Cracking D' Boards Study & Review Center, Inc.

Microbiology-‐Parasitology-‐Virology-‐Mycology MEGA Table 2018 Edition

PARASITOLOGY GURU
GUIDE

PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC MUST REMEMBER MODE OF

STAGE PATHOLOGY & CLINICAL TRANSMISSIO
DISEASE PRESENTATIONS

Stool Exam- Excyst in ileum, invade colonic epithelium

Ameba Quadrinucleate OPEH causing necrosis and spread (Liver, lung) Ingestion Of
cysts Infecti
Entamoeba Amebic colitis Trophozoites Flask shaped/Tear drop colon ulcers cysts
Amebic liver active, progressive, In liquid stools
Histolytica greenish-yellow directional; Most invasive among Entamoeba family Fecal-oral
abscess
quadrinucleate, pseudopod PSD: Saline &
thick, rodlike finger-shape, Methylene blue Only member to cause colitis and liver Prevalent among
chromatoidal bodies hyaline; w/ stain abscess m
central karyosome ingested RBC homosexuals
with chromatin dots Culture, serology Majority is asymptomatic
Pseudopodia are for to detect invasive
locomotion Amebiasis Amoebic liver abscess (ALA) is MC
Ring and Dot extraintestinal form of amoebiasis (Fever,
Appearance nuclei Lacks mitochondria, ELISA most RUQ)
no RER Sensitive indicator
Ingested RBCs to differentiate Anchovy sauce/paste aspirate
other entamoeba
MC site of amoebic liver abscess-
Postero-inferior lobe of liver

3 virulence factors:
Lectin (For cell adherence)
Amebapore (forms pores on
host cellmembrane)
Cysteine proteinases (cytopathic for host
cell)

Amoebic dysentery- bloody, mucoid

diarrhea; Fish odor stools

+ Charcot Leyden Crystals

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Microbiology-‐Parasitology-‐Virology-‐Mycology MEGA Table 2018 Edition

Large Intestines (cecal and sigmoido-

rectal)

PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC MUST REMEMBER MODE OF

STAGE PATHOLOGY & CLINICAL TRANSMISSIO
DISEASE PRESENTATIONS

Naegleria “Brain No cyst Trophozoite Trophozoites Primary Amebic Meningoencephalitis Oral & Intranasal rou
Eating” Only Flagellated form In CSF and tissue (PAM) while swimming
Fowleri
Amoeba Fever, Severe frontal
(Pathogenic) slug-like; Flagellate form in Headache,Blocked nose, Penetrate
PSD: blunt CSF Altered taste and smell Cribriform Plate

Naegleria gruberi Kernig’s sign; Leukocytosis with # Multiply in

Large, usually neutrophil, # protein, $ glucose brain
(non-pathogenic)
Central Karyosome
PCR, ELISA Freshwater lakes, ponds, swamps,
lagoons

PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC MUST REMEMBER MODE OF

STAGE PATHOLOGY & CLINICAL TRANSMISSIO
DISEASE PRESENTATIONS

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CNS
Acathamoeba Dormant Cysts Cornea Lower respi
Acanthamoeba keratitis trophozoite and Trophozoites Tract or
inTissue Amebic Encephalitis ulcerated,
Granulomatous large central sluggish; PSD: spine- (immunocompromised) – AIDs pt Broken skin
Amebic Karyosome like Giemsa or PAS of Granulomatous Amoebic Encephalitis
Encephalitis double cell wall No peripheral Scrapings or (GAE) presents as confusion, Route of invasion of
(GAE) chromatin Corneal biopsy somnolence, hallucinations, seizures is via blood

Most affected areas of brain (brainstem,

thalamus & diencephalon)

Amebic Keratitis
(associated w/ use of
contaminated contact lenses)
presents as loss of vision, corneal
ulceration, corneal clouding

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PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC MUST REMEMBER MODE OF
STAGE PATHOLOGY & CLINICAL TRANSMISSIO
DISEASE PRESENTATIONS
Cracking D' Boards Study & Review Center, Inc.
Microbiology-‐Parasitology-‐Virology-‐Mycology MEGA Table 2018 Edition
Entamoeba Non-pathogenic Amoeba
coli t

yellow-brown; 1-8 sluggish

nuclei, K eccentric; PSD: short,
blunt; Bacteria/
splinter-like
debris Inclusions

Entamoeba Found in oral cavity

Periodontitis Mod active, prog By mouth to
Gingivalis mout
PSD : blunt, hyaline infected periodontal crevices
kissing.
spheroid nucleus found in 95% of people with gum disease
and rarely in people with healthy gums It may be transmit
Only the due to
trophozoites are residing in the tartar and puspockets of coughing
formed teeth of pyorrhoea infected human beings

Endolimax iodine-stained wet

mounts
nana
pale green;
1-4 nuclei
CB : bacilliform
Living trophozoites
small, with a are sluggish and
spherical to generally non-
ellipsoidal shape. progressive.
Mature cysts contain
four nuclei single nucleus

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Microbiology-‐Parasitology-‐Virology-‐Mycology MEGA Table 2018 Edition

PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC MUST REMEMBER MODE OF

STAGE PATHOLOGY & CLINICAL TRANSMISSIO
DISEASE PRESENTATIONS

Iodamoeba - Amebiasis in Commonly found in

butschlii
immunecompromise
d - An indicator of oral-fecal contamination
large intestines
people, pigs and o
individuals and humans may experience diarrhea
1 nuclei sluggish mammals
yellow green;
surrunded pseudopodia for
w/ granules; locomotion
endosome The pseudopodia is
short and blunt. It
moves in a slow
manner

