Hemoflagellates

Hemoflagellates
It is called Hemoflagellates because they have a flagellum and require blood medium to culture them. It is included Trypanosoma ssp. and Leishmania ssp. - Two host life
- Humans and their domestics are Definitive Host
- Insect vectors are the Intermediate Host
Leishmania
Important prosperities
Leishmania spp are protozoans that cause Leishmaniasis in humans. They belong to the same family as the Trypanosoma species.. Leishmaniasis transmitted by the bite of a sandfly of the genus Phlebotomus in the Old World, and of the genus Lutzomyia in the New World. Their primary hosts are vertebrates; Leishmania commonly infects hyraxes, canids, rodents, and humans. Sandflies transmit the parasite by the bite between humans and from canines or rodents to humans. The incidence of disease is wide-spread is present in Africa, the Middle East, regions around the Mediterranean Sea, and Central and South America.



The clinical spectrum of leishmaniasis ranges from a self-resolving cutaneous ulcer to a mutilating mucocutaneous disease and even to a lethal systemic illness.
Leishmaniasis There are many different species of Leishmania and the disease that they cause. directly linked to the species of Leishmania with which a person Several species of Leishmania are pathogenic for man: L. donovani causes visceral leishmaniasis (Kala-azar, black disease, dumdum fever); L. tropica cause cutaneous leishmaniasis (oriental sore, Delhi ulcer, Aleppo, Delhi or Baghdad boil); and L. braziliensis (also, L. mexicana and L. peruviana) are etiologic agents of mucocutaneous leishmaniasis .
Life Cycle
Leishmania are transmitted by a arthropod. In this case it is a small biting fly known as a sand fly. Leishmaniae spend part of their life cycle in the gut of the sandfly, but their life cycle is completed in a vertebrate host. within the sandfly gut, the protozoa are carried as extracellular promastigotes, these parasites multiply in the gut and migrate toward the pharynx. Sandflies transferred promastigotes to the vertrebrate host when the sandfly takes a meal blood by expelling leishmaniae into the bite wound of the mammalian host. from where they pass into the blood and tissues of the human host.
Pathogensis and clinical finding

Leishmaniasis is a parasitic disease caused by several species of genus Different species of leishmania cause different disease.
1. L. donovani causes Viceral leishmaniasis also called Kala-azar and Dum Dum fever. pleenomegaly & hepatomegaly The infection is generalized and the parasite is distributed in the internal organs. The parasite may also cause a variety of skin lesions (dermal leishmaniasis) without any visceral manifestations.
2. L. tropica : causes tropic sore or Baghdad boil, oriental sore and cutenaeous
Leishmianiasis. The infection is limited to a local lesion of the skin and subcutaneous tissues.
3. L. brasiliensis causes Espundia Mucocutaneous leishmaniasis. The infection is limited to a local lesion of the skin but may metastasise to other areas of skin and oro-nasal mucosa
Treatment
Pharmacologic therapies include the following:
• Pentavalent antimony (sodium stibogluconate or meglumine antimonate): Used in cutaneous leishmaniasis
• Liposomal amphotericin B (AmBisome): Effective against pentavalent antimony ? resistant mucocutaneous disease and visceral leishmaniasis
• Oral miltefosine (Impavido): Approved for visceral leishmaniasis due to L donovani; cutaneous leishmaniasis due to L braziliensis, and mucosal leishmaniasis due to L braziliensis
• Intramuscular pentamidine: Effective against visceral leishmaniasis but associated with persistent diabetes mellitus and disease recurrence