The document provides guidelines for analyzing stool samples in a laboratory setting. Key steps include collecting the sample in a clean cup, examining a thin smear of the stool under the microscope using 10x and 40x lenses, and noting any observations of mucus, pus, blood cells, parasites, or other abnormal findings. The results are interpreted to help diagnose common gastrointestinal issues or parasites present in the stool. Multiple samples over several days may be needed to rule out the presence of parasites if not seen on initial examination.

1. ‫العملى‬ ‫خطوات‬ ‫شرح‬

2. 
‫البراز‬ ‫تحليل‬ ‫قبول‬ ‫شروط‬
•
‫كوب‬ ‫فى‬ ‫العينة‬ ‫تجميع‬ ‫يجب‬
‫نظيف‬
•
‫ال‬
‫كبيرة‬ ‫زمنية‬ ‫مدة‬ ‫العينة‬ ‫على‬ ‫يمر‬
(
‫الطفيلية‬ ‫األطوار‬ ‫تموت‬ ‫ال‬ ‫حتى‬
‫و‬
‫ساعة‬ ‫خالل‬ ‫الفحص‬ ‫يفضل‬
)
•
‫مراعاة‬
‫األطوار‬ ‫تقتل‬ ‫ألنها‬ ‫األطفال‬ ‫عند‬ ‫خاصة‬ ‫بالبراز‬ ‫البول‬ ‫اختالط‬ ‫عدم‬
‫النشطة‬
•
‫مراعاة‬
‫حتى‬ ‫الشهرية‬ ‫الدورة‬ ‫أثناء‬ ‫النساء‬ ‫عند‬ ‫بالدم‬ ‫البراز‬ ‫اختالط‬ ‫عدم‬
‫ال‬
‫خطأ‬ ‫التشخيص‬ ‫ثم‬ ‫التحليل‬ ‫يكون‬
•
‫عينة‬
‫تشر‬ ‫نتيجة‬ ‫جاف‬ ‫البراز‬ ‫كان‬ ‫إذا‬ ‫ترفض‬ ‫الحفاضات‬ ‫فى‬ ‫األطفال‬
‫ب‬
‫البامبرز‬
.
•
‫إذا‬
‫فتر‬ ‫فى‬ ‫المعمل‬ ‫إلى‬ ‫العينة‬ ‫إعطاء‬ ‫يفضل‬ ‫المعمل‬ ‫خارج‬ ‫العينة‬ ‫أخذت‬
‫ال‬ ‫ة‬
‫بعض‬ ‫لتحلل‬ ً‫ا‬‫منع‬ ‫الساعتين‬ ‫عن‬ ‫تزيد‬
‫الطفيليات‬

3. •
‫إذا‬
‫ذل‬ ‫فحص‬ ‫يفضل‬ ‫مخاط‬ ‫أو‬ ‫صديد‬ ‫أو‬ ‫مثال‬ ‫كالدم‬ ‫طبيعي‬ ‫غير‬ ‫شيء‬ ‫أى‬ ‫البراز‬ ‫بعينة‬ ‫كان‬
‫الجزء‬ ‫ك‬
‫تحضير‬ ‫فى‬ ‫البدء‬ ‫قبل‬ ‫الميكروسكوب‬ ‫تحت‬ ‫أوال‬ ‫العينة‬ ‫من‬
‫العينة‬
•
‫تحضير‬
‫نموذجية‬ ‫شريحة‬
not too thin not too thick)
)
•
‫محدد‬ ‫سير‬ ‫خط‬ ‫اتبع‬ ‫و‬ ‫الشريحه‬ ‫على‬ ‫معينة‬ ‫نقطة‬ ‫من‬ ‫الفحص‬ ‫ابدا‬
zigzag
•
‫اذا‬
‫من‬ ‫اعلى‬ ‫الميكرسكوب‬ ‫تحت‬ ‫صديد‬ ‫وجدت‬
80
‫الظاهري‬ ‫الفحص‬ ‫فى‬ ‫المخاط‬ ‫و‬ ‫الصديد‬ ‫اكتب‬
+
‫او‬
++
•
‫عدد‬ ‫كتابه‬ ‫من‬ ‫فالبد‬ ‫الظاهرى‬ ‫بالفحص‬ ‫العينة‬ ‫فى‬ ‫دم‬ ‫وجدت‬ ‫اذا‬
‫ال‬
RBCs
‫الفحص‬ ‫فى‬
‫من‬ ‫اكثر‬ ‫الميكروسكوبى‬
100
‫الفحص‬ ‫اثناء‬ ‫مالحظات‬

