Parasitology

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PARASITOLOGY
 the study of HOST – PARASITE relationship
 the study of PARASITES which infect HUMANS
Parasite
 Any organism that lives in or on the body of another organism in order to survive.
Host
 any organism that harbors a parasite
Mode of transmission
Refers to the manner of how a parasite successfully enters a susceptible host.
Includes: ingestion, inhalation, breastfeeding, insect bite or sexual transmission
Pathogenic parasites  are disease-causing parasites

Non- pathogenic parasites  also known as commensal parasites that do not harm the host
Ectoparasites  thrive externally on host. Ex. Lice and fleas.

Endoparasites  parasite found inside the body of an infected host. More problematic and require special
specimen preparation
Eosinophilia  refers to the increase in eosinophil counts in blood associated usually with parasitism. Act
as cellular protectors against parasites. They eventually degrade and are passed in the stool in the form
of Charcot – Leyden crystals
SYMBIOSIS
-close association between two organisms that is permanent wherein one cannot exist independently.
 Mutualismclose association between two organisms that is permanent wherein one cannot
exist independently.
 Commensalism only the parasite benefit from the association while the host is
unaffected.
 Parasitism only the parasite benefit from the association while the host is unaffected.
HOST CLASSIFICATION
1. Definitive host harbors the adult/sexual stage of the
2. Intermediate hostharbors part or all the larval stages of the parasites
3. Reservoir host other animals that harbors the same species as that of man.
4. Paratenic host  harbors the parasite in an arrested state of development.
PARASITE CLASSIFICATION
 Based on Habitat
 Based on Relationship between Host – Parasite
 Based on the Effect of parasite on the host
 Based on Transmission
Based on habitat
 Ectoparasite
 Endoparasite
Based on Relationship between Host – Parasite

 Obligatory
 Facultative
 Intermittent
 Spurious
 Accidental/ incidental
Based on the Effect of parasite on the host

 Pathogenic
 Non pathogenic
Based on Transmission
 Soil Transmitted - Ascaris lumbricoides, Trichuris trichiura, Hookworm, Strongyloides stercoralis
 Arthropod/ Vector transmitted- Plasmodium spp, Leishmania, Trypanosomes, Babesia,
Schistosoma spp
 Food – borne - Taenia spp, Trichinella spiralis, Toxoplasma gondii, Capillaria philippinensis,
Heterophyds, Paragonimus westermani, Fasciolid
 Water – Borne - Amoeba, Giardia lamblia, Blastocystis hominis, Cryptosporidium spp, Cyclospora
cayetanensis
 Direct contact - Trichomonas vaginalis, Enterobius vermicularis
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Sources of infection
 Air
 Animal
 One’s self
 Inanimate objects
PORTALS OF ENTRY
Mouth
 Ingestion
 Intimate oral contact
Skin
 Active larval penetration
 Introduction of the vector
Intranasal
Transmammary
Transplacental
Sexual
PORTALS OF EXIT
Stool
Urine
Sputum
Blood
SPECIMEN COLLECTION AND TRANSPORT

Properly Collected & Prepared Stool specimens can recover:
 Protozoan's Trophozoites and cyst
 Helminth stages
 Proglottids
Stool collection Protocol:

 3 specimens
 Except for the Diagnosis of amoebiasis
For patients taking medications

 Prior to therapy
 Not until 5-7 days after completion of therapy.
For patients who have taken antibiotics or anti-malarial medications

 2 weeks after the therapy
 Clean, watertight container with a tight-fitting lid.

 Cardboard or a pan.
o transfer to a clean, dry, sterile, wide-mouthed container with a tight-fitting lid & sufficient
moisture before submitting to the lab.
Acceptable amount of stool specimen: 2 to 5 g

 pea/walnut/thumb sized
 Specimen should be rejected if it contains urine & toilet paper

 Specimen should not be retrieved from toilet bowl
Specimen container:
 properly labeled at the side (body) of the container (not on the lid)
 Should be placed on ziplock plastic bag
For the demonstration of the trophozoites motility.

