OUR LADY OF FATIMA UNIVERSITY

COLLEGE OF NURSING

Protozoans and nematodes

MICRP (LAB)

Submitted by:
Ivy N. Quimno
BSN 1 YB-22
MICROBIOLOGY & PARASITOLOGY

Submitted to:
Professor: Doc. Eric Fontelera
PROTOZOA
Parasite Source of Mode of Characteristic Manifestation Diagnosis
Infection Transmissi
on
Entamoeba - ingestion of -Fecal-oral EXTRAINTE 1. Acute 1.Stool
histolytica mature cysts route STINAL intestinal examination
through AMOEBIASI amoebiasis – to see the
ingestion of S motility of
Symptoms:
-From fecally the the
Symptoms:
contaminated a. Bloody trophozoites
Cysts from
food, water, mucus
contaminat • Diarrheic
or hands. containing
ed food and a. Right upper stools –
diarrhea
water. quadrant pain trophozoites
(Dysentery)
- Exposure to b. Weight loss • Formed
b. Lower
infectious stools – cysts
-Sexual c. Fever abdominal
cysts and
transmissio discomfort 2. Serologic
trophozoites d. Tender,
n (Release of testing – to
in enlarged liver
unprotected gas) diagnose
fecal matter sex with e. Amoebic invasive
c. Tenesmus
during sexual pneumonitis amoebiasis 3.
woman (Feeling of
contact may Biopsy -
with f. Infected incomplete
also occur obtained
vaginal organs like defecation)
during
amoebiasis pericardium, colonoscopy
or anal spleen, skin, or surgery.
and brain 2. Chronic
intercourse
(Meningoence intestinal
phalitis) amoebiasis
-Humans Symptoms:
are
Asymptomatic a. Occasional
considered
carrier state diarrhea
the main
host for allOccurs under b. Weight loss
species the following
except c. Fatigue
conditions:
for d. Formation of
a. If the
Entamoeba parasite Amoeboma
polecki, lesions in
involved is a
which is low-virulence
 usually strain cecum or
associated rectosigmoid
b. If the
with area
parasite load is
primates
low
and swine
c. If the
patient’s
immune
system is
intact

Giardia lamblia (each Infections . a. Multiple

passed in Asymptomatic stool
cyst produces
the stool or carrier state – examination
2
infected – 3 stool
trophozoites) person-to-
individual
in person specimens
unknowingly
transmissio collected on
small
n passes out separate days
intestine
parasite with
the feces
which can b. If
-Infections contaminate microscopic
passed in the water stool exam is
stool or
negative-
2. Giardiasis
person-to- string
(Traveler’s
person diarrhea) - a test – Entero
transmission non-bloody, test may be
foul smelling performed
diarrhea
-Ingestion of
cyst from Symptoms:
c. PCR –
contaminated a. Nausea (polymerase
water, food chain
b. Loss of
(fecal-oral reaction) –
appetite
route) can be used
c. Flatulence
to identify the
d. Abdominal subtypes of
cramps Giardia
 e. Steatorrhea
– presence
of fat in the
stool
f. Afebril
Tricomonas -sexually 1. Sexual Infection in Infection in 1. Wet mount
vaginalis transmitted intercourse Women - Men – usually test - vaginal,
asymptomatic asymptomatic prostatic
disease
secretions,
(STD),
2. Toilet
caused by urine, urethral
articles a. Scant, a. Prostatitis –
infection with discharges
watery vaginal inflammation
a protozoan
discharge of the prostate
3. Clothing
b. Pruritus – b. Urethritis 2. Direct
of infected
-Urogenital itchiness and immunofluor
individuals c. Urinary tract
infections burning escent
involvement
antibody
sensation in
d. Itching or staining
4. infants vagina
irritation inside
may be
c. Foul- the penis
infected
smelling and 3. Culture of
through e. Burning
greenish- the parasite
Infected after urination
yellow
birth canal or ejaculation • In women
vaginal examination -
during
discharge in should be
delivery
severe cases infections in performed
infants
d. Cervix on vaginal
-infection is appears very and urethral
highest red secretions.
(Strawberry Symptoms:
among
• In men -
sexually- cervix) a. anterior
active Conjunctivitis
e. Dysuria urethral or
women in
prostatic
f. Increased b. Respiratory
their secretions
frequency of infection
thirties,
urination should be
lowest in
examined
post-
menopausal
 women