4. •
‫عند‬
‫وج‬ ‫عدم‬ ‫من‬ ‫التام‬ ‫للتأكد‬ ‫شريحتين‬ ‫من‬ ‫اكثر‬ ‫افحص‬ ‫الشريحة‬ ‫فى‬ ‫دم‬ ‫او‬ ‫صديد‬ ‫وجود‬
‫ود‬
‫ديدان‬
•
‫التضع‬
‫عن‬ ‫تبحث‬ ‫ان‬ ‫مثل‬ ‫العينة‬ ‫فى‬ ‫تبحث‬ ‫انت‬ ‫و‬ ‫معين‬ ‫شىء‬ ‫تفكيرك‬ ‫فى‬
ova
‫مثال‬ ‫معينه‬
•
‫االحي‬ ‫بعض‬ ‫فى‬ ‫و‬ ‫لها‬ ‫لون‬ ‫ال‬ ‫بل‬ ‫احمر‬ ‫ليس‬ ‫الميكروسكوب‬ ‫تحت‬ ‫الحمراء‬ ‫الدم‬ ‫كرات‬ ‫لون‬
‫ان‬
‫ابدا‬ ‫دم‬ ‫ليس‬ ‫هى‬ ‫و‬ ‫طويل‬ ‫خط‬ ‫او‬ ‫لطخه‬ ‫شكل‬ ‫على‬ ‫حمراء‬ ‫شوائب‬ ‫الميكروسكوب‬ ‫تحت‬ ‫تظهر‬
‫و‬ ‫البطيخ‬ ‫خاصة‬ ‫االكل‬ ‫من‬ ‫او‬ ‫المالبس‬ ‫من‬ ‫الياف‬ ‫هى‬ ‫بل‬
‫الطماطم‬
•
‫اول‬ ‫فى‬ ‫الرضع‬ ‫االطفال‬ ‫براز‬
6
‫على‬ ‫اليحتوى‬ ‫اشهر‬
muscle fibers
‫طعام‬ ‫يأكل‬ ‫ال‬ ‫النه‬
‫تكتب‬ ‫لدلك‬ ‫و‬ ‫طبيعى‬
absent
‫اما‬
‫بعد‬
6
‫البراز‬ ‫ويكون‬ ‫طبيعية‬ ‫بصورة‬ ‫الطفل‬ ‫فيأكل‬ ‫اشهر‬
‫العادى‬ ‫الشخص‬ ‫مثل‬
.
‫التقرير‬ ‫وكتابة‬ ‫الفحص‬ ‫اثناء‬ ‫مالحظات‬

5. 
‫مثل‬ ‫الروتينى‬ ‫البراز‬ ‫تحليل‬ ‫فى‬ ‫تشخيصها‬ ‫يتم‬ ‫ال‬ ‫الهضمى‬ ‫الجهاز‬ ‫مشاكل‬ ‫معظم‬
:
o
‫العصبى‬ ‫القولون‬
o
‫القولون‬ ‫تقرحات‬
o
‫االنتفاخات‬
o
‫المعدة‬ ‫جرثومة‬
o
‫الهضم‬ ‫عسر‬
o
‫الطعام‬ ‫حساسية‬
o
‫المعوية‬ ‫النزالت‬
o
‫والبروسيلال‬ ‫التيفود‬
o
‫الجهاز‬ ‫سرطان‬
‫الهضمى‬
o
‫الدرقية‬ ‫الغدة‬ ‫امراض‬
o
‫المزمن‬ ‫االمساك‬
‫للمريض‬ ‫البراز‬ ‫نتيجة‬ ‫تفسير‬ ‫على‬ ‫مالحظات‬

