ARRIOLA, SKG MLS-4A

INTESTINAL NEMATODES
Ascaris lumbricoides = GIANT ROUNDWORM (Leoffler’s)
Enterobius vermicularis = SEAT WORM / PINWORM (Pruritis ani)
Strongyloides stercoralis = THREADWORM (Pneumonia)
Trichuris trichiura = WHIPWORM; Japanese lantern (Rectal prolapse)
Capillaria philippinensis = PUDOC WORM (Borborygmi)
Ancylostoma duodenale = OLD WORLD HOOKWORM (Ground itch)
Necator americanus = NEW WORLD HOOKWORM (Ground itch)
Trichenella spiralis = TRICHINA WORM (Bachman intradermal test)
Toxocara canis/cati = COMMON ROUNDWORM OF DOGS
Ancylostoma braziliense / Anzylostoma caninum = OCULAR LARVA MIGRANS
Drancunculus mdinensis = GUINEA WORM; Medina worm
Wuchereria bancrofti = BANCROFT’S FILARIA (Elephantiasis); Lower lymphatics; Nocturnal
periodic; Chyluric/Milky urine production

Brugia malayi = MALAYAN FILARIASIS (Swampy Forest); Upper lymphatics; Nocturnal periodic
Loa loa = AFRICAN EYE WORM (Calabar swelling); Vector: Chrysops; Diurnal periodic; Invades
Subcutaneous Tissue

Onchocerca volvulus = BLINDING FILARIA (River blindness); Vector: Black fly

Mansonella perstans = PERSTANS FILARIA (Nonpathogen); Vector: Midges
Mansonella ozzardi = NEW WORLD FILARIA (Nonpathogen); Vector: Midges & Blackfly
 ARRIOLA, SKG MLS-4A

DRUGS
A. lumbricoides: Albendazole & Mebendazole

E. vermicularis: (Pregnant: Pyrantel & Piperazine)

S. stercoralis: Ivermectin

T. trichiura: Albendazole

C. philippinensis, Albendazole & Mebendazole

A. duodenale,
N. americanus:
T. spiralis: Intestinal phase (Thiabendazole); Pathologic development
(Albendazole)

Toxocara spp: Thiabendazole, Ivermectin, Albendazole, & Diethylcarbamazine

Hookworms: Ivermectin & Thiabendazole

D. medinensis: Metronidazole, Thiobendazole

W. bancrofti & Diethylcarbamazine (DEC)

B. malayi:
O. volvulus: Albendazole & Ivermectin (Not FDA approved) &
Diethylcarbamazine (DEC)

M. ozzardi: Ivermectin
 ARRIOLA, SKG MLS-4A

TREMATODES
Fasciola buski = GIANT INTESTINAL FLUKE (Vector: Water
plant); Vit. B12 deficiency

Heterophyes heterophyes = HETEROPHID FLUKE / VON SIEBOLD’S

FLUKE; Snail & Freshwater fish (IH)

Metagonimus yokogawai = morphologically similar to H. heterophyes & C.

sinensis

Clonorchis sinensis = CHINESE LIVER FLUKE (Vector: Uncooked fish);

Snail & Fish (IH); ↑IgE; Adult worm live in BILE
DUCTS

Opistorchis felineus / O. viverrine = CAT LIVER FLUKE; Freshwater snail &

Cyprinid fish (IH); ↑IgE

Fasciola hepatica = SHEEP LIVER FLUKE / COMMON LIVER

FLUKE (Vector: Water plants); Sheep liver rot

Paragonimus westermanni = ORIENTAL LUNG FLUKE; (Vector:

Crab/Crayfish); Snail & Crab (IH); Pulmonary
distomiasis; Charcot-leyden crystals in sputum/lung
tissue

Schistosoma japonicum = ORIENTAL BLOOD FLUKE; Katayama

fever/Acute schistosomiasis; SMALL LATERAL
Spine

Schistosoma mansoni = MANSONI’S BLOOD FLUKE (Live in veins of

intestine); Swimmer’s itch & dysentery;
Biomphalaria (IH); LARGE LATERAL Spine

Schistosoma haematobium = BLADDER FLUKE / VESICAL BLOOD FLUKE

(lives in the vein of bladder); Squamous Cell
Carcinoma in bladder; Bulinis (IH); Katayama fever
& Bilharziasis; LARGE TERMINAL Spine

DRUGS
 ARRIOLA, SKG MLS-4A

F. buski: Praziquantel

H. heterophyes: Praziquantel (3x for 1 day)

C. sinensis & Opistorchis: Praziquantel (25 mg/kg: 3x a day for 2 days)

Fasciola spp.: Triclabendazole

P. westermani: Praziquantel (3x a day for 2-3 consecutive days)

S. mansoni & S. haematobium: Praziquantel (Single oral dose of 40 mg/kg

divided into two doses)

