Analysis of feces for protozoa. Fecal analysis for protozoa: how to pass it and what it reveals

Many types of unicellular organisms can be found in feces. The place of their deployment is mainly the intestines. You can detect cysts of the simplest of the following classes:

flagella
amoebic
coccidia
ciliated
Amoebiasis

This disease is caused by the simplest - dysenteric amoeba. This unicellular is localized in the large intestine and is excreted as a trophizite or cyst. Most amoebae are not pathogenic, they include: intestinal, Byuchli, Hartmann. Finding them in feces is quite difficult. A dysenteric amoeba cyst is easier to diagnose. Its presence in the feces indicates that a person has ulcerative or dysentery colitis. Suspicion of the presence of amoebas in the body may arise due to:

With weakness
Blood streaks in stool

The disease with untimely treatment can take a chronic course.

The following forms of amoebas are found in feces:

tissue
translucent
encysted

Peritonitis
Tumor neoplasm
Intestinal abscess
from the anus

Liver enlargement
Blood and mucus in stool
Dramatic weight loss

Sometimes balantidia are found in the feces in the form of cysts, even in healthy people.

Giardiasis

weight loss
Bloating
lack of appetite
Foamy chair
Skin rashes

Giardia affect the intestines mechanically and block its mucosa, which harms digestion. Food in the intestines cannot be digested, and its remains begin to rot. As a result, many bacteria are formed. This leads to diseases of the biliary tract, gallbladder and.

cholecystitis
Sclerosing cholangitis
Analysis for protozoan cysts

To detect some types of protozoa for staining glass, prepared according to Gram are used. In some cases, the method is ineffective in relation to some protozoa, for example, cryptosporidium. Their cysts are poorly capable of retaining color and are often confused with yeast-like fungi. In this case, coloring for acidity is applied. In this solution, cysts of cryptosprodia turn pink or red, other microorganisms, reacting to this solution, take on a purple hue.

In order to control treatment, an examination of the body for the presence of protozoan cysts is carried out depending on the disease:

In patients with amebiosis and balantidiasis - on the next day after treatment
In patients with giardiasis after a week

Preparation for analysis

On the eve of the analysis, it is necessary to exclude the use of laxatives and products that cause liquefaction of the stool. It should not be used for two days before the analysis, oils and drugs to stimulate intestinal motility. Do not eat coloring foods and medicines.

Research objectives

The study of feces for the content of protozoan cysts is carried out in order to:

Treatment of balantidiasis

Balantidiasis is treated in two courses of five days. Myomycin and Oxytetracycline are prescribed 4 times a day. The prognosis for timely treatment is favorable.

Amoebiosis treatment

Amoebiosis is treated depending on the type of infection, the condition of the mucous tissues and organs. For the treatment of invasive amoebiosis, 5 nitroimidazoles are used:

Seknidozol
Metronidazole
Trichopolum
Ornidazole
Fasijin

These drugs are used to treat intestinal amoebiosis and for abscesses of any form. Patients with amoebic dysentery, in whom the disease is severe, in addition to those listed, are prescribed antibacterial drugs to avoid the occurrence of purulent abscesses. With the formation of abscesses, it is drained through the skin (aspiration). To date, amebiosis can be cured completely if its therapy is started in time. And for this, early diagnosis and the right treatment are needed.

Detection and differentiation of protozoa (distinguishing pathogenic from non-pathogenic forms) is a rather difficult task. Most unicellular organisms in feces are found in two forms: vegetative (trophozoite stage) - active, mobile, vital, easily amenable to harmful influences (in particular, cooling) and therefore quickly dying after excretion from the intestine, and in the form of cysts resistant to external influences ( oocyst). In the formed feces, protozoa, as a rule, are found only in the encysted state; to detect vegetative forms, it is necessary to examine the feces while still warm. This is due to the fact that in the cooled feces, the vegetative forms of protozoa quickly die and the dead quickly succumb to the action of proteolytic enzymes, as a result of which they lose the characteristic features of their structure. In addition, during cooling, the mobility of protozoa decreases and then disappears - an important auxiliary factor in their differentiation.

In faeces, 20 species of protozoa can be identified (8 pathogenic and conditionally pathogenic and 12 commensals). Intestinal protozoa live in the small or large intestine in the trophozoite and/or cyst stage. They belong to one of 4 groups: amoeba, flagellates, ciliates and coccidia.

Entamoeba histolytica (dysentery amoeba) causes amoebiasis in humans. It is localized in the large intestine, excreted in the form of a trophozoite (with liquid feces) and / or cysts (in a decorated stool). Due to the fact that most types of amoeba (intestinal, Hartmann, Buchli) are not pathogenic for humans, great care should be taken when evaluating the results of faecal examination. Only the detection of hematophagous trophozoites (tissue form of E. histolytica forma magna) can serve as a reliable sign of amoebic dysentery and/or amoebic ulcerative colitis in a patient. The presence of erythrocytes in the protoplasm of amoebae is a very important diagnostic sign, since non-pathogenic forms of amoebae never contain them.

