Medical parasitology lab
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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.

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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


Medical parasitology lab

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


Medical parasitology lab

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


Medical parasitology lab

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


Medical parasitology lab

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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