PROTOZOANS: AMOEBA Entamoeba hartmanni

- Trophozoites form – motile, free  Trophozoites& cyst form

dividing stage, binary fission,  Non- progressive finger like
replication, engulf blood, vegetative pseudopods
stage, 1 nucleus, die rapidly by natural  Infective stage: Cyst
route.  Diagnostic test: stool sample
- Cyst form – dormant stage, contains 4  Diagnostic stage: Trophozoites & cyst
nuclei, resistant, non-motile, infective
stage.
Entamoeba coli versus Entamoeba histolytica
LOCOMOTORY ORGANS
 Trophozoites & cyst form
1. SARCODINA /RHIZOPODA AMOEBA –
moves by means of pseudopods (false Entamoeba coli Entamoeba histolytica
feet)
Example: Entamoeba histolytica Dirty looking Clean looking
2. MASTIGOPHORA/ FLAGELLATES – they Sphincter Sausage shape
move by means of flagella 1-8 nuclei 1-4 nuclei
Example: Giardia lamblia / Giardia
intestinalis
3. CILLIATA / CILIOPHORA-move by Entamoeba polecki
means of ciliates
Example: Balantidium coli  Cyst & trophozoites form
4. APECOMPLEXA /SPOROZOA – no  Infective stage: Cyst
locomotor organs, they don’t move,  Diagnostic test: Stool sample
Examples: Plasmodium, Toxoplasma  Diagnostic stage: Trophozoites
 Reservoirs: monkeys and pigs
Entamoeba histolytica

 Trophozoites & cysts form

 Causative agent: amoebiasis Endolimax nana
 1 nucleus in trophozoites, 4 nuclei in
 Trophozoites & cyst form
cyst small karyosome at the center,
 Irregular karyosome
nuclear membrane
 No peripheral chromatin
 Cyst shape: Spherical to round;
 Infective stage: Cyst
chromatoidal shape: cigar shaped
 Diagnostic test: stool sample
 Haematophagus
 Diagnostic stage: Cyst & trophozoites
 Only intestinal amoeba
 Infective stage: Cyst
 Diagnostic test: Stool sample
Iodamoeba butchilii
 Diagnostic stage: cyst &
trophozoites  Trophozoites & cyst form
 only 1 nucleus present in cyst
 1 nucleus with large karyosome in
Entamoeba coli surrounded by achromatic granules in
trophozoite.
Same morphology to E.histolytica but it’s not
 No peripheral chromatin
haematophagus
 Infective stage: Cyst form
 Trophozoites & cyst form  Diagnostic test: stool sample
 Infective Stage: Cyst  Diagnostic stage: cyst & trophozoites
 Diagnostic test: Stool sample
 Diagnostic stage: Cyst & trophozoites
 Dienthamoeba fragilis

Entamoeba gingivalis  Moves by pseudopods

 Trophozoites form
 Trophozoites form only
 Binucleate
 With gingival pocket biofilm near the
 Diagnostic test: stool sample
base of teeth
 Diagnostic stage: trophozoites
 Opportunistic amoeba
 Infective stage: trophozoites
 Diagnostic test: mouth scrapping
 Diagnostic stage: trophozoites Trichomonas hominis

Acanthamoeba species  Trophozoites form

 Nervous Jerky motility
 Trophozoites and cyst
 Conical cytostome
 (no peripheral chromatin & cyst form)
 Diagnostic test: stool
 Free living, facultative parasites
 Diagnostic stage: trophozoites
 Causes eye infection and meningitis
 Infective stage: trophozoites
 Diagnostic test: CSF brain tissue for
trophozoites & cyst; corneal scrappings Trichomonas vaginalis
specimen of choice for recovery;
 Urethritis , vaginitis
calcofluor used to stain Acantamoeba
 only cause sexual transmitted
cyst present in corneal scarppings.
 trophozoites form
 Diagnostic stage: Trophozoites & cyst
 ovoid round or pear shaped
 Diagnostic test: urine
Naegleria fowleri
 Diagnostic stage: trophozoite
 Trophozoite, cyst and flagellate form
 Thermophilic Trichomonas tenax
 Free living, facultative
 Infective stage: trophozoite  oval pear shaped
 Diagnostic test: CSF brain tissue  trophozoites form
 Diagnostic stage: trophozoites  Diagnostic test: mouth scrapping
 Diagnostic stage: trophozoites

