Parasitology Trans- Lecture Notes (half)
Parasitology Trans- Lecture Notes (half)
Schistosoma intercalatum
LOCATION: venules of the colon
OVA: resembles S. heamatobium has terminal
spine but found in feces and ACID-FAST
POSITIVE
Schistosoma mansoni
- Aside from Africa, it is also found in the
Western hemisphere which includes Latin
countries (e.g. Brazil, Venezuela and Puerto Schistosoma mekongi
Rico) LOCATION: venule of small intesstines
MOT: Skin Penetration to invade the OVA: resembles S. mansoni in size and shape
circulatory system but much smaller, and has a larger lateral
IS: Cercaria spine
GEOGRAPHICAL DISTRIBUTION: Africa,
Western Hemisphere (Brazil, Venezuela,
Puerto Rico, Caribbean Islands) LUNG FLUKE
1ST IH: Snail (Biomphalaria alexandrina in
African continent; Australorbis glabratus in the Paragonimus westermani
Western hemisphere; Tropicorbis) -Known as “Oriental Lung Fluke”
HABITAT: Inferior Mesenteric Vein; Portal -common among oriental countries (Asian
veins of the large intestine countries e.g. Japan, Philippines)
SYMPTOMS: Loss of Weight, Enlarged liver -not very common but once you see the
and spleen symptoms, it is almost always mistaken as
LIFESPAN: 20-30 years tuberculosis
DISCOVERER: Louis Westenra Sambon CHARACTERISTICS: Coffee-bean shape;
(1907) reddish brown in color
TESTES: 6-9 in clusters DIAGNOSTIC STAGE: eggs in stool or sputum
EGGS: Large lateral spine shaped like thorn (rust-colored, with foul fished odor)
rose MOT: Ingestion of metacercariae infected
DISEASE: Hepato-Intestinal Schistosomiasis; undercooked crabs
associated squamous cell carcinoma HABITAT: Lungs
SYMPTOM: Enlarged liver and spleen
OVA: Oval, yellowish brown, thick shaped egg, OVA: Operculated, immature, ellipsoidal,
has flattened but prominent operculum, rounded at both ends
opposite to the operculum is a thick DEFINITIVE HOST: Pigs and humans
abopercular region DIAGNOSIS: Eggs in feces
IS: Metacercaria EXAMINATION: Sedimentation Method
1st IH: Snails (Thiara granifera, Semisulcospira TREATMENT: Praziquantel (drug of choice);
libertina, Brotia asperata) Niclosamide (alternative drug)
2nd IH: Freshwater crabs and crayfish PREVENTION: Kill the eggs, miracidia and
(Parathelphusa grapsoides, Potamon dehaani, cercaria, in water with unslacken lime 100ppm
Sesarma amurensis, Astarcus) or copper sulfate 20 ppm. Also, cooking or
Disease: Paragonimiasis, Endemic steeping of plants in boiling water
Hemoptysis, Pulmonary Distomiasis, DISEASE: trauma, obstruction and toxication
Jacksonian Epilepsy 1st IH: Snails (Genus Segmentina, Gyraulus,
Symptom: Dry Cough; Production of blood Polypilus and Hippeutis)
strip sputum (tenacious rusty brown sputum) 2nd IH: Water chestnut (Eliocharis tuberosa),
Hemoptysis – spitting of blood from the Bufallo Nuts (Trapa natan/Trapa bicornis)
lungs ; sputum-containing blood coming from -Parasite of humans and pigs
the lungs (Rusty tenacious brown sputum) -Takes 7 weeks to mature and hatch 27-32
Hematemesis- Spitting of blood from deg, Celsius
the stomach -Inflammation at the site of attachment
DIAGNOSIS: Eggs in the stool and sputum provokes excess mucous secretion
LIFECYCLE: -Heavy infections block the passage of food
Ingestion of crayfish containing metacercaria – and interfere with normal digestive juices
intestine – peritoneal cavity (immature worm) – secretion
lungs (mature and produce eggs) Sensitization- caused by absorption of the
worms allergic metabolites. This may
SPECIMEN: Stool or sputum eventually cause the death of the patient
EXAMINATION: The sputum needs to be
centrifuged. The sediment will be treated with
NaOH and examined for the ova
Echinostoma ilocanum
microscopically Known as “Garrison’s Fluke”
Preventive measure: Proper cooking of crabs -Discovered by Garrison
and cleaning of crabs before cooking. -Discovered from a native in Luzon (an
-When found in the brain, it may cause Ilocano)
Jacksonian Epilepsy -A parasite of aquatic birds(Definitive Host)
-The person may also experience chest pain, - Not a parasite of humans; human only
irritation of the bronchi becomes an accidental host
-When it migrates to the brain, it can cause CHARACTERISTICS: bilobed testes in
Cerebral Paragonimiasis that may lead to tandem
neurologic condition. MOT: Ingestion of Metacercaria
