Laboratory Parasitology Atlas

2023
Laboratory Parasitology Atlas
Noha Madbouly Taha

Lecturer of Medical Parasitology
Faculty of Medicine – Cairo University
Consultant of Medical Parasitology
2nd edition
Preface
This Atlas is mainly prepared for laboratory workers containing the basic
techniques for parasitology samples processing and to help them to identify
Parasites in different samples. I love Parasites … and I used to cheer up when I
see any Parasite and always take photos for them. I collected all those photos in
this Atlas … and I hope you like it …
Sincerely …
Noha Madbouly Taha …
2023 / 13931 : ‫رقم اإليداع‬

978 – 977 – 94 – 6356 – 8 : (ISBN) ‫الترقيم الدولي‬
2|Noha Madbouly
© Copyright 2023 by Noha Madbouly Taha
This Book is provided as online pdf
You are allowed to keep a personal hard or soft copy
You are NOT ALLOWED to sell or print this book for commercial purposes
All rights reserved. All pictures in this book are captured or designed &
Copyrighted to Noha Madbouly Taha. No part of this book or any photo may be
used or reproduced in any manner whatsoever without written permission.
Second Edition 2023
I would really be pleased if you send me your comments at

Gmail: noha.madbouly@kasralainy.edu.eg
Watch all Parasitology illustration @YouTube

https://www.youtube.com/channel/UCcaSjLQm4jhFUUElViBYCBQ
And @Facebook
https://www.facebook.com/Doodaia
3|Noha Madbouly
About Author Noha Madbouly Taha
 Bachelor of Medicine & Surgery from Faculty of Medicine – Cairo University
2011
 Master Degree in Parasitology from Faculty of Medicine – Cairo University
2017
 MD Degree in Parasitology from Faculty of Medicine – Cairo University 2020
 Lecturer of Medical Parasitology – Faculty of Medicine – Cairo University
 Consultant of Medical Parasitology
 Certificate in Medical Education from MEDC (Medical Education Developing
Center) – Faculty of Medicine – Cairo University
 Studying Medical Education in the fellowship program of ASU-MENA-FRI
organization; the official representative of the International FAIMER Institute
(IFI) in Philadelphia
 Certificate of TOT (Training of Trainees) from Ain Shams University
 Author of Parasitology Art (Doodaia) book
 Creator of YouTube Doodaia Channel for Parasitology
https://www.youtube.com/channel/UCcaSjLQm4jhFUUElViBYCBQ
4|Noha Madbouly
Acknowledgment
Thanks to Allah … everything in this life runs upon his mercy.

All love to my family … My great Father, Mother and Sister … They are the
great supporters and my backbone in life
All thanks & gratitude towards my dear Professors in Parasitology department

Kasralainy School of Medicine, who gave me knowledge & support.
I would like to share my sincere thanks to Eng. Mohamed Gouda Zahran and
MS Company for trading and fixing all about microscopes and lab machines
that supported this work.
With all love and gratitude …
To every colleague passed in my life … from doctors, parasitologists,

microbiologists, clinical pathologists, chemists, veterinarians, students and
technicians …
I learnt from you all, a technique, an information, a moral or a lesson for life …
You made my journey great … and learned me that we should all work together
like puzzle pieces put together to complete the picture …
Thanks a million …
5|Noha Madbouly
Contents of Our Atlas
Content Page
Number
Chapter 1: How to deal with the Microscope 10
1- Parts of the Microscope 11
2- How to use both eyes 13
3- Choice of the lens 14
4- Cleaning of the lens 16
Chapter 2: Stool Analysis 17
1- Steps of Stool Analysis 18
2- Which technique for what 19
3- Essential Techniques 20
a- Direct saline wet mount 20
b- Iodine Wet Mount Preparation 21
c- Formalin-Ethyl-Acetate Concentration 22
d- Sheather’s sugar Floatation for Cryptosporidium spp. 23
e- Modified Ziehl-Neelsen staining for Intestinal sporozoa 25
f- Peri-anal Swab 26
g- Agar plate culture for Strongyloides stercoralis 27
4- Helminths in stool 28
Helminths Eggs in stool by Size 29
Morphology of Oval Operculated Helminths Eggs 30
Morphology of some Nematodes Eggs 31
Morphology of Schistosoma mansoni, Ascaris lumbricoides, 32
Taenia spp. & Hymenolepis nana eggs
Morphology of Cestodes Segments 33
Helminths adults & Larvae in Stool 34
Taenia spp. 35
Ascaris lumbricoides 36
Ascaris lumbricoides Vs Pollen grain 37
Enterobius vermicularis in stool 38
Enterobius vermicularis in stool 39
Enterobius vermicularis isolated from ileum 40
Enterobius vermicularis eggs stained with MZN stain 41
Peri-anal Swab 42
Schistosoma mansoni eggs 43
6|Noha Madbouly
Hymenolepis nana eggs 44
Capillaria philippinensis 45
Strongyloides stercoralis rhbditiform larva 46
5- Protozoa in stool 47
Morphology of Intestinal Protozoa 48
Morphology of Intestinal Sporozoa 49
Entamoeba histolytica in stool 50
Entamoeba coli in stool 51
Commensals in stool 52
Giardia lamblia in stool 53
Giardia lamblia in stool 54
Blastocystis hominis in stool 55
Blastocystis hominis in stool 56
Cystisospora belli oocysts in stool 57
Cryptosporidium parvum oocysts in stool 58
6- Arthropods in Stool 59
Morphology of some Arthropods in Stool 60
7- Cells, mucous, undigested food and others in Stool 61
Pus cells, RBCs, Mucous & Epithelial cells 61
RBCs 61
Mucous, Epithelial cells, Pus cells & Bacteria 62
Starch 63
Starch & Muscle Fibers 64
Fat Globules 65
Air bubbles artifacts 66
Yeast like cells & Vegetable fibers 67
Hair & Charcot-Leyden crystal 68
Fungal Spore 69
8- Stool Reporting 70
Chapter 3: Urine Analysis 71
1- Steps of Urine Analysis 72
a- Urine Sedimentation 73
b- Benedict Confirmatory test for urine Glucose 74
c- Heating Coagulation Confirmatory test for urine Albumin 75
d- Fouchet confirmatory test for Bilirubin 76
7|Noha Madbouly
e- Ehrlich’s confirmatory test for Urobilinogen 77
Benedict test for Glucose reading 78
Heating coagulation test for Albumin reading 79
Ehrlich’s test for Urobilinogen & Fouchet test for Bilirubin 80
3- Crystals in Urine 81
Common Crystals in Urine 82
Crystals in Acidic PH 83
Crystals in Alkaline PH 84
Amorphous in Urine 85
Calcium oxalate crystals in Urine 86
Uric acid crystals in Urine 88
Triple phosphate crystals in Urine 88
Other Crystals 89
4- Casts in Urine 91
Granular casts in Urine 92
Hyaline, WBCs & Granular casts in Urine 93
5- Cells & Fungi in Urine 94
Fungi & Epithelial cells in Urine 94
Pus cells, RBCs, Mucous 95
Pus cells, RBCs, Mucous 96
6- Parasites in Urine 97
Schistosoma haematobium & Enterobius vermicularis eggs 97
Trichomonas vaginalis 98
7- Urine Reporting 99
Chapter 4: Semen Analysis 100
1- Steps of Semen Analysis 101
Sperm morphology 102
Cells & Agglutination 103
a- Test for Viscosity 104
b- Test for Vitality 105
c- Sperm Counting 107
3- Azoospermia 109
4- Parasites in Semen 109
5- Semen Reporting 110
Chapter 5: Parasites in Blood 112
8|Noha Madbouly
1- Parasites in Blood 113
2- Thin & Thick Blood films 114
3- Malaria parasites 115
Morphology of Plasmodium spp. stages 116
Plasmodium falciparum 117
Plasmodium vivax & Plasmodium falciparum 118
4- Knott’s concentration technique for microfilaria 119
Chapter 6: Parasites in Duodenal, Biliary fluids & Liver 120
Aspiration
1- Parasites in Duodenal, Biliary fluids & Liver Aspiration 121
2- Fasciola spp. 122
3- Hydatidosis 123
4- Toxocara cati eggs 125
Chapter 7: Parasites in Different Samples 126
1- Parasites in Brain, CSF & Eyes 127
2- Parasites im muscles 128
Toxoplasma gondii tachyzoites 128
Sarcocystis 128
Trichinella spiralis 129
3- Parasites in Pathological Sections 130
Schistosoma haematobium egg in Bladder Carcinoma 130
Helicobacter pylori bacteria in stomach biopsy 131
4- Parasites in Skin 132
Sarcoptes scabiei mite 132
References 133
9|Noha Madbouly
Chapter 1:
How to deal with Microscope
Chapter 1: How to deal with Microscope
Content Page No.
1- Parts of the Microscope 11
2- How to use both eyes 13
3- Choice of the Lens 14
4- Cleaning of the Lens 16
10 | N o h a M a d b o u l y
1- Parts of the Microscope
2
2
4
5
6
12 7
13 9
8
11 10
Parts of the Microscope

1- Ocular Lens (commonly X 10 magnification)
2- Carrier for Objective lenses
3- Power X 4 Power lens  Magnifies 40 times (4 objective lens magnification
X 10 ocular lens magnification)  Used for relatively large specimens eg: Adult
worms like Adult Enterobius vermicularis
4- Power X 10 lens  Magnifies 100 times  Used for Helminth eggs
screening and Casts screening
1
11
2
3 2
4 5
6
8
12
13
7
8
9
10
Parts of the Microscope

5- Power X 40 lens  Magnifies 400 times  Used for routine stool, urine and
semen examination
6- Power X 100 Oil Immersion Lens (OIL)  Magnifies 1000 times  Used for
very small Protozoa, Bacteria and Permanent stained smears
7- Stage for Holding the Slide
8- Button for moving the stage right to left and up and down
9- Diaphragm that controls illumination
10- Light Source
11- Button for illumination control
12- Coarse Adjustment
13- Fine Adjustment
2- Use Both Eyes
How to Adjust vision by Both Eyes