6. 
‫البراز‬ ‫تحليل‬ ‫من‬ ‫االساسى‬ ‫تشخيصها‬ ‫التى‬ ‫الطفيليات‬ ‫وحتى‬
o
‫وجودها‬ ‫رغم‬ ‫تظهر‬ ‫ال‬ ‫قد‬
(
‫بفحص‬ ‫االقل‬ ‫على‬ ‫ينصح‬
3
‫النفى‬ ‫تشخيص‬ ‫اجل‬ ‫من‬ ‫متتالية‬ ‫عينات‬
)

‫تتجاوز‬ ‫وال‬ ‫قليلة‬ ‫الطفيليات‬ ‫تواجد‬ ‫نسبة‬
10 %
‫تقدير‬ ‫اقصى‬ ‫على‬

‫وليس‬ ‫التشخيص‬ ‫قبل‬ ‫طفيليات‬ ‫وجود‬ ‫الستبعاد‬ ‫البراز‬ ‫تحليل‬ ‫طلب‬ ‫يتم‬ ‫كثيرة‬ ‫احيان‬ ‫فى‬
‫اجل‬ ‫من‬
‫التشخيص‬

‫بالمنظار‬ ‫الفحص‬ ‫هى‬ ‫الهضمى‬ ‫الجهاز‬ ‫امراض‬ ‫لتشخيص‬ ‫وسيلة‬ ‫افضل‬

‫الجرعة‬ ‫تؤخذ‬ ‫الديدان‬ ‫حالة‬ ‫فى‬
3
‫الديدان‬ ‫تقتل‬ ‫النها‬ ‫وذلك‬ ‫شهر‬ ‫بعد‬ ‫ثم‬ ‫اسبوعين‬ ‫بعد‬ ‫تكرر‬ ‫ثم‬ ‫ايام‬
‫وال‬
‫قتلها‬ ‫يتم‬ ‫ثم‬ ‫ومن‬ ‫الديدان‬ ‫اخرجت‬ ‫اليرقات‬ ‫تكون‬ ‫حتى‬ ‫مدة‬ ‫بعد‬ ‫تعطى‬ ‫لذلك‬ ‫و‬ ‫اليرقات‬ ‫تقتل‬
‫للمريض‬ ‫البراز‬ ‫نتيجة‬ ‫تفسير‬ ‫على‬ ‫مالحظات‬

7. .1
‫الميكروسكوبى‬ ‫الفحص‬

8. ‫المباشر‬ ‫الفحص‬
Direct smear
.1
‫افحص‬ ‫ثم‬ ‫الملح‬ ‫محلول‬ ‫من‬ ‫نقطه‬ ‫مع‬ ‫امزجها‬ ‫و‬ ‫نظيفه‬ ‫شريحه‬ ‫على‬ ‫البراز‬ ‫من‬ ‫صغيرة‬ ‫قطعة‬ ‫ضع‬
‫ها‬
‫الميكروسكوب‬ ‫تحت‬
‫العدسه‬ ‫مستخدما‬
10
‫العدسه‬ ‫ثم‬
40
.2
‫با‬ ‫كان‬ ‫ادا‬
‫ل‬
‫الجزء‬ ‫هدا‬ ‫بفحص‬ ‫البدء‬ ‫يجب‬ ‫مخاط‬ ‫او‬ ‫صديد‬ ‫او‬ ‫دم‬ ‫به‬ ‫جزء‬ ‫عينه‬
.3
‫فحص‬ ‫يجب‬
‫الدقيقه‬ ‫باالمعاء‬ ‫طفيليات‬ ‫وجود‬ ‫الحتمال‬ ‫داخله‬ ‫من‬ ‫عينه‬ ‫و‬ ‫البراز‬ ‫سطح‬ ‫من‬ ‫عينة‬
‫او‬
‫الغليظه‬ ‫االمعاء‬
.4
‫النش‬ ‫الطور‬ ‫يقتل‬ ‫اليود‬ ‫لكن‬ ‫المتحوصله‬ ‫االطوار‬ ‫لرؤية‬ ‫العينة‬ ‫لصبغ‬ ‫اليود‬ ‫استخدام‬ ‫يمكن‬
‫فلذلك‬ ‫ط‬
‫اوال‬ ‫اليود‬ ‫بدون‬ ‫افحص‬
‫المميزات‬
‫المتحوصله‬ ‫االكياس‬ ‫لفحص‬ ‫أساسا‬ ‫وتستخدم‬ ‫وسريعة‬ ‫سهلة‬ ‫الطريقة‬
‫للطفيليات‬
‫العيوب‬
‫كانت‬ ‫اذا‬
‫الطريقه‬ ‫بهده‬ ‫رؤيتها‬ ‫ففرصه‬ ‫قليله‬ ‫العينه‬ ‫فى‬ ‫الطفيليات‬ ‫اعداد‬
‫ضعيفه‬