In all other cases, the detection of E. histolytica-like forms of trophozoites that do not contain erythrocytes is not a basis for the diagnosis of amoebiasis as a disease. Similarly, the results of detection of only E. histolytica cysts (luminal form), which can be detected in persons recovering from acute amoebiasis, in those suffering from a chronic form of amoebiasis, and in carriers, are evaluated in a similar way.

Among cryptosporidium species potentially pathogenic for humans are Cryptosporidium parvum and Cryptosporidium felis (detected in HIV-infected people). The most typical site of infection in humans is the distal small intestine. In patients with severe immunodeficiencies, the entire gastrointestinal tract can be infected - from the oropharynx to the rectal mucosa.

Diagnosis of cryptosporidiosis in most cases is based on the detection of cryptosporidium oocysts in feces and / or (much less often) in a biopsy specimen of the small intestine mucosa in the syndrome of watery diarrhea. Use microscopy of prepared preparations stained by Gram. In most cases, this method of staining does not reveal oocysts, due to their poor ability to retain the dye and the inability to distinguish them from yeast-like fungi. Therefore, coloring is used for acid resistance. With this method of staining, cryptosporidium oocysts are stained red or pink and are clearly visible against a blue-violet background, in which other microorganisms and intestinal contents are stained.

In acute cryptosporidiosis, the number of oocysts in the feces is large, which makes it easy to detect them by microscopy of stained preparations. However, in mild chronic cryptosporidiosis, when the number of oocysts in the feces is low, enrichment techniques should be used to increase the likelihood of their detection. In recent years, serological methods have become frequently used to diagnose cryptosporidiosis.

Cryptosporidiosis of the biliary tract can be manifested by cholecystitis, much less often by hepatitis (with an increase in the concentration of bilirubin, activity of AST, ALT, alkaline phosphatase in the blood) and sclerosing cholangitis. For the diagnosis of biliary cryptosporidiosis, liver and bile biopsies are examined, where cryptosporidium can be found in various stages of development.

To control the effectiveness of treatment of protozoal lesions of the intestine, feces are examined depending on the identified disease: with amoebiasis, balantidiasis - immediately after treatment, with giardiasis - after 1 week. After treatment of biliary tract invasions, efficacy can be monitored both in the study of feces and bile.

Many types of unicellular organisms can be found in feces. The place of their deployment is mainly the intestines. You can detect cysts of the simplest of the following classes:

The disease with untimely treatment can take a chronic course.

The following forms of amoebas are found in feces:

Sometimes balantidia are found in the feces in the form of cysts, even in healthy people.

Giardiasis

Cryptosporidosis

To detect some types of protozoa, preparations prepared according to Gram are used for staining glass. In some cases, the method is ineffective in relation to some protozoa, for example, cryptosporidium. Their cysts are poorly capable of retaining color and are often confused with yeast-like fungi. In this case, coloring for acidity is applied. In this solution, cysts of cryptosprodia turn pink or red, other microorganisms, reacting to this solution, take on a purple hue.

In order to control treatment, an examination of the body for the presence of protozoan cysts is carried out depending on the disease:

In patients with amebiosis and balantidiasis - on the next day after treatment
In patients with giardiasis after a week

Preparation for analysis

On the eve of the analysis, it is necessary to exclude the use of laxatives and products that cause liquefaction of the stool. Do not use rectal suppositories, oils and drugs to stimulate intestinal motility for two days before the analysis. Do not eat coloring foods and medicines.

People who have returned from a foreign trip
If you suspect the use of contaminated water or food. Such cases include accidental ingestion of water while swimming in a river or lake.
Children attending childcare facilities

Treatment

Treatment of balantidiasis

Balantidiasis is treated in two courses of five days. Myomycin and Oxytetracycline are prescribed 4 times a day. The prognosis for timely treatment is favorable.

Amoebiosis treatment

Amoebiosis is treated depending on the type of infection, the condition of the mucous tissues and organs. For the treatment of invasive amoebiosis, 5 nitroimidazoles are used:

These drugs are used to treat intestinal amoebiosis and for abscesses of any form. Patients with amoebic dysentery, in whom the disease is severe, in addition to the listed drugs, are prescribed antibacterial drugs to avoid the occurrence of purulent abscesses. With the formation of abscesses, it is drained through the skin (aspiration). To date, amebiosis can be cured completely if its therapy is started in time. And for this, early diagnosis and the right treatment are needed.

Treatment of giardiasis

Treatment of giardiasis lasts in courses of 5-10 days.

To start the treatment of giardiasis, a laboratory study of feces for giardia cysts is sufficient. If the patient has impaired liver function or intestinal disorders, additional examinations are recommended to diagnose concomitant diseases. The following drugs are used:

Treatment is prescribed in courses of 5-10 days with a break of a week. After therapy with antiprotozoal drugs, a course of enterosorbents is prescribed to cleanse the body of the waste products of protozoa.

The infection is often accompanied by diarrhea. Imodium can be used to treat it. In addition to drug therapy, a diet is necessarily prescribed. To restore the digestive function, enzymes and mucoprotectors are used. The patient also needs to drink plenty of fluids.

You can learn about the methods of treating giardiasis by watching the following video:

Prevention

Wash fresh fruits and vegetables thoroughly.
Observe the hygiene of the animals in the house.
Use only clean water for drinking and cooking.
Beware of unknown bodies of water.
Don't eat outside.

