CHAPTER 1 - MT 112

TERMS

SYMBIOSIS • Living together, each of different species

COMMENSALISM • Beneficial to one, neutral to the other
MUTUALISM • Beneficial to both
PARASITISM • Beneficial to one at the other’s expense
COMMENSAL • Relating to commensalism

PATHOGENIC • Parasite that has demonstrated the ability

to cause disease
DISEASE • A destructive process that has
characteristic symptoms
VECTOR • An insect that transports a parasite from
an infected host to an uninfected host
MICRONS • The official units of parasite measurement
EXCYSTATION • Morphologic conversion from cyst form to
trophozoite form
• Occurs in the ileocecal area of intestine
ENCYSTATION • Conversion from trophozoite form to cyst
form
• Occurs in the intestine when the
environment becomes unacceptable for
continued trophozoite multiplication
INFECTION • Invasion IN the body
INFESTATION • Invasion ON the body
 MODES OF TRANSMISSION POPULATIONS AT RISK

• Ingestion of contaminated • Individuals in

food/drink underdeveloped
ex. Toxoplasma gondii: areas/countries
definitive host (cats) • Refugees
> transplacental/congenital • Immigrants
Entamoeba histolytica: • Visitors from foreign
Definitive host (humans) countries
> most pathogenic in amoeba • Immunocompromised
> causative agent of primary individuals
amebic encephalins • Individuals living in close
• Hand-to-mouth transfer quarters
• Insect bite • Children who attend
Giardia lamblia: daycare centers
Definitive hosts (dogs and cats)
> non-bloody, foul smelling
diarrhea; high incidence in
daycare centers and mental
hospitals
ex. Trypanosoma:
intermediate host/vector
(glossina spp.)
Plasmodium malariae:
intermediate host (humans)
definitive host/vector (insects)
Plasmodium falciparum:
intermediate host (humans)
definitive host/vector (insects)
> most severe infection among
plasmodium
• Entry via drilling through the
skin
• Unprotected sexual
relations
ex. Trichomonas vaginalis:
definitive host (humans)
• Mouth-to-mouth contact
• Droplet contamination
• Eye contact with infected
swimming water
• Inhalation of airborne eggs
ex. Enterobius vermicularis:
definitive host (humans)
TYPE OF PARASITE

OBLIGATORY • Parasite that cannot survive outside of a

host
• Parasite that need a host to their life
cycle to complete its development at
propagate their species
FACULTATIVE • Parasite that is capable of existing
independently of a host
• Exist in free living state or may
become parasitic when the need
arises
ENDOPARASITE • Parasite that is established inside of a
host
ECTOPARASITE • Parasite that is established in or on
exterior surface of a host
ACCIDENTAL/INCIDENTAL • Parasite w/c establishes itself in a
host where it does not ordinarily live
TEMPORARY • Parasite that lives in a host for a short
period of time
PERMANENT • Parasite that remains in the body of
the host for entire life
SPORIOUS • A free- living organism that passes
through digestive tract w/o infecting
the host

TYPE OF HOST

DEFINITIVE/FINAL/PRIMARY • Host in which the adult sexual phase of

parasite development occurs
INTERMEDIATE • Host in which the larval asexual phase of
parasite development occurs
PARATENIC • Parasite don’t develop further
• Life cycle doesn’t continue but
becomes another source of infection
RESERVOIR • Host harboring parasites that are
parasitic for humans and from which
humans may become infected
• Allows to continue the life cycle of the
parasite and become additional
source of infection
ACCIDENTAL/INCIDENTAL • Host other than the normal one that is
harboring a parasite
TRANSPORT • Host responsible for transferring a
parasite from one location to another
CARRIER • Parasite-harboring host that is not
exhibiting any clinical symptoms but can
infect others
PARASITIC LIFE CYCLES

INFECTIVE STAGE • Morphologic form that invades humans

DIAGNOSTIC STAGE • Can be detected via laboratory retrieval
methods

AMEBIC LIFE CYCLE

TROPHOZOITE • Form that feeds, multiplies, and

possesses pseudopods
• Infective stage of parasite
• Found in watery stools
CYST • Nonfeeding stage characterized by a thick
protective cell wall for protection
• Resistant to dessication
• Sexual intercouse/Trichomonas vaginalis

MAJOR BODY AREAS ASSOCIATED WITH SYMPTOMS ASSOCIATED WITH PARASITIC

DISEASE
PARASITIC DISEASE PROCESSES PROCESSES
• GI tract • Diarrhea
• UG tract • Fever
• Blood & Tissue • Chills
• Liver, lung, and other major organs • Abdominal pain/cramps
• CSF, eye, skin, and extremities • Elephantiasis
• Anemia
• Vitamin deficiency
• Bowel obstruction
• Edema
• Enlargement of major organs
• Skin lesions
• Blindness
TREATMENT PREVENTION

