PARASITOLOGY LAB

CESTODES AND TREMATODES GUYSUE! ANG NAKA BLUE KAY MAO NA ANG
APRIL 2021 UNIQUE.
For updates and corrections → @mar4rii on Twitter RED: Additional info.

CESTODES

COMMON INFECTIVE INTERMEDIATE DEFINITIVE DIAGNOSTIC STAGE IN

NAME DIAGNOSIS SPECIMEN MOT
NAME STAGE HOST HOST STAGE MAN

INTESTINAL SPECIES
Taenia saginata
-unarmed rostellum
Beef tapeworm Eggs or gravid Ingestion encysted larva
MATURE-small lip Geni. P. Cysticercus
-no cow proglottids Adult in muscle tissue of
-2 lobes ovary bovis
autoinfection -radial striations pork/beef
GRAVID- manu uterin.
Branches. ➢ DFS- demonstration
Taenia solium Cysticercus of embryonated eggs in
➢ Ingestion encysted larva
-rostellum cellulosae/Ova stool Stool
Man in muscle tissue of
-hooklets – intestine Eggs or gravid (oncosphere) or
Pig, Man, dogs, bears pork/beef/
MATURE-3 lobe ovary Pork tapeworm -if larva ang proglottids Adult or larva proglottids
If Cystecercosis-man ➢ Ingestion of eggs
-lip like genital P magdevelop- -radial striations ➢ X-ray, CT scan, MRI
(cysticercosis)
GRAVID- uterine structures-no cystercercosis
ovary seen
goats, monkey, wild Ingestion of raw or
Asian Cysticercus boar, swine, Eggs or gravid Adult undercooked pork
Taenia asiatica
tapeworm larvae cattle proglottids

Hymenolepis nana Oncosphere/Cy (can be optional) Rats, mice, Ingestion of cysticercoid-

-super wide proglottid sticercoid larvae Flea and man Embryonated Adult or larva infected arthropods
-1 row of hooklets Dwarf Grain beetle egg
-long neck tapeworm Flour beetle
-3 testes 1 ovary Cockroaches ➢ DFS- demonstration
MATURE: ovary and testes are of embryonated eggs in Stool
seen stool
GRAVID- uterine branches, no (oncosphere)
ovary and testes seen
EGG- bipolar filament (dirty
looking)

Hymenolepis diminuta Cysticercoid Flea Rats, mice, Ingestion of cysticerci in

-rostellum no hooklets Rat tapeworm larvae Grain beetle man, and Embryonated Adult body of insects
-hamis ang hooklets -no auto Flour beetle dogs egg
MATURE: ovary and testes are infection Cockroaches
seen
GRAVID- uterine branches, no
ovary and testes seen
EGG- HAMIS (no bipolar
filament)
 Dipylidium caninum Dog and cat Cysticercoid Cysticercoid Larvae Dog, cats, Egg packets or Adult ➢ DFS-demonstration of Ingestion of fleas
-2 genital pore flea tapeworm Larvae man proglottids egg packets or proglottids containing cysticercoid
-many rows of hooklets --2 sets of -no cavity in stool
-suckers are deeply seated repro organ Stool
-protrude ang scolex
-short neck
MATURE: ovary and testes are
seen
GRAVID- full of egg packets, no
ovary and testes seen

Diphyllobothrium latum Broad or Fish Plerocercoid 1st - Copepod Man, dog, Unembryonated Adult worm ➢DFS – demonstration of Ingestion of raw or
EGG-No thickening of area in tapeworm larvae 2nd - Freshwater fish cat,and other eggs eggs + proglottids undercooked infected
operculum fish eating ➢Serologic test- ELISA freshwater fish
-MIDLINE Genital pore mammals ➢CT/ MRI- cerebral
MATURE- ovary and testes is ➢Biopsy
seen
GRAVID- well developed
proglottid
INTESTINAL-EXTRAINTESTINAL SPECIES
Hydatid worm Embryonated Cattle, sheep, goat, Dog, wolves, Hydatid cyst Larva ➢ X-ray, Ct scan, MRI Stool Ingestion of eggs
egg swine, man foxes, lions ➢ Serologic test- ELISA
Echinococcus granulosus (accidental; dead end) & IHA