9. .2
‫معلق‬ ‫محلول‬ ‫وعمل‬ ‫الترسيب‬ ‫طريقة‬

10. ‫الطريقه‬
.1
‫تؤخذ‬
‫في‬ ‫وتوضع‬ ‫البراز‬ ‫من‬ ‫قطعة‬
‫كوب‬
‫الكوب‬ ‫الى‬ ‫الملح‬ ‫محلول‬ ‫يضاف‬ ‫ثم‬ ‫نظيف‬
.
.2
‫جيدا‬ ‫المحلول‬ ‫في‬ ‫البراز‬ ‫يقلب‬
.
.3
‫البراز‬ ‫من‬ ‫الصلبة‬ ‫االجزاء‬ ‫ونترك‬ ‫بالستيك‬ ‫انبوب‬ ‫فى‬ ‫المحلول‬ ‫ينقل‬
.4
‫لمدة‬ ‫االنبوبه‬ ‫تترك‬
20
–
30
‫دقيقة‬
.
.5
‫بالميكروسكوب‬ ‫الراسب‬ ‫يفحص‬
‫ملحوظه‬
:
‫يمكن‬
‫التدوير‬ ‫لكن‬ ‫الترسيب‬ ‫من‬ ‫التسريع‬ ‫و‬ ‫العينه‬ ‫لتدوير‬ ‫السنترفيوج‬ ‫استخدام‬
‫يمكن‬ ‫القوى‬
‫اليرقات‬ ‫و‬ ‫البويضات‬ ‫جدار‬ ‫تكسير‬ ‫الى‬ ‫يؤدى‬ ‫ان‬
.
‫المميزات‬
‫من‬ ‫وزنا‬ ‫االثقل‬ ‫للطفيليات‬ ‫مناسبة‬ ‫الطريقه‬ ‫هده‬
‫االنب‬ ‫قاع‬ ‫فى‬ ‫تترسب‬ ‫بالتالى‬ ‫و‬ ‫الملح‬ ‫محلول‬
‫مثل‬ ‫وبه‬
:
Ascaris ,Shistosoma mansoni ,Fasciola ,Strongyloides stercoralis
‫العيوب‬
‫الكفاءه‬ ‫بنفس‬ ‫الطفيليات‬ ‫لجميع‬ ‫تصلح‬ ‫ال‬

