MTAP - Parasitology

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The condition caused from the migration of E. histolytica tropho-
Amoebic liver abscess
zoites in the liver.
Fixed in Methanol Must be done prior to smearing
Lysing or Laking of RBCs Must be done prior to staining
C - arbolfuchisin
Acid-fast stain A - cid alcohol (washing)
M - ethyl blue (seconds washing)
C - rystal violet
I - odine
Gram stain
A - lcohol
S - afranin
Symbiotic relationship in which one is harmed or injured through
Parasitism
the activities of the other animal.
Protozoa Unicellular organism and the lowest form of animal life.
Common name for a motile class of Protozoa equipped with
Amoebas
pseudopods for locomotion.
- Extension of the cytoplasm of the amoeba that aids the organism
Pseudopods in motility
- Referred to as "false feet".
Pseudopods The presence of this feature classifies a parasite as an amoeba.
Morphologic form in amoebic that feeds, multiplies and posseses
Trophozoites
pseudopods.
- Nonfeeding stage
- Thick protective cell wall for survival from the harsh outside
Cysts
environment
- Subsequent transmission into an uninfected host.
- Morphologic conversion from cyst form into the trophozoites form
Excystation
- Ileocecal area of the small intestine
Asexual binary fusion Multiplication of the nucleus in the trophozoites stage.
Encystation Conversion of trophozoites to cysts occurs in the intestinal lumen.
Primarily recovered from stools that are soft, liquid or loose con-
Trophozoites
sistency.
Cysts Recovered from formed stool specimens.
Saline wet preparation It will often show motility of the amoebic trophozoites.
It will show the internal cytoplasmic, as well as the nuclear struc-
Iodine wet preparation
ture, of the amoeba.
Permanent stain Allows refractive and invisible structures to be more clearly visible.
- trophs: 8-65 um
- cysts: 8-22 um
Entamoeba histolytica
- rapid, unidirectional, progressive movement with finger-like hya-
line pseudopods
Karyosome (Karyosomal chromatin) Small central mass of chromatin in the nucleus
Morphologic structure that surrounds karyosome and evenly dis-
Peripheral chromatin
tributed around the nucleus.
Entamoeba histolytica Ingested RBCs seen in the cytoplasm of the trophozoites.
Thin hyaline wall Recognizable appearance of the E. histolytica cyst.
Chromatoid bars Rod-shaped structures that contain condensed RNA material.
Cytoplasmic area without designed borders that is believed to
Glycogen mass
represent stored food in young cysts.
Entamoeba histolytica Mature infective cyst is quadrinucleated (four nuclei)

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TYI-S-33 Special medium known to supports E. histolytica in culture.
The number of trophozoites produced in a single cyst of E. his-
Eight trophozoites
tolytica.
- Human waste fertilizer
- Poor sanitation
- Mental hospital
Risk factors of E. histolytica
- Prisons
- Day care centers
- Homosexual communities
Entamoeba histolytica The only known pathogenic intestinal amoeba.
- Low virulence strain
Factors for asymptomatic carrier state (E. histolytica) - Low inoculation into host
- Intact patient's immune system
Intestinal infection caused by the presence of amoebas exhibiting
Amoebic colitis
symptoms.
Intestinal amoebic infection characterized by blood and mucus in
Amoebic dysentery
the stool.
Formation in the colon, cecum, appendix or rectosigmoid area
Flask-shaped amoebic ulcer
may develop secondary bacterial infections.
Nonpathogenic amoeba that has been identified that is morpho-
Entamoeba dispar
logically identical to E. histolytica.
Single nucleus with small karyosome Structure that is typical in trophozoites of E. histolytica.
- trophs: 8-12 um
- cysts: 5-12 um
Entamoeba hartmanni - nuclei: 1-4
- nonprogressive and sluggish motility with finger-shaped
pseudopods
Entamoeba hartmanni Designated as "small race" E. histolytica.
- trophs: 12-55 um
- cysts: 8-35 um
Entamoeba coli - nuclei: 1-8 and 16 or more
- sluggish, nonprogressive motility equipped with blunt
pseudopods
Appearance of E. coli trophs due to ingested bacteria, debris and
Dirty-looking cytoplasm
yeasts.
Thin chromatoid bars with pointed to splintered ends in young
Entamoeba coli
cysts.
- trophs: 8-25 um
- cysts: 10-20 um
Entamoeba polecki
- sluggish, nonprogressive motility (normal stool)
- progressive, unidirectional motility (diarrhoeal stool)
Number of nuclei in E. polecki cyst that differs from other Enta-
One nucleus
moeba spp.