The trophozoite has

a single nucleus

Entamoeba
hartmanii
1-4 nuclei; non prog;
K small/Central; PSD : fingerlike
Diffuse glycogen
mass

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SI Cysts _ Troph
DFS of Fecal-Oral
Balantidium Balantidiasis cyst Trophozoite and LI (cecal area) trophozoite
Coli in Ingestion of
cytostome; Feces Largest protozoan parasite known to Contam Food
bean-shaped nuclei And water
cytopyge cause human disease
Sigmoidoscopy
Ulcer w/ rounded Common in pigs
Base and wide i Tropics
Neck (vs flask shape)
Only ciliate that
Diarrhea and Dysenter affe man
(indistinguishable from Amebic)

PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC MUST REMEMBER MODE OF

STAGE PATHOLOGY & CLINICAL TRANSMISSIO
DISEASE PRESENTATIONS

DFS Cysts and Excysts in

Backpacker’s Quadrinucleate Trophs SI
diarrhea Cysts Duodenum, jejunum
Giardia Owl’s eye upper ileum Fecal-Oral
Lamblia “Gay” Bowel young – binucleated; NO invasion
Syndrome mature – thick walled “Old” Professor Homosexual
oval cyst with 4 “Old Man’s Attaches transmission
AKA G. nuclei; 4 pairs of Glasses” To intestinal villi
intestinalis, G. flagella retracted Via adhesion
duodenalis, L. Falling leaf
into axonemes
intestinalis motility Villus flat and crypt
trophozoite Hypertrophy;$electrolytes,
bi-symmetrical; Biopsy, Diarrhea, steatorrhea
pyriform/tear-drop; Entero-test, String most common symptom
pear-shaped Test (89%);
erratic IF and antigen
tumbling motion; 8 detection SSX: Flatulence, malabsorption, diarrhea,
flagella Foul smelling fatty stools

Outbreaks at daycare centers, mental

hospitals

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Female – Sexual
Trichomoniasis No cyst stage Wet mount Vaginal epithelium intercourse
Trophozoites
Trichomonas Trophozoites Male – Passed thru
vaginalis pyriform; In urine, Urethra, Birth canal
pearshaped Urethral Epididymis,
trophozoites, jerky secretions, Prostate gland “Ping-pong”
movements; 4 free Vaginal Phenomenon
flagella +1 secretions, Vaginal discharge –
undulating Cervical
membrane Liquid, foul-smelling, green to yellow,
secretions, Irritating
(Jerky movement) Semen,
Prostatic Speculum – Strawberry
secretions
Cervix (diagnostic)
Involves ECTOcervix

Vaginitis; urethritis

Men are usually asymptomatic

PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC MUST REMEMBER MODE OF

STAGE PATHOLOGY & CLINICAL TRANSMISSIO
DISEASE PRESENTATIONS

Smaller and longer Swabbing Oral cavity - Droplets,

Trichomonas than tartar Peridontal infections kissing
Tenax T. vaginalis

Dientamoeba In lumen
Fragilis No known cystic Of Large
stage Binucleate Intestines
Trophozoites in
fresh
rosette-shaped Stool samples - Mimics IBS
nuclei; (irritable bowel
no peripheral
syndrome)
chromatin;
w/ 4-6 granules; no
flagella

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Microbiology-‐Parasitology-‐Virology-‐Mycology MEGA Table 2018 Edition

Cysts in
Chilomastix Semi-formed Cecal region
Mesnili Stools; Of LI Fecal Oral Route
Trophs in
knob- Liquid stools
like prod, Lemon
shaped; nipple like
protuberance
spiral;
3 anterior
flagella
Modified Acid MCC infectious diarrhea in AIDS patient
Crytosporidium Fast Stain- especially if CD4 < 200 Fecal- Oral
Parvum/Hominis Kinyoun Stain Route
acute, watery, and nonbloody diarrhea
Fecal Smear
Infectious diarrhea in AIDs/HIV
Red oocytes in
stool smear Complex cycle occurs in epithelial cells of
Oocyst appear jejunum
redpink doughnut
shaped NO invasion occurs

PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC MUST REMEMBER MODE OF

STAGE PATHOLOGY & CLINICAL TRANSMISSIO
DISEASE PRESENTATIONS

Schizont, gametes Mature oocyst Immature Malabsorption syndrome; SI of man

Isospora Inside host w/ sporozoites Cysts in feces Shortened villi, hyper-
Belli -Oocysts/ Trophied crypts, infilt Definitive –
Sprorcysts in Of lamina propria, w/ MAN
immature cyst Dudenum Eosins, polys, rounded cells

Enterotest, Acalculous cholecystitis MC in children & m

duodenal aspirate homosexuals with
A

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Microbiology-‐Parasitology-‐Virology-‐Mycology MEGA Table 2018 Edition

PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC MUST REMEMBER MODE OF

STAGE PATHOLOGY & CLINICAL TRANSMISSIO
DISEASE PRESENTATIONS

Cyclospora Oocyst Oocyst Chronic & intermittent watery diarrhea (6-7 Host: Humans on
cayatensis Oocysts are weeks) with > 6 stools per day
autofluorescent and Acid fast staining Ingestion of green le
would appear as blue Safranin staining Self limiting infection vegetables/
or green circles contaminated wat
PCR D-xylose malabsorption noted in some
patients

PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC MUST REMEMBER MODE OF

STAGE PATHOLOGY & CLINICAL TRANSMISSIO
DISEASE PRESENTATIONS

Leishmania Old w/ ovoid or Skin tissue Cutaneous leishmaniasis

Tropica World rounded bodies biopsy
Cutaneous
Leishmaniasis Lesions resembling
promastigote
Lepromatous leprosy
Bite of

