PARASITOLOGY

Introduction to
Diagnostic Parasitology
(Specimen Collection and Handling)

College of Medical Laboratory Science

Our Lady of Fatima University-Valenzuela

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PARASITOLOGY Laboratory Diagnosis
- accurate diagnosis of parasitic infections can help

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decrease the prevalence and incidence of a parasitic
infection.

1. Confirm clinical impression

2. Rule out diagnosis
3. Aid a clinician in the choice of proper medication
4. Help in monitoring the effect of treatment
regimen

Diagnostic parasitology is done by:

A. Demonstration of parasites (e.g., eggs, larvae,
adults, cysts, oocysts, trophozoites)
B. Detection of host immune response to the
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parasites (e.g., Abs and Ags)
PARASITOLOGY FACTORS THAT SHOULD PRECIPITATE TESTING

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1. Travel history
2. Immune status of patients
3. Clinical symptoms
4. Documented previous infection
5. Contact with infected individuals
6. Screening outbreak situation
7. Occupational screening for food handlers
8. Therapeutic failure (retested after therapy)

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PARASITOLOGY SPECIMEN FOR FECAL SAMPLE
- Most common method of intestinal parasites

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CONTAINER: clean, wide-mouthed containers made of waxed
cardboard or plastic with tight fitting lid (screw-capped tops)

LABEL: Patient name

age
sex
date & time of collection
requesting physician
requested procedure
presumptive diagnosis
prior infections
travel history
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PARASITOLOGY FACTORS TO BE CONSIDERED

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1. No anti-diarrheals, antacids, bismuth, barium and
laxatives (samples must be collected 7 days after last
intake)
2. No intake of antibiotics
3. Thumb-sized (formed), 5 to 6 tablespoons (watery)
4. Contamination with toilet water, urine and soil must be
prevented
5. Age of stool is very important
6. Preservative may be needed in cases of delay
7. Never freeze stool nor keep in incubators, temporary
storage: refrigerated at 3 to 5˚C up to 4 hours

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PARASITOLOGY SPECIMEN TYPE, STABILITY AND PRESERVATION

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1. Fresh specimen is mandatory for the recovery of motile
trophozoites
2. Liquid stool should be examined or preserved within 30
minutes of passage. Trophozoite form are found in this
stool.
3. Soft stool should be examined or preserved within 1 hour
of passage
4. Formed stool should be examined or preserved within 24
hours of passage. Cyst form are found in this stool.

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PARASITOLOGY
STOOL PRESERVATIVES:

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1. Formalin
• all purpose fixative
• 5% formalin for protozoan cyst
• 10% formalin for helminth eggs and larvae
2. Schaudinn’s solution – preserve fresh stool for staining
purposes
- contains HgCl2 (highly toxic)
3. Polyvinyl Alcohol (PVA) – plastic resin, which serves to
adhere a stool sample onto a slide. Maintains the
morphological characteristic of the organism.
4. Merthiolate-Iodine Formalin - useful for fixation of
intestinal protozoans, helminth eggs and larvae.
5. Sodium Acetate-Acetic Acid Formalin (SAF)
• No HgCl2
• Not as sharped as PVA and Schaudinn’s fluid
• Longer shelf-life 7
PARASITOLOGY
STOOL COLLECTION

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• Detailed instruction must be given
• Collect sample on a clean container (bedpan or disposable
container)
• Must not be contained with toilet water and urine

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PARASITOLOGY ARTIFACTS, PSEUDOPARASITES, &
CONFUSERS

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Charcot-Leyden crystals
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PARASITOLOGY ARTIFACTS, PSEUDOPARASITES, &
CONFUSERS

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Muscle fiber
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PARASITOLOGY ARTIFACTS, PSEUDOPARASITES, &
CONFUSERS

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Vegetable spirals
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PARASITOLOGY ARTIFACTS, PSEUDOPARASITES, &
CONFUSERS

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Pollen grain
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PARASITOLOGY ARTIFACTS, PSEUDOPARASITES, &
CONFUSERS

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Fat globules 13
PARASITOLOGY ARTIFACTS, PSEUDOPARASITES, &
CONFUSERS

