HEM 352

MICROBIOLOGY IMAGES
Abdulrahman Alkhatib Nora Fathalrahman
0507607048 0555461381
 Disclaimer
Make sure to go through the lectures beforehand .

If you find any mistakes or have any suggestions,

please contact the lab committee heads
 Anopheles mosquitos
Vector of Malaria caused by the Plasmodium species
 Malaria parasite life cycle
●

P. vivax & P. ovale: Dormant hypnozoites in the liver and may cause a relapse
 Tertian malaria (P. falciparum) most dangerous
every 3 days "erythrocytic cycle is 48hrs"
higher temperature even between the 1st and 3rd day
 Tertian malaria (P. vivax and P.ovale)
every 3 days "erythrocytic cycle is 48hrs"
 Quartan malaria (P. malaria)
every 4 days "erythrocytic cycle is 72hrs"
Hepatosplenomegaly in malaria
 Severe anemia in malaria
Note: this complication is mostly associated with P. falciparum
 Cerebral malaria
- Sclerotic/hemorrhagic lesion in the brain, brain section
stuffed with parasites
- Clogging of the vessels by the parasite itself & by
rosetting of the reticulocytes
it is associated with high levels of death
Note: this complication is mostly associated
with P. falciparum
 Blackwater fever
occurs in non-immune adults, follows repeated attacks of falciparum
malaria
it happens due to rapid and massive intravascular hemolysis of infected
RBCs
which are excreted in the urine; the urine is not bloody. it’s hemoglobinuric
Haemoglobinuria, haemoglobinaemia & jaundice and Renal failure
Note: this complication is mostly associated with P. falciparum
Examination of Giemsa stained films: (Gold standard)

Thick blood films for detection of presence of parasite

Thin blood films for identification of species
Thick Blood Film

Thick blood film used to detect infection & estimate parasite concentration
RBC are hemolyzed in thick smears; Only leukocytes & malaria parasites present
are detectable
Young ring form (P. falciparum)
Gametocytes Banana shape (P. falciparum)
Trophozoite showing amoeboid appearance (P. vivax)
band form Trophozoite (P. malariae)
Plasmodium knowlesi is a primate malaria parasite commonly found in Southeast Asia. It causes
malaria in long-tailed macaques, but it may also infect humans, either naturally or artificially
 P. knowlesi
This disease’s distribution depends on the distribution of this long-tailed monkey
Capillary tube containing a drop of blood + fluorescent antibody (direct immuno-fluorescence)
Note: This test has a good sensitivity
 Malaria Rapid dipstick tests
Note: This test has a low sensitivity (<60%)
MALARIA DISTRIBUTION AND REPORTED DRUG RESISTANCE
Malaria prevention and control
Herpesviruses

Structure: enveloped, ddDNA

Transmission: through direct contact (kissing, sexual), Aerosal (VZV) and
vertical (CMV)
Causes a lifelong infection with cycles of latency and activation
HSV-1 → upper part of the body
HSV-2 → lower part of the body

in severe infections can manifest as meningitis or encephalitis

Ocular Herpes Eye infections - Herpetic keratoconjuctivitis

HSV causes corneal blindness diseases caused include the following:

• Primary/recurrent HSV keratitis
• Dendritic ulcers
•HSV conjunctivitis
•Acute necrotizing retinitis, chorioretinitis are uncommon but serious
manifestations
Varicella
 Zoster

After primary infection it remains latent in the dorsal root gnglia then can get activated later
in life usually after the age of 60 and more commonly in immunocomprommised individuals

Note: Healthy individuals can acquire chickenpox (but not shingles) from a person suffering
from shingles.
 Ramsey Hunt Syndrome

Symptoms include severe pain, headache, chills, numbness and itching

followed by a vesicular rash that forms over 3-5 days.
* The rash follows a nerve on one side of the body (otic/ophthalmic herpes)
Herpes Simplex Dendritic Keratitis
 Cytomegalovirus

Most common opportunistic pathogen in immunocompromised patients, it's

asymptomatic in healthy individuals but infection remains for life.
 Infectious Mononucleosis
80% caused by Epstin-Barr virus EBV
Infectious Mononucleosis
Infectious Mononucleosis
 Post-transplant lymphoproliferative disorder
Epstein-Barr Virus EBV is the main causative factor for this
Crimean-Congo hemorrhagic fever
Tick
Yellow fever virus
Dangue virus
Yellow fever Endemic in tropical and subtropical areas of South America & Africa
Aedes and Haemogogus mosquitoes the vector of both Yellow fever and Dngues viruses
Liver damage in the case of severe Yellow fever virus infection showing Councilman lesions
Yellow fever prevention:

1. live attenuated vaccine: single dose protects for 10 years

2. mosquito control
Immunocompromisisng conditions
Extra 1
Fever ≥ 38.3 C
Low grade fever 37.5 to 38.3
Hyperpyrexia > 40 C
Pseudomonas
Acinetobacter
 Collecting blood culture

Amount of blood: (Adults: 5-7ml optimum for each bottle, 1ml +1ml/yr of age in children)

Aerobic bottle always, anaerobic only if anaerobes are suspected (abdominal, gynecological
surgery, oncology)
Always take two blood cultures a few hours apart
 1. An artificial heart valve created with a 3-D printer.
2. PICC lines usually go in the arm, but they are smaller in size and may not be suitable for
all medications.
3. Swan Ganz: into the right side of the heart and the arteries leading to the lungs, done to
monitor heart function.

All of these are sources of infections

Biopatch contains 2% glutaraldehyde
just the biology of catheter infection and biofilm bacterial attachement
Candida albicans
Zygomyocytes: Mucorales
Mucormycosis
Aspergillus
Pulmonary Aspergilloma
Brewe’s lung
Septated hyphae
Brucellosis is a zoonosis, acquired from handling of infected animals or
consuming contaminated milk or milk products
 Brucella
facultative intracellular parasites, multiplying mainly in monocyte-macrophage cells.
Brucella Transmission

Extra 1
•B. abortus (cattle)
•B. suis (swine)
•B. melitensis (goats) most pathogenic
•B. canis (dogs)
Spread of Brucella in the body
 Well-formed hepatic granuloma from a patient with brucellosis

Note: Invading brucellae are rapidly phagocytosed by PMN where they survive and multiply.
brucellosis fever
Diagnosis of Brucella
osteoarticular disease, sacroiliitis and Spondylitis-related abnormalities are all features
related to brucellosis

Back pain + fever = brucella as a suspect!

 Rose Bengal Test: (Wright) standard agglutination test

In this test, a sample from patient’s blood is added. The red bengal contains
dead brucella. If antibodies are present in the blood, they will agglutinate.
Number 2 shows strong agglutination.
 Sophisticated version of measuring Titre

Different dilutions of serum tested in mixture with a constant amount of antigen and
greatest reacting dilution is taken as the measure or Titre.
Questions
Q) Which of the following is transmitting Crimean
Congo fever?

C (Tick)
Q) Which one of the following plasmodia is responsible
for tertian malignant fever?

A (P. falciparum)
Q) When the proper collection procedure for blood
culture is applied, alcohol 70% is used for which of
the listed purposes?

A. Cleaning the skin.

B. Disinfecting the skin.
C. Removing selectively potential pathogenic
organism.
D. Defat the skin.
E. Reducing the number of yeasts colonizing the skin.

Answer: D (for fat removal to facilitate the function of the disinfectant used after)
Q) Which of the following plasmodia is having
hypnozoites in the liver?

Both A (P. vivax) and C (P. ovale)

Q) For which of the following systemic infections
is a live attenuated vaccine available?

Answer: C (Herpes-Zoster has 2 vaccines 1 of them is life attenuated) and D (Dengue also has 2 and 1 is life
attenuated) and E (Yellow Fever)
A is malaria its vaccine isn't live attenuated.
B is crimean congo, no vaccines for it.
Q)Which systemic infections elicited by the attached
visual clues, is transmitted by ticks?

Crimean Congo
Q) Ribavirin/tetracycline therapy might be an option in
which of the following systemic infection?

D (Crimean Congo)
Q) Which one of the following visual clues elicits
malignant tertian malaria (Severe malaria with
48hrs cycle)?

B (P. falciparum)
Q) Which of the following is an EBV past infection?

Answer: D
Q) Which of the following statements best applies to
Brucellosis?
A. A vaccine is available and safe in humans
B. It is mainly distributed in south America and the
Caribbean
C. Therapy with tetracycline and genta is a doable
option
D. Ticks are the most common vectors in Pakistan
and India
E. Human to human transmission is exceedingly
common
Answer: C
Best of luck