???? ????? ( (Cytopyge

1
?????? ??? ???? ????? ?? ?? ????? ??

• ???? ????? ( (Cytopyge
• ?????? ??? ????? (Excretory Vacuoles)
• ?????? ??? ??????? (Contractive Vacuoles)

2
????????? ?? ????? ??

• ?????
• ?? ?????

3
????? ??? ?? ????? ??

• ????
• ???????

4
????? ??? ???? ?? ????? ??

• Syngamy ??????????
• Conjugation ???????????

5
????? ??? ??????? ?? ????? ??

• ?? ???? (Binary Fission)
• ??? ???? (Multiple Fission)
• ????? ??? (Budding)

6
????? ??? ??????? ?? ???? ?? ????? ??

• ???? ???????
• ???? ???????????
• ???? ????? ?????? ????
• ????? ??? ????? ?? ???? ???????????

7
????? ??? ??????? ??? ???? ?? ????? ??

• ???????? (Schizogony)
• ?????????? (Sporogony)

8
??? ???????? ???? ?? ????? ??

• ?????? ??????
• ???????

9
?????? ?????? ?? ????? ??

• ?????? ?? ???? ????? ? ???????
• ?????? ???? ????????
• ?????? ?? ???? ???
• ?????? ?? ???? ???
• ?????? ?? ???? ????
• ?????? ?? ???? ?????? ????

10
Classification of Protozoa
11
????? ???? ?? ????? ??

• ?? ????? ??? ???? ??
• ????? ???? ??
• ??????? ??????? (???????)
• ??????????? ??? (??? ???)
• ?? ????? ??????
• ?????????? ????????? (???????)
• ?? ????? ??? ???? ?????
• ????? ???????? (???????)
• ????? ??????????? (???????)
• ????? ??????????
• ??????????? ????? ??
• ???????? ??? ????????/??????

12
(No Transcript)
13
????????? ??? ? ????
14
????????? ??? ? ????

• ??? ?? ????? ?? ????? ?????? ????? ?? ??? ????
  (???????? ?????) ?? ?????.
• ?????? ???? ???????? ?? ?????.

15
(No Transcript)
16
???????????
17
African Trypanosomiasis (?????? ???? )
18
American trypanosomiasis?????? ?????
19
Leishmania????????
20
sandflies
21
Leishmaniasis Visceral mucocutaneous
cutaneous
Visceral
mucocutaneous
cutaneous
22
Leishmaniasis

• Leishmaniasis is prevalent in all tropical and
  substropical zones of the world.
• The parasites invade the cells of the
  reticuloendothelial system, such as macrophages,
  bone marrow cells, speen cells and the kupfer
  cells of the liver.

23
Leishmaniasis

• In total 350 million people are at risk and 12
  million people are infected.
• 1.5 Million new cases are reported every year,
  500.000 of which are visceral leishmaniasis.

24
???? ??? ????????

• L. tropica complex
• L. tropica
• L. major
• L. aethiopica

• L. donovani complex
• L. donovani
• L. infantum
• L. chagasi

25
???? ??? ????????

• L. mexicana complex
• L. mexicana
• L. pifanoi
• L. amazoniensis
• L. garnhami
• L. venezuelensis

• L. braziliensis complex
• L. braziliensis
• L. guyanensis
• L. panamensis
• L. lainsoni
• L. colombiensis
• L. peruviana

26
????????? ???? ??? ????????
??? ??????????
??? ??????????
27
sandflies
?????????
????????

• ??? ?????? ????? ????? ?? ?????? 5-2 ??????? ?
  ???? ?? ?? ? ??? ??? ???? ? ????? ????? ? ????
  ?????.

28
(No Transcript)
29
(No Transcript)
30
????????? ???? (????)
31
????????? ???? (????)

• ??? ?????? ?? 61 ???? ????? ??? ???.
• 90 ????? ?????? ????? ?? ?????????- ?????- ?????
  ??? - ??????? ? ????? ???.
• ?? ?????? ??? ???? ????? ???.
• ???? ??????? ?? ?? ????? ???? 15 ?? 20 ???? ????
  ???.

32
????? ????

• ???? ??? (????)
• Anthroponotic Cctanous Leishmaniasis (ACL)
• ???? ????? (???????)
• Zoonotic Cctanous Leishmaniasis (ZCL)

33
???? ??? ?????

• ??? ????
• ??? ????
• ????
• ??????? (??????)
• ?????
• ??????
• ?????????????
• ??????
• ??? ????
• ????????

34
??? ?????? ????