TREMATODES

Notes to Remember!!
● Eggs are operculated except Schistosoma spp.
● All require 2 IH except Schistosoma spp.
● Infective stage is METACERCARIA except in Schistosoma spp. (Fork-tailed cercariae)
● MOT: Ingestion except Schistosoma spp.
● 1 st IH: Snail
● 2 nd IH: Snail, Plant, Fish, Crab, Insects
● Treatment of choice is Praziquantel except for Fasciola: Triclabendazole

COMMON 2nd DEFINITIVE DIAGNOSTIC

INFECTIVE 1st TREATMEN
NAME STAGE INTERMEDIATE HOST
INTERMEDIATE DIAGNOSIS SPECIMEN MOT T
NAME HOST HOST STAGE
BLOOD FLUKES
➢ DFS: recovery of ova in
Schistosoma cer Pr
Oncomelania stool
japonicum Oriental car azi
hupensis quadrasi ➢ CSF Exam
-SMALL lateral spine blood fluke ia qu
➢ Serologic test Stool
ant
Manson’s ➢ DFS: recovery of ova in Blood
Schistosoma el
Blood Fluke Biomphalaria stool
mansoni N/A Man Skin penetration
Ova in feces ➢ CSF Exam
-LARGE lateral spine
➢ Serologic test
Bladder ➢ Urinalysis Urine
Schistosoma
Fluke/ Bulinus ➢ Sputum Exam Sputum
haematobium
Vesical blood ➢ CSF Exam Blood
-Terminal spine
fluke
LIVER FLUKES

2
 Tri
me
cla
tac
Fasciola hepatica be
erc
-vitellaria from Sheep Liver nd
ari
shoulders to tail fluke Man, Sheep, az
a Snail
PROG: Branched Temperate Cattle ole
intestine Live Fluke
SCOL: Cephalic cone
Aquatic/Water
Fasciola gigantica ➢ DFS: recovery of ova in
plants Ingestion of infected raw
-vitellaria from Unembryonated stool
(Kangkong and aquatic plants
shoulders to tail ovum ➢ Serologic Test
Giant Liver Watercress) Man, sheep,
PROG--Branched
Fluke/ cattle, and other
intestine Snail
Tropical Liver grazing ruminant
SCOL: Cephalic cone
Fluke mammals
-less prominent
shoulders Stool
-LARGER parts
➢ DFS- recovery of ova in stool
(small, flask shape, operculated Pr
Clonorchis sinensis- azi
eggs)
vitellaria middle 1/3 Snail: infected raw or qu
Chinese- Grass Carp, Man, dog, cat, ➢ Duodenal aspirate
-simple intestine Parafossarulus undercooked fish ant
Liver Fluke Freshwater fish hogs ➢ Entero test
-ovary lobed manchouricus ➢ serologic test/ complement containing the larvae. el
Testes- branched Embryonated
eggs fixation test
➢ intradermal test
Opisthorchis viverrin
Consumption of
i-LOBED testes Fish-Liver
Snail Freshwater fish Man, cats, dogs ➢ DFS uncooked fresh water
-clumped vitellaria Fluke
fish
-more prominent lobe me
tac INTESTINAL FLUKES
erc Ingestion of encysted
ari Water chestnuts, metacercariae from Pr
a water caltrops, aquatic plants (can occur azi
Fasciolopsis Snail- segmentina Man, pigs, dogs, ➢ DFS- demonstration of ova
Giant/Large lotus, bamboo when the plant itself is qu
buski and Hippeutis rabbits in stool eaten or when the skin of
Intestinal shots, and other ant
Fluke edible plants Unembryonated the fruits is peeled off el
ovum between the teeth)

