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Parasite

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Parasite
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Parasite Type Appearance of adult Appearance Mode/stage of Intermed. Reserv Egg loc. Larvae loc. Adult loc.

of egg infection host host



Enterobius Pinworm Non-seg; alae in X Embry., Ingest eggs or None None Anus, laid at Sm. Int Tr. & desc.

vermicularis (roundworm) section; fem: 1cm, football larvae crawl night colon, rectum

nematode straight; male: 4mm, back in thru

copulatory spicule, curly; anus

Cuticle,full GI,NS

Trichuris Whipworm Non-seg; thick front, thin Oval, embry, Ingest egg None none Feces, must Sm int, b/w epi Tr & desc

trichiura (roundworm) tail, male curved body; 3- dark, thick embry to be & lam. propria colon, imbed in

nematode 5cm edge infectious columnar cells



Ascaris Roundworm Non-seg; cuticle, 15cm, Contains 2nd Ingest egg Maybe Feces, embry in Pen. Cap to Upper sm int

lumbriocoides nematode long, skinny stage larv, pigs soil liver to heart to

round, lungs to trach.

splotchy coat



Toxocara canis Roundworm Ingest egg Dog/ca Int to brain/eye

nematode t



Necator Hookworm Rounded cutting plates; Thin outer Filariform Feces, devel to Rhab larv in Sm int, sucks

americanus nematode 1.5cm, male: cop bursa coat, clump larvae pen fil larv in soil soil, fil thru blood thru wall,

(hand); fem: pointy tail; in middle, skin skin, Cap to releases anti-

long, slender; short embry. lungs to trach. coags

esophagus,





Ancylostoma Hookworm Cutting teeth, 2cm, male: Thin outer Filariform feces, devel to Cap to lungs to Sm int sucks

duodenale nematode cop. bursa (hand); fem: coat, clump larvae pen fil larv in soil trach blood thru wall,

pointy tail;1cm; short in middle, skin, or ingest releases anti-

esophagus embry larv coags



Strongyloides nematode Fem: 2mm, long, slender; Not seen b/c Filar. Larv Dog, Hatch in sm. Int Cap to lung to Upper s m int,

stercoralis no parasitic male hatch in pen skin or fil primate into 1st stage trach in lam prop

intestine larv pen colon s, also larvae

to blood - free-

autoinfect living

in soil

Taenia saginata Tapeworm 8-10m, flat, seg, scolex + Thick rim, Cysticercus None Hatch in cow Cow tissue Upper sm int

cestode proglottids, tegument, 4 embry, can’t ingested w/ sm. int, go to ingested to sm

suckers on scolex tell which raw beef tissues, dev to int

taenia cysticerci







Taenia solium Tapeworm 10m, flat, seg, scolex + Thick rim, Cysticercus None Hatch in pig sm Pig tissue Upper sm int

cestode proglottids, teg, 4 suckers embry, can’t ingested w/ int, go to ingested to sm

+ 2 rows of hooklets tell which raw pork tissues, dev to int

taenia cysticerci







Cystircercosis Taenia No adult,egg to Thick rim, t. solium eggs none Ingested from oncospherepen

solium oncosphere to cysticercus embry, can’t ingested or feces or regurg, int wall to

cysterci only tell which regurgitated hatch in sm int blood to tissue,

taenia to stomach become cyst. In

brain, eye,

muscle

Echinococcus No adults in humans. Ingest embry. Dogs are Feces of dog, oncospherepen No adults in

granulosus 5mm, scolex + 3 segs, 4 egg definitive host; hatch in human int wall to humans

suckers + hooks humans, sheep - sm int blood to tissue

intermed hosts (oft. liver),

become hydatid

cyst, dev

protoscoleces

Parasite Type Appearance of adult Appearance Mode/stage of Intermed. Reserv Egg loc. Larvae loc. Adult loc.

of egg infection host host



Schistosoma Trematode Fem:15mm; male 1cm; Oval, lateral Cercariae Snail Monke Eggs in sm.int Miracidium to Inf mesenteric

mansoni blind gut, eat globin from spine, 300 enter skin y, wall, pre-sin cercariae in venules

