lOMoARcPSD|31411684

-In the brain, when the larvae migrate to the  OVA/EGGS:

muscles of CNS and, it can be viewed in a X- o Smooth
ray(Roentgenogram) when the cysticercus o Hard Shell that is transparent
had been calcified o generally yellow-brown or brown
 Cellophane Tape Swab/Graham
o Range in length from under 30um
Technique- can recover the egg (heavy
infection) to as much as 175um
-Adults have 800-1000 proglottids  The best method for identifying
-25-30 hooks trematodes is Sedimentation Method
-Each of the proglottid may contain 30,000-  Spines may be present :
40,000 eggs  either very small and inconspicuous as
-Presence of Cysticercus cellulosae in the in Clonorchis or Opisthorchis
brain can cause cerebral cysticercosis  large and striking as in certain species
-Presence of Cysticercus cellulosae in muscles of Schistosoma
appear as nodules and is visible in the X-ray - Lifespan of most trematodes reach 30 years
film.
- Reproduction: By self-fertilization/self-
Taenia asiatica fecundation
-3 taenia species
rd
- Nutrition is obtained from the tissues,
Common name: Taiwan taenia secretions, or intestinal contents of the host
-Adults spp resemble T.saginata - Respiration: Anaerobic
-Larva form resemble T. solium - Larval forms still require oxygen
 Most trematodes require 2 Intermediate
hosts
TREMATODES
Monostome – presence of only 1 oral sucker
*the following characteristics apply to all Amphistome – 1 oral sucker and acetabulum
trematodes, with the exception of at the posterior of the body
Schistosomes/Schistosoma* Distome - acetabulum is on the ventral surface
-Still under the Phylum Platyhelminthes Operculated eggs – because they have
- Leaf-like/ Leaf shaped operculum in their eggs/ova
- Much shorter than cestodes Operculum - serves as an exit for the larva,
- Hermaphrodites (capable of self- may be difficult to detect but can usually be
fertilization)/Monoecious seen by careful focusing with reduced
 Not segmented illumination.
 Usually 2 testes leading to genital pore
for Male -Have 2 testes; single ovary
 1 ovary for Female -Ova are operculated except for the blood
 Series of glandular structures called flukes which are usually elongated and worm-
like
Vitellaria, usually in 2 masses lying
-The eggs cannot be concentrated by ZnSO4
lateral to the intestinal ceca, produce the
Floatation Method because the operculate and
shell material non-operculate ruptures instead
 Vitelline ducts lead inward to the region SEDIMENTATION METHOD is required.
of the ovary where the shell is formed -Eggs of flukes is not an ovum but the
over the ovum. developed embryo is enclosed by its shell or
 Uterus winds forward to the genital pore. capsule.
- Adult flukes have suckers sued for  Praziquantel- highly effective drug against
attachment; they have no hooks many flat worms
- They have oral and ventral suckers  Niridazole- anti schistosoma drug that
- They have 2 testes leading to genital core; causes glycogen depletion in the
with one ovary schistosomes. Inhibits the conversion of
- Usually move by Contraction, Elongation phosphatase to the inactive form
and Flexion
Order of Development:
 Eggs of trematodes cannot be 1. Marita- adult stage
concentrated by ZnSO4 solution 2. Parthenita- larval stage
because the eggs are operculated and
once they rupture, they do not float Parthenita Stages/Order of Development:

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

1. Miracidium o Additional embryos developed

2. Sporocyst within a rediae
3. Redia o Emerges from the snail and has a
4. Cercaria tail for aid in swimming
5. Metacercaria
o Represent juvenile stage of the
2 Groups of Trematodes: vertebrate inhabiting adult
1. Considered as Hermaphroditic; Self- 5. Metacercaria
Fertilizing o Infective Stage
2. Separate Sexes; Blood Flukes; o Usually encysted
Cytosomes o Absent in Schistosoma

2 Categories of Trematodes base on Lifecycle: LIFECYCLE

1. ORGAN DWELLING- those that miracidum>sporocyst>redia>cercaria>metacer
reside in the intestine, bile duct,
caria
lungs except for the cystosome
2. BLOOD DWELLING- those that
reside in blood vessel, intestine, *Eggs are operculated except schistosomes
bladder *Infective stage of the final host is the
metacercaria except for schistosomes
PREVENTION: Boil snails and refrigeration at - (cercaria)
15 deg, Celsius for 20 hours *Requires 2 intermediate host to complete
cycle except schistosomes
*Cercaria are sluggish and free moving in
water
*Schistosomule – cercaria minus a tail
5 Larval Stages
1. Miracidium 2 Groups of Trematodes
o Ciliated, free-swimming larva a. Hermaphrodites
o hatches from its shell and b. Blood Flukes
penetrates the 1st I.H
o can swim at a rate of 2mm per 2 Suckers or Attachement Organs
second i. Oral Sucker-surrounding
o can survive as a free-living the mouth and anterior
organism for a few hours one
o Must find a suitable molluscan ii. Acetabulum or Ventral
host rapidly Sucker- posterior one and
o Take 30mins to complete ventral surface
penetration and begin the next 3 Movements of Adult Fluke
phase of its life cycle as the 1. Elongation
sporocyst. 2. Flexion
2. Sporocyst 3. Contraction
o Larvae which have discarded its
2 Categories of Trematodes
ciliated epithelium and
1. Organ dwelling – reside in the intestine
metamorphose into a sac-like
by duct/ in the lung
form
2. Blood dwelling – reside in the blood
o losses the ciliated epithelial cells
vessels around the intestine and urinary
upon penetration
bladder
o referred to as germinal sac
3. Redia
SCHISTOSOMES
o Embryos developed within a
- blood flukes
sporocyst (asexual) - ova contains spines
o Burst out of the sporocyst, the Schistosoma japonicum – abbreviated/short
embryos within will develop into a lateral spine
daughter rediae or into cercariae.
4. Cercaria
PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

Schistosoma mansoni – prominent lateral

spine Differences of the three species of
Schistosoma haematobium – large terminal Schistosomes
spine - Testes
- Freezing can kill its ova S. japonicum – 7 to 9 in rows
 Dioecious (having separate sexes) S. haematobium – 4 to 5 in clusters
S. mansoni – 6 to 9 in clusters
 Blood flukes will use blood specimen for
diagnosis
Schistosoma japonicum
BLOOD FLUKES/SCHISTOSOMES - discovered by Katsurada in 1904
-Known as “Oriental Blood Fluke”
PHASES MOT: Skin Penetration to invade the
1. Migratory Phase – the time from circulatory system
penetration until maturity and egg production. IS: Cercaria
(The term penetration means invasion of the 1ST IH: Oncomelania quadrasi (Philippines);
cercariae into the skin). This phase is Oncomelania formosana (Japan);
asymptomatic. It causes dermatitis because Oncomelania hupensis (Southeastern China)
the cercaria penetrates the skin (only the head RESERVOIR HOST: Rats, mice, cats, dogs,
gets in and the tail remains outside). horses, cows, water buffalo, and swine
2. Acute Phase/Katayama Fever – when HABITAT: Superior Mesenteric Vein; Veins of
schistosomes begin to produce eggs. small intestine
Symptoms include chills, fever, fatigue, DIAGNOSIS: Eggs in stool; Rectal Biopsy in
headache, muscle ache, and increase of chronic cases
eosinophilia. SYMPTOMS: Severe anemia, bulging of the
3. Chronic Phase stomach
-- S. mansoni: mild chronic bloody diarrhea LIFESPAN: 20 years
-- S. haematobium: pain on urination with blood DISCOVERER: Katsurada (1904)
in the urine FEMALE ADULT: 1.2-2.6 cm x 3mm in
-- S. japonicum: eggs reach the brain more diameter
often MALE ADULT: 0.6-2.2 cm
EGGS: 55-85 micrometer x 40-60 nm with
* If the schistosome passes through the lungs, minute lateral spine
it can cause Pneumonia. TESTES: 7-9 in rows
* Causes Swimmer’s itch or Clam digger’s itch -Endemic in Yangtze River Valley in Central
China
Diagnosis: Specimens used are stool, blood, Lifespan: 20 years
biopsy (e.g. rectal biopsy especially for S. Main clinical sign: Diarrhea (as S. japonicum
haematobium, liver biopsy, bladder biopsy). is an intestinal schistosome)
For the examination of stool specimen, aside Main symptom: Bulging of the stomach
from DFS, it should be augmented with Disease can also be called as Katayama’s
Concentration method. Disease or Oriental schistosomiasis;
In some cases, modern techniques are used Swimmer’s Itch
(e.g. Strips like of pregnancy and drug test that TREATMENT: Praziquantel
will show two lines if you are positive for
schistosomiasis).
Schistosoma haematobium
-- From the egg, the parasites develop into a -Urinary Schistomiasis; “Bladder Fluke”
ciliated miracidium which is found in the water. GEOGRAPHICAL LOCATION: Africa and
The miracidium becomes infective to the 1 st IH Middle East
(Snail). In the snail, the stages will develop MOT: Skin Penetration to invade the
until it becomes cercariae, and the cercariae circulatory system
will come out of the snail and be found IS: Cercaria
swimming in the water. Then, the cercariae will DIAGNOSIS: Recovery of eggs by
eventually penetrate the skin of humans. Centrifugator or Sedimentation of Urine; Eggs
-- Upon penetrating the skin, it can migrate into in biopsy material from the bladder wall; Ova in
the liver of the human host. stool
-- The parasite usually goes into the DISEASE: Schistosomal Hematuria, Urinary
mesenteric veins. Bilharziasis

