PARASITOLOGY

- the study of the parasites

- the science that deals with a specialized group of animals which are physiologically dependent
on other organisms for their survival
 Parasites
 organisms ranging from microscopic to macroscopic which are known to inflict disease in man
 exhibit great diversity in morphology and physiology
 animals depending on bigger organisms for food and shelter
 has intimate almost always obligatory relationship with the host (ALWAYS harms the host)

 Ascaris lumbricoides
 compete for available nutrients (sugars, proteins, fats) in the food we had already eaten
 tangled worms may obstruct the gut
 may damage vital organs during erratic migration
o Description:
 Harms its Host
 Associated closely with host and derive nutrition from host

PARASITES
 CLASSIFICATION OF PARASITES
A. According to Location
1. Ectoparasites
-found outside or on the surface of the body of the host
-may cause INFESTATION
-ex) Scabies (Sarcoptes scabiei – human itch mite)

2. Endoparasites
-found living within the host in any internal organs (GIT, Respiratory Tract, RBCs)
-may cause INFECTION
-examples of Endoparasites :
 Ascaris (GIT Lumen)
 Plasmodium (RBC) – Malarial Parasite
 Schistosoma (Mesenteric Veins)
B. According to Degree of Association
1. Obligate Parasite
-those who cannot survive or reproduce outside the host
-always parasitic (must always be in contact with a susceptible organism)
-ex) Trichomonas vaginalis
2. Facultative Parasite
-those that may exist in a free living state or as a commensal
-if opportunity presents itself, they may become Parasitic
-they can both live as free living or parasitic parasites
-ex) Strongyloides stercoralis
3. Permanent Parasite
- if the live continuously in the host, and remain in the body of the host – from the
early stage until maturity
- requires continuous contact with the host

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 4. Intermittent (Temporary) Parasites
- contact with the host is only temporarily – closely associated with its host
temporarily to feed
5. Accidental Parasites
- enters the host that is not normally its host
- does not develop to full maturity since the host is not physiologically compatible
- association lasts only for a short time
 TYPES OF HOST
1. Definitive Host
- harbors the sexual or the mature stage of the parasite (site where sexual
reproduction occurs, if present)
-ex) Man, Pig, Dog, Mosquitoes
 Mosquitoes: definitive host in Malaria
 Ascaris: man is the definitive host
2. Intermediate Host
- host that harbors the asexual or the immature / larval forms of the parasites
- site where the asexual reproduction occurs
- Paratenic Host: host in which the parasite does not undergo any development
3. Reservoir Host
- these are the animals that harbor the parasite that are also parasitic to man
- site where the asexual reproduction occurs
4. Accidental (Incidental) Host
- these are the hosts that accidentally ingested the Parasites (that usually affect
the animal kingdom)
- infection occurs in a host other than the normal host species
5. Vector
- an invertebrate animal that transmits a parasitic organism from one host to
another
- has two types: Mechanical Vector + Biological Host

 Mechanical Vector: an invertebrate animal which merely transfer parasitic

organisms from one host to another (by carrying feces on their feet)
-ex) Flies, Cockroaches

 Biological Vector
- there is a development of the parasite inside the host
- harbor the parasite internally in which it may undergo further development,
multiplication, or both
- ex) Mosquitoes in Malaria
 TAXONOMIC GROUPINGS OF PARASITES
A. Protozoans (Unicellular Eukaryotic Parasites)
o Phylum Sarcomastigophora
o Phylum Apicomplexa
o Phylum Microspora
o Phylum Ciliophora
PHYLUM REPRODUCTION LOCOMOTION SPECIES

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 Sarcomastigophora: Asexual Pseudopodia Entamoeba
Sarcodina histolytica
Sarcomastigophora: Asexual Flagella Giardia lamblia
Mastigophora Dientamoeba fragilis
Trypnasoma spp
Loishmania spp
Apicomplexa Asexual & Sexual None Plasmodium spp
Toxoplasma
Sarcocystis
Ciliophora Cilia Balantidium coli

1. Phylum Sarcomastigophora
- has Subphylum: Sarcodina and Mastigophora
- both reproduce Asexually

a. Subphylum Sarcodina
- move by Pseudopodia (can only move in one direction)
- Pseudopodia: cytoplasmic protrusions
- ex) Amoeba, Entamoeba (pathogen)

b. Subphylum Mastigophora
- move by flagella (Flagellates)
- Flagellum: long threadlike extension of cytoplasm
- ex) Giardia, Trypanosoma, Leishmania, Trichomonas

2. Phylum Apicomplexa
-no locomatory organ
-have a complex life cycle with alternating sexual and asexual generations
-Blood Parasites that cause Malaria: Isospora, Cyclospora, Cryptosporidium,
Sarcocystis
-Other Parasites: Taxoplasma, Sarcocystis

3. Phylum Ciliophora
-move by beating of many Cilia
-mostly free living and symbiotic species
-ex) Balantidium coli (the only pathogenic ciliate)

4. Phylum Microspora
-no locomatory organ
-intracellular parasite of many kinds of vertebrates and invertebrates
-rarely cause disease in immunocompetent persons

B. Helminths (Metazoa; Wormlike Invertebrates)

PHYLUM PHYLUM PLATYHELMINTHES
ASCHELMINTHES
CLASS NEMATODA CLASS CESTODA CLASS TREMATODA
AKA Round worms Flatworms Flukes

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 Shape Elongated, Cylindrical Elongated, Ribbon Leaf-shaped,
Like Elongated
Segmentation Unegmented Segmented Unsegmented
Sexes Separate Hermaphrodite Hermaphrodite

1. Phylum Aschelminthes
a. Class Nematoda -Nematodes or Roundworms
-elongated, cylindrical worms attenuated at both ends
-unsegmented worms; sexes are separate
-reproduction by:
 Oviparous (ex. Ascaris, Enterobius)
 Viviparous (ex. Trichinella, Filarial Worms)

**Infection by:
 Ingestion of Eggs (ex. Ascaris, Trichuris)
 Skin penetration by Larvae
 Vector Borne
 Ingestion of Encysted Larvae
2. Phylum Platyhelminthes
-also called Flatworms – multicellular animals characterized by flat, bilaterally
symmetric body
-most Flatworms are Hermaphroditic, having both male and female reproductive
systems

a. Class Trematoda -majority are transmitted by ingestion (except –

Schistosoma)
-unsegmented
-Hermaphroditic
-flattened, leaf-shaped or cylindrical
-Order Digenea: contains all species that are parasitic to
humans
-Infection by: Metacercariae ORSkin penetration by
Cercariae

b. Class Cestoda -segmented

-Hermaphroditic, ribbon like
-reproduction by: Oviparous (Ex. Taenia); multiplication of
larval forms
-Infection by: Ingestion of Encysted Larvae

C. Arthropods
1. Phylum Arthropoda
-have segmented body parts: Head Thorax and Abdomen
-have three to four pairs of jointed appendages and covered by hard chitinuous
skeleton
-bilaterally symmetrical body

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 **Classes in Phylum Arthropoda
CLASS DESCRIPTION EXAMPLE
Crustacea Some serve as intermediate Crabs, shrimps, copepods
hosts
Chilopoda Centipedes
Arachnida spiderlike Scorpions, spiders, ticks,
mites
Insecta Includes most important of
arthropods

**Class Insecta
 Order Anoplura
 Order Hemiptera
 Order Coleoptera
 Order Hymenoptera
 Order Siphonaptera
 Order Diptera
LIFE CYCLES

