SAN PEDRO COLLEGE MLS 409 LEC (CLIN.

PARASITOLOGY)
BSMLS 2ND YEAR | SECOND SEMESTER Clarion, Charlie RMT, MD
AY: 2023-2024 INTRO TO PARASITOLOGY | LEC

INTRODUCTION TO PARASITOLOGY

DEFINITION OF TERMS

● Symbionts: organisms living together

● Symbiosis: association/relationship of two or more
organisms living together
→ 3 Major Symbiotic Relationships:
1) Mutualism
2) Commensalism *Left: Entamoeba histolytica trophozoite with ingested red
3) Parasitism blood cells
*Right: an amoebic ulcer in the colon caused by the parasite
3 MAJOR SYMBIOTIC RELATIONSHIPS
NOTE: take note of the flask shaped ulcer typical of
1. MUTUALISM amoebic ulcer

● symbions/s
Biological relationship between two or more
organisms when both the host and organism benefit PARASITOLOGY
symbiosis
from one another
● Parasitology: is a branch of science that deals with
○ Nobody is harmed in this relationship
● Ex. Flagellates inside the digestive system of the study of parasites
termites ● Medical parasitology or Human parasitology: is
○ Termites mechanically digest and devour food restricted to studying those parasites that are living
that is made up of cellulose. This termite in or on the body of humans, their geographic
cannot effectively by itself absorb the wood in distribution, the diseases caused by them, clinical
its gut. The flagellates inside the GIT of the picture, and the response generated by humans
termite digest the wood producing by-products against them.
that are digestible and readily assimilated by ○ ALL parasites that affect humans either
both the termite and the flagellates. In this naturally or accidentally
case, both the organisms are mutually
benefiting from each other. OTHER TERMS

● Anthroponosis: parasitic infection is found in man

2. COMMENSALISM
alone (humans only)
● Zooanthroponosis: parasitic infections mainly
● One organism benefits but there is NO beneficial or
affect man; animals become infected in life cycle of
harmful effect to the host
parasite line in taeniasis (taenia saginata or taenia
● Ex. Entamoeba coli in intestinal lumen of humans
solium)
○ Entamoeba coli, which is a protozoa, thrives in
● Anthropozoonosis: parasitic infection is mainly in
the human gut. It eats the bacteria and other
animal, may be acquired by man as in trichinosis,
artifacts in the human gut. Nevertheless, it is
echinococcosis (echinococcus granulosus)
neither harmful nor beneficial to the human
host.
TYPES OF PARASITES

3. PARASITISM CLASSIFICATION:
● Location
● One species (microbe) benefits at the expense at ● Need of Host
the other
○ Parasite = living organism that takes LOCATION
nourishment and other needs through contact
with another species 1. Ectoparasites
○ Host = organism that supports parasite - a parasitic organism that lives on the outer
(nourishment) and later develops a disease surface of its host
● Ex. Entamoeba histolytica derives nutrients from - E.g. lice (head & pubic), ticks, mites etc.
human host causing intestinal ulcers and dysentery 2. Endoparasites
○ An organism that that thrives in the colon - parasites that live inside the body of their host
causing intestinal ulcers and dysentery while - E.g. Entamoeba histolytica and Ascaris
deriving nutrients from the human host lumbricoides

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 - Red arrows (left): represents growth & reproduction
in external environment of human host
(nonparasitic)

OTHER TYPES OF PARASITES

● Accidental/Incidental Parasite
○ parasite attacks an unnatural host and survives
but may or may not complete life cycle
● Infestation: presence of ectoparasites - Echinococcus granulosus: accidental
● Infection: presence of endoparasites parasite; (normally attacks canines)
Humans: accidental host

● Erratic or Aberrant Parasite

○ parasite that wanders into an organ in which it
is not usually found
- Ascaris lumbricoides in humans = lives
inside the small intestine but can crawl to
the pancreatic duct causing pancreatitis
- Entamoeba histolytica = usually thrives
in the colon but may reach the liver or
lungs causing amoebic liver abscess or
*Left: bolus of ascaris lumbricoides amoebic lung abscess or empyema
*Right: head louse

