CLINICAL PARASITOLOGY LAB
FINALS
Phylum Nematoda: Class Adenophorea (Aphasmidia)
Other name/s
Trichuris trichiura
Capillaria philippinensis
Capillaria hepatica
Trichinella spiralis
“Whipworm”
“Pudoc worm”
“Capillary liver worm”
“Trichina worm”
Actual Image(Adult)
Illustration (Adult )
Description
Female: 35-50 mm
Male: 30-45 mm
Female: 2.3-5.3 mm x 29-47μm
(2- 5 mm in length)
Male: 1.5-3.9 mm x 23-28 μm
Anterior 3/5 : attenuated whip-like 3/5
traversed by a narrow esophagus
resembling string of beads
Posterior: more robust , 2/5 containing
the intestine and a single set of
reproductive organsMale: coiled posterior at 360 deg
Female: bluntly rounded end
Typical female: oviparous (1 row of
eggs : 8-10 eggs)
Atypical female: larviparous(2-3 rows
of eggs: 40-45 eggs)
Female: 20 mm length w/
protrusible vulvar opening in the
esophageal region
Male: 10 mm length w/ slightly
chitinized spicule w/in a protrusible
membranous sheath
Female: 3 x 0.06 mm
Male: 1.5 x 0.04 mm
Anterior: Slender end w/ small,
circular mouth w/ syphilis papillae
Posterior end bluntly rounded in
female and ventrally curved w/ a pair
of caudal alae (claspers), on either
side of the cloacal orifice
Schistosome: ½ (M) and ⅕ (F) of the
length of body
Single reproductive tract in female w/
vulva in the anterior fifth on the ventral
side; Long, narrow digestive tract
Page 1 of 13
Clinical Parasitology Lab_ ANGELES, Q.A
-2-2-0
Actual Image
(Egg/Ova/Larva)
Illustration (Egg/Ova/Larva)
Larva
Description (Egg/Ova/Larva)
Size: 50 x 22 μ “Lemon-shaped”/
“Barrel-shaped”/ “Japanese lantern”
; with hyaline plugs / plug-like
translucent polar prominence; yellowish
outer shell and translucent inner shell.
Distinct Feature
(Egg/Ova/Larva)
-
Japanese lantern
Very prominent bipolar plugs
Size: 20 x 40 μ
“Peanut- shaped” w/ flattened bipolar
plugs;
moderately thick-shelled;
has striations;
shows straw color.
-
Peanut-shaped
Striations
Size: 50-65 μm x 30-35 μm
“Lemon-shaped”
outer shells are pitted like a golf ball
w/ minute pores
-
Not striated
Bipolar plugs are more
prominent
Larva : Size: 90-100 x 6.0 µm
-
Seen in muscles
Life Cycle
Lab DIagnosis
Demonstration of parasite
1. DFS
2. Concentration techniques
3. KTS
4. Kato Katz - utilizes
premeasured volume of sample
(quantitative)
Demonstration of parasite
1. DFS
2. Concentration techniques
3. KTS
Demonstration of parasites
1. liver biopsy
1. Demonstration of parasites
a. muscle biopsy (encysted larvae) (diagnostic stage: larva)
b. xenodiagnosis (using albino rats fed w/ infected muscles
obtained from patient w/ infection
2. Bachman intradermal test (a skin test; Ag is prepared from
the larva) (+) blanched wheal 5mm or > diameter surrounded
by an area of erythema
3. serological test:
a. bentonite flocculation
b. latex agglutination
other laboratory findings: Increased CPK and LDH Increased myokinase
Page 2 of 13
Clinical Parasitology Lab_ ANGELES, Q.A
-0-22--0--06
LECTURE NOTES:
Parasite
Infective stage
Trichinella spiralis
Trichina worm
*smallest nematode
infecting man
Encysted larva
Trichuris trichiura
MOT
Host
Ingestion of undercooked Vertebrate
pork
*domestic cycle
*sylvatic cycle
Ingestion of ova (STH)
Primarily human
Habitat
Ingestion of ova
Embryonated ova
Capillaria
philippinensis
Larvae
Dioctophyme/
Dioctophyma
renale
L3 larvae
*giant kidney worm
largest nematode
infecting man
Page 3 of 13
Zoonotic (low host specificity)
Primarily rodent & carnivore
*true & spurious infection
Diagnostic tool/ feature
Small intestine
Trichinosis
Trichinelliasis
Trichiniasis
*myocarditis, encephalitis
Large intestine; cecum
and ascending colon
Trichuriasis
Trichocephaliasis
Iron deficiency anemia
Appendicitis
Rectal prolapse
Stichocytes in adult
Male: coiled ventrally at
360 deg
“Japanese lantern ova”
Liver parenchyma
Hepatic capillariasis (liver
cirrhosis)- rare
Adult resembles T.
