Parasite Ova Infective Stage
Host Host
E. histolytica Trophozoite – (+)
pseudopodia
Cyst – highly refractile
hyaline wall, chromatoidal
bars; 4 nuclei
E. coli Trophozoite – more
vacuolated, sluggish,
eccentric karyosome
Cyst – 8 nuclei, more
granular cytoplasm,
splinter-like chromatoidal
bodies
G. lamblia or Trophozoites – tear-drop
G. duodenalis shaped; (+) axostyle –
distinct medial line
Cyst – flagella retracted
into axonemes, deeply
stained curved fibrils
surrounded by a tough
hyaline cyst wall
Plasmodium P. vivax trophozoite –
signet-ring form with
heavy red dot and blue
cytoplasmic ring
P. falciparum trophozoite 0
(+) small thread-like blue
cytoplasmic circle with 1-2
small red chromatin dots
Balantidium Trophozoite – covered
with cilia; (+) cytostome
(oral apparatus) and
cytopyge (waste extreion);
bean-shaped
macronucleus; (+)
mucocysts (extrusive
organelles)
Cysts – double-walled
Trichomonas Trophozoite only –
vaginalis pyriform shape, (+) 5th
flagellum
Chilomastix Trophozoite –
mesnili asymmetrical pear shape,
boring spiral forward
movement
Cyst – pear or lemon shape
Trypanosoma Trypomastigotes in blood,
cruzi amastigotes in tissue cells
Intermediate Definitive Mode of Transmission Clinical S/Sx Diagnostic Procedure Treatment
Mature cyst (-) Human Ingestion of Asymptomatic Microscopic detection – Metronidazole
contaminated feces Amebic colitis – gradual onset unidirectional movement,
abdominal pain and diarrhea +/- trophozoites with ingested RBCs
mucus and blood in tools
Amebic liver abscess
Cyst and (-) Human Ingestion of Non-pathologic Stool examination None
trophozoite contaminated feces FECT and iodine staining
Mature cyst (-) Human Ingestion of Causes intestinal villous flattening and Stool examination Metronidazole
contaminated food or crypt hypertrophy, resulting to • Trophozoites –
water malabsorption floating leaf-like
motility
Sporozoite Mosquito Human Mosquito bite Merozoites enter RBCs (rupture later Microscopic identification of Artemisinin-based
(Anopheles) on) malarial parasites in thick and thin combination therapies
Regular paroxysms of fever with blood smears stained with Giemsa
asymptomatic intervals or Wright’s stain
(+) prodromal s/sx (cold, hot, and
sweating stage)
Cyst (ingested cysts (-) Human Ingestion of Primarily inhabit the cecum Stool examination Tetracycline
excyst in the small contaminated food or (trophozoites) Metronidazole if for
intestine and water Attack the epithelium and create a pregnant women or
become characteristic ulcer with a rounded children < 8 y/o
trophozoites) base and wide neck (amoebiasis:
narrow neck)
Forms:
• Asymptomatic
• Fulminant (balantidial
dysentery) – diarrhea
with bloody and mucoid
stool
• Chronic – diarrhea
alternates with
constipation
Trophozoite – (-) Human Sexually transmitted Green-yellow vaginal discharge Saline preparation of vaginal fluid Metronidazole or
multiples by Itchiness, burning sensation Culture – gold standard tinidazole
longitudinal binary Strawberry cervix
fission
Cyst (-) Human Ingestion of Inhabits the cecum Stool examination None
contaminated food or
water
Trypomastigotes Triatomine Bug Human Insect bite Causes Chagas disease or American Direct visualization of parasites in Acute: nifurtimox and
trypanosomiasis thick and thin blood smears using benznidazole
Intracellular parasite infecting mostly Giemsa stain Chronic: symptomatic
myocytes and RES cells treatment
Romanas sign – eyelid swelling
Chagomas – site of entry; furuncle-
like lesions
Leishmania Diploid protozoa
A. Polymyarian type of
lumbricoides somatic muscle
(giant round arrangement
Worms have a terminal
worm) mouth with 3 lips and
sensory papillae
Egg – mamillated coating
with refractile granules
T. trichiura Narrow esophagus
(whip worm) resembles a string of beads
Egg – lemon or football-
shaped with translucent
polar prominences
N. americanus Head curved opposite to
(hook worm) body (N. americanus)
Head same direction as
A. duodenale
body (A. duodenale)
(hook worm) Egg – bluntly rounded ends
and a single thin
transparent hyaline shell
S. stercoralis Finely striated cuticle
(thread worm) Egg – clear thin shell
E. vermicularis Meromyrian
(pin worm) D-shaped eggs
C. philipinensis Egg - peanut-shaped with
striated shells and flat
bipolar plugs
W. bancrofti Creamy white, long
No staining on Giemsa
Nuclei do not reach tail’s
end
1:1 cephalic space: breadth
Promastigote Sand fly Human Insect bite Categories: cutaneous (oriental Demonstration of amantigotes Antimony-based
button), diffuse cutaneous (anergic or from tissue sample compounds: sodium
lepromatous), mucocutaneous stibogluconate, n-
(espundia), visceral (kala azar; caused methyl-glucamine
by L. donovani complex) Alternative: IV
