Leishmania donovani
Professor: Jianping
Chen
Sichuan University
Leishmania and Leishmaniasis
Leishmania donovani
Visceral leishmaniasis (Kala-
azar)
Leishmania braziliensis
Mucocutaneous leishmaniasis
Leishmania tropica
Leishmania mexicana
Cutaneous leishmaniasis
I. Morphology
1. Amastigote: small, oval, measuring 2.8-4.4
µm, non-flagellated.
(1) Under microscope
a. Nucleus
b. Kinetoplast
c. Basal body
d. Rhizoplast
Leishmania donovani
Amastigote in human and Proamastigote in sandfly
dog
(2) Under electron microscope
a. Surface membrane
b. Subpellicular microtubule
c. Pouch of flagellum
d. Kinetoplast
e. Basal body
f. Mitochondrion
g. Nucleus
2. Promastigote
(1) Nucleus
(2) Kinetoplast
(3) Basal body
(4) Flagellum
Promastigote
Promastigote
Sandfly
Binary fission
无性生殖
II. Life cycle
Host: man or mammal; sandfly
Promastigote amastigote
(digestive duct (macrophagocyte of man
of sandfly) or dog etc.)
1. Development in sandfly
2. Development in man or mammal
Infective mode: by insect
Life cycle of Leishmania donovani
3. How leishmanias not only to escape
from destruction by macrophages but to
survive, differentiate, and multiply
intracellularly?
(1) Attachment of leishmanias to
macrophages
(2) Entry of leishmanias into
macrophages
(3) Intracellular survival of
leishmanias in macrophages
(4) Cellular differentiation of
leishmanias
(5) Intracellular multiplication of
leishmanias
life cycle
1. infective stage: Promastigote
2. diagnostic stage: amastigote /
Promastigote
3. pathogenic stage: amastigote
4. infective route: by sandfly
5. host: man or mammal; sandfly
III. Pathogenesis
1. Pathologic characteristics:
2. Clinical aspects
(1) Intermittent fever
(2) The liver, spleen and lymphoglandula
become enlarged.
(3) Anemia
(4) Hemorrhage
(5) Reversal of albumin and globulin ratio
(6) Proteinuria and cruenturesis
(7) Immunosuppress
(8) Dermal leishmaniasis
(9) Lymphadenoid
leishmaniasis
Visceral Leishmaniasis
(kala-azar)
CLINICAL MANIFESTATION
(1)Enlargement of
Spleen, Liver and Lymph
nodes.
(2)Fever.
(3)Anaemia .
The liver and spleen become enlarged
Visceral Leishmaniasis (kala-azar)
内脏利什曼病（又称黑热病）
The enlarged liver and spleen
Mucocutaneous leishmaniasis
Dermal leishmaniasis
Dermal leishmaniasis
Patients of VL
Intermittent Fever
Anemia /Hemorrhage
Patient of
splenectomy
IV. Diagnosis
1. Detection of pathogen
(1)smear
a. Bone marrow puncture
b. Lymphoglandula puncture
c. Spleen puncture
(2) Culture
(3) Biopsy
2. Immunodiagnosis: McAb-AST,
ELIST, CIE etc.
3. Molecular biological method: PCR
etc.
Detection of pathogen
Dip-stick test for VL (kala-azar)
Dipstick 试纸条法 :
操作及应用
A. 取待测血清或新鲜全血 1 滴
B. 滴于试条一端的样品垫上
C. 滴加 0.01mol/LPBS3-5 滴，
待 血样浸湿印迹上移
D. 3-5min 后观察结果
阳性 : 试验对照线和特异检测线
均出现紫红色条
阴性 : 仅出现对照条带
V. Epidemiology
1. Source of infection
In plain areas, kala-azar
patients
In hilly lands, infected dogs
In some deserts, infected
animals
2. Infective route: bitten by
sandfly
3. Susceptible person
Epidemic area in Sichuan and Gansu
Sandfly suck blood cause Kala-azar
Canine leishmamiasis
Epidemic area of VL in Sichuan
九寨沟
黑水
理县
北川
汶川
茂县
The VL cases in Sichuan 1984-2009
图 3. 1984- 2009年 全 省 黑 热 病 疫 区 发 病 曲 线 图
病 例数 （人 ）
100
90
80
70
60
50 病 例数
40
30
20
10
0
年 份
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Distribution
2004- 2007年 全 国 黑 热 病 病 例 的 地 区 分 布
2%
17% 新疆
48% 甘肃
四川
其他
33%
20 世纪 90 年代我国黑热病流行状况
The VL cases of in China 2018
省份 流行县 人源型 野生动物型 犬源型 病例数 构成比
甘肃 14 0 0 66 66 37%
山西 16 0 0 38 38 21%
陕西 12 0 0 27 27 15%
四川 10 0 0 17 17 9%
新疆 13 11 7 0 18 10%
其它 6 省 13 0 0 18 18 10%
合计 78 11 7 162 180 100%
VI. Prevention and
treatment
1. To prevent and destroy
sandfly
2. To eradicate source of
infection
(1)To treat patients: sodium
stibogluconate etc.
(2)To strengthen the
administration of dog
To kill sick dog
Trichomonas vaginalis
I. Morphology
1. Nucleus
2. Basal body
3. 4 anterior flagella
4. 1 posterior flagellum
5. Undulating membrane
6. Axostyle
Trophozoite of
Trichomonas vaginalis
II. Life cycle
1.Trichomonas vaginalis only
exists in trophozoite stage. Cystic
stage is absent. The trophozoite
habitats in vagina and urinary duct
etc.
2. Infective mode: sexually transmit
3. Reproduction: binary fission
4. Infective stage: Trophozoite
5. Pathogenic stage: Trophozoite
6. Diagnostic stage: Trophozoite
III. Pathogenesis
1. Trichomonal
vaginitis: frothy
and creamy ,
white
discharge.
2. Trichomonal
urethritis and
prostatitis
IV. Diagnosis
1. Detection of the vaginal
secretion
(1) Smear
(2) Culture
2. Detection of urine
V. Epidemiology
1. Source of infection: patients
and carriers
2. Infective mode: sex
transmitted
3. Susceptible person
VI. Prevention and
treatment
1. Attention to personal
hygiene
2. Drug: metronidazole
Question:
（ 1 ） Which is pathogenic stage and
detective stage of Leishmania
donovani?
(2)Which is infective stage of
Leishmania donovani ?
（ 3 ） Please describe the life cycle
and the mechanism of
pathogenesis of Leishmania
donovani.
(4) Please describe the
mechanism of pathogenesis and
the method of detection of
Trichomonas vaginalis.
