INTRODUCTION TO

PARASITOLOGY
DEFINITION OF TERMS
A. Parasitology
- dependence of one living organism on another.
Clinical Parasitology
- Concerned with animal parasites of man
Divisions of Parasitology
1. Protozoology
2. Helminthology
a. Roundworms (nematodes)
b. Flatworms –Cestodes (tapeworm)
Trematode (fluke)
3. Medical Entomology
B. Host
- Organism upon which parasites live
- Types of hosts:
1. Final Host or Definitive Host
- Harbors the sexual stage
2. Intermediate Host
- Harbors the larval or asexual stage
3. Reservoir Host
- Harbors the same species or parasites as man
4. Carriers
5. Vectors
- Hosts that transmit parasites to man
- An insect that carries the infective stage of an
organism to another person.
C. Parasite
- An organism living upon or within another organism for
nourishment.
- Types:
1. Obligate parasite
- Organism which cannot exist without a host.
2. Facultative Parasite
- Organism which may live either a parasitic or
free-living existence
3. Incidental parasite
- lives on another host other than its present host
- animal parasites which occur in human beings.
 4. Spurious parasite
- parasitizes other hosts and are recovered in
living or dead state from human feces
5. Endo vs. Ectoparasites
a. Endoparasites---- produces an
infection
b. Ectoparasites---- Attached to the
skin or temporarily invade the superficial
D.tissues of the host’s body. Produces an
Host- Parasite Relationships
infestation.
1. Parasitism
 a relationship between 2 living
organisms of different species
 one of the members lives at the
expense of the other and at the same
time causes it harm.
2. Commensalism- parasite benefits without
reciprocating but without injury to the host.

3. Mutualism- beneficial to both but life without

the other is still possible

4. Symbiosis
 close association of 2 organism
 both members are so dependent upon
each other that life apart is impossible.
SOURCES OF PARASITIC INFECTION

A. Contaminated Soil or water

- Soil Ascaris lumbricoide, Trichuris trichura
Hookworms, Strongyloides
- Water Amoeba, Flagellates, Taenia solium
Blood Flukes

B. Food containing the Immature

Infective Stage of the Parasite
--Fish, crab, snail  tapeworms, capillaria
-- Beef, pork  Trichinella, Taenia
-- Intestinal, liver and lung flukes
C. Blood sucking Insect
-- Malaria, Leishmaniasis, Trypanosoma

D. Domestic or Wild Animal Harboring the Parasite

-- Dogs: D. caninum, E. granulosus, T. canis
A. Caninum
--Cats: Toxocara cati
-- Herbivorous animals: Trichostrongylus
E. Another person, his clothing, bedding or
immediate environment that he has
contaminated.
-- E. histolytica, pinworm, tapeworm
-- scabies

F. One’s self (auto-infection)

-- Strongyloides stercoralis
-- E. vermicularis (pinworm)
 MODE OF TRANSMISSION
PORTAL OF ENTRY
1. Mouth- most common portal of invasion
- ingestion
2. Skin
a. Skin penetration Filaria, cercaria
b. Blood sucking arthropods--- mosquitos, flies, mites
3. Inhalation--- Enterobius vermicularis
4. Transplacental– Ascaris lumbricoides
--Toxoplasma, Malaria (Plasmodia)
5. Transmammary--- strongyloides, Ancyclostoma,
Plasmodia,Schistosomes
6. Sexual Intercourse– Trichomonas vaginalis
B. PORTAL OF EXIT
1. Feces --- mostly all kinds of parasite
2. Urine --- Trichomonas vaginalis
Strongyloides stercoralis,
Schistosoma haematobium
3. Sputum --- Paragonimus westermani
Ascaris lumbricoides
4. Discharges--- Trichomonas vaginalis
Dracunculus medinensis
MECHANISM OF PATHOGENESIS
A. General Life Cycle
Parasite Host Migrate to location for
maturation

Reproduce

B. Factors that determine intensity of parasitic infection

a. Topography of Locality
b. Social condition
c. Age
d. Hygienic Measure
e. Sewage Disposal
f. Water supply
C. Ways of damage to Host
1. Inapparent infection
-- causes no symptoms and produces no harm
2. Traumatic damage
a. External --- invades the skin
b. Internal --- Direct damage to organs
3. Lytic necrosis -- Elaborate enzymes
4. Stimulate Host-tissue reaction
-- Cellular proliferation and infiltration
5. toxic and allergic phenomena --- introduce toxins
D. Immunity in Parasitic infections
E. Infective vs. Pathogenic stage
CLASSIFICATION OF PARASITES
ANIMAL KINGDOM

