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Adnan I. AL-Hindi , PhD Islamic University of Gaza 2009-2008 31 A practical guide to Diagnostic Medical Parasitology PROTOZOA * Amoebae (Intestinal) Endolimax nana Pathogenic Disease Acquired Body site Symptoms Clinical specimen Epidemiology Control Diagnosis General comments Description No None Faecal-oral transmission; contaminated food and water Intestine None Stool Worldwide, primarily human-to-human transmission Improved hygiene, adequate disposal of faecal waste, adequate washing of caontaminated fruits and vegetables The standard O&P examination is recommended for recovery and identification of E. nana in stool specimens. Microscopic examination of direct saline wet mount may reveal small, motile trophozoites. An asymptomatic individual may have few trophozoites and possibly only cysts in the stool. Although many people worldwide are infected with this organism. E. nana is one of the smaller amoebae, and its trophozoite stage and that of Iodamoeba bϋtschlii look very similar. Motility has been described as sluggish and nonprogressive with blunt, hyaline pseudopods, In the permanent stained smear, the nucleus is easy to see. The karyosome tend to be large. The trophozoites measure 6 to 12 µm, with a usual range of 8 to 10 µm. The cytoplasm may have small vacuoles containing ingested debris or bacteria. Trophozoites discharge their undigested food and begin to round up prior to precyst and cyst formation. Early cysts may contain very thin, curved chormatoidal bars. Eventually the nuclei divide until the mature cyst, containing four nuclei, is formed. Cysts usually measure 5 to 10 µm, with a normal range of 6 to 8 µm.