1,2- Don’t closely approach the ocular lens, Keep a distance between your eyes
and both ocular lenses
3- Separate Ocular lenses far and near to each other until your both eyes can see
a single shot under the microscope
3- Choice of the Lens
2 3 4
Objective Lenses
1- Power X 4
-Marked by Red Line
-Magnifies 40 times (4 objective lens magnification X 10 ocular lens
magnification)
-Used for relatively large specimens eg: Adult Helminths – Cestodes Segments
2- Power X 10 lens
-Marked by Yellow Line
-Magnifies 100 times
-Used for Screening for Helminth eggs, Urine Casts and sites of pus collection
NB: X 4 and X 10 Lenses need Low Illumination … Bring the condenser down,
close the diaphragm and Reduce Light
Objective Lenses
3- Power X 40
-Marked by Blue Line
-Used for Routine Urine, Stool and semen examination
4- Power X 1000 lens
-Marked by White Line
-Needs oil
-Used for Permanently stained smears, Blood films and very tiny Bacteria and
Protozoa
NB: X 40 and X 100 Lenses need High Illumination … Bring the condenser up,
open the diaphragm and increase Light
Tip: Turned slides upside down can’t be examined by X 40 and X 100 Lenses,
If you can’t adjust the field make sure that the slide is put correctly
4- Cleaning of the Lens
Steps of Lens Cleaning

1- Use a cotton pad with lens cleaning fluid or alcohol
2- Clean the lens in a circular movement in one direction
3- Repeat the process with a dry cotton pad
4- Remove any dust using an air pump or a brush
Chapter 2: Stool Analysis
Chapter 2: Stool Analysis

Content Page No.
1- Steps of Stool Analysis 18
2- Which Technique for What 19
a- Direct Saline wet mount
b- Iodine wet mount
c- Formol-ether Concentration
d- Sheather’s sugar Floatation
e- Modified Ziehl Neelsen staining
f- Peri-anal Swab
g- Agar plate culture for Strongyloides stercoralis
4- Helminths in stool 28
5- Protozoa in stool 47
6- Arthropods in stool 59
7- Cells, Mucous, Undigested food and Others in stool 61
8- Stool Reporting 70
1- Steps of Stool Analysis
Tips for Stool Analysis

1- Take a good history about GIT symptoms – Other symptoms – Drugs –
Residency – Occupation
2- Be a good Observer  Look directly at the sample and Notice any moving
subject – Mucous – Blood
3- If you are searching for a moving Protozoal Trophozoite  examine a wet
saline mount
4- Examine Iodine wet mount and examine mucous especially
5- If you are searching for Protozoal Cysts or Helminth Eggs, and you did not find
anything in the direct wet mount  Do concentration
6- Examine any slide in a zigzag manner in order not to miss any field
7- If you are suspecting Cryptosporidium spp.  Do Sheather’s Sugar Floatation
and Modified Ziehl-Neelsen stain.
2- Which Technique for What
1- Direct Saline wet mount  Moving Protozoal Trophozpoites (Entamoeba –

Giardia – Balantidium)
2- Iodine wet mount  Routine stool examination – Protozoa – Helminth eggs
3- Formol-ether concentration  Protozoal Cysts and Helminth eggs (Highly
sensitive)
4- Sheather’s sugar Floatation  Small Sporozoa (Cryptosporidium parvum)
5- Modified Ziehl-Neelsen staining  Sporozoa (C. parvum – Cyclospora
cayetanensis – Cystisospora belli – Microsporidium) – Differentiate Taenia
saginata from T. solium eggs
6- Peri-anal swab  Enterobius vermicularis (Pinworm) – Taenia saginata
7- Agar plate culture  Strongyloides stercoralis
3- Essential Techniques
a- Direct Saline wet mount preparation

1- Mix a drop of the sample with a drop of Saline then add a coverslip
2- Used for detection of Motile Protozoal Trophozoites
(Entamoeba histolytica – Giardia lamblia – Balantidium coli)
3- Should be examined directly within 30 minutes 
Trophozoites die after that
b- Iodine wet mount preparation
1- Mix a drop of the sample with a drop of Iodine then add a coverslip
Or
2- Mix a drop of the sample with a drop of Saline and add a coverslip 
Then add a drop of Iodine at the peripheral margin of the coverslip
 allow to diffuse into the sample
- Temporary stain Used for Routine stool examination

- Suitable for Protozoa and Helminths
c- Formalin – ethyl acetate concentration
1- Mix a pea-sized piece of feces with 4 ml formalin 10% or 7%
2- Sieve the mixture through gauze into another tube
3- Add 3 ml ethyl acetate
4- Vortex for 1 minute
5- Centrifuge at 3000 rpm for 10 minutes
6- 3 layers will be formed; the sediment at the bottom then the
supernatant and at the top a layer of fat
7- Loosen the layer of the fat by a stick
8- Discard the fat and the supernatant
9- Vortex the sediment
10- Examine the sediment
11- Perfect for Helminth eggs and Protozoal Cysts
d- Sheather’s sugar Floatation (For Cryptosporidium spp.)
1- Add 1 gm feces to a tube
2- Fill the tube to the end with the Sheather’s Sugar solution (see below)
3- Centrifuge 500 xg for more than 10 minutes
4- Move a coverslip on the top of the tube to collect the floating material
5- Move the coverslip on top of a glass slide
6- Stain with MZN stain
7- Examine
Sheather’s sugar solution
1- Add 500 gm Sucrose to 320 ml water
2- Boil
3- Add 6.5 gm Phenol
4- Allow mixture to cool
e- Modified Ziehl-Neelsen Stain (For Sporozoa)
1- Spread a thin film of the sample on a glass slide
2- Allow to dry
3- Add Methanol for fixation
4- Allow to dry
5- Add Carbol Fuchsin [(1.6 basic Fuchsin + 20 ml 95% ethanol) + (8 gm
phenol crystals + 100 ml dd water)] for 10 – 15 minutes
6- Wash with water
7- Wash with Decolorizer (97 ml Absolute Ethanol + 3 ml conc. HCl) until
smear is faint pink
8- Add Methylene Blue (0.3 gm Methylene blue + 30 ml 95% Ethanol) for
1 – 2 minutes
9- Wash with water
10- Allow to dry
11- Examine under Oil Immersion Lens (OIL) X100
12- Used for Cryptosporidium spp., Cyclospora cayetanensis,
Cystisospora belli and Microsporidia
13- Differentiate between T. saginata and T. solium eggs. Only T.
saginata eggs take the stain
Peri-anal Swab for Pinworm
f- Peri-anal Swab
14- Collect the sample in the morning before defecation or washing
15- Apply a transparent adhesive tape onto the anus and the adjacent
skin of the peri-anal region
16- Stick the tape onto a glass slide
17- Make more than one slide
18- Put slides into a cup and transfer to the laboratory
19- Examine slides under the microscope
20- Used for detection of Enterobius vermicularis eggs as they are present
adherent to the perianal region & Taenia saginata eggs that may be
dispersed in the anal region from the migrating gravid segments
Agar plate Culture for Strongyloides stercoralis
g- Agar Plate Culture

1- Prepare media (1.5% agar + 1% peptone + 0.5% NaCl + 0.5% Meat
extract + 96.5% distilled water) and autoclave
2- Dispense in plates and allow to dry
3- Put 2 gm from feces sample in the center of the plate
4- Cover the plate and seal with adhesive tape (To prevent infection)
5- Incubate at room temperature for 48 hours
6- Examine under the microscope for rhabditiform larvae of
Strongyloides stercoralis
7- Used for Strongyloides stercoralis
4- Helminths in Stool
A. Eggs: (Commoner to less Common)
1- Enterobius vermicularis (Pinworm)
2- Hymenolepis nana
3- Taenia spp.
4- Ascaris lumbricoides
5- Schistosoma mansoni (Bilharzia)
6- Ancylostoma duodenale (Hookworm)
7- Fasciola spp.
8- Capillaria philippinensis
9- Trichuris trichiura
10- Diphyllobothrium latum
11- Heterophyes heterophyes
12- Paragonimus westermani (Lung Fluke)
B. Segments (Tapeworms):
1- Taenia spp. gravid segments
2- Diphyllobothrium latum mature segments
C. Larvae:
1- Strongyloides stercoralis rhabditiform larvae
D. Adults:
1- Enterobius vermicularis
2- Ascaris lumbricoides
Helminths eggs in Stool
Helminth Eggs that can be seen in Stool

