PARASITOLOGY REVIEW NOTES – REVISED JULY 2022

INTRODUCTION
:
HOST-PARASITE RELATIONSHIPS
1. SYMBIOSIS — living together of phylogenetically different organisms e.g., host and parasites
2. MUTUALISM — beneficial to both organisms
3. COMMENSALISM — beneficial to one organism, neutral to the other
4. PARASITISM — one organism benefits, the other is harmed
HOST
DEFINITIVE Harbors the adult/sexual stage harbors a parasite that does not
of parasite develop but remains alive and is
able to infect another susceptible
host
INTERMEDIATE Harbors the larval/ asexual animal that allows the
stage of parasite parasite’s life cycle to
continue and become an
additional source of human
infection
PARASITE
Ectoparasites those outside the body of the Accidental/incidental Occurring in an unusual host
host
Endoparasite Those inside the body of the Erratic Occurring in an unusual habitat
host
Facultative capable of parasitic and free- Intermittent Visits the host during feeding time
living existence
cannot live without a host; Zoonotic
depends entirely upon its host
for existence
Permanent Can complete its cycle in Periodic requires for the larval and
________host adult stages
Transitory Larval stage passed in a host
but adult is free living
VECTOR
Biologic Mechanical

MEDICALLY IMPORTANT PARASITES:

A. Helminths or worm parasites
Nematodes ______________________; Trematodes ____________________; Cestodes __________________
B. Non-Helminths or non-worm parasites
2.1 Protozoa (Amoeba, Flagellates, Ciliate, Sporozoa, Microsporidia)
2.2 Arthropods _____________________________________________________

ARTHROPODS
Pediculus humanus capitis Cimex spp. __________________ Mosquitoes
Pediculus humanus corporis Mosquitoes (Wuchereria, Plasmodium & Brugia)
Pthirus pubis Fleas Ticks (Babesia)
Sarcoptes scabiei Ticks Biting flies Bugs (T. cruzi)
Biting Flies (Leishmania spp. &
Trypanosoma brucei complex, Filariae)
Beatles, cockroaches & Fleas

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 PARASITOLOGY REVIEW NOTES – REVISED JULY 2022
S

PROTOZOA

INTESTINAL & HABITAT EFFECT TO DEVELOPMENTAL INFECTIVE STAGE MODE OF

ATRIAL HOST STAGE TRANSMISSION
AMOEBA
E. histolytica Pathogenic Cyst & Trophozoite Ingestion / fecal -
E. coli oral route
E. nana
I. butschlii
E. gingivalis Trophozoite Oral contact

CYST TROPHOZOITE
 Usually, infective  Usually not infective
 Found in formed feces  Found in liquid feces
 Resistant to damage  Susceptible to damage; easily disintegrates
 Usually Smaller than trophozoite  Usually larger than cyst
 Best visualized using iodine  Best seen using permanent stains

INTESTINAL & CYST TROPHOZOITE

ATRIAL AMOEBA SIZE NUMBER CHROMATODIAL SIZE KARYSOME CYTOPLASMIC
OF BODIES INCLUSIONS
NUCLEI
Entamoeba 10-20 12-60 um
histolytica um
Entamoeba coli 10-35 Splintered ends; 15-50 um Bacteria, food
um with broomstick vacuoles &
appearance debri
Endolimax nana 5-10 Small spherical 6-12 um
um
Iodamoeba butschlii 5-20 8-20 um Surrounded with
um achromatic
granules
Entamoeba Unable to produce cyst 10-20 um Central & Food vacuoles
gingivalis DISTINCT and

NOTES
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________

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 PARASITOLOGY REVIEW NOTES – REVISED JULY 2022

INTESTINAL AMEBIASIS
1) ACUTE/SYMPTOMATIC – bloody diarrhea, abdominal pain; patient passes out
________________in feces
Entamoeba 2) chronic/asymptomatic – stool consistency is NORMAL, patients are CARRIERS; patient passes
histolytica out _____________________in feces

