MT 106.1 CLINICAL PARASITOLOGY, LAB.

AY 2022-2023 | 2ND YEAR, 2ND SEM

Instructor: Ms. Marivic Tuazon AELP 2BSMT2

TOPIC: PARASITOLOGY • The means by which a parasite gains

HISTORICAL PERSPECTIVE entry into an unsuspecting host,
• The documentation of parasites dates referred to as mode of transmission,
back to prehistoric times. vary by specific parasite species and
• A number of discoveries over the are listed here.
years contributed to our current
knowledge of parasitology. For
example:
o The importance of healing
parasite-infected individuals
was recognized once it was
determined that parasites can
be responsible for infections,
infestations, and diseases.
• Other important advances that
contributed to the current PARASITE-HOST RELATIONSHIPS
understanding of parasites: • In order to understand parasite-host
o Invention of the microscope relationships, one must first become
o Improvements in global familiar with the different types of
travel parasites and hosts.
o Enhanced preservation of
• The next few slides highlight the
samples submitted for
types of parasites, the types of hosts,
parasitic examination
and the types of parasite-host
o Laboratory diagnosis
relationship
methods and tools

EPIDEMIOLOGY
• Most parasitic infections are found in
underdeveloped tropical and
subtropical countries.
• Contributing factors to parasite
incidence:
o Increased population density
o Poor sanitation/marginal
water sources
o Poor public health practices
o Environmental changes
affecting parasite vectors
o Habits and customs of the
people
o Advances in worldwide
travel
PARASITIC LIFE CYCLES
• Defined as the route a parasite
follows from any one stage in its
development throughout its life, back
to the stage where the route began

Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB. AY 2022-2023 | 2ND YEAR, 2ND SEM
Instructor: Ms. Marivic Tuazon AELP 2BSMT2

• All parasite life cycles have three ➢ Major organs

common stages: ➢ Eye
o A mode of transmission ➢ Skin
o A stage that infects humans, ➢ Extremities
known as infective stage
o One or more stages that are
detectable in the laboratory,
known as diagnostic stage(s)

There are two phases to each parasitic life

cycle:
Inside the (human) body
• Provides an understanding of
symptomatology and pathology,
method of diagnosis, and selection of
appropriate treatment medication
Outside the (human) body
• Provides crucial information
pertinent to epidemiology, TREATMENT
prevention, and control

Parasitic Life Cycle Example

PREVENTION AND CONTROL

SPECIMEN PROCESSING AND

DISEASE PROCESSES AND SYMPTOMS
LABORATORY DIAGNOSIS
• May affect the whole body or any of
its parts • Most common specimen type tested
– stool
• Examples of body systems that may
be affected: • Analysis consists of:
➢ GI/GU ➢ Macroscopic exam
➢ Blood and tissue ➢ Microscopic exam
Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB. AY 2022-2023 | 2ND YEAR, 2ND SEM
Instructor: Ms. Marivic Tuazon AELP 2BSMT2

• Fecal debris removal process

typically performed as part of
analysis
• Analysis often referred to “O&P”
(ova and parasites)

• Parasites are measured using units

known as microns (one millionth of a
meter: 10-6), often abbreviated as
μm.
• “Artifacts” or “confusers” are
suspicious forms resembling
parasites but are not parasites.

PARASITE NOMENCLATURE AND

CLASSIFICATION
• Scientific names are written in italics.
• Two parts to scientific names:
➢ Genus and species
➢ Example: Giardia intestinalis
➢ Common abbreviation
format: G. intestinalis Looking Back
• Suffix of “-iasis” after genus name • Organisms that live in or on and
indicates associated obtain their nourishment from other
disease/condition name. organisms are referred to as
➢ Example: giardiasis parasites.
• Three major groups of clinically • Selected parasites have evolved over
significant parasites for humans: time from being commensal into
o Group #1 human pathogens.
▪ Single-celled parasites –
protozoa
o Group #2
▪ Multicellular worms –
helminths
o Group #3
▪ Arthropods (insects and
their allies) – animalia

Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB. AY 2022-2023 | 2ND YEAR, 2ND SEM
Instructor: Ms. Marivic Tuazon AELP 2BSMT2

TOPIC: o Biologic Vector –

MEDICAL PARASITOLOGY morphologic change or
Emphasis is placed on: transformation of the
• Identification parasite before transmission
to another host
• Biology and Life Cycle of the
Parasite ▪ Ex. Aedes
o Mechanical/Phoretic
• Laboratory Diagnosis of Parasitic Vector – no morphologic
Infections change occurs on the
• Treatment and Prevention parasite
▪ Ex. Cockroaches and
FUNDAMENTALS OF Flies
PARASITOLOGY
Parasitology ❖ Accidental Host – host that
• Study of parasites, its hosts, and their harbors a parasite that usually does
relationships not infect it

Host-Parasite Relationship ❖ Paratenic Host – aka Transfer

• Symbiosis Host
• Commensalism o Host that harbor parasites
➢ Ex. Entamoeba coli, that do not develop to
Endolimax nana, and other further to later stages
commensal protozoans ▪ Ex. Boars
• Parasitism
➢ Parasite ❖ Dead-end Host (Incidental Host)
➢ Host o Host that does not anymore
allow the life cycle of the
➢ Ex. E. histolytica Ascaris,
parasite to continue
Hookworms, Trichuris,
▪ Ex. Humans
Enterobius
• Mutualism ❖ Reservoir Host
o Host other than parasite’s
PARASITOLOGY usual hosts that allow the life
HOST cycle to continue
• Species which harbors the parasite; it ▪ Ex. Pigs, Field Rats,
may show no harmful effects or may Cats
suffer from the pathogenic effects of PARASITE
the parasite
❖ Obligate – parasite that always
❖ Final Host – Definitive Host require a host for it to survive
o Man is usually the Definitive o Ex. Ascaris, Hookworms,
Host Trichuris

❖ Intermediate Host ❖ Facultative – free living and a

o Ex. Lower Animals, parasitic phase
Vegetation o Ex. Threadworms
❖ Vectors – responsible for ❖ Commensal – non pathogenic
transmission o Ex. Entamoeba coli
Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB. AY 2022-2023 | 2ND YEAR, 2ND SEM
Instructor: Ms. Marivic Tuazon AELP 2BSMT2

Parasites according to habitat: Larva

❖ Ectoparasite • L1-L3
o Infestation – presence of an
ectoparasite in a host
❖ Endoparasite
o Infection – presence of an
endoparasite in a host
❖ Spurious Parasite
o Parasite not living in its
natural host
❖ Erratic Parasite
o Parasite not living in its
natural habitat
❖ Accidental/Incidental Parasite
o Parasite that does not live in
its usual host

Parasites according to egg laying

capacity:
❖ Oviparous
o Ex. Ascaris, Trichuris
❖ Viviparous
o Ex. Schistosoma, Clonorchis Egg/Ovum
❖ Larviparous
o Ex. Trichinella

Parasites according to sexes:

❖ Monoecious
❖ Dioecious
❖ Parthenogenetic

PARASITE STAGES
Helminthes
Protozoans
• Adult
• Trophozoite

Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB. AY 2022-2023 | 2ND YEAR, 2ND SEM
Instructor: Ms. Marivic Tuazon AELP 2BSMT2

STAGES OF DEVELOPMENT TRANSMISSION

• Trophozoite
Soil Transmitted Helminthes
❖ Hookworms
❖ Ascaris lumbricoides
❖ Trichuris trichiura
❖ Strongyloides stercoralis

Vector Borne
❖ Ex. Plasmodium, Hemoflagellates,
Filarial Worms

Food Borne
❖ Ex. Fasciola, Opisthorchis, Clonorchis,
Echinostoma, Heterophyes, Taenia

