AMOEBA KELAS RHIZOPODA

PROTOZOA BERGERAK DG PSEUDOPODI (KAKI SEMU)

• PATOGEN: 1. ENTAMOEBA HISTOLYTICA,2. MENINGOENCEPHALITIS AMOEBA (FREE-LIVING AMOEBA)

• TIDAK PATOGEN:1. ENTAMOEBA COLI

2. E. GINGIVALIS3. ENDOLIMAX NANA4. IODAMOEBA BUTSCHLII5. DIENTAMOEBA FRAGILIS

MORPHOLOGYNUCLEI

MORPHOLOGY TROPHOZOTES& CYSTS

MorphologyEntamoeba histolytica

E.histolytica vs E.coli cyst/troph

DIFFERENTIATION E.HISTOLYTICA VS E.COLI

LIFE CYCLEENTAMOEBA HISTOLYTICA

AMOEBIASISEpidemiology

Prevalence : varies with level of sanitation• higher in tropics and subtropics than in temperate

climates. • Entamoeba histolytica is the second leading

cause of mortality due to parasitic disease in humans. (The first being malaria).

• Worldwide prevalence is about 10% to 50% WITH 50.000-100.000 DEATH/YEAR

• Cyst passers (CARRIER):important source of infection

TRANSMISSION

• 1.DIRECT CONTACT of person to person

( FECAL-ORAL)• 2- VENEREAL TRANSMISSION among

homosexual males( ORAL-ANAL )• 3- FOOD & DRINK contaminated with feces

containing the E.hist. cyst• 4- Use of human FECES fertilizer• 5- contamination of foodstuffs by FLIES, and

possibly COCKROACHES

Clinical Symptoms

• Asymptomatic infection/CARRIER• SYMPTOMATIC INFECTION AMOEBIASIS

• INTESTINAL EXTRAINTESTINAL

Amebiasis symptoms: Hepatic: Liver abscces Diarrhea or dysentery, PulmonaryAbdominal pain, The extra fociCramping , Anorexia,

COLITIS: Dysenteric Non-Dysenteric

AMOEBIASISDIAGNOSIS

CLINICAL SYMPTOMMICROSCOPIC EXAMINATONIMMUNODIAGNOSIS RADIOLOGIC (X –RAY) EXAMINATION

(EXTRA INTESTINAL) 

IMMUNODIAGNOSIS

1- Antibody detection

2- Antigen detection may be useful as an adjunct to microscopic diagnosis

3- SEROLOGY(complement fixation test 3- SEROLOGY(complement fixation test (CFT), indirect hemagglutination ((CFT), indirect hemagglutination (IHAIHA), ), Precipitin test)Precipitin test)

44- - Intradermal Test Intradermal Test

TREATMENTAMOEBIASIS

METRONIDAZOLEMETRONIDAZOLE DRUG OF CHOICE

INTESTINAL AMOEBIASIS

ADULT, 3X750 MG/DAY FOR 10 DAYS

CHILDREN. 3X15 MG/KG BW FOR 10 DAYS

LIVER AMOEBIASIS: 1X1.5G-2.5G/DAY FOR 3 DAYS

OTHER DRUGS: TINIDAZOLE, ORNIDAZOLE, NIMORAZOLE, SECNIDAZOLE

PREVENTION

• FOOD/DRINKING WATER:COOKED WELL

• PERSONAL HYGIENE

• ENVIRONTMENTAL HYGIENE

• VECTOR CONTROL:FLIES, COCKROACHES

• LABORATORY WORKERS (PRIMATE FECES)

• CARRIER : FIND &TREAT

FREE-LIVINGAMOEBA

(a). ACANTHAMOEBA : WARM BRACKISH WATER

(b). NAEGLERIA FOWLERI: WARM FRESH WATER

TROPH: 14-40 MICRON CYST : 10-25 MICRON

CLINICAL INFECTION

MENINGOENCEPHALITIS PHARYNGITIS, FEVER,HEADACHE

MENINGITIS DEATHEYES & SYSTEMIC INFECTIONSKIN INFECTION

TREATMENT: AMPHOTERICIN BPREVENTION: WARM WATER RECREATION

HYGIENE

CRYPTOSPORIDIUM PARVUM

CRYPTOSPORIDIOSIS:

• CHOLERA-LIKE DIARRHEAE

• FEVER, NAUSEA, DEHYDRATION• IN HIV/AIDS FATAL

EPIDEMIOLOGY LIFE CYCLE

• COSMOPOLIT • ZOONOSIS. • CROWDED

POPULATION• LOW HYGIENIC ,

PATOGENESIS & GEJALA KLINIK

SPOROZOITKERUSAKAN&KERADANGAN EPITEL USUS

D.P.T NORMAL: KLINIS RINGAND.P.T RENDAH , GANGGUAN SISTEM IMUN (MISALNYA AIDS/HIV• DEMAM• DIARE CAIR (CHOLERA-LIKE DIARRHEA)• NYERI PERUT, MUAL• DEHIDRASI, BERAT BADAN MENURUN

PATOGENESIS & GEJALA KLINIK

SPOROZOITKERUSAKAN&KERADANGAN EPITEL USUS

D.P.T NORMAL: KLINIS RINGAND.P.T RENDAH , GANGGUAN SISTEM IMUN (MISALNYA AIDS/HIV• DEMAM• DIARE CAIR (CHOLERA-LIKE DIARRHEA)• NYERI PERUT, MUAL• DEHIDRASI, BERAT BADAN MENURUN

OOKISTA CRYPTOSPORIDIUM

PEWARNAAN TINJA DENGAN

ACID-FAST KIYOUN MODIFICATION

(diameter: 4- mikron)

SPORULATED OOCYST

Toxoplasma gondii(toxoplasmosis)

SEBARAN GEOGRAFIS

Toxoplasma gondii :• KOSMOPOLIT, termasuk ZOONOSIS.

• OBLIGAT INTRASELULER

• 2 FASE SIKLUS HIDUP:– INTESTINAL (ENTEROEPITELIAL)– EXTRAINTESTINAL

SIKLUS HIDUP

• FASE INTESTINAL (PADA KUCING) terbentuk OOKISTA (oocyst) 

• FASE EXTRAINTESTINAL (PADA HEWAN TERINFEKSI LAINNYA, TERMASUK KUCING DAN MANUSIA)

Terbentuk BRADIZOIT dan TAKIZOIT

PENULARAN

1. PER ORAL( OOKISTA –pada tinja kucing) 2. BRADIZOIT (pada DAGING

MENTAH/TAK MATANG

3. PENULARAN TRANSPLASENTAL   ABORSI SPONTAN, LAHIR MATI, BAYI LAHIR CACAT MENTAL/FISIK.

TOXOPLASMOSIS (MANUSIA)

• UMUMNYA : ASIMTOMATIK • PADA IMUNITAS YG RENDAH (MISALNYA

AIDS) BISA TERJADI: TOXOPLASMOSIS BERAT, DG HEPATITIS, PNEUMONIA, BUTA,

GANGGUAN SARAF.

TAKIZOIT INTRASELULER

. 

• BRADIZOIT DI DALAM OTOT JANTUNG.

GEJALA KLINIK • Sebagian besar toksoplasmosis asimtomatik.• Imunokompeten: flu like symptom, limfadenopati• Gejala klinis berat pada:

– Kehamilan • abortus, • kerusakan otak janin (mental

retardation), • kerusakan mata (retinochorditis)

– Imunodefisiensi (immunocompromised)• Kerusakan otak, hati, paru, organ lain• Kematian penderita

DIAGNOSIS

DUGAAN TOXOPLASMOSIS ISOLASI TOXOPLASMA GONDII DENGAN

MELAKUKAN BIOPSI

• TONSIL • KELENJAR LIMFE

PENGOBATAN

• Infeksi akut: pyrimethamine atau sulphadiazine.

• Spiramycin : terapi alternatif • Perempuan hamil dicegah terinfeksi

toksoplasmosis dengan:• Daging mentah ditangani dengan baik• Tidak makan daging kurang matang• Hindari kontak tinja kucing

PENCEGAHAN TOXOPLASMOSIS

• MASAK MAKANAN-MINUMAN• HINDARI KONTAK LANGSUNG DENGAN

DAGING/ORGAN MISALNYA DI ABATOIR DAN PENJUAL DAGING

• CUCI TANGAN/GUNAKAN SARUNG TANGAN JIKA BERKEBUN

• OBATI PENDERITA MANUSIA/HEWAN• LINGKUNGAN BEBAS TINJA KUCING/HEWAN LAIN• PEMERIKSAAN IBU HAMIL