Protozoa darah
Parasit yg hidup di darah •
Trematoda: –
•
Schistosoma
Protozoa: –
Trypanosoma
–
Toxoplasma
–
Plasmodium
Parasit yg hidup di darah •
Trematoda: –
•
Schistosoma
Protozoa: –
Trypanosoma
–
Toxoplasma
–
Plasmodium
Bag. Parasitologi FK UNEJ
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TRYPANOSOMIASIS
African Trypanosomiasis Atau Ngana
Gambianse Sleeping sickness (Kronik)
American Trypanosomiasis atau Chaga’s Chaga’s disease
Rhodesiense Sleeping sickness (akut) 4
Morfologi
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Trypomastogote di Darah tepi
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SIKLUS HIDUP
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Trypanosomiasis gambian (chronic sleeping sickness) •
Distribusi Geografis : – Afrika Barat (Gambia-Congo), Tengah ,Af. Timur (Uganda)
•
Morfologi dan daur hidup parasit: – anterior station – multiplikasi binair ( di primary chancre & usus lalat)
•
Gambaran Klinis : – Inkubasi (Africans = non Africans) – Trypanosomal chancre – sembuh spontan 2-3 mgg – Demam (Tryp.+) – Tidur siang hari – Keterlibatan nll :Winterbottom sign +(Lnn membesar) – SSP :perubahan motorik, sensorik: Kerandel sign+(hiperestesi) – Stad. akhir : koma & meninggal 8
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Sleeping sickness
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TRIPANOSOMIASIS CRUZI (CHAGAS DISEASE) •
Distribusi geografis: Amerika Tengah (Mexico) dan Selatan (Argentina)
•
Morfologi dan daur hidup: posterior station –
Stad. Amastigot intraceluler pada otot jantung dan jaringan lain
–
Bentuk Tryp.
bervariasi
–
nukleus sentral, kinetoplast posterior, bentuk C atau U 11
SIKLUS HIDUP
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Disease
:Toxoplasmosis
Phyllum: Class:
Apicomplexa
Coccidia
Order: Eimeriida Genus:
Toxoplasma
Spesies:
Toxoplasma gondii
Sejarah: 1908 Nicolle&Manceaux menemukan hewan Ctenodactylus
gondii pd semua hewan kec.ikan
MORFOLOGI 1. Trophozoit -bentuk spt busur panah/crescent -1 ujung runcing, ujung lain agak membulat/tumpul -uk. 4-8 x 2-4 µm (< eritrosit) -nukleus oval, subsentral -pd ujung runcing, tdp apical complex : conoid, toxonema
Trophozoit dapat berada: • Di dalam sel makrofag berbiak dgn cepat (disebut btk proliferatif/Tachyzoit) koloni dalam makrofag berisi 8-32 tachyzoit Pseudocyst • Di dalam sel jaringan (otot, otak, dsb) berbiak dgn lambat btk non proliferatif / Bradyzoit tjd coloni yg dikelilingi oleh dinding CYST (True Cyst)
Pembiakan trophozoit secara: •
Pembelahan biasa (bynary fission)
•
Internal budding
2. CYST (True cyst / tissue cyst) •
Ukuran 10-100 µ
•
Sel hospes dpt pecah cyst mjd extraseluler dgn dinding asli bentukan parasit sendiri
3. OOCYST Immature
-bentuk oval, dinding tebal, unsporulated -ukuran 10-12 µm -non infektif -infektif : 5-37°C, 1-5 hari Infektif
-sporulated, berisi 2 sporocyst masing2 mengandung 4 sporozoit
Tachyzoit T.gondii
Trophozoit tahap proliferatif
Tachyzoit dengan bentuk crescent, prominen, nukleus sentral kadang subsentral
Kista Toxoplasma gondii
Ookista toxoplasma gondii
SIKLUS HIDUP
SIKLUS HIDUP Mrpk parasit obligat intraseluler Ada 2 fase : o Asexual : dlm tubuh berbagai jenis hewan mamalia dan unggas, tms manusia o Sexual : dlm tubuh kucing Secara normal dimulai dengan masuknya: o Cyst berisi sporozoit o Oocyst
MALARIA
•
Malaria : masalah kesehatan dunia dan negara tropis, termasuk Indonesia.
•
Di Indonesia 10 besar penyakit infeksi, insiden tahun 2009/2010 sebesar 22,9 ‰ dan prevalensi 10,6 % (Riskesdas, 2010; Ditjen P2PL, 2011)
•
Di dunia, diperkirakan penderita malaria mencapai 216 juta kasus (81% terdapat di Afrika) dengan angka kematian sekitar 655.000 kasus (91% terjadi di Afrika). (WHO, 2011). 3/25/2014
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Malaria •
Infectious disease transmitted by mosquitoes (Anopheles.sp)
•
Caused by protozoa of the genus : Plasmodium
3/25/2014
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Six species infect human : P. falciparum (malignan tertian malaria) P. vivax (malaria tertian) P. ovale (malaria tertian) P. malariae (malaria quartan) P. knowlesi (Singh et al, 2004; Sulistyaningsih et al, 2010)
P. cynomolgi (Ta et al , 2014) 3/25/2014
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•
•
Widespread species : –
P. falciparum
–
P. vivax
Less widespread species : –
P. malariae
–
P. ovale
–
P. knowlesi
–
P. cynomolgi
3/25/2014
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3/25/2014
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Transmission and life cycle of malaria parasites : •
A-sexual reproduction in a human host.