Water Borne
❖ Ex. Giardia, Cryptosporidium,
Entamoeba histolytica

Vertical Transmission
❖ Ex. Ancylostoma, Strongyloides

Transmammary
• Cyst ❖ Ex. Ancylostoma, Strongyloides

Inhalation
❖ Ex. Enterobius

Intimate Contact
❖ Ex. Trichomonas vaginalis

EXPOSURE AND INFECTION

Cyst Pathogens
harmful and frequently cause
mechanical injury to their hosts

Infection
establishment of the infective agent
in the host

Incubation Period
period between infection and
appearance of signs and symptoms

Pre-patent period
period between infection and
evidence/demonstration of infection

Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB. AY 2022-2023 | 2ND YEAR, 2ND SEM
Instructor: Ms. Marivic Tuazon AELP 2BSMT2

Autoinfection SOME CHARACTERISTICS OF

infected individual becomes his/her PARASITIC DISEASES:
own source of infection • Prevalence in developing countries;
Ex. Capillaria, Strongyloides, in lower socioeconomic population
Enterobius, Cryptosporidium • Low mortality and morbidity
• Limited drug-development
Superinfection/Hyperinfection
• No current vaccines
infected individual is further infected
with the same parasite • Morphology
Ex. Strongyloides • Geographic distribution
• Life cycle
EPIDEMIOLOGY • Symptoms
Study of patterns, distribution and • Pathogenesis and immunity
occurrence of disease • Diagnosis
• Prevalence • Treatment and prevention
• Incidence
• Sporadic SPECIMEN COLLECTION &
• Endemic HANDLING
• Epidemic Stool Specimens
• Pandemic • Most common
• Eradication • Detection of Protozoans and
• Elimination Helminths

PARASITOLOGY Container
An area of biology that deals with the
dependence of one organism on another.
• Host
• Parasite

Medical Parasitology
Tropical Medicine

PARASITES: A PUBLIC HEALTH

CONCERN Number of Collections
• Millions of people are affected • 3 stool specimens in 10 days
worldwide • Up to 6 specimens per day
• Mostly in poor, developing countries (AMEBIASIS)

❖ Proper labelling
❖ Medications can interfere
❖ Antibiotics and antimalarias should
be deferred for 2 weeks

Amount of Stool Specimen

❖ 2-5 grams (Thumb Size or Walnut
Size)
❖ 5-6 tablespoons (Watery Stool)

Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB. AY 2022-2023 | 2ND YEAR, 2ND SEM
Instructor: Ms. Marivic Tuazon AELP 2BSMT2

Examination
❖ 30 minutes
❖ 1 hour
❖ 24 hours

STOOL SPECIMENS
Fixatives
❖ Ratio: 3 parts preservative to 1 part
stool specimen
❖ Fixation Time: 30 minutes
1. Formalin
2. Merthiolate Iodine Formalin
3. PVA (combined with Schaudinn’s)
4. SAF
5. Modified PVA
6. Alternative Single Vial System

OVA & PARASITE EXAM

Microscopy MICROSCOPIC EXAMINATION
❖ Still gold standard for the diagnosis
❖ Standard Procedure performed in Three Distinct Procedures
stool specimens ❖ Direct Wet Preparations
o Macroscopic o DFS
o Microscopic ❖ Concentrated Wet Preparations
o Sedimentation – ex, FECT,
MACROSCOPIC EXAMINATION AECT
Physical Characteristics o Flotation – ex. Zinc Sulfate
❖ Consistency or Form of Stool Flotation (1.18 -1.20);
❖ Color Sheather’s Sugar Flotation
❖ Gross Abnormalities ❖ Permanent Stained Smear
o Trichrome, Iron
Hematoxylin, Specialized
Stains

❖ Presence Presence of Cysts, Eggs,

Adult forms, larval forms,
trophozoite stages
❖ Fecal Elements that might be
mistaken as Parasites
> Leukocytes
> Muscle Fibers
> Vegetable Cells
> Vegetable Spiral
> Vegetable Hair
> Fat Droplets
> Fungal, Yeast Cells

Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB. AY 2022-2023 | 2ND YEAR, 2ND SEM
Instructor: Ms. Marivic Tuazon AELP 2BSMT2

❖ Charcot Leyden Crystals: eosinophil ❖ Biopsy Material

breakdown product o Cutaneous Ulcer, Muscle,
o Significant Rectum, Bladder

EYE SPECIMENS, MOUTH

SCRAPINGS, NASAL DISCHARGE,
SKIN SNIPS
❖ Eye Specimens
o Corneal Scrapings
o Mouth Scrapings
o Nasal Discharge
o Skin Snips
STOOL SPECIMENS
Other Procedures BLOOD SPECIMENS
❖ Cultures ❖ For Diagnosis of Blood Parasites
o Harada Mori Technique such as Plasmodium, Filaria and the
o Corpro Culture Hemoflagellates
o Use of Culture Media
❖ Egg Counting Procedure ANIMAL INOCULATION,
o Kato-Katz (Cellophane Covered XENODIAGNOSIS
Thick Smear) ❖ Animal Inoculation
o Stoll Egg Count ❖ Xenodiagnosis
o Uses arthropod vectors or
OTHER SPECIMENS FROM THE other hosts as an indicator of
INTESTINAL TRACT AND infection
UROGENITAL SYSTEM o Used in diagnosis of Chagas’
❖ Collection of Perianal Swab disease and Trichinosis
o Scotch Tape Swab or Cellulose
Tape Swab QUANTIFICATION AND REPORTING
❖ Sigmoidoscopy Material ❖ Report presence of parasite (Genus –
❖ Duodenal Contents species – stage)
o Duodenal Drainage ❖ Quantitation is indicated in the
o Duodenal Capsule Technique following parasites:
(Entero-Test) o Blastocystis hominis, Helminth
❖ Urogenital Specimens eggs (including Ascaris,
o Urethral and Vaginal Trichuris, Hookworms,
Discharges Clonorchis and Schistosomes),
o Prostatic Secretions Plasmodium, and Babesia
o Urine Sediment ❖ Report other relevant structures
o SemiQuantitate (Rare, Few,
SPUTUM, ASPIRATES AND TISSUE Moderate, Many)
BIOPSIES
❖ Sputum MEDICALLY IMPORTANT
o Expectorated or Induced PARASITES
Sputum ❖ Protozoans
❖ Aspirates ❖ Helminthes
o Lung, Liver Aspirates, o Nematodes
Lymph Nodes, Spinal Fluid, o Trematodes
Bone Marrow o Cestodes
Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB. AY 2022-2023 | 2ND YEAR, 2ND SEM
Instructor: Ms. Marivic Tuazon AELP 2BSMT2

PROTOZOANS Suborder Eimeria

(KINGDOM PROTISTA)