EXTRAINTESTINAL- trophozoite is TISSUE INVADING

Most common form of extraintestinal amebiasis
________________________________________________________________________________________
_
EXTRAINTESTINAL CYST TROPHOZOITE IMPORTANT NOTES
& ZOONOTIC SIZE NUMBER
AMOEBA OF
NUCLEI
Entamoeba dispar 10-20 4 Bacteria; NO RBCs
um
Entamoeba hartmanni 5-10 um
Entamoeba polecki May appear like E. histolytica but is zoonotic infecting pigs & monkeys

FACULTATIVE CYST # OF TROPHOZOITE IMPORTANT NOTES

AMOEBA SIZE NUCLEUS
Naegleria fowleri 7-15 1 Measures 10-35 um Infective stage: amoeboid trophozoite
um With amoeboid & flagellated
forms Diagnostic stage: trophozoite in CSF &
Brain Tissues; flagellated forms
occasionally in CSF

Cyst is NOT SEEN in brain tissues; cyst

has ______________wall

Flagellated forms with _____flagella and

is RAPIDLY MOTILE
Acanthamoeba 10-25 1 Measures 15-45 um Infective stage: Cyst & trophozoite
spp. um With spine like projections
ACANTHOPODIA Diagnostic stages: Cyst and
trophozoites in tissues;

cyst has OUTER _________________wall

Trophozoite has spine like process

called ACANTHOPODIA; SLOWLY
MOTILE
Balamuthia - Isolated from soil and dust or from autopsy specimens of infected humans & animals
mandrillaris - Infective stages: cyst and trophozoite
- Can enter thru 1) nasal passages and 2) ulcerated or broken skin
- Cyst & trophozoites in tissues; cyst is 10-25 um with DOUBLE CYST WALL

NOTES
________________________________________________________________________________________________________
________________________________________________________________________________________________________
______________________________________________________________________________________________________
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 PARASITOLOGY REVIEW NOTES – REVISED JULY 2022

INTESTINAL & ATRIAL HABITAT DEVELOPMENTAL INFECTIVE MODE OF

FLAGELLATES STAGE STAGE TRANSMISSION

G. lamblia

CYST AND
C. mesnili TROPHOZOITES INGESTION
R. intestinalis
E. hominis
D. fragilis
Pentatrichomonas hominis

Trichomonas vaginalis GUT TROPHOZOITE SEXUAL CONTACT

Trichomonas tenax ORAL CONTACT

CYST
ATRIAL & LUMINAL SHAPE/SIZE NUMBER OF IMPORTANT NOTES
FLAGELLATES NUCLEI
Giardia lamblia Ovoid
8-15 um
Chilomastix mesnili Lemon or Nipple curved fibril alongside of cytostome, usually
7-10 um referred to as a

Enteromonas hominis Ellipsoidal Resembles cyst of

6-8 um
Retortamonas intestinalis Ovoid or Pyriform fibrils extend above nucleus giving it a
4-7 um

G. lamblia C. mesnili E. hominis R. intestinalis

TROPHOZOITE
ATRIAL & LUMINAL NUMBER # OF MOTILITY IMPORTANT NOTES
FLAGELLATES OF NUCLEI FLAGELLA
Giardia lamblia
Chilomastix mesnili Stiff, rotary
Enteromonas hominis Jerky slow directional
Retortamonas intestinalis Rapid directional corkscrew

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 PARASITOLOGY REVIEW NOTES – REVISED JULY 2022

FLAGELLATES WITHOUT CYSTIC FORMS

Dientamoeba - ________________________________________________________
fragilis - Trophozoite is 5-15 um
- With ___________________________________________________pseudopodia
- Karyosome is composed of a cluster of 4-8 granules; often referred to as
________________________________________________________________

Pentatrichomonas - As to size - P. hominis is 5-15 um; T. tenax is 5-12 um and T. vaginalis measures 7-23
hominis um
Trichomonas - With RAPID JERKY MOTILITY
tenax - Equipped with __________________________ and _____________flagella
Trichomonas - Axostyle EXTENDS BEYOND THE BODY
vaginalis
 Causes Giardiasis, lambliasis or Traveller’s diarrhea, can cause GAY BOWEL SYNDROME among
HOMOSEXUAL MEN:
______________________________________________________________________________________________
 May carry D. fragilis trophozoites in its eggs
_____________________________________________________________
 T. vaginalis can cause Trichomoniasis; vaginitis; urethritis; prostatitis