amphotericin B
Fully embryonated (-) Human Ingestion Penetrate intestinal wall, enter Microscopic examination of stool Albendazole,
egg (hatch in the venules, go to liver, heart and lungs sample mebendazole, or
lumen of the small (molt then migrate to the larynx / Kato techniques for individual and pyrantel pamoate
intestine, releasing oropharynx to be swallowed mass screening
larvae which Vague abdominal pain
migrate to the Eosinophilia and allergy during larval
cecum or proximal migration
colon) Vit A malabsorption, lactose
intolerance
Bowel obstruction
Biliary ascariasis, appendicitis,
pancreatitis
Acute or chronic granulomatous
peritonitis
Embryonated eggs (-) Human Ingestion Anterior portions cause petechial Direct fecal smear with saline drop Mebendazole
hemorrhages, predisposing to
amoebic dysenteric
Intestinal bleeding, rectal prolapse if
severe
Appendicitis
Anemia
No larval migration
Filariform larvae (-) Human Skin penetration (enter Severe itching (ground or dew itch) Direct fecal smear only if infection Albendazole
venues, migrate to heart Bronchitis or pneumonitis is heavy (egg count > 400 per gram
and lungs, ascend to Abdominal pain, steatorrhea, diarrhea of feces)
trachea and are with blood and mucus Kato techniques
swallowed); become Anemia, hypoalbuminemia
sexually mature at the
intestines
Filariform larvae (-) Human Skin penetration; Larval skin invasion – erythema, Unexplained eosinophilia Albendazole,
autoinfection may occur pruritic elevated hemorrhagic papules Harada Mori culture thiabendazole, or
if rhabtidiform larvae Larval migration – lungs are destroyed Repeated concentration ivermectin
pass down the large causing lobar pneumonia with techniques (Baermann funnel
intestine and develop hemorrhage gauze method)
into filariform larvae Penetration of intestinal mucosa by
adult females – mostly at duodenum
and jejunum
• Heavy infection –
intractable painless
intermittent diarrhea
(Cochin China diarrhea)
Embryonated eggs (-) Human Ingestion; eggs deposited Enterobiasis or oxyuriasis Microscopic examination Mebendazole or
at perianal skin (females Perianal itching (pruritus ani) Graham’s scotch adhesive tape albendazole
migrate from intestines Aberrant adult migration swab
at night to lay eggs)
Infective larvae Freshwater or Human Ingestion of raw or Intestinal capillariasis – abdominal Microscopic examination of stool Mebendazole
(egg hatched at fish brackish water undercooked fish pain, chronic diarrhea, gurgling
intestine) fish stomach
Protein-losing enteropathy
Malabsorption
L3 larvae – from Mosquitoes Human Mosquito bite From skin, reach the lymphatics Blood microscopy (specimen taken DEC
mosquito proboscis (Aedes, Culex, (mostly at LE, inguinal, epididymis, at night)
to skin (mosquito Anopheles) labia)
ingests Cause lymphatic filariasis
B. malayi Enclosed in a sheath with
angular curvatures
(secondary kinks)
Pink stain on Giemsa
Nuclei reach the tail’s end
2:1
T. saginata No hooks or rostellum
(beef Ova – brownish, thick
tapeworm) striated embryophore
T. solium (pork < proglottids, smaller and
tapeworm) more spherical acetabula
(4)
Gravid proglottid – (+)
accessory ovarian lobe, (-)
vaginal sphincter, <
follicular testes
H. nana (dwarf Scolex subglobular with 4
tapeworm) cup-shaped suckers
Egg – spherical, clay
colored or colorless
H. diminuta Scolex – (+) rudimentary
(rat tapeworm) unarmed rostellum
Egg – bile-stained
D. latum (fish Scolex - spatulate
tapeworm or
broad
tapeworm)
S. japonicum Egg – pale yellow; curved
(Oriental blood hook near 1 polar end;
fluke) hatch in slightly alkaline
water at 25-31ºC
S. hematobium
S. mansoni
microfilariae from Infection usually acquired in
blood) childhood and takes years to manifest
Expatriate Syndrome – individuals
who migrated to endemic areas;
hyperresponsiveness
Lymphangiectasia, lynphangiogenesis
Acute dermatolymphangioadenitis
(ADLA) – MC acute manifestation
Lymphedema, elephantiasis – MC
chronic manifestation
Encysted larvae Cattle Human Ingesting raw or Passage of proglottids or segments in Gravid proglottids brought by Praziquantel
(Cysticercus bovis) undercooked meat the stool patients
Epigastric pain, weight loss, anorexia, Fecal exam
**adult worm pruritus ani
inhabits upper Actively motile – visible; migrate to
jejunum biliary tree or appendix (obstruction)
Human, Swine Human Ingestion of Obstruction unlikely Taeniasis – fecal exam Praziquantel,
contaminated food or Cysticerci MC at striated muscle and Cysticercosis – CT scan niclosamide
**human drink brain (neurocysticercosis) – MC
cysticercosis – seizure
oncosphere Autoinfection Also at subcutaneous tissue, eye,
hatches at heart, lung, and peritoneum
duodenum and
spreads
hematogenously
