4
Trichomonas vaginalis, direct antigen detection strip used for rapid testing (OSOM Trichomonas Rapid Test). (Courtesy of Genzyme Diagnostics, Cambridge, Mass.)
10.1128/9781555816018/ch6fig4_thmb.gif
10.1128/9781555816018/ch6fig4.gif
Figure 6.4
Trichomonas vaginalis, direct antigen detection strip used for rapid testing (OSOM Trichomonas Rapid Test). (Courtesy of Genzyme Diagnostics, Cambridge, Mass.)
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06fig05
Figure 6.5
Life cycle of Toxoplasma gondii. The active forms (trophozoites) are also referred to as tachyzoites, while the resting stages within the cysts are called bradyzoites (very slowgrowing trophozoites).
10.1128/9781555816018/ch6fig5_thmb.gif
10.1128/9781555816018/ch6fig5.gif
Figure 6.5
Life cycle of Toxoplasma gondii. The active forms (trophozoites) are also referred to as tachyzoites, while the resting stages within the cysts are called bradyzoites (very slowgrowing trophozoites).
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06fig06
Figure 6.6
Toxoplasma gondii in the intestine of a cat. (A) Bradyzoites (×1,000); (B) gametocytes (×1,000); (C) oocyst containing two sporocysts with sporozoites (×1,600). (Courtesy of J. K. Frenkel, University of Kansas School of Medicine, Kansas City.)
10.1128/9781555816018/ch6fig6_thmb.gif
10.1128/9781555816018/ch6fig6.gif
Figure 6.6
Toxoplasma gondii in the intestine of a cat. (A) Bradyzoites (×1,000); (B) gametocytes (×1,000); (C) oocyst containing two sporocysts with sporozoites (×1,600). (Courtesy of J. K. Frenkel, University of Kansas School of Medicine, Kansas City.)
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06fig07
Figure 6.7
Forms of Toxoplasma gondii found in humans. (A) Trophozoites (tachyzoites) seen within a cell; (B) cyst containing the bradyzoites (illustration by Sharon Belkin; based on illustration from H. H. Najarian, Textbook of Medical Parasitology, The Williams & Wilkins Co., Baltimore, Md., 1967); (C) tachyzoites recovered from mouse peritoneal fluid.
10.1128/9781555816018/ch6fig7_thmb.gif
10.1128/9781555816018/ch6fig7.gif
Figure 6.7
Forms of Toxoplasma gondii found in humans. (A) Trophozoites (tachyzoites) seen within a cell; (B) cyst containing the bradyzoites (illustration by Sharon Belkin; based on illustration from H. H. Najarian, Textbook of Medical Parasitology, The Williams & Wilkins Co., Baltimore, Md., 1967); (C) tachyzoites recovered from mouse peritoneal fluid.
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06fig08
Figure 6.8
Forms of Toxoplasma gondii found in humans. (Upper) Tachyzoites seen within bone marrow. (Lower) Bradyzoites seen in human tissue.
10.1128/9781555816018/ch6fig8_thmb.gif
10.1128/9781555816018/ch6fig8.gif
Figure 6.8
Forms of Toxoplasma gondii found in humans. (Upper) Tachyzoites seen within bone marrow. (Lower) Bradyzoites seen in human tissue.
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06fig09
Figure 6.9
Chart for the diagnosis and treatment of neonatal toxoplasmosis. (Adapted from reference
14
.)
10.1128/9781555816018/ch6fig9_thmb.gif
10.1128/9781555816018/ch6fig9.gif
Figure 6.9
Chart for the diagnosis and treatment of neonatal toxoplasmosis. (Adapted from reference 14 .)
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06fig10
Figure 6.10
Toxoplasmosis: risk management in pregnancy.
10.1128/9781555816018/ch6fig10_thmb.gif
10.1128/9781555816018/ch6fig10.gif
Figure 6.10
Toxoplasmosis: risk management in pregnancy.
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06fig11
Figure 6.11
Chart for the analysis of conventional antibody tests for Toxoplasma gondii by the IgM technique. Interpretation depends on the type of test used. In the IgM-indirect immunofluorescence assay test, a titer of 1:64 would support a diagnosis of infection acquired 1 to 3 months earlier. In the double-sandwich IgM-ELISA (IgM capture), titers of 1:256 and higher should be expected in the first 4 months of infection. (Adapted from references
10
,
14
, and
43
.)
10.1128/9781555816018/ch6fig11_thmb.gif
10.1128/9781555816018/ch6fig11.gif
Figure 6.11
Chart for the analysis of conventional antibody tests for Toxoplasma gondii by the IgM technique. Interpretation depends on the type of test used. In the IgM-indirect immunofluorescence assay test, a titer of 1:64 would support a diagnosis of infection acquired 1 to 3 months earlier. In the double-sandwich IgM-ELISA (IgM capture), titers of 1:256 and higher should be expected in the first 4 months of infection. (Adapted from references 10 , 14 , and 43 .)
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06alg01
Algorithm 6.1
Toxoplasmosis.
10.1128/9781555816018/ch6alg1_thmb.gif
10.1128/9781555816018/ch6alg1.gif
Algorithm 6.1
Toxoplasmosis.
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06fig12
Figure 6.12
Chart for the prevention of TE in HIV-positive patients; the approach is based on results of the Toxoplasma IgG serology. (Adapted from references
10
,
14
, and
43
.)
10.1128/9781555816018/ch6fig12_thmb.gif
10.1128/9781555816018/ch6fig12.gif
Figure 6.12
Chart for the prevention of TE in HIV-positive patients; the approach is based on results of the Toxoplasma IgG serology. (Adapted from references 10 , 14 , and 43 .)
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
References
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Tables
Protozoa from Other Body Sites
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06tab01
Table 6.1
Characteristics of Trichomonas vaginalis
Table 6.1
Characteristics of Trichomonas vaginalis
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06tab02
Table 6.2
Virulence factors associated with Trichomonas vaginalis pathogenesis
a
Table 6.2
Virulence factors associated with Trichomonas vaginalis pathogenesis a
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06tab03
Table 6.3
Summary of commercially available kits for immunodetection of Trichomonas vaginalis
Table 6.3
Summary of commercially available kits for immunodetection of Trichomonas vaginalis
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06tab04
Table 6.4
People at risk for severe toxoplasmosis
Table 6.4
People at risk for severe toxoplasmosis
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06tab05
Table 6.5
Clinical use of immunodiagnostic tests
a
Table 6.5
Clinical use of immunodiagnostic tests a
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06tab06
Table 6.6
General comments on the performance and interpretation of serologic results for the diagnosis of toxoplasmosis
a
Table 6.6
General comments on the performance and interpretation of serologic results for the diagnosis of toxoplasmosis a
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06tab07
Table 6.7
Guide to interpretation of serologic tests for the diagnosis of toxoplasmosis
a
Table 6.7
Guide to interpretation of serologic tests for the diagnosis of toxoplasmosis a
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6
/content/10.1128/9781555816018.ch06.ch06tab08
Table 6.8
Prevention of infection with Toxoplasma gondii
Table 6.8
Prevention of infection with Toxoplasma gondii
Citation:
Garcia L.
2007.
Protozoa from Other Body Sites,
p 123-141.
In
Diagnostic Medical Parasitology, Fifth Edition.
ASM Press, Washington, DC.
doi: 10.1128/9781555816018.ch6