Clinical Parasitology

Mohieddin Abdul Fattah

Samples, signs and symptoms

Type of specimens taken for parasitologic diagnosis:

1.Blood

2.Stool

3.Urine

4.CSF

5.Vaginal discharge

6.Bronchoalveolar lavage (BAL).

7.Aspirates

8.Tissues and skin (biopsies)

Parasites in blood samples Parasites in blood film (thin or thick)1. Plasmodium P. vivax, ovale, malariae: ring , schizonts & gametocytes P. falciparum: ring and gametocytes only2. Trypanosoma African: Trypomastogotes American: Trypomastigotes3. Filariae: Microfilariae W. bancrofti Brugia malayiae Loa loa Parasites in Buffy coat layer:1. Those detected in blood film2. Toxoplasma3. visceral leishmaniae

Other Samples for parasitologic diagnosis:

1. Stool: Heterophyes, Fasciola and schistosoma eggs

Eggs, segments of intestinal cestodes.

Eggs or larvae of intestinal nematodes.

Trophozoites, or cysts of Entamoeba, Balantidium and Giardia.

Oocysts of intestinal coccidia (cryptosporidium)

2. Urine: Trichomonas vaginalis trophozoite

Schistosoma eggs,

W. bancrofti, O, volvulus (microfilariae)

Pthiurus pubis (pubic Flea), Sarcoptes (scabies mite).

4. CSF: Trypanosoma (trypomastigotes),

Naegleria trophozoites (Free living amoebae).

5. Aspirates from affetced organs; Duodenum: Giardia, Strongyloides, Fasciola. Liver: L. donovani, Entamoeba histolytica Spleen: L. donovani bone marrow: L. donovani. LN: Trypanosoma, Leishmania and Toxoplasma.6. Biopsies: Muscle: encysted Larva of T. spiralis Skin: A. cutaneous Lesihmania, B. Onchocerca, C. Medina worm, D. Myiasitic larvae, E. Sarcoptes, and F. Tunga flea

Other Samples for parasitologic diagnosis

Other samples for parasitologic diagnosis

Rectal Biopsy: 1. Schistosoma mansoni, 2. Entamoeba histolytica 6) Vaginal discharge: T. vaginalis trophozoites

7) Sputum:

Strongyloides larvae,

Ascaris larvae,

hookworm larvae.

Entamoeba histolytica (amebic lung abscess)

Symptoms and signs caused by parasitic infections

Fever1. Acute fever Malaria Toxoplasmosis. Trichinosis. American trypanosomiasis.2. Chronic fever: Prepatent fascioliasis. Visceral leishmaniasis. Toxocariasis. Katayama fever

(schistosomiasis) Filarial fever.3. Recurrent fever: Malaria.

Coma

1. Cerebral malaria.

2. African Trypanosomiasis.

Anaemia:

1. Diphylobothriasis.

2. Hookworm infection.

3. Malaria.

4. visceral leishmaniasis.

5. Fasciolasis

6. schistosomiasis.

Symptoms and signs caused by parasitic infections

Eosinophilia:1. Filariasis2. Fascioliasis.3. Schistosomiasis.4. strongyloidiasis.5. Toxocariasis6. Trichinosis Hypopigmented skin macules:1. Onchocerciasis (patches over shins).2. Post-Kala-Azar dermal leishmanoid. Hyperpigmented skin macules:1. Onchocercal dermatitis (Sowda).2. Visceral leishmaniasis (Kala-Azar).3. Chronic pediculosis.

Lymphadenopathy:1. Filariasis2. Toxoplasmosis.3. African trypanosomiasis.4. American trypanosomiasis Myocarditis:1. Chagas disease.2. Trichinosis.3. Rhodesian

trypanosomiasis.4. Acute toxoplasmosis5. Heterophyes (granuloma

around the egg).

Symptoms and signs caused by parasitic infections

Diarrhea (Bloody):

1. Amoebic dysentery.

2. Balantidium coli.

3. Kala-Azar (infiltration of submucosa with leishmania-containing macrophage mucosal ulceration.

4. Falciparum malaria (plugging of mucosal capillaries with parasitized RBCs).

5. Heavy trichuriasis.

Watery diarrhea:

1. Trichinosis (food poisoning)

2. Cryptosporidium.

3. Giardia lamblia(malabsorption).

4. Hymenolepis nana (during development of cysticercoids in the villi).

5. Strongyloides stercoralis

6. Capillaria philippinensis. (malabsorption).

7. Schistosomiasis mansoni(profuse diarrhea or dysentery).

8. Primary heavy hookworm infection.

Symptoms and signs caused by parasitic infections

Intestinal obstruction:1. Ascariasis.2. Chagass disease (Chronic

(megacolon).3. Taenia saginata4. Taenia solium Jaundice:1. Obstructive (Fasciola).2. Haemolytic (falciparum malaria,

bilious remittent fever). Worm passed from anus or

mouth: Ascariasis (anus & mouth). Oxyuris. (anus) Taenia saginata (anus)

Parasites transmitted by undercooked meat:

1. Taenia saginata.2. Taenia solium.3. Trichinella.4. Toxoplasma,5. Fasciola (Halzoun). Parasites transmitted by

autoinfection (nosocomial).1. Cryptosporidium.2. Entamoeba histolytica.3. Giardia lamblia,4. Strongyloides.5. Oxyuris.6. Cysticercosis.7. Capillaria Philippinensis.8. Hymenolepis nana

Epidemiologic aspects of parasitic infections

Epidemiologic aspects of parasitic infections Soil mediated helminth

infections:

1. Hookworms

2. Strongyloides

3. Ascaris

4. Toxocara

5. Trichuris trichiura.

6. Capillaria hepatica

Opportunistic Infections:

1. Strongyloides.

2. Cryptosporidium

3. Toxoplasma

4. Acanthamoeba (GAE).

5. Giardia.

Sexually transmitted parasites:

1. T. vaginalis

2. S. scabeii.

3. Phthirus pubis.

4. Parasites transmitted by auto infection.