diagnosis Flashcards
– concentrates helminth eggs, larvae
and protozoan cysts
Formalin-Ether technique
sample for Acanthamoeba species
Cerebrospinal fluid
collection for CSF
lumbar tap
collection: hydatid cyst and liver amoebic abscess
Liver aspirate-
collection: Giardiasis and Strongyloidiasis infection
b) Duodenal aspirate
collection for duodenal aspirate
endoscopy
Duodenal drainage or “String test”: duodenal contents collected for
Giardia and Strongylode
Tissue aspirates: Duodenal aspirate-
collectin: Sigmoidoscopy: Schistosomiasis, Amoebiasis, Balantidiasis and Shigellosis
(Large intestines)
Tissue aspirates:
Duodenal aspirate
T.spiralis phase: Can also be known as the incubation/ intestinal invasion
INTESTINAL PHASE
for concentration of
microfilariae’ utilizes venous blood as specime
- Knott Concentration Technique
T.spiralis phase: ✓ first week
✓ small intestinal edema and inflammation
. Intestinal Phase
T.spiralis phase: Signs and symptoms: nausea, vomiting, abdominal pain,
diarrhea, headache and fever, myalgia
Splenomegaly in severe case can also be found as well as
gastric and intestinal hemorrhages
INTESTINAL PHASE
T.spiralis phase: Aka larval migration and muscle invasion
MIGRATION PHASE
T.spiralis phase: Happens up to the 6th week of infection with the following signs
and symptoms:
o High fever (40oC)
o Blurred vision as well as ocular disturbances
MIGRATION PHASE
T.spiralis phase: Cough, pleural pains
Eosinophilia (15-40% for 1 month)
4th to 8th week: deat
MIGRATION PHASE
T.spiralis phase:Acute local inflammation
Edema and pain of musculature
muscular phase
T.spiralis phase: Larval encystation
In 3 -4 days after larval invasion, the muscle fibers will become
edematous, spinle shape, lose their cross striations because
the Trichinallis spiralis larva will already lodged itself into the
muscle fibers.
muscular phase
T.spiralis phase: Fever, weakness, pain and other symptoms start to abate.
Full recovery is expected in this phase since trichinellosis is a
self-limiting disease.
ENCYSTMENT/ ENCAPSULATION PHASE
This is done when meat is suspected of harboring the existed
larvae of trichinella and feeding the meat to the albino rats.
This is done when meat is suspected of harboring the existed
larvae of trichinella and feeding the meat to the albino rats.
T.spiralis phase: Self-limiting disease: eventually Trichinella spiralis will die. It
just has a specific life cycle once it enters the human body, it
will undergo its life cycle and during this phase the parasite
will die.
ENCYSTMENT/ ENCAPSULATION PHASE
Observation is done 14 days after inoculation for the presence
of female worm in the duodenum, and larvae in the muscles
of the experimental animal.
Beck’s Xenodiagnosis
Disease:
o Capillariasis or Mystery Disease
o Malabsorption Syndrome
Flattening of the villi
CAPILLARIA PHILIPPINENSIS
T.trichuria main habitat
cecum and appendic
similar to that of T. trichiura
CAPILLARIA PHILIPPINENSIS
Largest among intestinal nematodes affecting man measuring
15-35 cm in length in adulthood
ASCARIS LUMBRICOIDES
This would provide the confirmatory diagnosis but the problem
with this one is that there is a late rise of the antibody titers
which usually commences 3-4 weeks after a light infection.
Serodiagnosis
main habitat of A.lumbricoides
Small intestines (duodenum)
A.lumbri phase? Theses clinical manifestation is also called Loeffler’s
syndrome
THE BLOOD-LUNG MIGRATION PHASE OF THE LARVAE
T.trichuria Principal host
Man, hogs, monkeys, cattle, dogs and mice
A. lumbri diagnosis: o Recovery and identification of fertile or infertile eggs
in feces
Fecalysis
Diagnosis of T.trichuria
Diagnosis:
o Direct Fecal Smear
o Kato Thick smear
o Concentration Methods
A.lumbri phase? Large numbers of worms may give rise to allergic symptoms
THE BLOOD-LUNG MIGRATION PHASE OF THE LARVAE
ENTEROBIUS VERMICULARIS
diagnosis and prevention
Graham Scotch Tape Technique/Cellulose Acetate
Technique
Better personal hygiene
A. lumbri preventation
Personal hygiene
S.stercoralis habitat
duodenum of man
diagnosis of S/stercoralis
Recovery and identification of rhabditiform larvae in feces
o The larvae must be differentiated from the
hookworm larva once they are found in the feces.