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Microbiology-‐Parasitology-‐Virology-‐Mycology MEGA Table 2018 Edition

1 free flagella Bone marrow, Mediterranean/ Middle East, Saharan Sandly vector
Leishmania Kala-azar arising from Spleen or Africa, India (Phlebotomous sp
Donovani (Visceral kinetoplast Lymph nodes Lives
Leishmaniasis) Intracellular
Leshmanin – In Chronic low grade fever, anorexia, weight Reserviors: Dog,
amastigote DTH skin test Macrophages loss, skin hyperpigmentation. Bone fo rodent
negaive, poor PMS and reticulo marrow involvement results in anemia,
cellular response Endothelial leukopenia, throbocytopenia
Cells Sand fly
PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC MUST REMEMBER MODE OF
Pheobotomus
STAGE Promastigote _ PATHOLOGY & CLINICAL Spp
TRANSMISSIO
DISEASE Amastigote PRESENTATIONS
Amastigote _
Promastigote in
West Trypomastigote Trypomastigote Bite gut of fly
of Vector
Trypanosoma African Serology – Massive
In blood, LymphSplenomegaly,
and CSF presence of
Leishmania
Gambiense New
Sleepng For supportive Parasites in RE cells; earliest SSx is a cha
Braziliensis World
Sicknes diagnosis Vector: Glossina sp (Tsetse Fly) (local, hard, painfu
Cutaneous “Sleep-sleep” fly lesion at the site o
Leishmaniasis Mucocutaneous or Central or South inoculation)
East amastigote flattened and Where the parasiteAmerican Leishmaniasis
trypomastigote form develop into
Trypanosoma African fusiform, body tapes Trypomastigote epimastigotes (in the salivary gland)
Rhodesiense Sleepng anteriorly and is Tapir nose African Sleeping
Sicknes blunt posteriorly, Erosion of pinna of forest Workers
Reservor Sickness- cyclical fev
pale bue cytoplasm Host: lymphadenopathy,
is granular and may Domestic demyelinating
be vacuolated, red- Animals encephalitis, HA,
staining flagellum insomnia, slurred
speech, ataxia, mood
Local Infiltration from
+ undulating changes, somnolen
bite area to lymph and
membrane coma
CNS c
Winterbottom’s s
-Chronic inflammation
Of lymphatics (Enlarged posterio
cervical LN) i
-Atrophy of dendrons
Of ganglion cells
Kerandel’s sign
(Hyperesthesia
Epimastigote Trypomastigote Histiocytes - Engulfed by )
Trypanosoma Chaga’s Trypomastigote Thick and thin RE cells (adipose, myocardial, RE, histocy and invade
Cruzi Disease Blood smears Neuroglial) tissue
Giemsa stain - inflammatory
American Reduviids,Triatomid Bugs respo with fibrotic
Sleeping Serology –CSF encapsulation
Sickness Reservoir:
Xenodiagnosis Wild CHAGOMA; Romana
mammals sign (periorbital
10 AD MAJOREM DEI GLORIAM ELISA, IF
Mega-colon, m
Muscle biopsy esophagus, Dil
cardiomyopathy (Ca
most frequent)
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Microbiology-‐Parasitology-‐Virology-‐Mycology MEGA Table 2018 Edition

adip

edem i

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 PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC MUST REMEMBER MODE OF
STAGE PATHOLOGY & CLINICAL TRANSMISSIO
DISEASE PRESENTATIONS
Cracking D' Boards Study & Review Center, Inc.
Microbiology-‐Parasitology-‐Virology-‐Mycology MEGA Table 2018 Edition
Tachyzoite, Serology – MOT: cat feces
Toxoplasmosis bradyzoite and IgM detection Ingestion, t
oocyst By ELISA; Transplacental Cysts rupture and inv
Heterophile IFA for IgG gut mucosa, ingestel
Toxoplasma antibody (man) Humans eat And IgM; PCR In SI of macrophages,
(cat) cysts in meat or
gondii negative bradyzoite, cyst Of Toxo DNA Cat (sexual differentiate into
male and female cat feces tachyzoites (Rapid
infections And asexual
gametocytes multiplying triphozo
Cycle); in
Life pseudocyst Intracerebral Tissues in
Crescent shaped and oocyst w/ Brain lesions; hepat
threatening with a pointed Calcifications Asexual cycle
encephalitis Sporozoites on Imaging
anterior and a -Oocyst prod
Definitive host –CAT Chorioretinitis;
rounded posterior By sexual
Sabin Feldman Lymphadenitis
end Cycle in cat;
dye test Note: Complete life cycle only occurs in
members of the cat family 2 types of postna
disease
1) mild lymphatic
(infectious
Mononucleosis)
2) acute fulminatin

Brain abscess in H

Congenital
Toxoplasmosis

HIV/AIDs Patients
AIDs defining illness

TORCH syndrome
Triad:
Chorioretinitis
Hydrocephalus
IntraCranial
Calcifications

PARASITE A.K.A. CYST TROPHOZOITE INFECTIVE DIAGNOSTIC MUST REMEMBER MODE OF

STAGE PATHOLOGY & CLINICAL TRANSMISSIO
DISEASE PRESENTATIONS

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Sarcosporidiosis Oocysts are banana Western Blot, Macrocysts and microcysts penetrate Diarrhea, eosinoph
Sarcocystis
shaped IFA, ELISA intestinal epithelium and spread enteritis, myalgia
hominis Sarcosytosis hematogenously weakness, mild
incre
in creatinine

