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Medical Parasitology Lab. . Prepared By: Mr. Raed Z. Ahmed. Artifacts. Definition . 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”. Blastocystis.

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Medical parasitology lab

Medical Parasitology Lab.

Prepared By:

Mr. Raed Z. Ahmed

Artifacts

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Definition
Definition

  • 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”.

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Blastocystis
Blastocystis

  • Round or oval, sometimes with angular irregular edges, contain one large vacuole taking up almost the whole cell, the compressed cytoplasm forms a granular ring round it.

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Blastocystis1
Blastocystis

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Yeast
Yeast

  • Oval, often with buds, often contain eccentric cluster of 3-6 small granules.

  • Some related forms of yeast are rectangular, with a very clear oval cytoplasm inside: arthrospores.

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Yeast1
Yeast

Giardia lamblia cyst

Yeast

Yeast in an iodine-stained concentrated wet mount of stool. Yeast in wet mount may be confused for Giardia lamblia cyst.

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Leukocytes
Leukocytes

  • Round or slightly elongated, with an irregular outline.

  • Contain refractile cytoplasm, clear and granular with tiny vacuoles.

  • Nucleus indistinct, sometimes with a star- shaped false karyosome.

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Pus

  • Pus can be seen by the naked eye as opaque, greyish streaks( not transparent like mucus).

  • Under the microscope it appears as a mass of more or less degenerate leukocytes

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Bacteria
Bacteria

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Coccidia
Coccidia

  • These are protozoa that may be parasite of men without causing any significant pathogenic effects, or may be found in transit in stool following the consumption of infected foods.

  • They appear in stool in a form resembling cyst called oocysts or sporocysts.

  • An elongated oval, sometimes tapered at one pole.

  • There three types:

    • 4 sporozoites (small banana shaped rods), each containing a small round nucleus, sometimes a few large granules massed at one pole.

    • One large round granular cell.

    • Refractile granules completely fill the interior.

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Coccidia cont
Coccidia (cont.)

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Coccidia cont1
Coccidia (cont.)

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Air bubbles
Air bubbles

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Oil droplet
Oil droplet

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Fungal spores
Fungal spores

Fungal spore

Entamoeba histolytica/dispar cyst

Fungal spore in a wet mount of stool.  Such spores may be confused for the cysts of Entamoebaspp.

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Plant fiber
Plant fiber

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Strongyloides stercoralis larvae
Strongyloides stercoralis larvae

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Misdiagnosis can lead to improper treatment
Misdiagnosis can lead to improper treatment

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Hair fiber
Hair fiber

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Plant cell
Plant cell

May confused with helminthes eggs

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Plant cell1
Plant cell

  • Plant material in an iodine-stained concentrated wet mount of stool.

  • This material can be confused for a hookworm egg

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Charcot leyden crystals
Charcot-Leyden crystals

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Epithelial cells
Epithelial cells

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Macrophages
Macrophages

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


RBCs

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Pollen grains
Pollen grains

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Pollen grains1
Pollen grains

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Starch granules
Starch granules

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Crystals
Crystals

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Non parasitic structure found in stool
Non- parasitic structure found in stool

  • Non parasitic objects may be misidentified as parasites. The differentiation of the most common pseudoparasites is as follow:

  • Protozoan cyst: may be confused with air bubbles, fat globules or yeasts.

    • Iodine should be added to the wet preparation so that the internal structure of the cyst is stained and identifiable.

  • Amoebic trophozoites: must be differentiated from non- pathogenic protozoan trophozoites and macrophages.

    • Trophozoites of Entamoeba histolytica/dispar must be motile and hematophagus.

    • Macrophages found in cases of intestinal amoebiasis are distinguishable from amoebic trophozoites by possessing a larger nucleus and, although they can haematophagus, they are only motile for a very short time. Their pseudopodia are small, blunt and granular.

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Cont.

  • Ova, their general shape, except for Entrobius, is perfectly symmetrical, distinguishing them from various objects found in stools.

  • Trichuris and Taenia ova may be confused with pollen grains.

  • Ascaris ova may be confused with vegetable cells, the latter having smooth, thick walls but irregular shape.

  • Strongyloides or hookworm larvae can be confused with hair or vegetable fibers. The latter are usually tapered at one end and the other being blunt and with no internal structure.

    • Free living nematode larvae may be found in concentrates if contaminated water is used

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Cont.

Fasciola ova resemble vegetable cells.

Insect egg may be found in stools as spurious infection. Mite eggs may be confused with hookworm eggs.

Dipylidium caninum eggs sacs can look similar to vegetable cells.

Other structure found in stool are crystals, Charcot- Leyden are the breakdown products of eosinophil cells and may be present in stools or sputum.

Starch granules are sometimes seen in stool. When undigested, they appear as concentric rings and stain blue with iodine, when partially digested, they stain red.

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Entamoeba histolytica dispar

Intestinal Protozoa

Entamoeba histolytica/ dispar

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Entamoeba histolytica dispar1
Entamoeba histolytica/ dispar

  • E. histolytica inhabit large intestine and cause amoebic dysentery.

  • There is two diagnostic stages for E. histolytica/ dispar:

    • Cystis regular round measuring measure 10 – 20u in diameter with 4 nuclei, and it’s the infective stage.

    • Trophozoite is the motile form, measure 15-20u in diameter with large nucleus. (motility by pseudopodia).

  • Diagnosis:

    • Stool examination to see cyst stage, or trophozoite stage if the sample is fresh.

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Life cycle
Life cycle

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Entamoeba histolytica dispar cyst
Entamoeba histolytica/ dispar Cyst

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


Entamoeba histolytica dispar trophozoite
Entamoeba histolytica/ dispar Trophozoite

Raed Z. Ahmed, Medical Parasitology Lab.,2012-2013


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