I. TWO TYPES OF LIFE CYCLES:

-Parasites undergo a Life Cycle during its existence
-it involves survival and development in the external environment and in one or more hosts
-life cycle consists of the various morphologic forms and developmental stages
-life cycle summarizes development of the parasite from the time it leaves the host to start a
new infection in a
new susceptible host
-knowledge of life cycles = preventive measures

A. Direct Life Cycle

-there is no intermediate host required to transmit the parasite from one host to another
-parasites are transmitted from an infected individual to a susceptible host without
requiring an
intermediate host

**Ex1) Trichomonas vaginalis

-direct cycle where the parasite is immediately infective when it leaves the
host
-Man  Man

**Ex2) Ascaris lumbricoides

-direct life cycle where the parasite develops into the Infective Stage in the
external
environment
-Man  Development in External Environment  Vectors (optional) 
Man

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 B. Indirect Life Cycle
-at least one intermediate host / vector is required for the parasite to complete its
transmission from the
originally infected host to the susceptible potential new host
-the infective stage of the parasite develops in the Intermediate Host and the
Susceptible Host acquires
the infection through contact or exposure to the infected intermediate host

**Ex) Schistosoma japonicum, Capillaria phiippinensis

-Man  Intermediate Host  Contact / Ingestion of Raw Intermediate
Host  Man

II. COMPONENTS OF THE LIFE CYCLE

A. Infective Stage
-stage of development of the parasite which when ingested to the definitive host will
result to infection
-in the direct life cycle: Infective Stage comes from original infected host
-in the indirect life cycle: it originates from the Intermediate Host or Vector
-ex) Ascaris – Infected Stage is the Embryonated Egg

B. Portal of Entry
-refers to site of opening in the susceptible host through which the infective stage enters
-most common portal of entry: Mouth, Skin, Nose
-ex) Ascaris – Portal of Entry: Mouth

C. Mode of Transmission
-refers to the process on how a new host acquires the infective stage of the parasite
-man could acquire it by: Ingestion, Inhalation, Infected Intermediate Host, Skin
penetration, Inoculation
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 -ex) in Ascaris – Ingestion of Embryonated Egg; Hookworm by Skin penetration of Larva

D. Path or Route of Migration

-when the infective stage of parasite enters the new host, it usually undergoes without
maturation stages
-different developmental stages of parasites may occur in different parts or organs

E. Developmental Stages
-the parasite undergoes different developmental stages as it moves from the original
infected hosts to
the environment, inside the intermediate hosts & even w/in the new susceptible host
before settling down
-ex) For Helminths, developmental stage is Egg, Larva, Immature Adult and Adult

F. Habitat
-refers to the specific organ or site in the definitive host’s body where the sexually
mature parasite resides
-ex) Habitat of Ascaris is in the Lumen of Small Intestines

G. Portal of Exit
-opening or site in body wherein parasites leave the infected hosts to find a new
susceptible host
-ex) Eggs of Ascaris leave the host through the Anus

H. Diagnostic Stage
-stage passed out by the host or taken up by the vector or intermediate host
-serves as a basis for establishing presence of the parasite in host or diagnosis of
infection

II. PARAGONIMUS WESTERMANI

 Paragonimus westermani = Affects the Human Lungs (Lung Fluke)
 Transmission = Ingestion of Insufficiently cooked Crabs or Cray Fish infected with
Metacercariae
 Infective Stage = Metacercaria
 Diagnosis = Finding Medium Sized Operculated Ova in the Sputum
 Pathology = Acute, Subacute Inflammations of Lung Tissue; it may also wander erratically to
Brain and Skin

**IMPORTANT Note:
o Clinically, it is usually Mistaken with Tuberculosis Symptoms due to Hemoptysis
o TO Differentiate, we find Operculated Ova in the Sputum, instead of Acid Fast Bacilli

III. LIFE CYCLE OF P. WESTERMANI

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  Type = Indirect Life Cycle (One or Two Intermediate Hosts and One Definitive Host)
 Immature Larvae develops inside the Intermediate Host and Matures into Adult Stage inside
Man
 Mode of Transmission = Ingestion of Raw Infected Crabs / Crayfish
 Diagnostic Stage = Eggs in Sputum / Stool
 Infective Stage = Metacercariae from Crabs
 Definitive Host = Man
 1st Intermediate Host = Snails
 2nd Intermediate Host = Crabs / Crayfish

DEFINITIVE HOST = MAN SNAILS CRABS / CRAYFISH

Ingestion of Raw Infected Miracidium

Cercariae
Crabs / Crayfish Hatches & Penetrates Snail Enter the
Crabs

Immature Worm Sporocyst Encysts to form Metacercaria

Migrate into Peritoneal Cavity,
Diaphragm and Lungs Radiae

Adult Worm Cercariae Metacercariae

Encysted in Lung Tissue (Infective Stage)
(Lungs have Cavitary Lung Lesions,
Cough, Pleuritic Pain, Hemoptysis) Cercariae is released in the
Water
Eggs
in Sputum or Stool

III. DESCRIPTION OF THE SLIDES:

A. Paragonimus westermani Adult
-Plump, Ovoid
-Reddish-Brown Fluke (8-20mm in length; 5-9mm in breadth)

**Diagnostic Features of this Fluke

 Scale-Like Integumental Spines
 Two Equal-Sized Ventral & Oral Suckers located in the Anterior Half

**Other Structures:
 Two Lobate Testes situated Side-by-Side
 Centrally Located Lobate Ovary Anterior to the Testes
 Laterally, the entire body is occupied by the Highly Branched Vitellaria
 Excretory Bladder
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  Coiled Uterus

B. Paragonimus westermani Egg

-Medium Sized, Oval Shaped Egg (85 x 55u)
-Operculated: has a characteristic Broader Operculated Anterior End and a Thicker
Posterior End
-expectorated in Sputum or when swallowed, it can be detected in Feces in
Unembryonated Stage

EXPERIMENT 27: SPOROZOANS

INTRODUCTION
 Sporozoans = Group of Unicellular Parasites with a characteristic Apical Complex
 Has NO Locomotory Organelles (except for Flagellated Microgametes in some groups)
 Plasmodium = Commonly seen in Man which can cause Malaria
 Classification of Sporozoans (Based on Affected Organ)
o Blood Sporozoans
o Tissue Sporozoans

I. SLIDES TO VIEW:
 P. falciparum = Trophozoites, Schizonts, Gametocytes
 P. vivax = Trophozoites, Schizonts, Gametocytes
 P. malariae = Trophozoites, Schizonts, Gametocytes
 P. ovale = Trophozoites, Schizonts, Gametocytes

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II. PROCEDURE
 Stained Blood Smears are shown
 Pay attention to the Size of the Normal and Parasitized RBC, number of Chromatin Dots,
Amount of Hemozoin Pigments, Appearance of the Cytoplasm, and presence / absence of
Stippling on the Infected RBC’s Cytoplasm

III. STRUCTURE OF THE PARASITE (PLASMODIUM)

Host RBC
Stippling

Cytoplasm

Chromatin Vacuole

IV. LIFE CYCLE OF MALARIA PARASITES

 Type of Life Cycle = Indirect Cycle
 Infective Stage = Sporozoites
 Diagnostic Stage = Gametocytes
 Biologic Vector = Female Anopheles Mosquito
 Definitive Host = Female Anopheles Mosquito
 Intermediate Host = Human
 Two Phases = Human Phase + Mosquito Phase

