Parasitology

MUST TO KNOW IN PARASITOLOGY
Symbiosis Living together of unlike organisms

Commensalism 2 species live together
One species benefits from the relationship w/o harming or
benefiting the other
Ex. Entamoeba coli
Mutualism 2 organisms benefit from each other
Ex. Termites and the flagellates inside their digestive system
Parasitism 1 organism lives in or on another for its survival at the expense
of the host
Ex. Entamoeba histolytica
Endoparasite Lives inside the body of the host
“Infection”
Ectoparasite Lives outside the body of the host
“Infestation”
Erratic Parasite found in an organ w/c is not its usual habitat
Obligate parasite Need a host to complete their development
Facultative parasite May exist in a free-living state
May become parasitic when the need arises
Accidental/incidental Parasite that established itself in a host where it does not
parasite ordinarily live
Ex. Echinococcus granulosus
Permanent parasite Remains on or in the body of the host for its entire life
Temporary parasite Lives on the host only for a short period of time
Spurious parasite Free-living organism
Passes through the digestive tract w/o infecting the host
Definitive/final host Parasite attains sexual maturity
Intermediate host Harbors the asexual/larval stage of the parasite
Paratenic host One in which the parasite does not develop further to later
stages
Parasite remains alive and is able to infect another host
Reservoir host Allows the parasite’s life cycle to continue and become
additional sources of infection
Biologic vector Transmits the parasite only after the the latter has
completed its development within the host
Ex. Aedes mosquito
Mechanical/phoretic Only transports the parasites
vector Ex. Flies and cockroach
Epidemiology Study of patterns, distribution and occurrence of disease
Incidence Number of new cases of infection in a given period of time
Prevalence (%) Number of individuals estimated to be infected w/ a particular
parasite
Cumulative prevalence % of individuals in a population infected w/ at least 1 parasite
Intensity of infection Number of worms per infected person
(Worm burden)
Morbidity Clinical consequences of infections or diseases that affect an
individual’s well-being
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Deworming Use of antihelminthic drugs in an individual
Cure rate (%) Number of previously positive subjects found to be egg-
negative
Egg reduction rate % fall in egg counts after deworming
Selective treatment Individual-level deworming
Targeted treatment Group-level deworming
Universal treatment Population-level deworming
Coverage Proportion of the target population reached by an intervention
Efficacy Effect of a drug against an infective agent
Effectiveness Measure of the effect of a drug against an infective agent
Information- A health education strategy that aims to encourage people to

education- adapt and maintain healthy life practices
communication
Environmental Planning, organization, performance, and monitoring of
management activities for the modification and/or manipulation of
environmental factors
Environmental Interventions to reduce environmental health risks
sanitation
Sanitation Provision of access to adequate facilities for the safe disposal
of human excreta
Eradication Permanent reduction to zero of the incidence of infection
caused by a specific agent, as a result of deliberate efforts
Elimination Reduction to zero of the incidence of a specified disease in a
defined geographic area as a result of deliberate efforts
Protozoan Unicellular organism
Metazoan Multicellular organism
Classification of Protozoan Parasites
Sarcomastigophora
Sarcodina Acanthamoeba
Endolimax
Entamoeba
Iodamoeba
Naegleria
Mastigophora Chilomastix
Dientamoeba
Giardia
Trichomonas
Leishmania
Trypanosoma
Ciliophora Balantidium
Apicomplexa Babesia
Cryptosporidium
Cyclospora
Isospora
Plasmodium
Toxoplasma

Microspora Enterocytozoon
Encephalitozoon
Vittaforma
Trachipleistophora
Pleistophora
Brachiola
Microsporidium
Classification of Metazoan Parasites
Nematoda
Intestinal Ascaris
Capillaria
Enterobius
Hookworm
Strongyloides
Trichuris
Extraintestinal Angiostrongylus
Filarial worms
Trichinella
Cestoidea
Cyclophyllidea Dipylidium
Echinococcus
Hymenolepis
Raillientina
Taenia
Pseudophyllidea Diphyllobothrium
Spirometra
Trematoda Artyfechinostomum
Clonorchis
Echinostoma
Fasciola
Fasciolopsis
Heterophyids
Opisthorchis
Paragonimus
Schistosoma
Arthropoda
Arachnida Mites
Scorpions
Spiders
Ticks
Chilopoda Centipedes
Crustacea Copepods
Crabs
Diplopoda Millipedes
Insecta Flies
Flea
Beetle
Bees
Lice
Wasp
Bugs
Mosquitoes
Pentastomida Tongue worms
Common/Other Names
Ascaris lumbricoides Giant intestinal roundworm
Lumbricus teres
Enterobius Pinworm
vermicularis Oxyuris vermicularis
Seatworm
Social or Society worm
Trichuris trichiura Whipworm
Capillaria Pudoc worm
philippinensis
Necator americanus American hookworm
American murderer
New world hookworm
Ancylostoma Old world hookworm
duodenale
Ancylostoma Cat hookworm
braziliense
Ancylostoma caninum Dog hookworm
Strongyloides Threadworm
stercoralis
Trichinella spiralis Muscle worm
Garbage worm
Wuchereria bancrofti Bancroft’s filarial worm
Brugia malayi Malayan filarial worm
Loa loa Eye worm
Onchocerca volvulus Blinding worm
Dirofilaria immitis Dog/canine heartworm
Dracunculus Guinea worm
medinensis Fiery serpent of the Israelites
Medina worm
Dragon worm
Anisakis Fish and Marine mammal roundworm
Herring’s worm
Toxocara canis Dog ascarid
Toxocara cati Cat ascarid
Fasciola hepatica Sheep liver fluke
Fasciola gigantica Giant liver fluke
Clonorchis sinensis Oriental liver fluke
Chinese liver fluke
Fasciolopsis buski Giant intestinal fluke