Entamoeba polecki Irregular thin chromatoid bars with pointed or angular ends.
A nondescript oval seen in approximately 50% of the E. polecki
Inclusion mass
cycts.
- Amoeba of pigs and monkeys
Entamoeba polecki - Common in Papua, New Guinea
- Zoonotic infection
- trophs: 5-12 um
- cysts: 4-12 um
Endolimax nana
- nuclei: 1-4
- sluggish, nonprogressive motility with blunt, hyaline pseudopods

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Often describe to the appearance of the E. nana large and irreg-
Blotlike
ular karyosome.
Entamoeba nana Characterized by a large refractive dot
Endolimax nana The smallest intestinal amoeba, as small as RBCs (6-8 um)
No peripheral karyosome and chormatoid bodies Key feature that aids in the identification of E. nana trophozoites.
Cross-eyed, ovoid or ellipsoid Appearance of E. nana cysts
- trophs: 8-22 um
- cysts: 5-22 um
Iodamoeba bütschlii
- progressive, sluggish motility
- "Iodine cyst"
Iodine stain Prove to be benefit in identification of I. bütschlii
Iodamoeba bütschlii Only amoeba with just one nucleus in cyst.
- Its nucleus does not undergo typical division
Iodamoeba bütschlii
- Often described as "basket of Flowers" in shape
Iodamoeba bütschlii Amoeba of swine (pigs)
- trophs: 8-20 um
Entamoeba gingivalis - no cysts stage
- active motility with multiple pseudopods
Inclusions that are typically found in E. gingivalis fine granular
Ingested WBCs and epithelial cells
cytoplasm.
- lives in gum line of the teeth in the tartar and gingival pockets
Entamoeba gingivalis - scavenger that feed on disintegrated cells
- recovered from women with IUDs
- Mucus and bloody stool
Amoebiasis - No granulocytosis and no high fever
- Fishy smell of stool
- "glitters" characteristic
Blastocystis hominis - common in rural areas
- nuclei arrangement is pushed to the side or in the periphery
Inhabitants in contaminated lakes, ponds, streams, pools, tap
Free-living amoebaflagellate
water, air conditioning units and healthy units.
Very fatal disease or condition of N. fowleri that causes inflamma-
Primary amoebic meningoencephalitis (PAM)
tion of meninges in the brain.p
Only amoeba with three known morphologic forms— ameboid
Naegleria fowleri
trophs, flagellate forms and cysts.
Sluglike motility Motility of N. fowleri trophs accomplished by blunt pseudopods.
Flagella Whiplike structures that assist select parasite in locomotion.
- sluglike motility trophs
- jerky movement or spinning flagellate
Naegleria fowleri
- thermophilic
- MOT: swimming in contaminated water
Diagnostic sign for meningitis, where patient is unable to fully
Kernig's sign straighten his/her leg when the hip is flexed at 90° due to hamstring
stiffness.
Amphotericin B with rifampin/miconazole/clotrimazole Treatment of choice for N. fowleri
Specimen of choice for the recovery of N. fowleri and Acan-
Cerebrospinal fluid
thamoeba spp. trophs/cysts.
Granulomatous amoebic encephalitis (GAE) Common associated disease or condition of Acanthamoeba spp.
Spine-like pseudopods that project outward the trophs of Acan-
Acanthapodia
thamoeba spp.

Acanthamoeba spp.
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- double cell wall cyst: smooth inner and jagged outer
- associated with contaminated saline
Calcoflour white Used to stain Acanthamoeba cysts present in corneal scrapings.
Contact lens wearers using homemade, nonsterile saline solu-
Acanthamoeba keratitis
tions contaminated with Acanthamoeba spp.
Acanthamoeba castellani Responsible for most CNS and eye infections in humans.
Fin-like structure connected to the outer edge of some flagellates
Undulating membrane
- for locomotion (wave-like pattern)
Axostyle Rod-like support structure found in flagellates
Small mass of chromatin located within the nucleus of certain
Karyosome
protozoan parasites.
- resistant to destructive forces
Flagellate (no cyst stage) - surviving passage into stomach following ingestion
- survive in the outside environment
Nonpathogenic flagellates From ingestion of contaminated food or drink
- Giardia intestinalis
Giardia lambia - Giardia duodenale
- Cercomonas intestinalis
- pear or teardrop shaped
- falling leaf motility
- four pairs flagella: 2 anterior, 4 lateral and 2 conal/posterior
Giardia lamblia - two axonemes
- RH: beavers
- alkaline pH 7.8-8.2
- chlorine resistant
Intracellular or interior portion of flagellum; the internal cytoskele-
Axonemes
tal structure that supports flagella
Slightly curved rodlike-shaped structure (comma) located in the
Median bodies (Parabasal bodies)
posterior portion of G. lamblia trophs and cysts.