A.lumbri phase? A heavy worm burden can result in malnutrition
THE INTESTINAL PHASE OF THE ADULTS
A.lumbri phase? During the migration through the lungs, the larvae may cause
pneumonia
THE BLOOD-LUNG MIGRATION PHASE OF THE LARVAE
A.lumbri phase? Vague abdominal pains or intermittent colic, especially in
children
THE INTESTINAL PHASE OF THE ADULTS
New World
hookworm,
American
hookworm
Necator
americanus
Cat &
Dog
Hookwor
m
braziliens
e
Old World
Hookworm
Ancylostoma
Duodenale
OLM occurs when a microscopic worm enters the eye causing
inflammations, lesions and formation of scar in the retina.
TOXOCARA SPP.
Benign: 20-80% eosinophilia and hepatomegal
toxocara; VLM
Heavier, or repeated Toxocara infections, while rare, can
cause VLM, a disease that causes swelling of the body’s
organs or central nervous system
toxocara
Causes visceral larva migrans
Toxocara
Dog
Hookworm
Ancylostom
a Caninum
linical grounds
o Marked eosinophilia
o Hepatomegaly
o Hyperglobulinemia
Toxocara
diagnosis of wuchereria bancrofti: method of choice
Fresh Giemsa-stained blood- serve as the laboratory
diagnostic method of choice
specimen of choice for the recovery of loa loa
giemsa stained blood
wuchereria bancrofti sensitive method for diagnosis
A more sensitive method of microfilariae recovery would be
filtering heparinized blood through a special filter, known as a
nuclepore filter and then staining and examining the filter
components/contents.
loa loa common name
African eye worm
Diagnosis of filariasis
PBS-peripheral blood smear (called also the Night blood
because it is nocturnal which is the specimen should be
collected at night specially for microfilaria
Serology
Antigen capture
you cna find Brugia malayi in what country>
o Eastern Asia, Southwestern Pacific Islands, parts of
India
o Brugia timori (island of Timor)
can be found in tropics and sub-tropics areas
W.bancrofti
O.volvu vector
Black fly genus simulium
The one primary characteristic that this organism will be
distinguished from other microfilariae is that it does not
produce a sheath. Another difference is the location of
microfilariae because it is found in subcutaneous tissues and
not found in blood
o.volvu
laboratory diagnosis for O.volvu
Multiple GIEMSA: stained slides of tissue biopsies, known as
skin snips (as little blood as possible, collected from
suspected infected areas are the specimens of choice for the
recovery of O. volvulus microfilariae.
treatment fo O.volvu
Diethyl carbamazine
mansonella ozzardi is found in what country
tropical america
Mansonella streptocerca is found in what country
Tropical africa
Progressively matures and functions individually
Originates from posterior neck region of the organism
With completely formed sexual organs
PROGLOTTID
o no scolex; with oncospiral hooks
o can be found in coat pads?
procercoid
- also known as “true bladder”. Enlarged central
cavity
cysticercus-
o elongated, infective stage
o with developing scolex & strobila
plerocercoid
slightly developed bladder and a scolex at the
apex
cysticercoid-
several scolices
Cyst is well developed
multiple invaginated scolices
coenurus
with daughter cyst present
cyst is well developed
brood capsules and daughter cells
echinococcus/ hydatid cyst
LABORATORY DIAGNOSIS of this parasite?