Infective: Diagnostic: Malaria like infection

Babesia single or paired, sporozoite Trophozoite Host: Dogs,
amoeboid, bite from and infected black-legged tick, cattle
microtiGAMETE
Plasmodium
SCHIZONT TROPHOZOITE Must Life Diagnostics Pathogenesis
oval/spherical/ PCR: Diagnostic Ixodes scapularis (also knownVector
to carry Clinical
species bizaare-shaped Knows Cycle modality of choice Borrelia burgdoferi), vertical transmission Manifestation
headache, fever, ch
bodies ; from an infected mother to fetus, blood altered mental statu
Causes Mosquito – RBC (Man)
IFA (Immuno transfusion DIC, anemia with
severe Gametocytes; Vivax – young Febrile
intraerythrocytic fluorescent assay) dyserythropoiesis
Malaria Man – Malariae – old Anopheles paroxysms
parasites look The larval form of the tick attaches to the respiratory distress
Sporozoites Peripheral Falciparum –all Flavirostris Cold stage
Plasmodium "teardrop-shaped" Maltese Cross white-footed mouse for a blood meal and renal
Infects RBCs Blood smears Minimus Hotinsufficiency
stage
Falciparum Appearance
at ALL stages picks up the parasite from the host.
Hypnoxoite – (Giemsa or Mosquito : Sweating stage
Banana Latent stage, Wright) 1)Stomach – (Drenching sweats
shaped Causes Cause -thick Gamete form, Anopheles
gametocyte ADHERENCE relapse -thin 2)Stomach -litoralis Infective stage to
of RBCs to wall – oocyst - Man: Sporozoites
Pigment: cerebral Gold standard and sporozoite in balabacensis
Schizogony:
Maurer’s vascualr smears (obtain release -mangyanus Infective stage to
Liver, RBC
dots endothelium every 6-8 hours) 3)salivary -maculates mosquito:
Produce:
via KNOB glands – sporozoites Gametocytes
Merozoites
PROTEINS
(Cerberal Quantitative
Malaria) Buffy Coat (QBC) Asexual Schizogony
Sexual Endemic in
phase: Humans Tissue anoxia –
Constant Philippines
Gametogony: Malaria rapid (Palawan), basic
fevers Exoerythocytic Phase:
RBC diagnostic tests Africa pathophysiologic
Sporogony: such as - Mosquito change in malaria
Mosquito Histidine-rich injects
Plasmodium Benign
Vivax
protein sporozoites 4 mechanisms
malaria which attack leading to tissue
Sporogany – hepatocytes, sporozoites in anoxia:
Has relapse replicate, differentiate into 1. anemia-
Pigment: Mosquito LC;
Schuffner’s Schizogony – merozoites which hemolysis 2.
Incubation infect RBCs changes in blood
dots Human LC
Period: 12-20 flow 3. changes in
days - exoerythro
Erythrocytic Phase: capillary
(merozoites)
- Merozoites endothelium 4.
Infects young - erythro
RBCs, histotoxic shock -
RBC (gametocytes) parasite virulence
differentiate into
Produces ring shaped factors:
fevers each trophozoites, 1. multiplication
13
Plasmodium
Malariae
AD MAJOREM DEI GLORIAM 72 hours develop capacity 2. red cell
schizonts filled selectivity 3.
Incubation with cytoadherence
period: 18-40 merozoites. and resetting
days int ability 4. potential
o to induce cytokine
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 release 5.
-
Merozoites lyse antigenicity
Benign RBCs at regular 6. antimalarial drug
malaria intervals and resistance
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Plasmodium Jame’s dots Microbiology-‐Parasitology-‐Virology-‐Mycology
Has relapse RBCsMEGA Table 2018
Blackwater fever, Edition
Ovale liver dysfunction,
Infects ONLY Sexual Sporogony hypoglycemia,
young RBC in mosquitoes: Acidosis, GI
- Some blood dysfunction, placen t
Incubation merozoitesdeve dysfunction,
Period: 11-16 lop into pulmonary
days edema, renal failure
male/female
coagulopathy and
gametocytes in
thrombocytopenia
RBCs
coma
- Female
mosquito eats ,
Splenomegaly is
these RBCs,
common
form one female
MACROGAMET
E or 8 spermlike
*
MICRO-
Glycosylphosphatidy
GAMETE in the
GUT. Inositol (GPI) act lik
- DIPLOID entotoxin of gram
negative bacteria
ZYGOTE
Lipopolysaccharide
differentiates
they stimulate
into motile
monocytes to
ookinete which
release TNF or
burrows
cachectin which is
through gUT wall
implicated as the
- Oocyst with
cause of Malarial
haploid
fever
sporozoites
form on stomach
wall, sporozoites
released and
migrate to
mosquito salivary
glands

PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST PATHOLOGY

LOCATION CLINICAL MANIFESTATIONS

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Embryonated DFS Unembryo eggs LI, Whip - Prolapse of Anus

Trichuris trichiura Whip worm Egg in soil/feces in feces inserted into - IDA, $Alb, D
wall - Sometimes appendicitis
- symptoms due to unique mode of
no migration attachment
phase to lungs
embryonated in soil
Barrel-S, 2 plugs M – curved 360
unembryo F – blunt; stichocytes
Seat Scotch tape Ileum of SI, 1) site - ulceration
Enterobius Worm Swab (Graham Cecum,LI man 2) eggs - prupritus
Vermicularis Embryonated ova Cellophane 3) migration
Pin Method) Gravid female
worm spindle-S, cephalic ala, corpus, Migrates to
isthmus, bulb Embryonated Perianal area
M – curved tail Eggs
D-shape, football F – pointd tail
Encysted larvae in -Rheumatic pain
Trichinella Spiralis Inadequately cooked Tissue biopsy Muscle tissue of (intestinal flu)
pork man, pigs - # M eosin
Xenodiagnosis - swollen eyelids