V. OTHER IMPORTANT SPOROZOANS:

 Cryptosporidium
 Isospora
 Blastocystis
 Pneumocystis carinii
 Toxoplasma gondii

V. STAGES OF THE PARASITE

 Asexual Stages = Trophozoites + Schizonts
 Immature Sexual Stages = Gametocyte
 NOTE: Man is just an Intermediate Host in Malarial Infections because they harbor only the
Immature Forms of the Parasite (the Mature forms are found in the Mosquito)

A. Trophozoites (Ring Form)

-it is the earliest stage
-they develop from Sporozoites in the Pre-Erythrocytic (Hepatic Schizogony) Cycle; in
the Blood Cycle,

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 it develops from Merozoites – therefore, we see Throphozoites in BOTH Cycles of
Human Phases
-with ONE or TWO Chromatin Dots
-ring-like structures with Few Malarial Pigment

**Chromatin Dots:
 Usually only ONE!
 P.falciparum (exception) = More than One in Trophozoite Stage (thin ring like
cytoplasm)

**Cytoplasms:
 Compact Cytoplasm = P.ovale and P.malariae
 Thin Delicate Cytoplasm = P. falciparum
 Amoeboid Cytoplasm = P.vivax
 Band form Cytoplasm = P.malariae

B. Schizonts
-once the Chromatin Dot divides by Binary Fission, Parasite is now a Schizont
-with Two or More chromatin Dots (Chromatin Dots now develop to form Merozoites)
-with plenty or increasing amount of Malarial Pigment (Hemozoin Pigment) in Cytoplasm
-can be divided into Growing / Immature and Mature (Cryptozoites) in the Pre-
Erythrocytic Cycle

**Merozoites
 P.falciparum = 12-32
 P.vivax = 12-24
 P.malariae = 6-12
 P.ovale = 4-12

**Tissue Schizonts:
 Primary Tissue Schizonts
 Secondary Tissue Schizonts

C. Gametocytes
-it is only an Immature form of the Sexual Forms of the Parasite
-Banana Shaped in P.falciparum or special with definite Chromatin material
-develops from Merozoites

DECSRIPTION OF THE SPECIES

I. MORPHOLOGY (From Lab Manual)

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 P. falciparum P. vivax P. malariae P. ovale

Trophozoite Size: Small-Medium Size: Small-Large Size: Small Size: Smaller than
Number: Numerous Number: Few- Number: Few vivax
Shape: Moderate Shape: Ring to Number: Few
Ring&Comma Form Shape: Broken Round Shape: Ring to
Chromatin: Two Ring Chromatin: Single Round
Dots Chromatin: Single Cytoplasm: Chromatin: Single
Cytoplasm: Regular Cytoplasm: Regular Cytoplasm:
Mature Forms: Irregular Pigment: Scattered Regular
Compact Mature Forms: Pigment: Course,
Pigment: Coarse Compact Scatter
Grains Pigment: Fine
Scattered

Schizont Associate w/ Ring Size: Large Size: Small, Size: like malariae
Forms Number: Few- Compact Number: Few
Size: Small, Moderate Number: Few Mature: 4-12
Compact Mature Form:12-24 Mature Form:6-12 Merozoite
Number: Few Merozoite Merozoite Pigment:
Mature Form:12-13 Pigment: Loose Pigment: Concentrated
Merozoites Mass Concentrated
Pigment: Single Daisy Flower Like
Dark Mass

Gametocyte Mature: Banana Mature: Round Mature: Round Mature: Round

Shaped Pigment: Scattered Chromatin: Single Chromatin: Single
Chromatin: Single Pigment: Scattered Pigment:
Pigment: Scattered Peripherally Scattered

II. GENERAL CHARACTERISTICS (From Notes)

FORM P. falciparum P. vivax P. malariae P. ovale
Infected RBC Not Enlarged Enlarged Not Enlarged Enlarged
Size
Shape Round but may be Round Round Oval; Fimbriated
Crenated

Stipplings Maurer’s Dots Shuffner’s Dots Zieman’s or Shuffner’s Dots

James Dots
Trophozoites Small Rings Small & Large Small Compact Small; Compact
Multiple w/ Acole Rings Rings Rings
Forms Amoeboid Band Forms

Schizont Rare (Seen in Irregular Compact; Round Compact

Severe Cases) Contours

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 # of 12-32 12-24 6-12 4-12
Merozoites Forms Regular Forms Irregular
Rosette-Like Rosette-Like
Clusters Clusters

Gametocyte Banana / Sausage Round-Large Round, Compact Round, Small

Shape

ANSWERS TO QUESTIONS
 Plasmodium falciparum Schizont VS Plasmodium vivax Schizont
FEATURES P. falciparum P. vivax
Size Small & Compact Large
Number Few, Uncommon Few to Moderate
Mature Forms 12-32 Merozoites 12-24 or More Merozoites
Cluster Compact Clusters Irregular Clusters
Pigment Single Dark Mass Loose Mass

EXPERIMENT 28: BLOOD & TISSUE FLAGELLATES

INTRODUCTION
 Trypanosoma and Leishmania Flagellates belong to Order Kinetoplastida of Superclass
Mastigophora
 They Multiply in the Blood (Hemoflagellates) or Tissue of Humans
 All Species require an Arthropod Intermediate Host

I. SLIDES TO VIEW
 Trypanosoma brucei gambiense (Trypomastigote)
 Leishmania tropica (in Culture)
 Leishmania tropica (Hamster)

II. MORPHOLOGIC DIFFERENCES

AMASTIGOTE PROMASTIGOTE EPIMASTIGOTE TRYPOMASTIGOTE
AKA Leishmania Leptomonas Crithidia Trypanosoma
Morphology Ovoidal / Spherical Spindle Shaped Spindle Shaped Spindle Shaped
Flagellum Intracellular Free Flagellum Free Flagellum Free Flagellum
Axoneme
Course of Intracellular (Not Arise from Ends in Ends in Kinetoplast
Flagellum Free) Kinetoplast in the Kinetoplast Posterior to the
Anterior End Anterior to Nucleus
Nucleus
Found in Macrophages Vector
Reticuloendothelials
Stage Leishmania Leishmania Typanosoma Trypanosoma
Diagnostic Stage Infective Stage Infective Stage
 Leishmania = Amastigote + Promastigote
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  Trypanosoma = Trypomastigote + Epimastigote

III. TRYPANOSOMA SPECIES

A. Comparison of Diseases and Vectors
SPECIES DISEASE VECTOR
T. brucei gambiense West African Sleeping Sickness Riverine Tsetse Fly
T. brucei rhodesiense East Sleeping Sickness Woodland Tsetse Fly
T. cruzi Chaga’s Disease, Megacolon Reduviid Bug (Triatoma)

B. Life Cycles:
1. T. brucei gambiense
 Infective Stage = Metacyclic Trypopmastigote
 Diagnostic Stage = Trypomastigote
 Stage that develops in the Salivary Glands of the Vector (Tsetse Fly) =
Epimastigote
 Mammalian Hosts = Humans, Pigs, Wild Animals
 Vector = Riverine Tsetse fly (Glossina palpalis) = Day time biters
 NOTE: Epimastigotes are NOT found in the Human’s Blood (it develops in the
Tsetse Fly)

2. T. brucei rhodesiense
 Infective Stage = Metacyclic Trypopmastigote
 Diagnostic Stage = Trypomastigote
 Stage that develops in the Salivary Glands of the Vector (Tsetse Fly) =
Epimastigote
 NOTE: Epimastigotes are NOT found in the Human’s Blood (it develops in the
Tsetse Fly)

3. T. cruzi
 Infective Stage = Metacyclic Trypomastigote
 Epimastigote Develops inside the Reduviid Bug (Vector)
 Diagnostic Phases:
 Blood = Trypomastigote
 Heart Tissues = Amastigote
IV. LEISHMANIA SPECIES
A. Comparison of the Diseases Caused:
LEISHMANIA DESCRIPTION DISEASES
Leishmania tropica Old World Cutaneous Dry, Chronic, Urban Cutaneous
Leishmaniasis Leishmaniasis
Oriental Sore
Aleppo or Baghad Boil
Recividans or Chronic Relapsing
Cutaneous L.

