PARASITOS

PRESENTED BY:
BRAJAS, Angeli Nicole

NOCEDO, Tiffany N.
PARASITOS

Learning Objectives:
define symbiosis;

enumerate the different types of symbiotic relationships and

give examples for each;

classify the various forms of parasites and hosts;

enumerate the various sources of parasitic infections and cite

examples for each;

discuss the various mechanisms by which parasites produce

disease in humans;

describe the proper way of collecting and handling specimens

for laboratory diagnosis;

compare the various procedures used for laboratory diagnosis

of parasitic infections;

illustrate by means of a diagram the taxonomic classifications

of parasites.
What is Parasitology?
Parasitology is the scientific
discipline concerned with the study
of the biology of parasites and
parasitic diseases, including the
distribution, biochemistry,
physiology, molecular biology,
ecology, evolution and clinical
aspects of parasites, including the
host response to these agents.
Let's Define
Some Terms
SYMBIOSIS
This refers to the relationship wherein
unlike organisms exist together
 FORMS OF SYMBIOTIC RELATIONSHIPS

COMMENSALISM
refers to the forms of symbiotic
relationships in which two species live
together, One species benefits from the
other without harming or benefiting the
other. An example of this is the
relationship between the human body
and normal flora in the body.

Another example of this is the relationship

of leopard shark and remora

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MUTUALISM
refers to the symbiotic relationship in which two organisms mutually
benefit from each other
FORMS OF
Normal flora produces vitamin K which is essential for activity of some
of the body’s clotting factors. These flora benefit from humans by SYMBIOTIC
obtaining nutrients from the body- needed for metabolism

PARASITISM
RELATIONSHIPS
this refers to the form of symbiotic relationship where one party or
symbiont (parasite) benefits to the detriment of the other (the host).

Most common case scenarios the parasite deprives the host of

essential nutrients and produces disease in the host.
PARASITOS
Two important elements in
parasitism: the parasite and the
host. The parasites are categorized
as the organisms who depend on
the host for survival. These
parasites are classified as:
Based on habitat

1. Ectoparasites
These are parasites that live outside the host’s body ( lice,
fleas). Invasion of the body by ectoparasites are called
infestations.

2. Endoparasites
Parasites that live within the body of the host as their
environment (helminths or worms). Invasion of the body by
endoparasites is called infection. As a result of entry, the
parasites multiply within the host.
 Facultative parasites
this refers to the parasites that
can independently of the host
(i.e. free- living). These parasites

Based on the do not have to live inside a host

to complete their life cycle.

ability to live
independently
of the host Obligate parasites
parasites that must live inside a
host ( e.g. Plasmodium,
leishmania, hookworms)
Majority of the parasites that
infect humans are obligate
parasites.
BASED ON MODE OF LIVING
PERMANENT PARASITES INTERMITTENT PARASITES INCIDENTAL PARASITES
parasites that remain in a host from parasites that simply visit the host parasites that occur in an unusual host
early life to maturity (e.g Plasmodium) during feeding time

TRANSITORY PARASITES ERRATIC PARASITES

Parasites whose larva develops in a host parasites that are seen in an unusual
while the adult is free living organ, different from that which it
ordinarily parasitizes.
The hosts are the vital component of the existence of the parasites. Hosts are the
organisms that harbor, provide nourishment and environment to the parasite.
The hosts are classified into four:

DEFI NI TI VE HOST
These are hosts that harbor the adult stage of the parasite. (e.g.
humans for the intestinal roundworm - Ascaris).

Sexual stage or sexual phase of the life cycle of the parasite occurs
(malaria parasite- plasmodium.)