thread-like ; F – blunt; M Bachman

larva – w/ – curved w/ 2 lobular Intradermal test 3 stages of infection:
spearlike appendages; intestinal, larval, encapsulated
burrowing tip A-end- non-papillated -Stage of conval
- death due to
Myocarditis or encephalopathy
DFS SI (jejunum ) - intestinal malabsorption
Capillaria Larva in raw fish -eggs (E) of fish, man - Borborygmi
Philippinensis -larva (L) - Abdominal Pain
Eggs embryonate in -adults (A) larvae in gastric - Diarrhea
embryonated eggs in F Fresh water mucosa and - Villi flattened
typical F – 8 in 1 row intestines - death
peanut shape atypical F – 40 in 2 M –
“Football” Shape w/ chitin spicule

PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST PATHOLOGY

LOCATION CLINICAL MANIFESTATIONS

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Microbiology-‐Parasitology-‐Virology-‐Mycology MEGA Table 2018 Edition

Embryonated Egg DFS of eggs SI of man Lung migration –Asthma and pneumonia
Giant (not attach) (LOEFFLER’S PNEUMONIA- Eosinophilic
Ascaris Round Adults in SI Pneumonia)
Lumbricoides Worm Gall bladder, Liver-lung
tri-radiate xs Liver, nares, Migration Capillary penetration
Decorticated,
Unembryo F-3 lips; M–2 spicules Appendix (larvae
larvae, corticated Pain due to adult Migration; Intestina
egg swallowed)
females are longer and Obstruction and # eosinophils
PARASITE A.K.A. EGG widerADULT
than the males INFECTIVE DIAGNOSTIC HOST INT PATHOLOGY
LOC. HOST
Most common Intestinal nematode
Ascaris roundworms exhibit
kinky, Larvae In Blood smear Lymphatics mosquitos Acute –
Brugia Malayi Filarial sexual dimorphism,
overlapping Arthropod (thick Bloodstream Hypersensitizatn
meaning eachnuclei,
gendernuclei Vector “Scariest” roundworm
nematode worm And Knott W.B. –
reach tail
possesses distinctly Conc) Peripheral Culex Chronic – (poor
different sexualend
organs Quinque MC parasitic infection in Philippines
Bites at Night Blood prognosis), elephantiasis
(terminal, Microfilaria Fasciatus (blocks lymphs)
Ancyclostoma Old subterminal n.) 3rdEnters
stage Bite
filariform In blood at SI Ground itch; <500 eggs in feces = light worm
Duodenale World giemsa – sheath unstained DFS Rural- Weingarten’s
wound Night
Hook smooth, Lung Anopheles;
>500 eggs = heavy–worm; Hookworm anemia
Syndrome
Wuchereria Filariasis or
worm single Urban- due to suction
migration Hyper-eosinophilia of
teeth Bioincubation CARD Test –
Bancrofti elephantiasis row of of blood/ Peripheral
Fatigans; bleeding blood
New cutting - 1 year Antigen det
Necator nuclei,
Pacific- aedes
Americanus World plates
no pointed tail, short DFS Microcytic Hypochromic Anemia
DNA probes Lymphatic Filariasis
Hook terminal esophagus
worm nuclei
8-cell stage >L than BM
Strongyloides giemsa – pink stain filariform; 3rd stage filariform Rhab in stool SI man; Lung Larval migration – Lobular pneumonia with
Loa Loa
Stercoralis Thread no F M Larvae Thin blood Subcutaneous Vector-hemorrhage
Migr aftr skin Calabar swelling
Worm Long eso, crawl into Smear tissue Penet; reproDipteranPeripheral Eosinophilia
Prominent wound parthogenesis(chrysops)
Malabsorption syndrome
Adult in eye
Genital biopsy
primordium, notched tail short buccal Eggs hatch SI hypersensitivity
shedding of sheath, cavity
Dracunculus Fiery Larvae in Local lesion Mesenteric Copepods Blister w/
Medinensis Serpent copepods Worm/Larvae Tissues Ingest Serous exudates
Israelites Larva in
Calcifiqed Larva migrate water Pseudoperitoneal
Guinea Worms by To lower ext syndromes
worm larva migrates to lower ext. x-ray
Oncocerca Larvae Biopsy Subcutaneous Vector- - Black River Blindness
Volvulus Crawl into tissue Black fly - Eye lesions
Bite wound Mazzotti - Skin lesions i
- Scrotum enlargement
nd
Slit lamp - 2 MCC of blindness due to infect
Trachoma (Chlamydia)
3rd stage larva History Brain Mollusks, Eosinophilic
Angiostrongylus Rat in snails and -eating, travel Snails: Meningoencephalitis
17 AD
Cantonensis MAJOREM
Lung DEI GLORIAM slugs or rats Spinal cord Achantina,
Pila
worm ingested leukocytosis + eosins in CSF,
by man & eosinophilia Man- CN involve, diplopia
Accidental Planaria, and strabismus
adult emale Skin test needs hosts Slugs, prawns CSF >= 500 cells/ml
“Barber pole” dark red evaluation w/ 10-90% eosins
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PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST INT. PATHOLOGY

LOC. HOST
3rd stage larva Mollusks “acute abdomen”
Angiostrongylus in snails/ slugs Intestines - inflammation of ileoceca
costaricensis ingested by (gut wall) Snails, - Abdominal pain localized
man nd cotton slugs lower quad + palpable tu
rat mass
(Sigmodon
hispidus) - Severe gastrointestinal or
centra system disease
Terranova sp – juveniles 3rd stage larva Endoscopy Marine Pseudoterranova spp –
Anisakis Herring in flesh of raw Crustaceans Not penetrate stomach
disease Pseudoterranova sp – not fish; larva Immunologic And fish Anisakis simplex (USA)
penetrate migrate from Tests under Intense inflammation in stomach
viscera to Study Reaction surrounding larva
Eustrongylides sp – muscle after Associated with PUD and gastric
perforates large bowel death of fish CA