Trypanosoma cruzi triatomine a. acute phase: 1. Acute

bug, or transmitted disease –
-Fever
"kissing by the bite thick or thin
bug."- when of the -chills films of
they swallow reduviid or patient’s
blood from triatomid - -malaise
blood for
an animal -myalgia
vector visualization
that is
(Triatoma -fatigue of parasites
infected with
or “ cone-
the parasite.
nose” bug
or kissing chronic 2. Bone
bug) phase: marrow
aspiration
-
Hepatospleno
megaly 3. Muscle
b. Blood
biopsy
transfusion -
Lymphadenop
c. Sexual athy –
intercourse enlargement of 4. Culture on
lymph nodes special
d.
medium
Transplace -Myocarditis
ntal
transmissio -Loss of tone
n (Colon and 5.
esophagus) Xenodiagnos
e. Mucous es - exposing
membrane - possibly
– bite site Meningoencep infected
eye or halitis
mouth tissue to a
-Cysts vector and
-Death – then
cardiac failure examining
and the vector
arrhythmias for the
presence of
the
microorganis
 ms or
pathogen it
may have
ingested

6. Serologic
test

Trypanosoma brucei microscopic ▪ Glossina - 1. Indurated 1.

parasites tsetse fly as ulcer (chancre) Microscopic
the vector exam –
Giensa-
▪ Humans –
2. Intermittent stained slides
reservoir
weekly fever of the blood,
for T.
lymph node
brucei
gambience aspirations
3. and CSF –
▪ Domestic Lymphadenop
during the
animal athy early stages
(cattle, wild
of the disease
animals) –
T. bruce 4. Enlargement
rhodesiense of cervical 2. Aspiration
lymph nodes of the chancre
▪
or enlarged
Trypomasti (Winterbottom'
lymph nodes
gote – s sign)
infective 5. Red rash 3. Serologic
and accompanied test –
pathogenic by pruritus detection of
stage the presence
of IgM and
6. Localized protein in the
edema CSF

7. Kerandel’s
sign – delayed
pain sensation
 8. Encephalitis
(headache,
insomnia,
mood changes)

9. Muscle
tremors,
slurred speech,
apathy follow

10.
Somnolence
(Sleeping
sickness)

11. Coma
Lesmani donovani -Lutzomyia a. a. Intermittent a.
sandfly Leishmani fever Montenegro
a donovani skin test –
-Phlebotomus
chagasi – screening for
sandfly
b. Weakness large
transmitted
by population at
Lutzomyia risk
sandfly c. Weight loss (Tuberculin
skin test)
mainly seen
in d.Hyperpigme b. Definitive
ntationoftheski diagnosis -
(Mexico,
n Giemsa
West
stained slides
Indies, S.
–
Africa)
specimen
from blood,
b. bone marrow,
Leishmani lymph
a donovani
nodes, and
donavani –
biopsies of
 transmitted infected areas
by
c. Culture of
Phlebotomu blood, bone
s sandfly marrow and
other
(Africa,
Asia - tissues
Thailand,
d. Serologic
India,
test – indirect
China,
fluorescent
Burma, and
antibody
East
(IFA),
Pakistan)
enzyme-
linked
immunosorbe
c.
nt
Leishmania
donovani assay(ELISA)
infantum – , direct
transmitted agglutination
by (DAT)
Phlebotomu
s sandfly
(Mediterran
ean, Europe
Near East,
Africa)
Toxoplasma gondi -intestinal 1. Ingestion 1. Infection in 3.Infection in 1.
cells of the of immunocomp immunocomp Immunofluor
cat improperly etent romised hosts escence assay
cooked individuals – – manifest - for high
-ingestion of
meat or asymptomatic antibody
oocysts in with
animals
undercooked a. Acute neurologic titers
that serve infection – symptoms
meat or
as non-specific
contact with (encephalopath
intermediat symptoms 2. Giemsa-
cat feces y,
e hosts (chills, fever, stained
meningoencep
- headache, preparation –
halitis, or brain
contaminated fatigue) show
water 2. Ingestion crescentshape
b. Chronic
of oocysts infection – tumors, d
from lymphadenitis, infection of the trophozoites
contaminat hepatitis, lungs, eye, and
ed water myocarditis, testes)
encephalomyel 3.
itis Ultrasonogra
3. phy
Transplace
ntal 2. Congenital
transmissioinfection – 4.
n in severeoccurs in Amniocentesi
infants born to s
consequenc
mothers who
es on the
were infected
fetus
during
pregnancy