Subkingdom Protozoa Subkingdom Metazoa

-Class Rhizopoda or Sarcodinia - Phylum Nematoda or
(Amoeba) Nemathelminthes
- Class Mastigophora or Flagellata - Phylum Platyhelminthes
(Flagellates) (Flatworms)
- Class Ciliata or Infusoria --- Class Trematoda
(Ciliates) (Flukes)
- Class Sporozoa (Sporozoas) --- Class Cestoda
(Tapeworms)
-Phylum Arthropoda
PROTOZO
A
INTRODUCTION
A. Morphology
1. Ectoplasm--- more homogenous and less granular
Function: locomotor apparatus for procurement and
1 ingestion of food ( locomotion)
2 Respiration, Discharge of metabolic wastes
(excretion), Protection of organism
Structures:
3 a. Contractile or Pulsating vacoules– osmoregulators
b. Plasma membrane
c. Locomotor apparatus: pseudopodia, flagella and
cilia
d. Cystosome and cytophage
e. Excretory vacoules
2. Endoplasm
--more granular
--Function: food synthesis
--Structures: a. Chromatoidal bodies
-- glycogen or protein stores
-- seen in cystic stage only
b. Mitochondria
c. Golgi apparatus
d. Microsomes
e. endoplasmic reticulum
-- Nucleus
Forms: a. Vesicular nucleus
-- small amount of chromatin material in large amount
of nucleoplasm
-- Karyosome
-- ex. Entamoeba coli
b. Compact nucleus
--large amount of chromatin material in small amount of
nucleoplasm
--Ex. Balantidium coli

Life Cycle
Excystation

Trophozoite Cyst

Encystation
 Trophozoite– feeding stage
-- absorbs nutrients from the plasma
membrane
-- Motile stage
-- Have organ of locomotion
Cyst--- non feeding stage
-- rely on stored food (chromatoidal bodies)
--- Non motile stage

Factors for excystation:

1. Osmotic changes in the medium
2. Enzymatic action of enclosed organism on inner
surface of cyst wall
3. Favorable pH and enzymatic action of host
tissues
 Factors for Encystation:
1. Deficiency or overabundance of food
2. Excess of catabolic products
3. marked change in the pH
4. Desiccation of the medium
5. Depletion or excess supply of oxygen
6. Overpopulation
CLASS RHIZOPODA (SARCODINIA)
Mode of locomotion : Pseudopodia (false feet)
C. Entamoeba histolytica
--- Disease: Amoebiasis
--- Reservoir: major: humans
minor: dogs, pigs, monkeys
Transmission: Contaminated food or drinks
1. polluted water supply
2. unclean handling of infected individuals
3. Droppings of flies and other insects
4. use of night soil
5. gross carelessness in personal hygiene
--- incubation period: 2-5 days
 Infective stage: cyst  Types of Amoebiasis:
1. Asymptomatic--- carriers
--- Cigar shaped or cyst passers
chromatoidal body 2. Symptomatic
a. Intestinal amebiasis
 Pathogenic stage: - amoebic colitis
trophozoite - amoebic dysentery
- amoebic appendicitis
--- central b. Extra-intestinal amebiasis
karyosome - Liver most common
- Lung, brain, skin
cyst
trophozoite
Diagnosis:
- History and P.E.
- Stool exam
- Proctosigmoidoscopy
-Liver function test, serologic exam,
hepatoscan, ultrasound

Treatment:
- Metronidazole

Prevention:
- Personal hygiene
-Environmental sanitation
Life cycle
Entamoeba coli
 Stages: 5 developmental stages
Trophozoite
-- Eccentric karyosome
-- Dirty looking sytoplasm
Cyst
-- 8 nuclei
-- whisk broom shaped chromatoidal body
 Non- pathogenic  commensal tissue dweller
 Life cycle like E. histolytica
 Infective stage: cyst

 Pathogenic stage: none

 S/sx: none

 Diagnosis: demonstration of organism in stool

 Treatment: None

 Prevention: same as E. histolytica

Cyst trophozoite
Endolimax nana
 Smallest protozoa
 Non-pathogenic
 Trophozoite
--- Eccentric karyosome
--- Narrow rim of cytoplasm
 Cyst
---Ovoidal or round
Entamoeba gingivalis
 Found in buccal cavity, gums
 Present in people with poor oral hygiene
 Only trophozoite stage is present
-- Infective stage: trophozoite
-- Pathogenic stage: none
 Manner of transmission:
1. droplet spray
2. Sharing of food and utensils
3. kissing
 If present indicates need for better oral hygiene
 Prevention: proper care of teeth and gums
 FREE LIVING AMOEBAS
(OPPORTUNISTIC AMOEBA)