Anisakiasis – local
Tissue response;
(Eustrongylides spp)
Perforation of L bowel

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PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST INT. PATHOLOGY
LOCATION HOST CLINICAL
MANIFESTATIONS
Schistosoma S. Japonicum Free- Eggs, miracidia Adults - Bladder, Calcified Bladder (dead eggs= Skin
Hematobium swimming in urine liver “sandy patches”); Painful Pene
Cercaria larva – urination; Thru
Platy- Venous Terminal Hematuria Infe c
helminthes Plexuses Bulinus Snail To S. typhi and paratyphi carriers wate
(Miracidia to
terminal spine cercaria) Causes Urinary Bladder CA
Schistosoma Free- Ova in feces Liver Claypipe-stem Fibrosis = Cerc
Mansoni swimming (blood, Thickening of portal vessels due Pene
Cercaria mucus) Inferior to Skin
Rectal biopsy c
Platy- Mesenteric rxn w/ eggs; Hepatosplenomegaly Infe
helminthes venules, Portal HTN, ascites, eggs wate
lungs Biomphalaria sometimes
Snail Deposited in SC, lungs
# liver enzy,$serum alb,#
lateral spine glob(prot)
Schistosoma in copula, males have Ova in feces, Liver, Katayama reaction: fever, reaction Cerc
Japonicum Bilharziasis Rectal biopsy, Superior to Eggs in tissue Pene
gynecophoric canals
COPT test, Mesenteric Skin
ELISA Venules, CNS damage- calcifications in Infe
Platy- Oncomelania brain; Presents as seizures
lateral knob SI, heart, wate
helminthes Quadrasi,
(smallest) Kato Katz Spleen, CNS
Cercaria Formosa Hepatosplenomegaly, Portal HTN,
Ascites; mucus/blood in feces,
# liver enzy,$serum albumin

Swimmer’s Itch

Endemic in Agusan, Surigao,

Leyte, Samar
Schistosoma
Intercalatum
Schistosoma
Mekongi

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PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST INT. HOST PATHOLOGY
LOCATION CLINICAL
MANIFESTATIONS
Fasciola Sheep Metacercaria Unembryo Bile duct of Snails- Aquatic Halzoun – ingestion Inge
Hepatica Liver Encysted ova in feces, Sheep Lymnea vegetation Raw sheep, goat livers Infec
Fluke On aquatic duodenal Philippinensis, (dyspnea, deafness, Veg
Fasciolidae vegetation aspirates Herbivore Lymnea asphyxiation, death) Infec
leaf S, w/ shoulders animals swinhoe (TAI) fibrotic vs. traumatic/ Live
“popping cephalic cone, spinous, (sporocyst- necrotic lesions; obs;
operculum” dendritic testes redia-cercaria) False vs true (no eggs)
Fasciola Giant Larger than Metacercaria Unembryo ova Giant Snail Aquatic Inge
Gigantica Liver F. hepatica Encysted Animals- vegetation Infec
Fluke On aquatic Cattle Veg
Fasciolidae vegetation Biliary tract
no shoulders (BT)
Clonorchis Chinese Metacercaria Embryo Man Operculate Fresh Associated with Inge
Sinensis Liver Encysted ova In Snails water Cholangiocarcinoma Unc
Fluke On Fresh feces or BT (Alocinma, Fish fish
Opistorchidae Water fish Biliary Parafossarulus, (FWF) : Liver function
duodenal Bithynia) Cyprinidae, Impaired but SGPT and

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Branched testes; aspirate (BDA) Ctenopha- SGOT are normal