S. japonicum: Praziquantel

CESTODES
Dibothriocephalus latus FISH TAPEWORM / BROAD TAPEWORM; Copepod fish

/ Diphyllobothrium latum = & Freshwater fish (IH); Operculum in one end; 2 suckers
 ARRIOLA, SKG MLS-4A

Dipylidium caninum = CAT TAPEWORM/DOG TAPEWORM/PUMPKIN SEED

TAPEWORM/ CUCUMBER SEED TAPEWORM; Flea
(IH); 4 suckers

Hymenolepis nana = DWARF TAPEWORM; Fleas & Flour beetles (IH);

pumpkin seed gravid proglottid; 4 suckers

Hymenolepis diminuta = RAT TAPEWORM; Fleas & Beetles (IH); 4 suckers

Taenia solium = PORK TAPEWORM; Swine & Humans (IH); adult worm in
upper jejunum; Cysticercosis

Taenia saginata = BEEF TAPEWORM; Cattle (IH); 4 suckers; Radial

striations on yellow brown embryophore

T. multiceps = BLADDER WORM; Staggers; Gastrointestinal disease

Echinococcus granulosus = DOG TAPEWORM/HYDATID TAPEWORM; Smallest

tapeworm with 3-5 proglottids; Hepatomegaly

DRUG
D. latum: Niclosamide (2 gm per orem; stat after light breakfast)

D. caninum: Praziquantel & Niclosamide

H. nana & H. diminuta: Niclosamie (4 tablets chewed in a single dose daily for 5 days)

T. solium: Niclosamide (2 gm per orem stat)

T. saginata: Niclosamide (4 tablets chewed in a single dose) & 100mg (2x

daily for 3 days)
 ARRIOLA, SKG MLS-4A

E. granulosus: Surgery; Albendazole (400 mg 2x a day for 1-8 periods of 28

days each, separated by drug-free rest intervals of 14-28
days)

INTESTINAL PROTOZOA
MOTILITY
PATHOGENIC (AMOEBA):
E. histolytica: Directional, Progressive with hyaline, fingerlike pseudopods;
Cigar/Barr shaped cyst; “Bull’s Eye” Karyosome; Produce
“Flask-shaped” Ulcer; Ground glass appearance; Hematophagus
in nature
E. coli: Sluggish, Non-Directional, Non-progressive, with blunt
pseudopods
E. hartmanni: “Small Race Histolytica”; Usually non-progressive; occasionally
progressive

NON-PATHOGEN (AMOEBA):
 ARRIOLA, SKG MLS-4A

E. polecki: Usually sluggish, similar to E. coli in diarrheic specimens, may

be progressive
E. nana: Sluggish, usually non-progressive; SMALLEST INTESTINAL
PROTOZOA; “Cross-Eyed” Cyst
I. butchlii: Sluggish, usually non-progressive; “BASKET” nucleus
E. gingivalis: No cyst; Contains WBC

PROTOZOA FROM OTHER SITES OF THE BODY (AMOEBA):

Naegleria fowleri: Primary Amebic Encephalitis; SMOOTH wall; RAPIDLY
motile
Acanthamoeba spp.: Granulomatous Amebic Encephalitis & Acanthamoeba Keratitis;
WRINKLED wall; SLOWLY motile
FLAGELLATES:
Giardia duodenalis / Giardiasis; Traveler’s Diarrhea,
Giardia lamblia / Gay Bowel Syndrome, Steatorrhea
Giardia intestinalis: Motility = Falling Leaf; Cyst=Green, Glowing; Bilaterally
Symmetrical
Chilomastix mesnilli: Non-pathogen; Motility = Stiff, rotary, corkscrew-like, Spiral &
jerky; “Shepherd’s crook” appearance”; NIPPLE Cyst
Dientamoeba fragilis: Symptomatic infection; Motility = Sluggish; No flagella,
resemble E. nana & E. hartmanni; Tetrakaryosome
Trichomonas vaginalis: Persistent urethritis, vaginitis, Infant T. & vaginalis infection; No
Cyst; Pear-shaped Motility = Rapid, jerky
Trichomonas hominis: Non-pathogenic; Motility = Rapid, jerky; often recovered from
diarrheic stool; Resembles E. nana cyst
Trichomonas tenax: Non-pathogenic; Motility = Rapid, jerky; recovered from
teeth/gums/tonsillar crypts
Retortamonas intestinalis: Pyriform; Bird’s Beak Fibrillar Appearance; Resembles C.
mesnili cyst; Not tissue-invading
CILIATES:
Balantidium coli: Motility = Rotary, boring; Kidney-shaped troph & ovoid cyst;
bodty covered with spiral, longitudinal rows of cilia, Lugol’s
iodine for staining
COCCIDIA, MICROSPORIDIA:
 ARRIOLA, SKG MLS-4A