• ????? ????? ???? ???
• ???? ??? ? ???? ????
• ???? ??????
• ?????? ???? ? ???? ????? ??????

35
???? ???
36
???? ???
37
Purple plaque of Cutaneous Leishmaniasis
38
???? ???

• ???? ???? 8-2 ???
• ???? ??? ? ????? ???? ??? ???? ??? ???
• ?????? ???? 12-6 ???
• ???? L. tropica
• ???? ???? ?????
• ???? ????? ??
• ??? ?????? ???
• ?????? ????? ????? ???? L. tropica

39
???? ?????

• ???? ???? ??? ???? ?? ??? ???
• ???? ??? ? ????? ???? 15-10 ???? ?????? ????? ?
  ???? ???? ? ???
• ?????? ???? 6-4 ???
• ???? L. major
• ???? ???? ??????? ??????
• ??? ?????? ???? ?? ?? ??? ???
• ?????? ????? ????? ???? L.major ? L. tropica

40
Classic Leishmania major lesion shows a volcanic
appearance with rolled edges
41
Cutaneous leishmaniasis
42
(No Transcript)
43
(No Transcript)
44
(No Transcript)
45
Cutaneous Leishmaniasis
46
Cutaneous leishmaniasis
47
Cutaneous leishmaniasis
48
Ulcerated lesion of Cutaneous Leishmaniasis over
the knee. Super infection with streptococcus is
noted
49
(No Transcript)
50
(No Transcript)
51
(No Transcript)
52
Cutaneous Leishmaniasis
53
Cutaneous leishmaniasis
54
Cutaneous leishmaniasis
55
Scar on skin of upper leg representing healed
lesion of leishmaniasis CDC

• Scar on skin of upper leg representing healed
  lesion of leishmaniasis

56
Cutaneous leishmaniasis

• Atypical appearance of Leishmania major lesion
  with local spread beyond the borders of the
  primary lesion. Many of the lesions in cases from
  Iraq show an atypical appearance.

57
??? ??? ????? ?? ??????? (recidivan)

• ????? ?? ????? ??????? ???? (?? ?????)
• ??????? ?? ????? ?????? ???? (????????) ????? ???.

58
Cutaneous leishmaniasis with sporotrichotic spread
59
Disseminated cutaneous leishmaniasis
60
??? ????????
Leishmania aethiopica infection
61
Skin lesions of cutaneous leishmaniasis on the ear
62
Cutaneous leishmaniasis in a dog. Affected areas
of skin have alopecia, dryness, and scaling
63
????? ??? ????????? ???? ???? ?? ?????

• ??
• ????
• ?????
• ??????

• ?????
• ????
• ???????
• ?????
• ?????
• ??

64
????? ??? ????????? ???? ??????? ?? ?????

• ????? ???? ???? ? ???
• ???
• ??????
• ??? ???
• ?????
• ??????
• ??? ????
• ?????
• ?????
• ?????

• ????? ??? ????? ? ???? ????
• ??????
• ???? ??? ????
• ????? ????
• ????? ? ????? ??????
• ?????? ???
• ????? ??????

65
???? ??? ????? (abortive)

• ??????? ???? ???? ???
• ????? ?????
• ???? ??? ????
• ?????? ????
• ???? 3-5/2 ???

66
????? ????????? ??????????
????
67
(No Transcript)
68
?????? ?????????? ????? ???? ??? ?? ????? ????
69
Leishmania tropica amastigotes from an impression
smear of a biopsy specimen from a skin lesion
70
??? ????? ???? ? ???? ?????
71
??? ?? ???? NNN
72
????? ?????????? ????

• ????? ?? ????? ???? ??????????
• ??? ????? ????? ???? (????????)
• ???? ????????? ???? ???? ??? ???????

73
?????

• ????? ??????
• ??????? 5?????? ????????
• ????????
• ?????????

74
?????

• ???? ??????
• ???? ??????
• ???? ??????

• ????? ??????
• ????? ? ??????? ?????
• ?????? ?????

75

• Carbon dioxide laser for the treatment of lupoid
  cutaneous leishmaniasis (LCL) A case series of
  24 patients LCL on the face of the 10-year-old
  girl present for 7 years and resistant to
  conventional therapy.

76

• The same patient 5 months after CO2 laser. There
  is no sign of active disease or scaring. Only
  minimal hyperpigmentation is present.

77
????? ? ??????? ????

• ?????? ?? ??????
• ????? ???? ?????
• ?????? ????? ????
• ????????? ??? ??? ????? ?? ???? ??
• ??????? ?? ???????? ??? ?????
• ?????????????
• ???????????