trichiura
“Lemon-shaped ova”
Mystery disease
Internal capillariasis
Malabsorption syndrome
(CHON losing
enteropathy)
-borborygmi
Adult resembles T.
trichiura
Larviparous
(autoinfection)
“Peanut-shaped ova”
Dioctophymiasis
(hematuria, abdominal,
pain, fever, and
eosinophilia)
Egg in urine, sometime
adult
Embryonated egg
Capillaria hepatica
Disease
Ingestion of uncooked
fish with infective larvae
“internal autoinfection”
IH: glassfish “bagsit”, “bagsang”,
“ipon”,
DH: Primarily humans
Small intestine mucosa
Ingestion of
undercooked paratenic
host with L3 larvae
IH: aquatic oligochaete worms
(blackworms)
DH: mustelids, canids, otters,
martens, racoons, *rare in human
Paratenic: freshwater fish and
amphibian
Kidney
*larva migrate in the
subcutaneous nodules
Muscle biopsy: larva (tigtly
coiled & enclosed w/in
fibrous capsule
Beckman Intradermal test
(hypersensitivity test)
Beck’s Xenodiagnosis
ELISA (reco)
Western blot & LA (conform
ELISA)
Clinical Parasitology Lab_ ANGELES, Q.A
foodie
Phylum Nematoda: Class Secernentea (Phasmidia)
Other name/s
Ascaris lumbricoides
Enterobius vermicularis
Strongyloides stercoralis
Toxocara canis
Toxocara cati
“Giant intestinal roundworm”
“Pinworm” / “Seatworm”
Old name: Oxyuris vermicularis
“Threadworm”
“Dog ascaria”’ / “dog
roundworm”
“Cat ascaria” / “cat roundworm”
Actual
Image(Adult)
Illustration
Rhabditiform and Filariform larva
Description
Female: 200-350 x 4-6 mm
Male: 150-200 x 2-4 mm
Female : 8-13 x 0.3- 0.5 mm
Male: 2-5 x 0.1 mm
Smooth cuticle, unstriated ,
nonsegmented.
- Trilobite lips
Distinctive feature:
- Cephalic alae
- Esophageal bulb
Female: 2.5 mm x -.05 mm
Male: not seen in human
infections
Similar to Ascaris lumbricoides in appearance but only a
quarter to half its size.
Toxocara : body is bent ventrally
Female: thin, colorless. Semitransparent,
finely striated cuticle, slender tapering
anterior and short conical pointed tail.
Cylindrical esophagus: occupies ⅓ of the
body and the intestines in the posterior. W/
paired uteri, vagina, vulva.