Eggs: can be demonstrated without concentration techniques
D.latum
pseudo or cylo? operculated immature when laid
pseudo
D.latum stage that swims freeling in the water
coracidum
Intermediate host: pig, man
TAENIA SOLIUM
T.solium infective stage
Cysticercus cellulosae
- ellipsoidal, translucent, thin walled bladder with an opaque invaginated neck and
scolex equipped with suckers and hooks
Common Name: beef tapeworm
TAENIA SAGINATA
infective stage of D.latum
procercoid larva
Found in: Mexico, Latin America, Eastern Europe, Africa and
Asia
Taenia solium
T. saginata infective stage
Cysticercus bovis
- pinkish cyst, opaque, with invaginated
neck and scolex
H. nana infective stage
-E. ova
-Cysticercoid larva
Normal host: canines and fleas
DIPYLIDIUM CANINUm
Very common parasite of dogs and cats worldwide
DIPYLIDIUM CANINUM
Intermediate Host: larval stages of the dog or cat flea, or
occasionally the Trichodectes canis or the dog louse
DIPYLIDIUM CANINUM
DIPYLIDIUM CANINUM
ECHINOCOCCUS GRANULOSUS
ECHINOCOCCUS GRANULOSUS Infective stage:
embryonated ova
3 Major Components of E.granu: o Outermost morphological contour
o Responsible for the uptake of essential resources
from the host
Germinal Layer
3 Major Components of E.granu: o Asexually buds from the blood capsule
o Protrudes from the germinal layer
o Develops into an adult
Protoscolex
3 Major Components of E.granu: o Comprises of numerous proteinaceous and nonproteinaceous materials wich are secreted from the
parasite as well as absorbed from the host
Hydatid fluid
LABORATORY DIAGNOSIS: echinococcus granulosus
Roentgenography
o Production of x-ray images using radiography. It
can be used for the diagnosis of Echinococcus
granulosus
3 Major Components of E.granu: Harbors tegumental materials shed from the
protoscolex and resources derived from the
metabolic turnover of the germinal layer
Hydatid fluid
LABORATORY DIAGNOSIS: echinococcus granulosus
C/S (cross section) of a slow-growing tumor with Eosinophilia
Hydatid cysts fluid may be examined on biopsy samples
o Presence of scoleces, daughter cells, brood
capsules, or hydatid sand
o Care must be used as infected patients may suffer
from anaphylaxis, if the fluid escapes
Serological Tests
o ELISA – for screening
o Indirect hemagglutination
o Western blot test
Resembles S. mansoni in size and shape
SCHISTOSOMA HEMATOBIUM
a ciliated embryo that hatches in water
- MIRACIDIUM
would escape from the egg shell usually through the operculum into
the environment
MIRACIDIUM
sac like structure with germ cell that would usually proliferate
MOTHER SPOROCYSTS
Develops from a miracidium in the 1st IH
- MOTHER SPOROCYSTS
it lacks a gut and gives rise asexually to daughter sporocysts or
rediae
- MOTHER SPOROCYSTS
sac-like, having an oral sucker, a pore & pharyn
REDIAE (REDIA)/DAUGHTER SPOROCYSTS
would usually develop in 1st intermediate host
- REDIAE (REDIA)/DAUGHTER SPOROCYSTS
The larval form of trematode
- CERCARIA/DAUGHTER REDIA
The motile cercaria finds and settles in a host wherein it can
become either an adult or a mesocercaria depending on the
specie
CERCARIA/DAUGHTER REDIA
Has a tapering head with a large penetration glands
It may or may not have a long swimming tail or it may have a
fork-tail appendage for free swimming depending on the
specie
CERCARIA/DAUGHTER REDIA
It develops within the germinal cells of the sporocysts/redia
CERCARIA/DAUGHTER REDIA
Arises from the 1st intermediate host and penetrates the 2nd
intermediate host
A more developed larva
CERCARIA/DAUGHTER REDIA
Develops from a cercaria
METACERCARIA
Encysted metacercaria is usually found in the fish muscle
METACERCARIA
Non-encysted (naked) metacercaria is found in the body
cavity crawling among the internal organs of the fish
It is in this stage that the parasite infects the definitive human
. METACERCARIA
Encysted, resting or maturing stage
Develops in tissue of the 2nd intermediate host
- METACERCARIA
It is in this stage that the parasite infects the definitive human
host via ingestion of the snail or other second intermediate
host
- METACERCARIA
mono or dio? Straight-tailed for
swimming and
movement
mono
clinical manifestation of this parasite?