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

HABITAT: Veins of Urinary Bladder COLLECTION: Early afternoon 12pm-2pm

SYMPTOMS: Hematuria, painful micturition, (BEST TIME)
elephantoid condition of penis and scrotum MEDICATION: Praziquantel
(Painful micturition with Hematuria (as its
habitat is in the Urinary bladder); Elephantoid Characteristics S. S. S.
haematobium manson japonicum
condition of the penis and scrotum) i
LIFESPAN: 20 years (20 to 25 years) Size:
1ST IH: Snail (Bulinus) (Species: Bulinus Male
Length
globosus, B. forskalii, B. nasutus, B. Width
10-15mm 10- 12-20mm
nyassanus, and B. truncatus) 0.8-1.0mm 15mm 0.50-
0.8- 0.55mm
ADULT FEMALE: 2 cm 1.0mm
ADULT MALE: 1.5 cm Female
EGGS: 112-170 micrometers x 40-70 Length 20mm 20mm 26mm
Width 0.25mm 0.25mm 0.3mm
micrometers with conspicuous terminal
# of testes 4-5 6-9 7-9
spine Position of ovary Near In Posterior
TESTES: 4-5 in clusters midbody anterior to mid
-Associated with Splendore-hoeppli half body
Uterus With 20-100 Short; Long; up
phenomenon (the eosinophilic antigen- eggs, few to 300
antibody precipitation around the egg) average: 50 eggs at eggs,
DISEASE: Urinary schistosomiasis or one average:
time 50
Bilharziasis (named after its discoverer - Egg Elliptical, with Elliptical Oval to
Bilharz) sharp with almost
TREATMENT: Praziquantel terminal sharp spherical,
spine lateral lateral
DISCOVERER: Theodor Bilharz (1851) spine spine

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

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

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

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

MOT: Ingestion of raw or fresh mullets or SYNONYM: Distoma sinensis

fessikh (known as salted mullets) pickled for MOT: Ingestion of fresh water fishes
less than 14 days IS: Metacercaria
HABITAT: Small intestine TESTES: branched; in tandem/pair
IS: Metacercaria DIAGNOSIS: Specimen used is feces; May
DH: Humans, Dogs, Cats also use duodenal aspirates or biliary drainage;
Disease: Heterophyiasis; inflammation
Eggs in feces and biliary drainage
excessive mucus production, peptic ulcer
1st IH: Snails
disease, acid peptic disease
Diagnosis: Finding eggs in the stool using o Bulimus fuchsianus / Bulimus
Kato Katz fuchsias
- Common among fish-eating mammals and o Parafossarulus manchouricus /
fish-eating birds (pelicans) Parafossaruhis machowricue
OVA: does not have abopercular protuberance o Hua ningpoensis
1st IH: Brackish water snails (Egypt: Pirenella nd
2 IH: Fresh water fish
conica; Japan: Cerithidea) o Tilapia masonhica
2nd IH: Freshwater fishes (Egypt: Tilapia
LIFESPAN: 20-25 years
masomhica; Japan: Acanthogobius)
TESTES: Two lobed and obliquely oriented DAILY OUTPUT OF EGGS/WORM: 1100-
2400 in feces of dogs and cats
Metagonimus yokogawai OVA: with prominent shouldered opercula, with
- common in the Far East small knob at the end opposite (Old-fashioned
SYNONYMS: electric bulb)
-- In 1912, Kobayashi gave the name SOURCES: include raw, pickled, smoked, or
Loxotrema ovatum dried fish
-- In 1913, Yokogawa gave the name
HABITAT: Distal Bile ducts, Gallbladder, Bile
Metagonimus ovatus
PREVENTIVE MEASURE: Thorough cooking
COMMON NAME: Yokogawat Fluke
DISEASE: Metagonimiasis of fish
DH: Human, Cats, Dogs, Hogs -Chronic infection may lead to liver
MOT: Ingestion of Raw/freshwater fishes enlargement
IS: Metacercaria -Adult worms can be found even during
Diagnosis: Finding eggs in the stool autopsy
1st IH: Snails (Semisulcospira libertina, Thiara, -Light infections are asymptomatic
Hua ningpoensis) -Can develop into heavy infection over a period
2nd IH: Salmonoid fishes (Plectoglossus of years
alpitvelis, Salmo perryi) -Can impair liver, biliary gall bladder, or can
Testes: One big, one small cause cholelithiasis
-Body is transparent that is why the
reproductive organs can be seen on stained
sample
-Parasite of fish-eating mammals and humans
Haplorchis yokogawai -Large areas of China, Japan, Korea, Vietnam
st
1 IH: Egypt: Pirenella conica; Japan: SIZE: 1 to 0.25 cm by 0.3 to 0.5cm
Cerithidea; Thiara -Broadest in the mid portion of the body,
2nd IH: Egypt: Tilapia masomhica; Philippines: tapering toward both ends
Biya; Japan: Acanthogobius -Adult worms live in the bile ducts, and
Testes: One big testis
apparently localize first in the more distal
portions, just under the capsule of the liver
LIVER FLUKES DISEASE: cholangiocarcinoma, pancreatitis
TREATMENT:
Clonorchis sinensis o Praziquantel, administered at
Known as “Chinese liver fluke”, “Oriental 25mg/kg, three times daily for 1
Liver Fluke” day
-Most important liver fluke of man o Albendazole, given at 10mg/kg
CHARACTERISTICS: elongated, transparent, daily for 7 days
gray, tapering anteriorly and rounded SYMPTOMS:
posteriorly, branched/dendritic testes
PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

o Light infections- Asymptomatic o Biliary obstruction, Jaundice,

o Heavier infections - Seldom Eosinophilia
cause early symptoms o Fever, chills, right-upper-
o Cirrhosis is probably a rare quadrant pain with radiation to
complication the scapula
o Ingestion of large numbers of
metacercaria may produce DIAGNOSIS: Finding of eggs/ova in the
symptomatic infections which is bile/feces
characterized by fever, diarrhea, HABITAT: Bile ducts
epigastric pain, enlargement of DISEASE: traumatic-acute inflammation,
the liver and jaundice obstruction of bile ducts

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:

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

Jan Swammerdam in 1737 described the RESERVOIR HOST: Cats

cercaria and redia HABITAT: Liver, Bile ducts, Gall bladder and
Linnaeus gave the name Fasciola hepatica in Pancreatic ducts
1758 but considered it as a leech DIAGNOSIS: Finding of eggs in feces or
Pallas was the first to find Fasciola in a human duodenal drainage/biliary drainage/pancreatic
host in 1760 drainage(Sedimentation
Characteristics: Method:Examination)
 cephalic cone at the anterior end TESTES:2 Lobes; oblique to each other
 Adult worms reside in the larger biliary DEFINITIVE HOST: Cats, Dog, Man
passages and gallbladder DISEASE: desquamination of epithelial cells,
 Infection follows consumption of aquatic hyperplasia, pancreatitis
vegetation upon which metacercariae of TREATMENT: Praziquantel if administered at
Fasciola have encysted the rate of 25mg/kg three times daily for 2
 sucker are comparatively small days.
 2 testes highly branched occupying the In central and eastern Europe and in Siberia, it
2nd and 3rd quarters of the body is prevalent in both dogs and cats
 Ovary is dendritic, situated in front of the  In various sectors where the human
anterior testis population eats raw or pickled fish, humans
 Uterus is coiled and relatively short are also infected.
 Vitellaria extend to the whole lateral field
of the hind body
Opistorchis viverrini
Common name: Southeast Asian liver fluke
 Intestinal ceca, long and highly
Habitat: gall bladder, bile duct
branched
Characteristics: Deeply lobulated testes
Cycle:
Disease: cholangiocarcinoma, hyperplasia
- Fasciola metacercariae burrow into and
Diagnostic stage: eggs in stool
through the duodenal wall, migrate actively
1st IH: snail
across the peritoneal cavity and enter in the
2nd IH: brithyria
bile duct by way of Glisson’s capsule and the
liver parenchyma.
Fasciola gigantica
Common name: Tropical Liver Fluke, Giant
Liver Fluke
MOT: ingestion of infected food
Habitat: affecting cattle and water buffaloes
Characteristics: longer and its shoulders are
less developed
Accidental host: Humans