Echinostoma ilocanum Garrison’s fluke
Heterophyes Von Siebold’s fluke
heterophyes
Paragonimus Oriental lung fluke
westermani
Schistosoma Oriental blood fluke
japonicum
Schistosoma mansoni Profile of a man
Schistosoma Bladder fluke
haematobium
Taenia saginata Beef tapeworm
Taenia solium Pork tapeworm
Hymenolepis nana Dwarf tapeworm
Hymenolepis diminuta Rat tapeworm (Norway rats)
Dipylidium caninum Dog tapeworm
Double-pored tapeworm
Diphyllobothrium Broadfish tapeworm
latum
Echinococcus Hydatid worm
granulosus
Infective Stages
Cyst Protozoans (amoebas)
Trophozoite T. vaginalis
Sporozoites Plasmodium
Trypomastigote Trypanosoma
Promastigote Leishmania
Embryonated egg “HATE”
H. nana
A. lumbricoides
T. trichiura
E. vermicularis
Larva T. spiralis
C. philippinensis
Filariform larva Hookworm
S. stercoralis
3rd stage larva W. bancrofti
(filiform) B. malayi
A. cantonensis
L. loa
O. volvulus
Mansonella
Cercaria S. japonicum
S. haematobium
S. mansoni
Metacercaria F. hepatica
F. buski
C. sinensis

O. felineus
P. westermani
E. ilocanum
Heterophyids
Cysticercus bovis T. saginata
Cysticercus cellulosae T. solium
Plerocercoid larva D. latum
Hydatid cyst E. granulosus
Cysticercoid larva H. diminuta
D. caninum
Nematodes (Roundworms)
Separate sexes Female = larger, pointed tail
Male = smaller, curved tail
Life cycle Egg stage > Larval stage > Adult stage
Aphasmids Lacks phasmids or caudal chemoreceptors
“TCT”: Trichuris-Capillaria-Trichinella
Phasmids w/ caudal chemoreceptors
Hookworm
S. stercoralis
W. bancrofti
B. malayi
Amphid Cephalic chemoreceptors
Oviparous Lays eggs in unsegmented stage (unembryonated)
Ovoviviparous/ovi Lays eggs in segmented stage (embryonated)
viparous
Viviparous/larvipa Larva
rous
Frequency “EAT”: Enterobius > Ascaris > Trichuris
Small intestines “CASH”: Capillaria, Ascaris, Strongyloides,
Hookworms
Large intestines “ET”: Enterobius, Trichuris
Heart-to-lung “ASH”: Ascaris, Strongyloides, Hookworm
migration
Extraintestinal Filarial worms = lymphatics and subcutaneous
Nematodes tissues
T. spiralis = muscles
A. cantonensis = meninges
Visceral Larva T. canis and T. cati
Migrans
Triad of “HAT”: Hookworm, Ascaris, Trichuris
infection/Unholy
3
Ascaris lumbricoides
Characteristics Resembles common earthworm
Fertilized Egg 3 layers:
-Inner: Vitelline membrane

-Middle: Glycogen layer
-Outer: Mammilation (corticated)
Unfertilized Egg 2 layers:

-Inner: Glycogen
-Outer: Mammilation
Has lecithin granules
Adult Buccal cavity: Triangular, trilobate lips
MOT Ingestion
Symptoms and Larval migration: Eosinophilia (resembles Loeffler’s
Pathology syndrome)
Adult: Erratic  Extraintestinal sites
Intestinal perforation
Lab. Diagnosis 1. Stool exam
= Egg: Diagnostic stage
= If (-) stool exam:
a. No infection
b. Early infection
c. All MALE WORM infection
Enterobius vermicularis
Characteristics Autoinfection: Same host (EV, SS)
External autoinfection
Egg Elongated, flattened on 1 side
D-shaped
Adult w/ lateral wings or cephalic alae
MOT Ingestion
Symptoms and Mother’s complex:
Pathology -Pruritus ani
-Lack of sleep
-Extraintestinal enterobiasis
Lab. Diagnosis 1. Perianal swab: Scotch tape swab
Trichuris trichiura
Characteristics Causes trichocephaliasis
Egg Barrel-shaped w/ bipolar mucus plug
Resembles Japanese lantern
Adult Slender or attenuated in the anterior
Resembles a whip
MOT Ingestion
Symptoms and Rectal prolapse (Heavy infection)
Pathology
Capillaria philippinensis
Characteristics Causes pudoc disease or mystery disease
Egg w/ bipolar mucus plugs that are not as protruded as
T. trichiura egg