spatulate ryngodon
Opistorchis Cat Metacercaria Embryo ova Small Snails - FWF Periportal fibrosis, Inge
Felineus Liver Encysted In feces Animals- Bithynia Cyprinus Invasion of pancreas, Infec
Fluke On fresh or BDA Cats, dogs, Funiculate Carpio Form bile stones fish
Opistorchidae Water fish etc (BT SI) (Taiwan)
2 INT
PARASITE A.K.A. EGG lancet S reddish-ADULT INFECTIVE DIAGNOSTIC HOST INT HOST HOST with
Associated
PATHOLO
bile color LOCATION Cholangiocarcinoma
Opistorchis Metacercaria
Metacercaria Embryo ovaUnembryo Civet cat, Encapsulated
Snailsin
- Snail - FWF Crabs –
Hyperplastic Granulomatous
biliary Inge
Paragonimus
Viverrini Oriental In crustacean Dog, fish-Parenchyma
In feces eggs in feces of
Bithynia Miracidia (M)_
Punteus Epithelium (Stimrxnby in lungs; Infec
Westermani Lung Or BDA or sputum eating lung; in fibrotic CercariaOrphoides,
Goniomphalus, (C) Sundathelphusa rust colored
Nitrosamines); assos.
Opistorchidae Fluke knob at Cercaria w/ capsulesFuniculate,AntemelaniaHampala Philippina sputum,
w/ cholangiocarcinoma
branched spines complement laevis Asperta; dispar w/ Foul fish
abopercular lobed testes like O.
fixation Reservoir – Antemelania C _ meta-C Odor
end felineus testes
side by Cats & dogs Dactylus
Dicrocoelium Lancet 2 large Metacercaria Embryo ova sheep Snails- Abida, Formica Same as F. hepatica Inge
side; Misdiagnosed
Dendriticum fluke testes Cochilcopa, Fusca ants
operculum at lancet, coffee For PTB
w/ fully dev Helicella, Zeb (ants) Portal cirrhosis,
Dicrocoellidae broad end, bean; integument
miracidium Periductal fibrosis
thick
deep golden- aboper w/ spines
flat,
brown transparent Metacercaria Unmebryo Duodenum of Snails – Aquatic Worms cause
Fasciolopsis Giant In water Eggs in feces Man or pigs M _ C Vegetation Traumatic,
Buski Intestinal Plants C _ meta-C Obstructive and
Fluke Segmentina, Water caltrop, toxic effects;
indistinguish MC are Hippeutis Water chestnut, ulceration and
ND
from F. hep, 2 dendritic testes Sensitive to Water morning # mucus prod.
F. gigantica in tandem Dryness Glory, lotus
Heterophyes Metacercaria Unembryo Small Snails : Many fish in the Heterophyses ca
Heterophyes In fish Eggs in stool Intestines Freshwater, Phil. (30 inflammatory rea
Using Kato- Brackish or Species); in the heart muscle
Miracidium Katz method Reservoir – Marine muscles at base
hard to distinguish adults; present in of the fin Inflammation
Fish eating
Metagonimus scale-like spines, w/ The egg once Sloughing off
mammals M _ C
genital sucker, globular Deposited by C _ meta-C Of layers, xs
yokogawai
testes Mucus prod
adult
H.
Misdiagnosed
For acid
Peptic ds
(APD),
consisten w/
M. PUD
eggs no
protuberance
Metacercaria Unembryo Small Snails: Snails: Inflamm,
Echinostoma Eggs in Intestines -Gyralus -Pila luzonica Ulceration,
Ilocanum No sporocyst feces Convexlusculus “kuhol” and Diarrhea,
oral sucker with collar of stage Reservoir- -Hippeutis -Vivipara intoxiacation
Umbilicalis
21 AD MAJOREM DEI
indisting.from GLORIAM
spines; 2 lobed testes in rats
M _ C
Angularis“suso”
C _ meta-C
fasciolas tandem, reddish-grey
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ND
2 INT
PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST INT HOST HOST PATHOLO
LOCATION
Cysticercous Ripe or gravid Small intestines Hogs, wild Inflamm,
Taenia Pork Cellulosae Proglottid of man Boars, sheep, Eosinophilia,
Solium Tapeworm Deer, dogs, leukopenia
formaldehyde cysticercosis Monkeys, rats,
soln in muscles cats Develop
Cisticerc
rostellum w/ hooks eggs _ (ingestion of
solex with 4 suckers; ripe Scolex after cysticercous eggs), larva in
eggs – cause cellulosae brain, muscle,
proglottid therapy
cysticercosis eye
<13 lateral branches; 3m
Cysticercous Ripe or gravid Man SI Cattle, llama, Epigastric
Taenia Beef bovis Proglottid (accidental) Giraffe, Pain, vertigo,
Saginata tapeworm Carabao Nervousness,
Scolex after eosinophilia
indistinguish
therapy eggs _
from each
cysticercous
other and from
bovis
E. granulosus; no rostellum, hooklets
hexacanth (6 ripe >15 branches; 5m;
hooklets); tree-like dicho branching
radially
Sho
striated shell
Eggs – man x-ray to SI of Dog Sheep, man Obstruction –
Echinococcus Dog Hydatid sand detect - Cysts (accidental, Growing cysts;
Granulosus Tapeworm hydatid ds; Ingested intermediate– Anaphylactic
immunologic and Release in liver and Cyst ruptures
one long gravid proglottid tests scolices lungs)
dogs MCC of splenic
Scolex and 3 proglottids c
(small)
Smallest
Tapewo man

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2
PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST INT HOST INT PATHOLOGY ND
LOC. HOST
copepods (fish) Anemia (misdiag
Plerocercoid Operculated SI in man (Cyclops & perch, for pernicious
Diphyllobothrium Fish/ Larva Eggs; trout, type Vit B12
Broad Encyted Proglottids Reservoir salmon, deficiency);
Latum
tapeworm yellow-brown In fish Host: Dogs, pike hyperchromic
knob like Kato tech cats,Bears megaloblastic;
thickening spatulate, rosette uterus ProC _ examine for HCl
Diaptomus) PleroC in gastric juice
Paratenic
solex with 2 bothria = (+ infection)
host:
sucking
Carnivore
grooves Scandinavia and
fish
Coracidia (CO) Japan
No hooks
_
Procercoid
Gravid uterus in rosette
(ProC)
form
Dog Cysticercoid Gravid SI of dog or Ctenocephalides Minimal
Dipylidium Tapeworm Larva in Proglottids cat canis (dog flea) symptoms
Caninum Arthropod That are passed
Double Host when out/ Crawl out, Ctenocephalides
Pored ingested Egg packets, felis (cat flea)
egg packets
Tapeworm Melon-shaped
(8-15 eggs)
Proglottids in Pulex irritans
oncosphere w/ retractile, conical scolex; Chains (human flea)
6 hooklets rose-thorn shape hooklets (Not stool bec
mature proglottid – Trichodectes
proGlot disint
with 2 lateral genital
in environment canis (dog louse)
pores