Opistorchis felineus PROTOZOANS

-Known as “Cat Liver Fluke”
CHARACTERISTICS: slight Lobate/lobed I. Rhizopoda/ “Sarcodina” (Amoeba)
testes, adult is lancet shaped, reddish yellow a. Entamoeba histolytica
SYNONYM: Distoma felineum b. Entamoeba coli
c. Entamoeba gingivalis
MOT: Ingestion (Metacercariae in raw or
d. Entamoeba polecki
insufficiently cooked fish)
e. Entamoeba moshkovskii
IS: Metacercaria f. Entamoeba nana
1st IH: Snails g. Iodamoeba butschlii
o Bithynia leachi h. Dientamoeba fragilis
2nd IH: Fresh water fishes II. Zoomastigophora (Flagellates)
o Idus melanotus a. Giardia lamblia
-When 2nd IH are insufficiently cooked/eaten b. Chilomastix mesnili
raw, O. felineus is transmitted to humans c. Retortamonas intestinalis
PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

d. Enteromonas hominis  Not just watery but mucoid (when you

e. Trichomonas tenax use an applicator stick and stir then
f. Trichomonas hominis raise, it is going to cling on the
g. Trichomonas vaginalis applicator stick)
h. Leishmania sp.  Foul odor
i. Trypanosoma sp.
III. Ciliata (Ciliates) - Amoebas are known as Lumen-dwelling
a. Balatidium coli protozoans (Lumen is the lining of the
Locomotory Structures: intestines)
Amoeba – Pseudopodia (fingerlike structure) CHARACTERISTICS:
Ciliates – Cilia (hair-like structure)  Possess a small vesicular nucleus with
Flagellates – Flagella (taillike structure) small intestine
 Chromatin granules attached to the nuclear
- They have locomotory structures, which membrane
means that they are motile (Note: Only the  Reproduction is through BINARY FISSION
Trophozoite stage is motile, while cysts are (splitting of the trophozoite or through the
stationary/does not move/nonmotile. development of numerous trophozoites
-They are not “worm like” in appearance within the mature multinucleated cyst,)
- They do not have mouth part but can engulf  MOTILITY is accomplished by extension of
RBCs (for E. histolytica) and bacteria (for E. pseudopodia or the
coli) using their phagocytic stomas “false foot”.
 Protoplasmic Streaming – movement  Contain at least 1 nucleus, some has
produced by amoeba by using their several
pseudopodia  Some contain vacuoles
 With Special organs for locomotion
IS: Cyst  Have Pseudopodia/Protoplasmic processes
Feeding/Vegetative Stage: Trophozoite
MOT: Ingestion GENUS ENTAMOEBA
-Amebae of this genus, widely distributed in
both vertebrate and invertebrate animals, are
LUMEN-DWELLING PROTOZOANS characterized by possession of a vesicular
Subphylum: Sarcodina nucleus with a comparatively small karyosome
Superclass: Rhizopoda located at or near its center and with varying
Family: Entamoebidae numbers of peripheral chromatin granules
Genus: Entamoeba (Other: Iodamoeba and attached to the nuclear membrane.
Endolimax) -In the case of amoeba there are several
species but the most popular, the culprit in
-Six species of the genus Entamoeba causing Amoebiasis, the most popoular, most
including the commensals Entamoeba pathogenic is Entamoeba histolytica
gingivalis, E. coli, E. hartmanni, E. dispar, E. (described in 1875 from a Russian peasant in
moshkovskii, and the pathogen E. histolytica. the port of Arkhangelsk, a scant 100 miles from
Entamoeba polecki, an intestinal ameba of pigs the Arctic circle, Prevalence rates are highest
and monkeys, is seen occasionally in humans in areas of crowding and poor sanitation,
and may cause diarrhea. Other commensals notably in the tropics.) (Entamoeba gingivalis
are Endolimax nana and Iodamoeba is the first amoeba discovered by Gross)
bütschlii - The first Entamoeba found in human is E.
-Single-celled or unicellular (contains only gingivalis (Discovered by Gros)
one cell in their body and that’s the reason why - E. histolytica was first discovered by Losch
they are too small to be seen by the naked (1875) in a Russian peasant
eye.) - E. histolytica contains pseudopods as its
MOT: Ingestion of infected food, Ingestion of locomotory structure, and because of this, it
Infected water will be able to move and find its food (RBC)
IS: Cyst - As they are lumen dweller, ulceration in the
Amoeba (SYMPTOMS): intestinal wall of the patient can be observed
 Diarrhea (cause for having a bloody stool)
 LBM
 Watery stool (diarrheic stool) Entamoeba histolytica- inhabits the large
 (black is for cholera, salmonellosis, intestine and usually it feeds on RBC so it is
shingleasis colorless to yellowish) engulfing the RBC, when found especially the

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

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 4C (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
50C 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.

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

- Filtered through different grades of sand -actively motile feeding stage

and gravel to filter water from the mountain (vegetative stage)
and when deposited to water inlet, it is -Pathogenic
reserved in a dam then chlorine is added. -10-60 µmin diameter
- Deep well should be 50 meters away from -Motility is rapid, progressive, and
septic tank unidirectional through pseudopods.
- Iodine added to drinking water makes it -Nucleus is characterized by evenly
safe for consumption. arranged chromatin on the nuclear
membrane
For amoebiasis, the most common is Intestinal -Presence of small, compact, and
Amoebiasis due to drinking of contaminated centrally located karyosome
water with cyst, intestinal amoebiasis is -Cytoplasm is usually described as
developed. It is the most common form of the finely granular with few ingested
amoebiasis infection. bacteria or debris in vacuoles.
2. Precyst
 Skin amoebiasis (may lead to -Trophozoite becomes approximately
Gangrenous ulceration) the same size as the cyst
 Amoebiasis of the Penis and Vagina -Cytoplasm is cleared of all food
(genital Amoebiasis) inclusions but usually contains diffused
 Lung Amoebiasis (Pulmonary glycogen deposits and occasional
Amoebiasis) chromatoid bodies
 Liver amoebiasis (Hepatic amoebiasis) -It is uninucleate and the enlarged
nucleuscontains karyosome that is more
Usually the liver is not affected when there is or less eccentric
medication given to the patient, the Liver is 3. Cyst
their hiding place. With the amoebiasis, it is -quiescent, resistant, infective stage,
possible that when left untreated this may non-motile
damage the liver and become fatal. If it is -10-20 µm
asymptomatic, there is no LBM and even if the -Counterpart of Ova
specimen is hard stool the cyst is still found. -As the cyst matures, the glycogen
The cyst hides in the liver and attacks later on, completely disappears and the
once infected by amoeba symptoms are felt chromatoidal bars may be absent.
repeatedly. - A cyst wall develops around the
precystic form and the single nucleus
- Sometimes Abdominal pain followed by divides to form the mature
cramping and even flatulent are seen as quadrinucleate stage
symptoms. -Chromatoidal bodies is cigar shaped
- In the Cecum or in the Recto sigmoid 4. Metacyst
region, elision can develop and called -During the process of encystation, the
Ameboma a chronic granulomatous lesion encysted ameba containing four nuclei
in the cecum and recto sigmoid region. becomes very active, separating from
- Manner of reporting when 0-1 cyst or the cyst wall.
trophozoites per HPM cannot be seen by -The quadrinucleate ameba escapes
low power, shift to high to see on the the from the cyst wall through a tiny pore,
nucleus, chromosoidal bodies, rbc if it is and nuclei clump together
trophozoites, sometimes circular because 5. Metacystic Trophozoite
pseudo coat is moving, and if not moving it -The quadrinucleate ameba begin to
becomes circular. Best seen in fresh separate from surrounding cytoplasm
smear. and undergo division to form eight
- If cyst, it is a finger-like structure. It is uninucleate metacystic trophozoites.
circular and has no pseudo coat. -It continue to feed and grow, finally
achieving the size normally associated
MEDICATION: Flagyl (Commercial Name), with trophozoites
Metronidazole (Generic)
Immature Cyst- with 1 nucleus
MORPHOLOGICAL FEATURES OF THE Mature Cyst- with 4 smaller nuclei
DIFFERENT STAGES OF PROTOZOA:
1. Trophozoites