Guitar, peanut-shaped
Adult Male: w/ chitinized spicule (spicule sheath)
Female: have eggs in utero
MOT Ingestion of freshwater fishes
IH Fresh water fishes:
-Hypselotris bipartite (ipon)
-Birot
-Bagsang
-Bagtu
Symptoms and Malabsorption (CP, GL)
Pathology Borborygmi = peculiar abdominal gurgling sound
LBM alternating w/ constipation
Hookworms (Necator, Ancylostoma)
Characteristics Agent of laziness in poor white population and
tropical anemia in Puerto Rico
Egg Same for all species
Ovoidal, thin-shelled, colorless
“Morula ball”
Adult N. americanus: S-shaped, w/ semilunar cutting
plates
A. duodenale: C-shaped, w/ 2 pairs of teeth
Male copulatory bursa:
-Bipartite (2 digits): Barbed & bristle like
-Tripartite (3 digits): Simple & not barbed
Rhabditiform 1st stage larva
larva Short and stout
Open mouth: feeding stage
Buccal cavity: long
Genital primordium: small or inconspicuous
Filariform larva 2nd stage larva
Long and slender
Closed mouth: nonfeeding stage
Sheath: (+)
Tail: Pointed
MOT Skin penetration
Symptoms and Mazza Mora/Water sore or ground itch
Pathology Severe itching/allergic reaction at the site of skin
penetration
IDA
Cutaneous larva migrans (Creeping eruption): A.
braziliense and A. caninum (animal hookworm)
2. Harada Mori Culture technique
= Filter paper culture technique
= For hookworm and threadworm larvae
3. Baermann funnel technique (Strongyloides)
Strongyloides stercoralis
Characteristics Causes Cochin-China diarrhea
Facultative nematode:
-Parasitic: small intestine
-Free-living: soil
Adult Female: capable of parthenogenesis (fertilization
w/o the benefit of male)
Rhabditiform Buccal cavity: short
larva Genital primordium: prominent or conspicuous
Filariform larva Sheath: (-)
Tail: Notched
MOT Skin penetration
Symptoms and Skin: Allergic reaction
pathology Larval migration: pneumonia
Intestines: abdominal pain, diarrhea, vomiting
Trichinella spiralis
Characteristics Adult: in intestines
Larva: in muscles
Requires 2 host to complete its life cycle
Propagated by black and brown rats
Man: both DH and IH, dead-end host
Freezing destroys the larva
Adult Male: w/ conical papillae
Female: w/ club-shaped uterus
(viviparous/larviparous)
MOT Ingestion of meat
Symptoms and Larva: muscle
pathology -Edema, muscle pain, difficulty in breathing and
swallowing
Adult: intestines
-Abdominal pain, diarrhea
Lab. Diagnosis 1. Muscle biopsy
= Encysted larva: Diagnostic stage
2. Immuno-tests:
a. Bentonite flocculation (TS, EG)
b. Intradermal test (Bachmann)
3. Xenodiagnostic tests (TS, TC)
= Beck’s albino rats/mice
Filarial Worms
Characteristics Vector-borne nematodes
DH: man (IS: filiform larva/3rd stage larva)
IH: vector (IS: microfilaria)
DS: Microfilaria
Adults In lymphatics and subcutaneous tissue
Microfilaria In blood
Lab. Diagnosis 1. Knott’s technique

= Isolation of microfilaria
= Blood + formalin + Giemsa stain
Wuchereria bancrofti
Habitat Lymphatics
Vector Aedes
Anopheles
Specimen Blood
Microfilaria Sheathed
Nuclei absent in tail
Periodicity Nocturnal (10PM-2AM)
Brugia malayi
Habitat Lymphatics
Vector Mansonia
Specimen Blood
Tail w/ 2 separate nuclei
Periodicity Subperiodic
Nocturnal
Loa loa
Habitat Subcutaneous tissue
Vector Chrysops
Tabanid (mango fly)
Specimen Blood
Nuclei continuous up to the tip of the tail
Periodicity Diurnal
Onchocerca volvulus
Habitat Subcutaneous tissue
Vector Simulium (black fly)
Specimen Skin snips/shavings
Microfilaria Unsheathed
Nuclei absent in tail
Periodicity Nonperiodic
Dipetaloma perstans (Acanthoculonema perstans)
Habitat Body cavities
Vector Culicoides
Specimen Blood
Nuclei up to the tip of the tail
Mansonella ozzardi
Habitat Body cavities
Vector Culicoides
Specimen Blood
Tail is free of nuclei
Dirofilaria immitis
Characteristics Human infection: solitary, peripheral nodules in the
lung (coin lesions), or as subcutaneous nodule
Dracunculus medinensis
Characteristics Longest nematode of man
IH Cyclops (copepods): aquatic crustacean
DH Man
MOT Ingestion of crustacean
Angiostrongylus cantonensis
Characteristics Causes human eosinophilic meningoencephalitis
IH Mollusks:
-Achatina fulica
-Japanese snail
-Pila luzonica (kuhol)
-Brotia asperata (suso)
DH Rats
Adult Female: “Barber’s pole appearance”
Looking of whitish uterus to red digestrive tract
Anisakis
Characteristics Causes Herring’s disease
1st IH Various marine crustaceans
2nd IH Smallest fishes
3rd IH Larger fishes
DH Dolphins/whales
MOT Ingestion of raw fish (ex. sashimi)