THE HAEMOFLAGELLATES -BLOOD & TISSUE FLAGELLATES

AMASTIGOTE / leishmania Oval shaped; with nucleus & kinetoplast but NO undulating membrane &
flagellum

PROMASTIGOTE/ leptomonas Elongated with nucleus, kinetoplast & flagellum but NO undulating membrane

EPIMASTIGOTE / crithidia With nucleus, kinetoplast, flagellum & undulating membrane

Kinetoplast is ____________________the nucleus
TRYPOMASTIGOTE / With nucleus, kinetoplast, flagellum & undulating membrane
trypanosoma Kinetoplast is ____________________the nucleus

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 PARASITOLOGY REVIEW NOTES – REVISED JULY 2022

HAEMOFLAGELLATES VECTOR DEVELOPMENTAL INFECTIVE DISEASE CAUSED

STAGES STAGE
TO MAN
Leishmania donovani Kala-azar Fever / Visceral
leishmaniasis
Dumdum Fever/ Death fever
Phlebotomus Amastigote Tropical splenomegaly /
spp Promastigote Black disease
Leishmania braziliensis Muco-cutaneous
Leishmaniasis
Espundia, Uta, Chiclero
Ulcer
Leishmania tropica Cutaneous Leishmaniasis/
Delhi Ulcer
Baghdad Boil, Aleppo

NOTES__________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
HAEMOFLAGELLATES VECTOR DEVELOPMENTAL INFECTIVE DISEASE CAUSED
STAGES STAGE
TO MAN
Trypanosoma brucei Glossina spp Epimastigote Metacyclic
gambiense Trypomastigote trypanosome
Trypanosoma brucei
rhodesiense
Trypanosoma cruzi Reduviid, All 4 stages Metacyclic
Triatoma, trypanosome
Panstrongylus
spp.

African Sleeping Sickness Chaga’s Disease

Old World Trypanosomiasis South American Trypanosomiasis
New World Trypanosomiasis
Lesion at bite site: Trypanosome chancre Lesion at bite site:
blood invasion __________________________________
lymph node ____________________________________
CNS __________________________________________ unilateral conjunctivitis or orbital edema called
RAPIDLY FATAL: _______________________________
Longer course ______________________________________

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 PARASITOLOGY REVIEW NOTES – REVISED JULY 2022

CILIATE- Balantidium coli

 Common parasite of pigs; habitat ________________________; regarded as the largest intestinal protozoa
 Cyst has Macronucleus __________________________________________________________________
and Micronucleus_______________________________________________________________________
 Trophozoites shows __________________________________________motility;
 with cytostome & cytopyge
_________________________________________________________________
Cytostome _______________________________cytopyge
_______________________________________
 Causes balantidiasis or balantidial dysentery, a tissue invading protozoa – produce lesions & ulcers with wide
neck & round bases

MALARIAL PARASITES-GENUS PLASMODIUM

Species: P. falciparum – P. malariae – P. ovale – P. vivax and P. knowlesi
General characteristics:
1. arthropod -borne ________________________________________________________________________
2. Mode of transmission: Primary Mode ________________________________________________________
Other modes of transmission __________________________________________________________
3. infective stage to Man: SPOROZOITES while infective to vector are GAMETOCYTES (male and female)
4.Intraerythrocytic parasites ____________________________________________________________________
5. Life cycle has 2 phases
5.1 SEXUAL or SPOROGONY CYCLE – happens in the vector
5.2 ASEXUAL or SCHIZOGONY CYCLE – happens in MAN
a) exo-erythrocytic cycle _______________________________
b) erythrocytic cycle __________________________________
6. require 2 hosts
Definitive host _________________________-host for the sexual/sporogony cycle
Intermediate host ______________________-host for the asexual cycle/schizogony
Diagnosis: Examination of Thick and Thin Blood Smear
 Thick smear is for ________________________________& must be ________________________________prior
to staining
 Thin smear is for ________________________________ & must be ___________________________ prior to
staining
 Best time to collect blood for Malaria ______________________________________________________________

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 PARASITOLOGY REVIEW NOTES – REVISED JULY 2022