Actual Image
(Egg/Ova/Larva)
Immature egg
Page 4 of 13
mature egg containing larva
Clinical Parasitology
Lab_ ANGELES,
Q.A
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f
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Illustration
(Egg/Ova/Larva)
Description
(Egg/Ova/Larva)
Fertilized: Corticated-Thick Shelled
60x 45 μm
Broadly ovoid; golden brown in color;
unembryonated at oviposition. Thick-shelled
Inner: non-permeable , lipoidal vitelline
membrane Middle: thick, transparent,
glycogen membrane Outer: coarsely
mammilated, albuminous layer
Size: 50-60 x20-30 μm
- Thick-walled ; colorless shell;
- shell flattened on one side
- coiled larva developing in egg
- “D”-shaped
- embryonated
Unfertilized: Decorticated Thinner shell
88-94 x 39-44 μm
Longer and narrower than fertilized egg;
completely filled with disorganized, highly
refractile granules Thinner shell and irregular
mammilated, albuminous layer
Egg: Size: 50-60 µm x 30-35 µm
segmented in 2-4 cell stage at
oviposition
Rhabditiform larva (L1): Size:
250µm (with rhabditiform-type
esophagus), has a short buccal canal
about 4 µm in length that appears as long
as wide. A conspicuous genital primordium
measuring about 22 µm can be seen about
two-thirds of the way back from the anterior
end.
Size: 85 x75 μ Superficially
pitted
Resemble those of Ascaris,
but are larger, less elongate
and have thinner shell and
albuminoid outer covering
Size: 65-70 μ in diameter
Resemble those of Ascaris,
but are larger, less elongate
and have thinner shell and
albuminoid outer covering
Filariform larva (L3): Size: 600 µm
The esophagus of uniform length is long,
about one-half the length of the body. The
posterior is characterized by a notched or
bifurcated tail.
Life Cycle
IS: Embryonated ova
Lab Diagnosis
Demonstration of parasite
1. DFS
2. Concentration techniques
3. KTS
4. Kato Katz
5.
Sputum sample : larvae x-ray
examination ( bolus)
Page 5 of 13
Demonstration of parasite:
1. perianal swab :
Graham’s scotch tape
method (adult female)
2. beneath the nail bed
swabs
DFS
Morphologic larva
- Short buccal cavity (as long as wide)
- Genital primordium (cluster stage) : described
as conspicuous, large/long
-Isolated by SCT
-Coproculture technique
-- Baermann Technique: a culture technique,
w/c uses a funnel apparatus/method
- A fresh stool is placed in a wire mesh, then
wrapped w/ cloth (several layer of the gauze /
cloth)
-Placed in a container w/ water w/ the funnel,
the rhabditiform will pass through the wire gauze
-Enterotest
-Sputum/ Urine
- eosinophilia
- concentration techniques
- serology:
1. Ab detection – ELISA on serum
Clinical Parasitology Lab_ ANGELES, Q.A
fighters
LECTURE NOTES:
Parasite
Infective stage
MOT
Host
Habitat
Ascaris
lumbricoides
Embryonated ova
Ingestion of embryonated
ova
Primarily human
Monkeys/ apes
*dog: spurious
Small intestine
Giant/ large intestinal
roundworm
*largest nematode
parasite in the
intestine
Disease
Diagnostic tool/ feature
*wandering
Adult mouth: 3 finely
Larva: lungs- ascaris
denticulated lips (hence, the
Pneumonia (Loefller’s
triangular part)
syndrome)
*migrating adult: occlusion Adult male posterior end:
of biliary tract, appendicitis curved ventrally to form a
nasopharyngeal expulsion
hook with 2 copulatory
spicules
*A suum: swine
Ova: unfertilized, fertilized,
decorticated
Enterobius
vermicularis
Embryonated ova
Oxyuris
vermicularis,
Pinworm,
seatworm,
threadworm
Ingestion of embryonated
ova
Inhalation or swallowing
or embryonated ova in
dust
*retroinfection
Only human: high host
specificity
*occasional infection in
captive
Large intestine
*larvae are often found in
the appendix but role in