11. Normal stool

Undigested food

Bacteria

Yeast

Fibers

Air bubbles

Oil droplets

Crystals

12. Microscopic Examination

13. Normal urine under microscope

14. Normal Fimdings

46. Abnormal findings

47. Pus RBCs

48. Parasites

49. Protozoa
Entameba histolytica
Cyst
Trophozoite
Giardia lamblia
Cyst
Trophozoite

Protozoa

50. Entameba histolytica
Cyst
Trophozoite
(12 to 15 µm)
(10 to 60 µm)

51. Entameba histolytica
Cyst
Trophozoite
(12 to 15 µm)
(10 to 60 µm)

52. Entameba histolytica
Cyst
Trophozoite

53. Entameba histolytica
(8 to 15 µm)
(10 to 60 µm)
(12 to 15 µm)
(7 µm)
‫االستدارة‬ ‫تامة‬
(
‫بالبرجل‬ ‫مرسومة‬
)

54. Entameba histolytica

55. Giardia lamblia
Cyst
Trophozoite
(12 to 15 µm)
(10 to 20 µm)

56. Giardia lamblia
Cyst
Trophozoite
(12 to 15 µm)
(10 to 60 µm)

57. Giardia lamblia
Cyst
Trophozoite
(12 to 15 µm)
(10 to 20 µm)

58. Giardia lamblia
Cyst
Trophozoite
(12 to 15 µm)
(10 to 20 µm)

59. Giardia lamblia
Cyst
Trophozoite
(12 to 15 µm)
(10 to 20 µm)

60. Giardia lamblia

61. 
Oxyuris Vermicularis

Strongyloides spp.

Pinworms

nematode

‫الدبوسية‬ ‫الدودة‬
Worm
(0.5–1 cm in length(
Egg
(40 to 60 µm)
Larva

62. Egg

63. Larva

64. Egg

65. Egg

66. Worm

67. 
Worm

68. Ancylostoma egg H.nana egg
S.mansoni
egg
Taenia Trichuris
Enterobius
Capillaria
Big-
sized
eggs
Medium-
sized
eggs
Small-
sized
eggs
150X 60µ 140X 70µ
60
X
45µ
60
X
40µ
50µ
40µ 50X 20µ 40X 20µ 50X 20µ
Heterophyes
30X 15µ
Fasciola
egg
Parasite Eggs in Stool (10X)
egg egg egg egg egg
Ascaris egg

69. H.nana egg
S.mansoni
egg
Enterobius
Big-
sized
eggs
Medium-
sized
eggs
Small-
sized
eggs
150X 60µ
60
X
45µ
50µ
50X 20µ
Parasite Eggs in Stool (10X)
egg
Ascaris egg

70. Artifacts & Parasites

71. Non – Pathogenic
(Like Entameba)
E.coli cyst 30µ Endolimax 12µ

72. Yeast cells
Fungal spore
Size: 6-40 µm
Chromista
Non – Pathogenic
(Like Entameba)

73. Cells in stool mistaken for Giardia lamblia
Giardia lamblia cyst Yeast cells
Fungal spore
Iodine-stained cyst 40X

74. Blastocystis hominis
Size: 6-40 µm
no parasites are present
Kingdom:
Chromista
Clinical picture : asymptomatic or symptomatic
Written in the following condition:
Stool sample shows watery diarrhoea
many Blastocystis hominis are seen

75. Artifacts in stool mistaken for Ascaris Eggs
Ascaris egg 10X
Pollen grains 40X
Plant cell 10X

76. Artifacts in stool mistaken forTaenia eggs
Pollen grains 40X
Taenia egg
40X

77. Taenia egg
40X
Pollen grains 40X

78. Air-born fungus
Plant parasites
attached to plant roots
Artifacts in stool mistaken for human parasites
Diatoms in
stool
Pollen grain
Plant parasite
(Heterodera)

79. Strongyloides larva
250 µ
Hairs of variable length
Iodine stained Unstained
Artifacts in stool mistaken for Strongyloides larva

80. The END

81. 
Giardia lamblia

82. Artifacts in stool mistaken for Enterobius eggs
Morel Mushroom
spore Enterobius eggs
unstained
Iodine
stained

83. 
Protozoa
ENTAMOEBA HISTOLYTICA
ENTAMOEBA coli

84. Giardia lamblia cyst
E.histolytica
/ dispar cyst
Entamoeba histolytica
seen within mucus
Protozoa in stool seen by the High Power
E.coli cyst
Endolimax
nana cyst
12X7µ
15X8µ 25µ
12µ 15µ
30µ
iodine stained
E.histolytica/dispar
pre-cyst
Giardia lamblia trophozoites

85. URINE ANALYSIS

Physical Examination
•
Colour, Volume, Turbidity
•
‫االهمية‬ ‫قليل‬

Chemical Examination

Microscopic Examination

86. .1
‫ال‬ ‫شريط‬ ‫باستخدام‬ ‫الكيميائى‬ ‫الفحص‬
‫بول‬
Urine Strip

87. +ve Protein Strip
Heat in glass tube
-ve ppt.
Proein –ve
(Error in strip)
+ve ppt.