 The Size of the egg is a very important feature in identification
 The largest egg is Schistosoma mansoni egg that is identified by the
lateral spine
 Fasciola spp. egg is oval, yellowish with an operculum and is nearly
the double size of Paragonimus westermani egg and
Diphyllobothrium latum egg
 Ascaris lumbricoides egg is mamillated
 Hookworm egg is characterized by the blunt poles and the large space
between the shell and the content
 Trichuris trichiura egg have a mucoid plug at each pole and is larger
than the golden yellow Capillaria philippinensis egg which is peanut
shape
 Enterobius vermicularis egg is plano-convex
 Hymenolepis nana egg is rounded with large space between its two
shells that contain filaments while Taenia spp. egg is darker in color
and smaller
 Heterophyes heterophyes egg is very small with thick shell and
operculum
A. Fasciola spp. egg. The egg is 140 x 70 µ, oval and yellowish brown. The arrow
denotes the operculum. Fasciola is a liver fluke. B. Diphyllobothrium latum egg.
The egg is 70 x 50 µ, oval and yellowish brown. The arrow denotes the
operculum. C. Heterophyes heterophyes eggs. The eggs are small 30 x 15 µ,
oval, yellowish brown with thick shell and a miracidium inside. The black arrow
denotes the operculum while the red one points a knob at the posterior end.
D. Paragonimus westermani egg. The egg is 90 x 55 µ, oval and brownish. The
black arrow denotes the operculum while the red one points a thickening at the
posterior end. P. westermani is a lung fluke.
A. Enterobius vermicularis egg. The egg is plano-convex 50 x 25 µ. The red arrow
points to rhabditiform larva that may be seen inside the egg. B. Hookworm egg.
The egg is oval, 60 x 45 µ with blunt poles. There is a large space (the black
arrow) between the shell and the content (4 cell stage denoted by the red
arrow). C. Capillaria philippinensis egg. The egg is peanut shape, 40 x 20 µ,
golden yellow with a mucoid plug at each pole (The black arrows). D. Trichuris
trichiura egg. The egg is barrel shaped, 50 x 20 µ with a mucoid plug at each
pole (The black arrows).
A. Schistosoma mansoni egg. The egg is oval 150 x 60 µ with a lateral spine (The
red arrow). The egg contains a mature miracidium (The black arrow). B. Ascaris
lumbricoides egg. The egg is mamillated (The black arrow) and is 60 x 45 µ. C.
Hymenolepis nana egg. The egg is rounded about 50 µ in diameter, with large
space between its two shells that contain filaments (The black arrow). It
contains mature hexacanth onchosphere (The red arrow). D. Taenia spp. egg.
The egg is brown in color, about 40 µ in diameter with striated shell. It contains
mature hexacanth onchosphere (The red arrow).
Helminths segments in Stool
A. Taenia saginata gravid segment. Longer than broad segment about 1 cm,
with lateral uterine branches 15 – 30 branches on each side. B. Taenia solium
gravid segment. Longer than broad segment about 1 cm, with lateral uterine
branches 9 – 12 branches on each side. C. Diphyllobothrium latum mature
segment. Broader than long segment about 1 cm, with rosette shaped uterus
(The black arrow).
Helminths Adults & Larvae in Stool
A. Enterobius vermicularis adult female worm. About 1 cm in length with pin

tail (Green arrow). It shows Double-bulbed esophagus (Red arrow) and cephalic
alae (Black arrows). It has 2 uteri full of eggs (Yellow arrow). B. Strongyloides
stercoralis rhabditiform larva. It shows short buccal cavity (Black arrow),
rhabditiform esophagus (Red arrow), gut (Yellow arrow) and genital primordia
(Blue arrow).
A. Taenia spp. worm. Flat white segmented worm 4 – 10 meters. B. Taenia spp.
gravid segment. White rectangle about 1 cm. C. Taenia saginata gravid segment
stained with carmine stain. Rectangular segment, longer than broad with > 15
lateral uterine branches on each side. D. T. saginata eggs inside gravid segment
x 4 magnification. E. T. saginata eggs inside gravid segment x 10 magnification.
F. Taenia spp. egg in stool sample stained with iodine x 40 magnification. The
egg is brown in color, about 40 µ in diameter with striated shell. It contains
mature hexacanth onchosphere.
- To differentiate T. saginata from T. solium eggs  Stain the stool sample with
MZN  Only the eggs of T. saginata will take the stain.
Mode of Infection: Ingestion of improperly cooked meat containing the larval
stage “Cysticercous bovis or Cysticercous cellulosae”.
Clinically: Abdominal pain and Digestive disturbances.
Complications: Appendicitis – Cholangitis – Intestinal Obstruction
A. Ascaris lumbricoides adult worm. Cylindrical white worm 20 – 25 cm. B. A.
lumbricoides egg in stool sample. Mamillated egg 60 x 45 µ. Oval, yellowish
brown with immature content. C. A. lumbricoides egg. D. A. lumbricoides
decorticated egg (without mamillations). E. A. lumbricoides egg. F. A.
lumbricoides eggs.
Mode of Infection: Ingestion of improperly washed vegetables and fruits
contaminated with mature eggs.
Clinically: Cough followed by Abdominal pain and Digestive disturbances after
2 weeks.
Complications: Appendicitis – Cholangitis – Intestinal Obstruction – Liver
Abscess
A. A. lumbricoides eggs in stool sample. Mamillated egg, more rounded than
oval and bigger in size. B. Pollen grain. May be mistaken for A. lumbricoides egg,
however, it is smaller and narrower. Note the difference in shape. C. A diagram
for A. lumbricoides egg. D. A diagram for the pollen grain.
A. Enterobius vermicularis adult female worm in stool sample x 4 magnification
stained with iodine. Rounded worm with pin tail (Red arrow), Double-bulbed
esophagus (Black arrow) and 2 uteri full of eggs. B. E. vermicularis adult female
worm x 40 magnification stained with iodine showing eggs inside uterus (Black
arrow). C. D & E. E. vermicularis eggs in stool sample x 40 magnification stained
with iodine. Plano-convex egg with straight border (Red arrow) and a convex
border (Black arrow).
Mode of Infection: Ingestion of eggs with contaminated food and drink
Clinically: Common in Children – Main symptom is Peri-anal Itching - Abdominal
pain
Complications: Enuresis – Urinary tract infection – Appendicitis
Diagnosis: Mainly by Peri-anal swab
Treatment: Drugs should be repeated after 10 days as this helminth is highly
infectious and the patient infects himself “Autoinfection” – The whole family
should receive the drug.
A. Enterobius vermicularis adult worms in stool appear as white threads 1 cm
each, on the surface of the sample (Red arrows) and trapped in mucous (Black
arrows). B. E. vermicularis adult female x 40 magnification stained with iodine
showing eggs inside uterus. C. E. vermicularis adult female x 4 magnification
stained with iodine showing eggs inside uterus.
Enterobius vermicularis adult female worm isolated from ileum. A. E.
vermicularis adult female worm x 4 magnification showing pin tail (Red arrow)
and extruded double-bulbed esophagus (Black arrow). B. E. vermicularis double
bulbed esophagus x 40 magnification. C. E. vermicularis adult female x 40
magnification showing eggs inside uterus (Black arrow). D. E. vermicularis adult
female x 10 magnification showing eggs inside uterus (Black arrow).
A & B: Enterobius vermicularis eggs stained with MZN stain x100
magnification.
Perianal Swab. A. Enterobius vermicularis eggs x 4 magnification. B. E.
vermicularis adult female worm x 10 magnification showing Cephalic alae (Red
arrows). C. Air bubbles Artifacts resembling E. vermicularis eggs. D. Air bubble
Artifact resembling E. vermicularis egg. E. E. vermicularis eggs x 4 magnification.
F. E. vermicularis eggs x 10 magnification. G. E. vermicularis eggs x 10
magnification.
A. Schistosoma mansoni egg in stool x 40 magnification. Oval, large egg, 150 x
60 µ. It carries a lateral spine (Black arrow) and contains a mature miracidium.
Note the pus cells and the RBCs surrounding the egg as the main clinical feature
of Schistosomiasis is dysentery. B. S. mansoni egg in stool x 40 magnification.
Note the Mature Miracidium inside (Red arrow). C. S. mansoni egg. D.
Schistosoma furcocercous cercaria X 10 magnification (The infective stage). It is
composed of an oval head and a forked tail.
Mode of Infection: Penetration of the skin by cercaria while swimming in canal
water.
Clinically: Main symptom is Dysentery
Complications: Chronic infection can result in Portal Hypertension
A. Hymenolepis nana egg in stool sample X 40 magnification. B. H. nana egg
showing hooked onchosphere (Black arrow). C,D,E,F. H. nana egg. G. H. nana
egg showing filaments between the 2 shells (Black arrow). H. H. nana egg
stained with iodine x 10 magnification.
Mode of Infection: Ingestion of eggs with contaminated food and drink
Clinically: Common in Children – Abdominal pain
Treatment: Drugs should be repeated after 10 days as this helminth is highly
infectious and the patient infects himself “Autoinfection” – The whole family
should receive the drug.
A. Capillaria philippinensis adult worm in stool x 10 magnification. Cylindrical
worm 2 – 5 mm with cellular esophagus. B. C. philippinensis larva in stool x 40
magnification. C. C. philippinensis egg in stool x 40 magnification. Peanut shaped
egg 40 x 20 µ with thick shell, a mucoid plug at each pole and immature content.
Mode of Infection: Ingestion of contaminated whole small fish containing
infective larvae
Clinically: Chronic watery diarrhea
Complications: Untreated cases die from dehydration, secondary infections or
electrolyte disturbances
Strongyloides stercoralis rhabditiform larva in stool. A. S. stercoralis larva in
stool sample x 40 magnification showing rhabditiform esophagus. B. S.
stercoralis larva in stool x 40 magnification stained with iodine. C. S. stercoralis
larva in stool showing rhabditiform esophagus (Black arrow). D. S. stercoralis
larva in stool showing short buccal cavity and distinct genital primordium (Red
arrow). E. S. stercoralis larva in stool x 10 magnification stained with iodine. F.
Hair fiber that should not be confused with nematode larvae.
Mode of Infection: Penetration of the skin by the filariform larva
Clinically: Diarrhea
Complications: Opportunistic with serious systemic symptoms in
immunocompromised patients
5- Protozoa in Stool
1. Entamoeba histolytica/dispar:
- Entamoeba histolytica and Entamoeba dispar are identical morphologically
and only differentiated by PCR. E. dispar is a commensal so definite
pathological amoebiasis caused by E. histolytica should be confirmed
clinically.
2. Giardia lamblia
3. Blastocystis hominis
The Commonest
4. Balantidium coli:
- A ciliate of Pigs
5- Opportunistic Sporozoa Oocysts:
A- Cryptosporidium spp.
B- Cyclospora cayetanensis
C- Cystisospora belli
D- Microsporidium spp.
- They Require MZN staining
6. Commensals:
A- Entamoeba coli
B- Chilomastix mensili
C- Iodamoeba butchlii
D- Trichomonas intestinalis (Pentatrichomonas hominis)
Protozoa in Stool
A. Entamoeba histolytica trophozoite. Irregular in shape about 25 µ. It contains