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

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

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

HABITAT: Cecal and Rectosigmoid region of TROPHOZOITE: Big karyosome adherent to

colon one side; Cytoplasm is finely granular and
DISCOVERER: Losch (1875); Schaudinn vacuolated ; narrow rim of ectoplasm
(1903) differentiated E. histolytica and E.coli SHAPE: Comma-shaped
DISEASES: Amoebiasis, Amoebic Dysentery, PSEDOPODS: Short and Blunt
Amoebic Hepatitis - Known as Cross-eyed amoeba (contains a
- real culprit of Amoebiasis large karyosome that is sometimes centrally
- pathogenic located, and most of the time pushed toward
- Cytoplasm: Clean-looking the side, giving a cross-eyed look/appearance)
- Inclusion bodies: RBC - Only found in humans
- No. of Nuclei: 1 to 4 -Smaller version
- Pseudopods: Long and sharp
- Motility: Progressive, directional
Entamoeba dispar
- Chromatoidal bodies: Cigar-shaped -Similar to E.histolitica but diffent DNA & RNA
content
-Stool population is 1% commercial
-PCR is a gold standard to differentiate with E.
Entamoeba coli histolitica
SYNONYM: Entamoeba hominis -Ground glass appearance with E. histolotica
HOSTS: Human
HABITAT: Colon an Cecum, Large Intestine
Entamoeba hartmanni
- not that bad compared to E. histolytica -Small nonhematophagous; sluggish motility
- presence of this parasite to sensitive patients -Similar to histolitica but smaller
(e.g. babies) can already cause LBM -Small race amoeba
- Cytoplasm: Dirty-looking -Quadrinucleated, coarse cytoplasm &
- Inclusion bodies: Bacteria chromatoidal bars are thin barlike w/tapered
- No. of Nuclei: 4 to 8 ends
- Pseudopods: Short and blunt Iodamoeba butschlii
- Motility: Non-progressive, non-directional SYNONYM: Entamoeba williamsi
- Chromatoidal bodies: Whisk broom TROPHOZOITE: 6-25 um; large vesicular
Entamoeba polecki nucleus w/ achromatic granules
SYNONYM: Entamoeba debliecki CYST: 6-15 um; irregularly pyrifom and ovoidal
HOSTS: Pig, Human, Monkey large vacuole which is densely packed with
HABITAT: Colon, Cecum, Large Intestine glycogen and stain distinctly as golden brown
- Parasite of monkeys and hogs/pigs with iodine; no chromatoidal body
- Only occasionally found in human NUCLEUS: prominent with a karyosome half of
- resembles the cyst of E. histolytica and the nucleus; Basket nucleus
trophozoite of E. coli MOTILITY: Active and progressive in fresh
TROPHOZOITES: 10-20 um and resembles stool; Sluggish in older stool
like E. coli in sluggish motility but smaller - non-pathogenic
karyosome/ peripheral chromatin - Known as Iodine cyst of Wenyoun
CYST: 5-11 um and resembles the cyst of E. - discovered by Wenyoun
histolytica in the presence of cigar-shaped - humans are the only host
chromatoidal bodies - Cyst contains a large vacuole which when
-Uninucleated added with iodine (in a fresh smear), its
vacuole becomes very prominent (becomes
Entamoeba moshkovskii golden yellow in color)
SYNONYM: Laredo Strain of E. histolytica;
Huff Strain
Dientamoeba fragilis
HOSTS: Sewage, Human MOTILITY: Actively motile, progressive
HABITAT: Colon and Cecum, Large intestine movements
- found in sewages; not a parasite of humans PSEDOPODIA: hyaline, leaf-like
- resembles the cyst and trophozoites of E. HABITAT: Glandular crypts of large intestine
histolytica as it has a cigar-shaped - Trophozoite stage only; no cyst
chromatoidal body - can serve as a vector of E. vermicularis
-No cystic stage, with 1-2 rosette shaped nuclei
Entamoeba nana -Amoeboid pathogen that infects the colon
SYNONYM: Endolimax intestinalis; Endolimax -Glycogen stains dark brown with iodine
nana Best technique to identify: Trichrome
MOTILITY: Sluggish motility permanent stain
PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

Blastocystis hominis -Can either exist as amoeba or flagellate

TROPHOZOITE: pair of flagella from tip of
-No cell wall, habitat is large intestine, large pear shaped cell body, lobose
central body form monopseudopodium & a very prominent
Culture: boeck & Drbohlav’s or the Nelson & nucleus with a centrally located nucleolus
Jones media PATHOGENESIS: Fatal/Primary meningo
May assume of the four forms: encephalitis, Primary amoebic
1. vacuolated, meningoencephalitis (PAM) acquired by
2. amoeboid: heavy infections; swimming in contaminated pools, lakes, rivers,
3. Granular; able to survive at 46C & hyper chlorinated
4. Multiple fission water, can cause death
CULTURE: non nutrient agar plate seeded with
heat-killed or living E.coli (bacteria)

-N. philippinensis – locally occurring specie

from thermally polluted stream, artificially
FREE LIVING PATHOGENIC AMOEBA heated pool, and from a brain aspirate
*STAT request -N. gruberi – most commonly studied non
- can be seen in waters/ swimming pool can pathogenic specie on differentiation and
cause Amoebic Meningitis (was found in 1965 induction of flagellation
in Florida and Australia) they found the species TREATMENT: Amphotericin B
Naegleria fowleri which caused Meningo
encephalitis. Usually Ice is added to drinking CILIATES
water, boiled water is crystal clear and tap
water is dirty white when frozen. Iodin can be Balantidium coli
added to drinking water usually in the form of -The only ciliates known to infect humans and
the biggest protozoan
tablets. Heating the water in 50º assures the
-Parasite of Pig
killing of amoeba. Vegetables should be -The cilia is found all over the body
washed thoroughly especially the leafy SYNONYMS: Paramoccium coli, Leukophyra
vegetables that grows few inches above the coli
ground. CYST: Spherical with two nuclei (1 small and 1
big) Macronucleus and Micronucleus
Acanthamoeba  Macronucleus- vegetative (kidney-
-Free living, common in river, can be acquired shape)
through dust  Micronucleus- reproductive (spherical)
TROPHOZOITE: active, singe & large nucleus, TROPHOZOITE: Sack-like; has the:
 mouth part (Cytostome)- for procuring
central nucleus, large contractile vacuole,
food
sluggish spinelike pseudopods, polydirectional  anal part (Cytopyge)- whre solid waste
CYST: dormant, outer-wrinkled/inner polygonal materials are discharge
-Can be isolated from contact lens cleaning DISEASE: Balantidiasis; Balantidial Dysentery;
agents, swimming pools and air Balantidosis
-Can be isolated from the CSF SYMPTOMS: Abdominal Pain, Diarrhea,
PATHOGENESIS: GAE (Granulomatous Vomiting, Nausea
MOT: Ingestion of Contaminated food and
Amoebic encephalitis) it’s a neurologic
water; Ingestion of infective cyst from feces of
condition, and with severe ocular pain swine
CULTURE MEDIA: PYGC (Proteus Peptone HABITAT: Large intestine of man, monkeys
Yeast Extract Glucose and cysteine) and pigs
MEDICATION: Tryparsamide, Tetracycline,
Naegleria fowleri Metronidazole
-Known as the “Brain-Eating Amoeba” REPRODUCTION: Binary Fission
DISEASE: IS: Cyst
Meningoencephalitis- inflammation of the FEEDING STAGE: Trophozoite
brain and surrounding protective membranes SIZE: 50-100 um
and it resembles both meningitis and DISCOVERER: Malmsten
encephalitis. It is caused by free-living STOOL CONSISTENCY: Diarrheic Stool
amoebas. MOTILITY: Boring and rotary in motion
PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

-Can cause diarrhea Tennis racket/teardrop/pear shape, with 4 pairs

-Infect humans because of the association of of flagella, a supporting structure called
man to pigs (Isolate animals if it is sick) Axostyle and 2 sucking discs; actively moving;
-The term Balantidium means “Little Bag” 9.5-25 um; bilateral sysmetry, distinct medial
-The trophozoite inhabits the Lumen of Large line(axostyle), ventral suciking disk
Intestine (pathognomic finding)
-B. coli cyst does not multiply; Only the MOT: Ingestion
trophozoite multiplies because it is liberated IS: Cyst
due to the disappearance of the cyst wall PATHOGENIC STAGE: Trophozoite
-Cyst are impregnated to stain HOST: Man
-When a person is infected, it does not invade MOTILITY: very motile (described as
the liver Tumbling Motion motility or Falling leaf-like
or Jerky)
REPRODUCTION: Longitudinal Binary fission
HABITAT: Duodenum and Jejunum of the
small intestine; Duodenal crypts
SYMPTOMS: Mild diarrhea, flatulence, cramp-
FLAGELLATES like abdominal pain, anorexia with steatorrhea,
Divided into 2 groups: full blown malabsorption syndrome
A. Those living in the GI Tract and DISEASE: Diarrhea, Giardiasis(Traveller’s
Genitalia Diarrhea) ; Gay Bowel Syndrome
MOT: Transmission by person to person STOOL: Fatty (Steatorrhea)
without biological vector EXAMINATION: String Test- trophozoite seen
B. Blood and Tissue Flagellates in duodenal fluid obtained in incubation
(Hemoflaggelates) VIABILITY: 1 to 3 months in soil
MOT: Transmitted by a blood sucking 10 hours when exposed to 20
vector deg. Celsius;
FUNDAMENTAL FEATURES: 6 days in mixture of urine, water
1. Cell Membrane and feces
a. Kinetoplast- energizing DISINFECTANT: 0.3% Caustic soda and 1%
component cresol (Bile salt sodium collates from the
i. Blepharoplast breast milk kills Giardia lamblia)
ii. Parabasal Body - culprit for diarrhea cases in US
b. Axoneme- motor component - causes Traveler’s diarrhea
2. Flagella - Most often, children are infected more than
a. Blepharoplast (Neuromotor the adults
Apparatus)- where the flagella Bile salt sodium collates from the breast milk
would come out kills Giardia lamblia
3. Cytostome- mouth - can withstand filtration, chlorination, and even
Phylum: Sarcomastigophora saturated solution of iodine
Subphylum: Mastigophora TERMINOLOGIES:
Class: Zoomastigophora Axostyle – vertical stalk; supporting structure
Family: Hexamitidae Sucking discs – used for engulfing; gives the
appearance of eyeglasses
Giardia lamblia Endocytosis – process of ingestion
SYNONYM: Giardia enterica; Giardia Pinocytosis – ingestion of fluid
intestinalis; Giardia duodenalis; Lamblia Phagocytosis – process of ingestion of solid
intestinalis foods
- Known as “Old man with eyeglasses” (old Blepharoplast or Kinetoplast – where the
man because the flagella represent the beard, flagella arise from
while the sucking discs represent the Chilomastix mesnili
eyeglasses) FAMILY: Chilomastigidae
CYSTIC STAGE: No flagella, oval/football in SYNONYM: Cercomonas intestinalis
shape, 2 nuclei are present at the center CYST:
(appears as two eyes with glasses); 8-14 um  Lemon-shaped with nipple-like
and Oval; finely granulated axoneme(forms projection
the core of a flagellum)  7-10 um
TROPHOZOITE STAGE:  Uninucleated; separation of cytoplasm
from cyst wall
PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

