Exercise 6

Parasitology laboratory

EXERCISE 6:
MALARIAL PARASITES

Basophilic Stipplings: represent the pigment produced by the parasite

due to metabolism of haemoglobin

Malarial Parasites
-

Protozoans w/c parasitize blood & tissues of man

4 species: P. falciparum, P. vivax, P. ovale, P. malariae
2 stages in the life cycle

Diagnosis (3 species aside from P. falciparum): examine trophozoites &

other stages unique to a particular specie

Mosquito: definitive host

Life Cycle

Man: intermediate host

Infective stage: sporozoites invade liver parenchyma merozoites

Some merozoites enter RBC either continue more merozoites or
develop into gametocytes

Life Cycle
-

Asexual phase (man)

o
Schizogony

Formation of merozoites
o
Gametogony

Formation of gametocytes
o
Exoerythrocytic Phase

In the liver after introduction by

mosquito
o
Erythrocytic Phase

In the RBC
o
*re-invasion of the liver (hypnozoites): vivax,
ovale
Sexual Phase (mosquito)

Hypnozoites: produced by ovale and vivax

-

Responsible for relapse (true relapse)

**recrudescence vs. true relapse!!!! Read!!!!

Gametocytes in mosquito develop: microgametocyte exflagellate to

become the microgamete w/c fertilized the macrogamete zygote
ookinete (motile) oocyst - ruptures sporozoites in mosquito gut
salivary gland of mosquito

Developmental Stages
1.
2.
3.
4.
5.

Red cell
preferenc
e
Infected
RBC
Basophilic
stipplings
Characteri
stic
features

Ring forms (young trophozoites)

Trophozoite
Schizonts
Merozoites
Gametocytes
Plasmodium
falciparum
No preference
(affects all
ages of red
cells)
Not enlarged

Plasmodi
um vivax
Immatur
e RBC

Plasmodi
um ovale
Immatur
e RBC

Plasmodium
malariae
Senescent/s
enile RBC

Enlarged

Enlarged

Maurers dots

Schuffner
s dots
*mature
ring
forms are
coarse &
large
*develop
ing forms
are
frequentl
y present

Schuffner
s dots
*Comet
forms are
common
*rings
are large
&coarse
*schizont
s similar
to
malariae
but are
larger &
more
coarse

Not
enlarged
Ziemanns
dots
*ring forms
are
squarish
*Band forms
are
characteristi
c
*chromatin
dot may be
on the inner
surface of
the ring

*Fine ring
forms: may be
several in one
cell (2
chromatin
dots)
*Marginal/App
lique forms
*Crescentshaped
gametocytes

Diagnosis
Do not treat based on s/s alone because resistance may develop
Definitive Dx: PBS (Gold standard)
-

Thick film
o
15 x 12 mm, many cells thick
o
Not fixed before staining
o
For low parasitemia, chronic infection under
treatment
Thin film
o
One cell thick
o
Fixed before staining
o
For the morphology of the parasite, speciation,
condition of red blood cells

Exercise 6
Parasitology laboratory

Other tests
-

Dipstick methods: plasmodial histidine-rick protein 2 and

parasite specific LDH
Antibodies to malaria: enzyme immunoassays,
immunofluorescence
QBC method: parasite DNA stained w/ acridine orange and
viewed
o
Quantitative buffy coat method
o
Parasite will appear bright green
o
Highly sensitive but has a low specficity
PCR: <10 parasites/10 uL of blood

Histidine rich protein 2: specific for falciparum

High tech methods cannot differentiate a current and past infection

**please refer to your drawings for the different stages