-The patient may experience seizure, vision IS: Metacercaria
difficulties, decrease precision of the motor DIAGNOSIS: Finding of eggs in stool
skills TESTES: Dumbbell in tandem
MEDICATION: Praziquantel, Bithionol OVA: straw-colored, operculated, small
HABITAT: Small intestine
1st IH: Snail (Gyraulus convexiusculus;
INTESTINAL FLUKE Hippeutis umbilicaris)
2nd IH: Freshwater fish (Pila luzonica)
Fasciolopsis buski DISEASE: Bloody diarrhea, abdominal pains
-Known as “Giant Intestinal Fluke” HETEROPHYIDS
MOT: Ingestion of raw water chestnuts or
caltrop/water plants - known to be the smallest but deadliest,
CHARACTERISTICS: does not have a causing hemorrhagic brain convulsion, cardiac
cephalic cone, and its intestinal ceca are Beri Beri and paralysis
unbranched and reaches posterior end
IS: Metacercaria
Heterophyes heterophyes
HABITAT: Intestine of Definitive Host COMMON NAME: Von Siebold’s Fluke
TESTES: 2 dendritic testes in tandem (smallest but deadliest)
CHARACTERISTICS: 3 suckers, third is
genital sucker, elongated, oval, pyriform
PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR
TREATMENT:
Fasciola hepatica o Rafoxanide, Dichlorophenol,
-Known as “Sheep liver fluke”/ “Giant Liver Dehydroemetine
Fluke” o Bithionol, administered orally at
-large, broad, flat body (18 to 51mm in length, the rate of 30 to 50mg/kg every
4 to 13mm in width) other day for 10 to 15 doses
-“Parasites of sheep and cattle” o Praziquantel, given at the rate of
-Common parasite of herbivores 25mg/kg 3 times a day for 5 to 7
-Biggest among the liver flukes days, seems to lessen the
-One of the largest flukes in the world (Length: severity of infection
30 mm/3cm; Width: 13 mm/1.5cm) o Tricalabendazole, for veterinary
SYNONYM: Distoma hepaticum use
MOT: Ingestion of infected plant -In the Philippines, infected animals are mostly
IS: Metacercaria carabaos
RESERVIOR HOST: Sheep -Shoulder appearance is distinct in F.
DISEASE: Fascioliasis; Causes Liver Rot hepatica
OVA: -Humans serve only as the accidental host,
o operculated (130-150 um x 63- while the sheep is the natural/reservoir host
90um); Has a larger operculum -Requires 23 weeks to develop at 10 degree
than C. sinensis Celsius and 8 days at 30 degree Celsius.
o Ovoidal PATHOGENESIS:
o Yellowish to brownish in color o In HUMANS, symptoms are
o released from the worm still occasionally seen that suggest
immature containing a large that there may be considerable
unsegmented mass of vitelline local irritation during the
cells. migration of the young worms to
LIFESPAN: 10 years (man-as accidental the liver
host) ; 5 years (sheep-as natural or reservoir o In SHEEP, migration through the
host) liver parenchyma gives res to
INCUBATION PERIOD: 9 to 15 days such massive tissue destruction
TESTES: highly branched that the disease at this stage is
PREVENTIVE MEASURE: Eliminating known as liver rot.
watercress from the diet or cooking it properly -at less than 30 degree Celsius, development
1st IH: Snail (found in the Philippines) slows
o Lymnaea philippinensis -at 37 degree Celsius development stops
2nd IH: -Freezing kills the eggs/ova
o Nasturtium officinale
(Watercress) Jean de brie published the 1st record in 1319
o Ipomea obscura (Morning glory “liver rot”
or Kangkong) Francesco Redi in 1668 was the first to
illustrate this fluke
SYMPTOMS:
trophozoite stage in a fresh stool specimen Few 3-5 Ova/ Cyst/ Trophozoites per smear
which contains RBC, how the amoeba engulfs
the RBC is clearly seen. Amoeba is a parasite Moderate 6-12 Ova/ Cyst/ Trophozoites per smear
that do not possess a mouth part. While it
moves, then sees an RBC, it engulfs and
Many >12 Ova/ Cyst/ Trophozoites per smear
enters the RBC.
- One should recognize the developmental
- Living trophozoites of E. histolytica vary in stage of the parasite present in the stool
size from about 12 to 60 μm in diameter (Either a Cyst or Trophozoite)
(average slightly more than 20 μm). - Count the number seen per high power field
(HPF) *get the average number – the lowest to
- and on occasion may invade the mucosal the highest number for both stages*
crypts, where they feed on red blood cells - If both cysts and trophozoites are present,
and form ulcers. Ulceration of the intestinal count them separately
wall may give rise to amebic dysentery.