Enteromonas hominis
PROTOZOANS: FLAGELLATES
 Trophozoites & cyst form
Giardia intestinalis / Giardia lamblia  Diagnostic test: stool sample
 Diagnostic stage: trophozoites & cyst
 Trophozoites & cyst form
 Infective stage: Trophozoites
 Intestinal flagellates considered
pathogenic. PROTOZOANS: CILLIATES
 Pear or tear drop shaped or racquet
-shaped in trophozoite Balantidum coli
 Motility is falling leaf  Micro and macro nucleus
 2 ovoids 2 spherical nuclei with large  Kidney shaped
karyosome.  Trophozoite & cyst form
 Absent of peripheral chromatin  Cyst – excystation in stomach;
 Diagnostic test: stool (multiple sample) trophozoites -encystation in large
 Diagnostic stage: cyst & trophozoite intestine
 Reservoir: Beaver  Infective stage: Cyst
 Infective stage: Cyst  Diagnostic test: stool sample
 Diagnostic stage: trophozoite & cyst
 Reservoir: pigs
 Toxoplasma gondii

PROTOZOANS: SPOROZOA  Trophozoites(tachyzoites) &

cyst(bradyzoites) form
Malaria-is caused by plasmodium whose
 Infective stage: oocytes
sporozoites was inoculated to initiate human
 Diagnostic test: blood sample using
infection by anopheline mosquito
serologic test
2 types of malaria  Diagnostic stage: trophozoites &cyst
1. Sporogony – sexual stage, female  Reservoir: cat
mosquito  MOT: ingestion
2. Schizogony – asexual, human RBC
METAZOANS
 Infective stage to human – sporozoites
 Infective stage to mosquito –  Multicellular eukaryotic composed of
gametocytes worms.
 Kingdom of Animalia
Merozoites – if the sporozoites develop in liver.
 It’s not microorganism

2 kinds of helminths
Plasmodium vivax
1. NEMATODES (roundworm)
 Benign malaria 2. Flatworms
 Larger than RBC, pale color, round,  Cestodes (tapeworms)
present of schizogony  Trematodes (flukes)
 Diagnostic test: peripheral blood films
METAZOANS: NEMATODES (ROUNDWORMS)

Asccaris lumbricoides
Plasmodium malariae
 Large intestinal roundworms
 Benign malaria  Initiate heart lung cycle with extra
 Quartan malaria invasion.
 Smaller than RBC, normal color, round  Sexes separated(diecious)
and none.  Both are unsegmented
 Dormant stage  Female worm hatch egg in the intestine
 Immature needs to soil to be matured
Diagnostic test: Giem stained peripheral blood
 About 4-6 weeks to matured become
films.
embryonated form.

Adult female: pencil lead thickness

Plasmodium falciparum
Adult male: prominent incurved tail
 Responsible for nearly all serious
 MOT: ingestion
complications and death
 Infective stage: embryonated egg
 Malignant
 Diagnostic test: stool
 Mature RBC, pale color, oval
 Diagnostic stage: egg and adult
 Diagnostic test: blood
Trichuris trichiura

Plasmodium ovale  Whipworm

 Infective stage: embryonated egg
 Seldom
 Diagnostic test: stool sample
 Oval shape, larger than RBC, pale in
 Diagnostic stage: egg and adult
color
 MOT: ingestion
 Similar to vivax
 Egg: barrel, football shaped with
 Diagnostic test: blood film thick and
bipolar flask, hyaline polar plug.
thin blood smears.
Adult female: smaller

Adult male: long, prominent curled tail

Enterobius vermicularis Trichenella spiralis

 D-shaped, pinworm  Encysted larva: coiled, striated muscle

 Matured in 4 hours at perianal area  MOT: ingestion of encysted larva
 No need soils.
Adult female: blunt, round posterior end,
 MOT: inhalation /ingestion
single ovary with vulva
 Diagnostic test: scotch tape method
 Diagnostic stage: adult and egg Adult male: curved posterior end with two
rounded appendages
Adult female: pointed, resembles end, cephalic
allae.  Both sexes have small mouth, thin
anterior end, long slender digestive
Adult male: posterior end curled
tract
 Infective stage: encysted larva
 Diagnostic stage: skeletal muscle &
Strongyloides stercoralis
blood test
 Threadworm  Reservoir: pigs

