Richard Rupert T.

Vicencio
▪ O and P procedure for stool specimen
▪ Ova refers to the eggs stage of the parasites
▪ Parasites encompasses the other morphologic forms
▪ Two components associated with routine parasitology:
1. Macroscopic
2. Microscopic
Microscopic examination consists of three possible components
a. Collection
b. Transport
c. Fixatives
▪ The typical stool collection protocol consists of three (3) specimens
▪ One specimen collected every other day or a total of three collected in 10 days
▪ In cases of amebiasis, six (6) specimens in 14 days is acceptable.
▪ Certain medications and substances may interfere with the detection of
parasites
▪ Stool samples from patients undergoing therapy that includes:
- Barium - Antacids
- Bismuth or mineral oil - laxatives

- should be collected prior to therapy or not until 5-7 days after the completion of
therapy
▪ Antibiotics or antimalarial medications – should be delayed for two (2)
weeks following therapy.
▪ Clean, wide-mouthed containers made of waxed cardboard or plastic,
watertight with a tight-fitting lid.
▪ 2-5 g is the acceptable amount of stool required for parasite study
▪ Size of the walnut or pea size or thumb size
▪ Urine contamination is not allowed as it may destroy some parasites
▪ Stool should not be retrieved from toilet bowl water because free-living
protozoa and nematodes may confused with human parasites.
▪ Also, water may destroy parasites.
▪ Toilet paper may mask parasites or make examination of the sample
difficult.
▪ Temporary storage of fecal samples in a refrigerator (3 to 5 C) is
acceptable.
▪ Time frame from sample collection to receipt and examination in the
lab is also an important consideration in testing.
▪ The recommended time frame for liquid stool within 30 minutes of
passage.
▪ Semi-formed stool should be examine within 1 hour of passage
▪ Formed-stool specimens can be held for 24 hours following collection.
▪ Should be labeled with the patient’s name and identification number
▪ Age and Sex
▪ Physician’s name
▪ Date and time of collection

▪ Other information :
▪ Suspected diagnosis
▪ Travel history
▪ Clinical findings

*The specimen should be placed into a zip lock plastic bag for transport to the laboratory and
the paperwork accompanying the specimen should be separated from the specimen
container.
1. How many stool samples should be collected when following the typical O&P
collection protocol?
A. 1
B. 2
C. 3
D. 4
1. How many stool samples should be collected when following the typical O&P
collection protocol?
A. 1
B. 2
C. 3
D. 4
▪ Are substances that preserve the morphology of protozoa
and prevent further development of certain helminth eggs
and larvae

▪ 3:1 is the ratio of fixative to stool specimens

▪ The specimen must be fixed in the preservative for at least

30 minutes before processing begins.
▪ All-purpose fixative for the recovery of protozoa and
helminths.
▪ Two concentrations of formalin are commonly used.
▪ 5% ideally preserves protozoan cysts and a 10%
concentration preserves helminths eggs and larvae.
▪ may be routinely used for direct examinations and
concentration procedures, but not for permanent smears
▪ Advantages:
1. Easy to prepare
2. Preserves specimen up to several years
3. Long shelf life
Disadvantages
1. It does not preserve parasite morphology adequately for permanent
smears
2. Trophozoites usually cannot be recovered and morphologic details of
cysts and eggs may fade
▪ Comprised of a plastic powder that act as a adhesive for stool specimen
when preparing slides for staining.
▪ Most often combined with Schaudinn solution, which usually contains zinc
sulfate, copper sulfate, or mercuric chloride as a base.
Advantages of PVA:
1. Can be used as for preparation of a permanent stained smear.
2. Long shelf live when stored at room temperature.