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Protozoan cysts in the human body

Causes of protozoan cysts

The kingdom of the simplest representatives of microorganisms that infect humans is quite a lot. All of them have a different structure, behavioral features and organs of localization.

They remain in the external environment until the moment of infection by different classes of protozoa:

Protozoan cysts: infection

How does the penetration of microorganisms into the body until the cyst is found in the feces.

That's just how the future protozoan microorganisms begin their life cycle. But only on the process of infection their activity does not end. They continue to develop, grow inside a person, contributing to the weakening of his immunity and leading to serious consequences and disorders.

Giardiasis. Provoke the disease - lamblia. Symptoms: temperature 38°C, swollen tongue, allergic rashes, swollen lymph nodes, keratinized parts of the skin near the mouth. No less dangerous are the consequences: disorders of the nervous system, allergic reactions, enteritis, cholecystitis, dysbacteriosis, pancreatitis, liver enlargement.

Trichomoniasis. Source - Trichomonas. Manifested in burning, itching, discharge in men and women. Leads to prostatitis, infertility.

Amoebiasis. It is characterized by vital activity in the body and the large intestine of amoeba. Against the background of helminths, diseases and symptoms appear: dysentery, indigestion, stools with bloody mucous secretions, impaired brain function, followed by encephalitis. Gradual anemia, weakening of the immune system.

Tests for the presence of protozoan cysts

It is not worth making a diagnosis and determining further treatment on your own. It is better to undergo an accurate diagnosis in specialized clinics in a laboratory. To determine the simplest, you should undergo a series of tests for microorganisms:

Treatment of protozoan cysts

Depending on the microorganism that was found during the study, a long-term treatment begins. All protozoa must be eliminated from the human body, including their cysts and eggs. The entire period of the course, the patient is monitored in the form of analyzes and a forecast of the compliance of the treatment with the disease.

"Fasigine". Strong anthelmintic drug. With amoebiasis, the daily intake is 600 grams 2 times. The duration of treatment is 5 days. With giardiasis - 2 grams once. Re-admission after 7 days. From trichomoniasis - 150 mg 3 times for 5 days.

"Trichopol". from protosinal infections. With trichomoniasis - 250 mg 2 times a day. Course - 10 days. From giardiasis - 500 mg 2 times a day Course - 10 days. With amoebiasis - 1.5 grams 3 times. Duration - 5 - 10 days. Against balantidiasis, a daily intake is prescribed - 750 mg 3 times. Treatment - 6 days.

"Decaris". From toxoplasmosis daily intake - 150 grams once. The duration of the course is 3 days. Repeat therapy after 1 week.

"Metronidazole". Trichomoniasis involves a daily intake of 250 mg - 400 mg 2 times a day. Course - 10 days. From lamblia appoint a course of 5-7 days. Daily dosage - 500 mg 2 times. Amebiasis is treated with a course of 10 days. Daily dosage - 1.5 grams 3 times. From balantidiasis, the duration of admission is 6 days. Daily dosage - 750 mg 3 times.

Cysts in biology

Important! The function of reproduction for some protozoa is secondary, while the maximum distribution in the environment is the main goal. Certain groups of microbes are generally able to share sexually.

The main causes of encystation

Among numerous laboratory studies, the main reasons for the formation of a thick shell, which ensures the preservation of the viability of microorganisms, were identified. Given the scale of the distribution of protozoa in the environment, the following factors are distinguished:

temperature factors;
excess or lack of oxygen in the environment;
drying up of reservoirs;
loss of food resources;
change in the concentration of acidity of the medium.

the allocation of feces in a natural way (without auxiliary drug methods, without catheterization);
biological samples must be fresh (no more than 5-6 hours should pass from the moment of collection to the study);
dieting 3-4 days before stool collection;
exclusion of absorbents and other medicines 2 days before the test;
urinate and shower before defecation;
collection containers must be hermetically sealed, sterilized.

In the laboratory, protozoan cysts are detected by two main methods for detecting cysts. Popular is a smear with Lugol's solution or iodine. To do this, a fresh portion of the feces is treated with one of these solutions, after which it is placed between the pieces of glass and studied under a magnifying glass. Another way is to mix with ether, when the stool sample is run in a centrifuge. After such manipulations, the cysts fall into a natural sediment.

But perhaps it is more correct to treat not the consequence, but the cause?

Fecal analysis for protozoa: how to pass it and what does it reveal?

The human body is a habitat for a variety of microorganisms. They are especially abundant in the large and small intestines.

One part of the microorganisms that colonize the intestines is "beneficial" to the body, helping to cope with the process of digestion. Another part of microorganisms, as well as helminths and protozoa, getting into the human body from the environment, causes various infectious diseases.

The value of the analysis of feces for protozoa

There are a lot of pathogenic and opportunistic protozoa that live in the distal intestines. The routes of infection are also varied.

The coprogram for the simplest allows you to identify:

adult forms of protozoa;
young forms of protozoa.

The greatest danger is for the elderly, as well as for children. People who have a disorder in the immune system.

When is the test scheduled?

The test is assigned in the following cases:

This allows you to identify the carriage and further infection.

