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PARASITOLOGY REVIEWER

PROTOZOA

GENERAL CHARACTERISTICS
- Unicellular organisms composed of a nucleus and cytoplasm
It is concerned with reproduction.

CLASS SARCODINA
CAUSATIVE
DISEASE HABITAT MODE OF TRANSMISSION DIAGNOSIS TREATMENT
AGENT
Entamoeba Amoebiasis, amoebic Large Intestine Food and drink contaminated FECALYSIS Metronidazole is the DOC for Amoebiasis, Giardiasis,
histolytica dysentery, amoebic with feces containing the cysts amoebic dysentery and Trichomonas vaginalis inf.
colitis, amoebic liver
abscess, cutaneous More on treatment: Diloxanide furoate is used for
amoebiasis, hepatitis asymptomatic carriers

NOTE:
Cysts is the dormant stage and is environmentally
stable. When the cysts are ingested, they then go through
excystation to release the active trophozoite stage.

The trophozoite are the actively metabolizing motile form


of protozoa

MASTIGOPHORA (Flagellate)
1. Lumen or Atrial Flagellate
Giardia lamblia Giardiasis ( A.K.A Small intestine Ingestion of food and water Direct fecal smear Metronidazole
Beaver Fever); contaminated with viable cysts of duodenal Quinacrine HCL
flagellate diarrhea the parasite. aspiration;
Fluoroscopy, X-ray NOTE:
films reveal mucosal Most G. lamblia infections are usually asymptomatic, but
defects. symptoms do present, such as diarrhea.

Severe cases of giardiasis show signs of foul-smelling,


fatty stools (steatorrhea) because the organism
interferes with the absorption of fat and fat-soluble
vitamins resulting to weight loss. (similar to celiac
disease)
Trichomonas Vaginitis Human vagina and During sexual intercourse, Parasite is seen is Treat infected sexual partners simultaneously orally = 250
vaginalis Trichomoniasis prostate gland PINGPONG REINFECTION sedimented urine, mg metronidazole daily
(infection through married vaginal secretion or
couples), direct contact with from vaginal NOTE:
infected fomite, toilet seats can scrapings or Trichomoniasis is one of the most common, if the most,
be also be transmitted prostatic massage STD.
congenitally but rare. in male.
Trichomonas vaginalis also have the simplest protozoan
life cycle in which there is no cyst form, so infection is
purely by direct contact. Their trophozoites can also
survive outside and on fomites for hours, unlike G. lamblia
trophozoites which disintegrate immediately.

2. Blood or Tissue Flagellate (hemoflagellates)


Leishmania Visceral Reticuloendothelial Skin bite by arthropod a.) Depends on the 2% berberine sulfate standard treatment; stibufen
donovani Leishmaniasis or cells demonstration of
Kala-azar, Death the parasites from Miltefosine originally developed as an antineoplastic
Fever Dum-Dum puncture of the Paromomycin an aminoglycoside
Fever ulcerated part.
Pentavalent antimonials (Na stibogluconate)
b) Do Montenegro
test and NNN NOTE :
VECTOR : culture. Visceral and Cutaneous Leishmaniasis
sandfly or Phlebotomus All causative agents of leishmaniasis are transmitted by
pappataci; Sandflies.

They also exhibit marked ulcerations on the site of initial


infection.
The promastigote is found on the insect host (saliva)
while it loses its tail when it is injected to the skin (by
macrophages) and it becomes the amastigote (on
humans).
Viscera plural of viscus internal organ

Leishmania American lives in tissue cells, Skin bite by arthropod same as L. donovani same as L. donovani
braziliensis leishmaniasis, endothelial cells
espundia, uta, ulcera involved portions of
de los chicleros, the skin and
cutaneous- mucous VECTOR :
mucocutaneous membranes of the sandfly or Phlebotomus
leishmaniasis, nose, mouth and pappataci;
nasopharyngeal pharynx. Not seen
leishmaniasis. in circulation and
in viscera.
Trypanosoma Gambian Blood, skin, lymph The trypanosomes ingested by blood, lymph juice, Suramin, melarsoprol
brucei gambiense trypanosomiasis, or glands, brain, spinal the feeding fly must reach the sternal bone
Mid and West fluid of host. salivary glands, attach to it, marrow or CSF.
African Sleeping transform into epimastigote then
sickness. to trypomastigote then be
transmitted to another host by
bite.

VECTOR :
Glossina (tsetse) flies, both male
and female

Trypanosoma Rhodesian same as Skin bite by insect same as for same as for T.gambiense
brucei trypanosomiasis or T.gambiense T.gambiense
rhodesiense East African Sleeping VECTOR : NOTE:
sickness. Glossina (tsetse) flies, both male Gambiense and rhodisiense are morphologically similar
and female but gambiense only have humans as a significant
reservoir, rhodesiense have many.

