PARASITOLOGY

PADAYON
FUTURE
RMT

must to know
Symbiosis – living together of unlike organisms Temporary parasite – lives on the host only for a
Commensalism short period of time
– 2 species live together Spurious parasite
– one species benefits from the relationship without – free-living organism
harming or benefiting the other – passes through the digestive tract without
– example: Entamoeba coli infecting the host
Mutualism Definitive/Final host – parasite attains sexual
– 2 organisms benefit from each other maturity
– example: termites and the flagellates inside their Intermediate host – harbors the asexual or larva
digestive system stage of the parasite
Parasitism Paratenic host
– 1 organism lives in or on another for its survival at – one in which the parasite does not develop further
the expense of the host to later stages
– example: Entamoeba histolytica – parasite remains alive and is able to infect
Endoparasite another host
– lives inside the body of the host Reservoir host – allows the parasite’s life cycle to
– “infection” continue and become additional sources of
Ectoparasite infection
– lives outside the body of the host Biologic vector
– “infestation” – transmits the parasite only after the latter has
Erratic – parasite found in an organ which is not its completed its development within the host
usual habitat – examples: Aedes mosquito
Obligate parasite – need a host to complete their Mechanical/phoretic vector
development – only transport the parasites
Obligate/strict aerobe – example: flies and cockroach
– grows only in the presence of oxygen Epidemiology
– with catalase & superoxide dismutase (SOD) that – study of patterns, distribution and occurrence of
converts toxic products to non-toxic substances disease
– example/s: Incidence – number of new cases of infection in a
– Pseudomonas given period of time
– Neisseria Prevalence (%) – number of individuals estimated
– Brucella to be infected with a particular parasite
– Bordetella Cumulative prevalence – % of individuals in a
– Francisella population infected with at least 1 parasite
– Mycobacterium Intensity of infection (worm burden) – number
– Nocardia of worms per infected person
– most fungi except yeast Morbidity – clinical consequences of infections or
Obligate/strict anaerobe diseases that affect an individual’s well-being
– grows only in the absence of oxygen Deworming – use of antihelminthic drugs in an
– without catalase and SOD individual
– example/s: Cure rate (%) – number of previously positive
– Bacteroides subjects found to be egg-negative
– Clostridium Egg reduction rate – % fall in egg counts after
Facultative parasite deworming
– may exist in a free-living (soil) state Selective treatment – individual-level deworming
– may become parasitic (small intestine) when the Targeted treatment – group-level deworming
need arises Universal treatment – population-level
Facultative anaerobe deworming
– aerobe that can grow in absence of oxygen Coverage – proportion of the target population
– example/s: reached by an intervention
– Staphylococcus Efficacy – effect of a drug against an infective
– Streptococcus agent
Accidental/Incidental parasite Effectiveness – measure of the effect of a drug
– parasite that established itself in a host where it against an infective agent
does not ordinarily live Information-education-communication – a
– example: Echinococcus granulosus health education strategy that aims to encourage
Permanent parasite – remains on or in the body people to adapt and maintain healthy life practices
of the host for its entire life
Environmental management – planning, – Ascaris
organization, performance, and monitoring of – Capillaria
activities for the modification and/or manipulation – Enterobius
of environmental factors – Hookworm
Environmental sanitation – interventions to – Strongyloides
reduce environmental health risk – Trichuris
Sanitation – provision of access to adequate Nematoda: Extraintestinal
facilities for the safe disposal of human excreta – Angiostrongylus
Eradication – permanent reduction to zero of the – Filarial worms
incidence of infection caused by a specific agent, as – Trichinella
a result of deliberate efforts Cestoida: Cyclophyllidea
Elimination – reduction to zero of the incidence of – Dipylidium
a specified disease in a defined geographic area as – Echinococcus
a result of deliberate efforts – Hymenolepis
Protozoan – Raillientina
– unicellular organism – Taenia
– eukaryotic (true nucleus) Cestoida: Pseudophyllidea
– many of which are motile – Diphyllobothrium
– trophozoite (vegetative stage) – Spirometra
– motile, feeding stage Trematoda
– in watery stool – Artyfechinostomum
– irregular in shape because of pseudopodia – Clonorchis
– cyst (infective stage) – Echinostoma
– dormant, survival stage – Fasciola
– in well-formed stool – Fasciolopsis
– round/oval in form surrounded by a thick wall – Heterophyids
– has more than one nuclei – Opisthorchis
Metazoan – multicellular organism – Paragonimus
CLASSIFICATION OF PROTOZOAN – Schistosoma
Arthropoda: Arachnida
PARASITES – Mites
Sarcomastigophora: Sarcodina – Scorpions
– Acanthamoeba – Spiders
– Endolimax – Ticks
– Entamoeba Arthropoda: Chilopoda
– Iodamoeba – Centipedes
– Naegleria Arthropoda: Crustacea
Sarcomastigophora: Mastigophora – Copepods
– Chilomastix – Crabs
– Dientamoeba Arthropoda: Diplopoda
– Giardia – Millipedes
– Trichomonas Arthropoda: Insecta
– Leishmania – Flies
– Trypanosoma – Flea
Ciliophora – Beetle
– Balantidium – Bees
Apicomplexa – Lice
– Babesia – Wasp
– Cryptosporidium – Bugs
– Cyclospora – Mosquitoes
– Isospora Arthropoda: Pentastomida
– Plasmodium – Tongue worms
– Toxoplasma
Microspora
CLASSIFICATION OF METAZOAN
– Enterocytozoon PARASITES
– Encephalitozoon Ascaris lumbricoides
– Vittaforma – giant/large intestinal roundworms
– Trachipleistophora – “Lumbricus teres”
– Pleistophora – largest nematode that infects the intestinal tract
– Brachiola of humans
– Microsporidium – infects an estimated 1.3 million people worldwide
CLASSIFICATION OF METAZOAN 1. habitat: small intestine
2. diagnostic host: man
PARASITES 3. infective stage: fully embryonated egg
Nematoda: Intestinal
4. mode of transmission: ingestion of embryonated
eggs in contaminated food and water
ADULT SIZE POSTER ANTERI
IOR OR
Female Larger Pointed Trilobate
lips
Male Smaller Curved Trilobate
lips

5. key manifestation of ascariasis:

– Ascaris pneumonitis (Loeffler’s syndrome)
– abdominal pain and diarrhea
– intestinal obstruction
6. diagnosis:
– demonstration of eggs in feces or recovery of
an adult in vomitus or feces
– < 20 eggs/slide: light infection
– > 100 eggs/slide: heavy infection

– a female Ascaris produce 200,00 eggs per day

– 3 layers of eggshell:
1. inner vitelline membrane or lipoidal
membrane
– not found in unfertilized egg
2. middle glycogen layer
3. outermost mammillation

Enterobius vermicularis
– pinworm, seatworm, society worm, social worm
– family oxyuridae: oxyurid worms are commonly
called “pinworms” (tapering shape & pointed tails)
– most common helminth infection on the world
– autoinfection
1. facultative host: man
2. habitat: large intestine
3. diagnostic stage: ova and adult
4. infective stage: fully embryonated egg
5. mode of transmission: ingestion & inhalation
ADULT
Female Gravid uterus filled with eggs;
oviposit eggs in the perianal
region at night
Male Flask-shaped esophagus, curved
posterior end; has cephalic alae
(lateral wings)
EGGS Lopsided ovum or D-shaped
ovum
6. pathology:
– nocturnal pruritis ani
– loss of appetite
– insomnia
– irritation
7. diagnosis: cellulose tape or scotch tape method