Phylum Sarcomastigophora
Subphylum Sarcodina – Ameba

Phylum Nematoda

Subphylum Mastigophora - Flagellates

Class Trematoda

Phylum Ciliophora - Ciliates

Phylum Apicomplexa Class Cestoda

• Class Sporozoa
• Suborder Haemosporina

Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB.
Instructor: Ms. Marivic Tuazon
TOPIC: PARASITIC INFECTIONS
BASICS IN DIAGNOSIS
BASIC TERMINOLOGY AND
PRINCIPLES
Symbiosis: Living together
Commensalism: One symbiont benefits,
other unaffected
Mutualism: Both symbionts benefit
Parasitism: One symbiont benefits, other is
damaged
Laboratory Methods For Parasites
in Faeces
• No technique is 100% successful in
detecting parasites by a single stool
examination, and at least three
serial stools must be examined
before a patient can be considered
free from infections in which stages
of parasites would be expected to be
found in the faeces.
• Whilst clinical symptoms or a case
history may provide clues as to
which parasites may be present, each
faecal specimen should be treated as
an unknown, as parasite stages
unrelated to the clinical picture may
be present.
Faecal specimens may contain
several stages of Parasites
• Faecal specimens are examined for
the presence of protozoa and
helminthes larvae or eggs.
• The stages of protozoa found in
stools are trophozoites and cysts.
The stages of helminthes usually
found in stools are eggs and larvae,
though whole adult’s worms or
segments of worms may also be seen.
Adult worms and segments of
tapeworms are usually visible to the
naked eye, but eggs, larvae,
trophozoites, and cysts can be seen
only with the microscope
AY 2022-2023 | 2ND YEAR, 2ND SEM
AELP 2BSMT2
COLLECTION OF FAECAL
SPECIMENS
1. Because of the fragile nature of many
intestinal parasites, and the need to
maintain their morphology for
accurate identification, reliable
microscopic diagnosis can’t be made
unless the stool is collected properly.
2. Approximately 10 grams of fresh
faeces uncontaminated by urine, oil,
water, dyes or radioopaque into a
clean plastic container.
3. The container should be free from
antiseptics and disinfectants.
4. Label all samples clearly with the
patient’ s name, reference number,
date, and time of collection.
5. All samples should be accompanied
by a requisition form from the
physician giving relevant clinical
details and recent travel history.
6. Samples and forms from patients
with a confirmed or suspected
diagnosis of certain infectious
diseases such as AIDS or hepatitis
should be clearly labeled with “Risk
of Infection” or “Biohazard”
7. Most viable parasites are susceptible
to desiccation or temperature
variation. If time lapse between
collection and observation is
considerable, i.e. more than 4 days, it
may be necessary to add some form
of preservative to the faeces to retain
the morphology as near to the
original as possible.
8. Formed samples can be kept in a
refrigerator at + 4c for a short while,
but not in incubator.
9. Any whole worms or segments
passed should be placed in a separate
container
Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB.
Instructor: Ms. Marivic Tuazon
Collect the Information of the
Patient
THE MICROSCOPY IN
PARASITOLOGY
• The Microscope is the
parasitologist’s main tool. If possible
the Microscope- should be binocular;
most suitable objectives are the x10,
x40, and x100.
• The Microscope must be covered and
immersion oil removed from the lens
-with xylene or ether when not in
use.
• Calibration of the Microscope
Eyepiece Micrometer:
➢ On many occasions
measuring the size of
suspected parasites in faeces
is helpful for identification.
(eyepiece micrometer)
MICROSCOPIC EXAMINATION
OF WET MOUNT
• Wet mount is the simplest and
easiest technique for the examination
of faeces, and this method should be
performed in all laboratories at the
peripheral level.
• A wet mount can be prepared
directly from faecal material or from
concentrated specimens. The basic
types of wet mount that should be
used for each faecal examination are
saline, iodine, and buffered
methylene blue
AY 2022-2023 | 2ND YEAR, 2ND SEM
AELP 2BSMT2
The saline wet mount
• Is used for the initial microscopic
examination of stools. It is employed
primarily to demonstrate worm's
eggs, larvae, protozoan trophozoites,
and cysts.
• This type of mount can also reveal
the presence of red blood cells and
white blood cells.
The Iodine wet mount
• Is used mainly to stain glycogen and
the nuclei of cysts, if present. Cysts
can usually be specifically identified
in this mount.
• The buffered methylene blue
(BMB) wet mount should be
prepared each time amoebic
trophozoites are seen in a saline wet
mount, or when their presence is
suspected.
Direct saline and iodine mounts
1. With a wax pencil writes the patient’
s name or number and the date at the
left-hand end of the slide
Preparing a faecal specimen
• Place a drop of saline in the centre of
the left half of the slide and place a
drop of iodine solution in the centre
of the right half of the slide.
• Note: If the presence of amoebic
trophozoites is suspected, warm
saline (37c) should be used.
Preparation of Wet film
• With an applicator stick (match or
tooth pick), pick up a small portion of
the specimen (size of a match head)
and mix the drop of saline.
Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB. AY 2022-2023 | 2ND YEAR, 2ND SEM
Instructor: Ms. Marivic Tuazon AELP 2BSMT2