I NTERMEDI ATE HOST

These are hosts that harbor the larval stage of the parasite
(e.g. cysticercus larva of the beef tapeworm - taenia
saginata)
 PARASITOS

RESERVOIR HOST PARATENIC HOST

Vertebrae hosts parasites and may act as an additional These serve as means of transport for the parasite (

source of infection in man. Example of this is capillaria e.g. insect vectors) that the infective stage of a

philippinensis ( normally acquired from contaminated certain parasite may reach its final hour.

fresh water)
 Sources of exposure to infection or infestation
Exposure to parasites may occur through one or more
of the following:

1. Contaminated soil or water

2. Food containing the parasite’s infective stage
3. A blood sucking insect
4. Domestic or wild animal harboring the parasite
5. Carrier - person; via clothing, bedding or immediate
environment he or she has contaminated
6. One’s self (auto infection)

13
 COMMON EXPOSURE OR SOURCE
IS THE CONTAMINATED SOIL OR
POLLUTED WITH HUMAN FECES.

Ascaris lumbricoides, trichuris trichiura, strongyloides

stercoralis and human hookworms.

Water can be the source of the viable cysts of the parasitic amoebae and intestinal

flagellates, the larvae of the blood flukes and the eggs of the pork tapeworm Taenia

solium.

Diphyllobothrium latum- (freshwater) Fish tapeworm, intestinal and liver flukes.

Trichinella spiralis - raw pork / improperly cooked

taenia solium- raw beef

BLOOD SUCKING INSECTS
MAY SERVE AS SOURCE
FOR CERTAIN PARASITES.
Plasmodium- Female anopheles mosquito for the malaria parasite
Leishmaniasis - sand fly
trypanosoma - tsetse fly and reduviid
Filariasis- culex and mansonia
Echinococcus - direct source of infection and hydatid cyst of the dog
tapeworm
Entamoeba histolytica - human beings are directly responsible for a
considerable amount of infection with the pathogenic
Auto-infection - accounts for some of the infections and some re-infections
with hymenolepis nana
MODE OF TRANSMISSIONS:
Fecal
oral transmission: ingestion of contaminated food and water
is the most common mode of transmission of most intestinal
parasites.

These are transmitted by ingestion of contaminated water

including the intestinal protozoa ( cyst stage) and the
embryonated egg stage of the intestinal roundworms. (ascaris
lumbricoides, trichuris trichiura)

Transmitted by eating food containing larva stage of the

parasites:
Trichinella spiralis, taenia solium, taenia saginata,
diphyllobothrium latum, intestinal flukes and lung flukes.
Parasites; entry via
penetration (soil to
skin):
Hookworms and strongyloides
Contaminated
water

Blood Fluke
 Other modes of transmission:
BITE OF BLOOD-SUCKING INSECT VECTORS
(MALARIA, LEISHMANIASIS)

INHALATION OF EGGS ( PINWORM OR

ENTEROBIUS VERMICULARIS)

TRANSPLACENTAL OR CONGENITAL INFECTION

(TOXOPLASMA GONDII)

TRANSMAMMARY INFECTION - MOTHER’S MILK

( STRONGYLOIDES, ANCYLOSTOMA)

SEXUAL INTERCOURSE (TRICHOMONAS

VAGINALIS)
 ANUS URINE SPUTUM VAGINAL DISCHARGE
Most common portal of portal of exit for lung fluke (paragonimus trichomonas vaginalis
exit trichomonas vaginalis, westermani and ascaris
Eggs of medically strongyloides stercoralis lumbricoides )
important roundworms are and schistosoma
excreted through human haematobium.
feces contaminating soil
and water

Portals of Exit
IN T R ODUCTION T O P A R A S I T OL O G Y

Pathogenesis
Mechanisms of this refers to the dynamics of
any disease process.
disease
production by
Helminthic infections
parasites signs and symptoms are
manifested if there is a large
number of worms

Some pathogens do not cause physically

evident infections, symptoms and harm.
Inapparent infection can remain for a long or
short period of time of relapse. ( Malaria )
 01 Trauma or physical damage

PARASITES
DAMAGE THE 02 Lytic necrosis

HOSTS THROUGH
ONE OR MORE OF 03 Stimulation of host tissue reaction

THE FOLLOWING
04 Toxic and allergic phenomena

05 Opening of pathways of entry of other

pathogens into the tissue
 PARASITOS
Trauma or physical damage
Manifested by physical damage caused by
the parasite in the organ or at the point of
entry of the parasite.