6. pathology:
– diarrhea
Trichuris trichiura – abdominal pain
– whipworm – hypoalbuminemia
1. facultative host: man – IDA secondary to ulceration in the intestines
2. habitat: large intestine – 0.005 ml of blood is lost per day per Trichuris
3. diagnostic stage: ova – rectal prolapse
4. infective stage: fully embryonated ova 7. epidemiology: 80-90% in rural areas
5. mode of transmission: ingestion of embryonated 8. diagnosis: stool exam/direct fecal smear (DFS)
eggs in contaminated food and water – kato-katz technique
– anterior 3/5 attenuated – used for “pin-fashion: – poor reproducibility, no longer recommended
attachment” for primary health care settings
ADULT – glycerol, cellophane, template, wire mesh
Female Curved posterior fleshy portion – determines the # of eggs per gram of feces
Male Pointed posterior fleshy portion – concentration technique
– a female Trichuris produce 10,000 eggs per day Capillaria philippinensis
– mucoid bipolar plugs – prominent/protruding – mystery worm, pudoc worm
– shell has no striations – discovered 1963 in Ilocos Norte, 1967 Ilocos Sur,
– japanese lantern/football/barrel/lemon-shaped PH
– yellowish brown in color due to bile staining
– described later in Thailand and other parts of SE
asia, middle east and south America
1. infective host: fresh-water fishes (ipon, birot,
bagsang, bagtu)
2. habitat: small intestine
3. diagnostic stage: ova/larva/adult
4. infective stage: larva in intermediate host
5. mode of transmission: ingestion
6. pathology:
– severe diarrhea
– gurgling stomach “borborygmi”
7. diagnosis:
– direct fecal smear
– AECT/FECT – more sensitive that direct wet mounts
– FECT: formal ether sedimentation technique

– buccal cavity: semi-lunar cutting plates

– size: smaller
– shape: S-shaped structure
– mouth: 1 pair of semi-lunar cutting plates
– copulatory bursa: bipartite (2 digits) bristle-like
and barbed

– size: smaller
– shell has striations
– shape: peanut or guitar shape
– mucus plugs – flattened
Necator americanus
– necator means murderer
– american hookworm, american murderer
– new world hookworm
– living worms are pinkish or cream yellow in color
or graying white
1. host: human
ADULT
Female Longer than male with a blunt
posterior end
Male Shorter; posterior end is Ancylostoma duodenale
expanded to form a fan-like – old world hookworm
bursa copulatrix or membranous
caudal bursa (organ of 1. host: human
copulation) – buccal cavity: 2 pairs of teeth
– size: larger
– shape: C-shaped structure
– mouth: 2 pairs of ventral teeth
– copulatory bursa: tripartite (3 digits) simple and
not barbed
 – rhabditiform larva
Ancylostoma braziliense – buccal cavity: short
– cat hookworm – esophagus: shallow, club-shaped
– buccal cavity: 1 pair of teeth – genital primordium: conspicuous (prominent)
1. infective stage: filariform larva – filariform larva
– eggs: ovoidal thin-shelled and colorless – sheath: negative (unsheathed)
– “morula ball” – tail: alpha-notched tail
2. pathology: due to larva
– dermatitis: ground/dew/colic itch (skin
penetration of filariform larva)
– pneumonitis: “Wakana disease” (larval
penetration through lungs)
– cutaneous larval migrans
Ancylostoma caninum
– dog hookworm
– buccal cavity: 3 pairs of teeth
Strongyloides stercoralis
– threadworm
– fecally transmitted and soil-transmitted helminth
– facultative parasite: may either be free-living
(soil) or parasitic (small intestine)
– parthenogenic female
– egg shaped: chinese lantern
1. diagnostic stage: rhabditiform larva
2. infective stage: filariform larva
3. mode of transmission: skin penetration

4. pathology:
– due to larva: dermatitis, pneumonitis
– due to adult: epigastric pain, cochin-china
diarrhea, vietnamese timebomb diarrhea Trichinella spiralis
– combined action of adult females and – trichina worm, muscle worm
rhabditiform larva result in the “honeycomb” 1. facultative host/infective host: pig, rat, man
appearance of the intestinal mucosa 2. habitat: larva – skeletal muscle, adult – small
5. diagnosis: intestine
– direct fecal smear (DFS) 3. diagnostic stage/infective stage: encysted
– harada-mori stool culture larva
– beale’s string test: duodenal aspiration 4. mode of transmission: ingestion of improperly
– more preferred: baermann funnel technique cooked pork
5. diagnosis:
– history, clinical symptoms, and eosinophilia
– muscle biopsy
– microscopy
– EIA: detect Trichinella-specific antibodies
– bentonite flocculation test
 – intradermal-bachmann
– xenodiagnoses (beck’s test)
– obsolete
– important notes:
– the host is both the intermediate and definitive
host (a second host is required to perpetuate the
species)
– in domestic
– 7 and sylvatic cycle, infection is propagated by
anthrophophilic rats
– man is the dead-end-host of the parasite
– to destroy the larva, one can freeze the meat
around -15 ̊ C for 20 days because larvae is
destroyed by freezing

Brugia malayi
– malayan filarial worm
1. vector: mansonia
2. habitat: upper lymphatics
3. specimen: blood
4. disease: elephantiasis (upper)
5. periodicity: subperiodic; nocturnal
6. time of collection: 10 pm-2 am
7. presence of sheath: (+)
8. distribution of cell nuclei: two distinct nuclei at
the tip of the tail

Wuchereria bancrofti
– bancroft’s filarial worm
1. vector: aedes; anopheles; culex
2. habitat: lower lymphatics
3. specimen: blood
4. disease: elephantiasis (lower)
5. periodicity: nocturnal
6. time of collection: 10 pm-2 am
7. presence of sheath: (+)
8. distribution of cell nuclei: tail is pointed and free
of nuclei

Loa loa
– eye worm
1. vector: chrysops (tabanid, mango fly)
2. habitat: subcutaneous tissue (conjunctiva of eye)
3. specimen: blood; eye tissue
4. disease: swelling of eyes (calabar or fugitive
swelling)
5. periodicity: diurnal
6. time of collection: noon
7. presence of sheath: (+)
8. distribution of cell nuclei: distinctly continuous
row of nuclei extends to the tip of the tail

Onchocerca volvulus
– blinding worm Dracunculus medinensis
1. vector: simulium (black fly) – guinea worm; fiery serpent of the israelites;
2. habitat: subcutaneous tissue serpent worm; dragon worm; medina worm
3. specimen: skin nips; skin shaving – produces skin blisters that ruptures upon
4. disease: blinding filarial worm causing river exposure to water releasing the larvae.
blindness – zooplanktons “copepods” ingest the larvae and
5. periodicity: nonperiodic develops into infective stage and transmitted back
6. time of collection: anytime to humans upon ingestion of copepods in
7. presence of sheath: (-) contaminated water
8. distribution of cell nuclei: the nuclei do not 1. causative agent: dracunculiasis (guinea worm
extend up to the tip of the tail disease)