a single nucleus with central nucleolus. It also contains food RBCs vacuoles (Red
arrow). B. Entamoeba histolytica cyst. Rounded 15 µ with a cyst wall. It contains
1 – 4 nuclei with central nucleoli. C. Entamoeba coli cyst. Rounded 25 µ with a
cyst wall. It contains 5 - 8 nuclei with eccentric nucleoli. It is a commensal. D.
Giardia lamblia trophozoite. Pear shaped with 2 sucking discs (Yellow arrow). It
contains axostyle and a parabasal body (Black arrow) and moves by flagellae
(Red arrow). E. Giardia lamblia cyst. Oval 12 µ with a double cyst wall (Red
arrow). It contains 4 nuclei and remnants of axostyle, flagellae and parabasal
bodies. F. Blastocystis hominis. Rounded 6 - 40 µ with a central vacuole (Black
arrow) and nuclei at periphery.
Intestinal sporozoa with MZN stain. A. Cystisospora belli oocysts. Fusiform 30
x 12 µ with blunt poles. It contains 2 sporocysts each contain 4 sporozoites.
Unsporulated oocysts with 1 or 2 sporoblasts may be shed in stool. B. Cyclospora
cayetanensis oocyst. Rounded 8 - 10 µ that stain differently. C. Cryptosporidium
spp. oocysts. Rounded 4 – 6 µ with 4 sporozoites. D. Microsporidium spores.
Very tiny 0.5 – 4 µ. It stains pink with belt like structure the polar tubule (Black
arrow). Microsporidia are best diagnosed by modified Trichrome stain or
Transmission Electron Microscope (TEM).
Entamoeba histolytica/dispar in stool sample stained with iodine x 40
magnification. A. E. histolytica/dispar cyst. Rounded cyst 15 µ surrounded by a
cyst wall. B. E. histolytica/dispar cyst. C. E. histolytica cyst showing well defined
cyst wall, a nucleus and a glycogen vacuole. D. E. histolytica/dispar trophozoite.
Irregular with a single nucleus. E, F,G,H,I. E. histolytica/dispar cyst. J. E.
histolytica trophozoite with single nucleus (Black arrow) and engulfed RBC (Red
arrow).
Mode of Infection: Ingestion of cysts with contaminated food and drink
Clinically: Dysentery
Complications: Severe colitis – Liver, Lung or Brain Abscess
E. coli trophozoite in stool sample stained with iodine x 40 magnification.
Irregular, large with single nucleus. The nucleus shows eccentric karyosome and
irregular peripheral chromatin. The sample contains no pus cells, RBCs or mucous
as the parasite is a commensal.
A. Iodamoeba butchlii cyst in stool sample stained with iodine x 40 magnification
showing large glycogen vacuole and a single nucleus. B. Entamoeba coli cyst in
stool sample stained with iodine x 40 magnification. Larger than Entamoeba
histolytica cyst with 5 – 8 nuclei. E. coli is a commensal. C,D. Chilomastix mensili
cyst in stool sample stained with iodine x 40 magnification. It is 6 – 9 μ with
Lemon shape. It has large single nucleus and a cytostome. It is non pathogenic.
Giardia lamblia in stool sample stained with iodine x 40 magnification. A. G.
lamblia cysts. B. G. lamblia trophozoite pear shaped with 2 nuclei (Red arrow).
C. G. lamblia cyst. D. G. lamblia cyst showing double wall (Red arrow). E. G.
lamblia cyst showing the axostyle (Black arrow). F,G. G. lamblia cysts.
Clinically: Diarrhea – Malabsorption
Complications: Jaundice
G. lamblia in stool sample stained with iodine x 40 magnification. A,B,C. G.

lamblia cysts (Black arrows). D. G. lamblia trophozoite (Black arrow).
Giardia lamblia in stool sample stained with iodine x 40 magnification. A,B,C. G.
lamblia cysts. D. G. lamblia cyst showing parabasal bodies (Red arrow).
Blastocystis hominis in stool sample stained with iodine x 40 magnification. B.
hominis is the commonest organism found in stool samples. It may cause
symptoms of Irritable Bowel Syndrome. A,B. B. hominis (Black arrows) showing
central vacuole and peripheral nuclei. C. B. hominis (Black arrow) and many
RBCs (Red arrows). D. B. hominis (Black arrows).
Clinically: The commonest in stool - Digestive disturbances
B. hominis in stool sample stained with iodine x 40 magnification. A,B,C,D. B.
hominis (Black arrows) showing central vacuole and peripheral nuclei.
A,B,C,D,E. Cystisospora belli oocysts in a stool sample stained with iodine x 40
magnification (Black arrow). C. belli causes severe disease in
immunosuppressed individuals. F,G,H,I,J. C. belli oocysts in a stool sample
stained with MZN stain x 100 magnification.
Mode of Infection: Ingestion of Oocysts with contaminated food and drink
Clinically: Diarrhea
Complications: Opportunistic with severe diarrhea and dehydration in
immunocompromised patients
Cryptosporidium parvum oocysts stained with MZN X 100 Magnification. A. C.
parvum oocyst appears spherical. B. C. parvum oocyst. C. C. parvum oocyst. D.
C. parvum oocyst showing 4 sporozoites. E. C. parvum oocyst. F. C. parvum
oocyst. G. C. parvum oocyst. H. C. parvum oocyst. I. C. parvum oocyst.
Mode of Infection: Ingestion of Oocysts with contaminated food and drink.
Clinically: Diarrhea.
Complications: Opportunistic with severe diarrhea and dehydration in
immunocompromised patients.
6- Arthropods in Stool
1. Intestinal Myiasis:
- Invasion of intestine with larvae of Dipterous Flies.
-Larvae found in stool
2. Intestinal Acariasis
- Adult Mites & Eggs found in stool
3. Earthworm
- Non pathogenic
- Contaminant of the sample
Arthropods in Stool
A. Musca domestica larva. Conical whitish worm like about 1 cm (Seen by Naked
eye) with 2 posterior spiracles posteriorly (Red arrow). B. Adult Mite. The body
is one piece with capitulum (Black arrow) and 8 legs (Red arrows). It is seen
under the microscope. C. Mite Egg. Seen under the microscope, larger than
helminth eggs and oval in shape. D. Earthworm. Resembles Ascaris 20 cm but
pinkish, striated and it is found as contaminant. It is free living.
7- Cells, Mucous, Undigested food and Others in stool
A. RBCs in a stool sample stained with iodine x 40 magnification (Black arrow).

B. Pus cells (Red arrow) and RBCs (Black arrows) in a stool sample stained with
iodine x 40 magnification. C. Pus cells in a stool sample stained with iodine x 40
magnification. D. Epithelial cells (Black arrow) and Mucous trapping pus cells in
a stool sample stained with iodine x 40 magnification. E. RBCs.
A,B. RBCs in a stool sample stained with iodine x 40 magnification.
A. Epithelial cells and pus trapped in mucous in a stool sample stained with
iodine x 40 magnification (Black arrows). B. Bacteria in a stool sample stained
with iodine x 40 magnification. C. Epithelial cells trapped in mucous. D.
Epithelial cells.
A. Starch in stool sample x 40 magnification. B. Starch appears purple after
iodine staining and compact. C. Starch. D. Starch.
A. Yeast like cells in stool sample x 40 magnification. B. Starch in stool sample x
40 magnification. C. Mucous trapping pus cells. D. Muscle fiber. E. Muscle fiber.
A. Fat globules in stool sample x 40 magnification stained with iodine. B. Fat
globules appear as glistening bodies. C,D,E,F. Fat globules.
A. Artifacts in stool sample x 40 magnification stained with iodine (Black arrows).
B. An artifact. C. Artifacts (Black arrows). D. Air Bubble.
A. Yeast like cells in stool sample x 40 magnification stained with iodine. B.
Vegetable fibers. C. Yeast like cells appear as small oval bodies with thick wall.
D. Yeast like cells. E. Yeast like cells.
A. Hair in stool sample x 40 magnification stained with iodine. B. Hair with shaft
and medulla. C. Hair. D. Hair. E. Charcot-Leyden Crystal (denotes eosinophils).
A. Fungal spores in stool sample x 40 magnification stained with iodine (Red
arrows). B. A Fungal spore in stool sample x 100 magnification stained with
MZN. C. A Fungal spore in stool sample x 100 magnification stained with MZN.
D. Fungal spores in stool sample x 100 magnification stained with MZN. E. A
Fungal spore in stool sample x 100 magnification stained with MZN.
8- Stool Reporting
A- Name – Sex – Age

B- Macroscopic Examination:
1- Colour: Normally Brown
2- Consistency: Formed – Semi-formed – Loose – Watery
3- Mucous: Absent - + - ++ - +++
4- Blood: Absent - + - ++ - +++
5- Parasites: Macroscopic Parasites (Ascaris – Enterobius – Tapeworm segments
– Larvae of Flies – Earthworm)
C- Microscopic Examination:
1- Pus cells: Normally 0 – 1 /HPF
2- RBCs: Normally 0 – 1 /HPF
3- Undigested Food: Vegetable fibers – Starch – Fat globules – Muscle fibers (+
- ++ - +++)
4- Parasites: Helminths – Protozoa
5- Fungi: Absent - + - ++ - +++
6- Others: eg: Yeast Like Cells
D- Comments:
- Intermittent shedding of some parasites is common so examination of 3
successive samples is recommended
- Recommend MZN for suspected Sporozoa
- Recommend Peri-anal Swab for suspected Pinworm
- Recommend Stool Culture & sensitivity for Pus cells > 15/HPF
Chapter 3: Urine Analysis
Chapter 3: Urine Analysis