Leishmania major Old World Cutaneous Wet or Acute Rural Cutaneous

Leishmaniasis Leishmaniasis

Leishmania aethiopica Old World Cutaneous Diffuse / Disseminated Cutaneous

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 Leishmaniasis Leishmanisis

Leishmania mexicana New World Diffuse / Disseminated Cutaneous

Cutaneous Leishmaniasis
Leishmaniasis Chiclero Ulcers

Leishmania braziliensis Mucocutaneous Mucocutaneous Leishmaniasis

Leishmaniasis Espundia (disfigures face)

Leishmania donovani Visceral Visceral Leishmaniasis

Leishmaniasis Kala-Azar or Black Disease
(Zoonotic)

B. Life Cycle
o Infective Stage = Metacyclic Promastigote
o Diagnostic Stage = Amastigote (inside Macrophages)
o Vector = Sandflies (Phlebotomus or Lutzomyia)
o Reservoir Hosts = Humans, Dogs, Wild Animals
o Habitat = Reticular Endothelial System

EXPERIMENT 29: FILARIAL WORMS

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INTRODUCTION
 Filarial Worms = Slender Tissue dwelling Nematodes with Reduced Lips and Buccal
Capsules
 All Species employ Arthropods as Intermediate Host
 Transmission = through Arthropod Vector Bite
 Infective Stage = Third Stage Larva (L3)

I. SLIDES TO VIEW (Blood Smears with):

 Wuchereria bancrofti
 Brugia malayi

II. PROCEDURE
 Blood Smears with Microfilariae
 Take note of Morphological Differences between the Two Species and Tabulate based on the
following: Shape & Size of the Larvae relative to the Host Cells, presence / absence of a
Membrane Sheath and Number of Nuclei at the Posterior or Tail End

III. FILARIAL WORMS OF MEDICAL IMPORTANCE

FILARIASIS VECTOR DEFINITIVE DISTRIBUTION
HOST
Wuchureria bancrofti Lymphatic Mosquitoes Man Philippines
Brugia malayi Lymphatic Mosquitoes Man Philippines
Brugia timori Lymphatic Mosquitoes Man Indonesia
Onchoceria volvulus Subcutaneous Fly Man
Loa loa Subcutaneous Fly Man
Manzonella perstan Animal Midget Animal
Manzonella ozzardi Animal Midget Animal

IV. LIFE CYCLE

 Infective Stage = L3 (Third Stage Larvae)
 Diagnostic Stage = Microfilariae
 Definitive Host = Man, Chimpanzee, Gorilla
 Mosquito Borne

L3 (Infective Stage)  Migrates to Lymph Gland  L1  L2  L3

Human Phase Mosquito

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EXAMINATION OF THE SLIDES

I. STAGES OF THE PARASITE

A. Adult Stage
-found in Lymph Glands (they can create Obstruction, leading to Edema)
-long slender, creamy white roundworm, smooth cuticle

1. Viviparous Female
-Vulva opens to the Surface of the Worm near the middle of the Pharynx
-gives birth to a Prelarval Form (Microfilariae)
-6-10cm in length; 0.3cm wide

2. Males
-possess Caudal Alae with two Spicules
-40-50mm in length, 0.3wide

B. Microfilariae
-also known as the Pre-Larval Form (L1)
-it is NOT an Infective Stage – it is a Diagnostic Stage
-given birth by a Viviparous Female Worm (there is NO egg stage)
-Body Nuclei = represents are Rudiments of Internal Organs

**Morphology:
 Morphology varies with Species
 May contain sheath with or without striations
 Body Nuclei represent Rudiment of Internal Organs
 Stained with Giemsa

**Comparison of Microfilariae between the Two Species:

W. bancrofti B. malayi
Cuticular Sheath Present Present
Cephalic Space Short Long
Length = Width Length > Width
Body Curves Regular, Large Irregular, Kinky, Small
Body Nuclei Round Medium-Size Small, Angular
Well Separated Overlapping (not
separated)
Tail No Terminal Nuclei With Two Terminal Nuclei
Pointed End Blunt Tip

*NOTE: Microfilariae are found in the Blood only at Night Time

II. COMPARISON OF LYMPHATIC AND SUBCUTANEOUS WORMS (BASED ON MICROFILARIAE)

W. bancrofti B malayi Onchocerca Loa loa
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 volvulus
Sheath Present Present Absent Absent
Cephalic Short Long Short Short
Space
Body Curves Regular Irregular Rigid Irregular
Body Nuclei Separated Overlapping Separated Overlapping
Tail No Nuclei With Terminal No Nucleus With Terminal
Nucleus Nuclei

III. ENDEMIC PLACES OF FILARIASIS IN THE PHILIPPINES

 Luzon
 Leyte
 Marinduque
 Mindoro
 Palawan
 Samar
EXPERIMENT 30: SCHISTOSOMA (BLOOD FLUKES)

INTRODUCTION
 Schistosoma = Comprises the Blood Flukes or the Blood Trematodes
 They only require ONE Intermediate Host – have NO Metacercarial Stage
 Adults have Separate Sexes

I. SLIDES TO VIEW:
 Schistosoma japonicum = Egg, Cercaria, Adult
 Schistosoma mansoni = Egg, Adult
 Schistosoma mekongi = Egg, Adult

II. THREE MAJOR SPECIES

MAJOR SNAIL HABITAT DISEASE DISTRIBUTION
SPECIES INTERMEDIATE
HOST
Schistosoma Oncomelania Veins of the Oriental Philippines (Misamis
japonicum Hupensis-Quadrasi Small Schistosomiasis Oriental)
Intestines Katayama Disease China, Sulawesi in
Schistosomiasis Indonesia, Japan,
japonica Taiwan
Schistosoma Biomphalaria spp Veins of the Intestinal Africa, South
mansoni (Biomphalaria Large Bilharziasis America, West
glabrata) Intestines Schistosomiasis Indies, Puerto Rico
mansoni
Schistosoma Bulinus spp Veins of Schistosomal Middle East, Africa,
haematobium (Bulinus Genitourinary Hematuria Southern Tip of
18truncates) Tract Vesical Europe
Schistosomiasis
18
 Urinary Bilharziasis

**NOTE: Schistosoma japonicum: produces the Most Number of the Eggs

III. LIFE CYCLE

 Infective Stage = Cercaria
 Diagnostic Stage = Eggs in Feces
 Form which Enter the Snails = Miracidia
 Intermediate Host = Snails (different species for specific species of parasites – see
table)
 Mode of Transmission = Skin Penetration