Disadvantages
1. Schaudinn solution contains mercuric chloride
▪ Contains merthiolate (also called thimerosal) and iodine which act as
staining components, while formalin acts as preservative.
▪ useful for the fixation of intestinal protozoans, helminth eggs and
larvae.
▪ Preserved stools ca be examined through wet mount, but difficulty in
the specific identification of protozoans has been encountered.
▪ Staining of preserved stools in the MIF yields unsatisfactory results.
▪ Can be used for performing concentration techniques and permanent
stained smears.
▪ Only requires single vial and it is mercury free.
Advantages
1. Easy to prepare, has a long shelf-life.
2. 2. Can be used for preparing smears for staining with the modified
acid-fast stain to detect coccidian cyst.
Disadvantages
1. The addition of albumin to the microscope slide
2. Protozoa is not clear
▪ Free of formalin and mercury
▪ can be used for concentration techniques and permanent
stained smears.
2. What is the purpose of fixatives for the collection of stool samples?
A. Enhance the motility of protozoa.
B. Stain the cytoplasmic inclusions of protozoa.
C. Preserve the morphology of protozoa and prevent further
development of helminths.
D. All of the above.
2. What is the purpose of fixatives for the collection of stool samples?
A. Enhance the motility of protozoa.
B. Stain the cytoplasmic inclusions of protozoa.
C. Preserve the morphology of protozoa and prevent further
development of helminths.
D. All of the above.
3. Which of the following characteristics is observed during the
macroscopic examination of stool specimens?
a. Consistency
b. Color
c. Adult worms
d. All of the above
3. Which of the following characteristics is observed during the
macroscopic examination of stool specimens?
a. Consistency
b. Color
c. Adult worms
d. All of the above
Macroscopic Examination
▪ Consistency
▪ Color
▪ Gross abnormalities
▪ Three (3) distinctive procedures
1. Direct wet preparations
2. Concentrated techniques
3. Permanently stained smear

* If the specimen is received in fixative, the direct wet

preparation can be eliminated from the O&P procedure; the
concentrate and permanent stain techniques are performed.
4. Which of these procedures is involved in the microscopic examination
of stool specimens for parasites?
A. Performing a concentration technique
B. Determining specimen consistency
C. Examining sample for gross abnormalities
D. Analyzing sample for color
4. Which of these procedures is involved in the microscopic examination
of stool specimens for parasites?
A. Performing a concentration technique
B. Determining specimen consistency
C. Examining sample for gross abnormalities
D. Analyzing sample for color
1. White blood cells
- Polymorphonuclears (PMNs)
- Eosinophils
2. Red blood cells
3. Macrophages, which are usually present in both bacterial and parasitic
infections. In actual practice, one can mistake the active macrophages for
amebic trophozoites.
4. Charcot Leyden crystals
5. Epithelial cells
6. Eggs or arthropods, plant nematodes and other spurious parasites
7. Fungal spores
8. Elements of plant origin which resemble some parasites include:
- Plant cells/fibers
- Pollen grains
- Vegetable spirals Starch granules