It should be noted that the test is prescribed when specific complaints appear in patients, such as:

Dyspeptic complaints: nausea, vomiting, flatulence, loose stools, tenesmus.
Weakness (malaise) with little physical exertion.
Dental "tapping".
Sleep disorder.
Irritability, depression.
Sudden change in weight.

Acute respiratory viral diseases, tonsillitis, bronchitis, influenza.
Susceptibility to various diseases of the reproductive system.
When swimming in a river or lake, in case of accidental ingestion of water into the gastrointestinal tract.
Use of well water.
Returning from a holiday in tropical countries, with poor hygiene conditions and an increased risk factor for infection with protozoa.

Preparation for analysis and material for research

Analysis for feces does not require special preparation, however, it is worth noting a few simple requirements:

For several days before the analysis, you should not take any medications. In particular, laxatives, antispasmodics. They affect the work of the small and large intestines, changing its peristalsis.
Limit rectal suppositories containing oils.
Avoid using a cleansing enema.
Do not take bismuth, barium sulfate preparations, as they contribute to the coloring of feces.
For a more reliable determination of the protozoa in the feces, it is necessary to refuse heavy food.
Limit the consumption of fruits and vegetables.
You can take low-fat dairy products.

Fecal analysis for protozoa or helminths:

Rented in the morning.
Before the act of defecation, it is necessary to urinate. This is necessary so that the feces do not mix with urine.
Another requirement - no need to wash.
After the act of defecation, a fence is taken using a spoon and a special container, which can be purchased at any pharmacy.
A small amount of feces is collected, about twenty grams.
Then the feces are examined in the laboratory of the clinic.
It should be noted that the time after the act of defecation before the feces are handed over to the laboratory should not exceed two hours.

The study proceeds as follows:

When examining the contents of feces, conditionally pathogenic forms can be detected. They characterize the normal functioning of the gastrointestinal tract. If they are present, we talk about the normal functioning of the immune system, and with a sharp decrease, about reduced immune protection. With a sharp increase in their population indicates the occurrence of a pathological process in the intestine.
In addition to visualization in the feces of adult (vegetative forms) protozoa, cysts can also be detected. They are less informative, since many protozoan cysts are similar to each other.

What should be the analysis of feces in the norm and what protozoa does it reveal?

Therefore, if protozoa are suspected in the body, and not detected during the first examination of feces, a second fecal examination is prescribed for microscopic examination. Repeated samples are prescribed with the effectiveness of drugs against protozoa.

Thanks to the analysis of feces, it is possible to visualize such forms of protozoa as:

Deciphering the analysis of feces

Amoeba

Amoeba - the detection of these protozoa in the feces indicates the occurrence of such an infectious disease as amoebiasis.

Infection occurs as follows:

The source of infection is a person who releases vegetative forms into the environment, as well as protozoan cysts.
Infection occurs when hygiene rules are not followed.
The simplest enter the gastrointestinal tract through dirty hands or with unwashed fruits or vegetables.
According to statistics, the disease affects mainly men aged twenty to forty years.
Prevalence: worldwide.

After the amoeba enters the distal intestines, it is introduced into the mucous membrane, which is accompanied by a specific syndrome.

There is a weakening of peristalsis, and deep or superficial defects are formed in the mucous or muscular membrane of the intestine. In this case, the diameter of the ulcers reaches several centimeters.

lamblia

Giardia - visualization in fecal contents indicates the presence of a disease such as giardiasis.

The source of infection is both humans and animals.
Colonizes the distal small intestine.
Infection occurs through contact with infected animals.
Ways of infection can also be: dirty hands, unwashed vegetables and fruits, things, unwashed dishes, accidental ingress of water with Giardia into the digestive system from a river or lake, well water.

ciliates

The routes of infection are the same as those of the amoeba or Giardia.
When it enters the intestine, it is introduced into the mucous membrane. Ulcers, erosion are formed.
Then there is scarring of the affected part of the intestine.
Most often found in people involved in farming.

Blastocysts

Blastocysts - the ways of infection of protozoan infection are the same as in amoeba, Giardia, ciliates.

Localized in the distal parts of the large intestine.
They occur even in healthy people.
Symptoms can often be absent and occur as a result of a decrease in the protective properties of the body.
Under adverse environmental conditions, like many protozoa, they are able to form cysts.

Cryptosporidiosis

Cryptosporidiosis - the latent period is on average about two weeks, from the moment of infection of the patient.

It has the following characteristic features:

It mainly affects the small intestine.
It occurs equally in both men and women.
After entering the small intestine, it invades the intestinal cells and forms an oocyst.
The route of infection is fecal-oral.

Serological methods for the study of protozoa

In addition to studying the analysis of feces for the presence of protozoa in the body. There is also a serological test - a hemagglutination reaction or latex agglutination can detect amoebiasis.

The complement fixation test or indirect hemagglutination test allows you to verify:

Where to take the test and how much does it cost?

The cost of analysis for the simplest:

A stool test can be taken at any clinic or private center. The price fluctuates bran.
The price for PCR and other serological tests will reach up to 3,000 rubles.

As a result, we found out that people need to undergo a fecal analysis in a planned manner for employment. Children to go to kindergarten or school. Students in higher education institutions or colleges.