Dwarf Embryo Embryo SI of man Insects, rice And Enteritis due to

Hymenolepsis tapeworm Eggs in Eggs in feces flour beetles Necrosis and
Nana Contam food Desquamation
and Water Proglottids not Of intestinal
Recovered bec Epithelial cells
with filaments Cyticerci - They
Can complete degenerate Direct/indirect
23 AD MAJOREM DEI GLORIAM
like D. caninum scolex Cycle in single pathways
but
Host (autoinf)
with less hooklets; ripe
segment
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ND
2
PARASITE A.K.A. EGG ADULT INFECTIVE DIAGNOSTIC HOST INT HOST INT PATHOLOGY
LOC. HOST
Cysticercoid Eggs in stool SI of man Fleas, beetles, Minimal and Non-
Hymenolepsis Rat Larvae in (more circular, cockroaches, specific
Diminuta Tapeworm insects larger, lack mealworms &
bipolar earwigs
thickening vs
H. nana
w/o filaments gravid segment;
bile-stained; rudimentary, unarmed
fan-like rostellum
Spirometra Plerocercoid White larvae Adult – Cyclops, Frogs, Painful edema
Sparganosis In toads, In lesion Intestines of copepods Snakes, Due to migrating
frogs, snakes, Cat/man Toads, Larvae
rats
Mansoni, paratenic Larvae – Eosinophilia,
Erinacei, hosts - pigs any part, Edema and
Ranarum eye, erythema
subQT,
muscles

mistaken for D. latum;

pseudosegmentation w/
slit-like invagination

MYCOLOGY GURU

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GUIDE
ORGANISM OTHER NAME DISEASE (S) MICROSCOPIC DIAGNOSTICS DRUG OF
A.K.A. FINDINGS CHOIC
CULTURE/COLONY
DESCRIPTION
MC Meningitis in HIV/AIDS Encapsulated yeast INDIA INK

Cryptococcus CALAS
Cryptococcal Latex Agglutination
neoformans

Hat shaped cells/ Disc shape

Pneumocystis jiroveci/ PCP Methenamine Silver Stain Trimethoprim-
Formerly PNEUMOCYSTIS CARINII Sulfamethoxsazole
carinii infection in humans TMP-SX
Lung biopsy/Bronchio-alveolar
Lavage (BAL)
MC pneumonia in HIV/AIDS

Inhalation of cysts. NOT Pentamidine

personperson

Spaghetti & Meatballs Miconazole

Malasezzia furfur Pityriasis Tinea versicolor Appearance

Budding yeast cells and

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hyphae

ORGANISM OTHER NAME DISEASE (S) MICROSCOPIC DIAGNOSTICS DRUG OF

A.K.A. FINDINGS CHOIC
CULTURE/COLONY
DESCRIPTION

Sporotrix schenckii Rose Gardener’s disease Dimorphic: Mold & Yeast Form

Cigar Shaped budding yeats

Flowerette Arrangement

Fluconazole
Coccidioides immitis San Joaquin Valley Fever Barrel-shaped arthoconidia

Pneumonia
Meningitis

Desert rheumatism

Itraconazole
Paracoccidioides Mariner’s wheel
Pilot’s wheel
brasillienses

Blastomyces dermatidis Broad-based budding yeast

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ORGANISM OTHER NAME Microbiology-‐Parasitology-‐Virology-‐Mycology
DISEASE (S) MICROSCOPIC MEGA
DIAGNOSTICS Table DRUG 2018OF Edition
A.K.A. FINDINGS CHOIC
CULTURE/COLONY
DESCRIPTION
Histoplasma capsulatum Spelunker’s Disease: Bat DOES NOT have a capsule
Guano/Starlings Amphotericin

ABPA Dichotomously branching Aspergilloma Fungus balls in

ITC
Aspergilllus fumigatus Allergic bronchopulmonary hyphae that forms acute xray Itraconazole (
aspergillosis voriconazole (VCZ) an
posaconazole (PCZ) a th
widely used for
management
of Aspergillus-related
infections. VCZ
the drug of choice
first-line treatment for
followed by liposom
amphotericin B (L-
angles AMB

Candidiasis Yeasts/ pseudohyphae Germ Tube Production at 37 Nystatin

Candida albicans degrees Fluconazole
Moniliasis

MC cause of esophagitis in
immunocompromised hosts

Amphotericin
Mucor, Rhizopus Rhino-orbital-cerebral Previously called Zygomycosis >90 branching (at right angles)
infection

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28 AD MAJOREM DEI GLORIAM

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ORGANISM OTHER NAME DISEASE (S) MICROSCOPIC DIAGNOSTICS DRUG OF

A.K.A. FINDINGS CHOIC
CULTURE/COLONY
DESCRIPTION
Cladosporium werneckii Tinea nigra Hyperpigmentation Salicylic acid

Trichophyton Affects Skin, hair, nails Terbinafine

Griseofulvin
Trichophyton Tinea favosa/favus Most serious form of tinea capitis Green Fluorescence on
Wood’s Lamp Griseofulvin
schloenleinii
* Don’t forget
Griseofulvin has
oncogenic potential

Trichophyton tonsurans MCC of outbreaks of tinea capitis in Fluconazole

children

Main cause of Endothrix

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References:

Brooks, G., Carroll, K., et. Al. Jawetz, Melnick & Adelberg’s Medical Microbiology. 25 th edition. McGraw-Hill Companies, 16 March 2010

Gladwin, M., Trattler, B. Clinical Microbiology Made Ridiculously Simple Edition 4. Medmaster, Incorporated, 2007.

Levinson, Warren. Medical Microbiology & Immunology. McGraw Hill Professional, 2004.

Recalled Concepts from Physician Licensure Examination

Prepared by:

JARUNGCHAI ANTON SATO VATANAGUL, M.D., FPNA, FPCP

Internal Medicine-Adult Neurology
President/CEO/Founder- CDB

30 AD MAJOREM DEI GLORIAM