MALARIAL Plasmodium Plasmodium vivax Plasmodium malariae Plasmodium ovale

PARASITES falciparum
Intraerythrocytic Young, immature, Young, immature,
Can infect juvenile RBCs juvenile RBCs
i.e Reticulocytes i.e Reticulocytes
Appearance of No change in RBC Enlarged RBCs RBCs are reduced in Enlarged RBCs
Parasitized RBCs size size
RBC Stippling MAURER’s dots Schuffner’s granules Ziemann’s James dots

Length of
Asexual cycle
Stages seen in Ring and Gametocyte
the blood
Disease caused

Plasmodium knowlesi
- The 5th Human Malaria causes Simian malaria
- 24 hrs cycle
- Infect any RBCs regardless of age; Infected RBCs usually normal size
- No schuffner’s dots; with 16 merozoites and Round Gametocytes
- Early stages mimic P. falciparum
- Late stages mimic P. malariae

ADDITIONAL INFORMATIONS:
 _____________________-classical sign of malaria characterized by chills fever and sweating
 Duffy negative individuals may show resistance to __________________________________________
 Associated with G6PD Deficiency _______________________________________________________
 May cause relapse due to persistence of Hypnozoites _______________________________________
 Individual with sickle cell anemia trait may show resistance to _________________________________
 Blackwater fever – complication that may develop following P. falciparum infection characterized by chills
fever & sweating
OTHER PROTOZOA
 ____________________________________ a cyanobacteria like body that shows AUTO-FLUORESCENCE
 __________________________ intraerythrocytic parasite transmitted thru Tick Bites (Ixodes spp) and can
develop trophozoites with Maltese cross appearance; may resemble P. falciparum
 _________________________ can cause mild diarrhea among healthy people but fatal diarrhea in those who
are immunocompromised.
 _______________________is both the infective and diagnostic stage of C. parvum and C. cayetanensis
 _______________________ a protozoan parasite requiring feline/cats as definitive host, can be detected thru
SABIN FELDMAN dye test (serologic tests). Man serves only as its intermediate host
 Mode of Transmission for T. gondii __________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________

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NEMATODES

CHARACTERISTICS:
(1) Adult worms with cylindrical, UNSEGMENTED bodies, commonly referred to as
______________________________
(2) Adults with separate sexes; Males- with dorsally curved tail while Females- with straight tail
(3) equipped with cephalic chemoreceptors; some are with caudal chemoreceptors
With CAUDAL CHEMORECEPTORS ___________________________________________
NO CAUDAL CHEMORECEPTORS /APHASMIDS:
INTESTINAL HABITAT COMMON FEMALE INFECTIVE DIAGNOSTIC MOT
_______________________________________________________
NEMATODES NAME STAGE STAGE
Ascaris Giant EMBRYONATED
lumbricoides Intestinal OVIPAROUS EGG
Roundworm EGGS/
Eel worm OVA
Trichuris Whipworm
trichiura
Enterobius Pinworm OVOVIPAROUS Ingestion
vermicularis Seat worm Inhalation

Capillaria Pudoc worm LARVA Ingestion of

philippinensis larva ff:
consumption
of
inadequately
cooked or
raw fishes
Human OVIPAROUS FILARIFORM
Hookworms LARVA
Necator New World
americanus Hookworm

Ancylostoma Old World

duodenale Hookworm

Strongyloides Threadworm OVOVIPAROUS RHABDITIFORM

stercoralis LARVA

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 PARASITOLOGY REVIEW NOTES – REVISED JULY 2022

OVIPAROUS Female nematodes that produce Ascaris, Trichuris, hookworms

eggs WITHOUT larva in its shell
OVOVIPAROUS Female nematodes that produce Strongyloides, Enterobius
eggs WITH fully developed larva in its
shell
VIVIPAROUS / Female nematodes UNABLE to T. spiralis and all Filarial worms, Dracunculus
LARVIPAROUS produce eggs instead deliver fully medinensis
developed larva

SPECIES EGG
Ascaris lumbricoides produces fertilized and Unfertilized eggs

Fertilized eggs with THICK shell

Unfertilized eggs usually with THIN shell

Shell outer layer: MAMILLATION

Eggs without mammilation may be referred to as:

Trichuris trichiura Barrel shaped; Football shaped

Lantern shaped with PROTRUDED mucus plugs/polar plugs
Eggs often referred to as:

Enterobius vermicularis D-shaped, flat on one side; lopsided with thin shell that encloses a motile larva
Capillaria philippinensis PEANUT shaped, with FLAT POLAR PLUGS and with striated shell
Human Hookworms RULE:
Necator americanus
Ancylostoma duodenal Ovoid, with thin shell containing 2-8 germ cells that resembles a MORULA BALL

Strongyloides stercoralis Similar to those of hookworms but are usually embryonated

NOTES
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________

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 PARASITOLOGY REVIEW NOTES – REVISED JULY 2022

ADDITIONAL INFORMATIONS:
 Rhabditiform Larva of S. stercoralis is 225 um long and has __________________________ buccal cavity- length
is HALF THE WIDTH of the BODY; and ________________________________genital primordium

 Rhabiditiform Larva of Hookworms have a length of 250 um with ____________________ buccal cavity-length is
EQUAL TO THE WIDTH of the BODY; and _______________________________ genital primordium

 Filariform larvae of Hookworms have a length of 700 um with

1) _____________________esophagus; 2) pointed _______________________ tail end and is 3) SHEATHED

 Filariform larvae of S. stercoralis has a length of 550 um with

1) ___________________ esophagus; 2) ____________________________tail end and is 3) UNSHEATHED

 E. vermicularis can cause Enterobiasis/Pinworm Infection - __________________________itchiness of anal region

caused by female migration
 Heavy Trichuriasis can lead to ________________________________________________
 Hookworm infection can cause ________________________________________________
 A. lumbricoides can cause intestinal ascariasis and ascaris pneumonitis called LOEFFLER’s SYNDROME – due
to migration of larva to the lungs
 Characteristic symptom of Capillariasis is called ______________________________________
 With eggs often referred to as CHINESE LANTERN OVA _________________________________
 Regarded as Unholy 3 ________________________________________________;
 with Lung Migration in cycle ______________________________________________
 equipped with cuticular alar expansion and well-defined esophageal bulb _________________________________
 Adult hookworms (male and female) have buccal cavity with dental pattern. Hookworms’ species with 1 pair of
teeth ______________________; with 2 pairs of teeth ______________________________; with 3 pairs of teeth
_______________________________________and with semi-lunar cutting plates

Male Necator
americanus

Male
Ancylostoma
duodenale

HELMINTHS – FILARIAL WORMS

General characteristics:
1) extraintestinal nematodes
2) arthropod-borne _____________________________________________________
3) Female worms are ___________________________________________________
4) infective stage to man _________________________________________________
5) diagnostic stage ______________________________________________________

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 PARASITOLOGY REVIEW NOTES – REVISED JULY 2022

FILARIAL WORMS HABITAT VECTOR

W. bancrofti Mosquitoes
(Aedes, Culex, Anopheles, Mansonia spp)
B. malayi Mosquitoes
(Mansonia spp)
L. loa Chrysops fly
Mango fly, Deerfly
M. perstans Midges (Culicoides Flies)
M. ozzardi
M. streptocerca Dermis of skin, less than 1mm
from skin surface
O volvulus Black Flies

FILARIAL WORMS MICROFILARIA

PERIODICITY SHEATH TAIL MORPHOLOGY

W. bancrofti Nocturnal periodic Nuclei do not extend to tip of tail

B. malayi Nocturnal sub- With 2 terminal nuclei
periodic
L. loa Diurnal periodic Nuclei extend to tip of tail
M. perstans
Non-periodic
M. ozzardi Nuclei do not extend to tip of tail
M. streptocerca Nuclei extend to tip of ________________tail
O volvulus Nuclei do not extend to tip of tail

 ___________________elephantiasis of lower limbs

 ___________________ fugitive, calabar, temporary swellings
 ___________________ river Blindness
 Infective stage to man of Filarial worms _______________________
 Diagnostic stage of Filarial worms ___________________________

NOTES
________________________________________________________________________________________________________
__________________________________________________________________________________________________

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 W. bancrofti & B. malayi causes Lymphatic Filariasis

 Can induce production of chyluric/milky urine___________________
 Assumes a Shepherd’s crook appearance _____________________
 Equipped with a uterus with Barber’s Pole appearance ____________
 Specimen to detect O. volvulus _______________________________
 KNOTT’S concentration- diagnostic procedure for Filariasis detection