78
(No Transcript)
79
Visceral Leishmaniasis(Kala Azar)(Dum Dum
Fever)
80
Visceral Leishmaniasis
81
???????? ?????? ?? ???? ??? ?? ?? ????? ???? ?
??? ? ?? ???? ?????? ?? ???.
82
??? ?????? ?? ???? ??? ????? ???? ?? 90 ?????
??? ??? ? ??? ?? ???.
83
???? ????????

• L. donovani complex
• L. Donovani???????? ???????
• L. Infantum???????? ????????
• L. Chagasi???????? ??????

84
??? ???? ?? ????? ?? ??? ???????? ??? ? ????
??????? ?? ????
85
????? ???? ???? ?? ??? ?????? ?????????

• ???????? ???????? ??
• ???????? ????
• ???????? ????????
• ???????? ????????

86
???????? ?? ?????

• ?? ??? ???????? ?? ???.
• ???? ?? ???????? ???????? ???.
• ?????? ?????? ?? ?????? ?????? ?? ???.
• ????? ???? ?? ?? ? ?? ????? ???.

87
70 ????? ???????? ?? ????? ?? ?????? ??? 4 ??? ?
97 ????? ?? ?????? ??? 9 ??? ?????? ?? ???.
88
????? ??? ???? ???? ???? ?? ??????????
??????????? ????????? ????????? ????
89
?????????? ? ????? ?????? ????????
90
?? ????? ?????? ????? ???? ????? ?????? ?? ?????
??? ?? ?? ????? ?????? ???.
91
????? ??? ????? ????????

• ??
• ??? ??????
• ??? ?????
• ????? ???
• ??? ? ?????
• ?????
• ???????
• ????? (????)

92
?????????? ? ????? ?????? ????????

• ???? ????? ?????? 2 ?? 18 ??? ???.
• ???? ?????? ?????? ?????? ???.
• ????? ????? ???? ????? ?????? ?? ???.

93
?????????? ? ????? ?????? ????????

• ?? ???? ??? ??????? ?????? ? ?? ?????? ????.
• ????? 2 ?? 3 ?????? ?????? ?? ?? ?????? ??????
  ???.
• ???? ?????? ???? ??? ? ???? ??????? ???.
• ???? ???? ?? ??????? ??? ? ????? ???? ????.

94
?? ? ?? ???? ???????? ????? ???????? ?????.
95
??????????? ? ??? ????? ???? ???? ????? ????????
?????
96

• ????? ? ????? ???? (??????)
• ???????????
• ??? ???? ?? ??? ? ????

97
?? ????? ??????? ???? ??? ???? ???? ???.
98
Coinfections

• HIV
• ??
• ???????
• ?????????

99
????? ??? ???? ????? ????? ?? ????????

• ??????
• ?????????????
• ????????? ????
• ???? ??????????? ?????????
• ?????????????
• ??????????????????

100
Post-Kala-azar Dermal Leishmaniasis (PKDL)

• ??? ?? ?? ?? ????? ???????? ????? ?? ??? ? ????
  ???? ???.
• ????? ?? ??? ? ????? ????? ??? ???.
• 3 ???? ?? ????? ?? ????? ????? ??? ????? ??? ???.

101
Nodular cutaneous leishmaniasis produced by L
infantum in Costa Rica
102
Non-ulcerated lesions harbouring L. chagasi /
infantum parasites, on the back shoulder
103
???????? ?? ??
104
(No Transcript)
105
(No Transcript)
106
(No Transcript)
107
(No Transcript)
108
????? ????????? ??????????
??????
109
????? ?????????? ????????

• ?????? ?????? ????? ?????
• ???
• ????? ?? ????? ???? ??????????
• ??????? ??????? IFA, ELISA, DA
• ??????? ??????????
• ??? ??? ??????? PCR

110
Bone marrow smear showing leishmania amastigotes.
Visceral leishmaniasis after allogeneic
hematopoietic stem cell transplantation
111
???
??????????? ?? ??? ?????
112
Kala Azar IFA Antibody Test
113
?????

• ????? ????? (???????????)
• ????? ?????????
• ???? ?? ?????

• ????? ?? ??????? 5?????? ????????
• ????????
• ?????????

114
????? ? ??????? ???????????

• ????????? ? ????? ????? ??? ??????
• ?????? ?? ????? ?? ??? ?????
• ????? ??????
• ??????? ?? ??? ??? ????? ?? ???? ??
• ??????? ?? ???????? ??? ?????
• ??????????? ????? ? ??

115
(No Transcript)
116
???? ? ????? ?????