Used to define structures believed to be associated with energy,
Median bodies
metabolism or support.
Serves as virulence factor or nourishment point of entry by attach-
Two ventral sucking disc
ing to the intestinal villi of an infected human (G. lamblia)
Old man's face with eyeglasses Appearance of G. lamblia
- Giardiasis
- Traveller's diarrhea
- Backpacker's diarrhea
G. lamblia diseases
- Beaver fever
- Gay bowel syndrome
- Explosive watery diarrhea
- loose (greasy, frothy) foul-smelling stools (rotten eggs odor:
Chronic diarrhea hydrogen sulfide)
- steatorrhea: abnormal quantities of fat in the stool
- usually done in DFS-negative
Enterotest
- Beale's string test
Produce light-colored stools with a high fat content that may be
Giardiasis (Traveller's diarrhea)
caused by secretions produced by the irritated mucosal lining.
He discovered G. lamblia in 1681 when he examined a sample of
Anton van Leeuwenhoek
his own stool.
- trophs: pear-shaped
- cysts: lemon-shaped with clear hyaline knob
Chilomastix mesnili - presence of cytosome
- stiff rotary motility (directional pattern)
- four flagella
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Giardia intestinalis
Cytostome
Chilomastix mesnili
Shepherd's crook
Dientamoeba fragilis
Dientamoeba fragilis
Iron hematoxylin
Polyvinyl alcohol or Schaudinn's fixative
Giardia lamblia
Hakansson phenomenon
D. fragilis trophs
Trichomonas hominis
Costa
Contaminated milk
Enteromonas hominis
Retortamonas intestinalis
Bird's beak
Trichomonas tenax
MOT of T. tenax
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Commonly associated with Giardiasis and Traveller's diarrhea
Rudimentary mouth of the parasite
- trophs: twisted jaw
- cysts: nipple-shaped
- boring/corkscrew/spiral forward motility
The appearance of structure bordening the cytostome and promi-
nent supporting cytostomal fibrils.
- amoeboflagellate
- no cyst stage
- ingested with Enterobius and Ascaris
- 2 nuclei (DI-entamoeba)
- fragile (FRAGILIS)
- Rosette karyosome
- no visible flagella
- pseudopods: angular appearance
- nonprogressive movement
- blend well with the background material in the sample
Permanent stain of choice for distinguishing and observing the
nuclear features and chromatin granules of D. fragilis.
Used fixatives for prompt fixation of D. fragilis.
Mild-moderate diarrhea which can lead to malabsorption and
steatorrhoea
Diagnostic identification of D. fragilis where numerous granules
are present and exhibit Brownian motion.
- swell, rupture and returns to its normal size
With two nuclei and four symmetrically positioned chromatin gran-
ules and vacuoles containing bacteria in the cytoplasm.
Trophs
- pearshaped
- nervous, jerking motility
- full body-length undulating membrane
- 3-5 anterior and 1 posterior flagella
Rod-like structure located between the undulating membrane and
the body of flagellate trophs, thus connecting the two structures.
It may also aid in supporting the undulating membrane.
One of the sources of Trichomonas hominis infection.
- oval shaped trophs
- jerky motility
- body is flattened on one side (half-circle)
- posterior end: small tail
- ovoid trophs exhibits jerky motility
- two anterior flagella
- cleft-like cytosome
- lemon to pear-shaped cyst
It is a two fused fibrils in the anterior nuclear region or cytostomal
fibrils of R. intestinalis cyst.
- oval/pear-shaped
- five flagella
- undulating membrane extends T of the body length
- no cyst stage
- commensal: mouth
- smallest urogenital flagellate
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Trichomonas vaginalis
Trichomoniasis
Trichomonas vaginalis
Siderophil granules
MOT of T. vaginalis
T. vaginalis disease manifestation
Persistent vaginitis
Mucopurulent discharge
Atypical pelvic inflammatory disease
Strawberry cervix
Persistent urethritis
Infant T. vaginalis infections
Pentatrichomonas hominis
Ciliates
Coccidia
Balantidium coli
Micronucleus
Macronucleus
Transverse binary fusion
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- direct contact or droplets (kissing)
- contaminated glass or dishes (sharing of utensils)
Commonly associated with Persistent urethritis, persistent vagi-
nalis and infant Trichomonas vaginalis infection
Disease caused by T. vaginalis that affect patients with STD.
