GROUP FIVE

CANEDO GRAN LAGUIAB LETRERO

• Know the importance of Learning
Objectives
detecting intestinal parasites

• Conduct a direct fecal smear

Most parasitic diseases cannot be established
based on clinical signs and symptoms alone.
Confirmation of a suspected parasitic
condition generally depends on the result of
proper laboratory examination.

A PARASITOLOGY LAB SHOULD BE ABLE TO:

• Confirm a clinical impression that the
condition has a parasitic nature
• Rule out differential diagnoses
• Aid a clinician in the choice of proper
medication
• Help in monitoring the effect of a treatment
regimen
Stool analysis: is a series of tests done on a stool sample to help diagnose
certain conditions affecting the digestive tract, including infection (such as
parasites, viruses, or bacteria) , poor nutrient absorption or cancer.
Human feces is called as STOOL.

Faeces / Feces is plural of Latin term faex

meaning RESIDUE.

It is the waste residue of indigestible

materials of an animal’s digestive tract
expelled through the anus during defecation.

Meconium is newborn’s first feces.

SCATOLOGY or CAPROLOGY is the study of
feces.
• ¾ Water, ¼ Solid
• Undigested and Unabsorbed
food
• Intestinal secretions,
Mucous
• Bile pigments and Salts
• Bacteria and Inorganic
material
• Epithelial cells, Leukocytes
Demonstration of eggs, larvae,
adults, trophozoites, cysts, or
oocysts in the stool
The ability of a parasitology laboratory to
generate reliable results is dependent
on the proper collection, handling, and
processing of specimens prior to
examination, skill of examiner, and
equipment quality.

Fecal specimen is best collected in

clean, wide-mouthed containers made
of waxed cardboard or plastic with a
tight-fitiing lid to ensure retention of
moisture and prevent accidental
spillage.
 Adult
Collect the specimen by passing
feces into plastic wrap stretched loosely
over the toilet bowl. A portion of the
sample is then transferred into the
supplied container; make sure it is
without contamination of urine or toilet
tissue. Do not take stool samples from
the toilet bowl water.
Young children and infants
The diaper should be lined with
plastic wrap. A urine bag can be attached
to the child to ensure that the stool
specimen is not contaminated with
urine.
 Bedridden Patients
The specimen should be collected
in a bedpan lined with plastic wrap, and
the nurse can transfer a portion of the
feces into the appropriate container.
 Contaminants to avoid

URINE: affects detection of

protozoa
TISSUE PAPER
TOILET WATER: contains cleaning
agents that affects the chem test
 COLOR
CONSISTENCY
ODOR
BLOOD/MUCOUS/OTHER
PARASITE
Human fecal matter is normally yellowish
brown in colour which results from a
combination of bile and bilirubin.

Bright Red/Maroon
Tan/Clay
Blood streak
White
Yellow
Pale greasy
Green
Black
Blue
• Exclusively breast fed infants pass
LOOSE AND GREEN OR PASTY AND
YELLOW STOOLS.
• Infants fed on cows’ milk preparations
pass stools of a PALER YELLOW COLOUR
AND OF A MUCH FIRMER CONSISTENCY.
• Babies fed on newer modified cows’ milk
preparations have CLAY COLOURED OR
GREENISH STOOLS.
• Some healthy children may pass
frequent, loose stools containing
undigested vegetable matter called as
TODDLER’S DIARRHEA.
It depends on the pH of the stool.

INDOLE and SKETOLE are the

substances that produce normal
odour formed by Intestinal
bacterial fermentation and
putrefaction.

A foul odour is caused by

degradation of undigested protein
and excessive carbohydrate
intake.

Sickly sweet odour is produced by

undigested Lactose.
• Diarrhea mixed with mucous and Blood is
suggestive of Typhoid, Amoebiasis, Typhus, Large
bowel Carcinoma.
• Diarrhea mixed with mucous and Pus is suggestive
of Ulcerative Collitis, Regional Enteritis, Shigellosis,
Salmonellosis, Acute diverticullitis, Intestinal TB.
• Pasty stool with high fat content is suggestive of
CBD Obstruction, Cystic fibrosis-butter stool.
• Translucent gelatinous mucous clinging to the
surface of the formed stool is found in Spastic
Constipation, Excessive straining, Mucous collitis.
• Rice water stools which is colourless and almost
devoid of odour is suggestive of Cholera.
• Stools may look like Redcurrant jelly in
Intussusception.
• ROUND WORM • TAPE WORM

• HOOKWORM • PIN WORM

• WHIPWORM
 MATERIALS
SLIDE PREPARATION
EXAMINATION OF PARASITES
NORMAL VALUES
• Microscope slides
• Cover slips
• Sodium chloride solution
• Lugol’s Iodine Solution
• Wooden applicator
• Fresh stool
• Gloves
• The search for eggs and larvae of
helminths (and of ciliates) is
classically done using the 10x
objective
• Always start in the corner and work
in a straight line towards the
opposite side
• Move one row aside and work back
• When parasitic structures are
found, details are examined at 40x
objective
 DIRECT FECAL
SMEAR

Mainly used to detect mobile trophozoites and larvae, red blood cells,
leukocytes, Charcot-Leyden cyrstals (saline preparation) and cysts of
protozoa (iodine preparation).

