You are on page 1of 9

Introduction to Parasitology

Parasitology is that branch of medical science with deals with the study of parasites.
Parasitology
Protozoology Helminthology
deals with protozoa deals with Helminths
Parasite: A living organism which receives nourishment & shelter from another living organism where it
lives.
A parasite always causes some kind of injury to the host
Grossly divided into 2 groups:
A) Protozoa &
B) Metazoa or Helminths
Protozoa consists of single cell which is morphologically & functionally complete
Example: Entamoeba
Leishmania
Plasmodium
Metazoa or Helminths are multicellular complex structure where each cell performs particular function
Helminths
Platyhelminthes Nemathelminthes
Cestodes Trematodes Nematodes
e.g Echinococcus, Fasciola e.g Ascaris lumbricoides
Type of parasites
1.Ectoparasite
Lives outside on the surface of the body of host e.g lice, tick
2.Endoparasite
Lives inside the body of the host i,e blood, tissues, body cavities, digestive tract & other organs e.g most
of medical parasites
3.Temporary parasite: visits its host for a short period e.g who passes their life cycle in two different
hosts
4.Permanent parasite: which leads a parasitic life throughout the whole period of life
5.Facultative parasite: lives a parasitic life when opportunity arises e.g Cryptosprodium
6.Obligatory parasite: can not exist without a parasitic life
7.Occasinal or accidental parasite: attacks an unusual host e.g Echinococcus granulosus
8.Wandering or aberrant parasite: happens to reach a host where it can not survive

Host
An organism which harbors the parasite
Types of host;
E Definitive host: The host which harbours the adult stage of the parasite or where sexual method
of reproduction takes place
E Man is the definitive host for most of the medical parasites

E Intermediate host: The host which harbours the larval stage of the parasite or where
asexual method of reproduction takes place
E Intermediate hosts are mostly non-human
E Man is the intermediate host only in 2 cases
× Hydatid disease harbouring the larval stage of Echinococcus granulosus
× Malaria where asexual method of reproduction of Plasmodium takes place
Paratenic host, also known as carrier or transport host:
A host where parasite remains viable without further development



Types of association between living organisms
1. Symbiosis
An association where both the partners are mutually benefitted from each other
None of the partners suffers any harm from the association
2. Commensalism;
An association in which the parasites only is deriving benefit without causing injury to its host
e.g Normal flora
3.Parasitism
+ An association in which the parasite only is deriving benefit & the host always suffers some
injury
+ A parasite has lost its power of independent life
Zoonosis
Zoonosis means diseases which occurs primarily in vertebrate animals from where humans can be
infected accidentally
Example of parasitic zoonotic diseases
+ African Leishmaniasis or Kala-azar
+ Echinococcosis or Hydatid disease
Scheme followed in parasitological studies
1.Geographical distribution
2.Habitat inside the human host
3.Morphology & life cycle
4.Mode of infection
× infective form
× reservoir
× host
× source of infection
× portal of entry
× vehicle of transmission
5.Effect of parasite
× Pathological lesion
× Clinical manifestation
6.Immunological response
7.Method of diagnosis
8.Therapy for eradication of parasitic infection
9.Prophylaxis- personal & community
Immunity to parasitic infection
1.Both humoral & cell mediated immunity develops following parasitic infection
2.Some of them are protective while others are used for immunodiagnosis
3.Antibodies (IgM & IgG) produced in Malaria are protective
4.IgE antibody in many helminthic infection- lower the worm burden
5.Antibodies produced in Kala-azar & Trypanosma infection is not protective- used for diagnosis
6.Cell mediated immunity is protective in these cases
7.Children carrying sickle cell trait are relatively resistant to Plasmodium falciparum
8.Glucose-6 phosphate dehydrogenase deficiency-protect against severe effect of malaria
9.In hyper endemic area of Malaria, infants born from immune mothers are protected for first 6 months
of life
Concomitant immunity
This is also known as ‘premunition’ or ‘infection immunity’ in which there is a relative resistance to re-
infection to that parasite which is still carried by the host
e.g Malaria & Shistosomiasis


Abnormal immune response
Autoimmunity:
Auto antibodies are formed against RBC in case of Kala-azar & Malaria leading to autoimmune
haemolytic anaemia
Hypersensitivity:
Immune complex mediated hypersensitivity causing nephrosis - occurs in Plasmodium malariae infection
Delayed type of hypersensitivity occurs in Schistosomiasis