‫البول‬ ‫شريط‬ ‫فى‬ ‫البروتين‬ ‫من‬ ‫التأكد‬

88. Stool analysis
Stool analysis
1- Direct
smear
2-
concentration
methods
A-
Sedimentation
B- Floatation

89. 1- Direct smear:
1. Prepare slides for each sample and numbering them.
2. Put one drop of normal saline on the slide.
3. Take small amount of stool by using stick & mix well with
normal saline.
4. Cover the sample by “cover slip”.
5. Examine it under the microscopic power (5,10,40).
Procedure:

90. A- Sedimentation:
• Add 3 ml of normal saline in test tube & add on it small a mount of stool (2-3)g. Mix
well.
• Filter the mixture in other test tube by using funnel & gouse.
• Add 6 ml of (10% formalin) solution in test tube that contains the filtrate sample for 5
min so as fix the sample.
• Add 3ml of “ether” to dissolve the fat in the sample , then lock the tube with cover &
shake well to mix ether with the sample.
• Put the test tube in centrifuge (1000 u / m) for 1 min , then take the test tube from the
instrument.
“Note:” If 4 layer are formed in test tube your procedure is correct. Otherwise you must
repeat the same steps.
• After that gets red from all contents in tube by pouring the contents in special box.
• Take one drop from the sediment & examine it under the microscopic power(5,10,40)
Procedure:
2- concentration methods

91. B- Floatation:
• Take (2-3)g of stool sample & dissolve it in 8 ml of normal saline. Mix
well.
• Filter the contents by using funnel & gouse.
• Place the tube in centrifuge (1000 u / m) for 1 min.
• Gets red the decetate & add 7 ml of “ ZnSO4 ”.
• Put the tube in centrifuge for 1 min.
• Take one drop from the decetate & examine it under the microscopic
power (5,10,40).
2- concentration methods
Procedure:

92. Occult blood test:
1. Take small amount from stool sample.
2. Prepare thin smear of stool on filter paper.
3. Add 2 drops from dereloping solution (stabilized solution of hydrogen
peroxide & alcohol ) on filter paper.
4. Read the result (1-2) min.
5. If the color change to blue, the result is positive & if it's not change the
result is negative.
Introduction:
It's A test use to examine occult blood in stool in colon & rectum disease.
Procedure:

93. Some Parasites in stool:
Class:
Phylum:
Stage:
Parasite:
Sarcodina
protozoa
Cyst -
trophozoite
 Entamoeba histolytica.
Sarcodina
protozoa
Cyst -
trophozoite
 Entamoeba coli.
Sarcodina
protozoa
Cyst -
trophozoite
 Endolimax nana.
Sarcodina
protozoa
Cyst -
trophozoite
 Iodamoeba butschlii.
Flagellate
protozoa
Cyst -
trophozoite
 Giardia lamblia.
‫به‬ ‫الخاصة‬ ‫الصور‬ ‫لترى‬ ‫الطفيل‬ ‫أسم‬ ‫على‬ ‫بالنقر‬ ‫قم‬

94. Class:
Phylum:
Stage:
Parasite:
Nematode
Nemathelimnthes
Ova ( egg )
Larva
 Ascaris lumricoides.
Nematode
Nemathelimnthes
Ova ( egg )
Larva
 Enterobius vermicularis.
Nematode
Nemathelimnthes
Ova ( egg )
Larva
 Ancylostoma duodenale.
(Hook worm)
Nematode
Nemathelimnthes
Ova ( egg )
Larva
 Strongyloides stercorails.
Nematode
Nemathelimnthes
Ova ( egg )
Larva
 Trichuris trichiura.
Some Parasites in stool:
‫به‬ ‫الخاصة‬ ‫الصور‬ ‫لترى‬ ‫الطفيل‬ ‫أسم‬ ‫على‬ ‫بالنقر‬ ‫قم‬