When examining diarrhoeic or liquid feces containing mucus, both

preparations should be applied to the mucous part of the stool.
• Warm stools are best for
detecting Ova or parasites.
• Do not refrigerate the
specimen.
• Because of cyclic life cycle of
parasites, three separate
random stool specimens are
recommended for
examination.
• Undigested food materials –
None to small amount
• Starch – None
• Eggs, Cysts, Parasitic
fragments – None
• Yeasts – None
• Leukocytes – None
• Large amounts of leukocytes is
suggestive of Chronic Ulceratice
Collitis, Chronic Bacillary Dysentry,
Localised Abscess, Fistulas.
• Mononuclear Leukocytes appear in
Typhoid.
• Polymorphonuclear Leukocytes appear
in Shigellosis, Salmonellosis, Invasice
E. coli Diarrhea, Ulceratice Collitis.
• Absent Leukocytes in Cholera, Viral
Diarrhea, Non-specific Diarrhea,
Amoebic Collitis, Giardiasis.
• Blood, pus, mucus, bacteria, virus,
parasites PRESENT
• High levels of fat - chronic pancreatitis,
sprue (celiac disease), cystuc fibrosis,
others
• Undigested meat fibers - pancreatitis
• > 6.8 pH - poor absorption of
carbohydrates or fat, and problems with
amount of bile in digestive tract
• < 5.3 pH -poor absorption of sugars
• Low level of enzyme ( trypsin or
elastase) - -digestive complication of
pancreas, problem conditions (cystic
fibrosis)
• Blood - bleeing indigestive tract
• WBC - bacterial diarrhea.
• High level of reducing factor - problem
digesting certain sugar (esp sucrase
and lipase)
• Low level reducing factor - sprue, CF,
malnutrition
• Medications ( colchine - for gout) or oral
contraceptive may cause low levels
 PHYSICAL
OBSERVATIONS

OBSERVATIONS

COLOR BROWN

ODOR FOUL ODOR

CONSISTENCY TYPE 4 (NORMAL)

BLOOD NONE
WITH SALINE SOLUTION WITH LUGOL’S IODINE
SOLUTION
• Why are fecal samples often preserved? What kind of preservatives are
used?

Preservation of specimens is necessary when stool specimens

cannot be examined within the prescribed time due to unexpected
circumstances. We can use 10% aqueous formalin and PVA (polyvinyl
alcohol) as preservatives.

• What is the relevance of conducting a fecalysis as a pharmacist?

Pharmacists conduct fecalysis in order to provide accurate

diagnosis and help in the intervention of the disease. Pharmacists work
with other healthcare professionals to contribute in the surveillance and
monitoring of the patient’s disease.
• What are the disadvantages in a direct smear method?

The disadvantages in a direct smear method includes the use of

small amount of feces, which means we can miss something and there’s a
large amount of fecal debris.

• What is the importance of early detection of parasitosis?

If a diagnosis is made early on in the course of the disease, the patient and
supportive others are given the opportunity to educate themselves about
the condition. In turn, they are able to make informed choices and plan
effectively.
 Fecalysis, also known as stool analysis, is a test done on a sample of stool. It is a series of
tests done on a stool sample to help diagnose certain conditions affecting the digestive tract,
including infection (such as parasites, viruses, or bacteria) , poor nutrient absorption or cancer. In
clinical setting, it usually takes at least one to three days for the test to be finished.

There are examinations for stool analysis which include physical examination, microscopic
examination, and chemical examination. For physical examination, you will observe for its color,
consistency, odor, presence of blood/mucous/others and visible parasites. Since physical
examination won’t be enough, microscopic examination will be done for further analysis. Its main
purpose is to detect parasites and their ova. Solutions like Lugol’s Iodine and Sodium Chloride are
usually used. Chemical examinations use the principle of pseudoperoxidase activity of hemoglobin.
This examination is for occult blood, increased fat associated with malabsorption syndromes and
reducing substances which is crucial in infant’s diarrhea.

In a nutshell, fecalysis just like urinalysis plays an important role in diagnostic purposes
especially when abnormal values are examined.