CLINICAL PARASITOLOGY

INTRODUCTION TO PARASITOLOGY

Parasitology – an area of biology concerned with the phenomenon of ________________ of one

living organism on another.

Clinical Parasitology – concerned primarily with parasites that affect humans and their
clinical significance. It includes __________________, __________________, ______________ and
________________, and ________________ and _________________.

BIOLOGICAL RELATIONSHIPS

1. Symbiosis – living together of ___________ organisms.

2. ____________________ – symbiotic relationship in which two species live together and one
species benefits from the relationship without harming or benefiting the other.
3. ___________________ – two organisms mutually benefit each other.
4. ___________________ – one organism lives in or on another for its survival and usually at
the expense of the host.
5. _________________ – mechanical carriage of a smaller organism by another.

COMPONENTS OF PARASITIC INFECTION

1. Host
a. Definitive/Final – harbors the __________ or ___________ stage of the parasite.
b. Intermediate Host – harbors the __________ or ____________ stage of the
parasite.
c. __________________ Host – parasite does not develop into further stages but
remains alive and is able to infect other susceptible host.
d. Reservoir – animal that allows the parasite’s life cycle to continue and become
additional sources of human infection.
2. Parasite
a. Endoparasite – living ____________ the body of the host. Causes ____________.
b. Ectoparasite – living ____________ the body of the host. Causes ____________.
c. _____________ – cannot live without a host; depends entirely on the host for
existence.
d. Facultative – may exist in a ____________________ or may become ___________
when the need arises.
e. Accidental – occurs in an ______________ host.
f. Permanent – completes its life cycle in ____ host.
g. Temporary/Periodic – requires ____________ hosts for the larval and adult
stages.
h. ___________ – free-living organism that passes through the digestive tract
without infecting the host.
i. __________ – found in an organ that is not its usual habitat.
j. Anthroponotic – found in ______ alone. Transmitted from one human host to
another.
k. Zooanthroponotic – primarily infects _______ but may be transmitted to
______________.
l. Zoonotic – primarily infects __________ but may be acquired by ______.
m. Intermittent parasite – visit the host only during ____________ time.
3. Vector

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a. ____________ – transmits a parasite only after the latter has completed part of its
development.
b. ____________ – responsible only for transporting the parasite.
4. Sources of Infection
a. Contaminated Soil and Water – ___________________ sources of infection.
b. Food – may contain the infective stage of parasites especially ______________ and
_____________.
c. Arthropods (crustaceans, bugs, insects)
d. Mosquitoes – vectors of _______________ and ______________ parasites.
e. ________________ – the infected person himself is the source of infection.
5. Portals of Entry/Mode of Transmission
a. Oral Cavity – ingestion, hand-to-mouth transmission, or oral contact
b. Skin – larval penetration or inoculation by arthropods.
c. Sexual Contact
d. Intranasal/Inhalation
e. Transplacental/Congenital

MEDICALLY IMPORTANT PARASITES AND VECTORS

1. PROTOZOA
a. Phylum Sarcomastigophora – amoebae and flagellates
b. Phylum Ciliophora – Balantidium coli
c. Phylum Apicomplexa – sporozoans and coccidians
2. OTHER UNICELLULAR PARASITES – Blastocystis spp. and microsporidians
3. HELMINTHS
a. Phylum Nemathelminthes – _______________
b. Phylum Platyhelminthes – _____________ and _____________
4. ARTHROPODS

INTERMITTENT
ECTOPARASITES VECTORS
PARASITES
▪ Pediculus humanus humanus ▪ Mosquitoes ▪ Mosquitoes (Plasmodium, Wuchereria, Brugia)
▪ P. h. capitis (________ louse) ▪ Fleas ▪ Biting Flies (Leishmania, Trypanosoma brucei)
▪ Phthirus pubis (_______ louse) ▪ Ticks ▪ Bugs (T. cruzi)
▪ Sarcoptes scabiei (_______mite) ▪ Biting Flies ▪ Ticks (Babesia)
▪ Tunga penetrans (________flea) ▪ Cockroaches, house flies

DIAGNOSTIC PROCEDURES

I. SPECIMEN COLLECTION AND PROCESSING

STOOL
A. Specimen Collection
▪ Ova and Parasite Sample collection: ______________________
▪ Diagnosis of Amebiasis: _________________________
▪ Clearance period following ingestion of certain drugs and compounds:
o Antimicrobial agents (antibiotics and antimalarial drugs): ___________
o Barium, Bismuth, or mineral oil therapy: ___________
▪ Container: ________, leak-proof container with screw top.
▪ Acceptable amount of stool: ________ for formed; __________ for watery.
▪ Liquid stools should be examined within: __________
▪ Trophozoites are usually found in: ____________

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▪ Specimens containing blood and mucus should be examined _______, followed by

_________ specimen.
▪ Semi-formed stool should be examined within: __________
▪ Formed stool can be held for: ____________
▪ Avoid contamination with water, urine, or soil

