Parasitology - protozoology (protozoa), helmintology(worms), enthomology(insects ) Laboratory diagnosis: - life cycle of parasits, material v laboratory.

Parasitology - protozoology (protozoa),

helmintology(worms),

enthomology(insects)• Laboratory diagnosis: - life cycle of parasits,

material v laboratory dg

• Protozoa – intestinal, genital, urinary, blood, tissue

• Worms - Helmints: Nematodes, Cestodes,Trematodes

• Ectoparasits: louse, ticks, flies – important as vectors

Diagnosis• Problematic, not ususals outside endematic areas• Nonspecific clinical manigestation• eosinophilia in helmintoses – not constant sign• Importance of history – personal, travellers, social, economic, food,

therapy• Conditions for successful dg: • - think on parasitosis,• - také a good sample – right sample, with good method at right time,

send it in appropriate conditions to the lab that is able to identify the parasit, good interpretation:

• Knowledge of life cycle is principal

Laboratory diagnosis• Usually based on morphology (mikroscopic) • Demonstration of the parasit in different stages of life cycle in

clinical material• Macroscopic examination of the sample (stool or tissue)• Microscopic examination – native smear, staining, concentration

method• Serology – detection of antibodies, detection of antigénu• Genetic probes - detection, identification• Cultivation• Animal model

Life cycle of parasits -terminology

• Complex life cycle – key to diagnosis• Host – hosts• Definitive host – parasit finishes the growing cycle and is

becoming adult in it• Not typical host - parasit cannot develop in in • Transient host – larves are developing in it and not sexual

multiplication is performed• Helmints : egg - larva - (cyste) – adult worm

Protozoa :trofozoit - motile, cyste – non motile - sexual multiplication - zygota - asexual- schizonts, sporogons

Stool for parasitological examination• Macroscopy – blood, mucous, adult worms• Microscopy - native smear - FS, iode – motility,

eggs of helmints, cysts of protozoa, ery, leu• Concentration methods – separation of cysts of

protozoa and eggs of helmints from other material in the stool

• Staining - identification – smear of native stool + hematoxylin eosin, trichrome

Other material acc.to clinical manifestation

• Perianal - Enterobius vermicularis• Sigmoidoscopy - Entamoeba histolytica• Duodenal aspiration - Giardia lamblia• Biopsia of abscesse of liver - Entameba histolytica• Sputum - Ascaris lumbricoides, Strongyloides, • Urine - Schistosoma • Urogenital sample - Trichomonas • Blood - (malaria, trypanosomiaois, leishmaniosis, filariosis)

smear, thick drop - staining Giemsa, HeO, • Serum

Protozoa

• Amoeba - Entamoeba histolytica, Entamoeba coli, Naegleria fowleri, Acanthamoeba, Endolimax nana

• Flagelata - Giardia lamblia, Trichomonas vaginalis, Leishmania, Trypanosoma

• Ciliata - Balantidium coli• Coccidia a Sporosoa - Cryptosporidium,

Blastocystis, Microsporidia, Plasmodia, Babesia,, Toxoplasma

Nematodes -worms• Enterobius vermicularis, Ascaris lumbricoides, Toxocara

canis,cati, Trichuris trichiura, Ancylostoma duodenale, Strongyloides stercoralis, Trichinella spiralis, Wuchereria bancrofti, Dracunculus medinensis - aesculapova palica

• Nonsegmented body, adult worms living in the GIT-e, - diagnosisa: identification of eggs in the stool (morphology of eggs)

• Filariae – tin worms parasiting in eye, skin, tissue, transmitted by insects. Larval form- microfilariae penetrate to blood and are transmitted by suckling insect

Cestodes -• Head - scolex, segmented body• Hermafrodit, male and female organs are present in every

segment - dif.dg. They have not GIT, absorbtion of food. Complex life cycle with transient host (sometimes - human – larval stage of cysticerkósis, echinococcosis)

• Taenia solium, Taenia saginata, Diphylobotrium latum, Echinococcus granulosus, Hymenolepsis nana

Trematodes -• Usually hermafrodits (ex Schistosoma)

• Need transient host

• Fasciolopsis, Clonorchis, Paragonimus, Schistosoma

Enterobius vermicularis

• Definitive host - human

• transient - none

• dg. – perianal sample – microscopy of eggs

• fecal oral transmission - autoinfection

Enterobius vermicularis

Ascaris lumbricoides

• Definitive host: human

• Larva migrans: intestin, colon - muc.membrane - blood- lung - cough - mouth - colon

• dg. Egg in stool

• Infection via contaminated food

• Symptoms acc.to localisation of the larva

Ascaris lumbricoides

Toxocara canis, cati

• Definitive host dog, cat

• Transient host: rat

• Human incidental: human (larves)

• dg. serology

• transmission: hand food

Taenia saginata

• Definitive: human

• transient: cattle

• dg. Segments in stool

• Transmission cysticercus in beef

Taenia solium

• Definitive: pig

• transient: rat

• incidental: human in small intestin

• dg. serology

• Contaminated food

Echinococcus granulosus

• definitive: dog• transient:sheep• incidental: human• dg serology• transmission: cyste in meat• infection: mechanic pressure from

expanded cyst, prolonged growing, rupture of the cyst and dissemination

Echinococcus granulosus

Entamoeba histolytica

• definitive: human

• dg.trofosoits in stool, serology

• dysenteria – diarhea with blood

Entamoeba histolytica

Naegleria fowleri, Acantamoeba

• Free Living in water

• Human (via nose)

• dg.microscopy in CSF- identification of invasive strains)

• disease: purulent peracute meningitis

Toxoplazma gondii• Definitive: cat• transient: rat• incidental: human• dg. serology KFR, IgA, IgG, IgM• transmission: food borne, hand, annimal• disease: - intrauterine primoinfection

- generalised lymfadenopathy, encystation in organs – abortion, eye……..

Trichomonas vaginalis

• Definitive: human

• transient: none

• dg. Cultivation - microscopy trophosoit - from vagina, urine

• Sexual transmission

• Therapy of both (all) partners

Giardia lamblia

• definitive: human – small intestin,dog, cat

• transient: non

• dg.microscopy – cysts and trophosoits in stool, transient in duodenal secretion

• Transmission contaminated food

• malabsorption

Giardia lamblia

Trypanosoma gambiensis (spavá choroba)

• Definitive host: insect - fly tse tse

• transient: human, monkey

• dg.microscopy – thick drop

• Transmission bite

• Disease – sleeping disease, myalgia, artralgia, lymfadenopathy, hyperactivity in acute fase, lethargy, meningoencefalitis, coma

Plasmodium-malariae, falciparum • Definitive host:Anopheles • Transient host: human, monkey• dg.microscopy thick drop• Transmission insect bite• disease: malaria acc.to the rate of schizogonia- clinically as

fever attacks - tercianna, quartana,