appendicitis controversial
Enterobiasis
*Perianal pruritus
*vulvovaginitis
*pelvic or peritoneal
granulomas
Chimpanzee
*school age
*crowding
Adule: 3 cephalic ale
Esophagus with double
bulb structure
D-shaped ova
Scotch tape method
Parasite
Infective stage
MOT
Host
Habitat
Disease
Diagnostic tool/ feature
Necator americanus
Filiform larvae
Skin penetration
Human
Small intestine (jejunum)
Ground itch
Ovoidal, thin shelled,
colorless, 2-8 cell stage ova
*transpulmonary migration
phase
Ancylostoma
duodenale
Filiform larvae
Skin penetration
Oral and transmammary
route
Human
Small intestine (jejunum
Ground itch or coolie itch
Pneumonitis
Iron deficiency
Anemia (microcytic,
hypochromic)
Ovoidal, thin-shelled,
colorless, 2-8 cell-stage
ova
Zoonotic; canids and
felids
Small intestine (jejunum
Cutaneous larva
Migrans / creeping
eruption
Ovoidal, thin-shelled,
colorless, 2-8 cell-stage
ova
Zoonotic; dogs, wolves,
coyotes, and foxes
Small intestine (jejunum
Cutaneous larva
Migrans / creeping
eruption
Ovoidal, thin-shelled,
colorless, 2-8 cell-stage
ova
Primarily Human
Small intestine (jejunum
Strongyloidiasis
Larva currens: ‘racing
larva’
Bronchopneumonia
Chronic bronchitis
Ovoidal, thin-shelled,
colorless, 2-4 cell-stage
ova
Larva in sputum
3 small lips
partenogenic
*hypobiosis in the intestine
or muscle
Ancylostoma
braziliense
Filiform larvae
Skin penetration
Ancylostoma
caninum
Filiform larvae
Skin penetration
Oral ingestion
Strongyloides
stercoralis
Filiform larvae
Page 6 of 13
Skin penetration
Clinical Parasitology Lab_ ANGELES, Q.A
_fh②t②
LECTURE NOTES
Parasite
Infective stage
MOT
Host
Habitat
Disease
Diagnostic tool/ feature
Toxocara canis
-Dog ascarid
Embryonated ova with L3
larvae
Ingestion of infective eggs,
larva, penetration
Transplacental and
transmammary
Dog
Small intestine
Visceral toxocariasis:
Visceral larva migrans
(VLM)
Distinct cephalic alae
Longer than broad
(bow-like)
Prominent lips
Accidental: human
Ocular toxocariasis: ocular
larva migrans (OLM)
→ irreversible blindness
Toxocara cati
-ascarid
Embryonated ova with L3
larvae
Ingestion of infective eggs
Larva , penetration
transmammary
Cat
Small intestine
Accidental: human
Visceral toxocariasis:
Visceral larva migrans
(VLM)
Distinct cephalic alae
Broader than thin (arrow
head)
Prominent lips
Ocular toxocariasis:
ocular larva migrans
(OLM)
→ irreversible blindness
Gnathostoma
spinigerum
-rust colored
Larvae
Eating undercooked fish
or poultry - larvae
1st IH: copepods
2nd: IH: aquatic animals
that feed on copepod
(fish, amphibians)
Paratenic: snake, duck
DH: Carnivorous mammal
Gastric wall
Cutaneous
gnathostomiasis
Prominent cephalic bulb
and body spines
Visceral gnathostomiasis/
larva migrans profundus
(pulmonary, GIT,
genitourinary, auricular,
ocular tissues, or CNS)
Accidental: human
Neuro-gnathostomiasis
Page 7 of 13
Clinical Parasitology Lab_ ANGELES, Q.A
-0ft
Phylum Nematoda: Class Secernentea (Phasmidia) —Hookworm species
Other name/s
Necator americanus
Ancylostoma duodenale
Ancylostoma caninum
Ancylostoma braziliense
“New world hookworm”
“Old world hookworm”
“Dog hookworm”
“Cat hookworm”
Actual image of Adult worms
Description (Adult)
Female: 1 cm long
Male: 5-9 mm long
Resembles ancylostoma but smaller;
head is sharply bent in relation to the rest
of the body, forming a definite hook
shape at the anterior end
Female: somewhat longer and stouter
Male : 1 cm x 0.5mm
Adult worm: grayish white / pinkish; head is slightly bent
No teeth, but contains cutting plate
Actual Image of Buccal
Capsule
Pair of semilunar cutting plates
Two ventral of fused teeth
Three ventral plates of fused teeth
Longer than broad.