Trematodes
Phylum Platyhelminthes
Class Trematoda (Flukes)
Characteristics All except blood flukes Schistosomes:
[Schistosomes] 1. Elongated and
1. Flat, leaf like cylindrical
2. Hermaphrodite 2. Separate sexes
3. Egg: operculated 3. Egg: Non-operculated
4. MOT: ingestion 4. MOT: skin penetration
5. IS: metacercaria 5. IS: Cercaria (fork-
6. IH: 2 IH tailed)
6. IH: 1 IH (snail)
Eggs:
a. Mature when laid (embryonated): “SHOC”
-Schistosoma
-Heterophyes
-Opistorchis
-Clonorchis
b. Immature when laid (unembryonated): “PEFF”
-Paragonimus
-Echinostoma
-Fasciola
-Fasciolopsis
Attachment 2 suckers: oral and ventral (acetabulum)
-Heterophyes: 3 suckers (3rd: genital sucker
[gonotyle])
Life cycle Egg > Larva
(Miracidium>Sporocyst>Redia>Cercaria>Metacercari
a) > Adult
1st IH Snail
2nd IH Fish, crab, plant/vegetation, snail
Fish Schistosoma
H. heterophyes
O. felineus
C. sinensis
Crab P. westermani
Plant/vegetation F. hepatica
F. gigantica
F. buski
Snail E. ilocanum
Habitat Liver:
-F. hepatica
-F. gigantica
-C. sinensis
-O. felineus
Small Intestines:
-F. buski
-E. ilocanum
-H. heterophyes
Lungs:
-P. westermani
Fasciola hepatica
Characteristics Causes sheep liver rot
Prevalent in sheep raising countries
Egg Resembles F. gigantica and F. buski
Adult w/ cephalic cone
Leaf-like hermaphrodite
Fasciola gigantica
Characteristics Infects cattle in the Philippines
Egg Resembles F. hepatica and F. buski
Clonorchis sinensis
Characteristics Most important liver fluke of man
Egg Old-fashioned electric light bulb
1st IH Snail
2nd IH Fishes
MOT Ingestion
Opisthorcis felineus
Characteristics Resembles C. sinensis
Fasciolopsis buski
Characteristics Largest fluke parasitizing man
Egg Hen’s egg shaped
Indistinguishable from Fasciola
Echinostoma ilocanum
1st and 2nd IH Snail
Heterophyes heterophyes
Characteristics Smallest but deadliest fluke of man
Adult w/ 3rd sucker (gonotyle)
1st IH Snail
2nd IH Fishes
MOT Ingestion
Paragonimus westermani
Characteristics Causes endemic hemoptysis
Egg w/ thickened abopercular end opposite the
operculum
Adult Resembles coffee bean
1st IH Snail
2nd IH Crabs
MOT Ingestion
Lab. Diagnosis 1. Examination: sputum and stool
Schistosomes
Characteristics Most romantic parasite of man
Adult Male: w/ gynecophoral canal where the female is
held
Lab. Diagnosis 1. Demonstration of egg in feces, rectal or liver
biopsies, and urine
2. Faust and Meleney’s egg hatching technique
3. Circumoval precipitin test (COP) of Oliver and
Gonzales
Pathology Larval penetration
-Human sp: slight allergic reaction
-Nonhuman sp: Swimmer’s itch
Tissue damage by eggs
Schistosoma japonicum
Characteristics Causes Katayama’s disease
Habitat Superior mesenteric veins in the small intestines
Egg w/ small knob-like or recurved hook on one side
IH Oncomelania quadrasi
Schistosoma mansoni
Characteristics Smallest of the blood flukes
Habitat Superior mesenteric veins of the colon and rectum
Egg w/ lateral spine
IH Biomphalaria
Australorbis
Tropicorbis
Schistosoma haematobium
Characteristics Vesical blood fluke causing bilharziasis or urinary
schistosomiasis (hematuria)
Egg w/ terminal spine
IH Bulinus
Physopsis
Biomphalaria
Specimen 24-hr unpreserved urine
Trematodes
Phylum Platyhelminthes
Class Trematoda
Characteristics Living worms: creamy white and yellowish
Adult: flat and ribbon-like (masking tape)
1 IH only
Cestode body Scolex = anterior attachment organ
Neck = region of growth
Strobila = chains of segments or proglottids
-Immature, mature, ripe/gravid (filled w/ eggs)
Order False tapeworm (Ex. D. latum)
Pseudophyllidea Scolex: Spoon-shaped w/ bothria (slit-like sucking
grooves), no hooklets
Strobila: Anapolytic (not shedding segments)
Egg: operculated w/ aboperculum, immature when
laid
Stages: Coracidium > Procercoid > Plerocercoid
IH: 2 IH (Copepods and fresh water fish)
Order True tapeworm