STOOL EXAMINATION objective on the top left-hand corner

and move the slide systematically
backwards and forwards, or up and
down.
4. When organisms or suspicious
material are seen, switch to the high-
dry objective, and increase the light
by opening the sub stage diaphragm
to observe the detailed morphology.
- This is a systematic examination.
If mounts are examined in this
way, any parasites present will
usually be found. If the mount is
not examined systematically,
parasites may be missed.
Examine each microscope field
carefully, focusing up and down,
before moving to the next field.

STOOL EXAMINATION
A Rapid Methods
EXAMINATION
1. Put the slide with the mounts on the
microscope stage and focus on the
mount with the x10 or low-power
objective.
2. Regulate the light in the microscope
field with the sub stage diaphragm.
You should be able to see objects in
the field distinctly. Too much or too
little light is not good.
3. Examine the entire coverslip area
with the x10 objective; focus the
Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB.
Instructor: Ms. Marivic Tuazon
Need for Concentration Methods for
Faecal Examination
• A concentration procedure is
performed mainly to separate the
parasites from faecal debris. The
concentration procedure not only
increases the numbers of parasites in
the sediment but it also unmasks
them, making them more visible by
removing organic and inorganic
debris
STOOL EXAMINATION
Saline sedimentation
STOOL EXAMINATION
Kato technique
AY 2022-2023 | 2ND YEAR, 2ND SEM
AELP 2BSMT2
Stool examination other Techniques
• Stoll’s technique for eggs of Ascaris,
T. trichiura., Hookworms, S.
mansoni
• Baermann’s technique Detec. Of
Nematode L. /stool, soil
• Cultures for Nematode larvae using
Filter paper culture for Larvae of: St.
stercoralis (A,L) and Hookworms
ARTIFACTS
• Artifacts other things, living or
artificial, present in the stool that are
not parasites and could mislead the
laboratory worker.
• Note: “Artifacts not to be mistaken
for cysts
Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB. AY 2022-2023 | 2ND YEAR, 2ND SEM
Instructor: Ms. Marivic Tuazon AELP 2BSMT2

Examining other Specimens BLOOD EXAMINATION

BLOOD FILMS

Observe the Thin and Thick Smear

QBC Method is used in

• The QBC Malaria method is the
simplest and most sensitive method
for diagnosing the following
diseases.
• Malaria
• Babesiosis
• Trypanosomiasis (Chagas disease,
Sleeping Sickness)
• Filariasis (Elephantiasis, Loa-Loa)
• Relapsing Fever (Borreliosis)

QBC A QUICKER ALTERNATIVE

IN MALARIA

Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB. AY 2022-2023 | 2ND YEAR, 2ND SEM
Instructor: Ms. Marivic Tuazon AELP 2BSMT2

HOW TO READ THE QBC

RESULTS
• When the operator looks through
the wall of the tube, the nucleus of
the parasite fluoresces bright green,
and the cytoplasm shows up as
yellow-orange. The shape and
colours are quite characteristic, and
since the parasites are concentrated
up to 1000X, there are usually a
large number of them in any field of
view in this area of the tube INDIRECT IMMUNOLOGICAL
DIAGNOSIS
Serology - All tests available
• IHA
• ELISA
More useful in
• Amoebiasis
• Leishmaniasis
• Malaria
URINE EXAMINATION • Toxoplasmosis
• richinosis
• Filariasis
• Echinococcosis

Skin Tests - Specificity low, cross reactions

common
• Casoni’s test
• Leishmanin test

URINE EXAMINATION
Membrane filtration technique

Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB. AY 2022-2023 | 2ND YEAR, 2ND SEM
Instructor: Ms. Marivic Tuazon AELP 2BSMT2