Rhodesian form also invades the CNS earlier than the


gambian form. The gambian form is more chronic, and
would sometimes take several years for the CNS effects
develop.

Treatment
Suramin and pentamidine effective but only before CNS
involvement.
Melarsoprol effective even if with CNS, but is highly
toxic.
Eflornithine Can cross BBB, can act even at late stages
Trypanosoma Chagas disease or Reticuloendothelial Posterior station Infective same as for Nitrofurtimox, Benznidazole
cruzi South American cells of spleen, stage (trypomastigote ) is T.gambiense
trypanosomiasis liver, lymph nodes, transmitted when the vector
Lymphatic tissue, bites and defecates on the
Usually causes myocardium, wound.
problems striated muscle
cardiovascularly cells, Bone marrow, VECTOR: NOTE:
suprarenal glands, Triatomid bug Triatoma T. gambiense multiply while in the blood or CSF.
tests ovaries, skin, dimidiata While T. cruzi replicate in the rectal sacs of vector
Intestinal mucous insects.
membrane, and the
CNS.
PLASMODIUM
P. vivax Benign tertian or Skin Source of Infection for man; Stained thin and The antimalarial drugs include :
vivax malaria blood transfusion, thru thick blood Chloroquine
contaminated smears; Chlorguanide
needle,transplacental serological test Pyrimethamine
(congenital) Quinacrine
INCUBATION VECTOR: Chlorproguanil.
PERIOD : female Anopheles mosquito
8 31 days (ave.
14)

Clinical
Manifestation:
Paroxysm; fever,
chill and sweat; 48
hrs. cycle; enlarged
spleen and liver
P. ovale Ovale Malaria; same as P. vivax same as in P. vivax same as in P. vivax same as in P. vivax
benign

INCUBATION
PERIOD
11 16 days

Clinical
Manifestation:
Paroxysm; 48 hour
interval

P. malariae Quartan Malaria; same as P. vivax same as P. vivax same as P. vivax same as P. vivax
benign

INCUBATION
PERIOD: 28 37
days (ave. 30
Clinical
Manifestation:
Paroxysm; 72 hour
interval
P. falciparum Malignant tertian P. vivax P. vivax P. vivax P. vivax
or falciparum
Malaria

INCUBATION
PERIOD
7-27 days (ave. 12)

Clinical
Manifestation:
Paroxysm; 24-48
hour cycle;
hemoglubinuria in
black water fever.

METAZOA
A. Intestinal Nematode or True roundworms

- Elongated, cylindrical, filiform with a definite antero-posterior axis.


- They are in segmented with fundamental bilateral symmetry end triradiate symmetry in the anterior and (mouth and esophagus).
- They are free-living or parasitic.

INTESTINAL NEMATODE
CAUSATIVE COMMON
DISEASE HABITAT PATHOGENESIS DIAGNOSIS TREATMENT
AGENT NAME
Ascaris Giant Ascariasis Mouth damage in man maybe due to: migrating larva or adult - Bronchial washing for the Piperazine (
lumbricoides intestinal Esophagus worm identification of larvae. Padrax, Expillin,
roundworm - Stool exam - X-ray Antepar, TMZ ),
Pyrantel
pamoate
Necator New World Necatoriasis Lungs, 1) Larval lesion - Direct fecal smear. - Mebendazole
americanus (American) uncinariasis skin When it penetrates the skin, it produces maculopapules Concentration technique (vermox),
hookworm and localized erythema. Itching called ground itch or - Copro-culture to Pyrantel
dew itch. If many migrate thru the lungs, bronchitis or differentiate hookworm from pamoate
pneumonitis may result in sensitized individuals. Strongyloides
- Baermans technique
2) Adult lesions - Stool dilution egg count
It is a chronic infection with no acute symptoms. Most surveys
prominent characteristic in moderate or heavy chronic
infection is progressive secondary microcytic
hypochromic anemia of nutritional deficiency type due to
loss of blood
Ancylostoma Old World Ancylostomiasis ( Same to N. Same to N. americanus Same to N. americanus Same to N.
duodenale hookworm hookworm americanus americanus
disease or
infection)
Strongyloides Threadworm Strongyloidiasis, Skin, lungs, 1) Filariform larva - Demonstration of Thiabendazole
stercoralis Cochinchina - When it penetrates the skin, produces petechial rhabditiform larva and adults
diarrhea hemorrhages, congestion and edema, violent pruritus at in stool.
site of skin penetration.
- In the lungs, delay in larval migration due to host - In the lungs, demonstration
response, they mature in the lung parenchyma and invade of adult larva from sputum
the bronchial epithelium causing destruction and and bronchial washing.
consolidation of the lungs (strongiloides pneumonitis).

