Clinical Parasitology Lab Introduction PDF

CLINICAL PARASITOLOGY Lab: Introduction to Medical Parasitology (Prelims) Parasitology Acanthamoeba spp. & Balamuthia the study of parasites...

CLINICAL PARASITOLOGY Lab: Introduction to Medical Parasitology (Prelims) Parasitology Acanthamoeba spp. & Balamuthia the study of parasites mandrillaris). the area of biology concerned with the Ectoparasites Organisms which (Inside of a host) live on the surface phenomenon of dependence of one living of the skin or organism on another. temporarily invade deals with the parasites which infect man the superficial (morphology, epidemiology, life cycle), the tissues of the host. The infection by diseases they produce (pathogenicity), the these parasites is response generated by him vs. them & known as various methods of diagnosis & INFESTATION. prevention. Mode of Transmission - lice Endoparasites Organisms that -Ingestion of contaminated food or drink (exterior surface live within the body (primarily water) of the host) of the host. The invasion by - Hand-to-mouth transfer endoparasites is known as - Insect bite INFECTION. - Entry via drilling to the skin - protozoa - helminthes - Unprotected sexual relation Type of Host - Mouth-to-mouth contact Host: An organism which harbors the - Droplet contamination parasite & provides the nourishment & shelter to the latter. - Eye contact with infected swimming water Accidental/Incidental organisms that Parasites attack an unusual host (E. granulosus Parasite-Host Relationship in man) Types of Parasites Definitive Host this is the host (Adult sexual phase) in which sexual Obligate Parasite organisms that reproduction of cannot exist w/o a the parasite host (T. gondii); takes place or entirely in which the dependent. most highly Facultative rganisms that developed Parasite under favorable form of a circumstances parasite may live either a occurs; parasitic or free- harbors the living existence (N. adult or sexual fowleri, 1 BALBUTIN, JYZA MAE C. CLINICAL PARASITOLOGY Lab: Introduction to Medical Parasitology (Prelims) stage of a phylogenetically different organisms (ex. parasite. host & parasite) Intermediate Host this is the host (Larval asexual which - involve in nature phase) alternates with the definitive host & in which the larval or asexual stages Commensalism – from Latin word of a parasite “eating at the same table”; an are found. association in which only parasite derives Reservoir Host it is a host benefit without causing any injury to the which harbors host; beneficial to one organism, neutral the parasite & to the other serves as an important source of infection to Mutualism – beneficial to both organisms other susceptible - Species A & B can be benefit hosts. Transport Host Host responsible for transferring a parasite from Parasitism – a relationship in which a one location to parasite benefits & the host provides the another. benefit. The host gets nothing in return & Carrier Parasite- always suffers from some injury. The harboring host degree of dependence of a parasite on its that is not establishing host varies; beneficial to one organism, any clinical harmful to the other. symptoms but - worst kind of relationship can infect others. -Species A benefits & B affected Parasite- Host Relationship Terms Symbiotic Relationships Pathogenic- Parasite that has when two species benefit each other by demonstrated the ability to cause mutually increasing their chances of disease. survival, or the progress of their environment, this is known as symbiosis. Symbiosis – literally means “living PARASITIC LIFE CYCLES together”; an association in which both Three common components: host & parasite are so dependent upon each other that one cannot live without Mode of transmission the help of the other. - living together of Morphologic Form 2 BALBUTIN, JYZA MAE C. CLINICAL PARASITOLOGY Lab: Introduction to Medical Parasitology (Prelims) -Invades humans, known as infective -Development and implementation of stage parasite awareness education programs Diagnostic Stage - Use of insecticides and other chemicals Can be detected via laboratory - use of protective clothing retrieval methods. - use of protective netting DISEASE AND SYMPTOMS - proper water treatment SYMPTOMS ASSOCIATED WITH PARASITIC DISEASE PROCESS - good personal hygiene Diarrhea - proper sanitation practices Fever -Proper handling, cooking, and protection of food Chills -Avoidance of unprotected sexual relations Abdominal Pain DIAGNOSING PARASITIC INFECTION Abdominal Cramping Clinical Diagnosis Elephantiasis Physical examination; based on Anemia signs and symptoms Vitamin Deficiency Sign- something I can detect. Bowel obstruction Symptoms - only the patient knows/ Edema experience Enlargement of major organs Laboratory Diagnosis Skin lesions Based significantly on laboratory reports or test results. Blindness Parasitic nature LABORATORY DIAGNOSIS TREATMENT - Crucial step to successful parasite Antiparasitic medications recovery - The most commonly submitted Change in diet specimens is stool and blood Vitamin supplements Examined macro and microscopically O&P Fluid replacement Recovery method. Blood transfusion - Blood, tissues biopsies, CSF, sputum, urine, and genital material. Bed rest SPECIMEN FOR PARASITIC EXAMINATION PREVENTION AND CONTROL FECAL SPECIMEN 3 BALBUTIN, JYZA MAE C. CLINICAL PARASITOLOGY Lab: Introduction to Medical Parasitology (Prelims) - common for intestinal parasites. SPECIMENS - Demonstrate eggs, larvae, adult trophozoites, cyst and oocyst. Urine is the specimen of choice for the recovery: Container for collection: - Schistosoma haematobium eggs -Clean, wide-mouth containers - Microfilariae of Wuchereria -Made of waxed cardboard, plastic or - Onchocerca glass -with tight-fitting