B. Stool Preservatives
▪ Beyond _______ hour, the stool must be refrigerated.
▪ Specimen must be fixed in the preservative for at least: ______________________________
▪ For longer periods of preservation, divide the specimen and store in __________ and
________________.
▪ Fixative to stool ratio: _______
▪ FIXATIVES:
o Formalin
▪ ________________________
▪ _____ concentration for protozoan cysts
▪ _____ concentration for helminth eggs and larvae
o Schaudinn’s solution
▪ It contains ______________________
▪ Preserve fresh stool in preparation for staining stool smears.
o Polyvinyl alcohol (PVA)
▪ Plastic resin that serves as an _____________ for stool
▪ Normally incorporated in Schaudinn’s solution
▪ Stool preserved in PVA can be concentrated using FECT.
▪ Major drawback: use of ___________________.
o Merthiolate-iodine formalin
▪ Merthiolate and iodine serve as _______________ while formalin acts as
___________________.
▪ Fixation of intestinal protozoan, helminth eggs and larvae
o Sodium acetate-acetic acid formalin (SAF)
▪ Does not contain mercuric chloride.
▪ Liquid fixative with a ______________.
▪ For WM, CT, PS, and IA

Fixative WM CT PS IA
Formalin
MIF
Schaudinn’s fluid
PVA
Mod. PVA
SAF

C. STOOL CONSISTENCY
▪ Soft to well-formed
▪ Gives clues on parasite stages present.
▪ Determines sensitivity of egg counting techniques

D. TECHNIQUES AND SPECIAL TESTS

❖ Direct Wet Mount
▪ Useful in detection of motile protozoan trophozoites, helminth eggs, and larvae
▪ _____ stool mixed with ___ drop of 0.85% NSS
▪ May be stained by _________ or __________________
❖ Concentration Technique:
➢ Sedimentation Procedures
▪ Formalin-Ethyl Concentration Technique (FECT)

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▪ _________________ sedimentation Technique

▪ Formalin acts as _______________
▪ Ether/Ethyl acetate is used to remove __________.
▪ Provides good recovery of protozoan cysts and helminth eggs and larvae.
▪ Less distortion of protozoan cysts compared to zinc sulfate flotation.
▪ Disadvantage: Preparation contains more ____________ than flotation
technique.
Acid-ether concentration technique
▪ ________ HCl serves as ______________
▪ Recommended for animal parasites: Trichuris, Capillaria, and
Schistosoma eggs.
➢ Flotation Procedures
Zinc Sulfate Flotation Technique
▪ 33% ZnSO4 with S.G of ________ (if fresh feces) to ________ (if
formalinized).
▪ Parasites float toward the top of the tube
▪ Advantage: more fecal debris are removed
▪ Disadvantage: dense particles will not float
Brine’s flotation
▪ Uses saturated _______ solution with SG of _____
▪ No centrifugation is required.
Sheather’s Sugar Flotation
▪ Uses boiled sugar solution with _______.
▪ SG = _____________
▪ Preferred for concentrating coccidian oocysts like those of
__________________ and _________________.
❖ Permanent Staining
➢ Iron Hematoxylin
➢ Gomori’s Trichrome
➢ Modified Trichrome – _____ strength/dye content – for ______________________.
➢ Modified Acid-Fast stain – used to identify _______________ and _______________
species.
❖ Special Tests
➢ Copro Culture
▪ Positive stools are mixed with moistened soil and granulated charcoal.
▪ Stimulates environmental condition in nature.
▪ Larvae are harvested using _____________________.
➢ Harada-Mori
▪ Use test tubes and filter paper strips with about ______ of boiled or
distilled water
▪ Kept in the dark for __________ at _________.
▪ _______________ moves downward while _____________ moves upward.
➢ Kato-Katz method
▪ Uses measured amount of stool, sieved through a wire mesh and pressed
under cellophane paper soaked in glycerin malachite green solution.
▪ Glycerin serves as ____________________.
➢ Cellulose Tape or Scotch Tape swab
▪ For the recovery of __________________ and __________spp. in the perianal
region
▪ Uses a strip of cellulose tape attached to glass slide.
▪ Should be collected first thing in the morning before bathing or
defecating.
➢ Enterotest
▪ Simple method of collection of duodenal material
▪ For the recovery of _____________ and _______________.

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➢ Knott’s concentration technique

▪ For cases of _______ microfilaremia
▪ 1mL of blood mixed with ______ of ___ formalin and then centrifuged.
➢ Buffy coat films
▪ For the recovery of ______________ and ________________.
➢ Thick and Thin smear
▪ For the diagnosis and identification of _____________ parasite.
➢ Baermann Funnel Test
▪ Uses cheesecloth to harvest ____________________________ larvae
➢ Circomoval Precipitin Test (COPT)
▪ Confirmatory test for Schistosome infection
▪ Reagent: lyophilized Schistosome egg
▪ Positive Result: __________ formation
▪ Specimen: ____________
▪ Principle: detection of _____________ that react with the eggs.
➢ Sabin-Feldman Dye test – for ___________
➢ Montenegro Test – for ___________
➢ Bachman test – for ______________
➢ Casoni Test – for _________________
➢ Moan Test – for ___________________

II. OTHER SPECIMENS

❖ Urine Specimen: T. vaginalis, S. haematobium.

❖ Sputum: Paragonimus and migrating larva of Ascaris, Strongyloides, and Hookworms.
❖ Tissue Aspirate: E. histolytica, E. granulosus cysts, G. lamblia, S. stercoralis
❖ CSF Specimen: Naegleria and Acanthamoeba trophozoites.
❖ Muscle Biopsy: _________________________
❖ Rectal Biopsy: S. mansoni, S. japonicum
❖ Skin snips: _______________________ and ______________.

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