Echinostoma Garrison’s Man, aquatic ➢ DFS- demonstration of ova

Frog, snails Stool Ingestion of raw snails
ilocanum Fluke Snail birds in stool

Snail: Mammals, fish-

Heterophyes Von Siebold’s Pironella conica ➢ DFS- demonstration of ova Ingestion of raw or
Freshwater fish eating
heterophyes Fluke (Egypt), Cerithidia in stool pickled fresh-water fish
cingula (Japan)
birds
Embryonated
Smallest eggs
Metagonimus Human Fluke dogs, cats, rats, ➢ DFS- demonstration of ova Ingestion of raw or
Snail Salmonid fishes
yokogawai / heterophyid and humans in stool pickled fresh-water fish
fluke
Pr
LUNG FLUKE azi
Paragonimus me DFS- demonstration of ova in stool qu
westermani tac Snail ➢ Sputum analysis- demonstration ant
THICK erc of ova in sputum- is frequently el
ABOPERCULAR END ari blood tinge and may contain
numerous dark
a
3
 brown eggs and Charcot-Leyden Stool ingestion of raw or
-Adult-Reddish brown, Carnivores, man Unembryonated crystals. Sputum insufficiently cooked
ventral sucker (found in Oriental lung Crustacean ovum ➢ Pleural fluid aspirate infected crustacean
the MID) fluke ➢ Serologic test- ELISA/ EIA

PROTOZOANS

NAME HABITAT PATHOGENESIS INFECTIVE STAGE DIAGNOSTIC STAGE DIAGNOSIS SPECIMEN MOT TREATMENT

INTESTINAL AND GENITAL FLAGELLATES

direct wet mount; Metronidazole
serological
Giardia duodenalis Duodenum,
diagnosis:
-pear shape jejunum,
Mature cyst (4 agglutination test, Stool sample,
Pointed posterior ileum of the Giardiasis ingestion
nucleus) fluorescent antibody, duodenal aspirate
-ONLY 2 nuclei small
enzyme linked
-has parabasal body intestine
immunosorbent
Cyst and trophozoites
assay (ELISA)
Chilomastix mesnili cecum and Nonpathogenic Stool sample
-1 nucleus colon
Ingestion of cyst in
-3 flagella in anterior (mouth
cyst direct wet mount fecal contaminated
part)
water
CYST- 1 nucleus
-clear hyaline knob
Dientamoeba fragilis Large trophozoite trophozoite direct fecal smear Ingestion, direct fecal-
intestine (wet and stained) oral transmission
Fecal smear stained
with permanent
stains (Trichome)
4
 Trichomonas hominis direct fecal smear
X-cyst trophozoites Cyst and trophozoites (wet & stained), Fecal-oral
Undu.mem- as long as the body serological tests
direct wet mounts of ingestion of cysts in
freshly produced fecal-contaminated
Enteromonas hominis cyst
stool food or water, or on
fomites
Stained stool
preparation
Ingestion of infected
Retortamonas intestinalis cyst direct wet mounts of
cyst
freshly produced
stool
EXTRAINTESTINAL FLAGELLATES
female lower Trichomoniasis Trophozoite Saline preparation of urine, vaginal,
genital tract vaginal fluid urethral, cervical
Trichomonas vaginalis
and male Culture - Diamond’s secretions and
X-cyst
urethra and Trophozoite medium scrapings Sexual intercourse
Undu. Mem.- less than or half of
prostate BD Affirm VPIII test
the body Metronidazole
InPouch TV (BioMed
Diagnostics)
Trichomonas tenax Oral cavity Nonpathogenic trophozoite smears from tartar tartar between droplet spray from the
X-cyst trophozoite between teeth (wet teeth, gingival mouth, kissing and
Undu. Mem.- 2/3 of the body and stained) scrapings ingestion
HEMOFLAGELLATES
Macrophages
of the host &
bite of an arthropod
Amastigote can be found
vector
throughout
the body
Blood, lymph node
and ulcer
aspirations, tissue
Trypomastigote
biopsies, bone
marrow, and
cerebrospinal fluid
Promastigote
Epimastigote
Amoebae Family: INTESTINAL SPECIES
Endolimax nana Cyst and trophozoite concentrated wet Stool sample Metronidazole
fecal-oral route and
NO peripheral chromatin Quadrinucleated mounts or
Intestine of ingestion of cysts from
KARYOSOME- large cyst permanent-stained
mammals contaminated water
CYST- 4 nucleus with NO smears
supplies
chroma
Commensal
Iodamoeba buetschlii
- Has granules Small and
Uninucleated fecal-oral route and
- large peri. chro large
cyst ingestion of cysts
-has clear area(GLYCOGEN) intestine
CYST- round with glycogen
Entamoeba histolytica Amoebiasis Quadrinucleated Colonoscopy Ingestion of
NUCLEUS- evenly distributed cyst Wet mount and contaminated water,
peripheral chromatin permanent staining fecal-oral (sexual