2. habitat: adult subcutaneous tissue

3. definitive host: man
4. mode of transmission: ingestion of zooplanktons
Dirofilaria immitis or copepods in drinking water harboring the
– dog heartworm or canine heartworm infected larvae
– produces a granulomatous nodule that appears as
coin lesions on chest radiograph
– a very common filarial parasite of dogs
1. definitive host: dog; cat; wolf; cayote; fox; ferret;
etc. (man – rarely)
2. vector: mosquito
– in man: pulmonary disease
– dead worm produce infarcts when they lodge in
pulmonary vessels; these infarcts are usually
referred to as “coin lesions” on chest radiography

Anisakis
– fish and marine mammal roundworm
– herring’s worm
Toxocara canis – dog ascarid
Toxocara cati – cat ascarid
Fasciola hepatica – sheep liver fluke
 Paragonimus westermani – oriental lung fluke

Fasciola gigantica – giant liver fluke

Clonorchis sinensis
– oriental liver fluke
– chinese liver fluke

Fasciolopsis buski – giant intestinal fluke

Schistosoma japonicum
Enchinostoma ilocanum – garrison’s fluke – oriental blood fluke
Heterophyes heterophyes – von siebold’s fluke 1. habitat: superior veins; small intestines
2. pathology:
– katayama disease
– snail fever
– oriental schistosomiasis
3. egg/ova: has a knob-like or reserved hook or
lump or protuberance on one side
4. intermediate host: oncimelania quadrasi
 6. follicular testes: 300-400 scattered throughout
7. eggs: spherical, striated, inside in an embryo
with 6 hooks
– eggs cannot be reliably differentiated microscopically
8. larva: cysticercus bovis
9. infective stage: cysticercus bovis
10. habitat/pathogenesis:
– small intestine
– taeniasis
11. diagnosis:
Schistosoma mansoni – demonstration of eggs in stool by scotch tape
– profile of a man method, formalin ether concentration technique
1. habitat: – differentiation of gravid segment pressed
– inferior mesenteric veins between two slides
– colon or rectum – cysticercosis – CAT, MRI
2. pathology: intestinal bilharziasis 12. prevention and control: freezing at -20 ̊C for 10
3. egg/ova: has characteristic lateral spine days will kill the cysticerci
4. intermediate host:
– biomphalaria
– australorbis
– tropicorbis

– scolex has 4 large muscular suckers

– no mouth or hooks exist

Schistosoma haematobium
– bladder fluke
1. habitat:
– vesical
– prostatic
– uterine
– venous plexuses
2. pathology: – “unarmed” – 4 large cup-shaped suckers
– urinary bilharziasis
– egyptian hematuria
– bloody urine
3. egg/ova: has characteristic terminal spine
4. intermediate host:
– bulinus
– physopsis
– biomphalaria

– human cysticercosis

Taenia saginata
– beef tapeworm
1. intermediate host: cattle
2. scolex: no rostellar hooks; 1-2 mm
3. length: 4-10 meter
4. no. of proglottids: 1000-4000 meter
5. gravid proglottids: 15-20 lateral branches with
97,000-124,000 ova (dichotomous or tree-like)
Taenia solium
– pork tapeworm
1. intermediate host: pig
2. scolex: with rostellum armed with 2 rows of large
and small hooklets (25-30 large and small hooks)
3. length: 7 meter – human cysticercosis
4. no. of proglottids: less than 1000 meter
5. gravid proglottids: 7-15 branches (dendritic or
finger-like) with 30,000-50,000 ova
6. follicular testes: 100-200
7. eggs: spherical, striated, inside in an embryo
with 6 hooks
– eggs cannot be reliably differentiated microscopically
8. larva: cysticercus cellulose
9. infective stage: cysticercus cellulose & ova
10. habitat/pathogenesis:
– small intestine
– taeniasis
– human cysticercosis (ingestion of ova)
11. diagnosis:
– demonstration of eggs in stool by scotch tape
method, formalin ether concentration technique
– differentiation of gravid segment pressed
between two slides
– cysticercosis – CAT, MRI
12. prevention and control: freezing at -20 ̊C for 10
days will kill the cysticerci

– scolex is relatively smaller

– has a rounded prominent rostellum with a double
row of chitinous hooks
Hymenolepis nana
– dwarf tapeworm Hymenolepis diminuta
1. proglottids: – rate tapeworm (Norway rats)
– 175-200 1. proglottids:
– mature has 3 ovoid testes and 1 ovary – larger than H. nana with 3 ovoid testes and 1
– genital pores along the same side of the ovary
segment – genital pores are unlateral, gravid type has sac
– uterus contains 80-180 eggs like uterus
2. definitive hosts: man 2. definitive hosts: Norway rats
3. scolex: subglobular, armed rostellum (20-30 Y- 3. scolex: unarmed rostellum (without hooklets)
shaped hooklets) 4. eggs: circular, larger that H. nana “sunny sideup”
4. eggs: spherical or subspherical with 3 pairs of with polar thickening but no polar filaments (3 pairs
hooklets with two polar thickenings and 4-8 polar of hooklets); (contains an embryophore enclosed in
filaments a inner membrane)
5. intermediate host: none (the only cestode that 5. intermediate host: insects (fleas, beetle, roaches)
does not require intermediate host) 6. infective stage: cysticercoid larvae
6. infective stage: eggs and cysticercoid larvae
 Diphyllobothrium latum
– a.k.a Dibothriocephalus latus
Dipylidium caninum
– broadfish tapeworm
– dog tapeworm; double-pored tapeworm
– usually assumed to be the most common agent of
1. proglottids: double set of reproductive organs
human diphyllobothriasis
with two genital pores
2. scolex: quarate in shape and contains 4 suckers
– armed rostellum
3. gravid proglottid: melon-shaped; pumpkin-seed
shaped or shaped like rice granules
4. egg: “mother packet” (8-15 eggs)
5. mode of transmission: ingestion of cysticercoid
larva
6. infective stage: cysticercoid larva
7. definitive host: dogs
8. intermediate host:
– dog flea (Ctenocephalides canis)
– cat flea (Ctenocephalides felix)
– human flea
– dog louse

– D. caninum egg packet

 ADDITIONAL PICTURES

Echinococcus granulosus
– hydatid worm
– unilocular hydatid disease
1. mode of transmission: accidental ingestion of
eggs
2. accidental intermediate host: human
3. usual host: sheep; cattle; pig
4. egg: hatch in the intestine and embryos
penetrate the intestinal and enters the bloodstream
and form hydatid cyst in the liver, lungs, etc.
5. hydatid cysts: contains hydatid sand composed
of protoscoleces, disintegrating brood capsules,
hooklets, and calcerous corpuscles