In addition to finding amoeba, giardia, balantidia, cryptosporidium or blastocysts in the feces, various helminths can also be found. For example: roundworm, bovine and pork tapeworm, pinworms and others.

There is also, in addition to the classical method for determining protozoa in feces, other methods, such as polymerase chain reaction, passive hemagglutination reaction, latex agglutination.

Moreover, some types of protozoa can survive in the form of a cyst for up to several years.

Protozoa live in the human small or large intestine. They are unicellular microorganisms. The ways of their penetration into the body of the host are raw water, unwashed hands and food.

To detect protozoa, a study of fecal masses is carried out for the presence of their cysts. They can be detected in excrement and in a vegetative form, when unicellular microorganisms are mobile and active. But leaving the intestines, microorganisms lose their own structure and rapidly die.

When the protozoa take the form of a cyst, they are covered with a special shell. In this form, it is much easier to diagnose their presence in human feces. But what types of single-celled organisms take the form of cysts, and how can they be found in stool?

In human excrement, many varieties of protozoa can be identified. Often, cysts of the following classes are localized in the intestine:

amoebiasis;
flagella;
ciliated;
coccidia;
amoebic.

Amoebiasis. Such a disease is provoked by a dysenteric amoeba. This simplest microorganism lives in the intestines of the host and is excreted from it as a cyst or trophozoite.

But most amoebas are not pathogenic microorganisms. These are Hartmann, Buchli, intestinal amoeba, entamoeba coli and en nana cysts. Determining their presence in feces is not easy.

But the cyst of a dysenteric amoeba comes to light easier. If it was found in feces, it indicates the development of dysentery or ulcerative colitis in a person.

In the feces, the following forms of amoebas will be eliminated:

translucent;
tissue;
encysted.

If cysts of the luminal amoeba are detected during the diagnostic process, this indicates that the disease has acquired a chronic form.

Complications of amoebiasis are:

bleeding from the anus;
peritonitis;
intestinal abscess;
tumor formations.

Balantidiasis. Balantidia is a peritoneal microorganism belonging to the ciliates that lives in the intestines.

It is noteworthy that sometimes cysts of balantidia are detected in the feces of healthy people.

Giardia belong to the flagella. Their cysts are very tenacious, because they are not afraid of low or high temperatures.

In the external environment, their life cycle is quite long. Moreover, in an active form in adverse conditions, they can be no more than 30 minutes.

Giardia cysts are oval pear-shaped. Their width (6-10 microns) and length (6-10 microns) can be different.

Favorable environment for the existence of the active form are the urinary tract, small intestine, duodenum and bladder.

Basically, giardiasis is diagnosed before the age of 10 years. At the same time, helminthiasis is difficult, which is accompanied by skin rashes, weight loss, foamy stools, loss of appetite, vomiting and bloating.

Giardia damage the intestinal mucosa, mechanically blocking the passage, which affects digestion. Thus, the food is not digested and rots, due to which a mass of bacteria is formed. All this provokes the development of diseases of the bile ducts, pancreas and gallbladder.

Cryptosporidosis. Cryptosporidium - microorganisms that harm the mucosa of the gastrointestinal tract and respiratory organs. Ooscysts of Cryptosporidium parvum are spherical in shape, 4.2–5.4 µm in diameter.

In HIV-infected individuals, cryptosporidium inhabits the entire gastrointestinal tract, from the mouth to the rectum. Complications of cryptosporidosis include:

sclerosing cholangitis;
hepatitis;
cholecystitis.

To identify amoeba nana cysts and other types of protozoa in human feces, a microscopic examination is carried out. To do this, a biomaterial is taken from the patient for analysis, to which an ether solution is added and placed in a centrifuge. Then the centrifuged material is divided into four parts.

The remaining sediment should contain cysts of unicellular microorganisms. Next, the mixture is applied to a glass slide, stained with a special solution. Thus, protozoan cysts can be seen using an electron microscope.

In addition, Gram's preparations are used to elicit certain types of single-celled glass stains. However, such an analysis in relation to some varieties of protozoa (cryptosporidium) is ineffective.

To control therapy, tests that detect the presence of cysts of unicellular microbes are done depending on the type of disease. So, with balantidiasis and amoebiasis, the study should be done 48 hours after the start of treatment, and in the case of giardiasis, after seven days.

In preparation for the analysis, you should not eat foods that thin the stool, as well as drink laxatives. In addition, two days before the study, it is not recommended to use oils, rectal suppositories and agents that stimulate intestinal motility. Also, do not eat coloring foods.

A study to identify protozoan cysts in the feces is recommended for children of school and preschool age and people who were abroad.

Also, tests must be taken in case of drinking poor-quality raw water (accidentally swallowed while swimming in an open pond) and unwashed or poorly thermally processed food.

The drugs should be drunk 4 times a day. In the case of timely adoption of therapeutic measures, the prognosis of the disease is favorable.

Amebiasis is treated based on the type of invasion and the condition of the organs and mucous tissues of the patient. Often, the treatment of the disease consists in taking Nitroimidazole:

Fasizhin;
Seknidozol;
Ornidazole;
Trichopolum;
Metronidazole.

Such drugs are used for the treatment of intestinal amoebiasis, as well as for all kinds of abscesses. Patients with amoebic dysentery who have a severe course of the disease, in addition to the listed drugs, are prescribed antibiotics. Thus, purulent abscesses can be prevented.