NEED OF HOST

1. Obligate Parasite
- Completely dependent on the host during a
segment or all of its life cycle
- It cannot complete its life cycle without the host
- Ex: Plasmodium spp. - causes malaria; need
mosquito and humans to develop and
reproduce *Ascaris lumbricoides crawling outside different body
2. Facultative Parasite orifices*
- Exhibits both parasitic and non-parasitic modes
of living and hence does NOT absolutely
depend on the parasitic way of life, but is
capable of adapting to it if placed on a host
- Can develop inside or outside the host
- Ex: Strongyloides stercoralis

Life cycle of Strongyloides stercoralis

*Entamoeba histolytica invading the lung that causes

amoebic lung abscess*

● Intermittent or Temporary Parasites

○ those that only visit the host from time to time
for feeding
- Ex: Mosquito - pregnant female mosquito
will not forever attach and live on the
human host, it just visits the host during
feeding
● Permanent Parasite
○ remains on the host for life
- Ex: Trypanosomes, Wuchereria, Filaria
● Spurious or Coprozoic Parasite
- Blue arrows (right): represents growth & ○ organisms that have been swallowed and
reproduction inside human host (parasitic mode of passed through the alimentary tract (GIT)
living) without causing any effect

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 ● Pseudoparasite IDENTIFY INTERMEDIATE & DEFINITIVE HOSTS
○ Terms used to mean an artifact but mistaken as
parasite (NOT a true parasite) Life cycle of Capillaria philippinensis
- Ex: thread, seeds, pollen, or air bubbles

*Black arrows = Football-shaped Trichuris trichiura eggs*

*Red arrows = air bubbles (pseudoparasites)*

*Fruit thorn* - Humans = definitive hosts

● Hyperparasite - Fish = intermediate hosts
○ Parasite that parasitizes another parasite
- Ex. Female ixodes angustus tick =
Life cycle of Taenia spp.
parasite to humans; Male tick =
hyperparasite asi it parasitizes the female
tick

TYPES OF HOSTS

● Definitive Host
○ a host that harbors a parasite in the adult stage
or where the parasite undergoes a sexual - Humans = definitive hosts
reproduction - Pigs & Cattle = intermediate hosts
- Ex. Humans in taeniasis
● Intermediate Host Life cycle of Malaria
○ harbors the larval stages of the parasite or an
asexual cycle of development takes place
- Ex. Pigs in T. solium, cattle in T. saginata

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- Humans = intermediate hosts ● Natural host
- Mosquitoes = definitive hosts ○ a host that is naturally infected with certain
species of parasite.
INTERMEDIATE HOSTS - Ex. Canines in Echinococcus granulosus
● Accidental Host
● Intermediate Hosts ○ a host that is under normal circumstances not
○ In some cases, larval development is infected with the parasite
completed in TWO different intermediate hosts - Ex. Humans in Echinococcus granulosus
referred to as
- First Intermediate Host Life cycle of Echinococcus granulosus
- Second Intermediate Host

Life cycle of Diphyllobothrium latum

- Canine = definitive host

- Human = accidental host
- Echinococcus granulosus = accidental parasite to
human
- Diphyllobothrium latum is a hermaphrodite
meaning the mature proglottid of the adult parasite TYPES OF LIFE CYCLE
contains both testes and ovaries. Sexual
reproduction happens in the human body ● Direct Life Cycle
- Humans = definitive host ○ AKA Monoxenous life cycle
- Copepod = 1st intermediate host ○ parasite does NOT REQUIRE an intermediate
- Small fish = 2nd intermediate host host to complete its life cycle
- Big fish = paratenic host ● Indirect Life Cycle
○ AKA Heteroxenous life cycle
TYPES OF HOSTS (cont.) ○ parasite REQUIRES an intermediate host to
complete its life cycle
● Paratenic Host
○ a host that serves as a temporary refuge and DIRECT OR INDIRECT?
vehicle for reaching an obligatory host, usually
the definitive host, i.e. it is NOT necessary for
the completion of the parasite's life cycle.
○ There is NO development of the parasite inside
the paratenic host
- Ex. Wild boar in Paragonimus westermani
● Reservoir Host
○ a host that makes the parasite available for the
transmission to another host and is usually not
affected by the infection.
○ The unending source of parasite - DIRECT
- Ex. Pigs for Balantidium coli, Field rats for
Paragonimus westermani, Cats for Brugia
malayi