EXAMINATION OF THE SLIDES

I. PROCEDURE:
 Note Morphologic Features of the Parasites and the Striking Differences between them

II. MORPHOLOGY
A. Adult Worms
-0.6-2.5cm in length with Oral and Ventral Suckers
-Narrow Elongated Shape; has separate Sexes; Integument is Smooth or Tuberculated
depending upon species
-number of Testes in Males and the length of the Uterus & Number of Eggs are
Distinctive to the species
-Excretory System = Flame Cells, Collecting Tubules leading into a Small Bladder with
Terminal Excretory Pore

MALE ADULT WORM FEMALE ADULT WORM

Shorter by more Sturdy; Grayish Longer
Has a Cylindrical Anterior End More Slender
Body Folded to form a Gynecophoral Canal Darker

19
 **Gynecophoral Canal = Found in Males in which the Female is embraced
during copulation

B. Ova / Egg
-with Spine or Knob-Like Projections
-depending on the Stage of Development at the time they are passed out with the
Feces, one may find
them from Multicellular Stage to full Embryonation with a developed Miracidium within the
Shell
S. japonicum Egg S. mansoni Egg S. haematobium Egg
*Developed *Developed Miracidium *Developed Miracidium
Miracidium *Large Lateral Spine *Large Terminal Spine
*Lateral Knob
*Small Lateral Spine

C. Miracidium
-ciliated, pyriform in shape with a Primitive Gut

D. Cercariae
-forked-tailed when Discharged from the Snail
-fork situated at the Posterior-Third of the Tail
-Oral and Ventral Suckers are developed

III. ANSWERS TO QUESTIONS

 Differentiate the Appearance of the Ova of the Different Species of Schistosoma
S. japonicum S. mansoni S. haematobium S. mekongi
Oval Light Yellow=Brown Terminal Spine Oval
With minute Spine Elongate Lateral Spine or Knob
or Knob Lateral Spine
Acid Fast

 What Specimen are you going to collect to demonstrate the Ova of Schistotoma japonicum?
o Feces are Collected
o When eggs cannot be found in Feces, a Rectal Biopsy may be done

EXPERIMENT 36: INTESTINAL AMOEBA

INTRODUCTION
 Protozoans in the Intestines obtain nutrients from the Parasitized Host or Predigested Food in
the GIT
 Trophozoite = Active or Feeding Stage
 Cysts = form when the Environment is Unfavorable for Survival (Not Active, Non-Feeding)

20
I. SLIDES TO VIEW:
 Entamoeba histolytica = Cyst, Trophozoite
 Entamoeba coli = Cyst, Trophozoite
 Entamoeba nana = Cyst, Trophozoite

II. ENTAMOEBA HISTOLYTICA

 The ONLY Pathogen (others are Commensals)
 It has the Potential to Invade the Intestinal Wall & other Organs
 Entamoeba dispar = another Intestinal Commensal which is morphologically similar w/ E.
histolytica
 They could be differentiated using Specific Tests (Isoenzyme Analysis, Immunoassays, PCR)

**NOTE: LIFE CYCLE Discussed Below

EXAMINATION OF THE SLIDES

I. TROPHOZOITES AND CYSTS:

TROPHOZOITES CYSTS
Entamoeba *Karyosome = Center *1-4 Nuclei (Mature Cyst)
histolytica *Nucleus = Eccentric w/ Fine Chromatin *Diffuse Glycogen Mass
Granules *Cigar-Shaped Chromatoidal
*Directional Movements (Active Bars
Progressive)
*Defined Ectoplasm
*Blade-Like Hyaline Pseudopodia
*Indistinct Nucleus
*Ingested RBC

Entamoeba coli *Karyosome = Eccentric Karyosome in *As many as 8-Nuclei (Mature

Nucleus Cyst)
*Nucleus = w/ Course Chromatin *Larger; Slender
Granules *More Granular Cytoplasm
*More Sluggish Non-Directional *Splinter-Like Chromatoidal
Movements Bodies
*More Granular Cytoplasm
*Contain Ingested Bacteria
*Narrower; Less Differentiated Ectoplasm
*Blunter and Broader Pseudopodia
*Heavier
*Irregular Peripheral Chromatin
*NO RBC inside

Endolimax nana *Karyosome = Eccentric, Large Irregular *Has 4-Nuclei

*No Peripheral Chromatin Granules

21
II. ANSWERS TO QUESTIONS
 What is the Morphologic Feature of Entamoeba histolytica that signifies Pathogenicity?
o Trophozoite of E. histolytica is Active, Motile Feeding Stage that causes Pathology in
the Colon
o It is Anaerobic with no mitochondria
o Erythrophagocytosis

EXPERIMENT 37: INTESTINAL FLAGELLATES & CILIATE

INTRODUCTION

I. SLIDES TO VIEW:
 Giardia lamblia
 Dientamoeba fragilis
 Chilomastix mesnili
 Balantidium coli

II. FLAGELLATES VS CILIATES

A. Flagellates
o Possesses one or more Flagella – Long Thread-Like Extrusions of the Cytoplasm
o The Pathogenic Intestinal Flagellate of Man is Giardia lamblia
o Classified into Two Groups (According to Habitat):
 Intestinal, Oral, and Genital Flagellates
 Blood and Tissue Flagellates

**NOTE: ALL have Trophozoite and Cystic Stage (EXCEPT Trichomonas)

 Dientamoeba fragilis was originally grouped under Amoebas (now it is a
Flagellate)
 Now, it is in the Order Trichomonadida
 Dientamoeba fragilis has Two Nuclei and NO Cystic Stage

B. Ciliates
o Move by means of Cilia – Threads of Cytoplasm (shorter and more numerous than
Flagella)
o The only Pathogenic Ciliate of Man is Balantidium coli

III. REVIEW OF PROTOZOANS

Entamoeba Giardia lamblia Dientamoeba Balantidium
histolytica fragilis coli
Disease Amoebiasis Giardiasis Balantidiasis
Amoebic Lambiasis Balantidosis
Dysentery Traveller’s Balantidial
Amoebic Hepatitis Diarrhea Dysentery
Infective Mature Cyst Mature Cyst Trophozoite Mature Cyst
22
 Stage
Habitat Large Intestine Small Intestines Large Intestines Large Intestines
(Cecum) (Cecum)
Diagnosis Parasite in Feces Cyst & Binucleate Cysts &
Trophozoites Trophozoites Trophozoites
Pathology Flask Shaped Malabsorption
Ulcer Syndrome
Steatorrheac Stool
Transmission Ingestion Ingestion Uncertain Ingestion
Drugs of Metronidazole Metronidazole Iodoquinol Tetracycline
Choice
Trophozoite
Nucleus Single & Eccentric Two Nuclei Two Nuclei Macro / Micro
(Binucleate) (Binucleate)
Karyosome Center Center
Movement Unidirectional 4-Flagella Pseudopods
Twisting Non-Directional
Movements
Others Easily Destroyed Sucking Disk No Flagella Surrounded by
Ventrally Cili
Pear Shaped (Old Cytosome &
Man) Cytopyge
2-Parabasal
Bodies
2-Axonemes
Cyst
Description Cigar-Chromatoid Ellipsoidal NONE Thick Cyst Wall
Bodies 2-4 Nuclei Round or Oval
1-4 Nuclei