TROPHOZOITE: - smallest among the three species of

 Pear-shaped with only 3 pairs of Trichomonas
flagella; -can cause inflammation of the gums
 Shepherd’s Crook (Pyorrhea)
 6-20 um;
 Uninucleated with 6 blepharoplast and
Trichomonas hominis
6 flagella; SYNONYM: Trichomonas confusi/
 Cytoplasm is highly vacuolated with a Cercomonas hominis
conspicuous cytostome with median UNDULATING MEMBRANE: Long (used for
constriction rotatory motion)
MOTILITY: Cork screw motility HABITAT: GIT
FLAGELLA: 6 MOT: Ingestion
HABITAT: Large Intestines MOTILITY: Jerky and not directional and
HOST: Man contains 4 anterior flagella
- non-pathogenic lumen dweller of the large - presence of this parasite is indicative of
intestine Direct fecal contamination
- has 3 pairs of flagella - Contains 4 anterior flagella
- Uni-nucleated; no undulating membrane - Flagella is used for propulsion
(waving structure) - Since it is found in the stool, it is transmitted
by Ingestion
Enteromonas hominis - It is found where you will not find nematodal
FAMILY: Enteromonadidae ova and amoeba
SYNONYM: Tricercomonas intestinalis Featur T. T. T. Vaginalis
TROPHOZOITE: 3 anterior flagella; flattened in es Hominis Tenax
one side; 10 um; uninucleated
Intestine Oral Genitals
CYST: oval in shape with shrinking cytoplasm;
Habitat Cavity/to
4-6 um; 2-4 nuclei nsils
MOTILITY: rapid, jerky fashion motility
FLAGELLA: 3
Retortamonas intestinalis size Medium Smallest Largest
FAMILY: Retortamonadidae
SYNONYM: Waskia intestinalis
TROPHOZOITE: Tear-shaped with two
anterior flagella; 2-9 um
CYST: Pear-shaped; 4-7 um Nucleu Ovoidal Rounde Ovoidal
MOT: Ingestion of Cyst via food and water s d
IS:Cyst
Undulat Whole ¾ of the ½ of the body
FLAGELLA: 2 ing body body
- Resembles C. mesnili cyst; shadow outline of membr
cytostome with supporting fibrils entends ane
above the nucleus “BIRD’S BEAK” fibril
arrangements
Inclusio None None Siderophil
TRICHOMONAS n Granules
-Distinct appearance is having flagella and Bodies
undulating membrane(rotatory motion)
 Dientamoeba fragilis- seen with flagellate
under the microscope, so it was classified Specim Stool Oral Urine, vaginal
under Trichomonas en for Scrappin swab/discharge
Diagno gs (Female)

Trichomonas tenax sis Prostatic

Secretions(mal
SYNONYM: Trichomonas buccalis e)
MOT: Kissing and Droplet spray
HABITAT: Buccal cavity; Pyorrheal pockets Trichomonas vaginalis
and tonsillar crypts UNDULATING MEMBRANE: 1/3 of the total
UNDULATING MEMBRANE: 2/3 of the total body length
body length
SIZE: 6-10 microns HABITAT: GUT (Genito-urinary tract); Vagina
in female; Urethra in males
PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

SYMPTOMS (FEMALES):Vaginal discharge in 2. Promastigote – Leptomonas

females associated with burning, itching 3. Epimastigote – Crithidia
sensation or strawberry cervix; frequency of 4. Trypomastigote – Trypanosoma
urination and dysuria (painful or difficulty in • Amastigote – (leishman-Donovan body) or
urination) LEISHMONIAL FORM
SYMPTOMS (MALES): Asymptomatic - oval, found in humans multiplies within
DISEASE: Ping Pong Disease; Trichomoniasis the cell, contains a nucleus, a basal
MOT: Sexual Contact body structure(blepharoplasty), and
DIAGNOSIS: Papanicolaou smear (Pap small parabasal body
smear) • Promastigote or LEPTOMONAL
SPECIMEN: Vaginal speculum using cotton FORM(culturable stage, IS)
swab; Urethral discharge; Vaginal Discharge; - Long & thin, found in arthropods
Urine (Centrifugal Urine) - Infective stage of Leishmania
CULTURE MEDIA: Diamond’s Modified • Epimastogote or CRITHIDIAL FORM
Medium - Long & thin, with undulating membrane
TEST: Serological Test (IHA or Indirect -Extracellular found in arthropod host
hemagglutination and GD OR Gel Diffusion • Trypomastigote or TRYPANOSOMAL
TROPHOZOITE: With Flagella FORM (C-shaped/U-shaped)
CYST: No Flagella -Long & thin, with undulating membrane, &
- biggest of the three species of Trichomonas free flagellum with VOLUTIN GRANULES.
- Can be found in urinalysis Found in arthropod present in the blood.
-Can be found in Gram-staining (Vaginal Does not have external Flagellum
Smear for female; Urethral smear for males)
- Often asymptomatic in males but Prostitis is 1. Amastigote- is a small, rounded cell
the most complication experienced containing a nucleus and kinetoplast,
- If the female is pregnant, when it gives birth, but lacking both flagellum and
the infant may also be affected (the eyes can undulating membrane. Amastigotes
get infected, which can cause blindness- infect smooth muscle cells (with a
Opthalmia neonatorum) particular affinity for cardiac muscle) and
divide there.
2. Promastigote - is the motile, long-
elongated flagellated infective form of
Leishmania parasite that develop in the
midgut of the sandfly and gets
inoculated in mammalian skin via a bite.
3. Epimastigote- is slightly smaller than
the trypomastigote. The body is still
elongated, but the nucleus and
kinetoplast are both centralized within it.
The flagellum originates centrally as
well, causing the undulating membrane
to cover only half of the body.
Epimastigotes are specialized to survive
in the harsh environment the vector’s
intestines.
4. Crithidia-multiplies in the salivary
glandsof the vector
GENUSES:
 Leptomonas: Parasitic in insects
 Trypanosoma: Blood of humans
 Leishmania: Intracellular in the cells of
RE system (Reticulo endothelial system)
GENUS LEISHMANIA
HEMOFLAGELLATES – transmitted to humans by means of sand fly
(Phlebotomus)
DEVELOPMENTAL STAGES
1. Amastigote – Leishmania

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

 Leishmaniasis is common in places

like Venezuela, Brazil, Mexico,
Leishmania donovani
SYNONYM: Pyroplasma donovani
Guatemala DISEASE: Visceral Leishmaniasis (English
 Common name for vector is Sandfly, term); Kala-azar (Hindi word which means
Genus is Phlebotomus which is also Black sickness); Death Fever; Dumdum
known now as Lutzomyia Fever (In 1900s, Sir William Leishman
 Leishmania donovani donovani observed the causative agent of Kala-azar in
(trinomial) cases are found in some an infected soldier, and the soldier got the
infection from Dumdum, Calcutta, India)
places in India, Uganda, Pakistan
- Kala-azar is characterized by darkening of the
 Becomes fatal after 2 years skin, mostly marked on the forehead, on the
 Jericho Boil became known in the temples and around the mouth
Middle East in 1917 and similar lesions HABITAT: REC (Reticulo-endothelial cell) of
have been observed during the 7 th internal organs such as Liver, Spleen, Bone
century before Christ Marrow, Lymph Nodes
 In the new world, evidence of CL was SPECIMEN: Blood, Bone marrow aspirates,
Liver puncture, Lymph node juice
found in Ecuador and Peru VECTORS: Phlebotomus argentipes (from
 Leishmania donovani causes Argentina); Phlebotomus chinensis; other
Thrombocytopenia ( decreased in name: Lutzomyia; common name: Sand fly
platelets), also causes anemia (such as IS TO INSECT: Leishmania
Normocytic-normal shape, IS TO HUMANS: Leptomonas
Normochromic-normal color) NATURAL HOST: Dogs and Cats
ACCIDENTAL HOST: Human
 The term Dumdum fever was given to
CULTURE MEDIA: Schneider’s drosophila
the disease by the discoverer William medium; NNN (Novy-MacNeal-Nicolle) medium
Leishman, it was first observed in a TREATMENT: Paromomycin (for 21 days)
soldier and he got the infection in a and Amphotericin
place known as Dum dum Kalkota (a
city in India)
Leishmania tropica
SYNONYM: Herpetomonas tropica/
 Kalaazar is characterized by dry rough Herpetomonas furunculusa
pigmented skin, brittle hair and bleeding DISEASE: Cutaneous Leishmaniasis
gums. If left untreated, Kalaazar patients (English term); Aleppo button; Delhi Boil;
generally die within 2 years Jericho Boil or Jericho Button (a case was
 Main geographical distribution of VL is found in the Ancient City of Jericho, Middle
East in the year 1917 but lesions were already
Latin America
seen in some people during the 7 th century BC);
 Transmission of disease is possible Oriental Sore; Forest Yaws; Yucatan
through Dogs to Humans, Man to man, Proparte
bite of vector but is rarely spread VECTOR: Phlebotomus papatasi
through Blood transfusion HABITAT: REC of Skin and Subcutaneous
 Examination of the bone marrow, liver tissue
puncture, lymph nodes aspirates can be SPECIMEN: Skin scrapings
TREATMENT: Paromomycin (for 21 days)
done by Direct Microscopy where in
and Amphotericin
the specimen has been stained using - very common in Venezuela, Colombia, Brazil
Giemsa - Contact infection is possible
 Serological tests can be done using
Complement Fixation Test (detecting
Leishmania braziliensis
DISEASE: Mucocutaneous Leishmaniasis
the antibody in the serum), Skin test (develop ulceration in oral/nasal mucosa); Uta;
called Montenegro Test (Leishmanian Espundia
skin test) HABITAT: REC of mucocutaneous tissue such
 During medication the patient is given as nasal cavity
High Protein Diet SPECIMEN: Mucosal scrapings
 Medication includes Paromomycin (for VECTORS: Phlebotomus verrucarum;
Phlebotomus peruensis
21 days) and Amphotericin
TREATMENT: Paromomycin

