Professional Documents
Culture Documents
Parasitic Diseases in
Immunocompromised Individuals
Acquired immunodeficiencies
Deficiencies of the immune system often
develop because of abnormalities that are not
genetic
Inducing opportunistic
infection
Iatrogenic immunodeficiencies
Due to some drugs either for the treatment
of inflammatory diseases or to prevent
rejection of tissues allografts
e.g. corticosteroids, cyclosporine
Albendazole
Ivermectin not registered for human use
in Indonesia
Cryptosporidium parvum
Cryptosporidiosis
Outbreak
Oocyts are ingested by the host, Life cycle includes both
then excyst to be sporozoites which asexual multiplication and
attach to epithelial cells of small sexual reproduction.
intestine. They become enveloped
by the host apical cell membrane,
resulting a parasitophorous vacuole
with membrane components from
both the host & Cryptosporidium, and
differentiate into the trophozoites
which resides intracellularly but
outside of the cytoplasm.
During maturation of trophozoite,
asexual multiplication occurs
resulting in the formation of a type 1
schizont contains 6-8 merozoites.
Rupture of the schizont results in
the release of merozoites which can
invade adjacent host epithelial cells
then develop subsequently into type 1
or type 2 schizonts.
Cryptosporidiosis
Oocyts retain viability, and therefore
infectivity, under moist and cool conditions
for several months.
Oocyst
Treatment
Paromomycin
Nitazoxanide
Highly active antiretroviral therapy (HAART)
aspartyl protease inhibitors of the human
immunodeficiency virus which directly interfere
with the life cycle of the parasite.
In AIDS patients without antiretroviral
therapy, AZT therapy should be started
In these patients, a relationship between
disease severity and CD4+ count.
Patients with AIDS may need higher doses
and long-term maintenance treatment.
TOXOPLASMOSIS IN IMMUNOCOMPROMISED
Congenital disorders
underlying acquired disease (AIDS)
Drug therapy
Malignancies or irradiation
Abnormalities in immunologic function
Individual who defects in cell-mediated immunity is at risk for
reactivation of infection
cerebral toxoplasmosis
Immunocompetent host cell-mediated
immunity :
- controls acute Toxoplasma infection
- prevents disease reactivation
tachyzoites bradyzoites
In immunocompromised :
dormant bradyzoites into rapidly dividing
tachyzoites reactivation (cyst rupture)
life-threatening toxoplasmosis with
encephalitis, necrotic lesions in CNS
Toxoplasmosis in HIV
impaired CD4+ T cells CD154 expression
IL-12 and IFN-
TNF-
NK cell
Mechanisms of parasite evasion