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INTRODUCTIONTOCLINICALparasitology

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SCOPEOFCONTENTS

Applicationstoexaminetheclinicallaboratorydiagnostics
tool

Whatisaparasite?

Amoebaandotherprotozoa

Theworms

Diagnosticmethods

Clinicalparasitologyspecialfeatures

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REQUESTSFORCLINICALRESEARCH

LABORATORYDiagnosticTool

Clinicallaboratorytestsareordered
Therequest

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Researchrequestcomprisesthesubscribersurvey,
thepatient'spersonaldata,thedesired
laboratoryexaminationsaswellastheessentialbackgroundinformation

Thelaboratorystudiesused
laboratorytests

Isintendedforlaboratorytests
toharmonizehealthcarerequestand
Answerpractices

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REQUESTSFORCLINICALRESEARCH

LABORATORYDiagnosticTool

ThestudyconsistsofAcronym:
0

systeemilyhenteest(=samplematerial)

tutkimusnimilyhenteest(=theanalyte)

rearappendix(=method)

Eachlaboratorytestsaredefinedintheirown
themeasuringunitorotherresponseform

LaboratoriotutkimusnimikkeistmaintainedbyLocalandRegionalAuthorities

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REQUESTSFORCLINICALRESEARCH

LABORATORYDiagnosticTool

Example:Helicobacterpyloridiagnostics

1)

FHepyAg(=antigendetection)

2)

PtHepyR(=breathtest)

3)

TsHepyVi(=culture)

4)

HepyAbS(=antibodyassay)

(Note.TheH.pyloriisabacterium!)

Helicobacterpylori.
Photo:WikimediaCommons

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REQUESTSFORCLINICALRESEARCH

LABORATORYDiagnosticTool

Alittlemotivation..

Whatisofparticularbenefittothecultivationmethod(TsHepyVi)
couldbe?Thinkaboutitintermsofpatientcare.
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Klebsiellapneumoniaecolonies
CLEDplate.Photo:AkiRonkainen

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REQUESTSFORCLINICALRESEARCH

LABORATORYDiagnosticTool

Functioningand
effectivetreatment
Sampling

condition:

Medicalstaff

Diagnostic

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Whatisaparasite?

Theparasiticorganismisaparasite,usingasecondorganism
(host)toproducethisbenefit.

Inmedicine,parasitesusuallybeincludedinsuch
parasiteswhicharenotcoveredbyviruses,bacteriaorfungi
context.

Parasitescanbecategorizedinmanydifferentways.

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Whatisaparasite?

Sharing

Traditional
habitat
distribution:

Accordingto:

Protozoa

Worms

Ihoparasiitit
Suolistoparasiitit
Veriparasiitit

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Arthropods
Kudosparasiitit

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Whatisaparasite?

Onthebasisofthetraditionalallocationmaybe
notedthattheparasitesareeukaryotes
andthattheyoccurinnumerous,very
distanttaxonomiccategories.

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Whatisaparasite?

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Eukaryoticphylogenetictree.
Photo:BrockBiologyofMicroorganisms,13thEdition

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Whatisaparasite?

Parasitecharacteristics

Eachofyourtypical(complex)
lifecycle
Thehostorganismisinadditiontoanynumberofintermediate
hosts
Avarietyofprotectivehosts
Yourimmunesystem
Pathogenicityvs.apatogeenisuus Allparasites
donotcausedisease!
thevirulenceofparasitesvaries
Thereareendemic,ietheprevalencevariesgeographic

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Amoebaandotherprotozoa

Protozoahavetraditionallybeenclassifiedas
modeoftravel:

Sarcodina(juurijalkaisetaamoeba):
castlegs,orpseudopodiat
Flagellata(dinoflagellates):flagella
cilia(ciliates):ietheciliaCilia
Sporozoa(apicomplexa):incapableofmovement

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Amoebaandotherprotozoa

Terminology

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trophozoite:Initialanimalnutrition
accommodating,fertileform

Cysts:thickwalled,thehostorganism
externalconditionsforsustainableform
Manyparasitesalsootherformsof

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Amoebaandotherprotozoa

Entamoebahistolytica(amoeba)

pathogen,whichcauses
amebiaasia
Occursworldwide
Infectiousfecesfootpathway
Thecauseofdiarrheaand/or
maksapaiseen
Itcannotbeseparatedfromthe

Entamoebahistolytica.
Photo:CDC/Dr.GeorgeHealy

microscopicallyEntamoeba
disparamebasta

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Amoebaandotherprotozoa

E.histolytica'slifecycle.
Photo:WikimediaCommons

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Amoebaandotherprotozoa

Giardialamblia(flagellateprotozoan)

pathogen,causing
giardiaasia
Occurs
worldwide

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Infectiousfecesfootpathway
Thecauseofdiarrhea

Giardialamblia.Photo:CDC

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Amoebaandotherprotozoa

Giardialamblia'slifecycle.
Photo:WikimediaCommons

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Amoebaandotherprotozoa

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Toxoplasmagondii(sporozoan)

Thecauseoftoxoplasmosis
Humanthemostcommonlatent
protozoalinfections
Infectiouscatfaeces,
soilormeat
Pregnantwomenatrisk
Thereisexcretedinthefaeces

FelixthecatSaturdaynight.
Photo:AkiRonkainen

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Amoebaandotherprotozoa

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Toxoplasmagondii,thelifecycle.
Photo:WikimediaCommons