Cyclophyllidea Scolex: Quadrate, w/ 4 cuplike suckers (rostellum
w/ or w/o hooklets)
Strobila: Apolytic (shedding segments)
Egg: non-operculated, embryonated (mature when
laid), hexacanth embryo
IH: 1 IH
Require T. solium (IH: pig)
vertebrate IH T. saginata (IH: cattle)
Require D. caninum (MOT: ingestion of “pulgas”)
invertebrate IH
May or may not H. nana
require IH
Diphyllobothrium latum
Characteristics Largest tapeworm of man
Causes Vit. B12 deficiency anemia
Uterus Rosette formation
Lab. Diagnosis 1. Stool examination
Taenia saginata Taenia solium
Scolex None, no rostellar hooks w/ rostellum armed w/ 2
rows of large and small
hooklets
Length 25 m 7m
# of proglottids 1000-2000 <1000
Gravid proglottid 15-20 lateral branches 7-13 lateral branches
(dichotomous or tree- (dendritic or fingerlike)
like)
Eggs Spherical, striated, Spherical, striated,
inside is an embryo w/ 6 inside is an embryo w/ 6
hooklets hooklets
Larva Cysticercus bovis Cysticercus cellulosae
Pathogenesis Taeniasis saginata Taeniasis solium,
cysticercosis
Hymenolepis nana Hymenolepis diminuta
Characteristics Smallest tapeworm of
man
Scolex w/ rostellum armed w/ a w/ an unarmed rostellum
ring of 20-30 spines
Eggs w/ oncosphere enclosed w/ oncosphere enclosed
in an inner membrane w/ in an inner membrane w/
2 polar thickenings, from 2 polar thickenings, but
each w/c arise 4-8 polar w/o filaments
filaments
IS Direct: Eggs Cysticercoid larva
Indirect: Cysticercoid
larva
DH Man Rat

Dipylidium caninum
Proglottids w/ double set of reproductive organs and genital
pore on each side of the lateral margin
Mature & gravid proglottids: melon seed/pumpkin
seed/rice grain-shaped
Eggs Egg packet (8-15 eggs)
IH Ctenocephalides canis (dog flea)
Ctenocephalides felis (cat flea)
Pulex irritans (human flea)
DH Dogs or cats
Man: accidental host
Echinococcus granulosus
Characteristics Shortest tapeworm (only 3 segments: immature,
mature, ripe/gravid)
Anti-P1
Eggs Resembles Taenia egg
IH Sheep (IS: eggs)
Man: accidental IH
DH Dog
Lab. Diagnosis 1. Exploratory cyst puncture
2. Roentgenogram (x-ray)
3. Immunologic tests:
= Bentonite flocculation test (TS, EG)
= Casoni (intradermal test)
Protozoans
Characteristics Unicellular
Animal-like protists
Division: Fission
No cell wall w/ outer membrane (periplast)
Cytoplasm: ectoplasm (outer) and endoplasm (inner)
Contains at least 1, and some several nuclei
Some contain vacuoles: for storage and transport
Hemotogranules Special organs for locomotion
-Sarcodina/Rhizopoda = Amoeba (pseudopods)
-Mastigophora/Flagellata
-Ciliophora/Ciliata
-Sporozoa = no definite locomotory organelle
Class Rhizopoda
Trophozoites Motile
Feeding stage
Diarrheic/liquid stool
Destroyed by iodine
Cyst Non-motile
Nonfeeding stage
Well-formed stool
Infective stage

Characteristics w/ cystic stage except Entamoeba gingivalis
Inhabit the large intestine except Entamoeba
gingivalis
Commensals except Entamoeba histolytica
Life cycle Trophozoite > Precystic > Cystic > Metacystic stage
Entamoeba True amoeba
Peripheral chromatin (trophozoite and cyst)
Chromatoidal bars (cyst)
Endolimax/Iodam Other amoeba
oeba No peripheral chromatin
No chromatoid bars
Entamoeba histolytica Entamoeba coli
Trophozoite -Motility: Unidirectional -Motility: several
& progressive directions, sluggish
-1 pseudopod (finger- -Many pseudopods (blunt
like) & rounded)
-Endoplasm: w/ RBC but -Endoplasm: w/ bacteria,
no bacteria or cell yeasts and cell detritus
detritus (clean-looking) (dirty-looking)
-Nucleus: not visible -Nucleus: when stained,
when stained; consists of consists of thicker
thin nuclear membrane nuclear membrane w/
w/ layer of uniformly layer of variously sized
sized fine chromatin chromatin granules
granules distributed unevenly distributed
along inside the border along the inside border
of nuclear memb. of nuclear membrane
-Karyosome: fine, -Karyosome: large,
centrally located (Bull’s eccentrically located
eye)
Cyst -Chromatoidal bars: -Chromatoidal bars:
coffin/rod/cigar/ splinter-like/ witch-
sausage-shaped broom/whisked broom
-Mature cyst w/ 1-4 -Mature cyst w/ 1-8
nuclei nuclei
Endolimax nana Smallest amoeba
Size = RBC
[Trophozoite]
-Karyosome: large round dot
[Cyst]
-Usually oval
-Nuclei: 4 (cross-eyed)
Iodamoeba [Trophozoite]
butschlii -Karyosome: w/ cluster of achromatic granules
Iodamoeba [Cyst]
williamsi -Large iodine-staining glycogen vacuole
Entamoeba Associated w/ gum infection
gingivalis [Trophozoite]
Karyosome: small and centrally located
Pseudopodia: similar to E. histolytica but does not
exhibit true progressive locomotion
Opportunistic Amoeba
Characteristics Free-living amoeba
Inhabits the CNS
Does not indicate fecal contamination
Cause PAM (fatal)
Includes: Naegleria, Acanthamoeba, Hartmanella
Naegleria fowleri Major causative agent of PAM