2) Adult
- By mechanical or chemical irritation, produce intestinal
disturbances; like severe diarrhea, abdominal pain, severe
infection. They also produce hyper-eosinophilia.
Enterobius Pinworm, Enterobiasis, Colon (Large Cause minute ulceration, hemorrhages from the Anal swab or Graham scotch Mebendazole
vermicularis seatworm oxyuriasis Intestine) ulceration, which may become infected causing tape method
intolerable itchiness.
Nocturnal pruritus and very mild tingling sensation to an
acute pain
Trichuris Whipworm Trichuriasis; Colon or Mild infection usually cause no symptoms. Direct fecal smears; Mebendazole,
trichiura trichocephaliasis abdomen Large numbers of worms may cause symptoms such as concentration methods Thiobendazole
abdominal discomfort, anemia, bloody stools, tenesmus sedimentation
to toxin produced. Egg counts to determine
warm burden.
Capillaria NONE Intestinal Colon N O N E Direct fecal smear; Thiobendazole
philippinensis capillariasis; concentration and
Mystery disease sedementation methods.
(ILOCOS)
Trichinella Trichina worm Trichinosis, Colon N O N E Muscle biopsy use the Albendazole,
spiralis trichiniasis, gastronomies or biceps do a Mebendazole
trichinellasis double slide compression
methods. Bachman
intradermal test
Serological Test demonstrate
appearance of antibodies by
precipitin test. Xenodiagnosis
feed scrap meat to lab.
Animal and detect for viable
larva afterward.
B. BLOOD AND TISSUE NEMATODE
FILARIAL PARASITES (WORMS)
General Characteristics:
a. Adult stage threadlike and creamy in appearance and varies in length. They are formed in different lymphatics or body cavities.
b. Larval stage eggs laid are embryonated which when hatched are called microfilaria.
c. If it escapes from its shell, it is said to be unsheathed. Otherwise, it is sheathed.
d. They are snake-like in appearance with column of cells from the anterior most portions down to the posterior end. The larval stages are extruded in the peripheral
circulation.

FILARIAL PARASITES (WORMS)


SHEATHED MICROFILARIA
CAUSATIVE COMMON
DISEASE HABITAT VECTOR DIAGNOSIS
AGENT NAME
Wuchereria Bancrofts Elephantiasis ADULTS: lower mosquitoes blood smear should be taken at night
bancrofti filaria Bancroftian lymphatic Anopheles minimums flavirostris-rural;
filariasis, MAN: Peripheral Aedes poecilus-urban
wuchereriasis blood Culex pians quinquefasciatus

Brugia malayi Malayan Malayan ADULTS: upper mosquitoes (Mansonia spp., Anopheles spp.) blood smear should be taken at night
filarial worm filariasis lymphatics
Elephantiasis MAN: Peripheral
blood
Loa loa Loa worm, Loaiasis, ADULTS: Chrysops spp.( deer flies) blood smear should be taken during daytime
eyeworm fugitive subcutaneous
swelling, calabar tissue
swelling MAN: Peripheral
blood

UNSHEATHED MICROFILARIA
Onchacerca convoluted onchoceriasis subcutaneous Simulium damnosum (black flies) one should do a skin biopsy or skin snip of the
volvulus Filaria nodules subcutaneous nodules
MAN:
Lymph spaces of
skin,
subcutaneous
nodules
Dracunculus guinea dracunculiasis viscera, in Cyclops spp. (small crustaceans) blood smear
medinensis worm, subcutaneous
serpent tissue
worm, female
discharges
dragon
rhabditiform
larvae
TREMATODA

GENERAL CHARACTERISTICS:
- They are broadly oval or leaf like in shape with an oral sucker, a prepharyngeal tube, a pharynx and esophagus and a bifurcatedintestinal ceca which ends blindly
except in the blood flukes.
- They vary in size and shape.
- Digestion is predominantly an extra cellular process.
- Respiration is essentially anaerobic.
- Excretory system is bilaterally symmetrical and open at the posterior end of the body with flame cell or aclenocytes.
- Nervous system is composed of a group of paired ganglion cells disposed like saddle on the dorsum of the pharynx or esophagus, and a main pair each of
posteriorly and anteriorly
- Directed nerve trunks in the dorsal.
- They are hermaphrodites except for the human blood flukes.
- They are sexually mature, diagnostic trematoda is found in the definitive host.
- Both male and female reproductive organ system have end common opening known as the genital pore.
- The male reproductive system is composed of the prostate enclosed by narcus pouch or sac followed by dilatation.
- Female reproductive system consists of a sac-like structure called the uterus which opens into the seminal receptacle, then the on type, than the oviducts ending
in a single ovary.
- All trematodes lay eggs which upon embryonation give rise to a ciliated embryo known as miracedium.
- All eggs to trematodes are provided with a lid called operculum
- Trematodes need body of water to complete the life cycle. All require two intermediate hosts except the blood flukes which only has one intermediate host
- Manner of Transmission: Ingestion of metacercaria