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Theworms

Ahumanpathogenicworms

dividedintothreegroups

Nematodes,ornematodes

Trematoda,ortrematodes

Cestodathatis,tapeworms

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Theworms

Nematodes,ornematodes

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Long,narrowbody,circularincrosssection
Advancedbowel,andfootandanus
Movingactively
Severalhumanpathogenicspecies
Dependingonthespeciesthatinfecttheintestinesaswellasthe
Tissues
Generallyunisexual

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Theworms

Ascarislumbricoides,orRoundworm(nematode)

Appearsacrosstheplanet
Theinfectionisacquiredbyeatingeggsfoodincluded
Intheintestine,theeggisreleasedfromthecaterpillar
Larvacirculatesinthebody:theliver heartlungs
intestine
Duringthecycleacaterpillardevelopsafullgrownworm
Infectionisusuallyasymptomatic,butcancauseeg.
sappitietukoksen

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Theworms

Ascarislumbricoides.Left:amatureegg.Right:adult
worm.Photos:(.Right)WikimediaCommons(.Left)andCDC

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Theworms

Pathogenicnematodeeggs:

Trichuristrichiura(whipworm).
Photo:WikimediaCommons

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Enterobiusvermicularis
(pinworm).
Photo:WikimediaCommons

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Theworms

Trematoda,ortrematodes

Flatjuotikasmainenbody
Imukuppimainenmouthandforked
thegastrointestinaltractwithoutanus
adhesiveintothebodybymouthandbody
suctioncups
Movingactively
Hermaphroditic(exception:Schistosoma)

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Theworms

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Schistosomamansoni(trematodes).
Photo:WikimediaCommons.

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Theworms

Thatis,tapewormsCestoda

Jaokkeellinenbody
Navigatinglow
Infectiousintestinalwallspecial
gripping,byanextensionofthe
theneckportionarecontinuouslycreatednewjaokkeita

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hermaphroditic

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Theworms

Taeniasp.(egg).Lugolstainedmicroscopy
formaliininytteestfaeces.
Photo:AkiRonkainen

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Theworms

Diphyllobothriumlatum(tapeworm).
Lugolstainedmicroscopy
formaliininytteestfaeces.Infected
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cangetbadlycookedfish.
Right:larva.Bottom:theegg.
Photos:AkiRonkainen

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Diagnosticmethods

Parasitesarephylogeneticallyveryheterogeneous
Group Eachparasiteownrequirements
usedinthemethod

Finlandsixmostcommonresearchcovers95%
parasiteexaminations

Theremaining5%oftherangeofspecialinvestigations

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Diagnosticmethods

Themostcommonparasitestudies

FParaO(alkuelinkystatandwormeggs)
FlTrHiVi(Trichomonasvaginalis)
EnveO(pinworm)
BPlasO(malariaplasmodit)
PncaAg(Pneumocystiscarinii)
FCrypVr(Cryptosporidiumparvum)

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Diagnosticmethods

FParaORequirements

Usedtodetectearlyorganismsandwormeggs
Fecesresuspended(1:5)of10%formalinparasites
tofix
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Thesampleisconcentratedbyfiltration,andsuch.
etyyliasetaattiksittelyll
AdropofthesampleisstainedwithLugol'ssolutiononaglassslide,and
mikroskopoidaan100400xmagnification
Identificationofparasitestakesplaceonthebasisofthemorphology
Thesamplewillbeansweredallfindings,whetherapathogen
orapatogeeni

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Diagnosticmethods

FParaOChallenges

Parasiteexcretioninthefecesisintermittent,
recommended2to3samples
representativenessofthesampleisimportant,wellmixedsample
imperative
Requiresexperience!
EntamoebahistolyticacannotbeseparatedfromaEntamoebadisparby
morphologically RecommendationFEhistAgresearch
Dientamoebafragilis:notkystamuotoa
coccidiaCryptosporidium,Isospora,andCyclospora
(apicomplexa)maygounnoticed RecommendationFCrypVr

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Diagnosticmethods

Existingmethods

ofcoloring:themodifiedZiehlNeelsenstaining(F
CrypVr)andMayGrnwaldGiemsastaining(B
PlasO)
AntibodyAssays(SAmebAbandSToxoAb)
PCR(ToxoNhO)
antigendetection(FEhistAg,FGiCrAg)
Also,methodsofcultivation(FlTrHiVi)

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Clinicalparasitologyspecialfeatures

Theprevalenceofparasitesvariesgreatly:some
foundeverywhere,othersonlyincertainregions

Inparticular,theproblemofdevelopingcountries(hygiene)

Travelingincreasedspreadofdiseasesendemic
areas

Alldiseasesarenotlethal(theparasiteecology)

Immunosuppressionpredisposepatientstoinfections,andcannotdo

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alifethreateninginfection

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Clinicalparasitologyspecialfeatures

Parasiticinfectionissuspected,itisabsolutely
matkustusanamneesiimportanttoknowthepatient'ssymptomsand,
inordertoknowhowtoasktherightresearch

Thediscoveryofasingleparasitedoesnotexcludeother
(coinfection)

Clinicalchemistryandhematologytests
parasitologicaldiagnosticsupport

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Clinicalparasitologyspecialfeatures

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Andyetasareminder:

Sampling

Medicalstaff

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Diagnostic

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