INFECTIVE STAGES
Cyst – protozoans (amoebas)
Trophozoite – Trichomonas vaginalis
Sporozoites – plasmodium
Trypomastigote – Trypanosoma
Promastigote – Leishmania
Embryonated egg – “HATE”
– Hymenolepis nana
– Ascaris lumbricoides
– Trichuris trichiura
– Enterobius vermicularis
Larva
– Trichinella spiralis
– Capillaria philippinensis
Filariform larva
– hookworm
– Strongyloides stercoralis
3rd stage of larva (filiform)
– Wuchereria bancrofti
– Brugia malayi
Cercaria
– Angiostrongylus cantonensis
– Loa loa
– Onchocerca volvulus
– Mansonella
Metacercaria
– Schistosoma japonicum
– Schistosoma haematobium
– Schistosoma mansoni Laboratory diagnosis
Cysticercus bovis – Taenia saginata 1. stool examination
Cysticercus cellulose – Taenia solium – egg: diagnostic stage
Plerocercoid larva – if (-) stool examination:
– Diphyllobothrium latum (Dibothriocephalus latus) a. no infection
Hydatid cyst – Echinococcus granulosus b. early infection
Cysticercoid larva c. all male worm infection
– Hymenolepis diminuta Enterobius vermicularis
– Dipylidium caninum Characteristics
NEMATODES (ROUNDWORMS) – autoinfection: same host (EV, SS)
– external autoinfection
Separate sexes Egg
– female = larger, pointed tail – elongated, flattened on 1 side
– male = smaller, curved tail – D-shaped
Life cycle – egg stage > larval stage > adult stage Adult – with lateral wings or cephalic alae
Aphasmids Mode of transmission – ingestion
– lacks phasmids or caudal chemoreceptors Symptoms and pathology
– “TCT”: Trichuris – Capillaria - Trichinella – mother’s complex
Phasmids – Pruritus ani
– with caudal chemoreceptors – lack of sleep
– hookworm – extraintestinal enterobiasis
– Strongyloides stercoralis Laboratory diagnosis
– Wuchereria bancrofti 1. perianal swab: scotch tape swab
– Brugia malayi – egg: diagnostic stage
Amphid – cephalic chemoreceptors
Oviparous – lays eggs in unsegmented stage
Trichuris trichiura
Characteristics – causes trichocephaliasis
(unembryonated)
Egg
Ovoviviparous/Oviviparous – lays egg in
– barrel-shaped with bipolar mucus plug
segmented stage (embryonated)
– resembles japanese lantern
Viviparous/Larviparous – larva
Adult
Frequency – “EAT”: Enterobius – Ascaris - Trichuris
– slender or attenuated in the anterior
Small intestines – “CASH”: Capillaria – Ascaris –
– resembles a whip
Strongyloides - Hookworms
Mode of transmission – ingestion
Large intestines – “ET”: Enterobius - Trichuris
Symptoms and pathology
Heart-to-lung migration – “ASH”: Ascaris -
– rectal prolapse (heavy infection)
Strongyloides - Hookworms
Laboratory diagnosis
Extraintestinal nematodes
1. stool examination
– filarial worms = lymphatics and subcutaneous
– egg; diagnostic stage
tissues
– Trichinella spiralis = muscles Capillaria philippinensis
– Angiostrongylus cantonensis = meninges Characteristics – causes pudoc or mystery
Visceral larva migrans disease
– Toxocara canis (dog ascarid) Egg
– Toxocara cati (cat ascarid) – with bipolar mucus plugs that are not as
Triad of infection/Unholy 3 protruded as Trichuris trichiura egg
– “HAT”: Hookworm – Ascaris - Trichuris – guitar, peanut-shaped
Ascaris lumbricoides Adult
– female: have eggs in uterus
Characteristics – resembles common earthworm
– male: with chitinized spicule (spicule sheath)
Fertilized egg
Mode of transmission – ingestion of freshwater
– 3 layers:
fishes
– inner: vitelline membrane
Intermediate host
– middle: glycogen layer
– freshwater fishes:
– outer: mammillation (corticated)
– birot
Unfertilized egg
– bagsang
– 2 layers:
– bagtu
– inner: glycogen
Symptoms and pathology
– outer: mammilation
– malabsorption (CP, GL)
– has lecithin granules
– borborygmi = peculiar abdominal gurgling sound
Adult – buccal cavity: triangular, trilobate lips
– LBM alternating with constipation
Mode of transmission – ingestion
Laboratory diagnosis
Symptoms and pathology
1. stool examination
– larval migration: eosinophilia (resembles loeffler’s
– egg: diagnostic stage
syndrome)
– adult: erratic → extraintestinal sites
Hookworms (Necator, Ancylostoma)
– intestinal perforation Characteristics – agent of laziness in poor white
population and tropical anemia in puerto rico
Egg – man:
– same for all species – both diagnostic host and infective host
– ovoidal, thin-shelled, colorless – dead-end host
– “morula ball” Adult
Adult – female: with club-shaped uterus
– Necator americanus: – viviparous/larviparous
– S-shaped, with semilunar cutting plates – male: with conical papillae
– Ancylostoma duodenale: Mode of transmission – ingestion of meat
– C-shaped, with 2 pairs of teeth Symptoms and pathology
– male copulatory bursa: – larva: muscle
– bipartite (2 digits): barbed & bristle like – edema
– tripartite (3 digits): simple & not inconspicuous – muscle pain
Rhabditiform larva – difficulty in breathing
– 1st stage larva – difficulty in swallowing
– short and stout – adult: intestines
– open mouth: feeding stage – abdominal pain
– buccal cavity: long – diarrhea
– genital primordium: small or inconspicuous Laboratory diagnosis
Filariform larva 1. muscle biopsy
– 2nd stage larva – encysted larva: diagnostic stage
– long and slender 2. immuno-test:
– closed mouth: nonfeeding stage a. bentonite flocculation (TS, EG)
– sheath: (+) b. intradermal test (bachmann)
– tail: pointed 3. xenodiagnostic test (TS, TC)
Mode of transmission – skin penetration – beck’s albino rats or mice
Symptoms and pathology
– mazza mora/water sore of ground itch
– severe itching/allergic reaction at the site of skin Filarial worms
penetration Characteristics
– IDA – vector-borne nematodes
– cutaneous larva migrans (creeping eruption): – definitive host: man
– Ancylostoma braziliense (cat hookworm) – intermediate stage: filiform larva or 3rd stage larva
– Ancylostoma caninum (dog hookworm) – infective host: vector
Laboratory diagnosis – intermediate stage: microfilaria
1. stool examination – diagnostic stage: microfilaria
– egg: diagnostic stage Adult – in lymphatics and subcutaneous tissue
2. harada mori culture technique Microfilaria – in blood
– filter paper culture technique Laboratory diagnosis
– for hookworm and threadworm larvae 1. knott’s technique
3. baermann funnel technique (Strongyloides) – isolation of microfilaria
Strongyloides stercoralis – blood + formalin + giemsa stain
Characteristics Wuchereria bancrofti
– causes cochin-china diarrhea Habitat – lympathics
– facultative nematode: Vector – Aedes; Anopheles
– parasitic: small intestine Specimen – blood
– free-living: soil Microfilaria
Adult – female: capable of parthenogenesis – sheathed
(fertilization without the benefit of male) – nuclei is absent in tail
Rhabditiform larva Periodicity – nocturnal (10 pm-2 am)