-Because of watery stool, when it occurs in
- The invading amebae at times find their babies and no efforts in defecating, among the
way into capillaries to be transported via infants the effect is reddening of their butt. And
the bloodstream to the liver or other because much water is lost, it leads to
organs, where abscess formation may dehydration. (immediate medical attention is
occur. Amebae that remain in or reenter required; it is fatal for infants due to
the lumen of the gut may, if intestinal dehydration, replenishing the water that was
motility is rapid, be passed out in liquid or lost from the body is important: (for
semi formed stools as trophozoites, but if replenishing)
motility is normal they will “round up” and Adding salt to drinking water
differentiate into the four nucleated Drinking of Gatorade (for
resistant cyst stages electrolytes)
- E. histolytica was considered to infect - Stop the real cause, use medicine specific
perhaps 10% of the world’s population. for killing the parasite. Sometimes it is
asymptomatic, and when it is
- In the human patient, the infection may asymptomatic it can hide in the liver, and
cause ulceration in the Intestinal wall and causes Liver Cirrhosis leading to death.
that is why although the stool is diarrheic,
there are strips of blood. (Most of the time The viability of the cyst can survive:
when examining watery stool, look for the 8 days in dump soil
stage of amoeba is present.) 12 days in moist cool situation
3 months in water 4C (refrigerator
Difference between E. histolytica and E. coli: temperature).
- - E. histolytica feeds on RBC, while E. coli 9-30 days in ordinary water
feeds on bacteria
7 years in liquid nitrogen
- - E. histolytica has a long and sharp
Cyst can remain viable in a fly’s
pseudopod, while E. coli has a short and
excreta for 48 hours after feeding
blunt pseudopod
on contaminated feces.
- - E. histolytica has a clean-looking
cytoplasm, while E. coli has a dirty-
- In order to kill the cyst, heat the water up to
looking cytoplasm
50C which is their Thermal Death Point
- - E. histolytica has a progressive and
(much more when boiling the water.)
directional movement, while E. coli
- If you are going to use reagent, 1:20
moves in a non-progressive and non-
dilution cresol solution is used and it gets
directional movement *note: movement
killed within 15 minutes.
of the trophozoites can only be seen in a
- 1% carbolic acid, it will be killed within 30
fresh specimen*
minutes
- 5% acetic acid at 30 C it will be killed
MANNER OF REPORTING:
within 15 minutes
WHO reporting of Ova/ Cyst/ Trophozoites per smear - As a means of making drinking water safe,
Occasional 1-2 Ova/ Cyst/ Trophozoites per smear Chlorine is used. Hyper chlorination can
kill the amoeba cyst.
Trophozoite Cyst
2 Stages of Seen in Stool Exam:
-Cyst and Trophozoite
Motile/ sensitive stage Non-motile
Pseudopodia- Finger-like structures, for
locomotion, ectoplasmic protrusion Destroyed by lugols Resistant stage
iodine
Consistency of Stool with Amoeba: vegetative Infective stage
1. Watery, mucoid, bloody, yellowish in
color and more foul in odor Watery stool Well formed stool,
Diarrheic Stool-contains mucous which can also be found
normally contains the trophozoite and cyst in soft stool
Formed Stool-normally, the cyst stage is seen
on this type of stool
Specimen:
1. Aspirates or Scrapings from
suspected sites of amoebic ulcerations
where it should be microscopically
examined immediately for motile
trophozoites
2. Biopsy and Post-Mortem Materials
where it should be examined with the
unaided eye then fixed in 10% formalin
for sectioning and staining. Autopsy
materials should be obtained within 4
hours after death
3.
Phagocytic Stomas- used in engulfment of
RBC and serve as the mouth
Small Endocytic Stomas- used in pinocytosis
Larger Stomas-involved in phagocytosis of
bacteria Entamoeba gingivalis
- first amoeba found in human, discovered by
EXAMINATION:
Gros
Serologic Techniques:
SYNONYM: Entamoeba buccalis
a. Indirect Hemagglutination
- can be found in the buccal cavity, causing
b. ELISA
gingivitis (inflammation of gums) *note:
c. Gel Diffusion Precipitin Test
instead of gingivitis, dentists use the term
d. Indirect Immunoflourescence
pyorrhea
e. Complement Fixation
- found in between the gums and teeth
f. Skin Test
HABITAT: Tonsillar Crypts, Pyorrheal pockets
between teeth and gums
MOT: Kissing and Droplet Spray, Shared
Utensils, Tartar Cement
PATHOGENIC STAGE: Trophozoite
MOVEMENT: Vigourous movement, due to
multiple pseudopodia
TROPHOZOITE: karyosome – centrally
located, pseudopodia similar to E. histolitica
-In the oral cavity, teeth, no cystic stage,
contains phagocytosed materials like WBC
epithelia cells, & Bacteria
-does not exhibit TRUE Progressive
locomotion
Entamoeba histolytica
HOST: Human
GENUS TRYPANOSOMA
Parasit Pathogenes Habitat Vector
e is -Generally causing the disease known as
Sleeping Sickness
L. Old world Endotheli Phlebotomu -Parasites are observed in the blood (still
tropic cutaneous al cells of s papatasii
a Leishmani the Phlebotomu
under hemoflagellates)
asis or infected s segenti -Trypanosomiasis
ORIENTA skin 2 types of Trypanosomes:
L SORE, capillaries 1. Stercorarian-Bite and Defecate
Aleppo and with (Trypanosoma Cruzi)
button, in the
Baghdad, cytoplasm *Si Cheryl CRUZi ay kumakain habang tumatae
or Jericho of the 2. Salivarian- Bite only (T. gambiense, T.
