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Blastocystishominis

Diantamoeba fragilis

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Superkingdom Protista

Subkingdom Protozoa

Phylum Sarcomastigophora

Order Amoebida

Family Blastocystidae

Genus Blastocystis

Species hominis

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Biology 4 morphological forms of Blastocystis hominis

 Vacoulated

 Amoeba – like

Granulated

Multiple fission

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Biology Vacoulated

Common in Stool

Large central vacuolepushes the cytoplasmand nuclei to theperiphery of the cell

Central vacoule –reproductive organelle

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Biology Amoeba – like

Occasional on stool

Pseudopodia

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Biology Granular

Onserved in oldculture

Develop into daughtercells of the amoebaform when rupture

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Biology Multiple fission

 Arise from vacuolatedform

Believed to producemultiple vacuolatedform

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Important Information Host – man (Reservoir host)

Motility: motile

Mode of Reproduction: Binary fission Sporulation in strict anaerobic condition

Optimal growth at 37°C in the presence of bacteria

Does not grow in the presence of fungus

Infective stage: Thick walled cyst

Diagnostic stage: Thick walled cyst

Habitat: Lower intestinal tract

Mode of Transmission: fecal – oral route

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Pathogenicity & Clinical Manifestation Pathogenicity: Blastocystosis

Clinical Manifestation

Sometimes asymptomatic

May cause recurrent diarrhea, abdominal cramps,anorexia.

Heavy infection nausea, vomiting, low grade feverand malaise

Stool eosinophilia

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Diagnosis Direct Fecal Smear

Culture:

Use Boeckand Drbohlav’s media Nelson and Jones media

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Treatment Metronidazole – drug of choice

750 mg 3 t imes daily for 10 days

Pedia: 35 – 50 mg/kg/day in 3 doses

Note:

Metronidazole is contraindicated with early pregnancy.

 Alcohol intake during treatment may result to vomiting and headache.

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Epidemiology Cosmopolitan

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Prevention and Control Consume safe drinking water

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Biology Only trophozoite stage available

No cyst stage

7-12 µm with 2-4 nuclei

No peripheral chromatin

Karyosomeconsists of 4-6 discrete granules

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Important information Host – man

Motility: motile (pseudopodia)

Mode of Transmission: fecal – oral route

Reproduction: Binary fission Infective stage: trophozoite

Diagnostic stage: trophozoite

Habitat: lumen of the caecumand upper colon

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Often asymptomatic

Disease: Dientamoebiasis or Hakansson’s Syndrome

 When symptomatic

 Anal pruritus (Most common)

Intermittent diarrhea with excess mucus

 Vague abdominal pain

 Anorexia

Pathogenicity & Clinical Manifestation

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Diagnosis Direct Fecal Smear

Fixation

Note:

Often mistaken with other amoebae

Can survive for 2 hours in distilled water

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Treatment Iodoquinol– drug of choice

650 mg 3x a day 

Pedia – 40mg/kg/day in 3 doses for 20 days

Tetracycline

Metronidazole

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Epidemiology Prevalent in Germany 

Usually in companion with Enterobius vermicularis

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Prevention and Control Proper sanitation

Proper disposal of human waste

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