MOT: ingestion

Filariform larva – long, slender, nonfeeding Capillaria philippinensis

with notched tail
 Peanut shaped
Rhabdiform larva- prominent genital  Infective stage: L3 larva
Adult female: long and slender esophagus  Diagnostic test: stool sample
 Diagnostic stage:embryonated egg in
 Infective stage: L3 larva feces
 Diagnostic test: stool sample  MOT: ingestion
 Diagnostic stage: egg if stool sample;
fresh stool &duodenal aspirates
rhabditiform METAZOANS: FILARIAE

Wuchereria bancrofti
Hookworms  Larger size they need arthropods like
Rhabditiform – long, buccal cavity, small vectors ex, mosquito
genital  Thread like appearance
 Elephantiasis in lower limbs
Filariform – short and pointed tail  Infective stage: L3 larva
 Egg: 2-4 or 8 cell stages  MOT: mosquito bite; skin penetration
 MOT: Skin penetration  Diagnostic test: blood test
 Infective stage: Filariform  Diagnostic stage: microfilariae
 Diagnostic test: stool
 Diagnostic stage: eggs &larvae
Brugia malayi

 Smaller size
2 forms of hookworms  Filariasisin upper limbs
 Necator americanus  Culex
- Cutting plate is ventral  Nocturnal periodicity 10 pm – 2 am
- Smaller  Infective stage: L3 larva
 Ancylostoma duodenale  MOT: mosquito bite; skin penetration
- 2 pairs of teeth  Diagnostic test: blood test
- White to pinkish body  Diagnostic stage: microfilariae
  Mode of transmission: through eating
the infective pigs.
Loa – Loa
 Eggs are infective only to cattle and
 Chrysops fly pigs not in humans.
 present of sheath  The egg of solium and saginata are
 distinct continuous row in nuclei; the same they are only
extend to tip of tail distinguished when there already
 cylindrical threadlike appearance an adult.
 With distinctive scolex, contains
Infective stage: L3 larva suckers and a rostellum as an organ
coil up in MOT: skin penetration of attachment. The main body is the
strobilla consist of segments known
Diagnostic test: Giemsa stained blood proglottids which has complete
Diagnostic stage: Microfiliriae reproductive unit. They are all
(hermaphrodites).

Onchocercca volvulus Taenia saginata

 Blackfly  Beef tapeworm
 Iliac crest  Unarm
 River blindness  Rectangular in shaped
 blinding filaria  Highly branched
 does not possess a sheath  Infective stage: cysticercus bovis
 found in subcutaneous tissue  Definitive host: human
 Infective stage: L3 larva  Intermediate: cattle
 MOT: buffalo flies; skin penetration  Diagnostic test: stool sample
 Diagnostic test: biopsy if microfiliriae or  Note: that if the scolex it’s still not yet
skin nips for adult showed up means the patient is not
 Diagnostic stage: microfilariae cured.

METAZOANS: CESTODES (TAPEWORMS) Hymenolepsis nana (dwarf tapeworm)

 Segmented body  Infective stage: cysticercoid
 Posses scolex,neck, and proglittid  Diagnostic test: stool sample
 Hermaphroditic  Diagnostic stage: proglottids
 Reproduction  Definitive host: human
- Oviparous  With arm, oncosphores contains 6
- Sometimes multiplication within larval hooklets.
forms.  Has 4 suckers.
- Infection generally encysted larva  Capable of completing lifecycle
All cestodes are non operculated except independently, but sometimes
D.latum intermediate hosts are the arthropods

Hymenolepsis diminuta (rat tapeworm)

Taenia solium
 Diagnostic test: stool sample
It’s a pork tapeworm, flat ribbon like shaped  Diagnostic stage: eggs and gravid
 Reservoir: pigs segments
 Definitive host: human  Intermediate host: rat
 Intermediate host: cattle and pigs  Definitive host: human
 Infective stage: cysticercus larva  Infective stage: cysticercoid
 Diagnostic test: stool sample  Without arm
 Diagnostic stage: proglottids  3 testes
 1 ovary
Diphylidium caninum Lung flukes (Paragonimus westermani)