9. Plant and animal hairs may loo like helminth larvae

▪ Is used to measure objects observed microscopically accurately.
▪ Is a disk that is inserted into the eyepiece of the microscope.
▪ diagnostic stages of parasites detected microscopically are measured
in units known as microns
▪ Calibration is necessary
▪ Also known as direct wet mount.
▪ Slide may by mixing a small portion (2g) of unfixed stool with saline or
iodine
▪ Under the microscope, the presence of motile protozoan trophozoites is
being detected.
▪ 0.85% saline solution is the reagent of choice
▪ 3 X 2 inch size is suggested for the glass slide.
▪ 22mm square cover slip is utilized.
▪ Trophozoites can be stained to demonstrate the nuclear morphology
using Nair’s buffered methylene blue solution (BMB)
▪ Entamoeba cytoplasm will stain pale blue and nucleus, darker blue
▪ May be made to enhance the detail of the protozoan cysts.
▪ Lugol’s or D’Antoni’s formula (drop of iodine)
▪ It destroy the TROPHOZOITES stage of protozoan.
▪ the cytoplasm will stain golden yellow, the nucleus will be pale and
refractile, and the glycogen will be deep brown.
▪ 50 to 60 mg of stool (approximately the size of two mongo beans)
is placed over a glass slide and covered with cut cellophane
paper soaked in a mixture of glycerine and malachite green
solution.
▪ Glycerine is a clearing solution
▪ Malachite green is used to give color to the cellophane in order to
give a pale green background to the eggs and to minimize the
brightness of the microscopic field.
▪ Green cellophane can also be used if malachite green is not
available.
▪ 10-20 minutes is the preparation to best examined the smear
▪ Useful in detecting eggs with thick shells such as in Ascaris
and Trichuris.
▪ not eggs with thin shells (hookworm)
▪ If the preparation is too long before examination, hookworm
eggs become too transparent or distorted making
identification very difficult.
▪ Not for protozoan cyst and trophozoites.
5. The direct wet preparation can be eliminated from the O&P
examination if the specimen is received in a fixative.
A. True
B. False
5. The direct wet preparation can be eliminated from the O&P
examination if the specimen is received in a fixative.
A. True
B. False
▪ Provide the ability to detect small numbers of parasites that
might be detected using wet preparations
▪ Aggregate the parasites present into a small volume of the
sample. ▪ can be performed on fresh or preserved stool
specimens.
▪ Trophozoites DO NOT usually survive the procedure.
Two types of Concentration methods:
a. Sedimentation
b. Flotation
These techniques use differences in specific gravity and centrifugation to
separate the parasites from fecal debris and increase their recovery.
1. Sedimentation
▪ Parasites are concentrated in the sediment of the tube following
centrifugation
2. Flotation
▪ The parasites are less dense than the solutions used and, during
centrifugation, they float to the surface
▪ Most widely used sedimentation technique.
▪ Based on specific gravity.
▪ Ethyl acetate is added to a saline-washed formalin-fixed sample and the
tube is then centrifuged.
Advantages:
1. It provides good recovery of most parasites
2. Easy to perform

Disadvantages:
1. The preparation contains more fecal debris than a flotation technique
▪ Recommended for the recovery of Trichuris, Capillaria, and trematode
eggs especially Schistosoma.
▪ Also the choice if stool material comes from animals like cats and dogs
▪ Reagents:
1. 40% HCl
2. Ether
▪ Disadvantages include: loss of parasite to the plug of debris and
possible destruction of protozoan cysts
▪ Useful for the recovery of both helminth eggs and protozoan cysts.
▪ Makes use of 10% formalin which is an all purpose fixative.
▪ Can also be done with formalin-preserved and PVA- preserved stools.
▪ More parasites can be recovered from formalin-preserved samples
▪ Parasite morphology is also better preserved in formalin than in PVA
▪ Also based on differences in specific gravity between the sample
debris, which in this case is heavy and sinks to the bottom of the test
tube, and potential parasites, which are lighter and float toward the top
of the tube.
▪ Zinc sulfate with a specific gravity of 1.18 to 1.20, is used as the
concentrating solution.
▪ Parasites float to the surface and can be skimmed from the top of the
tube.
▪ 33% ZnSO4 solution is the main reagent.
▪ If parasite is exposed to high specific gravity, distortion and shrinkage of
protozoan cysts and thin-walled nematodes eggs may occur.
Advantage:
1. more fecal debris is removed and it yields a cleaner preparation