- INDIRECT

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 SPECIAL TYPES OF INFECTION
1. Autoinfection
2. Hyperinfection or Superinfection

AUTOINFECTION
● Autoinfection
- Infected individual becomes his own direct
source of infection
- Ex. Enterobiasis through hand-to-mouth
transmission – In enterobiasis, infection may
occur through hand-to-mouth transmission.
Infective eggs may end up in the hands by
scratching the perianal areas where the gravid
females lay their eggs. Alternatively, parasites
may multiply internally, such as Capillaria
philippinensis.

In Strongyloides stercoralis, adult female worm undergo

parthenogenesis meaning, the adult female worm produces
embryonated eggs even in the absence of an adult male worm, even
if thereis no fertilization. So, if the patient is immunocompromised for
some reason, the adult female strongyloides stercoralis produce
embryonated eggs even if there is no male worm so that is
parthenogenesis. The egg may hatch even inside the intestine
liberating rhabdiliform larva that may also further develops to
become filariform larva this filariform nerve penetrates the intestinal
mucosa or perianal skin and migrate back to the small intestine to
become an adult worm. This cycle repeats again and again and
again resulting to hyperinfection.

TYPES OF VECTORS
HYPERINFECTION OR SUPERINFECTION
● Hyperinfection or Superinfection AGENTS OF TRANSMISSION
- Infected individual is further infected with
● Vehicle or Fomites: non-living entity
same species leading to massive infection
● Vector: living entity
- Ex. Capillaria philippinensis, Strongyloides
1. Biological Vector
stercoralis – An alteration in the normal life
cycle of Strongyloides results in a large increase ○ transports pathogens plus plays a role in
in worm burden, which may lead to severe the life cycle of pathogen
debilitation or even death due to an increase in ○ While carrying and transporting the
the proportion of rhabditiform larvae that organism develops further or even
transform into filariform larvae while in the gut. reproduces inside the vector
○ (Malaria inside mosquito)
● Female adult worms can be OVIPAROUS
or LARVIPAROUS 2. Mechanical Vector
○ organism that only transports a pathogen
Parthenogenesis ○ (Flies, cockroaches that feed on fecal
material with parasites)
Strongyloides stercoralis
- This is a parasitic
MODES OF TRANSMISSION
(parthenogenetic) female
recovered from a mucosal ● Peroral (Contaminated Food and Water): MC
scraping of the small intestine source; majority of cestodes, trematodes and
of a dog. intestinal protozoans like amoeba
- Note the small size, and long ● Percutaneous (Skin Penetration): hookworm,
esophagus. strongyloides, schistosoma
- There are no males in the ● Arthropod Vector: malaria, filaria, leishmania,
parasitic portion of the trypanosoma
life-cycle. ● Congenital Transmission: toxoplasma
(transplacental), ancylostoma and strongyloides
(transmammary)
● Inhalation of Airborne Eggs: enterobius
● Sexual Intercourse: Trichomona vaginalis, giardia,
entamoeba
● Blood-borne Transmission: malaria

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 EFFECTS OF PARASITE TO HOST
DIRECT EFFECTS ● Direct Effect: Invasion and Destruction
○ Plasmodium invades RBC → RBC rupture
● Direct Effect: Mechanical Injury ○ Schistosoma japonicum to liver → granuloma
- May be inflicted by a parasite by means of formation
pressure as it grows larger ○ Hookworms destroying intestinal villi
- e.g. Hydatid cyst causes blockage blood
vessels producing infraction to different organs
like liver, lungs, muscle, and other parts of the
body