EXAMINATION OF THE SLIDES

I. TROPHOZOITES AND CYSTS

TROPHOZOITE CYST
Giardia lamblia *Sucking Disk on Ventral Surface *2-4 Nuclei
*Pear Shaped *Surrounded by a Cyst Wall
*Old Man’s Face *Ellipsoidal (9-12um)
*Two Nuclei with Large Central
Karyosomes
*Two Axonemes
*Two Blepharoplasts
*Two Deeply Staining Bars (Parabasal
Bodies)
*4-Pairs of Flagella

23
 Dientamoeba fragilis *Sluggish Non-Directional Motility NONE
*Two Nuclei
*NO Flagella!!!
*May Ingest RBC

Chilomastix mesnili *One Nucleus *One Nucleus

*Four Anterior Flagella *Lemon-Pear-Shaped
*Cytosomal Groove *Clear Knob
*Curved Posteriorly *Cytosome

Balantidium coli *Surrounded by Cili *Almost similar: Round or Oval

*Has Vacuoles and Inclusions in the *Thick Cyst Wall
Cytoplasm
*Some unique structures:
 Cytostome = Primitive Mouth
 Cytopyge = Excretory Pore
 Macronucleus = Bean / Kidney
Shaped
 Micronucleus = within the
Macronucleus

II. ANSWERS TO QUESTIONS

 Give the Characteristic Morphologic Features
FLAGELLATE / CILIATE LOCOMOTORY DISTINCT FEATURES
ORGANELLE
Giardia lamblia 1-4 Flagella Two-Nuclei
Large Central Karyosome

Dientamoeba fragilis Amoebaflagellate Two-Nuclei (Binucleate)

No Cysts!

Chilomastix mesnii Flagella Trophozoite = Tear Drop

Shape
Evident Nucleus
Has a Cystosome (Cell
Mouth)
Cysts = Lemon Shaped

Balantidium coli Cilia Trophozoites: Large & Oval

24
 EXPERIMENT 38: INTESTINAL NEMATODES

INTRODUCTION

I. SLIDES TO VIEW
A. Adult Forms:
o Ascaris lumbricoides
o Trichuris trichiura
o Enterobius vermicularis
o Hookworms (Necator americanus, Ancylostoma ceylanicum, Ancylostoma caninum)
o Capillaria philippinensis
o Trichinella spiralis

B. Larva
o Strongyloides stercoralis
o Hookworms (Necator americanus, Ancylostoma ceylanicum)
o Trichinella spiralis

C. Ova
o Ascaris lumbricoides (Fertilized, Unfertilized, and Decorticated Ova)
o Trichuris trichiura
o Hookworms (Necator americanus, Ancylostoma ceylanicum)
o Capillaria philippinensis
o Enterobius vermicularis

II. NEMATODES
 Nematodes / Roundworms = comprise a Large Group of Helminths of simple structure
 Elongated, Unsegmented, Bilaterally Symmetrical
 Separate Sexes
 Males < Females
 Males have one or two Copulatory Spicules

25
EXAMINATION OF THE SLIDES

I. OVERALL CHARACTERISTICS
Ascaris Trichuris Enterobius Hookworms Strongyloides Cap
lumbricoides trichiura vermicularis stercoralis philipp

General Characteristics
Common Giant Round Whipworm Pinworm / Hookworms Threadworm
Name Worm Seatworm
Diseases Ascariasis Trichuriasis Enterobiasis Ancylostomiasis Strongyloides Capilla
Ascaris Trichocephaliasis Oxyuriasis Uncinariasis Strongyloidosis Pudoc’
Infection Necatoriasis Cochin-China Diseas

Habitat Small Large Intestines Large Small Intestines Small Small

Intestines Intestines Heart-Lung Intestines Intestin
Heart-Lung Route Heart-Lung
Route Route
Infective Embryonated Embryonated Embryonated Filariform Larva Filariform Third S
Stage Egg Egg Egg Larva Larva
Diagnosis Eggs in Stool Eggs in Stool Eggs in Eggs in Feces Rhabditiform Eggs in
Perianal Larva
Region
Transmissio Ingestion Ingestion Ingested Skin Skin Ingestio
n Penetration Penetration
Definitive Man Man (Monkeys) Man ONLY Man Man Man
Host
Intermediate NONE NONE NONE NONE NONE Freshw
Host Fish
Pathology Loeffler’s Rectal Prolapse Pruritus Ani Creeping Larva Curens Borbor
Syndrome Eruptions Gurglin
MH-Anemia Stomac
Pneumonia-
Like

Treatment Mebendazole Mebendazole Mebendazole Mebendazole Albendazole Meben

Pyrantel Albendazole Pyrantel Pyrantel Thiabendazole Albend
Pamoate Pamoate Pamoate Thiabe
Albendazole Albendazole Albendazole

Morphology
Female Adult Pointed Ends Blunt Posterior Sharp Parasitic Atypica
Pointed End Free-Living Rows
26
 Typical
Row
Male Adult Curved Curved Posterior Curved Bursa to hold No Parasitic Long S
Poserior End Single Spicule Posterior female Male Sheath
Retractile Sheet Single Free-Living
Spicule
Eggs Fertilized = Lemon /Barrel D-Shaped 2-8 Cell Stage Peanut
Embryo Shaped With Embryo Shaped
Unfertilized = Bipolar Mucus
Granules Plug
Rhabditiform -- -- -- Long Buccal Short Buccal
Larva Capsule Capsule
Filariform -- -- -- Pointed Tail Forked Tail
Larva
Distinct 3-Buccal Lips Anterior Whip Cephalic Rounded Ends
Features like Alae
Posterior Round

II. RHABDITIFORM & FILARIFORM LARVAE

HOOKWORMS STRONGYLOIDES

Rhabditiform Larva
Buccal Cavity Long Buccal Cavity Short Buccal Cavity
Genital Primordium Small Genital Primordium Large Genital Primodrium

Filariform Larva
Tail Pointed Tail Notched / Forked Tail
Esophagus Shorter Esophagus Longer Esophagus
EXPERIMENT 39: DIRECT FECAL SMEAR

INTRODUCTION

I. PRINCIPLES
 Direct Fecal Smear (DFS) = Simplest and most Rapid of all Fecal Examination Techniques
 Recommended for Identification of Protozoan Trophozoites and Detection of Helminthic
Infection
 One Direct Fecal Smear Preparation contains approximately 2mg of Feces
 Saline and / or Lugol’s Iodine Solution can be used to Emulsify the Fecal Material

A. Unstained Film
-useful for the Study of Living Parasite Objects
-ex) Motile Protozoan Trophozoites, Helminth Eggs, and Nematode Larva

B. Iodine Film
-employed to study the Diagnostic Features of Protozoan Cysts

27
II. PROCEDURE
 Place 1-2 Drops Saline at the Center of a Glass Slide
 With an Applicator Stick, poke at various portions of the Specimen (it with blood streaks, make
sure you touch your applicator at this portion)
 Make a smooth uniform emulsion in the drop of saline by Rotatory Motion starting from the
Center
 Place the edge of Cover Slip in the slide so that it touches the edge of the water
 Slowly lower the coverslip to prevent Air Bubbles
 Examine slide (first with LPO, then with High Power)

ANSWERS TO QUESTIONS
 Give the Advantage of using Logol’s Iodine over Saline Solution in Direct Fecal Smear
o Lugol’s Iodine or D’Antoni’s Iodine helps visualize internal structures of Trophozoites
and Cysts
o Because Stains will kill Motile Trophozoites, it is recommended that a Saline Smear and
an Iodine Smear be prepared Separately