In the case of abscesses, they are drained through the skin (aspiration). Today amoebiasis can be cured completely, but only with timely treatment. But for this it is necessary to conduct an early diagnosis and choose a competent treatment tactic.

Nitazoxadine;
Azithromycin;
Paromomycin;
Mepron.

Often this infectious disease is accompanied by diarrhea. Imodium is often used to get rid of it.

In addition to drug therapy, the patient must adhere to a diet without fail. To normalize the work of the digestive system, the doctor prescribes mucoprotectors and enzymes. At the same time, it is important to drink enough liquid during therapy.

When Giardia cysts are found in the feces, a multi-stage treatment is carried out:

preparatory;
main;
rehabilitation.

Wash your hands thoroughly after contact with animals. It is important to use only purified water for drinking and cooking. Moreover, you should not use someone else's towel or wear underwear.

The study of feces for protozoa is a universal method for diagnosing intestinal protozoonoses during epidemiological and diagnostic examinations of the population. Used to detect the presence of cysts and oocysts of the protozoan intestine.

The protozoa belong to the phylum Protozoa. A characteristic feature of this type is that at all stages of the life cycle they exist as a single cell. There are two stages in the life cycle: vegetative - the trophozoid stage (active, mobile, reproducing, feeding) and a stable stage - cysts.

Detection and differentiation of protozoa is one of the most difficult sections of the study of feces. The difference between pathogenic forms of protozoa and non-pathogenic forms requires a certain amount of experience and thoroughness in work.

It should be borne in mind here that most of these unicellular organisms occur in two forms: vegetative - active, mobile, vital, easily amenable to harmful influences (in particular, cooling) and therefore quickly dying after excretion from the intestine, and in the form of cysts resistant to external influences. The existence of vegetative forms requires a more or less liquid environment, so they are found mainly in liquid, semi-liquid, mucous feces. Under unfavorable conditions for their vital activity (for example, compaction of feces), they turn into cysts. In the formed feces, protozoa, as a rule, are found only in the encysted state.

Feces to find vegetative forms in it should be examined immediately after its release, while still in a warm state. This is necessary for two reasons. Firstly, in the cooled feces, the vegetative forms of the protozoa quickly die and the dead quickly succumb to the action of proteolytic enzymes. As a result, they first lose the characteristic features of their structure, which make it possible to distinguish pathogenic forms from non-pathogenic ones, and then completely dissolve. Secondly, during cooling, the mobility of protozoa decreases, and then disappears - an important auxiliary factor in their differentiation.

It should be noted that the preservation of feces in a thermostat is not allowed, since under conditions of artificial heating, protozoa very quickly undergo degenerative changes that make it difficult to recognize them.

In the formed feces, as a rule, only cysts are found, however, vegetative forms can sometimes be found in lumps of mucus located on its surface. Therefore, the determination of the vegetative forms of the protozoa in the mucus should be carried out as quickly as possible.

Sometimes, to detect protozoa, especially amoebas, use the material obtained during sigmoidoscopy. In these cases, it is especially necessary to remember the need for proper handling of the resulting small amount of material. During transportation to the laboratory, located even in the same building, this drop has time to cool down and sometimes dry up. Therefore, it is best to prepare everything necessary for the study in the same room where the endoscopy is performed. Lubrication of the proctoscope with vaseline oil or fat makes subsequent microscopy difficult.

To detect protozoa in the feces, a number of methods are used. The difficulties associated with the detection of protozoan cysts can be overcome to a certain extent by the use of concentration methods. Cultivation of protozoa and infection of animals with them, which are used mainly for scientific purposes, due to the complexity of the technique, are of little use in everyday practical work. Isolation of protozoa with feces occurs inconsistently. Therefore, one should not be limited in their search for a single study. The latter should be repeated 4-5 times in 2-3 days.

Unified methods for determining protozoa using a native smear and a smear with Lugol's solution.

Principle. Moving protozoa are detected by examining a suspension of feces in isotonic sodium chloride solution using a microscope. The drug in this solution serves primarily to identify vegetative forms of protozoa, which are recognized by the nature of the movement. The preparation of a suspension of feces in Lugol's solution is mainly used for the differentiation of protozoan cysts.

Evaluation of results. 2-3 preparations are examined, noting all the observed protozoa. In doubtful cases or when a negative result is obtained, the analysis is repeated; for 1-2 weeks, at least 3 analyzes are carried out. The method allows, along with non-pathogenic protozoa, to identify Entamoeba histolitica and Balantidium coli, as well as opportunistic Lamblia intestinalis.

Unified method with the use of preservatives.

Principle. The protozoa are fixed in the feces with a preservative solution, so the morphological features of the protozoa remain unchanged for a long time.

Evaluation of results. 2-3 preparations are examined, noting all the protozoa found. The structures of protozoa are stained blue with a dye when preservatives are used. The internal structure of balantidia becomes invisible in the preserved material, and balantidia are found only by a felt-like layer of cilia along the periphery of the cell.

Unified method of formalin-ether enrichment.

Principle. Formalin-ether treatment allows the isolation and concentration of protozoan cysts.