5
 Karyosome- Central techniques (DFS,
Has RBC FECT/FEACT, and transmission),
CYST- has chromatoidal bar MIFC) Immunologic mechanical vector
(sausage shape) test kit- ELISA (insects)

Entamoeba coli
NUCLEUS- UNevenly concentrated wet fecal-oral contact,
distributed peripheral chromatin mounts or Ingesting mature cysts
8 nucleus cyst
Karyosome- peripheral lumen of the permanent-stained from contaminated
CYST-8++ nucleus large smears water and food
Sharp -Chromatoidal bars intestine
Entamoeba polecki
CYST- 1 nucleus Mature cyst Pig-human interaction
Many chromatoid bars
Commensal
Entamoeba hartmanni
-same with E. histo and dispar Mature cyst
BUT SMALLER
Fecal-oral
Fresh stool: wet
transmission via cyst
Entamoeba dispar mounts and
“small race” form; contaminated
-same with. E. histo BUT NO permanently stained
Mature syst food and water
RBC preparations &
Concentrates from
fresh stool:
Amoebae Family: EXTRAINTESTINAL SPECIES
Invades brain Pathogenic Free-
through living -- causes
Naegleria fowleri antigen in CSF, Intranasal
olfactory Primary amoebic trophozoite trophozoite CSF Amphoterican B
CYST- rounded with 1 nucleus biopsy transmission
mucosa meningoencephal
itis
Entamoeba gingivalis Oral cavity Commensal trophozoite saliva Metronidazole
Oral, kissing, sharing
X-cyst trophozoite
utensils
-multiple pseudopod
Acanthamoeba castellani Eyes Pathogenic growth of the ameba Clotrimazole combined
Through the eyes
Troph- many spines (cornea) Ubiquitous Free from a scraping of with pentamidine
(only if
CYST- star shaped, double living the eye
trophozoite Cysts in tissue Corneal scraping immunocompromised),
walled Confocal microscopy Isethionate
respiratory tract, skin
to the brain
OTHER PROTOZOANS
cecum and Balantidiasis Stool exam
colon Watery- easily
Large recognized bec. Of
Balantidium coli
intestine their size, cilia,
TROPH -ONLY ciliated Ingestion of
motility like that of a Iodoquinol
-macronucleus (kidney shaped) cyst Cyst and trophozoites Stool contaminated food
thrown football Oxytetracycline
CYST- macronucleus (kidney and/or water
Formed- cyst;
shaped)
macronucleus are
seen w/in the cyst
wall
Blood smear Tick bite of Ixodes
Texas cattle serologic test scapularis or Ixodes
Babesia microti Blood sporozoite trophozoite Blood Clindamycin+quinine
fever, Babesiosis kitimmunoblot • PCR pacificus
• Indirect

6
 immunoflourescence
Asymptomatic,
Cystic form or
Gastrointestinal unstained wet-mount Metronidazol,
Blastocystis hominis Intestines vacuolar form Cystic and vacuolar forms Fecal-oral route
disease being preparations nitazoxanide
(not confirmed)
investigated

Cryptosporidium parvum Ingestion of

Small Stool
-round Diarrhea Mature oocyst Thick-walled oocyst Stool examination contaminated food Nitazoxanide
intestine
-has sporozoite and/or water

Cystoisospora belli
-elliptical Small Trimethoprim-
Cystoisosporiasis Mature oocyst Immature oocyst Stool examination Fecal-oral route
-1 sporoblast intestine sulfamethoxazole
2 sporoblast if immature
Ingestion of mature
oocyst from infected
cat feces, Ingestion of
contaminated
undercooked meat Pyrimethamine
Toxoplasma gondii Tachyzoite,
Blood, Blood, tissues, from cattle, pig or Sulfadiazine
Toxoplasmosis bradizoite, oocyst Tachyzoite, bradyzoite biopsy
tissues sheep, Placental Clindamycin
(with sporozoite)
transmission, Blood TMP-SMX
transfusion/Organ
transplant,
Consumption of
unpasteurized milk
Direct microscopic Stool
examination of fecal
Cyclospora cayetanensis Ingestion of
Small Sporulated smear • Trimethoprim/sulfamet
-round Cyclosporiasis Unsporulated oocysts contaminated food or
intestine oocyst Concentration hoxazole
-no sporozoite water
techniques • Acid
Fast staining

References: CDC and Lab & Lec video lectures