– buccal cavity: short Brugia malayi
– genital primordium: prominent or conspicuous Habitat – lymphatics
Filariform larva Vector – Mansonia
– sheath: (-) Specimen – blood
– tail: notched Microfilaria
Mode of transmission – skin penetration – sheathed
Symptoms and pathology – tail with 2 separate nuclei
– skin: allergic reaction Periodicity
– larval migration: pneumonia – subperiodic
– intestines: abdominal pain, diarrhea, vomiting – nocturnal
Trichinella spiralis Loa loa
Characteristics Habitat – subcutaneous tissue
– adult: in intestines Vector – Chrysops; Tabanid (mango fly)
– larva: in muscles Specimen – blood
– requires 2 host to complete its life cycle Microfilaria
– propagated by black and brown rats – sheathed
– nuclei is continuous up to the tip of the tail Class – trematoda (flukes)
Periodicity – diurnal Characteristics
Onchocerca volvulus – all except blood flukes (Schistosomes)
Habitat – subcutaneous tissue 1. flat, leaf-like
Vector – Simulium (black fly) 2. hermaphrodite
Specimen – skin snips/shavings 3. egg: operculated
Microfilaria 4. mode of transmission: ingestion
– unsheated 5. infective stage: metacercaria
– nuclei is absent in tail 6. intermediate host: 2 IH
Periodicity – nonperiodic – Schistosomes:
Dipetaloma perstans 1. elongated and cylindrical
(Acanthoculonema perstans) 2. separate sexes
3. egg: non-operculated
Habitat – body cavities
4. mode of transmission: skin penetration
Vector – Culicoides
5. infective stage: cercaria (fork-tailed)
Specimen – blood
6. intermediate host: 1 IH (snail)
Microfilaria
– eggs:
– unsheathed
a. mature when laid (embryonated): “SHOC”
– nuclei is up to the tip of the tail
– Schistosoma
Periodicity – nonperiodic
– Heterophyes
Mansonella ozzardi – Opistorchis
Habitat – body cavities – Clonorchis
Vector – Culicoides b. immature when laid (unembryonated): “PEFF”
Specimen – blood – Paragonimus
Microfilaria – Echinostoma
– unsheathed – Fasciola
– tail is free of nuclei – Fasciolopsis
Periodicity – nonperiodic Attachment
Dirofilaria immitis – 2 suckers: oral and ventral (acetabulum)
Characteristics – heterophyes: 3 suckers (3rd genital sucker
– human infections: “gonotyle”)
– solitary Life cycle
– peripheral nodules in the lung (coin lesions) – egg > larva (Miracidium > Sporocyst > Redia >
– subcutaneous nodule Cecaria > Metacercaria) > adult
Dracunculus medinensis 1st intermediate host – snail
Characteristics – longest nematode of man 2nd intermediate host – fish; crab;
Intermediate host – Cyclops (copepods): aquatic plant/vegetation; snail
crustacean Fish
Definitive host – man – Schistosoma
Mode of transmission – ingestion of crustacean – Heterophyes heterophyes
Angiostrongylus cantonensis – Opisthorcis felineus
Characteristics – causes human eosinophilic – Clonorchis sinensis
meningoencephalitis Crab – Paragonimus westermani
Intermediate host Plant/Vegetation
– mollusks: – Fasciola hepatica
– Achatina fulica – Fasciola gigantica
– japanese snail – Fasciolopsis buski
– Pila luzonica (kuhol) Snail – Echinostoma ilocanum
– Brotia asperata (suso) Habitat
Definitive host – rats – liver:
Adult – Fasciola hepatica
– female: “barber’s pole” appearance – Fasciola gigantica
– looking of whitish uterus to red digestive tract – Clonorchis sinensis
Anisakis – Opisthorcis felineus
Characteristics – causes herring’s disease – small Intestines:
1st intermediate host – various marine – Fasciolopsis buski
crustaceans – Echinostoma ilocanum
2nd intermediate host – smallest fishes – Heterophyes heterophyes
3rd intermediate host – larger fishes – lungs: Paragonimus westermani
Definitive host – dolphins or whales Fasciola hepatica
Mode of transmission Characteristics
– ingestion of raw fish – causes sheep liver rot
– example: sashimi – prevalent in sheep raising countries
Trematodes Egg
Phylum – platyhelminthes – resembles Fasciola gigantica
– resembles Fasciolopsis buski Habitat – superior mesenteric veins of colon & rectum
Adult Egg – with lateral spine
– with cephalic cone Intermediate host
– leaf-like hermaphrodite – Biomphalaria
Fasciola gigantica – Australorbis
Characteristics – infects cattle in the Philippines – Tropicorbis
Egg Schistosoma haematobium
– resembles Fasciola hepatica Characteristics – vesical blood fluke causing
– resembles Fasciolopsis buski bilharziasis or urinary schistosomiasis (hematuria)
Clonorchis sinensis Egg – with terminal spine
Characteristics – most important fluke of man Intermediate host
Egg – old-fashioned liver fluke of man – Bulinus
1st intermediate host – snail – Physopsis
2nd intermediate host – fishes – Biomphalaria
Mode of transmission – ingestion Specimen – 24-hr unpreserved urine
Opisthorcis felineus Trematodes
Characteristics – resembles Clonorchis sinensis Phylum – platyhelminthes
Fasciolopsis buski Class – trematoda
Characteristics – largest fluke parasitizing man Characteristics
Egg – living worms: creamy white and yellowish
– hen’s egg shaped – adult: flat and ribbon-like (masking tape)
– indistinguishable from Fasciola – 1 intermediate host only
Echinostoma ilocanum Cestode body
– scolex = anterior attachment organ
1st intermediate host – snail
– neck = region of growth
2nd intermediate host – snail
– strobila = chains of segments or proglottids
Heterophyes heterophyes – immature, mature, ripe/gravid (filled with eggs)
Characteristics – smallest but deadliest fluke of man Order Pseudophyllidea
Adult – with 3rd sucker (gonotyle) – false tapeworm (example: Diphyllobothrium latum)
1st intermediate host – snail – scolex: spoon-shaped with bothria (slit-like sucking
2nd intermediate host – fishes grooves), no hooklets
Mode of transmission – ingestion – strobila: anapolytic (not shedding segments)
Paragonimus westermani – egg: operculated with aboperculum, immature
Characteristics – causes endemic hemoptysis when laid
Egg – with thickened abopercular end opposite the – stages: coracidium > procercoid > plerocercoid
operculum – intermediate host: 2 IH (copepods & fresh water
Adult – resembles coffee bean fish)
1st intermediate host – snail Order Cyclophyllidea
2nd intermediate host – crabs – true tapeworm
Mode of transmission – ingestion – scolex: quadrate, with 4 cuplike suckers
Laboratory diagnosis (rostellum with or without hooklets)
1. examination: sputum & stool – egg: non-operculated, embryonated (mature
Schistosomes when laid), hexacanth embryo
Characteristics – most romantic parasite of man – intermediate host: 1 IH
Adult – male: with gynecophoral canal where the Require vertebrate intermediate host
female is held – Taenia solium
Laboratory diagnosis – intermediate host: pig
1. demonstration of egg in feces, rectal or liver – Taenia saginata