• Antiparasitic medications • Devp and implementation of parasite

• Change in diet awareness education programs
• Vit supplements • Use of insecticides/other chemicals
• Fluid replacement • Protective clothing
• Blood transfusion • Protective netting
• Bed rest • Proper water treatment
• Good personal hygiene
• Proper sanitation
• Proper handling, cooking, and protection
of food
• Avoidance of unprotected sexual
relations

NEWER PARASITE LAB DIAGNOSIS TECHNIQUES

• Direct fluorescent antibody (DFA)

• Enzyme immunoassay (EIA)
• Indirect fluorescent antibody (IFA)
• Latex agglutination (LA)
• Polymerase chain reaction (PCR)
• Rapid immunochromatography technique
 CHAPTER 2

STOOL EXAM FOR O&P

A. MACROSCOPIC EXAM B. MICROSCOPIC EXAM

• Determine consistency, color, and gross
abnormalities of the sample 1. Collection
• 3 specimens: one specimen collected
every other day or a total of 3 collected
in 10 days **Amebiasis 6 specimen in
14 days
• Patients whose therapy includes
barium, bismuth, or mineral oil: should
be collected prior to therapy or not
until 5-7 days after the completion of
therapy
• Patients who took
antibiotics/antimalarial medications:
should be collected delayed for 2
weeks ff. therapy
• Sample should be collected in a clean,
watertight container with a tight-fitting
lid
• Acceptable amount: 2-5g (size of a
walnut)
• Urine contamination is not allowed: it
may destroy some parasites
• Should not be retrieved from toilet
bowl water b/c free-living protozoa and
nematodes may be confused with
human parasites
• Water may destroy select parasites
such as schistosome eggs and amebic
trophozoites
2. Transport
• Should be labeled with the Px’s name
and ID number, physician’s name, and
the date & time of collection
• Form of request should accompany the
specimen (separated)
• Should be placed into a ziplock plastic
bag for transport
• Handler should be wearing PPE
• Protozoan Trophozoites, a fresh
specimen is required, it is found in
Liquid stool (w/in 30 mins of passage)
• Mixture of protozoan cysts and
trophozoites is found in
 Semiformed stool (w/in 1 hr of
passage)
• Not likely to contain any in
Formed stool (w/in 24 hrs ff.
collection)

3. Fixatives/Preservatives
• Are substances that preserve the
morphology of protozoa and prevent
further devp of certain helminth eggs
and larvae
• Ratio: 3f:1s
• Specimen must be fixed in the
preservative for at least 30 mins before
processing begins
1. Formalin • All-purpose
fixative for
the recovery
of protozoa
and helminths
• 5%:
protozoan
cysts
• 105: helminth
eggs and
larvae
• Easy to
prepare, long
shelflife
✔ direct
examinations
✔ concentration
procedures
✘ permanent
smears
2. Polyvinyl • Comprise of
Alcohol plastic pwder
(PVA) that acts as an
adhesive for
the stool
specimen for
staining
• Most often
combined
with
Schaudinn
soln
• contains
mercuric
chlorid
 ✔ permanent
stains smear
✔ concentration
procedures
✘ recovery of
certain parasites
is not as effective
3. Sodium Acetate • Viable alt to
Formalin (SAF) the use of
PVA +
Schaudinn
fixtaive
• Mercury-free
• Adhesion is
weak:
Albumin on
slide
✔ permanent
stains smear
✔ concentration
procedures
4. Modified Polyvinyl • Alt to
Alcohol mercury-
based PVA
• Do not
provide the
same quality
for
preservation
✔ permanent
stains smear
✔ concentration
procedures
5. Alt Single-Vial • Formalin-free
Systems and mercury-
free
• Do not
provide the
same quality
for
preservation
• Fecal
immunoassay
✔ permanent
stains smear
✔ concentration
procedures
Direct Wet Preps Concentration Methods Permanent Stains
Direct saline wet prep: Formalin-Ethyl Acetate Wheatley Trichrome
• A drop of 0.85% saline Sedimentation Procedure • Most widely used
on glass slide • Based on specific • Easy to perform
• Mix with a small gravity • Relatively long shelf
portion of unfixed • Ethyl acetate is added
stool to a saline-washed
formalin-fixed sample
and the tube is then
centrifuged

Direct iodine wet prep: Zinc Sulfate Flotation Iron Hematoxylin

• A drop of iodine Technique • Excellent morphology
(Lugol’s/D’anton’s • Based on specific
formula) gravity
• Mix with a small • Zinc sulfate with a
portion of unfixed specific gravity of 1.18
stool to 1.20, is added to the
specimen and
centrifuged
Specialized Stains
• They do not detect
oocysts of coccidian
parasites or spores of
microsporidia
• Detection of the
oocytes of
Cryptosporodium,
Isospora, Cyclospora