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Starch granules
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PARASITOLOGY MICROSCOPIC STRUCTURES

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RBC
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PARASITOLOGY MICROSCOPIC STRUCTURES

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RBC
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PARASITOLOGY MICROSCOPIC STRUCTURES

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WBC 17
PARASITOLOGY MICROSCOPIC STRUCTURES

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Yeast
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PARASITOLOGY
ROUTINE STOOL EXAMINATION

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Patient Instruction:
1. Within 3 days, patient should avoid eating red meats,
horse raddish, melons, broccoli & turnips (presence of
dietary pseudoperoxidase)

2. Within 7 days, prevent aspirin & nonsteroidal anti-

inflammatory agents (prevent GIT irritation)

3. Within 3 days, prevent taking Vitamin C (ascorbic acid is

strong reducing agent-may interfere peroxidase reaction)

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PARASITOLOGY ROUTINE STOOL EXAMINATION

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A. Physical Examination
1.Color (brown, green, black, white, gray)
COLOR POSSIBLE CAUSE
Black Upper GIT bleeding
Iron therapy
Charcoal
Red Lower GIT bleeding
Ingestion of beets
Rifampin
Pale yellow, Gray, white Bile duct obstruction
Presence of mucus, blood Dysentery
streak Malignancy

2. Consistency (formed, semi-formed, soft, watery*)

* must be examined immediately for presence of
amoebic trophozoites 20
PARASITOLOGY ROUTINE STOOL EXAMINATION

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B. Chemical Examination

Fecal Occult Blood Test (Hemascreen Guiac Slide Test Kit)

Principle: Detection of the pseudoperoxidase activity of

hemoglobin

1. Hema Screen Slide

2. Hema Screen developer (<6% H2O2)

(+) any trace of blue coloration

(-) no detectable blue coloration

C. Microscopic Examination
NOPS- No ova and/or parasite seen
NIPS- No intestinal parasite seen 21
PARASITOLOGY

Laboratory Safety in
Parasitology

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PARASITOLOGY 1. Handle all fresh specimens carefully. Use the universal
precaution. Fecal specimen may contain parasites and

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many potential pathogenic bacteria and contagious viral
agents.
2. Handling specimens and disposal of waste material are of
the utmost importance to maintain good health for the
laboratory personnel and the community.
3. No food and drink allowed in the laboratory. They can be
contaminated.
4. Smoking is not allowed in the laboratory.
5. Frequent hand washing can help to prevent the spread of
parasites.
6. Laboratory gown and uniform must be washed at the
working site. Special attention should be given to avoid
contamination of other items.
7. Obtain immunizations to prevent pathogenic organisms
and treat such.
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PARASITOLOGY 8. Dispose contaminated materials on properly labelled
waste containers with instructions for the waste

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collection.
9. Container for used slides must be filled with one third to
one half disinfectant. The container should be autoclaved
and emptied.
10. Specimen autoclaving before discarding is suggested.
11. Applicator sticks, tongue depressors and pipettes may be
discarded in the same container as slides.
12. Spillage must be soaked with disinfectant. Residue should
be cleaned and discarded as contaminated trash.
13. Chemicals must be considered poisonous, flammable and
corrosive. Distinct labels must be affixed.
14. Mercuric compounds cannot be disposed as regular trash.
A closed steel container is suitable.
15. Sandbox is required for strong acids and base. Avoid
storing strong acids and bases together.
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PARASITOLOGY 16. Flammables are considered to be explosives. Laboratory
should have adequate ventilation and no open flames.

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17. Poisons can intoxicate to the extent of death when
ingested or inhaled. Pipetting by mouth should be
avoided.
18. Prolonged contact with xylene and formaldehyde can be
carcinogenic.

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PARASITOLOGY

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REFERENCES
Mikhail A. Valdescona, RMT, MPH. Introduction to
Diagnostic Parasitology (Specimen Collection and Handling)
Powerpoint presentation. Our Lady of Fatima University.
Valenzuela City.

Domingo, E. (2012). Lecture Notes for Parasitology.

Our Lady of Fatima University. Valenzuela City.

Maria Dannessa Delost (1997). Introduction to

Diagnostic Microbiology: A Text and Workbook.

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