boil large rhodesiense)
phagocyti *Ang RUDE (rhodesiense) na GAGAMBA
c
(gambiense)ay nangangagat
monocyte
s Trypanosoma cruzi
L. American Mucocuta Phlebotomu - known to cause South American
brazili mucotane neous s peruensis Trypanosomiasis
ensis ous junctions, Phlebotomu - can be transmitted to humans by a bite of a
leishmani particularl s verrucaru vector
asis, y the VECTOR: Triatomid Kissing Bug/Reduviid Bug
espundia, nasal (Panstrongylus megistus)
bubas septum, MOT: Bite and Defecate in the Wound (the
Skin test: mouth
parasite is present in the feces of the vector)
Dr and
Monteneg pharynx DISEASE: Chagas Disease (named after the
ro skin discoverer Carlos Chagas); South American
test Trypanosomiasis
SPECIMEN: Anticoagulated Blood
L. Visceral Endotheli Phlebotomu - Generally, Trypanosomes causes disease
donov Leishmani al cells of s argentipes called “Sleeping Sickness”
ani asis, the
- Patients infected with this parasite will have
KALA- reticuloen
AZAR(bla dothelial Lesion on the nape, called as Winterbottom
ck fever) system: sign/Chagoma/Romana’s Sign)
or liver,
5. No Appetite 1. Nausea
6. Paleness 2. Vomiting
7. Insanity 3. Slight headache
4. Fever
PAROXYSMS: manifestation of malarial attack 5. Chills
9am-12 noon and 2-4 pm 6. Body Malaise
7. Paleness
-Known as the Malignant Tertian, Subtertian, or 8. Spleen enlargement common at 2-9 years
Estuvo autumnal (EA) old
-50 % of all malaria cases
-Laveran noticed the darkening of the gray matter PAROXYSM: manifestation of malarial attack 8am-
of the brain (1880) 12 noon and 2-4 pm
-Has higher levels of Parasitemia (can invade RBC
at any age) -Causes Benign Tertian Malaria or Tertian Ague
Early Ring-Stage Trophozoite- the smallest of -Fever paroxysms recur every 48 hours
any plasmodium species (1.2 um) -Relapses up to 8 years after initial infection
Maurer’s Cleft- irregular blotches developing in the -Merozoites invade only young erythrocytes,
infected erythrocytes. reticulocytes and are unable to penetrate mature
RBC’s
DRUGS/TREATMENT: -Blacks have natural resistance to malaria
Sexual Gametocytes- Primaquin Late Schuffner’s Dots- visible by light microscopy
Asexual Gametocytes- Camoquin after Romanovsky staining
DENSITY: I 1 to 10 parasites only -43% of malaria in the world
-1:4 ration enlarged
Plasmodium vivax
- Gametocytes develop after the 3rd day Plasmodium malariae
- Rings, trophozoites, ½ grown and etc. but very SYNONYM: Haemanoeba malariae
rare schizont can be seen
- undergo exoerythrocytic stage (stays in liver TROPHOZOITE STAGE:
cells) - Small, few
- due to the destruction of liver, yellowish - Ring to round, compact, vacuolated
discoloration (jaundice) may occur; often mistaken - Band forms are seen
as hepatitis - Dark, scattered pigments
- since they undergo exoerythrocytic stage, they Characteristics:
can infect the host again when medication is INFECTED CELLS:
already not present in the system BASOPHILIC STIPPLING: Ziemann’s Dot
- all its stages can be seen in a blood smear COLOR OF PIGMENT: Golden Brown
- treatment is given for 14 days MATURE TROPHOZOITE: Band form (thin
film)
MOT: GAMETOCYTES:
- Bite of Female mosquito (Anopheles minimus Male: Central Nucleus
flavirostris) Female: Peripheral Nucleus
- Blood transfusion MATURE SCHIZONTS: 8-12 merozoites