Amoeboflagellate (trophozoite)
Acquired while diving & swimming during hot
weather in brackish/freshwater
CSF: purulent, w/ motile amoeba
Acanthamoeba Causes keratitis (from contaminated contact lens
care solution)
Causes GAE
Culture: BAP flooded w/ E. coli
Class Mastigophora (Flagellata)
Characteristics Possesses whip-like locomotory organelle called
flagella
Motor component: flagella and axonemes
Neuromotor apparatus: kinetoplast w/c consists of
blepharoplast and parabasal body (energizing
portion)
Digestive tract & Enteromonas hominis
Genital flagellates Embadomonas intestinalis
Chilomastix mesnili
Giardia lamlia
Trichomonas hominis
Trichomonas tenax
Trichomonas vaginalis
Blood and Tissue Leishmania tropica
flagellates Leishmania braziliensis
Leishmania donovani
Trypanosoma rhodesiense
Trypanosoma gambiense
Trypanosoma cruzi
Embadomonas [Trophozoite]
intestinalis -Cleftlike cytostome
Chilomastix [Trophozoite]
mesnili -Pear-shaped
-Spiral groove curving across the body
-Spiral boring, jerky movement
-3 anterior flagella and 1 w/in the cytostome
[Cyst]
-Lemon to oval-shaped
-Protrusion at end
-Nipple-like cyst
Giardia lamblia/ Associated w/ Gay bowel syndrome
Lamblia [Trophozoite]
intestinalis -Pear-shaped
-Bilaterally symmetrical
-2 nuclei, each w/ a large karyosome, lying w/in the
sucking disk
-Falling leaf motility
-Old man’s face/old man w/ eyeglasses
[Cyst]
-2-4 nuclei
-Football-shaped
Trichomonas
Characteristics Trophozoite stage only
Pear-shaped
4-5 flagella
Jerky motility
Undulating membrane: aids in locomotion
Costa: thickening of membrane
Trichomonas tenax
Habitat Oral cavity
Size Smallest
Nucleus Rounded
Undulating 2/3 of the costa
membrane
Inclusion bodies None
Specimen Oral scrapings
Trichomonas hominis
Habitat Intestine
Size Medium
Nucleus Ovoidal
Undulating As long as the costa
membrane
Inclusion bodies None
Specimen Stool
Trichomonas vaginalis
Habitat Genitalia
Size Largest
Nucleus Ovoidal
Undulating < ½ of the costa
membrane
Inclusion bodies Siderophil granules
Specimen Urine
Vaginal swab/discharge (female)
Prostatic secretion (male)
Characteristics Causes Pingpong’s disease

Male: carrier
-Asymptomatic chronic urethritis
-Epididymis, prostate & urethra
Female:
-Burning sensation
-Strawberry cervix
Lab. Diagnosis 1. Modified Diamond medium
2. Feinberg-Whittington medium
Hemoflagellates
Characteristics Include the trypanosomes and leishmanias
May infect the blood, lymph nodes, muscles and RES
Amastigote Leishman-Donovan body
Leishmanial form
Promastigote Leptomonal form
Anterior to nucleus
Epimastigote Crithidial form
Near nucleus
Trypomastigote Trypanosomal form
Posterior to nucleus
Leishmania tropica
Agent of Old world cutaneous leishmaniasis
Oriental sore
Aleppo button
Baghdad or Jericho boil
Dry lesions
Habitat Endothelial cells
Monocytes
Vector Phlebotomus
Lutzomyia
Pathology Localized cutaneous infection (macule  papule)
Leishmania braziliensis
Agent of American mucocutaneous leishmaniasis
Espundia
Bubas
Habitat Mucocutaneous junctions (nasal septum, mouth,
pharynx)
Vector Phlebotomus
Lutzomyia
Pathology Wheeping lesions
Lab. Diagnosis 1. Dr. Montenegro’s (skin test)
Leishmania donovani
Agent of Visceral leishmaniasis
Kala-azar (black fever)
Dum-dum fever
Habitat Endothelial cells of RES
Macrophages
Vector Phlebotomus

Lutzomyia
Pathology Splenomegaly
Severe anemia
Lab. Diagnosis 1. Culture:
= NNN: Novy-McNeal-Nichole medium (culture for
Leishmania & Trypanosoma)
Trypanosoma rhodesiense & Trypanosoma gambiense
Agent of African sleeping sickness
-East Africa: T. rhodesiense
-West Africa: T. gambiense
Vector Glossina (tsetse fly)
Habitat Febrile: blood, lymph node
Sleeping sickness: CSF
Winterbottom Inflammation/swelling of lymph nodes
sign
Lab. Diagnosis 1. Febrile stage: blood, lymph node aspirate
2. Sleeping sickness stage: CSF
Trypanosoma cruzi
Agent of American trypanosomiasis
Chagas’ disease
Vectors Triatomid bugs
Kissing bugs
Reduviid bugs
Assasin bugs
Cone nose bugs
Triatoma rubrofasciata = Philippines
Habitat RES, cardiac muscle, CNS
Characteristics C-shaped
Romaña’s sign Unilateral swelling of eye lids
Lab. Diagnosis 1. Chang’s medium
2. Xenodiagnostic test (TS, TC)
Ciliates
Balantidium coli The only significant ciliate
Host: Pigs
Largest parasitic protozoan
MOT: ingestion of cysts (from swine feces)
S/S: Dysentery
[Trophozoite]
-Macronucleus: kidney-shaped, vegetative
-Micronucleus: dot-like, reproductive
-Cilia, oral cytostome (mouth)
[Cyst]
-Refractive double wall enclosing cilia
-Nonmotile
Sporozoa
Characteristics Obligate intracellular
No apparent means of locomotion