TOPIC: WHITE BLOOD CELLS

ARTIFACTS AND CONFUSER
• Key Definitions • Often mistaken for amebic
• Select Artifacts and Confusers cysts
➢ White Blood Cells • Present in patients
➢ Pollen Grains suffering from:
➢ Vegetable Cells and Spirals o Ulcerative colitis
➢ Charcot-Leyden Crystals o Bacterial dysentery
➢ Yeast o Intestinal amebiasis
➢ Plant Hair
• Select Artifacts and Confusers POLLEN GRAINS
(continued) • Often resemble
➢ Plant Material eggs of Taenia
➢ Epithelial Cells spp. but have no
➢ Fungal Elements inter
➢ Starch Cells • Can appear round
➢ or Fused Platelets or symmetrically
➢ Stain Precipitate lobed in shape
➢ Red Cell Abnormalities
➢ Looking Back VEGETABLE CELLS
• Often mistaken for
KEY DEFINITIONS amebic cysts
• Often resemble
Artifacts and confusers helminth eggs
• Microscopic elements that resemble • Can appear large,
parasites but are not parasites that roundish oval to
are found primarily in stool and irregularly round in
blood samples shape with thick cell
walls
Example of artifact/confuser • Interior portion unorganized and full
of vacuoles

VEGETABLE SPIRALS
• Often resemble
helminth larvae except
spirals do not have a
head or tail region
• Distinguished from
parasites because of
interior ladder
appearance

Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB.
Instructor: Ms. Marivic Tuazon
CHARCOT-LEYDEN CRYSTALS
• Have most clinical
significance when
seen (breakdown of
eosinophil
products)
• Presence indicates
an immune • Nucleus may consist of a large
response of
unknown origin.
• Reported when seen
• Examine specimens closely that have
Charcot-Leyden crystals
YEAST
• Often resemble
protozoan cysts
except have no
internal structures
• Easily distinguishable
from parasite forms
when in budding
stage
PLANT HAIR
• Often resemble helminth larvae
except have no diagnostic internal
structures (e.g., buccal cavity, head
or tail)
• May have a nondescript internal
structure
PLANT MATERIAL
• Often resemble
helminth eggs
• Can appear round to
oval in shape with or
without a cell wall
• Edges are usually
rough with hairs
(pseudocilia)
• Resemble group of odd-shaped vacuoles
AY 2022-2023 | 2ND YEAR, 2ND SEM
AELP 2BSMT2
EPITHELIAL CELLS
• Often resemble
amebic trophozoites
because of single nucleus
and distinct cell wall but
have no interior
structures
chromatin mass.
FUNGAL ELEMENTS
• Often resemble
protozoan cysts
• Lack of interior
structure easily
distinguishes from
parasitic forms
STARCH CELLS
• Often resemble
protozoan cysts
• Lack of interior
structure easily
distinguishes from
parasitic forms
• Have dark blue to
black appearance when
stained with iodine
CLUMPED OR FUSED
PLATELETS
• Often resemble
malarial parasites,
especially in the young
trophozoite form
• Appear in various
shades of purple
• Often appear in
Giemsa-stained blood
smears
Clinical parasitology
 MT 106.1 CLINICAL PARASITOLOGY, LAB. AY 2022-2023 | 2ND YEAR, 2ND SEM
Instructor: Ms. Marivic Tuazon AELP 2BSMT2

STAIN PRECIPITATE
• Often resemble
malarial parasites but
appear bluer in color on
Giemsa-stained blood
smears
• Vary in size and
shape

RED CELL ABNORMALITIES

• Often resemble malarial parasites but
stain differently according to
abnormality
• Present on Giemsa-stained blood
smears
o Howell-Jolly bodies
o Cabot rings

LOOKING BACK
• Artifacts and confusers are
microscopic forms that resemble
parasites but are not parasites.
• Careful screening and thoughtful
consideration will help in deciding
their identity.
• Charcot-Leyden crystals should be
reported whenever seen due to their
indication of an immune response
that may or may not be caused by a
parasitic infection.

Clinical parasitology