- rapid jerky tumbling motility
- undulating membrane: wave-like structure extending ½ of the
body length
- axostyle: curves around the nucleus
- alkaline pH
- also known as paraxostylar granules seen in T. vaginalis
- iron-rich, along axostyle
- sexual intercourse
- infant delivery
- contaminated towels and underwear
- degeneration and desquamation of vaginal epithelium, followed
by leukocytic inflammation of the tissue layer
- foul smelling, greenish-yellow liquid vaginal discharge
- vaginal pruritus (itching) with burning ang chafing sensation
- red punctate lesions
- dysuria
- frothy, yellow or green vaginal discharge
- secretion of fluid containing mucus and pus from the eye, nose,
cervix, vagina or other infected and inflamed body parts
Can lead to sterility
- red dots (hemorrhages) seen in cervix caused by T. vaginalis
- inflamed cervix
- persistent or recurring urethritis in symptomatic men result from
T. vaginalis infection
- often release a thin, white urethral discharge with T. vaginalis
trophs
- suffers from both respiratory infection and conjunctivitis
- organism migrate from infected mother to infant thru the birth
canal/vaginal delivery
- formerly known as T. hominis
- 5 flagella
- colon inhabitant
- conical cytostome
- full body length undulating membrane
- jerky motility
Parasites that move by means of hairlike cytoplasmic extensions
called cillia
A group of protozoal parasites in which asexual replication occurs
inside a human host
- largest protozoan
- oval to sac-shaoed trophs
- rotary, boring motility
- with micro and macronucleus
A small dotlike nucleus found in B. coli; often difficult to see, even
in stained prepation.
Large, often kidney-bean shaped (often vary) nucleus found in B.
coli; often appear as hyaline mass (unstained prep).
Multiplication of each B. coli trophs from which two young trophs
emerge.
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Ingested food and water contaminated with feces (oral-fecal) from
Pig
the "RESERVOIR HOST" of B. coli
- mild colitis and diarrhoea, resemble amoebic dysentery
Balantidiasis
- up to 15 liquid stools daily with pus, mucus and blood.
"Little bag" B. coli trophs is often referred to as resembling a sac in shape.
Organism that is similar to life cycle of B. coli and its clinical
E. histolytica
symptoms.
Only known coccidal parasite that does not have intermediate
hosts
- young oocyst: two sporoblast
Isospora belli
- mature oocyst: two sporocysts with four sausage-shaped sporo-
zoite
- Isosporiasis
Roundish immature sac within the oocyst consisting of developing
Sporoblast
sporozoites.
Roundish mature sac within the oocyst with fully developed
Sporocyst sausage-shaped sporozoites; or saclike serving as the larval form
of flukes in snail and emerges from miracidium.
Pigs and cattle Intermediate hosts for I. belli
It serve as definitive host of I. belli: both sexual and asexual
Humans
reproduction take place.
Cryptosporidium parvum
Most likely responsible for autoinfection: ruptures while still inside
Thin-shelled oocyst (C. parvum)
the host
Thick shelled oocyst (C. parvum) Remains intavh and is passed out of the body.
- neonatal diarrhea (calves and lambs)
Cryptosporidiosis - diarrhea for 2 weeks
- episodes of diarrhea 1-4 weeks
Modified acid-fast Permanent stain of choice for the recovery of C. parvum.
Characterized by having a large, central, fluid-filled VACUOLATED
Blastocystis hominis
FORM that consumes almost 90% of the cell of the organism.
Sporulation or binary fission B. hominis reproduction
- only has TACHYZOITES & BRADYZOITES
Toxoplasma gondii
- infective form: OOCYST
- ACTIVELY MULTIPLYING
Tachyzoites - CRESCENT-SHAPED
- responsible for the TISSUE DAMAGE and INITIAL INFECTION
- SLOW-GROWER
Bradyzoites - CLUSTER INSIDE A HOST CELL
- CYSTS: contain hundreds to thousands of bradyzoites
Cat (or other felines) DEFINITIVE HOST of T. gondii
It serves as the INTERMEDIATE HOSTS, ingesting the infected
Rodents: mice and rats
mature T. gondii oocyst.
1. In contact with infected cat feces and ingested the mature
oocyts (hand-to-hand)
2. Ingestion of contaminated undercooked meat from cattle, pigs
or sheep infected during feeding.