Content Page No.
1- Steps of Urine Analysis 72
a- Sedimentation
b- Benedict test
c- Heating Coagulation test
d- Fouchet test
e- Ehrlich’s test
3- Crystals in Urine 81
4- Casts in Urine 91
5- Cells and Fungi in Urine 94
6- Parasites in Urine 97
7- Urine Reporting 99
1- Steps of Urine Analysis
Steps of Urine Analysis

1- Take a good history about urinary symptoms – Other symptoms – Drugs
– Residency – Occupation
2- Inspect sample precisely for color and clarity  Notice Mucous & Blood
 If there is mucous examine separately
3- Concentrate the sample
4- Discard supernatant
5- Vortex the sediment and examine
6- Do chemical Analysis by strip followed by confirmatory tests
a- Urine Sedimentation
1- Put the sample in a test tube
2- Centrifugation at 2000 – 3000 rpm for 5 – 10 minutes.
4- Vortex the sediment for 1 minute
5- Examine the sediment
b- Benedict Confirmatory test for urine Glucose
1- Add 0.5 ml of the urine sample to a test tube
2- Add 2.5 ml of Benedict solution
3- Boil until color change
Benedict test reading, Color change denotes Positive Glucose
c- Heating coagulation confirmatory test for Albumin
Heat the urine sample until coagulation appears
Heating coagulation test reading, Turbidity and Coagulation denote

positive Albumin
d- Fouchet confirmatory test for Bilirubin
1- Add to a test tube 1/3 urine to 2/3 BaCl2
2- Centrifuge at 3000 rpm for 5 minutes
4- Add Fouchet 2 – 3 drops  Allow to stand then read
Fouchet test reading

Look at the color of the precipitate at the bottom of the tube, Green
color denotes positive bilirubin
e- Ehrlich’s confirmatory test for Urobilinogen
1- Put 0.5 ml Urine in a test tube
2- Add 9 ml distilled water
3- Mix
4- Add 3 drops Ehrlich’s solution
Ehrlich’s test reading

Positive samples appear violet with a dark violet ring at the top
Benedict test. A. Different samples; 1,2. Absent glucose, 3,4. Glucose is present
in trace amounts (The color is changed to grades of green). 5. Glucose is +1
(Green color with yellow precipitate), 6. Glucose is +2 (Yellow color), 7. Glucose
is +3 (Brick red color). B. Trace Glucose. C. Glucose is +. D. Glucose is ++. E.
Glucose is +++. F. Different samples; 1. Absent glucose. 4. Glucose is present in
trace amounts. 5. Glucose is +1. 6. Glucose is +2.
Heating Coagulation test for Albumin. A. Different samples; 1. Absent Albumin
(Clear sample), 2. Trace Albumin (Turbid sample), 3. Albumin is +1 (Precipitate),
4. Albumin is +1 (Precipitate), 5. Albumin is +2 (Precipitate), 6. Albumin is +1
(Reddish precipitate denotes presence of RBCs). B. Albumin is +1 (Reddish
precipitate denotes presence of RBCs). C. Different samples; 1,2,3. Trace
Albumin (Turbid sample), 4,5. Albumin is +1 (Precipitate). D. Albumin is +2.
A,B. Ehrlich’s test for Urobilinogen. A. Normal Trace Urobilinogen. B.
Urobilinogen is +1. C,D. Fouchet test for Bilirubin.
3- Crystals in Urine
A. Crystals in Acidic Urine:

1- Amorphous urate 2- Uric acid
3- Na Urate 4- Bilirubin
5- Leucine 6- Tyrosine
7- Cystine 8- Cholesterol
9- Hippuric acid
B. Crystals in Alkaline Urine:
1- Amorphous phosphate 2- Triple phosphate
3-Ammonium biurate 4- Ca phosphate
5- Ca carbonate
C. Crystals in Any PH:
Ca Oxalate (the commonest)
The Common Crystals. A. Amorphous Urate: in Acidic pH. B. Amorphous
Phosphate: in Alkaline pH. C. Uric Acid Crystals: in Acidic pH. D. Triple
Phosphate Crystals: in Alkaline pH. E. Calcium Oxalate Crystals: in Any pH. 1.
Envelope shape. 2. Dumbbell shape. 3. RBC shape.
Crystals in Acidic pH. A. Tyrosine Crystals: with Liver disease or Tyrosinemia. B.
Sodium Urate Crystals: with Cystitis. C. Bilirubin Crystals: with Liver disease. D.
Leucine Crystals: with severe Liver disease. E. Cholesterol Crystals: with
Refrigerated urine, Renal Failure or Renal Tubular Disease.
A. Hippuric Acid Crystals: in acidic pH may be found in healthy. B. Cystine
Crystals: in acidic pH with Cystinuria and Cystine stones. C. Ammonium Biurate
Crystals: in alkaline old samples. D. Calcium Phosphate Crystals: in alkaline pH
with Diet rich in calcium or Parathyroid disease. E. Calcium Carbonate Crystals:
in alkaline pH with Ca carbonate supplement intake or Stones.
A. Amorphous (Urate in Acidic pH and Phosphate in Alkaline pH). B. Amorphous
with Calcium oxalate crystal (Black arrow). C. Amorphous Urate. B. Amorphous
Phosphate.
A,B,C. Calcium oxalate crystals (Envelope shaped). D,E. Calcium oxalate
crystals (Red blood cell shape). F. Calcium oxalate crystals and epithelial cells.
A,B. Calcium oxalate crystals (Dumbbell shaped). C. Calcium oxalate crystals
(Envelope shaped). D. Calcium oxalate crystals (Red blood cell shape).
A. Uric acid crystals (Rhomboid shaped, yellowish and present in Acidic pH). B.
Uric acid crystals in urine sample X40 magnification. C. Uric acid crystals. D. Uric
acid crystals. E. Uric acid crystals. F. Uric acid crystals. G. Uric acid crystals. H.
Uric acid crystals.
A,B,C,D,E. Triple phosphate crystals (Coffin shape and present in Alkaline pH).
A. Calcium carbonate crystals. Appear in alkaline pH with stones or calcium
carbonate supplements. B. Tyrosine Crystals. Needle like and present in Acidic
pH with Liver disease or Tyrosinemia. C,F. Bilirubin Crystals. Appear in acidic pH
with Liver disease. D,E. Calcium phosphate Crystals. Appear in alkaline pH with
Diet rich in calcium.
A,B,C. Cystine crystals. Hexagonal, refractile and present in Acidic pH with
Cystinuria or Cystine Stones. D,E. Hippuric Acid Crystals. Present in Acidic pH
and may appear in healthy urine.
4- Casts in Urine
Casts in Urine:
A- Hyaline Cast (Fever – Exercise)
B- Granular Cast (Renal Disease)
C- WBC Cast (Acute Infection – Interstitial Nephritis)
D- RBC Cast (Bleeding)
E- Waxy Cast (Advanced Renal Disease)
A. Granular cast & RBCs in a urine sample. B,C,D,E. Granular casts.
A,B. Hyaline Casts. C. WBCs Cast. D,E. Granular cast.
5- Cells & Fungi in Urine
A. Fungi appear budding. B. Fungi with pseudohyphae (Black arrow). C.

Epithelial cells in a urine sample X 40 magnification. D. Epithelial cells. E,F,G.
Fungi with pseudohyphae.
A,B. Pus cells in a urine sample. C,D. RBCs and Pus cells. E. Epithelial Cells &
RBCs.
A,B,C. Red Blood Cells in a urine sample. D. Pus clumps. E. Mucous (Black arrow)
trapping pus cells. F. RBCs.
6- Parasites in Urine
1. Schistosoma haematobium eggs (Associated with Haematuria)

2. Enterobius vermicularis eggs (More in young girls)
3. Trichomonas vaginalis trophozoites (Detected by movement – Die
within 30 minutes  Examine Directly)
4- Wuchereia bancrofti microfilariae
5. Hydatid sand
6- Microsporidium spp. spores (Needs Staining)
7- Myiasis (Larvae of Dipterous Flies  Macroscopic)
A,B. Schistosoma haematobium egg in a urine sample. Best from fresh mid-day
sample after 15 minutes of exercise. Oval egg about 140 x 60 µ with terminal
spine and contains a miracidium. It is surrounded by pus cells. Mode of
Infection: Penetration of the skin by cercaria while swimming in canal water.
Clinically: Haematuria Complications: Urinary Bladder Carcinoma. C. Enterobius
vermicularis egg.
A. Trichomonas vaginalis trophozoite. Pear shaped with single anterior nucleus
(Gray arrow). It contains axostyle (Blue arrow). It carries four anterior flagellae
(Red arrow) and an undulating membrane (black arrow). B,C,D,E. Trichomonas
vaginalis trophozoite in a urine sample moving with flagellae (Red arrows).
Trichomonas vaginalis trophozoite is mainly diagnosed by its motility, so
examine suspected samples within 30 minutes.
Mode of Infection: Sexually transmitted disease
7- Urine Reporting
A- Name – Sex – Age

B- Physical Examination:
1- Colour: Normally Yellow
2- Aspest: Clear – Slightly Turbid – Turbid
C- Chemical Examination:
1- PH: 5 – 8
2- Specific Gravity: 1005 – 1030
3- Glucose: Absent – Trace - +1 - +2 - +3
4- Acetone: Absent – +1 - +2 - +3
5- Bilirubin: Absent – +1 - +2 - +3
6- Urobilinogen: Normal Trace – +1 - +2 - +3
7- Albumin: Absent – Trace - +1 - +2 - +3
D- Microscopic Examination:
3- Epithelial Cells: Rare – Few – Some – Many
5- Fungi: Absent - +1 - +2 - +3 (± Pseudohyphae)
6- Others: eg: Many Immotile Sperms
E- Comments:
- Recommend Stool Culture & sensitivity for Pus cells > 15/HPF
Chapter 4: Semen Analysis
Chapter 4: Semen Analysis

