This document provides an overview of parasites that can be diagnosed from different clinical samples like blood, stool, urine, and biopsies. It describes the types of parasites that may be found in each sample, such as Plasmodium in blood films, helminth eggs in stool, and Schistosoma eggs or microfilariae in urine. Signs and symptoms caused by parasitic infections are also outlined, including fever, anemia, eosinophilia, and diarrhea. Finally, the document discusses epidemiological aspects like soil-transmitted helminths, opportunistic infections, and sexually transmitted parasites.

1. Clinical Parasitology
Mohieddin Abdul Fattah
Samples, signs and symptoms

2. Type of specimens taken for parasitologic diagnosis:
1.Blood
2.Stool
3.Urine
4.CSF
5.Vaginal discharge
6.Bronchoalveolar lavage (BAL).
7.Aspirates
8.Tissues and skin (biopsies)

3. Parasites in blood samples
 Parasites in blood film (thin or thick)
1. Plasmodium
• P. vivax, ovale, malariae: ring , schizonts & gametocytes
• P. falciparum: ring and gametocytes only
2. Trypanosoma
• African: Trypomastogotes
• American: Trypomastigotes
3. Filariae: Microfilariae
• W. bancrofti
• Brugia malayiae
• Loa loa
 Parasites in Buffy coat layer:
1. Those detected in blood film
2. Toxoplasma
3. visceral leishmaniae

4. Other Samples for parasitologic diagnosis:
1. Stool:
• Heterophyes, Fasciola and schistosoma eggs
• Eggs, segments of intestinal cestodes.
• Eggs or larvae of intestinal nematodes.
• Trophozoites, or cysts of Entamoeba, Balantidium and Giardia.
• Oocysts of intestinal coccidia (cryptosporidium)
2. Urine:
• Trichomonas vaginalis trophozoite
• Schistosoma eggs,
• W. bancrofti, O, volvulus (microfilariae)
• Pthiurus pubis (pubic Flea), Sarcoptes (scabies mite).
4. CSF:
• Trypanosoma (trypomastigotes),
• Naegleria trophozoites (Free living amoebae).

5. 5. Aspirates from affetced organs;
 Duodenum: Giardia, Strongyloides, Fasciola.
 Liver: L. donovani, Entamoeba histolytica
 Spleen: L. donovani
 bone marrow: L. donovani.
 LN: Trypanosoma, Leishmania and Toxoplasma.
6. Biopsies:
 Muscle: encysted Larva of T. spiralis
 Skin:
A. cutaneous Lesihmania,
B. Onchocerca,
C. Medina worm,
D. Myiasitic larvae,
E. Sarcoptes, and
F. Tunga flea
Other Samples for parasitologic diagnosis

6. • Other samples for parasitologic diagnosis
 Rectal Biopsy:
1. Schistosoma mansoni,
2. Entamoeba histolytica
6) Vaginal discharge:
• T. vaginalis trophozoites
7) Sputum:
Strongyloides larvae,
Ascaris larvae,
hookworm larvae.
Entamoeba histolytica (amebic lung abscess)

7. Symptoms and signs caused by parasitic infections
• Fever
1. Acute fever
• Malaria
• Toxoplasmosis.
• Trichinosis.
• American trypanosomiasis.
2. Chronic fever:
• Prepatent fascioliasis.
• Visceral leishmaniasis.
• Toxocariasis.
• Katayama fever
(schistosomiasis)
• Filarial fever.
3. Recurrent fever:
• Malaria.
• Coma
1. Cerebral malaria.
2. African Trypanosomiasis.
• Anaemia:
1. Diphylobothriasis.
2. Hookworm infection.
3. Malaria.
4. visceral leishmaniasis.
5. Fasciolasis
6. schistosomiasis.

8. Symptoms and signs caused by parasitic infections
• Eosinophilia:
1. Filariasis
2. Fascioliasis.
3. Schistosomiasis.
4. strongyloidiasis.
5. Toxocariasis
6. Trichinosis
– Hypopigmented skin macules:
1. Onchocerciasis (patches over shins).
2. Post-Kala-Azar dermal leishmanoid.
– Hyperpigmented skin macules:
1. Onchocercal dermatitis (Sowda).
2. Visceral leishmaniasis (Kala-Azar).
3. Chronic pediculosis.
• Lymphadenopathy:
1. Filariasis
2. Toxoplasmosis.
3. African trypanosomiasis.
4. American trypanosomiasis
• Myocarditis:
1. Chagas’ disease.
2. Trichinosis.
3. Rhodesian
trypanosomiasis.
4. Acute toxoplasmosis
5. Heterophyes (granuloma
around the egg).

9. Symptoms and signs caused by parasitic infections
• Diarrhea (Bloody):
1. Amoebic dysentery.
2. Balantidium coli.
3. Kala-Azar (infiltration of
submucosa with leishmania-
containing macrophage→
mucosal ulceration.
4. Falciparum malaria (plugging of
mucosal capillaries with
parasitized RBCs).
5. Heavy trichuriasis.
• Watery diarrhea:
1. Trichinosis (food poisoning)
2. Cryptosporidium.
3. Giardia lamblia
(malabsorption).
4. Hymenolepis nana (during
development of cysticercoids
in the villi).
5. Strongyloides stercoralis
6. Capillaria philippinensis.
(malabsorption).
7. Schistosomiasis mansoni
(profuse diarrhea or
dysentery).
8. Primary heavy hookworm
infection.

10. Symptoms and signs caused by
parasitic infections
• Intestinal obstruction:
1. Ascariasis.
2. Chagas’s disease (Chronic
(megacolon).
3. Taenia saginata
4. Taenia solium
• Jaundice:
1. Obstructive (Fasciola).
2. Haemolytic (falciparum malaria,
bilious remittent fever).
• Worm passed from anus or
mouth:
• Ascariasis (anus & mouth).
• Oxyuris. (anus)
• Taenia saginata (anus)
• Parasites transmitted by
undercooked meat:
1. Taenia saginata.
2. Taenia solium.
3. Trichinella.
4. Toxoplasma,
5. Fasciola (Halzoun).
• Parasites transmitted by
autoinfection (nosocomial).
1. Cryptosporidium.
2. Entamoeba histolytica.
3. Giardia lamblia,
4. Strongyloides.
5. Oxyuris.
6. Cysticercosis.
7. Capillaria Philippinensis.
8. Hymenolepis nana
Epidemiologic aspects of
parasitic infections

11. Epidemiologic aspects of parasitic infections
• Soil mediated helminth
infections:
1. Hookworms
2. Strongyloides
3. Ascaris
4. Toxocara
5. Trichuris trichiura.
6. Capillaria hepatica
• Opportunistic Infections:
1. Strongyloides.
2. Cryptosporidium
3. Toxoplasma
4. Acanthamoeba (GAE).
5. Giardia.
• Sexually transmitted
parasites:
1. T. vaginalis
2. S. scabeii.
3. Phthirus pubis.
4. Parasites transmitted by
auto infection.