Parasites Entry of the infective larvae of hookworms or

blood flukes into the skin may produce

damage the
physical damage.
Evidence by:

hosts through
Small lesions- from mosquito bites and
insects.
Ruptured arteries (lungs) - migration of the

one or more of larval stage of certain roundworms.

Intestinal obstruction - large number of

the following worms

21
 PARASITOS
Lytic necrosis
Enzymes and other substances produced by
many parasites are necessary for them to
digest food available in the immediate

Parasites environment may cause harm to the host

tissues.

damage the Example of this is:

hosts through
entamoeba histolytica - releases enzymes
that lyse tissues (nutritional needs).
Enzymes also enable penetration of the

one or more of tissues of the colon.

Production of ulcerations in the colon and

the following extra-intestinal viscera.

21
Stimulation of host tissue reaction
25

Common case scenario:

There is cellular proliferation and infiltration at the parasite entry site and majority of animal
parasites provoke host tissue reactions.

There is also systematic increase in certain types of cells especially those circulating in the blood.
Stimulation of red blood cell production may occur specifically in infections that lead to
mechanical loss or destruction of blood cells. This may occur in hookworm infection and
malaria.
Stimulation of neoplastic (cancer) growth in the organ infected.
Schistosoma japoncicum- infection with blood fluke may develop cancer of the liver.
Clonorchis sinensis- cancer of the biliary ducts may be seen in infection with the liver fluke.
Toxic and allergic phenomena
(Immunopathology)
Stimulation of antibody production brought by the
proteins produced by the parasites may bring
hypersensitivity or allergic reactions.

An example of this is the

Enterobius vermicularis- a pinworm infection where an
allergic reaction occurs in the anus as a response to
the female worms and eggs. Manifestations are evident
through pruritus.
 Immunopathologic reactions of humans to various parasites

01
REACTION MECHANISM RESULT EXAMPLE

Type 1: allergy and Parasite antigen + Anaphylactic Helminths: african

anaphylactic IgE attach to mast shock: trypanosomiasis

cells -> histamine bronchospasm

02
release : local
inflammation
Type 2: antibody- Antibody + Lysis of cell- Trypanosoma cruzi
mediated parasite antigen bearing
on cell surface -> parasite
complement antigens
activation or ADCC
 Immunopathologic reactions of humans to various parasites

01
REACTION MECHANISM RESULT EXAMPLE

Inflammation
Type 3: immune Antibody+
Malaria, schistosomiasis,
tissue
complex extracellular
trypanosomiasis
damage ;
antigen complex complex

02
deposition in
organs and
tissues
Type 1: allergy and Sensitized T cell Inflammation,
Leishmaniasis,
anaphylactic reaction with mononuclear
schistosomiasis,

antigen, release of accumulation,

trypanosomiasis

lymphokines, macrophage
triggered activation;
cytotoxicity tissue damage
Opening of pathways for entry of other pathogens into the
tissues

The damage produced of parasites may bring entry and proliferation of other organisms. Case scenario of infection
located at the anus causes irritation and itching sensation. Superficial erosions may result due to the scratching of
anus brought by the itching sensation. These erosion may serve as the point of entry for bacteria surrounding the
anus area. Secondary bacterial infection brought by the bacteria contained feces near the eroded area.
PARASITOS

General Life Cycle of Parasites

Parasites comes in contact
with humans (Mode of
Transmission)
Parasites emerge from water,
Parasite enters and establishes
food, soil, or intermediate hosts
residence in or on human
(Infective Stage)
Morphologic form that infects

humans.