Congenital
infection First
Trimester of
pregnancy
a. Miscarriage
b. Stillbirth
c. Severe
infection -
encephalitis,
microcephaly,
hydrocephalus,
mental
retardation,
pneumonia
Plasmoduium -the bite of a a. Bite of 1. Abrupt 4. Timing of 1. Giemsa-
falciparum female female onset of chills the Fever cycle stained or
Anopheles mosquito (rigors) 72 hrs. for P. Wright-
mosquito vector accompanied malariae in stained
by headache, which
muscle pain symptoms
b. Blood (myalgia), recur 2. Thick
transfusion blood smears
Joint pains every 4th day
– used for
(arthralgia) – (quartan
screening
stage lasts for malaria)
c. purposes
10-15 mins
Intravenous
drug abuse
5. Every 3rd
with 3. Thin blood
2. Spiking day -
sharing IV smears – used
fever 2-6 hrs. Plasmodium
needles to
follow vivax,
differentiate
reaching up to Plasmodium
Plasmodium
41◦C ovale, P.
d. species
accompanied falciparum
Transplace by shaking, causes
ntal chills,
transmissio Tertian malaria• Best time to
n nausea and that causes
take blood
(congenital vomiting and severe films -
malaria) abdominal infection midway
pain, followed between
by drenching paroxysm of
6. Plasmodium chills and
sweats and feel
falciparum – fevers or
well between
causes
febrile before onset
malignant
episodes. of fever
malaria due to
severe
infection and
3.
Splenomegaly potentially life-
is often present threatening
and anemia (cerebral
malaria and
kidney
damage)
( Dark color
urine – due to
kidney damage
NEMATODES
Parasite Primary Source of Mode of Characteristic Diagnosis
Location Infection Transmission Manifestation
Entorobius lays eggs Pinworm 1. Ingestion of 1. 1. Scotch
around the infection the eggs of the Hypersensitivit Tape
anus at worm either y reaction – method or
directly or leads to anal cellophane
night,
fecal-oral itchiness tape method
indirectly
route,
and viewed
( hands, toys,
under
bedding, 2. Vigorous
microscope
clothing, and scratching of
toilet seats) the anus –
leads to the
2. Sample
development of from
2.
mucosal breaks fingernails
Autoinfection
in the anus under
– due to hand-
microscope
to-mouth
transmission
3. Obstruct the
(contaminated appendix –
hands leads to
(including appendicitis
one’s own)
around
ASYMPTOM
the mouth
ATIC:
area)
1. Intense
itchiness with
3.– transmitted inflammation
through skin in the
penetration
anal area
(pruritus ani)
or vaginal area
occurs
frequently at
night
 2. Intestinal
irritation and
mild nausea

3. Irritable
Trichuris Thousand of Ingestion of -fecal-oral 1. Ulcerative Stool
eggs are food or transmission colitis – a examination
produced water chronic
each day contaminat inflammatory
which are ed by -– transmitted condition
human through skin
passed in the of the colon
penetration
feces feces that has an
containing autoimmune
the etiology
-tropical infective
2. Chronic
countries and eggs
dysentery
areas with
(bloody,
poor
mucoid
sanitation
diarrhea)
practice

3. Severe
-human feces
anemia or
is used for
growth
fertilizer
retardation

4. Rectal
prolapse – due
to irritation and
staining during
defecation

5.
Hyperperistalsi
s
 6. Abdominal
pain,
tenderness,
weakness and
dysentery
Ascaris -small - -ingestion of 1. Abdominal 1. Stool
intestines ingestinginf food or water pain – most examination
ective eggs contaminated common – feces and
-blood to
with complaint eggs
enter the liver
human feces
-lungs -ingestion
containing
of food or 2. Vomiting, 2. Heavy
-coughed up infected
water fever worms
with the
contaminat embryonated burden –
sputum
ed with ova sputum exam
-feces 3. Abdominal during
human
distention
feces pulmonary
-– transmitted
containing phase
through skin
infected
penetration 4. Mass that
embryonate causes
d ova intestinal
obstruction

5. Obstruction
of different
organs like
appendix, liver
and
bile ducts

6. Perforation
of intestines
leading to
peritonitis

7. Secondary
bacterial
 infections
occur in
damaged tissue
Ancylostoma (feet or legs - walking ▪ Skin a. Skin 1. Stool
usual sites) barefoot on penetration by irritation at the examination
contaminat the filariform site of
a. Thin-
ed soil larva penetration
shelled eggs
(feet or legs -
usual sites)
b.
b. Occult
Inflammatory
blood in the
reactions in the
▪ Larvae are stool
lungs
carried by the
blood to the
Lungs, pass 2. Blood
c. Chronic
smear – show
and coughed blood loss in
microcytic,
up, swallowed small intestines
hypochromic
with sputum,
anemia
mature into
adult worms in
small 3. Sputum
intestines examination
– show larvae
where
thousands of
eggs are laid
and passed
out with the
feces