 Briefly Discuss the Advantages and Disadvantages of a Direct Fecal Smear

o Advantages
 Allows the viewer to Detect Motile Protozoa
 Can view Helminth Eggs / Larvae, Protozoan Cysts, WBCs, Some Yeast

o Disadvantages
 Should NOT be performed on Preserved Specimens
 Should be used for Fresh Stool Specimens that are very Soft or Liquid
 Cannot be examined using Oil Immersion

EXPERIMENT 40: CELLULOSE TAPE PERIANAL SWAB

INTRODUCTION

I. PRINCIPLES
 Pinworm Infection (Enterobius vermicularis) is suspected in children with Perianal Itching,
Insomnia, and Restlessness
 Evidence depends on recovery of Adult Worms, Eggs, or Both
 They are RARELY Found in Stool Examination
 Pinworm Infection can be best diagnosed by Swabbing Perianal Area using Graham’s
Cellophane (Cellulose) Tape Method

28
II. GRAHAM’S CELLOPHANE TAPE METHOD
 Highest Sensitivity and Specificity Results
 Best to Collect Specimens in the Morning before the Patient bathes or defecates

III. PROCEDURE
 Place a Strip of Cellulose Tape, Sticky Side Down, on a slide and on one end a Small Strip of
Paper
 Hold a Slide Against a Tongue Depressor one inch from the end and lift the tape away from
the Slide
 Loop the Tape over the end of the Tongue Depressor to expose the Gummed Surface (Hold
the Tape by the Paper Tab attached to its End Portion
 Hold the Tape and Slide against the Tongue Depressor
 Press the gummed surface of the tape against several areas of the Perianal Area
 Replace the tape on the slide and examine directly under the microscope for Pinworm Eggs or
Taenia Eggs

ANSWERS TO QUESTIONS
 Why is Early Morning the BEST Time to collect Specimens?
o The highest Positive Results and Greatest Number of Eggs can be detected in the
morning
o Specimens are best obtained a few hours after the Person has retired (10-11pm) or the
first thing in the morning before bowel movement or bath

EXPERIMENT 41: KATO THICK SMEAR AND KATO-KATZ THICK SMEAR

KATO THICK SMEAR (CELLOPHANE THICK SMEAR)

29
I. PRINCIPLES
 Kato Thick Smear = Qualitative Method to detect Helminthic Infections (better than Direct
Fecal Smear)
 Requires 50-60mg Fresh Fecal Material so that even Light Infection can be detected
 Cellophane Strips used is Soaked in Glycerine-Malachite Green Solution for 24 hours
before use
 This method is very useful in Mass Examination of Common Soil-Transmitted Helminthic
Infecitons

**Glycerine-Malachite Green Solution

o Glycerine = clears the Fecal Film to visualize the Helminth Eggs
o Malachite Green = Dye used to protect the eyes from Intense Light Needed in
examining Thick Smear
o Preparation: 500ml Distilled Water + 500ml Glycerine + 5ml 3% Malachite Green
Solution in H2O

**NOTE: This Method is NOT Suitable for Diarrheic Stool and CANT Detect Protozoan Cysts
and Trophozoites

II. PROCEDURE
 Place 50-60mg of Stool at the Center of a Glass Slide and Cover with a Square Piece of Pre-
Treated Cellophane
 Using a Rubber Stopper, press the Cellophane gently to spread the Stool Specimen evenly,
approximating the Circumference of the Rubber Stopper
 Leave the prepared slide at room temperature for 10-20minutes – during this time, the
Microscopic Field becomes clear due to the action of Glycerine on the Stool Constituents
 Examine the Slide (The slide should be examined after 10-20 minutes or within 1 hour after
preparation
 Allowing the slide to stand for Long Periods of time will cause Drying and Shells of Hookworm
Ova will become transparent and difficult to see

III. ADVANTAGES VS DISADVANTAGES:

A. Advantage
o Time Saving, Simple, Economical
o Useful in Mass Examination of Common Soil-Transmitted Helminth Infections

B. Disadvantages:
o Not Suitable for Diarrheic Stool
o Cannot be used to detect Protozoan Cysts & Trophozoites

30
KATO-KATZ THICK SMEAR (MODIFIED THICK SMEAR)

I. PRINCIPLES
 Kato-Katz Thick Smear is a Modification of Kato-Thick Smear Method
 It is a Quantitative Method for counting Helminthic Eggs
 The Number of Eggs per gram (NPEG) of Feces can be computed by Multiplying the
Number of Eggs Observed per Thick Smear by 24

II. PROCEDURE
 Place about Half a Gram of Fecal Sample on Filter Paper
 Place the wire net or screen on top of the fecal sample
 Using a Flat-Sided Applicator Stick, scrape across the upper surface of the screen to sieve the
Fecal Material
 Place a Template on a Clean Microscope Slide
 Transfer a small amount of Sieved Fecal Material into the hole of the Template and carefully fill
the hole
 Remove the Template carefully so that all the Fecal Material is left on the slide
 Cover the Fecal Sample on the slide with a Glycerine-Malachite Soaked Cellophane Strip
 Invert the Slide and Press the Fecal Sample against the Cellophane gently on a Smooth
Surface to spread evenly
 Let stand for about 20 minutes and examine
 Count all eggs seen in the whole preparation
 Multiply the Total Eggs counted by Factor 24 to express the Count as Eggs per Gram
Feces (EPG)

**IMPORTANT Notes:
o The Wire-Mesh Net is used to Separate Fecal Material from the Large Debris which
may affect the Approximate Fecal Weight and Clearing of Fecal Film by Glycerol

ANSWERS TO QUESTIONS
 Discuss the Advantages of Thick Smear over the Direct Fecal Smear
o Thick Smear can be used to Obtain an Accurate measure of the Number of Eggs in a
given amount of Sample so that the Worm Burden can be inferred
o However, Adult Schistosomes take weeks to months to pass eggs into the Feces

 Give the Rationale of using Glycerine-Malachite Green Solution in these two procedures
31
 o It is a dye used to Dye the Smear and Protect the Eyes from the Intense Light that is
required for the Microscopic Examination of the Specimen

EXERCISE 42: INTESTINAL TAPEWORMS AND FLUKES

INTRODUCTION
 Cestoda (Tapeworms) & Trematoda (Flukes) of Phylum Platyhelminthes (or Flatworms) are
Exclusively Parasitic

I. SLIDES TO VIEW
A. Trematodes
1. Adult, Egg
 Fasciolopsis buski
 Echinostoma ilocanum
 Clonorchis sinensis
 Opisthorchis sp
 Fasciola hepatica / gigantica

2. Adult
 Fasciola hepatica
 Metagonimus yokogaeai
 Haplorchis taichui

3. Metacercaria

B. Cestodes
1. Adult
 Taenia solium
 Taenia saginata

2. Egg, Scolex, Mature / Gravid Proglottid of:

 Taenia solium
 Taenia saginata
 Diphyllobothrium latum
32
  Hymenolepis nana
 Hymenolepis diminuta
 Dipylidium caninum

3. Cysticercus cellulosae

II. TREMATODES (Flukes)

 Have Conspicuous Suckers
 Leaf-Shaped, Unsegmented, and Dorsoventrally Flattened
 External Cuticle which most species may be covered with Scales, Spines, Tubercles, Ridges
 They have Complex Life Cycles, involving one or more Intermediate Hosts
 Transmission (Majority) = Eating Inadequately Cooked Second Intermediate Host
containing the Infective Metacercariae