Content Page No.
1- Steps of Semen Analysis 101
a- Test for Viscosity
b- Test for Vitality
c- Sperm Counting
3- Azoospermia 109
4- Parasites in Semen 109
5- Semen Reporting 110
1- Steps of Semen Analysis
1- Semen Analysis Steps

1- Take a good history
2- Incubate for 2 hours
3- Inspect sample for PH, color, consistency, viscosity, liquefaction and
presence of Blood
4- Examine well mixed 10 μl for motility (Total & Progressive), and
morphology, pus cells, RBCs, Spermatogenic cells and agglutination
5- If Motility is < 40%  Do Vitality Test
6- Count on haemocytometer
A. A normal sperm morphology; it has an oval head (Black arrow), a neck (Red
arrow) and a tail (Blue arrow). B. Abnormal sperms. 1. Small Head. 2. Large
Head. 3. Double Head. 4. Double Tail. 5. Bent Neck. C,D. Semen sample under
X 40 Magnification.
A. Agglutination (Red arrows). B. Spermatogenic Cell. C. Difference between
Pus Cells (1): Smaller; and Spermatogenic Cells (2): Larger and vacuolated.
a- Test for Viscosity

1- After complete liquefaction of the sample
2- Using a pipette withdraw the sample
3- If a longitudinal mucoid line >2cm is formed this denotes that the
sample is viscid.
b- Test for Vitality
1- Done when the Motility is < 40%
2- Add a drop of eosin to a drop of the sample, add a coverslip and
examine
3- Vital Sperms are colorless (not stained) while dead ones are pink
(take the stain)
4- The sample passed when vitality is ≥ 58%
A. Vitality Test. B. Vital sperm unstained (Black arrow) and Dead sperms stained
(Red arrows).
c- Counting of sperms on haemocytometer
1- Examine the sample directly under x 40 magnification.
2- If the sperms are crowded make a suitable dilution in normal saline (eg:
1/20, 1/40, ….)
3- Put 10 µl of the diluted sample on haemocytometer
4- Allow to stand 5 minutes
5- Count the number of sperms on the middle 25 small squares of the
haemocytometer
6- To calculate the number of sperms/ml ejaculate use this equation:
No. of Sperms/ml = No. of counted sperms X The used dilution (eg: 20,
40, …) X 104
7- To calculate the number of sperms/ejaculate use this equation:
No. of Sperms/ejaculate = No. of Sperms/ml X Semen Volume
A. Haemocytometer that is used for sperms counting, the sample is laid over it
and a coverslip added. B. Putting Sample on haemocytometer. C.
Haemocytometer under x 10 magnification. Area of sperms counting (Black
arrow), Areas for pus cells counting (Red X symbol). D. A diagram for
Haemocytometer. E. Area of sperms counting. You can count the number in 5
squares with red circles and borders and multiply the number by 5 to calculate
the number in 25 squares.
3- Azoospermia
Azoospermia
1- If you don’t see any sperm  Centrifuge the whole sample
2- Examine sediment
3- If no sperms seen  Write: No sperms were seen after centrifugation
of the sample
4- If few sperms seen  Write: Few immotile sperms were seen after
centrifugation of the sample
4- Parasites in Semen
1. Trichomonas vaginalis trophozoites (Detected by movement – Die within 30

minutes  Examine Directly)
2. Wuchereia bancrofti microfilariae
3. Schistosoma haematobium eggs
5- Semen Reporting
A- Name – Age
B- Physical Examination:
1- Volume: … ml (< 0.5 ml may indicate retrograde ejaculation)
2- Abstinence: Must be 2 – 7 Days
3- PH: 7.2 – 8
4- Color: Gray
5- Liquefaction time: Normally within 30 – 60 minutes
6- Liquefaction state: Partial or Complete
7- Viscosity: Mild or Viscid
8- Blood: Absent or Present
C- Counting:
1- Count /ml: Passed when ≥ 15,000,000
2- Count / Ejaculate: Passed when ≥ 39,000,000
D- Microscopic Examination:
1- Total Motility: Passed when ≥ 40%
2- Progressive Motility: Passed when ≥ 32%
3- Vitality: Passed when ≥ 58%
4- Abnormal forms: Passed when ≤ 96%
5- Agglutination: Absent or (Head to Head – Head to Tail – Tail to Tail – Mixed)
6- Agglutination grade: Isolated – Moderate – Large – Gross
9- Spermatogenic Cells: Normally 0 – 1 /HPF
E- Comments:
- One sample is not enough to confirm evaluation, So, if the sample did not
pass any parameter recommend examination of two other samples with
one-week interval
- If Semen volume is ≤ 0.5 ml recommend Post ejaculation urine test
- If Pus cells > 15/HPF recommend semen Culture & Sensitivity
Chapter 5: Parasites in Blood
Chapter 5: Parasites in Blood

Content Page No.
1- Parasites in Blood 113
2- Essential Techniques: 114
Thin & Thick Blood film
3- Malaria 115
4- Knott’s Concentration for Microfilariae 119
1- Parasites in Blood
1. Plasmodium spp. stages (Inside RBCs)

2. Babesia spp.
3. Wuchereria bancrofti microfilariae (Nocturnal 10 pm – 2 am)
4. Brugia malayi microfilariae (Nocturnal 10 pm – 2 am)
5. Loa loa microfilariae (Diurnal 10 am – 2 pm)
6. Trypanosoma brucei
7. Trypanosoma cruzi
8. Leishmania amastigotes (Inside WBCs)
9. Toxoplasma gondii tachyzoites
2- Thin & Thick Blood Films
1 – 4: Thin Blood Film formation. 1. Put a small drop of blood near one end of
the slide. 2. Use a second slide forming 30◦ angle with the first one and
touching the edge of the blood drop. 3. Move the second slide quickly and
evenly forward spreading the blood drop. 4. A thin film will be formed with the
best shots will be seen near the tail end (Black arrow) with less crowded RBCs.
Allow to air dry then add methanol for fixation. 5. Thick film formation. Put 3
drops of Blood on a slide. Stir together for 30 seconds forming an area about 2
cm. Allow to air dry. No methanol for fixation.
3- Malaria Parasites
- Malaria is a disease that is caused by a protozoa called Plasmodium

- It is Transmitted by the bite of Female Anopheles Mosquito
- This Protozoa parasitizes the Red blood cells causing Anemia –
Hepatosplenomegaly and Paroxysmal Fever
- 5 Plasmodia spp. can affect man:
1- P. vivax (The commonest)
2- P. falciparum (The most Dangerous – causes malignant malaria)
3- P. ovale
4- P. malariae
- Thick Blood Film is used for screening while Thin Blood Film is examined
for species identification
1. Plasmodium vivax ring. Occupies 1/3 of the RBC. 2. P. vivax trophozoite
appears pleomorphic. 3. P. vivax schizont contains 12 merozoites. 4. P. vivax
gametocytes large occupying the whole RBC. 5. P. ovale ring occupies 1/3 of
the oval RBC (Black arrow). 6. P. ovale trophozoite appears compact. 7. P. ovale
schizont contains 6-12 merozoites. 8. P. ovale gametocytes large occupying the
whole oval RBC. 9. Plasmodium malaiae ring. Occupies 1/3 of the RBC. 10. P.
malariae trophozoite appears band shaped. 11. P. malariae schizont contains
8 merozoites forming a rosette shape. 12. P. vivax gametocytes large occupying
the whole RBC. 13. Plasmodium falciparum ring. Occupies 1/6 of the RBC with
2 chromatin dots and multiple rings may be seen in the same RBC. 14. P.
falciparum trophozoite appears compact. 15. P. falciparum schizont contains
24 merozoite and occupies only 2/3 of the RBC. 16. P. falciparum gametocytes
Banana shaped.
Malaria parasites in Blood Film. A. Plasmodium falciparum ring. Small ring
(Black arrow) occupies 1/6 of the RBC. Red arrow points to a neutrophil. B. P.
falciparum rings with 2 chromatin dots (Black arrows). C. P. falciparum ring
(Black arrow). D. P. falciparum ring (Black arrow).
Mode of Infection: Bite of Female Anopheles Mosquito.
Clinically: Anemia and Fever
Complications: Malignant malaria with P. falciparum with respiratory distress,
renal failure and Coma.
Malaria parasites in Blood Film. A. Plasmodium vivax gametocytes (Red
arrows). B. P. vivax gametocyte (Red arrow). C. P. vivax ring occupies 1/3 of
the RBC (Black arrow). D. P. vivax ring (Black arrow). E. P. vivax trophozoite
(Black arrow). F. P. vivax ring (Black arrow). G. Plasmodium falciparum ring
occupies 1/6 of the RBC with 2 chromatin dots (Black arrow). H. P. falciparum
ring (Black arrow).
4- Microfilariae in Blood
Knott’s Technique for microfilariae concentration. 1. Add 1 ml of blood to 10

ml of formalin 2% and mix well. 2. Centrifuge at 500 xg for 1 minute. RBCs
will be hemolyzed and microfilariae and WBCs will be concentrated. 3.
Discard supernatant and spread sediment on one or more slides and leave to
dry (Thickness of thick blood film). 4. Stain with Giemsa.
Chapter 6: Parasites in
Duodenal & Biliary Fluid &
Liver tapping
Chapter 6: Parasites in Duodenal & Biliary Fluid
Content Page No.
1- Parasites in Duodenal or Biliary Fluid 121
2- Fasciola spp. 122
3- Hydatidosis 123
4- Toxocara cati 125
1- Parasites in Duodenum & Liver
A. Parasites in Duodenal Fluid:

1- Giardia lamblia trophozites
2- Fasciola eggs
3- Strongyloides stercoralis larva
4- Cryptosporidium spp. oocysts
5- Cystisospora belli oocysts Need Staining
6- Cyclospora cayetanensis oocysts
7- Microsporidia spores
B. Parasites in Biliary Fluid or Liver Aspiration:

1- Hydatid Sand
2- Entamoeba histolytica trophozoites
3- Adult Fasciola worm
4- Toxocara spp. larvae
2- Fasciola spp.
A. Adult Fasciola gigantica by naked eye, 6 cm. B. Adult Fasciola hepatica 3 cm.
C. Adult Fasciola hepatica removed by laparoscope. D. Adult Fasciola under X10
lens showing ventral sucker (Black arrow) and uterus full of eggs. E. Fasciola
spp. egg in stool x 40 magnification. Oval, large yellowish brown egg, 140 x 70 µ.
F. Fasciola spp. leptocercous cercaria formed of a body and a simple tail. G.
Fasciola spp. egg in stool x 40 magnification. Note the opened operculum. H.
Fasciola spp. egg in stool x 40 magnification. I. Fasciola spp. egg x 40
magnification.
Mode of Infection: Ingestion of contaminated vegetables or water with
Encysted metacercaria
Clinically: Fever – Tender hepatomegaly
3- Hydatidosis
Hydatid sand aspirated from hydatid cyst. Hydatidosis is a parasitic disease

caused by a Cestode called Echinococcus granulosus that lives in the small
intestine of dogs. The infection is acquired through ingestion of contaminated
food or drinks with E. granulosus eggs. A large cyst called Hydatid cyst which is
the larval stage of E. granulosus is formed in man organs commonly liver and
lungs. The cyst contains fluid, scolices that carry hooks and detached dagger-
shaped hooks. A. E. granulosus scolices (Black arrows). B. E. granulosus hooks
(Red arrows) stained with MZN stain. C. E. granulosus hooks (White arrows)
stained with MZN x 10 magnification. D. E. granulosus hook (Red arrow) x 40
magnification.
Mode of Infection: Ingestion of E. granulosus eggs with contaminated food or
drink or while playing with dogs
Clinically: Liver cyst with hepatomegaly and jaundice – Lung cyst with cough and
dyspnea
NB: If you don’t see hydatid sand in direct examination, centrifuge the sample
and examine sediment.
A. E. granulosus scolices (Black arrows). B. E. granulosus scolices carrying hooks
x 40 magnification. C. E. granulosus scolix carrying hooks x 40 magnification.
E. granulosus scolices carrying hooks x 40 magnification
4- Toxocara cati
A.Toxocara cati egg. A helminth of cats (Ascaris of Cats). Pitted eggs 75 x 65 µ.

Oval, brown with immature content. B. T. cati egg.
Ingestion of this egg with contaminated food and drink can result in Toxocariasis
disease (Visceral Larva Migrans) in Humans.
Chapter 7: Parasites in
Different samples
Chapter 7: Parasites in CSF, Brain & Eyes
Content Page No.
1- Parasites in Brain, CSF & Eyes 127
2- Parasites in muscles 128
3- Parasites in pathological sections 130
4- Parasites in Skin 132
1- Parasites in Brain, CSF & Eyes
A. Parasites in Brain & CSF:

1- Naegleria fowleri  Examine as soon as possible to catch motlity
2- Acanthamoeba spp.
3- Entamoeba histolytica trophozoites
4- Cysticercous cellulosae
5- Coenurus cerebralis cyst
6- Hydatid cyst
7- Toxoplasma gondii
8- Trypanosoma brucei  Centrifuge 7000xg 10 minutes & examine sediment
9- Nematode larvae (Visceral larva migrans)
10- Schistosoma spp. eggs
B. Parasites in Eyes:
1- Acanthamoeba spp.
3- Coenurus cerebralis cyst
4- Hydatid cyst
5- Nematode larvae (Ocular larva migrans)
6- Onchocerca volvulus micofilariae
7- Loa loa adult worm
2- Parasites in Muscles
3- Sarcocystis spp.
4- Trichinella spiralis encysted larvae
A&B. Toxoplasma gondii tachyzoites X100 magnification (Red arrows),

crescentic in shape. Mode of Infection: Ingestion of contaminated food or drink
or meat. Clinically: Lymphadenopathy – Retinopathy. Complications: In
pregnant women can result in abortion or severe congenital anomalies. C.
Sarcocyst with bradyzoites inside X40 magnification.
Trichinella spiralis. T. spiralis is an intestinal nematode that can infect human
through ingestion of improperly cooked pork meat containing the encysted
larvae. Trichinellosis is manifested by acute intestinal symptoms followed by
invasion of the muscles by larvae causing myopathy and fever. A. T. spiralis
adult female with larvae inside uterus (Black arrow). B. T. spiralis adult female.
C. T. spiralis adult female with larvae inside uterus (Black arrow). D. T. spiralis
adult male with 2 conical processes posteriorly (Red arrow). E. T. spiralis adult
female and male, the male shows 2 conical processes posteriorly (Red arrow).
F. T. spiralis adult male posterior end with x 40 magnification showing the 2
posterior conical processes. G. T. spiralis larva x 10 magnification. H. T. spiralis
larva x 40 magnification. I. T. spiralis encysted larvae in diaphragm muscles.
3- Parasites in Pathological Sections
Urinary bladder Carcinoma on top of Schistosomiasis haematobium infection

in pathological section stained with H&E. A. Brunn’s nest (White arrow). B.
Cystitis cystica (White arrow). C. Schistosoma haematobium egg with terminal
spine (White arrow) surrounded by granuloma.
A,B,C. Helicobacter pylori bacteria (Black arrow) in pathological sample from
stomach endoscopy in a young female patient with acute abdominal pain. D. ICT
rapid test for H. pylori antigens in stool. Red arrow represents control band
while Blue arrow represents test band. Black arrow points to the site of sample
putting. 1. Positive test, 2. Week positive test, and 3. Negative test.
4- Parasites in Skin
1- Sarcoptes scabiei mites

2- Leishmania spp. amastigotes (Samples taken from the edge of the ulcer)
4- Onchocerca volvulus microfilariae (Adult in nodules)
5- Dracunculus medinensis
6- Nematodes larvae (Cutaneous larva migrans)
7- Dipterous flies’ larvae (Myiasis)
8- Pediculus humanus (Lice)
9- Hard Ticks
A. Sarcoptes scabiei adult. S. scabiei is an Arachnid that can infect humans