Evaluation of results. In the study of the drug, all detected protozoa are noted. The method allows to reveal their cystic forms. The main forms of protozoa are presented below.

Rhizome class (Shizopoda)

Amoeba belong to the class of rhizopods. A characteristic feature of the vegetative stage of this unicellular organism is the absence of a shell, as a result of which the body does not have a permanent shape. Under adverse conditions, the body of the amoeba is covered with a shell and it turns into a cyst - a stable form that can remain viable outside the human body. In the cyst, the nucleus is divided into 2-4-8 parts. Once in the human intestine, the cyst is released from its shell under the influence of digestive enzymes. Its protoplasm divides with the formation of single-nuclear vegetative individuals, the number of which corresponds to the number of cyst nuclei.

The main task arising from the detection of amoebae is to distinguish between pathogenic dysentery and non-pathogenic forms. Therefore, the laboratory worker must be familiar with the morphological features of these types of protozoa.

Entamoeba histolytica.

In a fresh native preparation, dysenteric amoeba looks like an almost colorless lump of indefinite shape. The nucleus is not visible. Protoplasm is clearly divided into zones: outer - homogeneous ectoplasm and inner - endoplasm. The first is about 2 times smaller than the second.

When the amoeba moves, pseudopodia arise from the ectoplasm, and then the endoplasm gradually flows into the resulting protrusion. The nature of the movement is one of the most typical features of the dysentery amoeba. Pseudopodia is ejected by it instantly, and when the endoplasm moves into it, the movement becomes progressive. All this distinguishes the dysenteric amoeba from the intestinal one, which does not have a division into endo- and ectoplasm; the shape changes very slowly, and during the formation of pseudopodia, the body does not move in space.

E. histolytica occurs in the intestine in two forms: tissue and luminal. The tissue form, also called E. histolytica forma magna, got its name due to the fact that it penetrates into the tissues of the host and, settling there, causes ulceration of the intestinal wall. It is found in the feces in acute amoebiasis. The size of this amoeba varies considerably (from 16 to 60 microns). At rest, when the shape of the body is close to round, its size is 20-30 microns, and in the elongated state, the length can be 2 times larger. The presence of erythrocytes in the protoplasm of amoebae is a very important diagnostic sign, since non-pathogenic forms never contain them. Bacteria in the protoplasm of a living tissue form are found as an exception. Usually they penetrate the body of the amoeba only after its death. The translucent form, or E. histolytica forma minuta, lives in the intestinal lumen (hence its name). It does not penetrate into the intestinal wall, therefore it does not cause ulceration and the corresponding clinical picture. The luminal form of the amoeba is found in individuals recovering from acute amoebiasis, in those suffering from the chronic form of the disease, and in carriers.

The differences between the translucent form and the tissue form are as follows: it is smaller in size - usually 12-25 microns, occasionally even less. Movement is slower, although pseudopodia are sometimes ejected. There are no erythrocytes in the protoplasm and a small amount of bacteria is contained.

E. histolytica cysts are regular, round, colorless, with an average diameter of 10-12 microns. The protoplasm is slightly granular, the nuclei (1-4) are poorly distinguishable without color. In some cysts, chromatoid bodies can be seen - short, colorless, highly refractive rods with rounded ends, which are attributed to the role of reserve nutrient material. Cysts never contain erythrocytes.

In the preparation stained with Lugol's solution, one can detect a clearly distinguishable two-circuit membrane, nuclei and a glycogen vacuole in the cyst. The nuclei look like rings, in the center of which a karyosome is located in the form of a shiny dot. A mature cyst contains 4 nuclei. Chromatoid bodies do not stain with iodine.

The most characteristic feature of the dysenteric amoeba is the structure of its nucleus. It has a rounded shape with a diameter of 3-8 microns and is located eccentrically in the endoplasm. In the center of the nucleus there is a rounded or polygonal, regular shape, about 0.5 microns in diameter, karyosome, surrounded by a light zone. The space between the karyosome and the membrane does not contain any grains. Dysentery amoeba must be distinguished from non-pathogenic forms found in the intestine.

Entamoeba hartmanni- non-pathogenic amoeba, which has the greatest similarity with E.hisiolytica in the structure of the body, but differs in a much smaller size. Vegetative forms of it have a size of 5 to 12 microns. The size of 4-nuclear cysts is from 5 to 10 microns. Her movements are slow, she does not phagocytize erythrocytes.

Entamoeba coli- the most common type of amoeba found in the intestines. In the native preparation, the vegetative form has a size of 29-30 microns in a rounded state and up to 60 microns in an elongated one. In protoplasm there is no division into endo- and ectoplasm, it does not contain erythrocytes. In large slit-like vacuoles there is a significant amount of various inclusions: bacteria, fungi, leukocytes, starch grains, cysts of other protozoa. Movements are slow, not progressive. In contrast to E. histolytica, the nucleus is visible both in the native and even better in the preparation stained with iodine. E. coli cysts are round, larger than dysenteric amoeba cysts: their average diameter is about 19-20 microns. The double-walled shell is thicker than that of E. histolytica. Nuclei from 1 to 8, they can be seen in unstained preparations, but are better seen after staining with iodine.

