1. Flagellates
PETER S. AZNAR, M.D., FPSP

2. Giardia intestinalis AKA Giardia lamblia
S/S: bloating, flatulence, foul-smelling,
fatty diarrhea (often seen in
campers/hikers)
cysts in water

3. G. lamblia Old man with glasses Duodenal aspiration indicated
Entero String Test
Associated with nursery school diarrhea outbreaks
Tx: Metronidazole

4. Giardia lamblia trophozoite

5. Giardia lamblia cyst

6. Entero String Test

7. Chilomastix mesnili Lemon cyst
The cytosome is evident with a curved shepherd’s crook fibril

8. Shepherd’s crook

9. Shepherd’s crook

10. D. fragilis Commonly found together with gram (-) infection
Tetrad karyosome in the nucleus
No cyst form
Means of diagnosis:
Trichome stained smear
Associated with nursery school diarrhea outbreaks

11. Dientamoeba fragilis

12. Trichomonas hominis AKA intestinal trichomonas
organ of locomotion; undulating membrane
undulating membrane extends the whole part of the body
no cystic stage

13. Trichomonas hominis trophozoite

14. Enteromonas hominis nonpathogenic trophozoites have flagella
has cystic stage
common food contaminant

15. Enteromonas hominis

16. Enteromonas hominis

17. Enteromonas hominis

18. Retortamonas intestinalis
smallest flagellate cyst
has two flagella
cyst is similar to chilomastix mesnili

19. Retortamonas intestinalis

20. Trichomonas tenax AKA oral trichomonas present in periodontal disease
smallest trichomonas
organ of locomotion; undulating membrane (2/3 length of the body)
no cystic stage

22. Trichomonas vaginalis
Strawberry shaped lesion/cervix
Associated w/ Hanging Drop tech.
virulence factors; adhesins AP65, AP51, AP33, and AP23 to vaginal epithelial cells
lacks mitochondria
undulating membrane extends one half of the body

23. Trichomonas vaginalis

24. THANK YOU!