strongyloides intestine and Contact 1. Direct skin 1. Irritation on 1. Stool

enter the with soil penetration the site of skin examination
that is penetration – three
lymphatic 2. Indirect
contaminat samples
system or mode –
ed with collections
blood stream rhabditiform
free-living 2.
larvae passed one per day
larvae. Inflammatory
out in for three days
reactions in the
the feces lungs and
transform into intestinal wall,
2.
adult worm in diarrhea
Examinations
the soil
of duodenal
aspirates
3.
3. Autoinfection
Autoinfection leading to
3. Sputum
– rhabditiform secondary
examination
larvae develop bacterial
into infection
filariform in 4. Serologic
the intestine tests – ELISA
4. Sepsis
and enter the
lymphatic
system or ASYMPTOM
blood stream ATIC:
and starting
1. Skin
a new cycle irritation at the
site of entry

2. Migration of
larvae into the
lungs –
Pneumonitis

3. Abdominal
pain and
diarrhea –
presence of
numerous adult
worms

4. Urticaria and
eosinophilia -
recurrent
allergic
 reactions

5.
Malabsorption
syndrome –
due to
involvement of
biliary ducts,
pancreas, small
intestines and
colon

6. Steatorrhea
– fat in the
stool resulting
in nutrients
deficiencies,
epigastric pain
and tenderness,
diarrhea

7. Hyper-
infection –
mistaken for
peptic ulcer
syndrome

Wuchereria lymph and transmitted bite of 1. 1. Blood

blood through the mosquito Asymptomatic examination
channels bite of an vector – presence of – Giensa-
infectious thousands of stained
mosquito peripheral
microfilariae in
peripheral blood smear
blood, adult (Microfilariae
worms )
may be found
in lymphatic
system without 2. Blood
specimen 1
clinical
ml. immersed
manifestations
in 10 ml of
2%

2. Acute stage formalin

– marked by solution to
fever, with lyse RBC
inflammation
3. Serologic
of the lymph tests and
nodes Antigen
detection
methods –
a. alternative
Lymphadenitis diagnostic
- male genitalia methods
in (Bancroft’s
filariasis) and
extremities ▪ ideal times
(Brugia for specimen
malayi) collection
between
9:00 pm 4:00
2. Acute stage am – peak
b. Recurrent periods for
attacks: the

1. appearance of
Inflammation mosquito
of epididymis vectors
and orchitis

2. Retrograde
lymphangitis

3. Localized
inflammation
of the arms and
 legs

4. Calabar
swellings -
trans
Trichinella intestinal – pig but Ingesting of 1. Enteric or 1. Muscle
tract any raw or intestinal biopsy
mammal improperly phase
2. Blood
can be cooked pork
Manifestations: examination
infected meat
–
a. Diarrhea
eosinophilia,
b. Abdominal leukocytosis,
-eating raw
pain elevated
or
serum muscle
undercooke c. Vomiting enzyme level
d meat
from
animals 2. Invasion
infected phase – larval
with the migration and
microscopi muscle
c parasite invasion
Trichinella.
a. Periorbital
and facial
edema
b.
Conjunctivitis
c. Fever,
muscle pain
(myalgia)
d. Splinter
hemorrhages,
rashes and
peripheral
eosinophilia

3.
Convalescent
 phase –
encystation and
encapsulation
stage,
manifestation
start to
decline, full
recovery is
expected
Plasmoduium gastrointestin transmitted between 1. Abrupt onset 1. Giemsa-
falciparum al through the humans and of chills stained or
bite of a Anopheles (rigors) Wright-
female mosquitoes accompanied stained
Anopheles by headache,
mosquito muscle pain
(myalgia), 2. Thick
blood smears
Joint pains
– used for
(arthralgia) –
screening
stage lasts for
purposes
10-15 mins

3. Thin blood
2. Spiking
smears – used
fever 2-6 hrs.
to
follow
differentiate
reaching up to
Plasmodium
41◦C
species
accompanied
by shaking,
chills,
• Best time to
nausea and take blood
vomiting and films -
abdominal midway
pain, followed between
by drenching paroxysm of
chills and
sweats and feel
fevers or
well between
febrile before onset
episodes. of feve
3.
Splenomegaly
is often present
and anemia
4. Timing of
the Fever cycle
72 hrs. for P.
malariae in
which
symptoms
recur
every 4th day
(quartan
malaria)

5. Every 3rd
day -
Plasmodium
vivax,
Plasmodium
ovale, P.
falciparum
causes
Tertian malaria
that causes
severe
infection

6. Plasmodium
falciparum –
causes
malignant
malaria due to
severe
infection and
potentially life-
threatening
 (cerebral
malaria and
kidney
damage)
( Dark color
urine – due to
kidney damage
“black water
fever” )

Medically important stages in life cycle of tissues nematodes.