OTHER COMMON MODE OF PATHOLOGY

NEMATODES NAME TRANSMISSION
Trichinella Pork Ingestion of Trichinosis – may give rise to a intense eosinophilia;
spiralis Muscle _____________________ can cause periorbital edema
Adult worms in roundworm ff: consumption of Accurate Diagnosis is thru
SMALL INTESTINE _______________________________________
inadequately cooked
while Larvae in Other Diagnostic Tests:
pork Bentonite Flocculation Test & Bachmann Intradermal
Muscles
test
Dracunculus Dragon Consumption of Dracontiasis
medinensis Worm; contaminated water Diagnosis is made thru Observation of larvae after
Infects Serpent containing copepods placing a drop of water to open blister
Subcutaneous worm infected with larvae of
tissues Guinea D. medinensis
worm
Angiostrongylus Rat Lung Consumption of raw Eosinophilic Meningitis
cantonensis worm snails/slugs containing
the 3rd stage larvae of
A. cantonensis

Non-Human Ingestion of Visceral or Ocular Larva Migrans

Ascaris: embryonated egg
Toxocara canis
Toxocara cati
Non-Human Filariform Larval Skin Cutaneous Larva Migrans or Creeping Erruption
Hookworms: Penetration
A. braziliense
A. caninum
Dirofilaria Dog heart Can induce formation of granulomatous
immitis worm nodules/peripheral nodules in the lungs
Diagnosis:
Observation of ______________________in x-ray

Anisakis spp. Herring Ingestion of larvae ff: Herring’s disease, may mimic symptoms of Crohn’s
Worm; consumption of raw or disease
Cod Worm undercooked seafood
Seal Worm

NOTES
________________________________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________

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TREMATODES

S. japonicum S. mansoni S. haematobium

COMMON
NAME
HABITAT Superior Inferior mesenteric Vesical Veins or Veins of
Mesenteric veins veins the urinary bladder
ADULT
TEGUMENT
Oriental Intestinal Bilharziasis Schistosomal hematuria
DISEASE Schistosomiasis
CAUSED
EGG Non-operculated Non-operculated with Non-operculated with
with minute lateral distinct lateral spine distinct terminal spine
knob

DEVELOPMENTAL STAGES
EGG

MIRACIDIUM Ciliated larva released from

egg when hatched
SPOROCYST Sac like larva developed from
Miracidium
CERCARIA Larva with mouth, GIT & tail

ADULT

ADDITIONAL INFORMATIONS:
Schistosoma mekongi With eggs similar to S. japonicum but smaller
Produces non-operculated eggs with central bulge and terminal spine
Eggs may resemble those of S. haematobium but found in stool not in urine
Cercaria without tail
Serologic test for the diagnosis of S. japonicum infection
Uses Lyophilized eggs of S. japonicum as antigen
(+) result: BLEB formation
Hypersensitivity reaction caused by migration of schistosomula to appropriate vessel

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 PARASITOLOGY REVIEW NOTES – REVISED JULY 2022

SPECIES COMMON NAME

P. westermani

Fasciola hepatica

Clonorchis sinensis Chinese liver fluke

Oriental Liver fluke
Opistorchis felineus
Fasciolopsis buski
Echinostoma
ilocanum
Heterophyes
heterophyes
Metagonimus
yokogawai

SPECIES SECOND INTERMEDIATE IMPORTANT NOTES

HOST
P. westermani Fresh mountain Crab, Eggs with flat operculum and abopercular shell thickening
crayfish Adult assumes a coffee bean appearance
Sundathelpusa spp.
Fasciola hepatica Aquatic plants Adult equipped with CEPHALIC CONE
Ipomea obscura Large eggs with small operculum
Clonorchis sinensis Cyprinoid fishes Broadly ovoidal operculated eggs with abopercular knob
Eggs resembles an OLD-FASHIONED ELECTRIC BULB
Opistorchis felineus Similar to that of C. sinensis but elongately ovoid
Fasciolopsis buski Aquatic plants Adult may appear like F. hepatica but no cephalic cone
Water chestnuts Eggs indistinguishable from F. hepatica & F. gigantica
Bamboo shoots
Water caltrop
Echinostoma ilocanum Edible snails Adult with oral sucker equipped with spines
Pila luzonica CIRCUM ORAL DISK WITH SPINES
Vivipara angularis EGGS are STRAW COLORED & Ovoidal
Heterophyes Fish Adult with 3 suckers -oral, ventral & genital sucker (central
heterophyes 3rd sucker)
Eggs similar to those of Clonorchis but no abopercular
knob;
eggs are thick shelled
Metagonimus Salmonoid & Cyprinoid Adult may appear like H. heterophyes but no 3rd sucker
yokogawai fishes Eggs similar to those of Heterophyes but thin shelled