Life cycle Sexual (sporogony) = DH (arthropod vector)
Asexual (schizogony) = IH (man)
Plasmodium
Characteristics Cause of malaria (“bad air”)
IS IH (man): Sporozoites
DH (mosquito): Gametocytes
Asexual Life cycle Female Anopheles ---(sporozoites)---> Man ---> Liver
(Exoerythrocytic cycle)----
--->Infected cells (liver) will rupture & release
merozoites --> Erythrocytic cycle
Erythrocytic cycle:
1. Merozoites (RBC) ---> Trophozoites ---> Schizont
---> Release merozoites
2. Merozoites ---> Microgametocytes
(Male)/Macrogametocytes (Female)
3. Merozoites ---> Destroyed by immune system
Sexual Life cycle Macrogametocytes & Microgametocytes --->
Anopheles mosquito
Anopheles ---> Macro- + Microgametocytes = Zygote
(ookinete)
Ookinete ---> Oocysts (contains sporozoites) ---
>Matured: release sporozoites
Sporozoites ---(Female Anopheles)---> Man
Symptoms and 1. Recurrent chills and fever
Pathology -every 36 hours: malignant tertian malaria = P.
falciparum
-every 48 hours: ovale malaria = P. ovale
-every 48 hours: benign tertian malaria = P. vivax
-every 72 hours: quartan malaria = P. malariae
2. Anemia (RBC destruction), splenomegaly, joint
pain
3. P. falciparum: fatal
-Cerebral malaria: RBC, organisms and pigment block
brain vessels
-Blackwater fever: intravascular hemolysis +
hemoglobinuria
Resistant to G-6-PD deficiency
malaria Fy (a-b-)
Sickle cell disease
Hypnozoites Dormant stage
Found in the liver
Once activated, releases merozoites
Responsible for relapse (P. vivax, P. ovale)
Mixed infection P. vivax & P. falciparum
Lab. Diagnosis 1. Examination of blood film
a. Thick blood film = Screening purposes
-Dehemoglobinize RBCs
-Stain w/ Giemsa
b. Thin blood film = Identification of species
-Fix w/ methanol
-Stain w/ Giemsa
2. QBC: Quantitative buffy coat
-Fluorochrome: Acridine orange
3. Immunotests
a. Optimal assay
-Detects pLDH (parasitic LDH) = malarial organism
b. Malaquick test
-Detects HRP-2 or HRP II Ag (P. falciparum)
Plasmodium vivax
Characteristics Prevalent worldwide
Single large ring succeeded by amoeboid form in
pale large red cell
Schuffner’s dots (condensed Hgb)
Relapse: Hypnozoites
Infects reticulocytes only
Infected RBCs: enlarged
# of Merozoites Usually 16
Trophozoite Amoeboid
Gametocyte Round
Plasmodium malariae
Characteristics Single large compact ring or band forms
Invades old RBCs
Ziemann’s dots
Schizont arranged around central pigment
(rosette/daisy head/fruit pie arrangement)
# of Merozoites 8
Trophozoite Band
Gametocyte Ovoid
Plasmodium falciparum
Characteristics Prevalent in the Philippines
Ring forms: small (1/6 diameter red cell), appliqué
forms/marginal/accole formation/double chromatin
dots
Maurer’s dots (Stephen Christopher/Cuneiform
dots)
Multiple parasitization of red cells
Infects all age of red cells
# of Merozoites 24-32
Trophozoite Ring
Gametocytes Crescent/sausage/banana-shaped
Plasmodium ovale
Characteristics Single compact ring
Schuffner’s dots/James’ dots
Relapse: Hypnozoites
Infected RBCs: serrated/fimbriated

# of Merozoites 8-9
Babesia microti
Characteristics “Maltese-cross” formation
Resembles P. falciparum rings
-No malarial pigment
-No growing trophozoite
DH Deer
MOT Ixodes tick bite
Blood transfusion
Symptoms and Headache & fever
pathology Hemolytic anemia + hemoglobinuria
Babesia bigemia
Characteristics Causes “red water fever” in cattles
Coccidia
Characteristics Schizogony (asexual) = nucleated cells
Sporogony (sexual) = intestinal mucosa of DH
Infective stage Oocyst (feces)
Isospora belli IH: cattles, pigs
DH: man
MOT: sporulated oocyst in contaminated food and
water
Diseases:
-Asymptomatic
-Diarrhea, flatulence
-Acalculous cholecystitis
Cryptosporidium C. parvum: bovines
(C. parvum/C. C. hominis: man
hominis) Diseases:
-Watery, frothy diarrhea among immunosuppressed
patients
-Acute and gangrenous cholecystitis
Lab. Diagnosis:
1. Sheather sugar flotation
2. Stool examination
3. Modified acid fast stain (CIC)
Cyclospora Originally called a cyanobacterium-like body (CLB)
cayetanensis Causes chronic and intermittent watery diarrhea
Sarchocystis Zoite: simplest form (banana-shaped)
(S. hominis/S. Diseases:
suihominis) -Gastroenteritis w/ diarrhea
-Eosinophilic enteritis
-Myalgia (mild increase in CK)
Toxoplasma gondii
Characteristics Common cause of congenital infection
DH Cat
-Oocyst in cat feces may infect man
IH Man