Examples of parasites which enter through G.I tract
O Entamoeba histolytica
O Giardia lamblia
O Ascaris lumbricoides
O Taenia solium & Taenia saginata
O Echinococcus granulosus
Examples of Parasites which enter through penetration of skin
E Ankylostoma duodenale
E Necator americanas
E Strongyloides stercoralis
E Schistosoma hematobium
E Schistosoma japonicum
Parasites entering into host through insect bite
Plasmodium (Malarial parasite) through bite of female Anopheles mosquito
Leishmania donovani (agent Kala-azar) by female Sandfly
Wuchereria bancrofti (agent of Filariasis) by female Culex mosquito


Pathogenic effect of parasites
◙ In protozoal infection, lesion is greatly influenced by proliferation, multiplication & metastasis to
distant organs
◙ E.histolytica secrets a powerful histolytic toxin-causes destruction of tissues
◙ In Plasmodia, parasite during erythrocytic schizogony causes destruction of RBC

© In majority of helminthic infection- adult parasites are found inside the body & no
multiplication occurs
© The effect depends on site of infection & the pattern of laying eggs or larvae
© Body secretions of growing larvae & products released from dead parasites- may give rise to
allergic reaction
Parasitic infection causing immunosuppressive effect
× Trypanosomiasis
× Kala-azar
× Malaria
× Toxoplasmosis
Parasites causing neoplastic growth
ª Fasciola hepatica - adenocarcinoma of the bile duct & primary liver carcinoma
ª Schistoma species
× S.mansoni & japonicum - colonic, rectal & hepatic carcinoma
× S. hematobium – vesical (urinary bladder) carcinoma
ª Plasmodium- Burkitt’s lymphoma
Outline of Laboratory diagnosis
A) Examination of blood film
× In malaria, parasites are found inside the erythrocytes (RBC)
× In Kala-azar- Leishmania donovani are found inside the monocyte or macrophage
× In Filariasis- Microfilariae are seen in blood film
× In African sleeping sickness & Chaga’s disease- Trypanosoma are present in peripheral blood film
B) Examination of stool
i) In intestinal protozoal infection
(Entamoeba histolytica & Giardia lamblia)
× In acute phase- trophozoites are found
× In chronic phase- cysts in stool
ii) In helminthic infection- adult worm or their segments, larva or eggs are found in the stool
Eggs
♣ Ascaris lumricoides
♣ Ankylostoma duodenale
♣ Trichuris trichiura
♣ Schistosoma- S.mansoni & S.japonicum
♣ Taenia- T.solim & T.saginata
♣ Diphyllothium latum
♣ Hymenolepis nana
× In Enterobius vermicularis, eggs are rarely found in stool
× Eggs are deposited on the perianal skin from where swab is taken
Larva
♣ Strongyloides stercoralis
B) Examination of stool contd..
Adult worm found in stool
♣ Ascaris lumricoides
♣ Ankylostoma duodenale
♣ Enterobius vermicularis
♣ Trichuris trichiura
· Segments of adult worm in stool
♣ Diphyllobothrium latum
♣ Taenia sainata & Taenia solium
C) Examination of Urine
* Eggs of S. hematobium are found in case of Vesical Schistomiasis
* Microfilariae are found In case of chyluria caused by Wuchereria bancrofti
Examination of sputum
◘ Trophozoite of E. histolytica in case of liver abscess bursting into lungs
◘ Rupture of hydatid cyst of lungs-scolices & hooklets of Echinococcus granulosus are found
◘ Eggs of Paragonimus Westermanii- are found in sputum
Biopsy material
4 Bone marrow biopsy- in case of
Kala-azar & African trypanosomiasis
4 Spleen puncture- Kala-azar
4 Lymph node puncture- Mediterranean Kala-azar mainly
4 Skin biopsy- PKDL, Espundia & Onchocereciasis
4 Liver biopsy – E. histolytica, Kala-azar
4 Muscle biopsy- Cysticercosis bovis & Cysticercosis cellulosae (Taenia infection)
4 Lumber puncture
× Amoebic meningo-encephalitis
× African trypanosomiasis
Indirect or immunological test
+ CFT(Complement Fixation Test)
+ Latex agglutination test
+ ELISA
+ Direct Immunofluorescence test (DIF)
+ Indirect Immunofluorescence test (IIF)
+ DAT(Direct Agglutination Test)
+ I.C.T( Immunochromatographic Test)
Supportive tests
◙ Eosinophilia- Helminthic infection
◙ Leucopenia- Kala-azar
◙ Neutrophilic leukocytosis- Amoebic liver abscess
◙ Anaemia- Malaria, Kala-azar, Hookworm infection etc.
Supportive tests contd..
◙ Hypergammaglobulinaemia
4 Kala-azar
4 African trypanosomiasis
4 Visceral larva migrans
· Intradermal test: Casoni’s test in Hydatid disease