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

SEROLOGICAL TESTS: CFT (Complement Dumdum spleen,

Fixation Test); Leishmania Skin Test fever bone
(Montenegro Test) Diagnostic marrow
TREATMENT: Paromomycin (for 21 days) stage:
and Amphotericin amastigot
- Specimens taken from internal organs can be e
made into thin smear and stain with Giemsa Leishman-
- Transmission can be from Dog to Human or Donovan
bodies
Human to Human
can be
found in
the tissue
samples
of spleen,
lymph
node,
bone
marrow or
liver
Skin test:
Dr
Monteneg
ro skin
test

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,

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

 Romana’s Sign-swelling of ocular when Medium)

the portal of entry is upper face, eyes,
orbital edema T. brucei West During Tsetse
gambiens African febrile fly/
 Winterbottom’s Sign- cervical e Sleeping periods, in Glossina
lymphadenopathy; swelling of the lymph sickness the Glossina
nodes along the back of the neck, in the WINTERB circulating palpalis
posterior cervical chain of lymph nodes OTOM blood and Glossina
as trypanosomes travel in the lymphatic SIGN(cervi lymph tachinoid
cal nodes: es
fluid and cause inflammation lymphaden during
opathy) sleeping
Trypanosoma gambiense periods in
the
DISEASE: West African Sleeping cerebrospin
Sickness/West African Trypanosomiasis al fluid
VECTOR: Glossina palpalis (Tsetse fly) T. brucei East During Tsetse
Trypanosoma gambiense rhodesie
nse
African
Sleeping
febrile
periods, in
fly/
Glossina
DISEASE: East African Sleeping Sickness/ sickness the Glossina
Rhodesian Trypanosomiasis circulating mositans
VECTOR: Glossina morsitans (Tsetse fly) blood and Glossina
SEROLOGIC TESTS: Indirect lymph swynnert
nodes: oni
Immunofluorescence; ELISA; CFT during
(Complement Fixation Test) sleeping
periods in
the
ADDITIONAL SIDENOTES: cerebrospin
 African Trypanosomiasis (T. gambiense al fluid
and T. rhodesiense) ending is in the
blood –lymphatics – CNS – Death
 American Trypanosomiasis (T. cruzi) in
the feces of vector – lymph nodes –
blood – myocardium(myocarditis) – CNS
– Death
TREATMENT: Benznidazole, Allopurinol,
Ketoconazole(Antifungal)
PREVENTION: Spray insecticide like Baygon
Leptomonas- IS to man
Leishmania- Pathogenic Stage to man
Leishmania- IS to insects
T. gambiense and T. rhodesiense use
dextrose in the blood SPOROZOA
T. cruzi can use protein in the absence of 1. Coccidia – Genus Isospora, Eimeria
CHO. 2. Plasmodia – Spp. vivax, malariae,
-Trypomastigotes of T. cruzi atre U or S- falciparum, ovale
shaped
Characteristics:
Parasite Pathogen Habitat Vector 1. They have no definite organelle for
esis locomotion.
2. They are obligately parasitic/requires host.
T. cruzi American Reticuloend REDUVI 3. They undergo a series of sexual
Trypanoso othelial D
miasis or system, BUG/kissi
(sporogony or gametogony) and asexual
Chagas cardiac ng bug (schizogony) phases of reproduction.
dss, muscle and
Chagoma central -- Microgametocyte – male
(infected nervous -- Macrogametocyte – female
site where system
the bug bit)
Culture: COCCIDIA
NNN(Novy Genus Eimeria
McNeal - contains 2 sporozoites per sporocyst
Nicole - affects animals

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

- considered monoxenous because their life • C.parvum – parasites of bovines, that

cycle is completed within a single host, and infects humans
stenoxenous because they tend to be host • C.hominis – parasite of humans, internal
specific. autoinfection
- Genus Eimeria is named after the German
zoologist Theodor Eimer.
- Disease: Coccidiosis
Cyclospora cayetanensis
- Symptoms: Diarrhea (may be bloody due to -Oocyst(infective stage) can
intestinal epithelium dying off when a large Autofluorescence and may be wrinkled like
number of oocysts and merozoites burst out of crumpled cellophane
the cells), Weight Loss, Dehydration, Lethargy, Pathogenesis: 6-8 weeks diarrhea
Depression, Diagnosis: HPO(fecal smear), acid fast
- Infection is common in farming environments staining
where many animals are confined in a small -Originally called Cyanobacterium like
space. organism
- Life cycle: Sarcocystis hominis/Suihominis
--- Exogenous Phase – the oocysts are -Humans are definite host (ingestion of
excreted into the environment. sporocyst) and dogs (zoite – banana shaped
--- Endogenous Phase – parasite cell)
development occurs in the host intestine. In -Sporocyst – sarcocyst – zoites
this phase, several rounds of asexual Pathogenesis: penetrates epithelial tissue and
reproduction or schizogony take place, after brain
which sexual differentiation of gametes and Diagnosis: fecal flotation methods
fertilization occurs. -Sporocyst has 4 long pear-shaped sporozoites
--- Transmission is Oral-Fecal Route.
Toxoplasma gondii
Genus Isospora Infective stages: tachyzoites(active form),
contains four sporozoites per sporocyst bradyzoites(inactive form and IS to humans) &
oocyst (ingestion from feline/cat feces). It is an
Isospora belii intracellular parasite which infects nucleated
Synonym: Cystospora belli cells called macrophages & brain
MOT: Ingestion of oocyst containing 2 Definitive host: cat
sporocysts Serologic test: SABIN FELDMAN DYE TEST
IS: Oocyst Pathogenesis: encephalitis, can infect through
Life cycle: Sporoblast  Sporocyst  blood transfusion and organ transplantation,
Sporozoites (12 to 14 um by 7 to 9 um) retichorditis, STILLBIRTH / ABORTION,
- Infection occurs in immune-compromised chorioretinitis, death of newborn( usually
patients anemia with pneumonia)
Pathogenesis: Diarrhea for months (in Diagnosis: tissue stained with giemsa
patients with AIDS)
Symptoms: Mild gastrointestinal distress,
chronic dysentery, chronic diarrhea, crampy
abdominal pain, weight loss, weakness,
malaise, anorexia PLASMODIA
- Stool is loose, pale yellow, and foul-smelling Malaria – is a communicable disease characterized
(suggestive of malabsorptive process) by chills, fevers, sweating, headache caused by
Disease: Isosporiasis/Cystoisosporiasis the presence of single celled parasites in the blood
Treatment: Trimethoprim-sulfomethoxazole belonging to the genus Plasmodium.
- a protozoan disease caused by members of the
Diagnostic Test: Sheather’s sugar flotation
genus Plasmodium and transmitted by the bite of
procedure; Modified acid-fast procedure; the Anopheline mosquito, characterized by
Duodenal String Test (Enterotest) recurring fever, chills, and sweats.
Cryptosporidia hominis PHYLUM: Apicomplexa
-Oocyst (infective stage) infect humas through CLASS: Aconoidasida
accidental ingestion SUBORDER: Haemosporina
Pathogenesis: 2-3 weeks of diarrhea (AIDS) FAMILY: Plasmodiidae
Diagnosis: acid fast staining, SHEATHER’S GENUS: Plasmodium
SUGAR FLOATATION, formalin-ethyl-acetate
conc.

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

- The 2 most common malarial infection in the eynomotog/cynomolgi in monkeys and P.