-Bradyzoite = inactive form
-Tachyzoite = actively dividing
Lab. Diagnosis 1. Sabin-Feldman dye test
-Methylene blue staining of tachyzoites is inhibited
by prior addition of patient serum containing
antibodies to Toxoplasma
Other Intestinal Protozoans
Blastocystis Vacuolated form (most predominant):
hominis -A large central vacuole pushes the cytoplasm and
nuclei to the periphery of the cell
Dientamoeba Former amoeba
fragilis Now classified as a flagellate
Trophozoite stage only
-2 nuclei (“Binucleated trophozoite”)
MOT: via transmission of E. vermicularis eggs
Arthropods
Copepods IH of D. latum, D. medinensis and Gnathostoma
(Cyclops) spinigerum
Pthirus pubis Crab louse
Agent of “crabs”
Myiasis Invasion of mammalian tissues by dipterous larvae
(diptera/flies)
Cantharidin Volatile vessicating substance produced by the
blisters of beetles of the family Meloidae
Periplaneta American cockroach
americana Lays about 50 egg capsules (ootheca), each
containing about 15 eggs
Blatella German cockroach
germanica
Blatta orientalis Oriental cockroach
Aedes aegypti Tiger mosquito
Vector of urban dengue
Aedes albopictus w/ silvery stripe on the mesonotum
Vector of rural dengue
Culex Vectors of Japanese encephalitis
Anopheles Primary vector of malaria
flavirostris
Aedes poecilus Mosquito associated w/ Bancroftian filariasis
Mansonia bonneae Vector of the Brugian type of filariasis
Musca domestica Common housefly
Sarcophaga “Chess-board appearance”
Calliphora Bluish fly covered w/ yellow hairs

Lucilia Greenish fly w/ white genae
Phaenicia Bronze-bottle fly
Muscina Slightly larger and more robust than the housefly
Laboratory Methods
Examination of Blood
Detect agents of Malaria
Babesiosis
Trypanosomiasis
Leishmaniasis
Filariasis
Thick blood films Screening (malaria)
Thin blood films Identification of malarial species
Concentration 1. Preparation of buffy coat smears:
techniques -L. donovani
-Trypanosomes
-Microfilaria
2. Knott’s concentration membrane filtration
-Detection of microfilaria
3. Fluorochrome acridine orange in microhematocrit
centrifuge format
-QBC blood parasite detection method
Examination of Fecal Specimens
Stool fixatives 1. Formalin = all purpose fixative
= 5% conc.: protozoan cysts
= 10% conc.: helminth eggs and larvae
2. Schaudinn’s fluid = w/ HgCl2
3. Polyvinyl alcohol (PVA) = for Trichrome stain (w/
HgCl2)
4. Merthiolate-iodine-formalin (MIF) = a.k.a.
Thimerosal
= Merthiolate and Iodine: staining components
= Formalin: preservative
5. Sodium-acetate-formalin (SAF)
= Advantage: does not contain HgCl2
Direct wet mount 1. Saline mount = 0.85% NSS
2. Iodine mount = protozoan cysts (not
trophozoites)
Permanent stains 1. Wheatley’s trichrome stain

2. Iron hematoxylin stain
3. Modified acid fast stains (Cryptosporidium,
Isospora, Cyclospora)
Concentration Methods for Protozoan Cysts and Helminth Eggs and
Larva
Sedimentation Best for eggs of:
-Schistosoma
-Operculated egg
-Trematodes
-Cestodes
-T. trichiura
-C. philippinensis
1. Acid-ether concentration
= Ether: dissolves fats and CHO
2. Formalin-ether concentration
= Formalin: preserves the eggs
Flotation 1. Brine Flotation = NaCl
2. Zinc Sulfate centrifugal flotation technique
= SG (ZnSO4): 1.18
= for Protozoan cysts
= for Nematode eggs except T. trichiura and C.
philippinensis (sedimentation)
= NOT for Schistosomal and operculated eggs
(sedimentation)
Cultural Methods for Protozoa
Culture media for 1. Boeck and Dorbohlav’s diphasic medium (Modified
intestinal amoeba by Dobell and Laidlaw)
2. Cleveland Collier’s medium
NNN Medium for Trypanosoma and Leishmania
(Novy-McNeal-
Nicolle)
Additional Techniques for Examination of Enteric Parasites
Cellulose tape For pinworms
technique
Egg studies 1. Direct smear method of Beaver
2. Stoll dilution egg count
3. Kato thick smear = qualitative (Cellophane paper,
glycerine, malachite green)
4. Kato Katz smear (Cellophane fecal thick smear) =
quantitative
Nematode culture 1. Harada-Mori paper strip culture
and recovery 2. Baermann funnel techniques (Strongyloides)
techniques
Examination of Other Specimens
Detection of T. Specimens:
vaginalis -Vaginal and urethral discharge
-Prostatic secretions
-Urine
Sputum Recovery of protozoal and helminthic parasites
Biopsy 1. Skin biopsy = Onchocerca, Mansonella
2. Muscle biopsy = Trichinella spiralis

Parasitology

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MUST TO KNOW IN PARASITOLOGY

Symbiosis Living together of unlike organisms

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Information- A health education strategy that aims to encourage people to

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Unfertilized Egg 2 layers:

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Naegleria fowleri Major causative agent of PAM

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Permanent stains 1. Wheatley’s trichrome stain

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