NOTES
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
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CESTODES

Characteristics:
1) exclusively HERMAPHRODITIC
2) with FLAT SEGMENTED RIBBON LIKE bodies
3) can live up to 25 yrs
4) adult lives in the ____________________________
5) larva found in ______________________________

Parts of Tapeworm Body

1) Scolex ______________________________________
ROSTELLUM __________________________________

2) Neck- region of growth __________________________

3) Strobila- entire chain of proglottid
immature, mature & gravid /ripe (part that contains mature
eggs)

INTESTINAL CESTODES COMMON NAME INTERMEDIATE INFECTIVE STAGE

In Intestinal Cestodiasis HOST
(Intestinal Infection)
Man harbors _______________
Serves as _________________
Diagnosis: stool Exam

PSEUDOPHYLLIDEA Fish Broad tapeworm

Diphyllobothrium latum Russian Broad tapeworm
CYCLOPHYLLIDEA
Taenia solium Pork or Armed tapeworm
Taenia saginata Beef or Unarmed tapeworm
Hymenolepis nana Dwarf tapeworm
Hymenolepis diminuta Rat tapeworm
Dipylidium caninum Dog tapeworm

INTESTINAL CESTODES EGG MORPHOLOGY

Diphyllobothrium latum Eggs resembles those of _______________
Operculated with abopercular knob
CYCLOPHYLLIDEA
Taenia solium Non-operculated with striated shell that contains hexacanth embryo
Taenia saginata
Hymenolepis nana Non operculated with hexacanth embryo
Embryo shows polar thickenings & filaments
Hymenolepis diminuta Non-operculated with hexacanth embryo
Embryo shows polar thickenings but no filaments
Has intralaminal layer giving it a freid egg appearance
Dipylidium caninum Non operculated eggs contained in a sac or packets
“EGG PACKETS”

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TISSUE CESTODES INFECTIVE STAGE DISEASE CAUSED

In Tissue Cestodiasis

Man harbors _______________

Serves as _________________
T. solium
D. latum
Spirometra spp.
T. multiceps
Also called BLADDER WORM

ADDITIONAL INFORMATIONS:

IMPORTANT NOTES IN DIAGNOSTICS

 Stool must be collected in a clean, dry, leak proof and _________________________________

 For Ova & parasite, the amount to be collected must be 2-5 gms
 Collect 3 stool specimens collected on alternate days should be examined before confirming a (-) result.
 Stool must be collected 7-10 days ff: intake of the ff: Barium/Bismuth 2-3 wks following antibiotic therapy 3
wks following use of gall bladder dye
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 LIQUID stools must be examined within _______________ of passage; SOFT stools must be examined within
___________of passage

 If stool cannot be examined immediately, we can use stool preservatives:

5% formalin -for Protozoan Cyst and Trophozoites & 10% formalin – for helminth eggs and larvae
 10% FORMALIN – can be used for stool specimens for wet mount, concentration and immunoassays

 STOOL may be examined UNSTAINED or STAINED. ________________can be used to demonstrate CYST

while Methylene Blue can be used for __________________demonstration

 STOOL may be examined UNSTAINED or STAINED. Iodine can be used to demonstrate CYST while
Methylene Blue can be used for trophozoite demonstration

 Iron Hematoxylin can be used for__________________________, will impart black color

 ____________________will impart Bright red color and can be used for D. fragilis and Microsporidia

 __________________________are specimens considered STAT in PARASITOLOGY

 ____________________________ideal specimen for malarial smear

 Observation of E. histolytica trophozoite in stool with no ingested RBCs report it as

