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“HEMOFLAGELLATES SPECIES”
Hemoflagell Stages of Possible Models of Vector Disease Characteristics Clinical Mode of Diagnosis Treatment
ates Species Development Transmission (Common (Unique) Samples (Tests)
name and Sign/Symptom
Genus)
a) Trypanos  Amastigote  Congenital Common Names ✓ Chagas Acute phase:  Blood Direct examination ❖ Acute stage
oma cruzi  Promastigote  Vector ✓ Triatomine disease or ✓ Mostly ✓ nifurtimox (8-16
 Epimastigote  borne bugs American asymptomatic, ✓ Blood Smears mg/kg/day, 60-90 days)
 Trypomastigot Transfusion ✓ Reduviid Trypanosomia fever, malaise, ✓ In Vivo culture ✓ benzidazole (5-7 mg/kg/day,
e bugs sis lymphadenopathy, ✓ In Vitro Culture 30-120 days)
✓ Assassin hepatosplenomeg ✓ allopurinol (experimental)
bugs aly, nausea, Indirect examination ✓ azole antifungal agents
✓ Conenose diarrhea (experimental)
bugs Indeterminate Phase: ✓ Serological tests ❖ Chronic stage
✓ Kissing ✓ relatively – detection of ✓ treat symptoms
bugs asymptomatic with antibody against
Genus no detectable T. cruzi
✓ Triatoma parasitemia ✓ Hemagglutination
✓ Rhodnius Chronic Phase: ✓ Immunofluoresce
✓ Panstrongyl ✓ 10-30% of infected nce
us exhibit ✓ ELISA
cardiomyopathy or ✓ Complement
megasyndromes fixation
(megaesophagus,
megastomach,
megacolon)
b) Trypanos  Epimastigote  Tsetse fly  Glossina ✓ Human African Initial symptoms  Blood Card Agglutination ✓ Effective when begun early in
oma  Trypomastigot (Glossina spp.) morsitans Trypanosomia ✓ Chancre (earliest ✓ test for the course of the disease
brucei e ✓ Glossina (Trypanosom a sis sign)  Lymph Trypanosoma (Hemolymphatic phase)
complex morsitan brucei node (CATT) ✓ Pentamidine and suramin
s rhodesiense) Acute phase/Stage I aspirate ✓ Melarsoprol or tryparsamide
✓ (Trypanosoma  Glossina ✓ Hemolymphatic Indirect (late stage-CSF)
bruceirhodesiens palpalis phase  CSF ✓ hemagglutination, ✓ DL-alpha-
e (Trypanosom a Fever, Headache, Joint ELISA, diflouoromethylornithine
) brucei and Muscle Pain, immunofluorescen (DFMO, Eflornithine) is an
✓ Glossina palpalis gambiense) Weakness, And ce ornithine decarboxylase
(Trypanosoma Lymphadenopathy inhibitor that is highly effective
brucei Winterbottom’s sign. in early and late phase of
gambiense) Edema of Arms and Gambain Trypanosomiasis
Legs ✓ Eflornithine: not very effective
against Rhodesian sleeping
Late phase/Stage II sickness
✓ Meningoencephali
tic phase
Kerandel’s sign
Rhodesian
trypanosomiasis
c) Leishma ✓ Amastigote  Blood transfusion  Bite (blood  Cutaneous Incubation period:  Skin  Skin Biopsy First-line therapy (Antimonials):
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nia ✓ Pomastigote  Congenital feed) of the leishmaniasis, ✓ 2 weeks to several

tropica transmission female Old World months
 Contamination of sandfly, cutaneous Skin ulcer:
✓ SbV, Pentavalent antimonials
bite wounds. genus leishmaniasis, ✓ elevated and
include sodium stibogluconate
Phlebotomu oriental sores, indurated
and methylglucamine
s and Delhi boils,
Lutzomyia Baghdad antimonite.
boils, dry or Second line theraphy:
urban Amphotericin B,
cutaneous ✓ pentamidine (for kala-azar),
leishmaniasis metronidazole,
nifurtimox.
  Liposomal AMB (L-AMB) is less
toxic than AMB. It has been
effective in the primary treatment
of VL in both immunocompetent
and immunocompromised
patients
d) Leishm ✓ Amastigote  Blood transfusion  Bite (blood  Espundia e) Destructive and  Skin  Skin Biopsy f) First-line therapy
ania ✓ Pomastigote  Congenital feed) of the  Uta disfiguring lesions  Mucous  Membrane Biopsy (Antimonials):
brazilie transmission female of the face (Tapir Membra ✓ SbV, Pentavalent
nsis  Contamination of sandfly, nose) ne antimonials include sodium
bite wounds. genus stibogluconate and
Phlebotomu Espundia: methylglucamine
s and ✓ metastatic spread antimonite.
Lutzomyia to the oronasal and g) Second line theraphy:
pharyngeal mucosa ✓ Amphotericin B,
pentamidine (for kala-
azar), metronidazole,
nifurtimox.  Liposomal
AMB (L-AMB) is less toxic
than AMB. It has been
effective in the primary
treatment of VL in both
immunocompetent and
immunocompromised
patients
e) Leishm  Amastigote  Blood  Bite (blood  Dum dum f) Destructive and  Blood  Blood g) First-line therapy
ania  Pomastigot transfusion feed) of the fever disfiguring lesions  Bone  Bone marrow (Antimonials):
donova e  Congenital female  Kala-azar of the face (Tapir marrow  Liver/Spleen ✓ SbV, Pentavalent
ni transmission sandfly, nose)  Liver/Spl antimonials include
 Contamination genus Espundia: een sodium stibogluconate
of bite wounds. Phlebotomus ✓ metastatic spread and methylglucamine
and to the oronasal and antimonite.
pharyngeal mucosa h) Second line theraphy:
Lutzomyia
✓ Amphotericin B,
pentamidine (for kala-
azar), metronidazole,
nifurtimox.  Liposomal
AMB (L-AMB) is less
toxic than AMB. It has
been effective in the
primary treatment of VL
in both
immunocompetent and
immunocompromised
patients
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