Disadvantage:
1. some helminth eggs are very dense and will not float
▪ Is considered as the BEST for the recovery of coccidian oocysts,
mainly Cryptosporidium, Cyclospora and Isospora.
▪ Boiled sugar solution preserved with phenol is used in this method.
▪ With this procedure, visualization of oocysts can be better appreciated
through the use of a phase microscope.
▪ Use of a saturated table salt solution.
▪ Stools are directly mixed with brine solution.
▪ Centrifugation is not needed since helminth eggs rise to the surface of
the solution.
▪ Low cost and simple but helminth eggs like hookworm and
Schistosoma become badly shrunken.
▪ Not useful for operculated eggs like Clonorchis, and heterophyids
because these do not float in brine solution
6. Which of the following parasitic stages is not usually detected after
using a concentration technique?
A. Protozoan cysts
B. Protozoan trophozoites
C. Helminth eggs
D. Helminth larvae
6. Which of the following parasitic stages is not usually detected after
using a concentration technique?
A. Protozoan cysts
B. Protozoan trophozoites
C. Helminth eggs
D. Helminth larvae
▪ The final procedure in the O&P examination.
▪ defined as a microscope slide that contains a fixed sample that has
been allowed to dry and subsequently stained.
▪ designed to confirm the presence of protozoa cysts and/or trophozoites.
▪ allows laboratory technicians to observe detailed features of protozoa
by staining intracellular organelles
▪ The slides are reviewed under oil immersion (100×);
▪ 300 fields are reviewed before the slide can be considered negative
▪ Two common stains are used for routine O and P testing and these
includes
1. Trichrome (Wheatly modification)
2. Iron hematoxylin
▪ Special stains are also available.
▪ Specialized stains include the modified acid-fast and modified trichrome
stains
▪ Most widely used permanent stain
▪ it uses reagents with a relatively long shelf life and the procedure is
easy to perform
▪ distinct color differences among the cytoplasmic and nuclear structures
of select parasitic forms
▪ Time-consuming
▪ excellent morphology of the intestinal protozoa.
▪ In some cases, the nuclear detail of these organisms is considered to
be stained clearer and sharper than when stained with trichrome.
▪ they do not detect oocysts of the coccidian parasites or spores of microsporidia.
▪ modified acid-fast stain, has become an important permanent stain procedure for the
detection of the oocysts of Cryptosporidium, as well as those of Isospora and
Cyclospora.
▪ has been developed that incorporates a carbol fuchsin step;
▪ this allows for the detection of acid-fast parasites in addition to the
other protozoa normally recovered using the iron hematoxylin stain.
7. The permanent stained smear is critical for detection of helminth eggs and larvae.
A. True
B. False
7. The permanent stained smear is critical for detection of helminth eggs and larvae.
A. True
B. False
1.Stool Culture Methods
Copro culture
- Positive stools are mixed with moistened soil or granulated charcoal.
- This simulates environmental conditions in nature.
- Larvae are harvested using the Baermann procedure
Play video
▪ Use of test tubes and filter paper strips.
▪ Positive stool is applied to the filter paper and placed into a test tube
with about 7cc of boiled or distilled water.
▪ Filariform larvae will generally moves toward downwards against the
upward capillary movement of water, therefore be recovered from the
water at the bottom of the tube.
▪ Strongyloides larvae may instead move upwards and accumulate at
the upper end of the filter paper strip.
▪ Correlate the severity of clinical disease with the intensity of infection or worm burden
▪ Also done with to assess the efficacy of anthelminthics and the reduction of worm
burden following treatment.
3.1 Kato Katz Method
▪ Uses a measured amount of stool which has been sieved through a wire mesh and
pressed under cellophane paper soaked in glycerin-malachite green solution
▪ Used for assessing the intensity of infection in schistosomiasis and common soil
transmitted helminthiases like ascariasis, trichuriasis and hookworm infection.
▪ Consistency of the stool is the main determinant for the sensitivity of
this technique.
▪ For the sensitivity of this technique, some drier stools yield higher egg
counts than moist ones.
▪ Can only be done on fresh formed stools and not on liquid and
preserved samples.