 Double-pored tapeworm  Causative agent of paragonimiasis

 With arm, eggs pockets embryonated  Body covered with spines
eggs  Reddish brown
 Infective stage: cysticercoid  Measures 4-6 mm in width and 3.5.5
 Diagnostic test: stool sample mm in thickness
 Diagnostic stage: proglottids and eggs  Adult worms are found in pairs or
packets. threes in fibrotic capsules or cyst in the
lungs.
Diphyllobothrium latum (broad/fish
 Diagnostic test: sputum sample/
tapeworm)
Stool sample
 Infective stage: plerocercoid  Diagnostic stage: eggs
 Diagnostic test: stool sample  Intermediate host: snail and crab
 Diagnostic stage: eggs and proglottids  Definitive host: human
 Intermediate hosts:1st copepods and  Infective stage: metacercaria
2nd fish  MOT: ingestion
 With spatulate scolex; No hooks Coffee bean shaped adult worm
 Two long sucking grooves
Liver flukes
 Complex life cycle
Fasciola hepatica (sheep of liver flukes)
 MOT: ingestion
 Small oral- ventral sucker
 Treatment of choice: praziquantel and
 Large broad flat body
niclosamide.
 Anterior end forms a prominent
 Operculated and terminal knob
cephalic cone
Echinococcus granulosus  Long and highly branched intestinal
CAECA)
(hyatid worm/ dog worm)  Diagnostic test: stool sample
 With hooks  Diagnostic stage: eggs
 A cyclophyllid cestode  Infective stage: metacercaria
 With 36 hooklets and 4 suckers  Intermediate host: snail (1st) and water
 And are identical to taenia spp. plant (2nd)
 Hyatid cyst found in human tissue  Definitive host: human
 Daughter cyst miniaturizations
 Brood capsules lack of protective cyst Clonorchis sinensis
wall from the inner.
 Hyatid sand components found in the (Chinese liver flukes)
fluid of older E. Granolosus cyst.
Adult worm
 Infective stage: embronated eggs
 Diagnostic test: biopsy sample  Narrow , oblong flat worm
 Diagnistic stage: scolices,daughter  Oral sucker is slightly larger than the
cyst,brood capsules or hyatid sand ventral sucker
 Blind intestinal CAECA are simple and
METAZOANS: TREMATODES
extend to the caudal region
 Leaf like or cylindrical  Life span is 20- 30 years
 unsegmented  When you ingest raw or undercooked
 Generally hermaphroditic fish with metacercaria.
 Reproduction (digenetic)
Diagnostic test: Stool sample
 Oviparous
 Multiplication within larval form Diagnostic stage: Eggs
 Infection mainly by larval stages
Infective stage: Metacercaria
entering intestinal tract , sometimes
through skin. Definitive host: Human
Intermediate host: Snail and fish

Opisthorchis felineus/Opisthorchis viverrini Blood flukes

(Cat liver)  Dioecious

 Males are shorter and stouter than
 Measures 7-12 mm in length
females
 Have two testes one lying behind the
 Lateral margins of males are folded
other posteriorly located.
ventrally to form a GYNECOPHORAL
Coiled uterus between ovary and ventral sucker CANAL which females are received.
 Suckers are armed with delicate spines
Fasciolopsis buski  There is no muscular pharynx
 Giant intestinal flukes  Eggs are non operculated
 covered with spines  Eggs are fully embryonated when laid
 no cephalic cone  Embryonated eggs have ciliated embryo
 unbranched intestina caeca which reach called MIRACIDIUM.
up to the posterior end .  There is no encysted metacercarial
 endemic in india stage
 with oral sucker Schistosoma spp.
 acetabulum – ventral suckers , use to
attach  Male - big but short
 Female - slender but long
Diagnostic test: Stool sample  endemic in the Philippines
Diagnostic stage: Eggs Intermediate host: snail is 1st and only IH
Infective stage: Metacercaria Definitive host: human
Definitive host: Human

Intermediate host: Snail and water plant Schistosoma japonicum

 blood fluke
Echinostoma ilocanum  somewhat roundish
 small ; lateral
( Garrison’s fluke)
Diagnostic test: stool or rectal biopsy
 adult reddish gray
 horse shape collar of spines /circum Diagnostic stage : eggs
oral disk ) around the oral suckers
 49.51 colar spines
 Integument is covered with plaque like Schistosoma mansoni
scales
 manson’s blood fluke
 Simple intestinal cacca
 oblong shaped
 large; lateral

All trematodes are operculated except Diagnostic test: stool or rectal biopsy
scistosoma.
Diagnostic stage: eggs

Schistosoma haematobium

 bladder fluke
 somewhat oblong
 large; terminal

Diagnostic test: urine

Diagnostic stage: eggs

ANTI MALARIALS

Chloroquine

 Killing amoebic trophozoite

Primaquine: hepatic

Quinidine/Quinine: 1st line

Mefloquine: resistant

ANTI AMOEBIASIS

Metrodinazole

ANTI TRICHOMONIASIS

Metrodinazole

Acetarsol

ANTI SCHISTOSOMIASIS

Praziquantel