95. Some Parasites in stool:
Class:
Phylum:
Stage:
Parasite:
Trematoda
Platyhelminthes.
Ova ( egg )
 Schistosoma mansoni.
Cestoidea
Platyhelminthes.
Ova ( egg )
Taenia sp.
Cestoidea
Platyhelminthes.
Ova ( egg )
 Hymenolepis nana.
Cestoidea
Platyhelminthes.
Ova ( egg )
 Hymenolepis diminuta.
‫به‬ ‫الخاصة‬ ‫الصور‬ ‫لترى‬ ‫الطفيل‬ ‫أسم‬ ‫على‬ ‫بالنقر‬ ‫قم‬

96. Thanks 4 Download..
Ba6ee5ah
bye bye

97. Routine stool analysis
Test Principle:
1- Naked eye examination of stool sample.
2- Microscopic examination of stool sample.
Clinical Significance:
Detection of parasitic infection.

98. Before Analysis
Stool sample is better provided in the lab.
Stool samples must be examined
within 1 hour.
Parasites as
Stool sample contaminated with urine is refused
Giardia lamblia trophozoites
Entamoeba histolytica trophozoites
rapidly disintegrate at room temperature
Trichomonas hominis trophozoites
commonly mistaken

99.  Inspect by the naked eye for :
Steps of analysis
1- Colour of stool sample:
Brown
Greenish
Reddish
normal
Much green vegetables eaten
Giardia infection
Bleeding or due to some drugs
Light brown Undigested fat
Black Occult blood or due to some drugs

100. Steps of analysis (continued)
Undigested food (Nil, +, ++, +++)
Mucus especially when mucus is tinged with blood
Worms (Enterobius, Ascaris, Taenia segments)
Blood (may be due to piles or anal fissure)
3- Inspect for the presence of:
2- Assess the pH of diarrhoeic stool specimen using
litmus paper. Normally it is alkaline.
It turns acidic e.g. in Entamoeba histolytica infection.

101. Worms Recovered In Stool
Ascaris lumbricoides
Cylindrical worm
about 20 cm long
Taenia worm
Ribbon-like
several meters long
Enterobius
vermicularis
cylindrical worm
about 10 mm long
Single segments
creep out of anus

102. Artifacts in stool mistaken for worms
Citrus particles
Tomato skin
Earthworm
Bean sprouts
Aquatic larvae
of arthropods
Mucus casts

103.  Loose or watery stool samples & mucoid samples
should be examined by direct smear method
e.g. Entamoeba trophozoite
Drop of
iodine
- Iodine stained (10% in distilled water)
 Formed, semi-formed, soft stool samples should be
examined after concentration by sedimentation method
Steps of analysis (continued)

104. Concentration of Faecal Samples by Sedimentation
10%
formal
saline
Stool
sample
Wooden
rod
Ethyl acetate
Stool
sediment
Supernatant
Fat
10% iodine
Centrifugation for 10 min at 3000 RPM
Slide

105. Microscopic examination
• Digestion:
Vegetable cells
Starch
Muscle fibres
Fat
• Cytology:
• Pus cells / H.P.F.
• RBCs / H.P.F.
• Epithelial cells.
• Yeast cells
• Parasites:
• Helminths (eggs, larvae)
• Protozoa (trophozoite, cyst)
Screening by
Low Power
Different shapes of
vegetable cells
Fat droplets
Don’t write many bacteria in stool
analysis report
Muscle fibres
Starch

106. After Analysis
 If pus cells (more than 10 / H.P.F. or with clumps) and no
parasite is seen during examination:
- Recommend for stool culture
 For watery stool samples showing no parasites:
- Recommend test for Cryptosporidium in stool
- Recommend test for Rota virus in stool
For samples provided to the lab write the following comment:
The sample was provided to the lab
The person who performed the analysis must write his
name at the end of the report.
Done samples are kept for 24 hours before discarding.
In children
between 2-5
years
- Recommend test for Cryptosporidium only
in stool
In adults