● Direct Effect: Traumatic Damage

- Insect bite causes skin lesions or an ascaris
lumbricoides heavy infection causing
obstruction of the intestine which may need
surgical intervention

*Life cycle of Malaria*

● Direct Effect: Enzymatic Interference

- E. histolytica trophozoites secrete cysteine *Schistosoma egg obstructing the portal venous system*
proteases which digest cellular material in the
colon and may consequently result to amoebic
ulcer

*adult hookworms attached and fed through intestinal villi*

● Direct Effect: Nutrient Deprivation

○ D. latum competes with host Vit B12
supply -> megaloblastic anemia

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 INDIRECT EFFECTS Life cycle of Ascaris lumbricoides

● Excessive proliferation of certain tissues due to

invasion by some parasites can also cause tissue
damage in man
○ e.g. fibrosis of liver after deposition of the
ova of schistosoma

● Tissue damage may be caused by immunological

response of the host - Unfertilized egg & fertilized unembryonated egg,
○ Nephrotic and/or nephritic syndrome adult worms recovered in feces = diagnostic stage
following Plasmodium infections - Embyronated egg = infective stage

CLINICAL VS. BIOLOGICAL IP

● Clinical Incubation Period/Incubation Period
○ Between infection and evidence of
symptoms
● Biological Incubation Period/Pre-Patent Period
○ Between infection and demonstration of
infection by laboratory means (there is
laboratory testing invloved)

CLASSIFICATION OF PARASITES
MECHANISM OF IMMUNE EVASION AND EFFECTS OF
I. Medical Helminthology (helminths):
HOSTS TO PARASITES
MULTICELLULAR
MECHANISM OF IMMUNE EVASION A. Platyhelminths (Flatworms)
● Immune Suppression 1. Class: Trematoda (Flukes)
○ E. histolytica produces suppressor factor 2. Class: Cestoda (Tapeworms)
that inhibits monocyte movement B. Nemathelminths
● Antigenic Variation 1. Class: Nematoda (Roundworms)
○ Surface protein variation in T. brucei II. Medical Protozology (protozoa): UNICELLULAR
gambiense III. Arthropods (Entomology)
● Host Mimicry
○ E. granulosus carries blood group
antigens
● Intracellular Sequestration
○ T. gondii multiplies inside macrophages

EFFECTS OF HOST ON THE PARASITE

● Sickle cell disease:
○ protection against P. falcifarum malaria
● Duffy blood group system:
○ increases susceptibility to P. vivax malaria
● High protein diet
○ not suitable for intestinal protozoan
development
HELMINTHIC PARASITES
INFECTIVE VS. DIAGNOSTIC STAGE ● Roundworms
● INFECTIVE STAGE – The stage in the life cycle at ○ NEMATODA
which the parasite is able to initiate an infection to
● Flatworms
its host.
○ CESTODA - Flat and Segmented
● DIAGNOSTIC STAGE – is the life cycle stage that
○ TREMATODA - Flat and Unsegmented
exits the definitive host found in specimen like
feces, urine, or biopsy sample.

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 CLASSIFY THE FOLLOWING PARASITES

- A = Nematode
- B = Cestode
- C = Trematode

PROTOZOLOGY (UNICELLULAR)

4 MAIN DIVISIONS DEPENDING ON THE TYPE OF

LOCOMOTORY APPARATUS

1) Apicomplexa - parasites that contain an apical

structure that is used for burrowing a cell so that the
parasite can get inside the cell
- All apicomplexa are intracellular
2) Mastigophora - uses flagellate as locomotory
apparatus
3) Sarcodina - uses pseudopods as locomotory
apparatus just like an amoeba
4) Ciliophora - uses ciliates for locomotion
- Balantidium coli = the only medically
important parasite (that uses ciliates)

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Catedral & Fontanilla | BSMLS 2C