College of Allied Medical Professions Parasitology Laboratory

Department of Medical Technology Questions for Research/Worksheet

Clinical Parasitology
Module 2: Macroscopic Evaluation of Stool & Intestinal Nematodes
Worksheet / Questions for Research

Introduction:

Stool specimens submitted for parasitic study should first be examined macroscopically to determine the consistency and color of the sample.
The specimen should be screened and examined for the presence of gross abnormalities. To perform this macroscopic examination , the laboratory
must receive a fresh, unpreserved stool specimen. Because most laboratories receive fecal specimens already in fixative, this step is often skipped
because these macroscopic characteristics cannot
be determined. In such situations, a notation of the gross appearance, either on the actual specimen container or on the requ isition form, is
recommended at the time of specimen collection. The consistency or degree of moisture in a stool specimen may serve as an ind ication of the types
of potential parasites present. For example, soft or liquid stools may suggest the presence of protozoan trophozoites. Protozoan cysts are more likely
to be found in fully formed stools. Helminth eggs and larvae may be found in liquid or formed stools. The color of a stool is important because it may
indicate the condition of the patient, such as whether a patient has recently had a special procedure (e.g., a barium enema) or if the patient is on
antibiotic therapy. The range of colors varies, including black to green to clay, and colors in between. The color of normal stool is brown. Unusual
colors, such as purple, red, or blue, typically suggest that the patient is on a particular medication.

Gross abnormalities possibly found in stool include adult worms, proglottids, pus, and mucus. First, the surface of the stool should be
examined for parasites, such as pinworms. tapeworm proglottids, and adult. Worms. The sample should then be broken up—a wooden applicator stick
works nicely for this task—and examined once more for macroscopic parasites, especially adult helminths. Samples containing adult worms may be
carefully washed through a wire screen. This process allows for the retrieval and examination of the parasites for identifica tion purposes. Other
macroscopic abnormalities in the specimen may have parasitic indications. For example, blood and/or mucus in loose or liquid stool may suggest the
presence of amebic ulcerations in the large intestine. Bright red blood on the surface of a formed stool is usually associated with irritation and bleeding.
Several possible terms may be used to describe the macroscopic appearance of a stool specimen.

Learning Objectives:
The students are expected to,
1) Learn how to evaluate stool sample.
2) Master the correct collection and proper labelling of the container.

Topic: I. MACROSCOPIC EVALUATION OF STOOL

Container with label

Prepared by: Kathleen Shindle C. Español

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 College of Allied Medical Professions Parasitology Laboratory
Department of Medical Technology Questions for Research/Worksheet

Picture of the specimen (Should be inside the

container with label)

MACROSCOPIC EVALUATION OF STOOL

Consistency
Color
Odor
Presence of mucus
Presence of blood

Topic: II. Intestinal Nematodes

Draw what is needed below and write their distinct characteristics below the drawing on the blacks provided. (You can draw digitally or
through paper. Which ever way you are comfortable)

ASCARIS LUMBRICOIDES

Fertilized egg, decorticated
_____________________
_____________________
_____________________
_____________________
Unfertilized egg
__________________________
__________________________
__________________________
__________________________
__________________________
Fertilized egg, not decorticate
__________________________
__________________________
__________________________
__________________________
__________________________
Adult worm
________________________
________________________
________________________
________________________
________________________

Prepared by: Kathleen Shindle C. Español

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 College of Allied Medical Professions Parasitology Laboratory
Department of Medical Technology Questions for Research/Worksheet

TRICHURIS TRICHUIRA

Trichuris trichuira ova Trichuris trichuira adult worm

___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________

Question for Research

1. Differentiate Ascaris lumbricoides, E. vermicularis and T. trichiura ADULT WORMS (5 pts)

Ascaris lumbricoides - Adult worms (male or female) are usually pink or white, both terminal mouths provided with
three lips (TRILOBATE LIP) Males are 10-31 cm long and with a curved posterior end. Females are 22-35 cm long.
They may superficially resemble an earthworm. Larvae simulate the morphology of adult worms.
Enterobius vermicularis - Adult worms are whitish in color with cuticular alar expansion at the anterior end and a
prominent esophageal bulb. Adult female is 3-8 mm x 0.4 mm long with a pointed tail end. Adult male is 2-5 mm x
0.1-2 mm and with curved tail.
Trichuris trichiura - Adult worms are pinkish gray in color. Anterior 2/3 of the worm is slender giving it a whip like
appearance. Adult males are slightly shorter than females. Adult females are 35-50 mm long and it has a bluntly
rounded posterior end. Adult male is 30-45 mm long and with a coiled posterior end.

2. Can freshly passed Ascaris lumbricoides can be effective immediately? (2 pts)

No. It needs to undergo embryonation in soil in its optimum environment.

3. How does trichuriasis causes prolapse rectum? (3 pts)

Due to overcrowding of T. trichiura adult worms in the intestine resulting migration of other adult worms in the rectal lining.

4. Differentiate hookworms and S. stercoralis based on their rhabditiform and filariform larva.

Hookworms Strongyloides stercoralis

Rhabditiform larva Length is 250 um. Resembles those of With short buccal cavity and has a large
Strongyloides stercoralis but larger. genital primordium.
Characterized by a long buccal cavity
and has a small genital primordium.

Prepared by: Kathleen Shindle C. Español

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 College of Allied Medical Professions Parasitology Laboratory
Department of Medical Technology Questions for Research/Worksheet

Filariform larva Length is 700 um, with short Long esophagus and with distinct cleft
esophagus and with pointed tail. at the tip of the tail. UNSHEATHED.
SHEATHED. “Notched tail end”

5. How does creeping eruption occur? (5 pts)

Creeping eruption is a skin infection caused by hookworms. Hookworms are found in dogs and cats. Exposure to
moist sand that has been contaminated by dog or cat feces can cause creeping eruption. Creeping eruption
appears as a winding, snake-like rash with blisters and itching.

Prepared by: Kathleen Shindle C. Español

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