Cysticercoid larvae None needed Human (both Direct cycle – host ingests Immunologic response leads to Stool examination Praziquantel
(the only human adult and the eggs which hatch in symptoms – HA, dizziness, anorexia,
tapeworm that larval stages) the duodenum; embryo pruritus of nose and anus, diarrhea,
can complete its penetrate mucosal villi vomiting, abdominal pain, pallor,
life cycle in 1 and develop into infective weight loss
host) cysticercoid larvae Heavy infection – enteritis
Indirect cycle – ingestion
Arthropods – of intermediate hosts or
rice and flour contaminated material
beetle
Autoinfection
Cysticerci Insects Human, Rat Ingestion Hymenolepiasis – s/sx minimal and Stool examination (eggs more Praziquantel
non-specific (short life span) circular, larger, and no bipolar
elements)
Plerocercoid larva Fish Human Ingestion of raw or Hyperchromic megaloblastic anemia Stool examination Praziquantel
undercooked fish with thrombocytopenia and
leukopenia (worms compete for vit DDx: pernicious anemia –
Ova develop in water and B12 if high at jejunum) associated with achlorhydria
release coracidium
ingested by copepods,
whre they develop into
procercoid larva; eaten
by fish, where they
develop into plerocercoid
larva
Cercariae Snail Human and Skin penetration Swimmer’s itch Rectal or liver biopsy (non- Praziquantel
(Oncomelenia other Schistosomula migration – Katayama practical)
hupensis mammals Embryonated eggs from fever Stool examination
quadrasi) stool contacts fresh Hepatosplenic disease (most serious MIFC technique for mod-sev
water, hatches into consequence of chronic infection
miracidia which infect schistosomiasis) Kato Katz for egg counting
snails, where they Wheezing, coughing
develop into sporocysts MC eggs deposit at liver, lungs,
then cercariae intestines, and CNS
 Cercariae transform into
schistosomula and enter
lymphatics or veins
Enter the lungs then the
portal vein (site of mating
and egg hatching, where
eggs are then deposited
to the intestines)
C. sinensis Egg – convex operculum Metacercariae Fish (Cyprinidae) Human Ingestion of raw fish, Migration into biliary tree Stool examination Praziquantel
fitting into the thickened ingestion of Increased risk of hepatocellular Cholangiography
rim of the eggshell contaminated water carcinoma and cholangiocarcinoma
F. buski Fasciolid digenetic; largest Encysted Snail Human Ingestion of aquatic Inflammation, ulceration Stool examination Praziquantel
intestinal fluke metacercariae (Segmentina or plants Gland abscess
Hippeutis) Metacercariae Intestinal obstruction
excysts at Toxin production, allergy
duodenum
and attaches
to intestinal
wall
E. ilocanum Digenetic trematode Metacercariae Snail (2) Human Ingestion of snail Inflammation, ulceration, intoxication Stool examination Praziquantel
Straw colored egg
F. hepatica Cephalic cone with marked Metacercariae 1. Snail Human Ingestion of aquatic Fascioliasis Stool examination – difficult Triclabendazolw
(temperate base widening (shoulder) 2. Aquatic plant plants / drinking water
liver fluke) Adult worm lives in the biliary tree
F. gigantica Longer, less developed
Acute – larval migration and worm
(tropical liver shoulder, shorter cephalic
maturation at hepatic tissue (triad:
fluke) cone
sudden onset fever, hepatomegaly,
marked eosinophilia)
Chronic – persistence at biliary ducts
H. heterophyes Light brown egg Metecercariae Fish Human Ingestion of raw fish Unusual inflammation (excessive Stool examination (Kato thick) Praziquantel
mucus production, sloughing of
superficial layers)
P. westermani Adult – red brown, Metacercariae 1. Snails Human Ingestion of raw crab At lungs – granulomatous reaction Microscopy of stool, sputum, or Praziquantel
(Oriental lung resembles a coffee bean (Antemelania leading to a fibrotic cyst aspirated material
fluke) asperata and Metacercariae excyst at • Chronic cough and
dactylus) the duodenum; wanders hemoptysis
2. Mountain to the abdominal wall, Ectopic infection: cutaneous
crab pleural space, and lungs (migratory lesion at abdomen or
(Sundathelphusa (site of mating and egg chest) and cerebral paragonimiasis
philipina) laying) Most serious complication – cerebral
involvement
T. gondi Sporozoite enters a new Tachyzoite Cats Human Ingestion of food or Parasite enters intestinal lamina Examination of tissue imprints Pyrimethamine and
cell and transforms into a Bradyzoite water contaminated with propria and gains entry into stained with Giemsa sulfadiazine
tachyzoite Oocyst cat feces lymphatics, infecting nucleated cells Sabin-Feldman methylene blue
Asymptomatic if (macrophages
immunocompetent
Encephalitis – MC
presentation in the
immunocompromised
Stillbirth and abortion if
acquired during the 1st
trimester