1. Naegleria fowleri
-- found in freshwater lake or ponds, swimming pools
-- life cycle:
a. trophozoite– amoeboid form and flagellate form
b. Cyst

Pathogenesis:
Portal of entry: olfactory neuroepithelium
-- causes primary amebic meningoencephalitis
-- seen in healthy individuals
-- Diagnosis:
-- amebas in tissues are present only as
trophozoites
-- no cysts seen in tissues
-- Treatment: Amphotericin B
-- Prevention: Avoid contact with stagnant or
thermal waters
Hyperchlorination not effective
2. Acanthamoeba
-- Most common species: Acanthamoeba
culbertsoni
-- Found in soil or stagnant waters
-- Source of infection: dust or water
-- Resistant to chlorine and drying
-- Life cycle:
a. trophozoite ----- no flagellate form
b. cyst
-- Pathogenesis:
Portal of entry: broken or ulcerated
skin/eyes, lungs and GIT
Disease: Chronic meningoencephalitis in
immunocompromised host, Corneal ulceration
-- Treatment: Sulfadiazine
-- Prevention: early diagnosis
Prompt treatment of lesions
CLASS CILIATA
 Balantidium coli

Mode of locomotion--- cilia

Habitat– cecum of large intestine

Epidemiology --- Final host: Pig

 man and monkeys accidental host

Mode of Transmission– fecal contamination

Morphology – Largest protozoa
2 stages:
1. Trophozoite – cytopyge and cytosome
-- covered with cilia
2. Cyst – thick cell wall

Pathology: Balantidiasis ----Dysentery ---fatal type

Asymptomatic

Diagnosis: (+) trophozoite or cyst in stool

Treatment: Tetracycline, Metronidazole

Prevention: same as E. histolytica

CLASS FLAGELLATA (MASTIGOPHORA)
 Mode of Locomotion: Flagella

4. Giardia lamblia

Morphology:
a. Trophozoite– pear shaped, pathogenic stage
b. Cyst --- Infective stage

Mode of Transmission: contaminated food or water, oral-

fecal route, anal sex

Habitat: Duodenum, jejunum

Binary fission
Incubation period: 7-10 days

Disease: Giardiasis, Lamblia intestinalis

,Giardia duodenalis and Giardia intestinalis,
Malabsorption Syndrome

Signs and Symptoms: steatorrhea, abdominal

pain, flatulence, severe diarrhea, foul
smelling and bulky stools,fatigue, nausea and
vomiting.
Treatment: metronidazole, furazolidone

Prevention
-- Do not drink from fresh water streams or lakes
without boiling or filtering the water.
-- Do not use ice or drink beverages made from tap
water that may be contaminated.
-- Do not eat uncooked or unpeeled fruits or
vegetables grown in conditions in which
contamination with Giardia might occur.
-- Wash hands before eating food, after changing
diapers, using the bathroom, or touching pets.
-- Avoid oral/anal sex.
Trophozoite emerging from cyst
Trophozoite emerging division
2. Trihomonas tenax (T. buccalis)
- non-pathogenic, found in mouth and gums
- trophozoite stage only
- transmission: droplet spray, kissing, sharing of
utensils
- treatment: none
- prevention: oral hygiene
3. Trichomonas vaginalis
- found in vagina and prostate gland
- trophozoite stage only: infective and
pathogenic stage
- transmission:
ingestion
unhygienic practices in females
- alkaline vaginal pH
sexual intercourse in males
“- disease: STD
- pruritus vulvae
- mucopurolent discharge
- dysparenuria, dysuria
- “strawberry cervix”

- diagnosis: discharge and demostration of

organism in urine
- treatment: Metronidazole
- prevention:
hygienic practices
douching
limit to no sex
Trichomonas vaginalis: mature and trophozoite
STRAWBERRY CERVIX
Blood and Tissue flagellates
Morphologial stages:
- amastigote  promastigote  epimastigote 
trypomastigote

Leishmaniasis
- species:
Leishmania donovani: kala-azar or visceral leishmaniasis
Leishmania tropica: oriental sore or cutaneous leishmaniasis
Leishmania braziliense: espundia or mucocutaneous
leishmaniasis
- stages:
amastigote  promastigote
(pathogenic stage) (infective stage)

- vector: sandfly (phlebotomus fly)

- Life cycle:
sandfly stageshuman stages
Cutaneous Leishmaniasis
2. Trypanosomiasis
A) African sleeping sickness
- species: T. brucei rhodiense (acute)
T. brucei gambiense (chronic)