CAUSATIVE COMMON
DISEASE HABITAT PATHOGENESIS DIAGNOSIS TREATMENT
AGENT NAME
Fasciola hepatica Sheep liver fluke Fascioliasis, liver NONE a. Immature adults ectopic Direct fecal smear Emetine HCl; Bithionol
rot lesions in the intestinal wall, orbit,
lungs, brain, blood vessels and
subcutaneous tissues.

b. Mature adults - Irritation and


inflammation of the bile ducts
including biliary obstruction due to
pressure toxic metabolites;
Development of parenchymal
atrophy and cirrhosis;
Enlarged tender liver, jaundice,
diarrhea, anemia.
S/S include sever headache,
irregular fever, chills, diarrhea,
urticarial rashes, stabbing
substernal pain, right upper
quadrant pain that radiate to back
and shoulder, vomitting.
leukocytosis w/ 60% esinophilia.
Clonorchis sinensis Chinese liver Clonorchiasis distal biliary passages NONE direct fecal smear, emethine HCl
fluke, Oriental duodenal aspirate,
liver fluke non-specific
immunological
tests
Opistorchis felineus cat liver fluke Opistorchiasis distal biliary passages NONE direct fecal smear ; Chloroquine
duodenal aspirate. phosphate
Fasciolopsis buski giant-intestinal Fasciolopsiasis mucosa of the small NONE History of the case; NONE
fluke. intestines. stool exam
Echinostoma Garrisons fluke NONE Walls of the small NONE Recovery of Hexylresorcinol
ilocanum intestines unembryonated crystoids,
egg of the parasite Tetrachloroethylene,
Synonyms: in the hosts stool Oleoresin of aspidium
Fascioletta
ilocanum,
Euparyphium
ilocanum.
Oriental Lung Paragonimiasis, NONE NONE Recovery of Bithionol (Actamer),
Paragonimus fluke pulmonary unembryonated Chloroquine
westermani distomiasis or egg of the parasite
endemic in the hosts
hemoptysis sputum

TREMATODA:
SCHISTOSOMES(Blood Flukes)

GENERAL CHARACTERISTICS:
- They are elongated cylindrical in shape with prominent oral and ventral suckers.
- They have separate sexes (diecious).
- Their intestine bifurcates and unites at a certain level to forth the united intestinal ceca.
- The male adult are provided with gynecephoral canal on the ventral side, the function of which is to cuddle the female throughout its entire life except
during oviposition. Since they are always in perpetual copula, they are known as the most romantic parasites. Trematoda: Schistosomes (Blood Flukes)
- Their life span may be as long as 30 years. f. They are the only trematodes found in the bloodstream, they can also be isolated in stool or urine (S.
haematobium).
- Ova are embryonated and not operculated.
- They are the only trematodes require only one intermediate host.
- Since they have no metacercariae, the infective stage is the cercaria which has a characteristic fork-tailed appearance.
- Manner of transmission: skin penetration by fork-tailed cercaria
- Majority of the schistosomes are parasitic in lower animals.
CAUSATIVE
COMMON NAME DISEASE HABITAT PATHOGENESIS DIAGNOSIS TREATMENT
AGENT
Schistosoma japonicum Oriental blood fluke Schistosomiasis NONE - Ability to produce irritation DFS, Circumoval Tartar emetic
japonica, Oriental and inflammation Precipitin Test (COPT) , (Potassium
Synonyms: Sinobilharzia japonica schistosomiasis - Ability of miracedia to Serological test using Antimony
(Katayamas disease) produce toxic metabolites Cercarial Antigen. Tartrate)
- Lytic property which enable
them to penetrate the
mucosa and submucosa of the
small intestines
- Possibility of using the spine
to penetrate the mucosa
Schistosoma mansoni Mansons blood fluke Mansons intestinal Inferior mesenteric Intemediate Host: Recovery of eggs from Tartar emetic,
schistosomiasis or plexus or portal Australorbis, Biomphalaria, urine or feces (more in Stibophen
bilharziasis venous system Planorbis feces); COPT; CFT;
intradermal test

Schistosoma haematobium Vesical blood fluke Vesical schistosomiasis Vesical and pelvic Intermediate Hosts: Bulinus, Recovery of eggs from Tartar emetic
plexuses of the Planorbis urine and stool (more in
venous circulations urine); aspirated
materials from
cystoscope,
proctoscope; Fairleys
complement fixation
test; COPT in chronic
cases.