Human infection of T. gondii
3. Transplacental infection; asymptomatic mother transmitted to
her unborn fetus
4. Contaminated blood transfusion

- mild and mimic infectious mononucleosis

- maculopapular rash, encephalomyelitis, myocarditis and hepati-
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Toxoplasmosis
Congenital Toxoplasmosis
Toxoplasmosis (mmunocompromised)
Toxoplasmosis (AIDS)
‘ spinal fluid IgG antibody and lack of IgM
T. gondii
B. coli and I. belli
I. belli and C. parvum
Cryptosporidium spp.
Gametogony
Balantidium coli
Pinworm or seatworm
Enterobius vermicularis
Adult female worms
Adult male worms
Cellophane tape prep.
Copulation
Gravid
Retroinfection
Autoinfection
Enterobiasis
Whipworm
Trichuris trichiura
Trichuriasis
Rectal prolapse and peristalsis
Zinc sulfate flotation
Ascaris lumbricoides
Chitin
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tis
- retinochoroiditis and blindness
- SEVERE & FATAL
- VIA TRANSPLACENTAL
- MENTAL RETARDATION & RETINOCHOROIDITIS
- due to ORGAN TRANSPLANT or NEOPLASMIC DISEASE:
Hodgkin's lymphoma
- Toxoplasmic encephalitis
- CNS involvement
Diagnostic for T. gondii as is the demonstration of trachyzoites in
CSF
Cat
Pig
Cow
Sporozoan oocyst with NO SPOROCYSTS.
Scientific name for SEXUAL REPRODUCTION that occurs in
select miscellaneous protozoa.
The parasite is recognized bc of the presence of TWO NUCLEI
and CILIA.
Another term for E. vermicularis
The ova is double-layered, thick-walled colorless shell that is
FLATTENED ON ONE SIDE (D-shape) with developing larva.
- eggs may become AIRBORNE
Pointed tail
Curled tail
SPECIMEN OF CHOICE for the recovery of E. vermicularis col-
lected from PERIANAL REGION.
SEXUAL UNION or MATING of certain helminths, including ne-
matodes.
PREGNANT female worms
INFECTIVE PINWORM EGGS that MIGRATE BACK into the
HOST to DEVELOP and REPRODUCE again.
INFECTED individuals may REINFECT THEMSELVES again, if
eggs are INGESTED VIA HAND-MOUTH contamination.
INTENSE ITCHING & INFLAMMATION of ANAL/VAGINAL areas
that may result to difficulty sleeping.
Another term for T. trichiura
- ova: BARRELSHAPED or FOOTBALL-SHAPED
- YELLOW-BROWN (bile contact) with prominent HYALINE PO-
LAR PLUG
- 3rd most common helminth
- heavy infections of 500-5000 worms
- ulcerative colitis, chronic dysentery, severe anemia and growth
retardation
Conditions that is common in children infected with T. trichiura
The best laboratory diagnosis technique for the recovery of T.
trichiura eggs.
Usually corticated egg (outer mammillated, albuminous coating)
Thick nitrogen-containing polysaccharide coating also known as
a shell, sandwiched in between the embryo and mammillated
albuminous material (corticated)
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Egg lacking an outer mammillated, albuminous coating in fertilized
Decorticated
eggs
New world hookworm N. americanus
Old world hookworm A. duodenale
- two, four, eight-cell stage
Hookworm - long buccal cavity/capsule
- small genital primordium
- newly hatched larva
Rhabditiform larvae
- actively feeding larva
- infective, nonfeeding larva emerge from rhabditi after second
molt
Filariform larvae - shorter esophagus than S. stercoralis
- distinct pointed tail
- migrate to lymphatics and blood systen
Necator Buccal capsule: pair of cutting plates
Ancylostoma Buccal capsule: actual teeth
Prominent, posterior, umbrella-like structure that aids in copula-
Copulatory bursa
tion in male hookworms.
Infected filariform larvae to humans when in contact with unpro-
3rd stage filariform larvae (L3)
tected feet.
Skin penetration or walking barefoot MOT of hookworm
Ground itch Intense allergic itching at the site of hookworm penetration.
- smaller egg than hookworms; surrounded by a THIN HYALINE
SHELL (fragile)
Strongyloides stercoralis - well developed larva
- short buccal & prominent genital primordium
- long esophagus and NOTCHED/FORK-TAIL
Threadword Another term for S. stercoralis
Parthenogenetic Adult female hookworm: male is not requires for fertilization

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