biopsies and urine – intermediate host: cattle
2. faust and meleney’s egg hatching technique Require invertebrate intermediate host
3. circumoval precipitin test (COP) of oliver and – Dipylidium caninum
gonzales – mode of transmission: ingestion of “pulgas”
Pathology May or may not require intermediate host
– larval penetration – Hymenolepis nana
– human sp: slight allergic reaction Diphyllobothrium latum
– nonhuman sp: swimmer’s itch Characteristics
– tissue damage by eggs – largest tapeworm of man
Schistosoma japonicum – causes vitamin B12 deficiency anemia
Characteristics – causes katayama’s disease Uterus – rosette formation
Habitat – superior mesenteric veins in small intestines Laboratory diagnosis
Egg – with small knob-like or recurved hook on 1 1. stool examination
side – egg: diagnostic stage
Intermediate host – Oncomelania quadrasi
Taenia saginata
Schistosoma mansoni Scolex – none, no rostellar hooks
Characteristics – smallest of the blood flukes
Length – 25 meter 2. roentgenogram (x-ray)
# of proglottids – 1000-2000 3. immunologic tests:
Gravid proglottid – 15-20 lateral branches – bentonite flocculation test (TS, EG)
(dichotomous or tree-like) – casoni (intradermal test)
Eggs – spherical, striated, inside is an embryo with Protozoans
6 hooklets Characteristics
Larva – cysticercus bovis – unicellular
Pathogenesis – Taeniasis saginata – animal-like protists
Taenia solium – division: fission
Scolex – with rostellum armed with 2 rows of large – no cell wall with outer membrane (periplast)
and small hooklets – cytoplasm: ectoplasm (outer) & endoplasm (inner)
Length – 7 meter – contains at least 1, and some several nuclei
# of proglottids – < 1000 – some contain vacuoles: for storage and transport
Gravid proglottid – 7-13 lateral branches Hemotogranules
(dendritic or finger-like) – special organs for locomotion
Eggs – spherical, striated, inside is an embryo with – Sarcodina/Rhizopoda = amoeba (pseudopods)
6 hooklets – Mastigophora/Flagellata
Larva – cysticercus cellulosae – Ciliophora/Ciliata
Pathogenesis – Taeniasis solium, cysticercosis – Sporozoa = no definite locomotory organelle
Hymenolepis nana Class Rhizopoda
Characteristics – smallest tapeworm of man Trophozoites
Scolex – with rostellum armed with a ring of 20-30 – motile
spines – feeding stage
Eggs – with oncosphere enclosed in an inner – diarrheic/liquid stool
membrane with 2 polar thickenings, from each – destroyed by iodine
which arise 4-8 polar filaments Cyst
Infective stage – non-motile
– direct: eggs – nonfeeding stage
– indirect: cysticercoid larva – well-formed stool
Definitive host – man – infective stage
Hymenolepis diminuta Characteristics
Scolex – with an unarmed rostellum – with cystic stage except Entamoeba gingivalis
Eggs – with oncosphere enclosed in an inner – inhabit the large intestine except Entamoeba
membrane with 2 polar thickenings, but without gingivalis
filaments – commensals except Entamoeba histolytica
Infective stage – cysticercoid larva Life cycle – trophozoite > precystic > cystic >
Definitive host – rate metacystic stage
Dipylidium caninum Entamoeba
Proglottids – true amoeba
– with double set of reproductive organs and genital – peripheral chromatin (trophozoite & cyst)
pore on each side of the lateral margin – chromatoidal bars (cyst)
– mature and gravid proglottids: melon Endolimax/Iodamoeba
seed/pumpkin seed/rice grain-shaped – other amoeba
Eggs – egg packet (8-15 eggs) – no peripheral chromatin
Intermediate host – no chromatoid bars
– Ctenocephalides canis (dog flea) Entamoeba histolytica
– Ctenocephalides felis (cat fles) – trophozoite:
– Pulex irritans (human flea) – motility: unidirectional & progressive
Definitive host – 1 pseudopod (finger-like)
– dogs or cats – endoplasm: with RBC but no bacteria or cell
– man: accidental host detritus (clean-looking)
Echinococcus granulosus – nucleus: not visible when stained; consists of
thin nuclear membrane with layer or uniformly
Characteristics
sized fine chromatic granules distributed along
– shortest tapeworm (only 3 segments: immature,
inside the border of nuclear membrane
mature, ripe/gravid)
– karyosome: fine, centrally located (bull’s eye)
– anti- P1 – cyst:
Egg – resembles Taenia egg – chromatoidal bars: coffin/rod/cigar/sausage-
Intermediate host shaped
– sheep – mature cyst with 1-4 nuclei
– infective stage: egg Entamoeba coli
– man: accidental intermediate host – trophozoite:
Definitive host – dog – motility: several directions, sluggish
Laboratory diagnosis – many pseudopods (blunt & rounded)
1. exploratory cyst puncture
 – endoplasm: with bacteria, yeasts and cell – Embadomonas intestinalis
detritus (dirty-looking) – Chilomastix mesnili
– nucleus: when stained, consists of thicker – Giardia lamlia
nuclear membrane with layer of variously sized – Trichomonas hominis
chromatin granules unevenly distributed along the – Trichomonas tenax
inside border of nuclear membrane – Trichomonas vaginalis
– karyosome: large, eccentrically located Blood tissue flagellates
– cyst: – Leishmania tropica
– chromatoidal bars: splinter-like/witch-broom/ – Leishmania braziliensis
whisked broom – Leishmania donovani
– mature cyst with 1-8 nuclei – Trypanosoma rhodesiense
Endolimax nana – Trypanosoma gambiense
– smallest amoeba – Trypanosoma cruzi
– size = RBC Embadomonas intestinalis
– trophozoite: – trophozoite:
– karyosome: large round dot – cleft-like cytostome
– cyst: Chilomastix mesnili
– usually oval – trophozoite:
– nuclei: 4 (cross-eyed) – pear-shaped
Iodamoeba butschlii – spiral groove curving across the body
– trophozoite: – spiral boring, jerky movement
– karyosome: with cluster or achromatic granules – 3 anterior flagella and 1 within the cytostome
– cyst: – cyst:
– large iodine-staining glycogen vacuole – lemon to oval-shaped
Iodamoeba williamsi – protrusion at end
– trophozoite: – nipple-like cyst
– karyosome: with cluster or achromatic granules Giardia lamblia/Lamblia intestinalis
– cyst: – associated with gay bowel syndrome
– large iodine-staining glycogen vacuole – trophozoite:
Entamoeba gingivalis – pear-shaped
– associated with gum infection – bilaterally symmetrical
– trophozoite: – 2 nuclei, each with a large karyosome, lying
– karyosome: small and centrally located within the sucking disk
– pseudopodia: similar to Entamoeba histolytica – falling leaf motility
but does not exhibit true progressive locomotion – old man’s face or old man with eyeglasses
Opportunistic Amoeba – cyst:
Characteristics – 2-4 nuclei
– free-living amoeba – football-shaped
– inhabits the CNS Trichomonas
– does not indicate fecal contamination Characteristics
– cause PAM (fatal) – trophozoite stage only:
– includes: – pear-shaped
– Naegleria – 4-5 flagella
– Acanthamoeba – jerky motility
– Hartmanella – undulating membrane: aids in locomotion
Naegleria fowleri – costa: thickening of membrane
– major causative agent of PAM Trichomonas tenax
– amoebboflagellate (trophozoite) Habitat – oval cavity
– acquired while diving & swimming during hot Size – smallest
weather in brackish/freshwater Nucleus – rounded
– CSF: purulent, with motile amoeba Undulating membrane – 2/3 of the costa
Acanthamoeba Inclusion bodies – none
– causes keratitis (from contaminated contact lens Specimen – oral scrapings
care solution) Trichomonas hominis
– causes GAE Habitat – intestine
– culture: BAP flooded with Entamoeba coli Size – medium
Class Mastigophora (Flagellata) Nucleus – ovoidal
Characteristics Undulating membrane – as long as the costa
– Possesses whip-like locomotory organelle called flagella Inclusion bodies – none
– motor component: flagella and axonemes Specimen – stool
– neuromotor apparatus: kinetoplast which consists Trichomonas vaginalis
of blepharoplast and parabasal body (energizing Habitat – genitalia
portion) Size – largest
Digestive tract & Genital flagellates Nucleus – ovoidal
– Enteromonas hominis Undulating membrane – < ½ of the costa
Inclusion bodies – siderophile granules – macrophages
Specimen Vector
– urine – Phlebotomus
– female: vaginal swab or discharge – Lutzomyia
– male: prostatic secretion Pathology
Characteristics – splenomegaly
– causes pingpong’s disease – severe anemia
– female: Laboratory diagnosis
– burning sensation 1. culture:
– strawberry cervix – NNN: Novy-McNeal-Nichole medium
– male: carrier – culture for Leishmania & Trypanosoma
– asymptomatic chronic urethritis Trypanosoma rhodesiense &
– epididymis, prostate & urethra Trypanosoma gambiense
Laboratory diagnosis – 7 Agent of
Hemoflagellates – african sleeping sickness
Characteristics – east africa: Trypanosoma rhodesiense
– include the Tyrpanosomes and Leishmanias – west africa: Trypanosoma gambiense
– may infect the blood, lymph nodes, muscles and RES Vector – Glossina (tsetse fly)
Amastigote Habitat
– Leishman-Donovan body – fibrile: blood, lymph node
– Leishmanial form – sleeping sickness: CSF
Promastigote Winterbottom sign – inflammation or swelling of
– leptomonal form lymph nodes
– anterior to nucleus Laboratory diagnosis
Epimastigote 1. febrile stage: blood, lymph node aspirate
– crithidial form 2. sleeping sickness stage: CSF
– near nucleus Trypanosoma cruzi
Trypomastigote Agent of
– Trypanosomal form – american trypanosomiasis
– posterior to nucleus – chagas’ disease
Leishmania tropica Vector
Agent of – triatomid bugs
– old world cutaneous leishmaniasis – kissing bugs
– oriental sore – reduviid bugs
– Aleppo button – assassin bugs
– Baghdad or Jericho boil – cone nose bugs
– dry lesions – Triatoma rubrofasciata = philippines
Habitat Habitat – RES, cardiac muscle, CNS
– endothelial cells Characteristics – C-shaped
– monocytes Romaña’s sign – unilateral swelling of eye lids
Vector Laboratory diagnosis
– Phebotomus 1. chang’s medium
– Lutzomyia 2. xenodiagnostic test (TS, TC)
Pathology – localized cutaneous infection Ciliates
(macule → papule) Balantidium coli
Leishmania braziliensis – the only significant ciliate
Agent of – host: pig
– american mucutaneous leishmaniasis – largest parasitic protozoan
– espundia – mode of transmission: ingestion of cysts (from
– bubas swine feces)
Habitat – mucutaneous junctions (nasal septum, – S/S: dysentery
mouth, pharynx) – trophozoite:
Vector – macronucleus: kidney-shaped, vegetative
– Phlebotomus – micronucleus: dot-like, reproductive
– Lutzomyia – cilia, oral cytostome (mouth)
Pathology – wheeping lesions – cyst:
Laboratory diagnosis – refractive double wall enclosing cilia
1. Dr. Montenegro’s skin test – nonmotile
Leishmania donovani Sporozoa
Agent of Characteristics
– visceral leishmaniasis – obligate intracellular
– kala-azar (black fever) – no apparent means of locomotion
– dum-dum fever Life cycle
Habitat – sexual (sporogony) = definitive host ‘arthropod
– endothelial cells of RES vector’
– asexual (schizogony) = infective host ‘man’ a. optimal assay
Plasmodium – detects pLDH (parasitic LDH) = malarial organisms
Characteristics – cause of malaria “bad air” b. malaquick test
Infective stage – detects HRP-2 or HRP II Ag (Plasmodium falciparum)
– infective host (man): sporozoites Plasmodium vivax
– definitive host (mosquito): gametocytes Characteristics
Asexual life cycle – prevalent worldwide
– female anopheles --(sporozoites)--> man --> liver – single large ring succeeded by amoeboid form in
(exoerythrocytic cycle) --> infected cells (liver) will pale large red cell
rupture & release merozoites --> erythrocytic cycle – schuffner’s dots (condensed Hgb)
– erythrocytic cycle: – relapse: hypnozoites
1. merozoites (RBC) --> trophozoites --> schizont -- – infects reticulocytes only
> release merozoites – infected RBCs: enlarged
2. merozoites --> microgametocytes (male) or # of merozoites – usually 16
macrogametocyte (female) Trophozoite – amoeboid
3. merozoites --(female anopheles)--> man Gametocyte – round
Sexual life cycle Plasmodium malariae
– macrogametocytes & microgametocytes --> Characteristics
anopheles mosquito – single large compact ring or band forms
– anopheles --> macro- + microgametocytes = – invades old RBCs
zygote (ookinete) – ziemann’s dots
– ookinete --> oocysts (contains sporozoites) --> – schizont arrange around central pigment
matured: release sporozoites – rosette
– sporozoites --(female anopheles)--> man – daisy head
Symptoms and pathology – fruit pie
1. recurrent chills and fever # of merozoites – 8
– every 36 hours: malignant tertian malaria Trophozoite – band
= Plasmodium falciparum Gametocyte – ovoid
– every 48 hours: ovale malaria Plasmodium falciparum
= Plasmodium ovale Characteristics
– every 48 hours: benign tertian malaria – prevalent in the Philippines
= Plasmodium vivax – ring forms: small (1/6 diameter red cell), applique
– every 72 hours: quartan malaria forms or marginal or accole formation or double
= Plasmodium malariae chromatic dots
2. anemia (RBC destruction), splenomegaly, joint pain # of merozoites – 24-32
3. Plasmodium falciparum: fatal Trophozoite – ring
– cerebral malaria: RBC, organisms and pigment Gametocyte
block brain vessel – crescent-shaped
– blackwater fever: intravascular hemolysis + – sausage-shaped
hemoglobinuria – banana-shaped
Resistant to malaria Plasmodium ovale
– G-6 PD deficiency
Characteristics
– Fy (a-b-)
– single compact ring
– sickle cell disease
– schuffner’s dots or james’ dots
Hypnozoites
– relapse: hypnozoites