- stages: epimastigote  trypomastigote

(infective stage) (pathogenic stage)

- vector: tse-tse fly (Glossina fly)

 Trypanosoma brucei  Tsetse fly
B) American trypanosomiasis (Chagas disease)
- species: T. cruzi
- stages:
amastigote (infective)  promastigote
epimastigote  tyrpomastigote(pathogenic)

-vector: Reduvid bug or kissing bug

Class Sporozoa
general life cycle
1. Shizogony 2. Sporogony
- asexual - sexual reproduction
reproduction in in mosquito
human - stages:
- stages: zygote
trophozoite oocyst
schizont cyst (sporoblast)
merozoite sporocyst
gametocyte: sporozoites
♀macrogamete
♂ microgamete
Subclasses
1. coccidia: Isospora belli, Cyptosporidium, Toxoplasma gondii
2. plasmodia: Plasmodium

Plasmodium species
Epidemiology
- strain: Plasmodium falciparum
Plamodium vivax
Plasmodium malariae
Plasmodium ovale

- vector: Anopheles mosquito

-stages: schizogony and sporogony
infective stage in man: sporozoite
pathogenic stage in man: merozoite
infective stage in mosquito: gametocyte
Plasmodium species
Plasmodium falciparum Plasmodium malariae
Incubation pd: 9-14 days Incubation pd: 14-30 days
Type of fever: malignant Type of fever: quartan
tertian
RBC affinity: old and young RBC affinity: old RBC
Schizont: not seen in blood Schizont: rosette pattern
smear
Gametocyte: Gametocyte:
sausage shape---male spherical shape---male
crescent shape---female spherical shape---female
Cytoplasm: Maurer’s dots Cytoplasm: Ziemann’s dots
Plasmodium falciparum
P. falcifarum trophozoite P. falcifarum schizont

P. falcifarum gametocyte fig. 27 & 28 (female) fig. 29 & 30 (male)

 Plasmodium Malariae
Plasmodium Malariae Trophozoite Plasmodium Malariae schizont

Plasmodium Malariae gametocyte

fig no. 23 - Developing gametocyte

fig no. 24 – Female gametocyte
fig no. 25 - Male gametocyte
Plasmodium Vivax
Plasmodium Vivax trophozoites Plasmodium Vivax schizont

Plasmodium Vivax gametocytes

Plasmodium species
Plasmodium vivax  Anopheles mosquito
Incubation pd: 14-15 days
Type of fever: benign tertian
RBC affinity: young RBC
Schizont: cluster of grapes
Gametocyte:
spherical shape---male
spherical shape---female
Cytoplasm: Schuffner’s dots
 P. Vivax P. Malariae P.Falciparum
12-24 Rosette Not seen in
Schizont chromatin pattern smear
dots 6-12 dots 18-24 dots
Spherical Spherical
(male) (male) Sausage-shaped
(males)
Gametocyte Larger Larger
spherical spherical Cresent-shaped
(females)
(female) (female
Schuffner’s Ziemann’s
Cytoplasm Maurer’s dots
dots dots
Multiple
rare Very rare common
infections
 Pneumocystis carinii
- Previously classified as sporozoa
- Recently classified as a fungus
- Transmission: inhalation
- Disease: Pneumocystis carinii pneumonia
- Manifestations:
most common opportunistic infection of AIDS patients
fever, shortness of breath, non-productive cough, death
- Diagnosis: CXR, silver staining of alveolar secretions
- Treatment: trimethoprim sulfamethoxazole, IV pentamidine
- Prophylaxis: primary--------- Co-trimoxazole
alternative------- dapsone, clindamycin, pentamidine
Toxoplasma gondii
- Obligate intracellular parasite

- Definitive host: cats

- Transmission:
ingestion of uncooked infected meat containing cysts
fecal-oral transmission
transplacental (TORCHES)
organ or blood transplantation
accidental inoculation
inhalation of cyst----- most common
- Manifestations:
fever, lymphadenopathy, splenomegaly, pneumonia
encephalitis, chorioretinitis

- Diagnosis: cranial CT scan, retinal examination, bone marrow

smear

- Treatment: sulfadiazine plus pyrimethamine

- Prevention:
cook meats completely
cleaning kitty liter with precaution
do not allow cats to scavenge for food
wash vegetables thoroughly
Quiz time

Please prepare ¼ paper

And number it 1-2
1. Etiologic agent of malaria
toxoplasma
histoplasma
plasmodium
2. Pathogenic stage
cyst
trophozoite