Parasitology - protozoology (protozoa), helmintology(worms), enthomology(insects)

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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

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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

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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

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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

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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

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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

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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

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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

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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

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Trematodes -

• Usually hermafrodits (ex Schistosoma)
• Need transient host
• Fasciolopsis, Clonorchis, Paragonimus, Schistosoma

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Enterobius vermicularis

• Definitive host - human
• transient - none
• dg. perianal sample microscopy of eggs
• fecal oral transmission - autoinfection

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Enterobius vermicularis
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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

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Ascaris lumbricoides
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Toxocara canis, cati

• Definitive host dog, cat
• Transient host rat
• Human incidental human (larves)
• dg. serology
• transmission hand food

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Taenia saginata

• Definitive human
• transient cattle
• dg. Segments in stool
• Transmission cysticercus in beef

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Taenia solium

• Definitive pig
• transient rat
• incidental human in small intestin
• dg. serology
• Contaminated food

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Echinococcus granulosus

• definitive dog
• transientsheep
• incidental human
• dg serology
• transmission cyste in meat
• infection mechanic pressure from expanded cyst,
  prolonged growing, rupture of the cyst and
  dissemination

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Echinococcus granulosus
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Entamoeba histolytica

• definitive human
• dg.trofosoits in stool, serology
• dysenteria diarhea with blood

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Entamoeba histolytica
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Naegleria fowleri, Acantamoeba

• Free Living in water
• Human (via nose)
• dg.microscopy in CSF- identification of invasive
  strains)
• disease purulent peracute meningitis

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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..

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Trichomonas vaginalis

• Definitive human
• transient none
• dg. Cultivation - microscopy trophosoit - from
  vagina, urine
• Sexual transmission
• Therapy of both (all) partners

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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

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Giardia lamblia
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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

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Plasmodium-malariae, falciparum

• Definitive hostAnopheles
• 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,

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