____________________________________________________________________

 Sabin Feldman Dye Test for T. gondii is no longer used nowadays since it uses live organism. Commonly used
are Immunofluorescent Antibody test, EIA using T. gondii as antigen.
 Corneal scrappings fixed using methanol and stained with Calcofluor white ______________________

 Plasmodium species Considered as MEDICAL EMERGENCY: _______________________________

 To demonstrate uterine branches in gravid proglottids of Taenia spp ________________may be used

 Diagnosis of VLM (Visceral larva Migrans) __________________________________

 Diagnosis of CLM (cutaneous larva Migrans) ____________________________________
 Use of Delafield’s Hematoxylin ______________________________________________
 Examination of DUODENAL ASPIRATES may be done to detect G. lamblia, C. parvum and S. stercoralis

 E. vermicularis eggs and GRAVID PROGLOTTIDS of Taenia spp, may be recovered thru PERIANAL
SWAB/SCOTCH TAPE SWAB

 When processing SPUTUM specimens, we add equal amount of 3% sodium hydroxide to the sample prior to
centrifugation

 S. haematobium egg, T. vaginalis trophozoites and Adult W. bancrofti may be demonstrated in URINE

Stool culture may likewise be done

 _____________________________________________________– culture techniques for Hookworms

and S. stercoralis, done to distinguish between Hookworms and S. stercoralis
Finding RHABDITIFORM LARVA in FRESH STOOL – report is as S. stercoralis (+), but if
RHABDITIFORM LARVAE is noted in OLD STOOL (not fresh sample, stool that was allowed to stand
for several hrs) , we need to do culture to check if it’s really S. stercoralis or possibly Hookworm
 NNN-Novy MacNeal and Nicolle Media – for Leishmania and Trypanosoma
 Diamond Medium or Feinbergh and Whittington’s – GOLD STANDARD for T. vaginalis
 NNA seeded with E. coli / non-Nutrient agar seeded with E. coli (Monoxenic agar) for Acanthamoeba

pg. 18
 PARASITOLOGY REVIEW NOTES – REVISED JULY 2022

Skin tests may be done to detect parasitic infections. Below are examples:

 Montenegro Skin test – Leishmanin Test – For Leishmania spp

 Bachman Intradermal test – ___________________________________
 Casoni’s – __________________________________________________
Immunoassays:
 HRP – II test – Histidine Rich Protein II – this is specific for ______________________________________
 pLDH (Parasite Lactate Dehydrogenase) – for Plasmodium spp
 Copro Antigen Test (stool is the specimen required) – for G. lamblia, C. parvum and E. histolytica
detection
 Sabin feldman Dye Test – GOLD standard for T. gondii. Live T. gondii cells (which is used as Antigen)
is made to react with the Patient serum (suspected to contain antibodies), methylene blue is added.
(+) result in this test is the PARASITE’s LOST OF AFFINITY FOR METHYLENE BLUE
 Circum Oval Precipitin Test – Serologic test for the diagnosis of S. japonicum. Uses LYOPHILIZED
EGGS of S. japonicum (freeze-dried eggs) as antigen. This is incubated together with patient’s serum.
(+) result: BLEB FORMATION or PRECIPITATES around the eggs of S. japonicum which can be noted
MICROSCOPICALLY.
 EIA (Enzyme Immunoassays) – for Toxocara spp and Non-Human Ancylostoma ; diagnosis of LARVA
MIGRANS
Note: HRP -II, pLDH and Copro antigen are antigen detection tests while Sabin Feldman Dye test, COPT and
EIA are antibody detection tests

XENODIAGNOSIS is likewise carried out to detect parasitic infections. This is a technique that uses LABORATORY
BRED/REARED ANIMALS. Examples of animals used are:

 Albino rats – used in the so-called BECK’s Xenodiagnosis which is for

________________________________________
 Reduviid bugs –_____________________________________________

“Always give your best foot forward in whatever you do, rise every time you fall, learn and never repeat the same mistakes &
believe that you can strike back in God’s perfect time. Remember, Success comes easy to those who have worked hard for it”

PREPARED BY: DR. MA CRISTINA SJ LIWANAG (MAM LIGHT)- [email protected]

pg. 19