▪ For the identification of Schistosoma ova, 1% eosin solution can be

layered over the cellophane paper. ▪ Can help in the visualization of the
miracidium.
▪ Make use of 0.1N NaOH and a stool displacement flask calibrated at 56
mL and 60 mL.
▪ Sodium Hydroxide – stool diluent
▪ It saponifies fat and frees eggs form fecal debris.
▪ Amount of diluted stool is used for egg counting is measured by Stoll
pipettes calibrated at 0.075 mL and 0.15mL.
▪ The constant used to multiply the total egg count depends on the
amount of stool examined.
▪ Used to recover eggs of Enterobius vermicularis and Taenia spp.
▪ The Enterobius gravid female migrates out throughout the anus at night
time, and deposits eggs on the perianal skin.
▪ Taenia spp. Gravid segments can crawl out of the anus and in the
process, ova are squeezed out of the segment and are deposited on
the perianal skin
▪ often referred to as rapid methods.
▪ can be obtained as kits that contain monoclonal antibody.
▪ This commercial antibody is used to detect antigens in patient
specimens.
▪ Current assays include enzyme immunoassay (EIA), direct fluorescent
antibody (DFA), and membrane flow cartridge techniques.
▪ highly sensitive and specific and
▪ not as technically demanding as the O&P examination, but they only
detect one or two pathogens at a time
8. What is one advantage of the stool screening method?
A. It is highly sensitive and specific.
B. It can detect all parasites.
C. It can be performed on fresh or preserved specimens.
D. It is labor-intensive.
8. What is one advantage of the stool screening method?
A. It is highly sensitive and specific.
B. It can detect all parasites.
C. It can be performed on fresh or preserved specimens.
D. It is labor-intensive.
1. Duodenal material
2. Sigmoidoscopy material
3. Cellophane Tape Preparation

1. Duodenal material
- Specimen may be collected by nasogastric intubation or by the enteric
capsule test (Enterotest)
- Trophozoites must be examined promptly in duodenal fluid because it is
easily disintegrate.
- The enterotest is the simpler method for collecting duodenal material without
requiring intubation.
▪ A gelatin capsule that contains a coiled length of yarn should be swallowed by the
patient.
▪ The capsule dissolves in the stomach and the weighted string is carried to the
duodenum.
▪ free end of the string is attached to the patient’s neck or cheek with tape.
▪ After a 4-hour incubation period, the yarn is pulled back out of the patient.
▪ The bile stained mucous material brought up on the string is then examined
microscopically via wet preps and, if necessary, permanent stains.
▪ often helpful for detecting E. histolytica.
▪ Material from ulcers obtained by aspiration or scraping should be
examined by direct wet preparations and permanent stains.
▪ Coccidian parasites and microsporidia may also be recovered.
▪ Samples suspected to contain amebae are best processed using
surgical pathology methods.
▪ is the specimen of choice for the detection of Enterobius vermicularis
(pinworm) eggs.
▪ otherwise known as the Graham technique.
▪ Morning specimen is ideal time to collect the sample. ▪
▪ To rule out a pinworm infection, a total 5 specimens should be collected
daily.
9. From which area can the Enterotest be used to collect specimens?
A. Duodenum
B. Sigmoid colon
C. Stomach
D. Perianal area
9. From which area can the Enterotest be used to collect specimens?
A. Duodenum
B. Sigmoid colon
C. Stomach
D. Perianal area
1. Blood
Blood Parasites that may recovered in the blood:
1. Leishmania donovani
2. Trypanosoma spp.
3. Plasmodium
4. Babesia spp.
5. Microfilaria
Methods
1. Wet/fresh preparation
2. Stained smears
3. Capillary tube method
4. Knott’s Concentration
5. Membrane Filtration
6. Culture
1. Wet/fresh preparation
▪ some parasites (e.g., Trypanosoma spp., microfilariae) that can be
detected by observing motility under low- and high-power magnification.
▪ species identification is not possible for this method.
2. Stained smears
▪ Thick smear are prepared from 2-3 small drops of blood which are mixed and
spread with continuous movement over an area which is about 2m in
diameter.
▪ Films are then thoroughly dried and then hemoglobinized prior to staining.
▪ Thin smears are prepared in such a way that they are thick at on end and thin
and feathery at other end.
▪ Streaks and holes should be avoided in the film and clean slides and spreader
are used.
▪ After air-drying, slides are fixed with methanol before staining.
▪ Thick smears are used in the demonstration of microfilariae
and rapid diagnosis of malarial infection.