Permanent parasite: which leads a parasitic life throughout the whole period of life 5.Wandering or aberrant parasite: happens to reach a host where it can not survive Host An organism which harbors the parasite Types of host.Obligatory parasite: can not exist without a parasitic life 7. also known as carrier or transport host: A host where parasite remains viable without further development .g Echinococcus granulosus 8.  Definitive host: The host which harbours the adult stage of the parasite or where sexual method of reproduction takes place  Man is the definitive host for most of the medical parasites  Intermediate host: The host which harbours the larval stage of the parasite or where asexual method of reproduction takes place  Intermediate hosts are mostly non-human  Man is the intermediate host only in 2 cases  Hydatid disease harbouring the larval stage of Echinococcus granulosus  Malaria where asexual method of reproduction of Plasmodium takes place Paratenic host.g who passes their life cycle in two different hosts 4.Facultative parasite: lives a parasitic life when opportunity arises e.Occasinal or accidental parasite: attacks an unusual host e.g Cryptosprodium 6.Temporary parasite: visits its host for a short period e.3.

Commensalism.Morphology & life cycle 4.Types of association between living organisms 1.Parasitism  An association in which the parasite only is deriving benefit & the host always suffers some injury  A parasite has lost its power of independent life Zoonosis Zoonosis means diseases which occurs primarily in vertebrate animals from where humans can be infected accidentally Example of parasitic zoonotic diseases  African Leishmaniasis or Kala-azar  Echinococcosis or Hydatid disease Scheme followed in parasitological studies 1.g Normal flora 3.Mode of infection  infective form  reservoir  host  source of infection .Habitat inside the human host 3. An association in which the parasites only is deriving benefit without causing injury to its host e.Geographical distribution 2. Symbiosis An association where both the partners are mutually benefitted from each other None of the partners suffers any harm from the association 2.

Children carrying sickle cell trait are relatively resistant to Plasmodium falciparum 8.Antibodies produced in Kala-azar & Trypanosma infection is not protective.IgE antibody in many helminthic infection.personal & community Immunity to parasitic infection 1.Some of them are protective while others are used for immunodiagnosis 3. portal of entry  vehicle of transmission 5.Effect of parasite  Pathological lesion  Clinical manifestation 6.Therapy for eradication of parasitic infection 9.lower the worm burden 5.Glucose-6 phosphate dehydrogenase deficiency-protect against severe effect of malaria 9.Method of diagnosis 8.In hyper endemic area of Malaria.Both humoral & cell mediated immunity develops following parasitic infection 2.Prophylaxis.Antibodies (IgM & IgG) produced in Malaria are protective 4.Cell mediated immunity is protective in these cases 7.used for diagnosis 6. infants born from immune mothers are protected for first 6 months of life Concomitant immunity This is also known as ‘premunition’ or ‘infection immunity’ in which there is a relative resistance to reinfection to that parasite which is still carried by the host e.Immunological response 7.g Malaria & Shistosomiasis .

occurs in Plasmodium malariae infection Delayed type of hypersensitivity occurs in Schistosomiasis Examples of parasites which enter through G.Abnormal immune response Autoimmunity: Auto antibodies are formed against RBC in case of Kala-azar & Malaria leading to autoimmune haemolytic anaemia Hypersensitivity: Immune complex mediated hypersensitivity causing nephrosis .I tract  Entamoeba histolytica  Giardia lamblia  Ascaris lumbricoides  Taenia solium & Taenia saginata  Echinococcus granulosus Examples of Parasites which enter through penetration of skin  Ankylostoma duodenale  Necator americanas  Strongyloides stercoralis  Schistosoma hematobium  Schistosoma japonicum Parasites entering into host through insect bite Plasmodium (Malarial parasite) through bite of female Anopheles mosquito Leishmania donovani (agent Kala-azar) by female Sandfly Wuchereria bancrofti (agent of Filariasis) by female Culex mosquito .