lid. - Loa For the purpose of: - Brugia - ensuring retention of moisture - prevention of accidental spillage - Strongyloides larvae (rare occasions) - prevention of contamination from the outside - Trichomonas vaginalis trophozoites (often recovered from both male and BLOOD SPECIMEN female patients) Second specimen commonly Urethral and vaginal discharge examined in the specimens and prostatic secretions are examined by direct wet mount for laboratory: the presence of T. Vaginalis - Malarial parasites Viable for 4 hours - Filarial worms - Trypanosomes Urine and vaginal discharge - Leishmanial specimens and prostatic secretions - Toxoplasma infection are examined by: Serum may be used for serologic test - Direct wet mount for the presence of T. vaginalis PURGED AND ENEMA SPECIMEN - Under low power objective Usually in cecal area when routine examination of stool has been - Reduced light consistently negative yet there is a strong clinical suspicion of intestinal -Demonstrates a jerky motility amoebiasis. SPUTUM SPECIMEN Purgative solution: Examination of the specimen is - Magnesium sulfate (Epsom salts) useful in recovering trophozoites of: - Sodium sulfate - Entamoeba histolytica in cases of - Phosphosoda - Enema pleuropulmonary amoebiasis and; Enema administration is a technique - The free scolices of Echinococcus used to stimulate stool evacuation granulosus in the event of rupture of A liquid treatment most commonly pulmonary hydatid cyst. used to relieve severe constipation. Also demonstrate eggs of: URINE SPECIMEN/GENITAL 4 BALBUTIN, JYZA MAE C. CLINICAL PARASITOLOGY Lab: Introduction to Medical Parasitology (Prelims) - Paragonimus westermani - Entero-test method - Lung fluke BIOPSY MATERIALS - Larva of nematodes (occasionally) Biopsy of skin, superficial lymph nodes, visceral organs like the liver Ascaris and the others can be proceed by Strongyloides routine histotechniques for Hookworms demonstrating parasitic stages. Others with heart-lung routes Only the pathologist can perform Examined in: unless given order - Direct wet mount with saline or iodine CORNEAL SCRAPINGS - Can be concentrated using N-acetyl- Diagnosis of Acanthamoeba keratitis is L cysteine and; best achieved by examination of this - Centrifugation specimen N-acetyl-L-cysteine is a mucolytic Container: airtight agent that is used to digest mucoid Scraping can be: specimens to released parasitic elements - directly inoculated into non-nutrient agar plates (Culbertson’s medium); - seeded with a suspension of live E. ASPIRATES coli Specimens that have been drawn from Scrapings can also be examined the body by suction directly using: A. Protoscopic aspirates and - calcoflour white stain scrapings - histologic specimen used in confirming suspicion of amebic ulcers in lower sigmoid colon CEREBROSPINAL FLUID and rectum On rare occasion, CSF may be B. Duodenal aspirates infected with parasitic organisms Employed for the demonstration of Certain genera that gravitate to the CNS: infections with: - Naegleria - Giardia lamblia - Acanthamoeba - Strongyloides stercoralis - Toxoplasma - Fasciolopsis buski - Trypanosoma - Cryptosporidium Patient with these infections generally Collection of specimens using: exhibit symptoms of meningitis and a - Tubing (duodenal intubation) lumbar puncture is performed. 5 BALBUTIN, JYZA MAE C. CLINICAL PARASITOLOGY Lab: Introduction to Medical Parasitology (Prelims) CSF is collected in a sterile, tight sealing MOUTH AND NASAL DISCHARGE Entamoeba gingivalis and Trichomonas tenax cause parasitic infection of the oral mucosa and gingival (moth discharge). Associated with poor oral hygiene Can be recovered from mouth scrapings, particularly around the gum line or pyorrheal pockets. Nasal Discharge is collected and examined for the presence of Naegleria fowleri Specimen obtained in a: - Sterile, airtight container or; - swab Examined by: - Direct wet mount for the presence of parasites 6 BALBUTIN, JYZA MAE C. CLINICAL PARASITOLOGY Lab: Introduction to Medical Parasitology (Prelims) STOOL COLLECTION AND HANDLING STRUCTURES MISTAKENLY VIEWED -Collected in clean, wide-mouth containers with tight-fitting lids and sealed in plastic bags for transport. ELEMENTS/ MISTA DISTING - collected prior to any anti-diarrheal STRUCTURE KENLY UISHING medications, radiological studies using SEEN barium, bismuth, mineral oil. AS Epithelial cells Amoebi Amoeba - If with treatment 5-7 days after the and c has completion of therapy. macrophage trophoz bigger oites nuclei - avoid contamination with any liquid as Pus cells Amoebi Amoebic but not limited to urine and water. c cyst cyst has CONSIDERATION IN STOOL distinct cell wall EXAMINATION Hairs and Larvae Larvae - Worms, eggs and protozoan fibres has parasites are best suited to detect internal structure in stool after enemas. Plant Cells cysts Cyst has - Stools after taking oil laxatives, thin walls barium, bismuth salts are not Yeast and Amoebi Yeast suitable for examination. Molds c cysts and mold - Do not accept stools with urine are contamination as it kills protozoan smaller trophozoite rapidly and no - Water contamination will cause nuclei Eggs of parasit growth of non-pathogenic arthropods es organisms making examination and plant difficult. - Series of specimen should be collected to rule-out a negative TIMING OF COLLECTION result since trophozoites and cysts Patients under helminthes infection appear in stool by interval. - Formed stool- protozoan cyst; - Must be checked 1-2 weeks post therapy. watery or diarrheic stool- - May extend 5-6 weeks for Taenia trophozoite - Immediate examination must be observed to avoid disintegration of protozoan trophozoites. - Do not leave stool exposed to air. - Do not freeze or incubate 7 BALBUTIN, JYZA MAE C.