•
Sexual multiplication (sporogony) in the anopheline mosquito
3/25/2014
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Life Cycle
3/25/2014
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3/25/2014
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3/25/2014
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Hypnozoites: •
Some of the sporozoites of P. vivax , P. ovale and P. cynomolgi after invading liver cells delay their development into PE schizonts. They become dormant forms called hypnozoites
•
Hypnozoites are reactivated to become PE schizonts by an unknown stimulus Relapse
•
–
P. vivax
–
P. ovale
; after 1-18 mo ; after 2-8 mo
Relapse is not the same as recurrence, which can be due to re-emergence of drug resistent parasites
3/25/2014
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E-phase •
Time between invasion and bursting of the infected RBC : – – – – – –
P. falciparum P. vivax P. ovale P. malariae P. knowlesi P. cynomolgi
: 48 hours : 48 hours : 49-50 hours : 72 hours : 24 hours : 48 hours
Fever is induced when the schizonts rupture, releasing pyrogens into the blood. Once the cycle is synchronized it is this cycle of multiplication in the blood which cause the periodic fevers of malaria. 3/25/2014
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MORPOLOGY
3/25/2014
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E-phase : trophozoite P. falciparum
Young: -Small delicate ring form(<1/3 rbc) -Fine delicate cytoplasm -Accole, Double chromatin, double inf. Mature: -Amoeboid shape -Maurer cleft/ dots -Pigmen granules 3/25/2014
- often numerous -Fine chromatine dots with delicate ring - Comma forms - Uniform appearance like stars in the sky
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E-phase : Schizont P. falciparum
-Not seen in peripheral blood - If (+) : severe malaria - Chromatine divission - Cytoplasm divission - 12-30 merozoite - Dark mass pigmen
3/25/2014
-Small compact -Few, uncommon, usually in severe malaria - mature: 12-30 or more merozoite in cluster - Single dark mass pigmen
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E-phase : gametocytes P. falciparum
Cressent or banana shape Central chromatine dots Rice grain pigmen
3/25/2014
-Banana shape or rounded - Single, well defined chromatine - Scattered, coarse, rice grain like
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E-phase :trophozoite P. vivax
-Inf.RBC > normal -Scuffner’s dots - Ring > 1/3 RBC - Heavy chromatin dots - Amoeboid cytoplasm
3/25/2014
-Schuffner stipling in ghost RBC - Broken ring to irregular form -Single, occasionally two chromatin -Scattered fine pigment
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E-phase :Schizont P. vivax
-Progressive chromatin division - Clump of brown pigmen - 12-24 merozoites
3/25/2014
-12-24 merozoites usually 16 in irregular cluster - Loose mass pigmen
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E-phase :gametocyte P. vivax
-Rounded or oval with homogenous cytoplasm - diffuse brown pigment - eccentric compact chromatin
3/25/2014
-Round large size - Single well defined chromatin - Scattered, fine pigment - Eroded form with scanty or no cytoplasm and pigment present
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E-phase :trophozoite P. malariae
-Inf RBC =/< nRBC - No Scuffner dots - Multiple ring: rare - Small ring with heavy chromatin dots - Vacuola at times ‘filled’ in - Band-shaped solid form -Pigmen form early 3/25/2014
-Ring to rounded compact form - Single, large chromatin - Regular dense cytoplasm - Compact, dense pigmen
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E-phase :Schizont P.malariae
-Progressive chromatin division ( - Clump of brown pigment smaller, darker, larger than that of P. vivax) - 6-12 merozoites - Central arrangement of browngreen pigment
3/25/2014
-Small compact - 6-12 merozoites, usually 8 in loose cluster, some without cytoplasm - concentrated pigmen
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E-phase :gametocyte P. malariae
-Rounded or oval with homogenous cytoplasm - dark & coarse diffuse brown pigment - eccentric compact chromatin
3/25/2014
-Round, compact mass - Single, well defined chromatin dot - Scattered, coarse pigment
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E.phase: Ring form & trophozoite P. knowlesi Ring form: •
Delicate cytoplasm
•
1 to 2 prominent chromatin dots
•
Occasional appliqué (accolé) forms
Trophozoite: • • • •
Compact cytoplasm Large chromatin Occasional band forms Coarse, dark-brown pigmen
E.phase: Schizont P. knowlesi Schizont: •
•
• •
Mature = up to 16 merozoites with large nuclei Clustered around mass of coarse, dark-brown pigment Occasional rosettes Mature merozoites appear segmented
E.phase: Gametocyte P. knowlesi Gametocyte: • • • • • •
Round to oval Compact, may almost fill RBC Chromatin compact Eccentric (macrogametocyte) More diffuse (microgametocyte) Scattered brown pigment
E.phase: P. cynomolgi • • •
•
Almost identical to that P. vivax red blood cell enlarges as the trophozoite grows, Prominence of Schüffner’s stippling and pigmentations in mature trophozoites. The cytoplasm becomes amoeboid and pigments in small granules with yellowish brown in colour are scattered throughout the cytoplasm.