causing a disease called Scabies characterized by severe itching. B. S. scabiei
adult. Body is formed of one piece with a capitulum and 4 pairs of legs.
Clinically: Main symptom is Severe Itching
Further Readings
-Garcia, L. S., & Procop, G. W. (2016). Diagnostic medical parasitology. Manual of Commercial Methods in
Clinical Microbiology: International Edition, 284-308.
-Ma, P., & Soave, R. (1983). Three-step stool examination for cryptosporidiosis in 10 homosexual men with
protracted watery diarrhea. Journal of Infectious Diseases, 147(5), 824-828.
-Taha, N. M., Yousof, H. A. S. A., El-Sayed, S. H., Younis, A. I., & Negm, M. S. I. (2017). Atorvastatin
repurposing for the treatment of cryptosporidiosis in experimentally immunosuppressed mice. Experimental
parasitology, 181, 57-69.
-Wattanagoon, Y. & Bunnag, D.(2012). Paragonimiasis. In Hunter's Tropical Medicine and Emerging
Infectious Diseases (pp. 892-895).
-Brinkkemper, O., & van Haaster, H. (2012). Eggs of intestinal parasites whipworm (Trichuris) and
mawworm (Ascaris): Non-pollen palynomorphs in archaeological samples. Review of Palaeobotany and
Palynology, 186, 16-21.
- https://www.cdc.gov/dpdx/toxocariasis/index.html
-https://www.cdc.gov/parasites/pinworm/diagnosis.html
-Haggag, A. A., Rabiee, A., Abd Elaziz, K. M., Gabrielli, A. F., Hay, R. A., & Ramzy, R. M. (2017). Mapping of
Schistosoma mansoni in the Nile Delta, Egypt: assessment of the prevalence by the circulating cathodic
antigen urine assay. Acta tropica, 167, 9-17.
-https://www.cdc.gov/parasites/fasciola/epi.html
-Lu, L. H., Lin, M. R., Choi, W. M., Hwang, K. P., Hsu, Y. H., Bair, M. J., ... & Chung, W. C. (2006). Human
intestinal capillariasis (Capillaria philippinensis) in Taiwan. The American journal of tropical medicine and
hygiene, 74(5), 810-813.
-Jaleta, T. G., Zhou, S., Bemm, F. M., Schär, F., Khieu, V., Muth, S., ... & Streit, A. (2017). Different but
overlapping populations of Strongyloides stercoralis in dogs and humans—Dogs as a possible source for
zoonotic strongyloidiasis. PLoS neglected tropical diseases, 11(8), e0005752.
-https://www.cdc.gov/dpdx/strongyloidiasis/index.html
-https://www.cdc.gov/dpdx/cryptosporidiosis/index.html
-https://www.cdc.gov/dpdx/cyclosporiasis/index.html
-Andreassen, J. (2010). Intestinal tapeworms. Topley & Wilson's Microbiology and Microbial Infections.
-Houpt, E. & Hung, C.. (2014). Entamoeba histolytica (Amebiasis). In Hunter's Tropical Medicine and
Emerging Infectious Diseases (pp. 660-667).
-https://www.cdc.gov/dpdx/intestinalamebae/index.html
Further Readings
-Ortega, Y. R., & Adam, R. D. (1997). Giardia: overview and update. Clinical infectious diseases, 25(3),
545- 549.
-Denoeud, F., Roussel, M., Noel, B., Wawrzyniak, I., Da Silva, C., Diogon, M., ... & El Alaoui, H. (2011).
Genome sequence of the stramenopile Blastocystis, a human anaerobic parasite. Genome biology, 12(3),
1-16.
-https://www.cdc.gov/parasites/blastocystis/health_professionals/index.html
-Junod, C. (1988). Isospora belli coccidiosis in immunocompetent subjects (a study of 40 cases seen in
Paris). Bulletin de la Societe de Pathologie Exotique et de ses Filiales, 81(3), 317-325.
-https://www.cdc.gov/dpdx/cystoisosporiasis/index.html
-Su, J. (2018). A brief history of Charcot-Leyden crystal protein/galectin-10 research. Molecules, 23(11),
2931.
-https://www.cdc.gov/dpdx/artifacts/index.html
-Milani, D. A. Q., & Jialal, I. (2022). Urinalysis. In StatPearls [Internet]. StatPearls Publishing.
-Athanasiou, L. V., Katsoulos, P. D., Katsogiannou, E. G., Polizopoulou, Z. S., Diamantaki, M., Kamatsos,
C., & Christodoulopoulos, G. (2018). Comparison between the urine dipstick and the pH‐meter to assess
urine pH in sheep and dogs. Veterinary clinical pathology, 47(2), 284-288.
-Kumar, V., & Gill, K. D. (2018). Qualitative Test for Bile Pigments and Urobilinogen in Urine. In Basic
Concepts in Clinical Biochemistry: A Practical Guide (pp. 123-127). Springer, Singapore.
-El‐Guindi, M. A. S., El‐Said, H. H., Hussein, M. H., Nassar, R. E. S., & Sira, A. M. (2016). Urinary
urobilinogen in biliary atresia: A missed, simple and cheap diagnostic test. Hepatology Research, 46(2),
174-182.
-Çakıroğlu, B., & Özacar, M. (2019). Photoelectrochemical and Non-Enzymatic Glucose Sensor Based on
Modified Fehling's Test by Using Ti/TiO2 NTs-rGO-Cu2O Electrode. Journal of The Electrochemical
Society, 166(8), B728.
-Juwaied, A. A., Al-Amiery, A. A., & Mohammed, A. A. (2012). Practical Biochemistry. Al Manhal.
-Kavuru, V., Vu, T., Karageorge, L., Choudhury, D., Senger, R., & Robertson, J. (2020). Dipstick analysis
of urine chemistry: benefits and limitations of dry chemistry-based assays. Postgraduate Medicine, 132(3),
225-233.
-Lee, A. J., Yoo, E. H., Bae, Y. C., Jung, S. B., & Jeon, C. H. (2022). Differential identification of urine
crystals with morphologic characteristics and solubility test. Journal of Clinical Laboratory Analysis,
e24707.
-Fogazzi, G. B., & Garigali, G. (2003). The clinical art and science of urine microscopy. Current opinion in
nephrology and hypertension, 12(6), 625-632.
-Becker, G. J., Garigali, G., & Fogazzi, G. B. (2016). Advances in urine microscopy. American journal of
kidney diseases, 67(6), 954-964.
Further Readings
-Poloni, J. A. T., & Rotta, L. N. (2020). Urine Sediment Findings and the Immune Response to
Pathologies in Fungal Urinary Tract Infections Caused by Candida spp. Journal of Fungi, 6(4), 245.
-Judd E, Sanders PW, Agarwal A. Diagnosis and clinical evaluation of acute kidney injury. In: Feehally
J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA:
Elsevier; 2019:chap 68.
-Riley RS, McPherson RA. Basic examination of the urine. In: McPherson RA, Pincus MR, eds. Henry's
Clinical Diagnosis and Management by Laboratory Methods. 23rd ed. St Louis, MO: Elsevier;
2017:chap 28.
-Sharda, N., Bakhtar, O., Thajudeen, B., Meister, E., & Szerlip, H. (2014). Manual urine microscopy
versus automated urine analyzer microscopy in patients with acute kidney injury. Laboratory
Medicine, 45(4), e152-e155.
-Gryseels, B & Strickland, G. T. Schistosomiasis in Magill, A. J., Ryan, E. T., Hill, D. R., & Solomon, T.
(2012). Hunter's Tropical Medicine and Emerging Infectious Disease: Expert Consult-Online and Print.
Elsevier Health Sciences.868-883.
-Esteves, S. C. (2014). Clinical relevance of routine semen analysis and controversies surrounding the
2010 World Health Organization criteria for semen examination. International braz j urol, 40, 433-453.
-M Tille, P. (2017). Bailey & Scott’s Diagnostic Microbiology Fourteenth Edition
-https://www.cdc.gov/parasites/malaria/index.html
-Klion, A. D. (2013). Loiasis. at Ryan, E. T., Hill, D. R., Solomon, T., Endy, T. P., & Aronson, N.Hunter's
Tropical Medicine and Emerging Infectious Diseases E-Book. Elsevier Health Sciences 823-826.
-Paris, L. (2013). Toxoplasmosis in in Hunter's Tropical Medicine and Emerging Infectious Diseases.
766-775.
-Warren, J. R. (2000). Gastric pathology associated with Helicobacter pylori. Gastroenterology Clinics
of North America, 29(3), 705-751.
-Garcia, L. S., Shimizu, R. Y., & Bruckner, D. A. (1986). Sinus tract extension of a liver hydatid cyst and
recovery of diagnostic hooklets in sputum. American journal of clinical pathology, 85(4), 519-521.
-Flisser, A., & Craig, P. S. (2010). Larval cestodes. Topley & Wilson's Microbiology and Microbial
Infections
-Kloos, H., Sidrak, W., Michael, A. A., Mohareb, E. W., & Higashi, G. I. (1982). Disease concepts and
treatment practices relating to schistosomiasis haematobium in Upper Egypt. The Journal of tropical
medicine and hygiene, 85(3), 99-107.
-Despommier, D. D. (2010). Trichinella. Topley & Wilson's Microbiology and Microbial Infections
-Levin, M. L. (2014). Medical entomology for students. Emerging infectious diseases, 20 (8), 1428.
About Author,
 Bachelor of Medicine & Surgery - Cairo University

2011
 Master Degree in Parasitology – Cairo University
2017
 MD Degree in Parasitology – Cairo University 2020
 Lecturer of Medical Parasitology – Faculty of
Medicine – Cairo University
 Consultant of Medical Parasitology
 Studying Medical Education in the fellowship
program of ASU-MENA-FRI organization; the
official representative of the International FAIMER
Institute (IFI) in Philadelphia
 Certificate in Medical Education from MEDC
(Medical Education Developing Center) – Faculty of
Medicine – Cairo University
 Certificate of TOT (Training of Trainees) from Ain
Shams University
 Author of Parasitology Art (Doodaia) book
 Creator of YouTube Doodaia Channel for
Parasitology
https://www.youtube.com/channel/UCcaSjLQm4
jhFUUElViBYCBQ

Laboratory Parasitology Atlas

Uploaded by

Copyright:

Available Formats

You might also like

Laboratory Parasitology Atlas

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Laboratory Parasitology Atlas

Uploaded by

Copyright:

Available Formats

2023

Laboratory Parasitology Atlas

Noha Madbouly Taha

2023 / 13931 : ‫رقم اإليداع‬

Second Edition 2023

I would really be pleased if you send me your comments at

Watch all Parasitology illustration @YouTube

Thanks to Allah … everything in this life runs upon his mercy.

All thanks & gratitude towards my dear Professors in Parasitology department

With all love and gratitude …

To every colleague passed in my life … from doctors, parasitologists,

Parts of the Microscope

Parts of the Microscope

How to Adjust vision by Both Eyes

Steps of Lens Cleaning

Chapter 2: Stool Analysis

Tips for Stool Analysis

1- Direct Saline wet mount  Moving Protozoal Trophozpoites (Entamoeba –

a- Direct Saline wet mount preparation

- Temporary stain Used for Routine stool examination

g- Agar Plate Culture

Helminth Eggs that can be seen in Stool

A. Enterobius vermicularis adult female worm. About 1 cm in length with pin

A. Entamoeba histolytica trophozoite. Irregular in shape about 25 µ. It contains

G. lamblia in stool sample stained with iodine x 40 magnification. A,B,C. G.

A. RBCs in a stool sample stained with iodine x 40 magnification (Black arrow).

A,B. RBCs in a stool sample stained with iodine x 40 magnification.

A- Name – Sex – Age

Chapter 3: Urine Analysis

Steps of Urine Analysis

Benedict test reading, Color change denotes Positive Glucose

Heating coagulation test reading, Turbidity and Coagulation denote

Fouchet test reading

Ehrlich’s test reading

A. Crystals in Acidic Urine:

A. Fungi appear budding. B. Fungi with pseudohyphae (Black arrow). C.

1. Schistosoma haematobium eggs (Associated with Haematuria)

A- Name – Sex – Age

Chapter 4: Semen Analysis

1- Semen Analysis Steps

a- Test for Viscosity

1. Trichomonas vaginalis trophozoites (Detected by movement – Die within 30

Chapter 5: Parasites in Blood

1. Plasmodium spp. stages (Inside RBCs)

- Malaria is a disease that is caused by a protozoa called Plasmodium

Knott’s Technique for microfilariae concentration. 1. Add 1 ml of blood to 10

A. Parasites in Duodenal Fluid:

B. Parasites in Biliary Fluid or Liver Aspiration:

Hydatid sand aspirated from hydatid cyst. Hydatidosis is a parasitic disease

E. granulosus scolices carrying hooks x 40 magnification

A.Toxocara cati egg. A helminth of cats (Ascaris of Cats). Pitted eggs 75 x 65 µ.

A. Parasites in Brain & CSF:

A&B. Toxoplasma gondii tachyzoites X100 magnification (Red arrows),

Urinary bladder Carcinoma on top of Schistosomiasis haematobium infection

1- Sarcoptes scabiei mites

A. Sarcoptes scabiei adult. S. scabiei is an Arachnid that can infect humans

-M Tille, P. (2017). Bailey & Scott’s Diagnostic Microbiology Fourteenth Edition

 Bachelor of Medicine & Surgery - Cairo University

You might also like