● Chronic bronchitis
● Hemoptysis
○ Characterized by a dry cough
○ Sputum sample with foul odor
● Abdominal and chest pains, dyspnea (shortness of breath;
air hunger)
● Low grade fever, fatigue and generalized myalgia
paragonimus westermani
Most pathogenic intestinal amoeba in man
ENTAMOEBA HISTOLYTICA
ENTAMOEBA HISTOLYTICA
ENTAMOEBA HISTOLYTICA
what morphology in E.histo where Red blood cells present
Trophozoite
what morphology in E.histo where its Devoid of food inclusion
Precystic
asymptomatic infection of E,histo
Lumina amebiasis (E.dispar)
Difference of E.hartman to E. histo
- Trophozoite doesn’t ingest RBCs
- Utility is less vigorous
- Chromatoidal bodies are shorter with tapered ends giving a
rice grain shape or thin fan like appearance - Non-pathogenic; causes only mild symptoms of enteritis
o Finely granular, vacuolated cytoplasm (with narrow rim
of ectoplasm)
ENDOLIMAX NANA Trophozoite:
similar to Entamoeba Histolytica but note that it is noninvasi
IODAMOEBA BUTSCHLII
Prominent glycogen vacuole (iodine-staining)- dark
brown
I. buts cyst
I. buts troph are difficult to detect in what preparation?
wet preparation
Resembles Trichomonads antigenically and
ultrastructurally
DIENTAMOEBA FRAGILIS (WENYON, 1909; DOBELLI, 1918)
Usually in co-infection with E. vermicularis
DIENTAMOEBA FRAGILIS (WENYON, 1909; DOBELLI, 1918)
Multiple leaf-shaped pseudopods
DIENTAMOEBA FRAGILIS (WENYON, 1909; DOBELLI, 1918
can be acquired while diving and swimming during hot
weather in brackish or fresh water including swimming pools
NAEGLERIA SPECIES (NAEGLERIA FOWLERI)
● Major causative agent of Primary Amebic
Meningoencephalitis (PAM)
NAEGLERIA SPECIES (NAEGLERIA FOWLERI)
On autopsy examination (of mice and animals), the normal
architecture of the brain, particularly the olfactory lobes and
cerebral cortex is completely destroyed. (“Brain-eating
amoeba”
NAEGLERIA SPECIES (NAEGLERIA FOWLERI)
Ulcerative Acanthemoeba Keratitis in contact lens wearers
○ Causes keratitis, acquired from trauma and contact
lens wear
ACANTHAMOEBA SPP. (A. CASTELLANI, A. CULBERTSONI, A.
HUTCHETTI, A. POLYPHAGA, A. RHYSOIDES)
Bilaterally symmetrical; pear-shaped
GIARDIA INTESTINALIS/ GIARDIA LAMBLIA
habitat of giardia
gallbladder and duodenum
Motility: jerky falling leaf (one of the
confirmatory that it is), kite like,
spinning, flip-flop
GIARDIA INTESTINALIS/ GIARDIA LAMBLIA
Trophozoite
○ Pear-shape
CHILOMASTIX MESNIL
The transmission is usually
through sexual intercourse by often the infected male who
would act as the intermediary
T.vaginalis
Common parasite of pigs and monkeys
Entamoeba polecki
parasite? Thick double wall
(“double-walled
cyst”); cytoplasm
shrinks away from
the cell wall
Giardia
parasite? Axostyle and fibrillar remnants of locomotory apparatus
present
giardia
Common among pre-school children and immunocompromised
patients (AIDS patients)
giardia
Excystation occurs in the duodenum and become trophozoites
3. Trophozoite inhabits the mucosa of duodenum and proximal
jejunum (optimal pH: 6.4 – 7.0)
giardia
a. Duodenal Involvement (Duodenitis)
b. Gall bladder involvement (Cholangitis)
Giardia
Motility: Boring or spiral forward movement, corkscrew,
clockwise, twisting motility
Chilo.mes
Pear- or lemon-shaped,
rounded at one end and
conical at the other end
with knob-like
protuberance projection
chilo mesn
✓ Pear-shaped or ovoid
✓ No cytostome
✓ 4 flagella:
C. Enteromonas hominis
Characteristic cleft – like cytostome may be seen near
the nucleus
✓ 2 anterior flagell
D. Embadomonas intestinalis
Exist only as trophozoites; NO CYSTIC STAGE
Genus Trichomonas
– small, located on one side of the anterior end
o Cytostome
– rod-like structure arising from or near the anterior
end and extends through the entire body, protruding as a
rather sharp spike through the posterior end of the
cytoplasm; functions for anchorage
Axostyle
located between the nucleus and the
anterior margin of the organism
Blepharoplast –
Trichomonas vaginalis
▪ Optimum pH for survival:
5.2 to 6.4
n the healthy female, the normally acid vaginal secretions o
f pH 3.8 – 4.4