▪ Thin smears are most useful in species identification of

malarial parasites.
1. Giemsa Stain
2. Wright’s stain
3. Delafield hematoxylin
1.Giemsa Stain
- considered the preferred stain because it allows for the detection of parasite detail necessary
for species identification.
- may be prepared from powder or may be commercially purchased a concentrated stock
solution.
With this stain:
▪ Red cells stain pale red
▪ White cell nuclei stain purple
▪ Eosinophils stain bright purple red, and
▪ Neutrophils stain deep pink purple
▪ Fixation is not needed because it already contains alcohol.
▪ Stained smears show:
▪ Light red RBC’s
▪ Bright blue nuclei of WBC
▪ Bright red eosinophilic granules
▪ Pink neutrophilic granules
▪ Useful in demonstrating the detailed structures of microfilariae.
▪ In this method, thick films are dehemoglobinized in 2% formalin with 1%
acetic acid.
▪ The main stain is a mixture of hematoxylin and ammonium alum which
enhances nuclear detail ad morphological feature
▪ Stained smears could be permanently mounted with Canada balsam or
permount.
3. Capillary tube method
▪ Tube is sealed at one end and then centrifuged. ▪
▪ After centrifugation, there will be three (3) layers.

1. Red cell layer

2. White cell layer
3. Plasma
▪ Microfilariae and trypanosomes can be readily visualized at the buffy
coat are when the capillary tube is examined under a microscope.
3. Capillary tube method
▪ Buffy coat films
▪ Trypanosomes and Leishmania are concentrated at the buffy coat portion.

▪ The capillary tube can be broken down at the area of the white cell
layer after centrifugation of the capillary tube.
▪ White cell layer can be spread and stained either with Giemsa or
Wright’s stain.
▪ Makes use of a capillary tube which is precoated with acridine orange and
potassium oxalate.

▪ A cylindrical float is inserted to enlarge the layers. After centrifugation, the

tube is read using an ultraviolet microscope.

▪ DNA of the parasites takes up the acridine orange stain causing fluorescence
among the non-fluorescing red blood cells
s
▪ Useful in the demonstration of malaria parasites, microfilariae, trypanosomes
and Babesia.
4. Knott’s Concentration
▪ designed to concentrate blood specimens suspected of containing low
numbers of microfilariae.

▪ 1 mL of venipuncture collected blood can be mixed with 10mL of 2%

formalin and then centrifuged for 1 minute at 500 x g.

▪ The supernate is discarded and the sediment is studied.

▪ Thick slides may be made, dried, and subsequently Giemsa-stained

from the resulting sediment.
5. Membrane Filtration
▪ Also useful when the density of microfilariae is low.

▪ Make use of syringe attached to a Swinney filter holder

▪ 1mL of fresh or anticoagulated blood is drawn up into the syringe and lyzed by
adding 10mLof distilled water.

▪ The lyzed blood is then passed through the Swinney membrane filter where
microfilariae will be recovered.

▪ The membrane filter can be examined like a wet smear preparation or may be
dried, fixed and then stained.
6. Culture
▪ Specimens submitted for culture can be blood, bone marrow, and tissue.

▪ Novy-MacNeal-Nicolle (NNN) medium is an example of culture medium

designed for the recovery of Leishmania spp. and Trypanosoma cruzi.

▪ NNN slant is inoculated by the addition of a single drop of collected blood or

ground tissue.

▪ Penicillin is added to the medium if the specimen originates from a source that
may contain bacteria.
▪ For the diagnosis of amebic conditions and African sleeping sickness.
▪ Must be examined promptly for the motility of the parasites
▪ Parasites found in the CSF:
1. Naegleria fowleri
2. Acantamoeba spp.
3. Trypanosoma spp. Trypomastigotes “NATToMiTE”
4. Toxoplasma gondii
5. Microsporidia
6. Taenia solium cysticercus larvae
7. Echinococcus spp.
▪ If Naegleria or Acantamoeba are suspected of being potential
pathogens, the specimen can be cultured on non-nutrient agar seeded
with Escherichia coli.