Philippines are caused by P. falciparum and p. vivax in humans.
vivax  William Gorgos – mosquito central
- There are also cases of malarial infection caused measures
by P. malariae from Sulu Archipelago
- Antipyretics/Analgesics will just distort the  Trophozoite – ring form; earliest form; bluish
parasite cytoplasm with a clot-like nucleus of red
- The longer you will leave the patient untreated, chromatin.
the more dangerous it will be as the patient’s life  Gametocytes – sexual stages
will be at stake  P. falciparum – gives the highest parasitemia
infecting 10 to 40% of RBCs; infects cells of all
- Heteroxenous – with merozoites produced in the ages
vertebrate host and sporozoites developing in the  P. vivax and P. ovale – invade young cells
invertebrate host.  P. malariae – has an affinity for mature or older
- Malaria has been known since antiquity: cells
 Ebers Papyrus (3550) mentions fevers, - Without treatment, all species of human malaria
splenomegaly, and the use of oil of the may ultimately result in spontaneous self-cure, but
Balamite tree as a mosquito repellant. with P. falciparum, there is progressively increasing
 Hippocrates studied medicine in Egypt and parasitemia and fatal outcome.
clearly described quotidian, tertian, and
quartan fevers with splenomegaly. GENERAL MORPHOLOGY
1. Plasmodium spp. requires 2 hosts: invertebrate
 Schizogony – asexual cycle; takes place in (mosquito) and vertebrate (reptile, bird, or
RBC of vertebrates mammal)
 Sporogony – sexual cycle in mosquitoes 2. Invertebrate – definitive host; sexual
reproduction
- Italian words “Bad Air” - or malaria (Mal=Bad; Vertebrate – different asexual reproduction takes
Aria=Air) place
- “Paludism” – marsh das -- But since gametocyte actually form in the blood
- Quinine – malarial drug extracted from Cinchona or vertebrate and fertilization occurs while still in
this medium in the stomach of the mosquito, the
Discoverers: vertebrate is the definitive host.
 Laveran (1880) – P. malariae
 Giovanni Battista Grassi (Grassi and Stages:
Feletti) (1890) – P. vivax Asexual Stages – Trophozoites, Schizont,
 Welch (1897) – P. falciparum Merozoites
 Stephens (1922) – P. ovale Sexual Stage – Gametocyte

 Charles Louis Alphonse Laverans – a 1. Plasmodium falciparum

French army physician) who in November 6,
SYMPTOMS: headache, chilling, sweating, fever
1880 saw or observed the formation of male
- Cerebral malaria / Malignant malaria (presence of
gametes by exflagellation; observed the
parasites in the brain; insanity results if untreated
gametocyte of P. falciparum
and can cause death) / Estuvo autumnal
 Edwin Klebs (German) and Conrado
INCUBATION PERIOD: Normal Range – 7 to
Tommasi-Crudelli (Italian) – gave the
17 days
name Bacillus malariae
Duration – 12 days average
 Ettore Marchiafava and Angelo Celli –
FORMS VISIBLE: Rings and Gametocytes
originally favored the bacillus hypothesis;
RADICAL TREATMENT: 5 days
became convinced that Laveran was
CHROMATIN DOTS: Maurer’s/Christopher’s
correct; revealed the complete erythrocyte
- No changes in RBC size
cycle of the malarial parasite
- 8 to 40 merozoites
 Camillo Golgi – differentiated between
species of Plasmodium
 Romanovsky – (1891) in Russia, 2. P. vivax
developed a new method of staining blood SYMPTOMS: abdominal pain, nauseated, vomiting
smears based on methylene blue and eosin - Recurrent type/Benign Tertian Malaria
 Ronald Ross – exflagellation occurs in the INCUBATION PERIOD: Normal Range – 8 to
stomach of a mosquito; on August 16, 1897, 21 days
he dissected the “dapple-winged mosquito” Duration – 14 days
(anopheles spp.) CHROMATIN DOTS: Late Schuffner’s
 P. James and P. Tate – (1938) discovered FORMS VISIBLE: rings, gametocytes, ½ grown
the exoerythrocytic stages of P. gallinaceum mature trophozoite, schizonts
 H. C. Startt and Percy Cyril Claude - 1:4 ratio
Garnham – demonstrated the - 12 to 24 merozoites
exoerythrocytic stages of P.
PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

3. P. ovale - presence of gametocyte in the blood smear

means that the infection has already advanced
- Ovale tertian
- presence of schizont in the blood smear means
CHROMATIN DOTS: Early Schuffner’s
that the patient is already severely infected, or
- 1:2 ratio
already close to death
- 6 to 12 merozoites
- treatment is given for 5 days
4. P. malariae - cases of mixed infection is also possible (P.
SYMPTOMS: pale, anemic falciparum with P. vivax)
- Quartan malaria - there are cases that RBCs are also destroyed
INCUBATION PERIOD: Normal Range – 21 to when schizonts rupture, which will lead to the
60 days liberation of hemoglobin and will lead the patient to
Duration – 28 days average become anemic
CHROMATIN DOTS: Ziemann’s dot - if the schizont ruptures, it will also be liberating the
- No changes in RBC size 8 to 40 merozoites
- 6 to 12 or 8 to 10 merozoites - RBCs in the blood smear are seen as pale violet
because of the liberation of hemoglobin
Spleen Detection – 2 to 9 years (children only)
Stages:
3 DEMONS THAT CAUSE MALARIA 1. Sexual: Gametocytes
1. Stone – fever dust *Gametocytes develop 9 days after infection
2. Hammer – headache 2. Asexual:
3. Water – perspiration a. Trophozoite or rings (young)
b. Grown ½ or developing
TIME WHEN MALARIA ATTACKS c. Late/Mature/Old
- 9-10-11-12 a.m. d. Schizont
- 1-2-3 p.m.
TROPHOZOITES:
CONSECUTIVE PAROXYSMS OR MALARIAL - Small, regular, fine to fleshy cytoplasm
ATTACK - Not enlarged RBC
1. Cold Stage - Numerous, multiple infection is common
- chilling, loss of appetite, goose flesh, convulsion - Ring, comma, marginal form
in children which lasts for 1 to 2 hours and body SCHIZONT STAGE:
temperature is going up. - Small, rarely fill the RBC
- chilling is simultaneous or caused by the bursting - Rare in peripheral blood
of schizonts - 16-32 or more merozoites in compact
2. Hot Stage cluster
- sensation of great heat, restlessness, pulse is full - Simple, dark pigment
and pounding, vomiting, blood pressure goes down, GAMETOCYTE STAGE:
intense headache, dry skin which lasts for 2 to 4 - Banana shape
hours - Macrogametocyte: small compact, central
3. Sweating Stage chromatin; pigment closely adhere to the
- profuse sweating, temperature goes down chromatin
gradually, less intense headache which lasts for 2 - Microgametocyte: sausage shape
to 5 hours, patient feels exhausted until falls asleep
4. Apyrexial Interval Characteristics:
- P. falciparum - 2 hours to 1 day  INFECTED CELLS: Normal
- P. vivax and P. ovale - 2 days and 1 night  BASOPHILIC STIPPLING: Maurer’s Dot
- P. malariae - 60 hours  GAMETOCYTES: Crescent shape/
Sausage/ Banana Shape
 COLOR OF PIGMENTS: Black
Duration Average: Normal Range:  MATURE SCHIZONTS: 40 merozoites
12 P. falciparum 7-17 days  YOUNG TROPHOZOITE: wing shape and
14 P. vivax 8-21 days double chromatin
28 P. malariae very viable within 2-  IMMATURE TROPHOZOITE: ½ growth
60 days (amoeboid trophozoite)
(lifetime duration of infection; pale, anemic)  MATURE TROPHOZOITE:
-- Gametocytes
 Male: Stout
Plasmodium falciparum  Female: slender
-“falx” ; sickle or crescent
SYNONYM: Oscillaria malariae SIGNS AND SYMPTOMS:
- invades RBCs 1. Severe intense headache
- rings are commonly seen in a blood smear; 2. Fever
means that infection is just newly acquired 3. Chilling
4. Body Malaise
PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

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

SCHIZONT STAGE: -Quartan Malaria

- Large, converting -Paroxysm every 72 hours
-7% of malaria cases in the world
GAMETOCYTE STAGE: -Merozoites can only invade aging RBC
- Round, large -Recrudescence occurs up to 53 years after initial
- Usually compact nucleus infection
- Chromatin is Deep Red or Magenta
- develops after 3 days
Characteristics: Plasmodium ovale
 INFECTED CELLS: enlarged - Synonym: Plasmodium vivax minutum
 BASOPHILIC STIPPLING: Late Schuffner’s -Somewhat the same as that of P. vivax
Dots -Smaller than P. vivax
 COLOR OF PIGMENTS: Golden Brown -few
 MATURE TROPHOZOITE: Vacuolated -Single prominent chromatin
 GAMETOCYTES: -6-12 merozoites
 Male: Central Nucleus -causes Mild Tertian Malaria
 Female: Peripheral Nucleus -Early Schuffner’s Dots appear early in infected
 MATURE SCHIZONTS: 24 merozoites RBC
-West Africa
SIGNS AND SYMPTOMS: -Slightly enlarged RBC
PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