Dorsal rays – deep cleft and tips bipartite
Two spicules – fused and barbed.
Short and broad
Dorsal rays – shallow cleft and tips
tripartite
Two spicules – unfused and NOT
barbed.
Large, flame-shaped.
Rays – long and slender.
Two ventral plates of unfused teeth
Actual Image of Copulatory
Bursa
Page 8 of 13
As broad as long.
Rays – stunted.
IIM
Clinical Parasitology Lab_ ANGELES, Q.A
Life Cycle
Lab DIagnosis
Demonstration of parasites:
a. DFS
b. SCT
c. KTS
d. Kato-katz method
e. Coproculture: culture of feces (harada-mori technique – larvae; filter paper test tube method)
Page 9 of 13
Clinical_
Parasitology Lab_
ANGELES,
Q.A
_
_
_
Phylum Nematoda: Class Secernentea (Phasmidia) —Filaria species
Wuchereria bancrofti
Brugia malayi
Onchocerca
volvulus
Loa loa
Mansonella pertans
Mansonella
streptocerca
Mansonella ozzardi
Size
230-320 x 10 um
170-260 x 5-6 um
150-368 x 5-9 um
250-300 x 6-8.5 um
200 x 4.5 um
180-240 x 3 um
175-240 x 4.5 um
Size (width
compared to RBC)
Thick filariae
Thick filariae
Thick filariae
Thick filariae
Thin filariae
Thin filariae
Thin filariae
Sheath
Sheathed
Sheathed
Unsheathed
Sheathed
Unsheathed
Unsheathed
Unsheathed
Unstained in Giemsa
Stained in Giemsa
Unstained in Giemsa
Lightly stained in
Hematoxylin
Unstained in
hematoxylin
Stained in
Hematoxylin
Cephalic Space
Short
Long
Long
Short
Short
Short
Slightly longer than wide
Somatic column
Nuclei dispersed
regularly spaced in 2-3
rows
Nuclei compact,
overlapping
irregularly-spaced
Moderately compact
Compact
Compact
Start in the anterior as
single row of 10-12 (or
more) nuclei
Compact
Tail
Tail tapered to a point,
free from nuclei
Tail tapered; two
discrete nuclei
(terminal and
subterminal) in tip of
tail
Tail tapered to a
point, typically flexed
free from nuclei
Tail tapered and coiled
within the sheath;
nuclei irregularly
spaced to tip of tail
Tail tapered bluntly
rounded; nuclei
continue to tip
Tail tapered and bluntly
rounded; bent in
shepherd's crook”
shape, nuclei almost
to tip
Tail long and slender;
tip of tail free of
nuclei
Addt’l
Graceful appearance
Kinky appearance
Angular curves
Rhythmical
appearance/
Nocturnally periodic (mf
is found in PB either at
Nocturnally periodic
10pm – 2am
Diurnally periodic
(found at day time)
None
Aperiodic ( no rhythm
or pattern in
None
Aperiodic ( no rhythm
or pattern in blood;
Actual Image
Illustration
Page 10 of 13
Clinical Parasitology Lab_ ANGELES, Q.A
-fe②-II
occurrence on
peripheral blood
day time/ the night
time)
Nocturnally subperiodic
(peak con’c is at night)
blood; found
anytime)
found anytime)
Life Cycle
LECTURE NOTES:
Parasite
Infective stage
MOT
Wuchereria
bancrofti
3rd stage filarial larvae
Mosquito bite
Brugia malayi
3rd stage filarial larvae
Mosquito bite
Brugia timori
3rd stage filarial larvae
Mosquito bite
Loaloa
-African eye worm
3rd stage filarial larvae
Vector bite
Onchocerca
volvulus
Mansonella pertans
3rd stage filarial larvae
Vector bite
3rd stage filarial larvae
Vector bite
DH: Human
IH:Midge (Culicoides)
Subcutaneous tissue
Mansonella ozzardi
3rd stage filarial larvae
Vector bite
Manzonella
streptocerca
Dracunculus
medinensis
3rd stage filarial larvae
Vector bite
Peritoneal cavity or pleural
cavity, less frequently in
pericardium
Dermis
Infective larvae
Drinking unfiltered water
containing copepods
DH: Human, monkey
IH: blackfly, (simulium).
