Names: Date:

Yr. & Sec.: Assigned Parasite: Entamoeba histolytica

Directions:
1. Develop a hypothetical case for the parasite assigned to you.
2. Include all possible factors that will aid in determining the presence of this parasite.
3. You may provide images (such as sample microscopy result), if necessary.
4. Limit your case into two paragraphs with a maximum of 600 words.
5. Refer to our learning guide for the case analysis rubric assessment and grading.
6. Submit this file in pdf format.
7. The due date of this activity will be reflected in the google classroom.
Hypothetical Case
A 28 year-old foreigner who visited the Philippines is
presented to the emergency room due to non-relieving fever
and is ambulant. Based from the background information of
the patient, the patient is a content creator and loves to
travel around provinces and eat indigenous foods in the
country. Following fever, that patient had loose feces, and is
feeling stomach pain, and stomach cramping. 

The patient’s physician ordered fecal analysis in the

laboratory. The specimen is observed by the medical
laboratory scientist as watery, bloody and has a fishy odor. The stool examination had an estimated
over 100 red blood cells. Additionally, few bacilli, trophozoites with ingested red blood cells,
Charcot-Leyden crystals are also seen upon the microscopic examination. No pus cells were seen.
The trophozoites exhibit ingested red blood cells and clear pseudopodia, 60 in diameter and
motility is rapid and unidirectional. The presence of a small centrally placed karyosome is clearly
visible. The cysts are spherical and usually measure 12 to 15 µm (range may be 10 to 20 µm). A
mature cyst is also seen and it has 4 nuclei. Peripheral chromatin is fine, uniform, and evenly
distributed. With these findings, the physician suspected that it is a parasite causing the patient’s
signs and symptoms. 750 milligrams (mg) of metronidazole was given to the patient subjected for 3
times a day for 5 to 10 days. What is the causative agent?

Base on your hypothetical case, answer the following questions:

1. What are the agent-host-environment factors that determine the occurrence of the
parasitic disease in the area? Explain.

Factors Justification
Environmental Factors Entamoeba species are single cell organisms
Poor Sanitation with two life cycle stages. Cysts are directly
Crowded dwellings excreted in the stool and spread through the
Contaminated food and water environment via contaminated water, soil,
and fresh vegetables as well as unsanitary
 household conditions. 
Host Factors Humans are the major reservoirs of infection
People who live in areas with inadequate with E. histolytica. The infection is acquired
sanitation and personal hygiene. by ingestion of cysts in contaminated water
or food or by fecal-oral contact. Acquisition of
the parasite can result in asymptomatic
infection (most common), diarrheal illness,
or extraintestinal infection, the latter most
commonly manifest as amebic liver abscess.
Agent Factors Ingestion of food and drink contaminated
Ingestion with E. histolytica cysts from human feces,
and direct fecal- oral contact are the most
common means of infection. Amebic infection
is prevalent in the Indian subcontinent,
Africa, East Asia, and South and Central
America. In developing countries, prevalence
depends on the level of sanitation, crowding,
socio-economic status, cultural habits, and
age.
2. What are the recommended diagnostic tests for this parasitic infection? Explain.

Diagnostic Test(s) Justification

Microscopic Detection Microscopic identification of cysts and
Immunodiagnosis trophozoites in the stool is the common
Molecular Diagnosis method for
diagnosing pathogenic Entamoeba species. In
line with this, Enzyme immunoassay (EIA)
kits for Entamoeba histolytica antibody
detection as well as EIA kits for antigen
detection are commercially available in the
United States. Antibody detection is most
useful in patients with extraintestinal disease
(i.e., amebic liver abscess) when organisms
are not generally found on stool
examination.  Moreover, In reference
diagnosis laboratories, molecular analysis by
conventional PCR-based assays is the method
of choice for discriminating between E.
histolytica and E. dispar.