Organism Insect Stage that Stage(s) in humans Important Diagnosis
Vector infects most associated with stage( s )
humans the disease outside of
humans
Enterobius Pinwor Ingestion of - 1 to 2 months or ▪ Oval and 1. Scotch
m, the eggs of longer for the adult flat on one side Tape method
Seatwor the worm gravid female to mature or cellophane
▪ Adult worm
m either in the small intestine. tape method
– small and
directly or and viewed
- Once mature, the yellowish-
indirectly under
adult female worm white in color
microscope
migrates to the colon
▪ Adult
and lays eggs around 2. Sample
female
the anus at night, when from
Pinworm –
many of their hosts are fingernails
 asleep clear, pointed under
tail microscope

Trichuris Whipw Ingestion of Thousand of eggs are ▪ Barrel or Stool

orm food or water produced each day football shape examination
contaminated which are passed in the with hyaline
by human feces plug at each
end of the egg
feces
containing ▪ Adult worms
the infective
Anterior end –
eggs
colorless
Posterior end
– pinkish color
Ascaris Large ingestion of Entry into small Adult worms – 1. Stool
Intestin food or water intestines – larvae creamy-white examination
al contaminated released from the eggs, in color with – feces and
Round with human penetrate intestinal wall outer covering eggs
worm feces → enter the blood to
of cuticle 2. Heavy
containing enter the liver localizes
worms
infected in the Lungs →
burden –
embryonated migrates into the
sputum
ova bronchioles → larvae
exam during
coughed up with the
pulmonary
sputum, swallowed
phase
returning the worm into
the intestines → larvae
mature into adult
worms lay their eggs
and eliminated with
fece
Ancylostoma (Old Skin Larvae are carried by 1. Eggs 1. Stool
World penetration the blood to the Lungs, examination
2.Rhabditiform
Hookw by the pass and coughed up,
larva a. Thin-
orm filariform swallowed with
shelled eggs
larva (feet or sputum, mature into 3. Filariform
legs - usual adult worms in small larva b. Occult
sites) intestines where blood in the
thousands of eggs are 4. Adult worm
stool
laid and passed out with
the feces 2. Blood
 smear – show
microcytic,
hypochromic
anemia
3. Sputum
examination
– show larvae

Strongyloides Thread stercoralis 1. Direct skin (Host and free- 1. Stool

worm hatch into penetration living cycle in examination
larvae in the soil) – three
2. Indirect mode –
intestine. samples
rhabditiform larvae 1.
Most of these collections
passed out in Strongyloides
larvae will be one per day
ova – smaller
excreted in the feces transform into for three days
and well-
the stool, but adult worm in the soil
developed 2.
some of the
larvae may 3. Autoinfection – larvae Examinations
rhabditiform larvae of duodenal
mature and 2.
develop into aspirates
immediately Rhabditiform
re-infect the filariform in the larva – have 3. Sputum
host either by intestine and enter the longer buccal examination
burrowing cavity and
into the lymphatic system or smaller genital 4. Serologic
intestinal blood stream and primordium tests –
wall, or by starting ELISA
penetratin a new cycle
Wuchereria Bancrof bite of Infective larvae – Morphologic 1. Blood
t’s mosquito migrate to the tissues, form – adult examination
Filarial vector mature and localize in worm and – Giensa-
Worm lymphatics, larvae stained
subcutaneous tissues, (microfilariae) peripheral
internal body cavities Microfilariae – blood smear
have delicate (Microfilaria
transparent e)
covering
2. Blood
(sheath)
specimen 1
ml. immersed
in 10 ml of
2% formalin
 solution to
lyse RBC
3. Serologic
tests and
Antigen
detection
methods –
alternative
diagnostic
methods

Trichinella Muscle Ingesting of 1. Enteric phase – 1. Larva – 1. Muscle

Worm, raw or incubation and have coiled biopsy
Trichin improperly intestinal invasion stage appearance
2. Blood
a Worm cooked pork and encysts in
2. Invasion phase – examination
meat muscle tissues
larval migration and –
surrounded by
muscle invasion eosinophilia,
striated muscle
leukocytosis,
3. Convalescent phase – cells
elevated
encystation and
2. Adult serum muscle
encapsulation stage
worms enzyme level