Midge (Culicoides)
DH: human, chimpanzee
IH: midge (culicoides)
IH: copepoelids
Dirofilaria immitis
-Dog heartworm
Infective larvae
Mosquito bite
Some zoonotic
DH: Carnivore (dogs,
coyote, jackal, wolf)
IH; Mosquito (Aedes, Culex,
Anopheles, Mansonia)
Heart
Page 11 of 13
Host
Habitat
Disease
DH: human
Lymphatics
Elephantiasis of the lower extremities
IH: Mosquito (Culex, Aedes,
“Tropical pulmonary eosinophilia”
Anopheles
DH: human
Lymphatics
Elephantiasis of the upper extremities
IH: Mosquito (Mansonia,
“Tropical pulmonary eosinophilia”
Aeses)
DH: human
Lymphatics
IH: Mosquito (Mansonia,
Milder than bancroftian or malayan filariasis
anopheles)
DH: Human
Subcutaneous tissue
Calabar swelling (episodic angioedema), fugitive swelling,
IH: Chrysops
*subconjunctival migration
loiasis
of adult
IH: blackfly (simulium) bite
Subcutaneous tissue
Onchocerciasis, river blindness, dermatitis
Subcutaneous tissue
Asymptomatic
Adult migration transient subcutaneous swelling,
pericarditis,pleuritic, ocular symptoms
Asymptomatic
Fever, pruritus, arthralgia, headache, rashes,
lymphadenopathy, edema, and pulmonary symptoms
Asymptomatic
Pruritus, dermatitis, hyperpigmented lesion
Guinea worm disease
Skin infection
Pulmonary disease
“Coin lesion”
Papule ulcers
Clinical Parasitology Lab_ ANGELES, Q.A
foote
Phylum Nematoda: Cla
Phylum Platyhelminthes: Class Cestoda–Order Pseudophyllidea and Order Cyclophyllidea
Order Pseudophyllidea
Diphyllobothrium
latum
Other name/s
Fish tapeworm / broad
tapeworm / broad fish
tapeworm
Order Cyclophyllidea
Taenia solium
Taenia saginata
Hymenolepis nana
Hymenolepis
diminuta
Dipylidium caninum
Echinococcus
granulosus
Pork tapeworm
Beef tapeworm
Dwarf tapeworm
Rat tapeworm
Dog tapeworm
Hydatid tapeworm
Scolex (Actual
image)
Scolex
(Illustration)
Description
(Scolex)
Gravid
Proglottids
(Actual Image)
Page 12 of 13
Clinical Parasitology Lab_ ANGELES, Q.A
e②r②@
Gravid
Proglottids
(Illustration)
Description
(Gravid
Proglottids )
Ova (Actual
Image)
Ova (Illustration)
Description
(Ova)
ss Secernentea (Phasmidia) —Hookworm species
Page 13 of 13
Clinical Parasitology Lab_ ANGELES, Q.A
Boggs