Leishmania donovani are found inside the monocyte or macrophage  In Filariasis.Burkitt’s lymphoma Outline of Laboratory diagnosis A) Examination of blood film  In malaria.adenocarcinoma of the bile duct & primary liver carcinoma  Schistoma species  S.may give rise to allergic reaction Parasitic infection causing immunosuppressive effect  Trypanosomiasis  Kala-azar  Malaria  Toxoplasmosis Parasites causing neoplastic growth  Fasciola hepatica . hematobium – vesical (urinary bladder) carcinoma  Plasmodium. parasites are found inside the erythrocytes (RBC)  In Kala-azar. multiplication & metastasis to distant organs E.adult parasites are found inside the body & no multiplication occurs  The effect depends on site of infection & the pattern of laying eggs or larvae  Body secretions of growing larvae & products released from dead parasites.Microfilariae are seen in blood film . lesion is greatly influenced by proliferation.histolytica secrets a powerful histolytic toxin-causes destruction of tissues In Plasmodia. parasite during erythrocytic schizogony causes destruction of RBC ◙ ◙  In majority of helminthic infection.Pathogenic effect of parasites ◙ In protozoal infection.mansoni & japonicum .colonic. rectal & hepatic carcinoma  S.

mansoni & S.japonicum ♣ Taenia. In African sleeping sickness & Chaga’s disease.adult worm or their segments.saginata ♣ Diphyllothium latum ♣ Hymenolepis nana  In Enterobius vermicularis..Trypanosoma are present in peripheral blood film B) Examination of stool i) In intestinal protozoal infection (Entamoeba histolytica & Giardia lamblia)  In acute phase.T.cysts are found in stool ii) In helminthic infection. Adult worm found in stool ♣ Ascaris lumricoides ♣ Ankylostoma duodenale ♣ Enterobius vermicularis ♣ Trichuris trichiura . eggs are rarely found in stool  Eggs are deposited on the perianal skin from where swab is taken Larva ♣ Strongyloides stercoralis B) Examination of stool contd.S.trophozoites  In chronic phase.solim & T. larva or eggs are found in the stool Eggs ♣ Ascaris lumricoides ♣ Ankylostoma duodenale ♣ Trichuris trichiura ♣ Schistosoma.

in case of Kala-azar & African trypanosomiasis  Spleen puncture. Segments of adult worm in stool ♣ Diphyllobothrium latum ♣ Taenia sainata & Taenia solium C) Examination of Urine  Eggs of S. hematobium are found in case of Vesical Schistomiasis  Microfilariae are found In case of chyluria caused by Wuchereria bancrofti Examination of sputum ◘ ◘ ◘ Trophozoite of E. histolytica. histolytica in case of liver abscess bursting into lungs Rupture of hydatid cyst of lungs-scolices & hooklets of Echinococcus granulosus are found Eggs of Paragonimus Westermanii.PKDL.are found in sputum Biopsy material  Bone marrow biopsy. Espundia & Onchocereciasis  Liver biopsy – E.Kala-azar  Lymph node puncture.Cysticercosis bovis & Cysticercosis cellulosae (Taenia infection)  Lumber puncture  Amoebic meningo-encephalitis  African trypanosomiasis Indirect or immunological test  CFT(Complement Fixation Test)  Latex agglutination test  ELISA . Kala-azar  Muscle biopsy.Mediterranean Kala-azar mainly  Skin biopsy.

Hookworm infection etc.. ◙ Hypergammaglobulinaemia  Kala-azar  African trypanosomiasis  Visceral larva migrans  Intradermal test: Casoni’s test in Hydatid disease .C. Kala-azar. Direct Immunofluorescence test (DIF)  Indirect Immunofluorescence test (IIF)  DAT(Direct Agglutination Test)  I. Supportive tests contd.T( Immunochromatographic Test) Supportive tests ◙ ◙ ◙ ◙ Eosinophilia.Malaria.Kala-azar Neutrophilic leukocytosis.Helminthic infection Leucopenia.Amoebic liver abscess Anaemia.