The 4-nuclear cyst stage is very brief and therefore rarely seen, unlike E. histolytica; the finding of 8-nuclear cysts confirms their belonging to the species E. coli. Due to the fact that the nuclei lie in different planes of the spherical body of the cyst, they can be seen and correctly counted only by working with a micrometer screw. When stained with iodine, one can see a karyosome in the nucleus, and a large glycogen vacuole in the protoplasm of immature (I-2-nuclear) cysts.

Endolimax nana- non-pathogenic amoeba of small size (on average about 7 microns). In the preparation of freshly excreted feces at the temperature of the human body (on a heating table), its movements are quite active, reminiscent of the movements of E. histolytica, but when the preparation cools, they quickly stop. Protoplasm, dividing into endo- and ectoplasm, never contains erythrocytes; only a large number of included microbes are noticeable in its vacuoles. The core in the native preparation is imperceptible.

Cysts are round or more often oval, 8-16X6-8 microns in size, contain 1-4 nuclei. Both in unstained and in iodine-stained preparations, they are difficult to distinguish from small cysts of the dysenteric amoeba.

Jodamoeba butschlii- non-pathogenic amoeba with a size of 8 to 20 microns. Movements are slow, quickly stopping when the drug cools down - Pseudopodia are formed from ectoplasm; the endoplasm is granular, its vacuoles contain bacteria, starch and other particles, but they never contain erythrocytes. In unstained preparations, the nucleus is usually imperceptible; when stained with hematoxylin, it is quite large in size with a thin membrane and a large karyosome. The latter lies in the center of the nucleus, occupying about half of it, and is surrounded by a light zone.

The cysts of this amoeba differ in more characteristic features. They have a different, often irregular shape, a rather thick two-circuit shell and, as a rule, one core. Their appearance is most characteristic when stained with Lugol's solution. Against the background of greenish-yellow protoplasm, a clearly contoured large glycogen vacuole, intensely stained reddish-brown, stands out sharply. It occupies about half of the protoplasm. Occasionally there are 2 or 3 glycogen vacuoles.

Flagella class (Flagellata).

Lamblia intestinalis.

Giardia, like the Trichomonas described below, belong to the flagellate class. A common feature of the latter is the presence of one or more flagella on the surface of the body, with the help of which they move. Unlike amoebas, the body of flagellates is covered with a shell, the presence of which determines the constancy of their shape.

On stained preparations, a rather complex internal structure of Giardia is revealed. They are completely bilaterally symmetrical. In the middle of the body along its length there are two parallel filamentous supporting formations - axostyles. On both sides of them, 2 nuclei and 4 pairs of blepharoblasts are symmetrically located - point bodies, from which the same number of flagella extends. There is only one unpaired formation - the parabasal body, extending in the form of a comma from the middle of the axostyle; its purpose is unknown.

When examining feces, it is most important to be able to detect and distinguish giardia cysts, the detection of which often makes it possible to diagnose giardiasis without duodenal sounding. In the native preparation, Giardia cysts look like oval, less often round, colorless, refractive formations 10-14 µm long with a double-contour transparent shell.

A clearer picture is obtained by staining with Lugol's solution. In such a preparation, the cyst shell, axostyle, 2 or 4 nuclei lying at one of the poles, blepharoblasts, and flagella are clearly visible. All this forms a complex but characteristic pattern.

Trichomonas hominis.

Chilomastix mesnili- a non-pathogenic flagellate, with a pear-shaped body resembling Trichomonas. It differs from the latter in the absence of an undulating membrane, the presence of a spiral groove passing through the entire body from the anterior to the posterior end. There are four flagella, they are located at the anterior end, three of them are directed anteriorly and determine the rapid rotational movement of the protozoan, and one flagellum lies along the mouth opening. The latter is located at the anterior end and is equal in length to 1/3-1/2 of the body. Length of Chilomastix mesnili 13-24 µm, width 6-10 µm. A stained preparation shows a round nucleus located in the anterior part of the body, with several chromatin grains and one karyosome. The protoplasm contains many food vacuoles filled with bacteria. There is no axostyle. The cysts are shaped like a lemon, 7-9 X 5-6 microns in size. In cysts stained with iodine, one nucleus, a wriggling flagellar apparatus and fibrils bordering the cntostome are visible.

Class ciliary (Ciliata).

Balantidium coli.

B. coli forms spherical cysts with a diameter of 50-60 microns. They are covered with a colorless double-circuit shell. In stained preparations, they have a macronucleus and one contractile vacuole (non-functioning).

Sporozoa class.

Blastocystis hominis. In the feces, there is often a formation that looks like protozoan cysts and can be mistaken for them. This is a blastomycete (mushroom) Blastocystis hominis. It is found more frequently in liquid than normal feces, but is apparently a harmless inhabitant of the intestine. Blastocysts are easily distinguished from protozoan cysts when stained with iodine. They have an almost regular round shape, varying in size - from 5 to 30 microns in diameter. The entire central part of their body is occupied by a large vacuole - homogeneous, round, not stained with iodine. The protoplasm is pushed to the periphery and surrounds the vacuole with a thin layer in the form of a ring.

Laboratory research methods in the clinic: a Handbook / Menshikov V.V. M.: Medicine, - 1987 - 368 p.