INTRODUCTION TO PARA LAB Common terms used for consistency

General symptoms of parasitic infection Watery Loose

Fever Pain Mucoid Mushy
Chills Diarrhea Hard Soft-formed
Fatigue Loss of vitality
Patient’s History- very important in diagnosing parasitic CHEMICAL EXAMINATION
infection 1. Ph – LITMUS PAPER
Specimens used to examine parasites - Clues for metabolic conditions
Stool Urine - Influenced by patient’s diet
Sputum Aspirations - Reported as alkaline or acidic
Blood 2. Occult Blood
- Black with tarry consistency- large amount of
Ova and parasite Fecal examination occult blood
Malarial parasite Blood examination - Indicative of lesion in the intestinal tract due to
Immunologic test  Parasitic infection
Ectoparasite (OUTSIDE)  Cancerous tumor
- Easily seen and identified  Bleeding ulcers
Endoparasite (INSIDE) - Occult blood test is primarily done to screen for
- Intestinal and atrial parasite COLO-RECTAL CANCER
- Blood and tissue parasite - Positive test: BLUE-COLOR
“Examining intestinal parasite, used stool specimen” - Positive and negative control must be run
SPECIMEN COLLECTION - Occult blood detects presence of small amount
- Clean, dry, wide-mouth, leak-proof container, of blood by detecting HB’S PSEUDOPEROXIDASE
tight fitting lid ACTIVITY
- Patient’s names, time, and date of collection - PEROXIDASE from vegetables may cause FALSE
- Process within 2 HOURS POSITIVE when large amount in diet
3 PHASES OF ROUTINE STOOL EXAM 3 types of chemical methods
 Macroscopic- color and consistency  Benzidine method- most sensitive and
 Chemical- pH and occult blood cheapest
 Microscopic  O- toluidine method
MICROSCOPIC (PHYSICAL EXAMINATION)  Gum Guiac method- most specific and most
1. Color expensive
- Presence of parasite and metabolic disorders “Antibodies against human hemoglobin and erythrocytes to
- Presence of blood should be noted detect blood from specimen”
Bright red Bleeding hemorrhoids
Bloody mucus Amoebic ulceration in large MACROSCOPIC EXAMINATION METHODS
(loose/liquid specimen) intestine I. Direct fecal smear (Saline mount/ Wet mount
Bloody tinged Trophic amoebae - Fresh or preserved fecal specimen
(Patches of mucus) - Helminth ova, larvae, protozoan cysts and
Occult blood Gastrointestinal disorder trophozoites
Dark colored blood Bleeding in high up - 2 mg to stool mixed with drop of NSS and
gastrointestinal tract
covered with coverslip
Bright colored blood Bleeding at lower
II. Iodine Wet mount
gastrointestinal tract
- Drop of iodine solution to saline mount or new
“O & P examination- routinely performed for ova and parasite
mount using iodine alone
/occult blood exam”
- Increases the visibility of protozoan cysts
2. Consistency
- Example: weak iodine solution
Indication of the types of organism
 Lugol’s
Formed Semi-formed
Mushy Liquid  D’ Antoni’s
 Dobell and O’ conner
Liquid and soft stool Trophozoites III. Kato thick smear
Fully formed stool Cysts - 50-60 mg of fresh stool and covered with a CUT
Liquid/formed stool Helminths eggs CELLOPHANE soaked in a mixture of MALACHITE
GREEN GLYCERINE
 - Alternative: colored cellophane strip - 40% HCl to dissolve albuminous materials
- Thin-shelled ova- difficult to find due to clearing - Ether to dissolve neutral fats
agent (GLYCERINE) - Protozoan cysts may be destroyed using this
- Most sensitive for detection of thick-shelled ova technique
- Cannot be used for liquid stool and preserved Quantitative and Semi-quantitative methods
samples X. Stoll’s egg counting methods
IV. Kato-Katz smear - Used for formed and liquid stools
- Uses a measured amount of stool for - Samples are dilutes using 0.1 N NaOH
quantitation - Exact amount is measured using STOLL PIPETTE
- Samples passed through SIEVE to remove large and read microscope
particles - Counts are multiplied by a factor depending on
- All eggs are counted and multiplied by a factor the amount of stool sample used and the
depending on the amount of stool used consistency
CONCENTRATION METHODS XI. Kato-Katz
- Increased the possibility of detecting parasites - Only for formed stool samples
when only few are present in feces
Floating methods
- Uses liquid of a higher specific gravity
- Top layer is skimmed from the surface and
examined microscopically
- Performed with METICULOUS ATTENTION
- Ova and cysts are selectively floated out from
the sample using a reagent with a high specific
gravity
- Not useful for detecting trophozoites
- Uses large amount of stool, increases the
specificity
V. Zinc Sulfate Flotation
- 33% zinc sulfate with S.G of 1.18-1.20
- Provide cleaner concentration
- Good for recovery of protozoan cysts and most
eggs
VI. Sheather’s sugar flotation
- Boiled sucrose solution preserved with phenol
Sedimentation methods
- Present in large amount of feces about 2 gm of
sediments
Straining the stool Remove large particles
Formalizing To kill and preserve the
organisms
Adding a solvent such as To dissolve fats
ether or ethyl acetate
- Uses a reagent with LOW SPECIFIC GRAVITY
- The parasite sinks to the bottom
- Not useful for detecting trophozoites
VII. Formalin ether concentration technique
(FECT/Ritchie’s method)
- 10% formalin used as preservatives
- Ether to dissolve neutral fats and sediment the
parasite
- Ether is explosive and flammable so it may
replaced with ether acetate
VIII. KOH Method for Cyclospora
- 10% KOH and saline
IX. Acid ether concentration technique (AECT)