Parasites comes in contact

with soil or water and other
intermediate hosts (Source of
Infections)
Parasites emerges from
humans (Diagnostic Stage)
Parasites enters outside
Morphologic form thatcan be
environment
detected through laboratory

methods.
CLASSIFICATION
OF PARASITES
 INTRODUCTION TO PARASITOLOGY

TWO MAJOR GROUPS:

PARASITES

PROTOZOA HELMINTHS
Single celled. Multicellular
(Parasitic) classified into four (Parasitic) worms subdivided into
groups based on motility and two phyla: Nemathelminthes
reproduction. (roundworms) and
Amoeba and flagellates (phylum Platyhelminthes (flatworms)
Sarcomastigophora), sporozoa Flatworms are composed of two
(phylum Apicomplexa), and classes: Trematoda (flukes) and
ciliates (phylum Ciliophora) Cestoda (tapeworms)
12
PROTOZOA BIOLOGIC, MORPHOLOGIC, and PHYSIOLOGIC CHARACTERISTICS

01
AMOEBA Unicellular; cyst and Binary fission Pseudopods Facultative anaerobe pinocytosis or
Assimilation by

trophozite forms phagocytosis

FLAGELLATES Unicellular; cyst and Binary fission Flagella Facultative anaerobe Simple diffusion or ingestion

trophozite forms via cytostome, pinocytosis,

or phagocytosis

02
CILIATES Unicellular; cyst and Binary fission Cilia Facultative anaerobe Ingestion viacytostome, food
trophozite forms or conjugation vacuole

SPOROZOA Unicellular; Schizogony None Facultative anaerobe Simple diffusion

frequently and
intracellular; multiple sporogony
forms, including

trophozoites,

sporozoites, cysts

(oocysts), gametes
HELMINTHS BIOLOGIC, MORPHOLOGIC, and PHYSIOLOGIC CHARACTERISTICS

01
CESTODES Multicellular; head Binary fission Pseudopods Facultative anaerobe Absorbtion of nutrients from

with segmented body intestines

(proglottids); lack of
digestive tract; head

equipped with hooks

02
and/or suckers for

attachment No single
Hermaphroditic; organelle; usually
Adults usually Ingestion or absorption
TREMATODES Multicellular;leaf- Schistosoma attachment to
anaerobic ofbody fluids, tissue,
shaped with oral and spp. mucosa;
or digestive contents
ventral suckes, blind has separate possible muscular

alimentary tract sexes motility

NEMATODES Multicellular; round-

Separate No single Adults usually Ingestion or absorption

smooth, spindle-
sexes organelle; active anaerobic; larvae ofbody fluids, tissue,
shaped, tubular
muscular motility possibly aerobic
or digestive contents
digestive tract:

possibility of teeth or

plates for attachment

Gallery
FLORISTA

Laboratory
Diagnosis of
Parasitic
Infections
INTRODUCTION TO
PARASITOLOGY

For instance, the most common portal of entry

for parasites is the mouth. As such, the most
common portal of exit is the anus, in which case
the proper specimen to collect is the stool
Thus, multiple specimens may be needed for
adequate detection.
This involves collection of three specimens, one
specimen collected every other day.
Laboratory Diagnosis
SPECIMEN COLLECTION, 2021

HANDLING, AND TRANSPORT

11.

Timing of specimen collection is important.

Fresh specimens must be used to
demonstrate the motility characteristics of a
protozoan parasite.
The diagnostic stage for most protozoans is
the trophozoite, which is usually found in
liquid stool.
Preservatives or fixatives may be added if
the specimen cannot be examined right
away.

Formalin, polyvinyl alcohol, sodium acetate

formalin, and modified polyvinyl alcohol
PARASITOS

COLLECTION OF STOOL
SPECIMEN

Must be collected in a clean, No contamination with urine must Stool should be collected from

water-tight container and should be allowed. water from the toilet bowl.

be covered tightly.
 LABORATORY DIAGNOSIS OF PARASITIC
INFECTIONS

Reminders

Proper labelling of the container Information other than the patient

must be observed, accompanied by general data may be included.
the fully accomplished request
form.