 Fresh stool samples are required
Liquid stool within 30 minutes
 Semisolid stoolwithin one hour
 Formed stoolCan be held for 24 hrs following collection
SPECIMEN PROCESSING
Stool specimen for Ova & Parasite (O&P)Most common procedure
Routine Parasitology
 Macroscopic
 Microscopic
MACROSCOPIC/ GROSS EXAMINATION

 Determine the color and consistency
 Examine the Gross Abnormalities
 Fresh and unpreserved stool.
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MICROSCOPIC EXAMINATION
A. Direct wet preparation
 Direct wet mount
 Mix a small portion of unfixed stool with saline or iodine
 Detection of trophozoite
B. Cellophane covered thick smear

 Kato thick
 Kato Katz
C. Concentration Techniques
 Sedimentation
 Flotation
NEMATODES
 “Roundworms”
 Unsegmented bodies, cylindrical and tapered at both ends
 With sensory organs known as chemoreceptors
 Sexes are separate
General life cycle:
 𝑒𝑔𝑔→𝑙𝑎𝑟𝑣𝑎𝑒→𝑎𝑑𝑢𝑙𝑡
3 basic morphologic forms:

 Eggs
 Larvae
 Adult
Ascaris lumbricoides
 “Giant intestinal roundworm”
 Habitat: Small intestine
 MOT: ingestion of embryonated eggs
 Clinical significance: Ascariasis
Laboratory diagnosis:
 ova / adult in stool
 x-ray
Treatment: Albendazole, Mebendazole, Pyrantel pamoate
FORMS
 Adult worm
 Ova/ Egg
 Fertilized
 Unfertilized
Enterobius vermicularis
 “Pinworm”
 Habitat: Large intestine
 MOT: ingestion of embryonated egg
 Clinical significance:Enterobiasis
Laboratory diagnosis: Scotch-Tape technique/Cellulose tape
Treatment: Albendazole & Pyrantel pamoate
Trichuris trichiura
 “Whipworm”
 Habitat: Large intestine
 MOT: ingestion of embryonated egg
 Clinical significance: Trichuriasis
Laboratory diagnosis: Ova in stool
Treatment: Albendazole and Mebendazole
Egg: barrel/ football/ japanese lantern/ lemon shaped with prominent hyaline polar plug
HOOKWORMS
 Necator americanus
 Ancylostoma duodenale
 Ancylostoma braziliense
 Ancylostoma caninum
Necator americanus
 “New world hookworm”
 Characteristic shape of adult is S shape
 Buccal capsule is provided with semilunar cutting plates
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 Equipped with an amphidial gland

 Tail contains a copulatory bursa and copulatory spicule
 Clinical significance: Necatoriasis
Ancylostoma duodenale
 “Old world hookworm”
 Characteristic shape of adult is letter C
 Adult worm has a 2 pairs of ventral teeth
 Has a pair of copulatory spicule which is bristle like
 Clinical significance: Ancylostomiasis and Miners anemia
Ancylostoma braziliense
 “Cat hookworm”
 Adults have a pair of teeth and a pair of inconspicuous median teeth
 Copulatory bursa is broad and long with short lateral rays
 Clinical significance: Cutaneous larva migrans / creeping eruption
Ancylostoma caninum
 “Dog hookworm”
 Clinical significance: Cutaneous larva migrans/creeping eruption and eosinophilic enteritis
 Adult worm has 3 pairs of ventral teeth
 Cephalic amphidial gland
Strongyloides stercoralis
 “Threadworm”
 Adult contains short buccal cavity and a long esophagus
 Body of the worm is transparent with fine striated cuticle
 Ova has a characteristic Chinese lantern shape
 Clinical Significance: Strongyloidiasis , Cochin china diarrhea
TPGRMT

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Pathogenic parasites  are disease-causing parasites

Ectoparasites  thrive externally on host. Ex. Lice and fleas.

2. Intermediate hostharbors part or all the larval stages of the parasites

4. Paratenic host  harbors the parasite in an arrested state of development.

Based on Relationship between Host – Parasite

Based on the Effect of parasite on the host

SPECIMEN COLLECTION AND TRANSPORT

Stool collection Protocol:

For patients taking medications

For patients who have taken antibiotics or anti-malarial medications

 Clean, watertight container with a tight-fitting lid.

Acceptable amount of stool specimen: 2 to 5 g

 Specimen should be rejected if it contains urine & toilet paper

For the demonstration of the trophozoites motility.

MACROSCOPIC/ GROSS EXAMINATION

B. Cellophane covered thick smear

3 basic morphologic forms:

 Equipped with an amphidial gland

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