III. CESTODES (Tapeworms)

 Endoparasitic Worms with Elongated, Segmented, and Flat Body devoid of a Body Cavity
 Adult Tapeworm = Scolex (Head) + Neck + Proglottids that comprise the Strobila or Body of
the Tapeworm
 Each proglottid contains one or two sets of Male and Female Reproductive Organs

EXAMINATION OF SLIDES:

I. TREMATODES (FLUKES)

A. Intestinal Flukes (Trematodes)

Fasciolopsis Echinostoma Heterophyes Metagonimus
buski ilocanum heterophyes yokogawai
Disease Fasciolopsiasis Echinostomiasis Heterophyiasis Mentagonimiasis
Common Giant Intestinal Garrison’s Fluke None None
Name Fluke
Life Cycle Indirect Indirect Indirect Indirect
Definitive Humans, Hogs, Humans, Humans, Fish- Humans, Fish-
Host Dogs Mammals, Birds Eating Mammals Eating Mammals
1st Planorbid Planorbid Snails Brakish-Water Snails
Intermediate Snails Snails
2nd Water Plants Snails (Pila Freshwater Fish Freshwater Fish
Intermediate luzonica)
Habitat Small Intestines Small Intestines Small Intestines Small Intestines
Infective Metacercaria Metacercaria Metacercaria Metacercaria
Stage
Diagnostic Eggs in Feces Eggs in Feces Eggs in Feces Eggs in Feces
Stage

Morphology
33
 Testes Dendritic Lobed Lobate Oval
Tandem Tandem Side by Side Obliquely Side by
(Opposite) Side
Suckers Oral + Ventral Oral + Ventral Oral + Ventral + Oral + Ventral +
Genital Genital
Egg Unembryonated Unembryonated Embryonated Embryonated
Operculated Operculated Operculated Operculated

Unique Char. Vitellaria Surrounded by Fan-Shaped

Lateral to the Crown of Spines Vitellaria
Ceca

B. Liver Flukes (Trematodes)

Fasciola spp Clonorchis sinensis Opisthorchis spp

General Characteristics
Disease Fascioliasis Clonorchiasis Opisthorchiasis
Liver Rot
Pharyngeal Fascioliasis
Halzoun

Common Sheep Liver Fluke (F. Chinese / Oriental Liver Cat Liver Fluke
Name hepatica) Fluke
Liver Fluke (F.
gigantica)

Life Cycle Indirect Indirect Indirect

Infective Metacercariae Metaceracariae Metaceracariae
Stage
Definitive Man, Sheep, Cow, Man and Dog Man and Dog
Host Deer, etc
Diagnostic Ova in Feces Ova in Feces Ova in Feces
Stage
1st Lymneid Snail Planorbid (Operculate) Planorbid Snails
Intermediate Snails
2nd Water Plants Freshwater Fish Freshwater Fish
Intermediate (Cyprinoid) (Cyprinoid)
Reservoir None None
Host
Habitat Bile Ducts & Biliary Bile Ducts & Biliary Bile Ducts & Biliary
Passages Passages Passages

Morphology
Shape Leaf Shape Oblong, Lanceolate Oblong, Lanceolate
Shaped Shaped
Suckers Oral < Ventral Oral > Ventral Oral = Ventral
Testes Dendritic; Tandem Branched; Tandem Lobate; Oblique

34
 Ovary Fan-Shaped Oval Oval
Egg Unembryonated Embryonated Embryonated
Intestinal Branched Simple Simple
Ceca
Vitellaria Branched Diffuse, Irregularly Cluster / Compressed
Distributed Follicles
Unique Cephalic Cone / Eggs smaller than C.
Feature Shoulder sinensis

II. CESTODES
Taenia Taenia Diphyllobothriu Hymenolepis nana Hymenolepis
solium saginata m latum diminuta

General Characteristics
AKA Pork Beef Broad-Fish- Dwarf Tapeworm Rat Tapeworm
Tapeworm Tapeworm Tapeworm
Disease Taeniasis Taeniasis Diphyllobothriasis Hymenolepiasis Hymenoleipasis
(Adult) (Adult)
Cysticercosis Sparganosis
(Larva) (Larva)

Habitat Small Small Small Intestines Small Intestines Small Intestines

Intestines Intestines
Larval Form Cysticercus Cysticercus Plerocercoid Cysticercoid Cysticercoid
cellulosae bovis Larva
Infective Cysticercus Cysticercus Plerocercoid Embryonated Egg Cysticercoid
Stage Egg Larva
Procercoid Larva
Diagnostic Gravid Gravid Unembryonated Embryonated Egg Embryonated
Stage Proglottids Proglottids Egg Egg
Embryonated Embryonated
Egg Egg
Definitive Man Only Man Only Man, Dog, Cat, Man, Mice, Rats Rat, Mouse,
Host etc Man
Intermediate Pig Cattle First: Copepod NONE Required Fleas, Beetle
Host Second: Fish (Rat Fleas)
Transmissio Ingestion Ingestion Ingestion Ingestion Ingestion
n

Morphology
Scolex Globular Pyriform Spatulate / Globular Club-Shaped
Armed No Almond Retractile.Rostellum Unarmed /
Rostellum Rostellum Bothria (Grooves) Four Suckers Rudiment
Four Suckers Four Suckers Grooves Rostellum
Mature Trilobed Bilobed Bilobed Ovary Bilobed Ovary Bilobed Ovary

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 Segment Ovary Ovary Broader > Long 3-Testes 3-Testes
More Testes Rosette Like
Uterus

Gravid <13 >13 Saccular

Segment Branches Branches Uterus
Egg Masses
Egg Embryonated Embryonated Unembryonated Embryonated Embryonated

Distinct Longest Egg Bigger

Feature Tapeworm than H.nana

ANSWERS TO QUESTIONS

I. CLASSIFICATION OF FLUKES
A. Classification of Flukes According to Size (Those in Bold Letters are the Intestinal Flukes)
1. Large Flukes (2-8cm)
 Fasciolopsis buski (largest)
 Fasciola spp

2. Medium Fluke (1-2cm)

 Echinostoma ilocanum
 Clonorchis sinensis
 Opisthorchis spp
 Paragonimus westermanii

3. Small Flukes (<1cm)

 Heterophyes heterophyes
 Metagonimus yokogawai
 Phanerophsolus bonnie
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  Haplorchis spp

B. Classification of Flukes According to Second Intermediate Host

1. Water Plant-Borne
 Fasciolopsis buski
 Fasciola spp.

2. Snail-Borne
 Echinostoma ilocanum

3. Fish-Borne
 Heterophyes heterophyes
 Metagonimus yokogawai
 Clonorchis sinensis
 Opisthorchis spp

C. Classification of Trematode Eggs

1. Large Unembryonated Eggs (100-160u)
 Fasciolopsis buski
 Echinostoma ilocanum
 Fasciola spp

2. Medium Unembryonated Eggs (70-90u)

 Paragonimus westermanii

3. Small Embryonated Eggs (23-32u)

 Heterophyes heterophyes
 Metagonimus yokogawai
 Clonorchis spp
 Opisthorchis spp

II. SCOLICES OF THE DIFFERENT SPECIES:

CESTODE TYPE OF SCOLEX SCOLEX
Taenia solium Globular Sucking Disks (4)
Rostellum with Chitinous Hooks
Taenia saginata Pyriform Sucking Disks (4)
Diphyllobothrium latum Elongated / Spatulate 2-Elongated Suctorial Grooves = Bothria

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