Cryptosporidium spp.: Motility = Nonmotile; 4 “naked” sporozoites, no nucleus &

sporocyst
Blastocystis hominis: Motility = Nonmotile; Location: “Rim” of cytoplasm; nuclei
may be at opposite ends
Cytoisospora belli: Motility = Nonmotile; 2 sporocysts with 4 sporozoites each; No
nucleus; Immature oocyst (Diagnostic stage); String test or
biopsy of duodenal specimens if negative in stool exam
PROTOZOA FROM OTHER SITES OF THE BODY (COCCIDIA):
Toxoplasma gondii Sabin Feldman Dye Test (Gold Standard)

BLOOD & tISSUE PROTOZOA

SPOROZOA:
Plasmodium falciparum: MAURER’S CLEFT; Gametocyte: Crescent/sausage shape;
ACCOLE Forms; Affect ALL RBCs; SEVERE Anemia; Very
common in CNS, 36-48 hours periodicity; HISTIDINE RICH
PROTEIN II (specific for falciparum)
Plasmodium vivax: SCHUFFNER’S DOTS; MILD-MODERATE Anemia; Possible
Nephrotic Syndrome; Affect Young RBCs 48 hours periodicity
Plasmodium ovale: SCHUFFNER’S DOTS; Possible in CNS; Rare in Nephrotic
Syndrome; Affect Young RBCs; 48 hours periodicity
Plasmodium malariae: ZIEMANN’S STIPPLING; Occasional ROSETTES; Affect
OLD RBCs; Very common Nephrotic Syndrome; 72 hours
periodicity
Plasmodium knowlesi: SINTON & MULLIGAN STIPPLING; Occasional ROSETTES;
Possible CNS; Affect ALL RBCs
Babesia spp.:
B. microti: Hosts: Rodent (White-footed mouse Peromyscus leucopus) &
Tick (Ixodes); Humans infected when beaten by infected ticks
B. divergens:
B. duncani:

Leishmania spp.:
L. tropica: Old World Cutaneous Leishmaniasis, Oriental Sores, Delhi
Boils, Baghdad Boils, Dry/Urban Cutaneous Leishmaniasis
 ARRIOLA, SKG MLS-4A

L. braziliensis: Mucocutaneous Leishmaniasis, Chilero Ulcer, Espundia, Forest

Yaws, Pian bois, Uta
L. donovani: Visceral leishmaniasis, Kala-azar, Dum Dum Fever
Trypanosoma spp.:
T. bucei gambiense: West African Sleeping Sickness & Gambian Trypanosomiasis;
Vector: Tsetse Fly; Trypomastigotes are only stage found in
patients
T. brucei rhodesiense: East African Sleeping Sickness, Rhodensian Trypanosomiasis;
Vector: Tsetse Fly; Trypomastigotes are only stage found in
patients
T. Cruzi: Chaga’s Disease, American Trypanosomiasis; Hallmark:
ROMANA’S SIGN; Vector: Reduviid Bugs; TRIATOMA
(Kissing bug)
 ARRIOLA, SKG MLS-4A

PARASITOLOGIC TECHNIQUES:
1. Wet Mount Preparation
Lugol’s Solution Dilution: 1:5
Alternative of Lugol’s: Dobell & O’Connor Iodine; D’Antoni Iodine
Specimen w/ 10% Formalin: A drop of saline is omitted from unstained
preparation
Feces Ideal Amount: 2mg of Feces to each drop and mix well
Coverslip size: No. 1 (22mm square)
Standard Sedimentation Method: Formalin-Ethyl Acetate Sedimentation (FES)
Method
Floatation Procedure: Zinc Sulfate Method (MOST COMMON)

QUALITY ASSURANCE:
PARASITOLOGY SECTION SHOULD HAVE:
1. Reference book collection, including texts & atlases
2. Set of digital images of common parasites
3. Set of clinical reference specimens, including permanently stained smears & formalin-preserved feces

MICROSCOPE
Calibration for micrometer for each objective:
a. Stage micrometer = 0.1mm line that is ruled in 0.01mm units
b. Ocular micrometer = ruled in 100 units but has no value assigned to the units
NOTES:
Copro Antigen Test: G. lamblia, C. parvum, & E. histolytica
Circum Oval Precipitin Test: Lyophilized egg of S. japonicum (BLEB formation)
BECK’S Xenodiagnosis: Use ALBINO RATS for T. spiralis