107. Ancylostoma egg H.nana egg
S.mansoni
egg
Taenia Trichuris
Enterobius
Capillaria
Big-
sized
eggs
Medium-
sized
eggs
Small-
sized
eggs
150X 60µ 140X 70µ
60
X
45µ
60
X
40µ
50µ
40µ 50X 20µ 40X 20µ 50X 20µ
Heterophyes
30X 15µ
Fasciola
egg
Parasite Eggs in Stool (10X)
egg egg egg egg egg
Ascaris egg

108. Artifacts in stool mistaken for Ascaris Eggs
Ascaris egg 10X
Pollen grains 40X
Plant cell 10X

109. Artifacts in stool mistaken for H.nana Eggs
Hymenolepis nana eggs Unknown object
Mite Eggs mistaken for Ancylostoma egg
‫األنكلستوم‬ ‫دودة‬ ‫بيضة‬ ‫تشبه‬ ‫بويضات‬
‫ا‬
Ancylostoma
egg
Mite eggs
‫و‬ ‫التراب‬ ‫فى‬ ‫توجد‬ ‫المفصليات‬ ‫من‬ ‫نوع‬ ‫بيضة‬
‫الدقيق‬
‫التهوية‬ ‫سيىء‬ ‫مكان‬ ‫فى‬ ‫المخزونة‬ ‫والحبوب‬

110. Artifacts mistaken for Capillaria eggs
Pollen grain 40X
A fungal spore
(Morchella sp.)
Capillaria egg 40X

111. Artifacts in stool mistaken forTaenia eggs
Taenia egg
40X
Pollen grains 40X

112. Taenia egg
40X
Pollen grains 40X

113. Artifacts in stool mistaken for Enterobius eggs
Morel Mushroom
spore Enterobius eggs
unstained
Iodine
stained

114. Air-born fungus
Plant parasites
attached to plant roots
Artifacts in stool mistaken for human parasites
Diatoms in
stool
Pollen grain
Plant parasite
(Heterodera)

115. Strongyloides larva
250 µ
Hairs of variable length
Iodine stained Unstained
Artifacts in stool mistaken for Strongyloides larva

116. Giardia lamblia cyst
E.histolytica
/ dispar cyst
Entamoeba histolytica
seen within mucus
Protozoa in stool seen by the High Power
E.coli cyst
Endolimax
nana cyst
12X7µ
15X8µ 25µ
12µ 15µ
30µ
iodine stained
E.histolytica/dispar
pre-cyst
Giardia lamblia trophozoites

117. Cells in stool mistaken for Giardia lamblia
Giardia lamblia cyst Yeast cells
Fungal spore
Iodine-stained cyst 40X

118. Blastocystis hominis
Size: 6-40 µm
no parasites are present
Kingdom:
Chromista
Clinical picture : asymptomatic or symptomatic
Written in the following condition:
Stool sample shows watery diarrhoea
many Blastocystis hominis are seen

119. Blastocystis hominis
(iodine-stained)
Pollen grain
(iodine-stained)
Artifacts in stool mistaken for Blastocystis
(magnification x40)

120. Unstained oocyst
Stained oocyst by MZN stain
Stool examination to detect unstained and stained oocysts
Diagnosis of Cryptosporidium, Cyclospora & Isospora
Cyclospora Unsporulated
Isospora
Sporulated
Isospora
Cyclospora
Unsporulated
Isospora
Sporulated
Isospora
Cryptosporidium
‫مصبوغة‬ ‫غير‬ ‫أكياس‬
‫مصبوغة‬ ‫أكياس‬
‫اس‬ ‫تسبب‬ ‫طفيليات‬
‫هال‬
‫ذو‬ ‫المرضى‬ ‫فى‬ ‫شديد‬
‫ى‬
‫الضعيفة‬ ‫المناعة‬

121. +ve Protein Strip
Heat in glass tube
-ve ppt.
Proein –ve
(Error in strip)
+ve ppt.
Add drops of acetic acid
Still +ve ppt.
Protein +ve
ppt. disappear
Proein –ve
(ppt. is phospate salts.)

‫البول‬ ‫شريط‬ ‫فى‬ ‫البروتين‬ ‫من‬ ‫التأكد‬

122. Pus = W.B.Cs

123. R.B.Cs

124. Ammorphous Urate & Phosphate