– dormant stage
– infected RBCs: serrated or fimbriated
– found in the liver
# of merozoites – 8-9
– once activated, releases merozoites
– responsible for relapse Babesia microti
– Plasmodium vivax Characteristics
– Plasmodium ovale – “maltese-cross” formation
Mixed infection – resembles Plasmodium falciparum rings
– Plasmodium vivax – no malarial pigment
– Plasmodium falciparum – no growing trophozoite
Laboratory diagnosis Definitive host – deer
1. examination of blood film Mode of transmission
a. thick blood film = screening purposes – Ixedes tick bite
– dehemoglobinize RBCs – blood transfusion
– stain with giemsa Symptoms and pathology
b. thin blood film = identification of species – headache and fever
– fix with methanol – hemolytic anemia + hemoglobinuria
– stain with giemsa Babesia bigemia
2. QBC: quantitative buffy coat Characteristics – causes “red water fever” in
– fluorochrome: acridine orange cattles
3. immunotests COCCIDIA
Characteristics – agent of “rats”
– schizogony (asexual) = nucleated cells Myiasis – invasion of mammalian tissues by
– sporogony (sexual) = intestinal mucosa of DH dipterous larvae (diptera or flies)
Infective stage – oocyst (feces) Cantharidin
Isospora belli – volatile vesicating substance produce by the
– infective host: cattles, pig blister of beetles of the family
– definitive host: man – meloidae
– mode of transmission: sporulated oocyst in Periplaneta americana
contaminated food and water – american cockroach
1. infections/diseases: – lays about 50 egg capsules (ootheca), each
– aymptomatic containing about 15 eggs
– diarrhea, flatulence Blatella germanica – german cockroach
– acalculous cholescystitis Blatta orientalis – oriental cockroach
Cryptosporidium (C. parvum/C. hominis) Aedes aegypti
– Crystosporidum parvum; bovines – tiger mosquito
– Crystosporidium hominis: man – vector of urban dengue
1. infections/diseases: Aedes albopictus
– watery, frothy diarrhea among – with silvery stripe on the mesonotum
immunosuppressed patients – vector of rural dengue
– acute and gangrenous cholecystitis Culex – vector of japanese encephalitis
2. laboratory diagnosis: Anopheles flavirostris – primary vector of
– sheather sugar flotation malaria
– stool examination Aedes poecilus – mosquito associated with
– modified acid fast stain (CIC) bancroftian filariasis
Cyclospora cayetanensis Mansonia bonneae – vector of the brugian type of
– originally called a cyanobacterium-like body (CLB) filariasis
– causes chronic and intermittent watery diarrhea Musca domestica – common housefly
Sarchocystis (S. hominis/S. suihominis) Sarcophaga – “chess-board” appearance
– zoite: simplest form (banana-shaped) Calliphora – bluish fly covered with yellow hairs
1. infections/diseases: Lucilia– greenish fly with white genae
– gastroenteritis with diarrhea Phaenicia – bronze-bottle fly
– eosinophilic enteritis Muscina – slightly larger and more robust that the
– myalgia (mild increase in CK) housefly
Toxoplasma gondii LABORATORY METHODS
Characteristics – common cause of congenital Examination of Blood
infection
Detect agents of
Definitive host
– malaria
– cat: oocysts in cat feces may infect man
– babesiosis
Infective host
– trypanosomiasis
– man:
– leishmaniasis
– bradyzoite = inactive form
– filariasis
– tachyzoite = actively dividing
Thick blood films – screening (malaria)
Laboratory diagnosis
Thin blood films – identification of malarial
1. sabin-feldman dye test
species
– methylene blue staining of tachyzoites is
Concentration techniques
inhibited by prior addition of patient serum
1. preparation of buffy coat smears:
containing antibodies of Toxoplasma
– Leishmania donovani
– trypanosomes
OTHER INTESTINAL PROTOZOANS – microfilaria
Blastocystis hominis 2. knott’s concentration membrane filtration
– vacuolated form (most predominant): – detection of microfilaria
– a large central vacuole pushes the cytoplasm 3. fluorochrome acridine orange in microhematocrit
and nuclei to the periphery of the cell centrifuge format
Dientamoeba fragilis – QBC blood parasite detection method
– former amoeba
– now classified as a flagellate
Examination of Fecal Specimens
Stool fixatives
– trophozoite stage only:
1. formalin = all purpose fixative
– 2 nuclei “binucleated trophozoite”
– 5% concentration: protozoan cysts
– mode of transmission:
– 10% concentration: helminth eggs & larvae
– via transmission of Enterobius vermicularis egg
2. schaudinn’d fluid = with HgCl2
ARTHROPODS 3. polyvinyl alcohol (PVA) = for trichrome stain
Copepods (Cyclops) – infective host of (with HgCl2)
Diphyllobothrium latum & Gnathostoma spinigerum 4. merthiolate-iodine-formalin (MIF) = a.k.a
Pthirus pubis thimerosal
– crab louse
 – merthiolate and iodine: staining components – specimens:
– formalin: preservative – vaginal and urethral discharge
5. sodium-acetate-formalin (SAF) – prostatic secretions
– advantage: does not contain HgCl2 – urine
Direct wet mount Sputum – recovery for protozoal and helminthic
1. saline mount = 0.85% NSS parasites
2. iodine mount = protozoan cysts (not Biopsy
trophozoites) 1. skin biopsy = Onchocerca, Mansonella
Permanent stains 2. muscle biopsy = Trichinella spiralis
1. wheatley’s trichrome stain
2. iron hematoxylin stain
3. modified acid fast stains
– Cryptosporidium
– Isospora
– Cyclosporas
Concentration Methods for Protozoan
Cysts and Helminth Eggs and Larva
Sedimentation
– best for eggs of:
– Schistosoma
– operculated egg
– trematodes
– cestodes
– Trichuris trichiura
– Capillaria philippinensis
1. acid-ether concentration
– ether: dissolves fats and CHO
2. formalin-ether concentration
– formalin: preserves the eggs
Flotation
1. brine flotation = NaCl
2. zinc sulfate centrifugal flotation technique
– specific gravity (ZnSO4): 1.18
– for protozoan cysts
– for nematode eggs except Trichuris trichiura
and Capillaria philippinensis (sedimentation)
– not for schistosomal and operculated eggs
(sedimentation)
Cultural Methods for Protozoa
Culture media for intestinal amoeba
1. boeck and dorbohlav’s diphasic medium
– modified by dobell and laidlaw
2. Cleveland and collier’s medium
NNN (Novy-McNeal-Nicolle)
– medium for:
– trypanosoma
– leishmania
Additional Techniques for Examination
of Enteric Parasites
Cellulose tape technique – for pinworms
Egg studies
1. direct smear method of beaver
2. stoll dilution egg count
3. kato thick smear = qualitative
– cellophane paper, glycerine, malachite green
4. kato katz smear = quatitative
– cellophane fecal thick smear
Nematode culture and recovery techniques
1. harada-mori paper strip culture
2. baermann funnel techniques (Strongyloides)

Examination of Other Specimens

Detection of T. vaginalis