Once the specimen container is Universal precautions must be

sealed, it must be placed in a observed when handling all
ziplock plastic bag for transport to specimens.
the laboratory.
20
Microscopic
Examination

Three Stages:
Direct Wet Preparation
Concentration Techniques
Use of permanent stains
PARASITOS

Place small amount of unxfixed

stool on a glass slide

Add a drop of 0.85% saline

Direct wet preparation Mix using wooden applicator

or direct wet mount stick

To detect the presence of motile protozoan trophozoites;

Place a cover slip on the slide
other stages detected include cysts, oocysts, ova, and larvae

of worms

Examine slide using both lower-

(Small portion of unfixed stoll is mixed with saline or iodine) power and high-power objectives
 SEDIMENTATION (FORMALIN-ETHYL
ACETATE SEDIMENTATION PROCEDURE)

Principle: This is based on specific gravity.

Procedure: Ethyl acetate is added to a saline-washed
Concentration techniques can be used on formalin-fixed sample in a test tube and then centrifuged.
both fresh and preserved specimens. Two Advantage: It provides good recovery of most parasites.
types of concentration techniques are It is easy to perform.
available (flotation and Disadvantage: The preparation contains more fecal debris
sedimentation). than a floation technique.

ZINC SULFATE FLOTATION TECHNIQUE

Principle: This is based on the differences in specific gravity

CONCENTRATION and the sample debris.
Advantage: It is able to remove more fecal debris that will
METHODS yield a cleaner preparation.
Disadvantage: Some helminth eggs are denser and may not
To aggregrate parasites present into a small float to the upper layer of the test tube.
volume of the sample

Toremove debris and other contaminants

that might interfere with the microscropes
Permanent Stains
Final step of the microscopic examination.

A small amount of the fixed sample is placed on a slide glass

and allowed to dry after which it is stained.
A cover slip is then placed after which a sealant is applied.
Thus, allowing the sample to remain intact for a longer period.
It is designed to confirm the presence of cysts and/or
trophozoites of protozoans.

Wheatly trichome stain (most widely

16
used)
Other Specimens and Laboratory Procedures

Introduction to Parasitology

Duodenal Material Sigmoidoscopy Material

It may be collected using a nasogastric tube It is used to collect and examine material from the
(NGT) or through the enteric capsule test colon.
(Entero-test).
Cellophane Tape or Scotch Tape

The collected fluid must be examined Preparation

immediately. A volume of > 2 ml is

This procedure is done to detect the eggs of the
recommended.
pinworm Enterobius vernicularis.

In the Entero-test, the patient is made to

The procedure must be done first thing in the
swallow a gelatin capsule that contains a coil
morning, before the patient defecates or washes.
of yarn that is weighted.

It is also used to detect the eggs of the tapewrom

The bile-stained material attached to the
Taenia spp.
string is examined microscopically with wet
preparation followed by application of
permanent stains.
Other Specimens and
Laboratory Procedures

Cerebrospinal Tissue and

Blood
Fluid biopsy
This examination can detect the
CFS may be used to diagnose
specimens
presence of blood-borne
certain amebic infections and It may be utilized to detect the
parasites such as Leishmania
with African sleeping sickness. presence of Leishmania, and
and the filarial worms.
Taenia solium in tissues.
Blood from the fingertip or It must be immediately
examined if detection of In patient with
earlobe may be used (without
parasite motility is desired. suspectedamebic liver abscess,
anticoagulant) or from standard
the abscess material taken
venipuncture (with
Wet preparations can be done from the liver is the specimen
anticoagulant).
to detect characteristic of choice.
morphologic forms of
Typanosoma and
Echinococcus.
 01
Urine samples are centrifuged and the
sediments examined for the presence of
parasties. It may also be collected using a
sterile cotton swab.

Genitourinary 02 If detecting Schistosoma haematobium, the

specimen of choice is urine.

Secretions

03
Saline wet preparations is then performed
to demonstrate the trophozoite of the
parasites.
 OTHERS Skin fluid;
making a small
cut into the skin
with a razor
Loa loa
blade

MOUTH
EYE SCRAPINGS
SPUTUM SKIN SNIPS XENODIAGNOSIS
SPECIMENS AND NASAL
DISCHARGE

Paragonimus westermani E. gingivalis Chaga's

Larvae of hookworms disease
Typanosoma
cruzi 09
THANK YOU!