CESTODA
GENERAL CHARACTERISTICS:
- They are ribbon-like parasites, segmented, flattened dorsoventrally and varies in length from a few mm. to several meters.
- Composed anteriorly of an attenuated structure called scolex, whose main function is for attachment; the neck which follows the scolex and is the site of proliferation; then
the strobila or body which consists of segments differentiated into immature, mature and gravid proglottids. IV. Cestoda
- The immature segment lies proximal to the neck and is composed of immature reproduction organs, this is followed by the middle or mature segments which contain the well-
developed reproductive organs; the distal most portion is the gravid segment which characterized by its uteri filled with eggs.
- They are hermaphrodites
- Adults are attached to the intestinal wall by means of suckers or by hooks found at the anterior portion. IV. Cestoda
- There is no special digestive tract; nutrition is mainly derived from absorption of digested materials through its integument.
- Excretory system is as primitive as that of trematodes.
- Nervous system is confined primarily to the scolex.
- Genital organs are elaborately developed in each proglottid. The testes are usually multiple and are distributed throughout the median plane of each mature proglottid; the
ovary is commonly a bilobed organ posterior to the equatorial plane of each proglottid, IV. Cestoda
- The eggs are essentially spherical, nonoperculated, almost fully embryonated when they escape from the mother proglottid except for the pseudophyllideans wherein the eggs
are ovoidal, operculated and immature when laid.
- They require at least 1 intermediate host for transmission, except for D. latum where 2 intermediate hosts are required and H. nana where no intermediate host is needed.
- Infection is generally by encysted larva.
PSEUDOPHYLLIDEAN
CAUSATIVE
COMMON NAME DISEASE HABITAT PATHOGENESIS DIAGNOSIS TREATMENT
AGENT
Diphyllobothrium latum Broad tapeworm or Diphyllobothriasis or NONE First intermediate Based on recovery of Niclosamide
broadfish tapeworm fish tapeworm host: Copepods characteristic eggs in (Yomesan),
SYNONYMS: infection (Diaptomus vulbaris, patients feces. Dichlorophen,
Dibothriocephalus latus D. gracilis, Cyclops) Atabrine

Second intermediate
host: Fresh water fish
CYCLOPHYLLIDEAN
Taenia solium Pork Tapeworm Taeniasis solium or NONE NONE Taeniasis- DFS, double Quinacrine,
pork tapeworm slide compression Niclosamide
infection, Cysticercosis method of gravid
cellulosae segments;
Cysticercosis do
excision biopsy and
examine the specimen
for larval from under
microscope.
Intradermal test, high
penetration x-ray to
see calcification which
is not specific.
Taenia saginata Beef tapeworm Taeniasis saginata or NONE NONE DFS; recovery of Niclosamide,
beef tapeworm gravid segment, do a Quinacrine
infection double slide
compression and
count the lateral
uterine branches.
Diphylidium caninum Double pored dog Diphylidiasis or dog NONE Intermediate host: Recovery of the Niclosamide,
tapeworm tapeworm infection flea Ctenocephalidea characteristics eggs in Quinacrine,
sp.Man is only an the mother capsule or Paronomycin
accidental Host pumpkins seed shape
proglottids in the stool
or around the anus
Hymenolypis nana Dwarf tapeworm Hymenolepiasis nana NONE NONE Based on the Quinacrine,
identification of Hexyresorcinol
characteristic eggs.
Hymenolypis diminuta Rat Tapeworm hymenolepiasis NONE NONE Intermediate Hosts: Quinacrine,
diminuta All corpozoic or Niclosamide
scavenger in their
habits during their
larval of adult stage
(lepidopterans ,
earwig, myriapods,
fleas, beetles,
cockroaches).
Echinococcus granulosus Hydatid Worm Unilocular Lives attached to the Definite Hosts: Dogs - X-ray Surgical technique
echinococcosis, villi of small bowel of (optimal) e. - Immunologic. helpful only in
echinococcocis or dog and other canine Intermediate Hosts: a). Intradermal patients with
hydrated disease hosts Man, Sheep Casonis test unilocular cysts in
b). Precipitin test operable sites all non
c). Fluorescent surgical procedure are
Antibody Test usually non successful