Plasmodium falciparum forms

Schizont – “Fruit pie”
RBC INFECTED All stages (young and gametocytes-”ovoid”
old)
STIPPLINGS Ziemann’s Stipplings
APPEARANCE Normal
OF INFECTED Only ring forms
RBC
STAGES SEEN Gametocytes
IN PERIPHERAL (banana/crescent Plasmodium ovale (vata)
BLOOD shaped)
RBC INFECTED Young
# OF 12-24
MEROZOITES APPEARANCE Enlarged
OF INFECTED
PATHOGENESIS Malignant Tertian RBC
malaria (every 36
hours), Cerebral STAGES SEEN all
malaria, Black water IN PERIPHERAL
fever, BLOOD
G-6-P-D
deficient(individuals are # OF 8
resistant to malaria MEROZOITES
infection) PATHOGENESIS Ovale malaria (every 48
STIPPLINGS Maurer’s dots hrs)
Large pale red
cell(oval/frimbriated)
Most common malaria
in the Philippines, about STIPPLINGS James dots, Early
70% Schuffners

Plasmodium vivax (vata)

RBC INFECTED Young

Plasmodium malariae (matanda) APPEARANCE Enlarged

OF INFECTED
RBC INFECTED Old RBC

APPEARANCE Normal STAGES SEEN all

OF INFECTED IN PERIPHERAL
RBC BLOOD

STAGES SEEN Rings, band # OF 16

IN PERIPHERAL trophozoite, schizonts MEROZOITES
BLOOD
PATHOGENESIS Benign tertian
# OF 8 malaria(every 48
MEROZOITES hours), single large ring
and amoeboid in form
PATHOGENESIS Quartan malaria (every Duffy negative are
72 hours) ring- resistant to P.vivax
“basket forms” or “band

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

STIPPLINGS Late Schuffners

Hemozoin – staines as Plasmodium knowlesi

black granules in • Fifth human malaria
Giemsa or Wrigh- • No relapse from the liver
stained smears. • Rapid erythrocyte cycle (24 hours), will
infect all stages of rbc’s and can cause
ADDITIONAL SIDENOTES: serious damage
-mal’aria - BAD AIR • Early ring stages res. Falciparum
Plasmodium spp. • Older developing stages (trophs,
Definitive host: Female Anopheles mosquito schizont) res. Malariae (band forms and
Infective stage: Vector to man: Sporozoite rosette)
(asexual stage) (Schizogony)
Man to Vector: Gametocyte (sexual stage) BREEDING PLACES OF VECTORS
(sporogony) 1. Anopheles minimus flavirostris – breeds in
• Sporozoites – Cryptozoites – Merozoites clean, small, slow flowing, clear, partly shaded
stream
*(exoerythrocytic stage)
- principal and most common malaria vector
• Merozoites – Ring Trophozoites – 2. Anopheles mangyanus – secondary transmitter
Schizonts contain merozoites (released of malaria found in the forest area of Mindoro and
on the red cell rupture invading new red Negros Occidental
cells) – Gametocytes(ingested by - prevalent in Curuan, Vitali
Anopheles) – Gametes – Zygote – 3. Anopheles litoralis – transmitter of malaria in
Oocyst – Sporozoites coastal areas of the Sulu Island.
- All coastal areas (bukana) and brackish water
 Every 36 hours - Malignant Tertian (mixture of salty and fresh water)
Malaria - P. falciparum (Ferdinand 4. Anopheles balabacensis – no specific breeding
Marcos) 1st (Falciparum:Maurer’s Dot) place

Lifetime of Mosquito – 6 weeks

 Every 48 hours – Tertian Malaria – P.
vivax (Vilma Santos) 2nd (Vivax:Shuffner’s DDT (Dichloro-Diphenyl-Trichloroethane) – used
Dot-LATE) against Anopheles mosquito but was banned
eventually because it was not environment-friendly
 Every 72 hours – Quartan Malaria – P.
malaria (Manila Zoo) 3rd FACTORS OF MALARIA TRANSMISSION
(Malariae:Ziemann’s Dot) 1. Seed – malaria parasite
2. Sower – mosquito vector
3. Soil – susceptible individual
 Every 48 hours – Ovale Malaria – P.
ovale (Orange Juice) 4th (Ovale:Jame’s OTHER EPIDEMIOLOGICAL FACTORS OF
Dot/Early Schuffner’s) MALARIA TRANSMISSION
1. Temperature
 Most severe form of malaria & likely to - below 15 deg. Celsius and above 32 deg. Celsius
be fatal – P. falciparum - optimum temperature = 26 to 27 deg. Celsius
 Most widely disseminated & most 2. Relative Humidity
prevalent – P. vivax - low relative humidity shortens the life of mosquito
 Resistant to malarial invasion DUFFY 3. Rainfall
FACTOR Fy(a-b-) (P. vivax, P. knowlesi - it modifies the temperature and increases the
cant infect these people) relative humidity
 Ovale & vivax are similar because they
EFFECT OF MALARIAL INFECTION ON RBCs:
exhibit true stipplings (Schuffners dots) -- In general:
and have a true relapse in th life cycle. 1. Reduces the total RBC count
Both infect young RBCs, and contain 2. Lowers the hemoglobin level
malarial pigment. -- P. falciparum
 Medical Emergencies – Falciparum & 1. No change in size
Knowlesi 2. Individual cells becomes thick and the color
 Malariae & falciparum – do not produce becomes slightly paler
hypnozoites -- P. vivax
 Draw blood every 6 hours until 1. Increase in size (1:4 ratio)
confirmed positive or negative 2. Loss of color (becomes slightly paler)

PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])

 lOMoARcPSD|31411684

MAMMALIAN SUBGENERA OF MALARIA Densities:

PARASITES: I - 1 to 10 parasites found in whole film per 100
1. P. plasmodium – type species malariae with field
large erythrocyte schizonts and round gametocyte II – 10 to 100 parasites found in whole film per 100
occurring in parasite field
2. P. vinckeia – type species bubalis with small III – 1 to 10 parasites found per thick field film
erythrocytic schizonts and round gametocytes IIII - 10 to 100 parasites found per thick field film
occurring on rodents and other mammals except Thin field – for verification and record purposes
primates.
3. P. laverania – type species falciparum with large Pigments:
erythrocytic schizonts and round gametocytes -- black block - falciparum
occurring in antelopes, rodents and other mammals -- yellowish brown
except primates. a. malariae
b. vivax
Flight of mosquito – 5 miles (8 kilometers) or c. ovale
longer depending on the range of winds
- 8 to 12 kilometers – with strong wind BITING TIME:
- Only female mosquito bites to fertilize and lay 1. House Mosquitoes: 6pm-6am (night and
their eggs day)
- Normal: 2 km/hr 2. Vector Mosquitoes: 8pm-4am (night only)
- Typhoon: strong winds, miles or more (15 km) *biting peak hours are from 9pm-2am

SPOROGONIC CYCLE Sporogenic – sexual reproduction in mosquito

1. P. falciparum Schizogenic – asexual reproduction in man
- between 25 and 30 deg. Celsius
- completed in 10 to 15 days
- at 20 deg. Celsius, the cycle takes about 26 days BLOOD SMEAR
1. Thick Film
2. P. vivax 2. Thin Film
- at 15 deg. Celsius, it completes its extrinsic cycle
for 8 to 10 days Thin Film
- for tropical climate: average temperature of 30 to - to preserve the characteristics of the blood cells
35 deg. Celsius and other organisms that may be present in the
- temperate climate: 15 to 20 deg. Celsius for 14 to blood.
21 days - accurate diagnosis – in order to preserve the
morphology of both cells and parasites. Thin blood
films are fixed with methyl alcohol (Methanol-
TREATMENT: CH3OH) at the beginning of the staining process.
1. P. falciparum - hemolysis is prevented by fixation
- (smallest ring)
- ring only: 3 days radical treatment Thick Film
- ring + gametocyte: 5 days radical treatment - to enable to examine a comparatively large
2. P. vivax – 14 days radical treatment quantity of blood in a short space of time. It should
3. Mixed infection – same be about 20um in depth (magnification of x700).
There would be 15 to 20 WBC in each
- Sulfa drug – given at the last day of treatment to microscopical field.
regain the patient’s resistance - hemolysis is necessary in order to make the film
transparent
Side effects (overdose with empty stomach):
1. gastric irritability This is done by placing the film in a watery staining
2. blurredness solution and allowing the hemoglobin to be
3. deafness dissolved out of the blood during staining. The
result of this microscopical exam, the red cells are
Presumptive Treatment: 1 week before departure no longer visible; only the white cells and any blood
to a known malarious area, start chemotherapy parasite that are present may be seen.
- During the stay in the malarious area, continue
the 1 week treatment DEFINITION OF TERMS
- 1 week after arrival, take 3 tabs a week Trophozoite – early individual asexual parasites;
-- Adult dose: 3 tabs a week the youngest trophozoites of each species are
Camoprima (2 tabs only) commonly called “rings”.
Aralen Schizont – all adult asexual forms with two or more
Chloroquine divisions of the nucleus.
Primaquine Mature Schizonts – fully developed schizonts in
which merozoites are completely formed.
PARASITOLOGY LECTURE NOTES KERVY JAY T. AGRAVIADOR

Downloaded by SHERRIE MAE ANDABON ([email protected])