▪ The CSF sediment is inoculated to the medium, sealed, and incubated

at 35° C.

▪ The plate is then examined for evidence of the amebae feeding on the
bacteria.
1. Fluid present in cysts
2. Aspirates
3. Peritoneal fluid
4. Pleural fluid
5. Bronchial washings

* All these samples may be examined using wet preps and/or permanent
stains.
▪ Specimen should be collected early in the morning.
▪ Saliva is not appropriate for examination
▪ May be examined directly via wet preps and/or concentrated using N-
acetylcysteine.
▪ Wet preps and permanent stains
▪ Paragonimus westermani
▪ Strongyloides stercoralis
▪ E.histolytica, E. gingivalis, Ascaris lumbricoides and hookworms
▪ recommended for the recovery of a number of parasites, including
intracellular organisms such as Leishmania spp. and T. gondii.
▪ Surgical removal of the specimen
▪ Preparation of histologic tissue sections
▪ Impression smears

- is the preferred method for handling these samples.

▪ Other parasites
▪ free-living ameba
▪ Trypanosoma spp.
▪ Trichinella spiralis
▪ Microsporidia

HEPATIC ABSCESS - is the specimen of choice for patients suspected of liver

abscesses caused by E. histolytica
▪ Specimen of choice for the detection of Schistosoma haematobium
eggs
▪ Trichomonas vaginalis trophozoites
▪ Microfilariae can sometimes be found with a heavy filarial infection
▪ Sample should be centrifuged
▪ Vaginal, urethral specimens and prostatic secretions are usually collected and
examined for the presence of T. vaginalis trophozoites
▪ Specimen may be collected in swab of collection up with a lid.
▪ Saline wet preparations are the method of choice.
▪ Alternative techniques for the diagnosis of Trichomonas vaginalis includes:
1. Latex agglutination
2. EIA
3. Nucleic acid probe
4. Culture methods
▪ Acantamoeba keratitis is best diagnosed by the collection and
examination of corneal scrapings.
▪ Small tissues may be kept be moist with sterile saline.
▪ Ways on processing the samples:
1. Culture
2. Scrapings and stained using the calcofluor white

▪ *The Acantamoeba cysts stain apple green.

▪ Acanthamoeba
▪ T. gondii
▪ Microsporidia
▪ Loa loa
Mouth Scrapings
▪ E. gingivalis
▪ Trichomonas tenax

Nasal discharge
▪ Naegleria fowleri
▪ Useful in the detection of Onchocerca volvulus
▪ skin snips may be made using one of two collection techniques.
▪ The objective of both procedures is to obtain skin fluid without bleeding
▪ other technique uses a razor blade with which a small cut into the skin
is made.
▪ E. histolytica
▪ T. vaginalis
▪ Leishmania spp.
▪ T. cruzi
▪ T. gondii
▪ Appropriate specimens from patients suspected of suffering from
Leishmania and Trypanosoma and Toxoplasma
▪ Mice
▪ Guinea pigs
▪ Hamsters

Xenodiagnosis is a technique used for the diagnosis of Chagas’ disease

10. Thick blood smears for malaria are recommended for species
identification.
A. True
B. False
10. Thick blood smears for malaria are recommended for species
identification.
A. True
B. False
11. Giemsa is the preferred stain for the detection of blood parasites.
A. True
B. False
12. Which of the following is the specimen of choice to demonstrate
intracellular parasites such as Toxoplasma gondii and Leishmania spp.?
A. Sputum
B. Urine
C. Tissue
D. Genital secretions
12. Which of the following is the specimen of choice to demonstrate
intracellular parasites such as Toxoplasma gondii and Leishmania spp.?
A. Sputum
B. Urine
C. Tissue
D. Genital secretions