Hgb, male spoons female, per day baboon caps in liver, snail;

ant & vent suckers, spleen, lung Schistosomula

tegument exist feces, to blood to lung

hatch fresh to liver

water,

miracidium in

snail

Schistosoma Trematode Fem:15mm; male 1cm; Round, no Cercariae Snail None Eggs in sm. int, Miracidium to Sup. mesenteric

japonicum blind gut, eat globin from spine, 1500- enter skin pre-sin caps in cercariae in venules, chor

Hgb, male spoons female, 3000 per day liver, spleen, snail; plex, spinal ven

ant & vent suckers, lung; exist Schistosomula

tegument feces, hatch to blood to lung

fresh to liver

water,become

miracidium in

snail

Schistosoma Trematode Fem:15mm; male 1cm; Oval, Cercariae Snail Water Eggs in Miracidium to Bladder venous

haematobium blind gut, eat globin from terminal enter skin buffalo bladder, ureter cercariae in plexus

Hgb, male spoons female, spine , walls, exist snail;

ant & vent suckers, cow,pi urine, hatch Schistosomula

tegument g fresh water, to blood to lung

miracidium in to liver

snail

Plasmodium protozoa Mat troph: RBC enlarged, Gametocytes Sporoz. Man is intermed, Sporos go to Immat troph

vivax pale, Schuffner’s dots; lg large, circ. or Injected into defin is mosquito liver, enter cell, matures in

single mass chrom, irreg oval skin by form schiz, periph blood,

cytoplasm, brown female divide to prod makes schiz,

pigment, parasite fills Anopheles meroz, go enter meroz, inf more

cell; schizont: 12-24 mosquito RBCs cells

meroz.

Plasmodium protozoa Mat troph: RBC crenated, Sporoz. Man is intermed, Sporos go to Immat troph

ovale nl size, not totally full of Injected into defin is mosquite liver, enter cell, matures in

parasite skin by form schiz, periph blood,

female divide to prod makes schiz,

Anopheles meroz, go enter meroz, inf more

mosquito RBCs cells



Plasmodium protozoa Mat troph: RBC nl size, Gametocytes Sporoz. Man is intermed, Gametocytes in Sporos go to Caps of internal

falciparum color light cytoplasm, crescent- Injected into defin is mosquite sequestered liver, enter cell, organs, no mat

double infection; shaped skin by sites form schiz, trophs in periph

schizont: 8-24 meroz female divide to prod blood exc w/

Anopheles meroz, go enter heavy inf.

mosquito RBCs in deep

vasc not periph

bld

Plasmodium protozoa Mat troph: RBC nl or sm, Gametocytes Sporoz. Man is intermed, Sporos go to Immat troph

malariae dark, elongate chrom, large, oval or Injected into defin is mosquite liver, enter cell, matures in

dense cytoplasm, band circ; dark skin by form schiz, periph blood,

forms, pigment dark & pigment female divide to prod makes schiz,

coarse; schizont: 6-12 Anopheles meroz, go enter meroz, inf more

meroz, “Rosette” mosquito RBCs cells

Parasite Type Appearance of adult Appearance Mode/stage of Intermed. Reserv Egg loc. Larvae loc. Adult loc.

of egg infection host host



Toxoplasma Protozoa, Pseudocysts: collection of Double outer Ingest oocyst Man, many other Made in cat Sporos in sm Tachyz

gondii obligate bradyz, inside host cell, ring, inner in cat feces, mammals, are epithelial cells int go thru wall, becomes

intracellular can be anywhere, often in ring filled or intermed, defin is by fusing of ingested by bradyz, org into

brain, “rosettes” pseudocysts cat gametocytes to macs, become pseudocyst,

in infected form oocyst, tachyz, rupture dormant

meat, or trans- out in cat’s mac, go to

placental feces other cells,

repeat









Pneumocystis

carinii

Giardia lamblia Protozoa, Trophoz: pear shaped, No eggs Ingest cysts beaver No eggs Excystation in Sm int, trophoz

aerotolerant motile 15 m, 8 flagella, from feces sm int to 2 reencyst, pass

anaerobic binucleate, 2 median trophoz, attach out with feces

bodies, no mito, perox, to epi, binary

some have dsRNA virus; fision

cyst: oval, 4 nuclei

Entamoeba Protozoa, Trophoz: motile, 25 m, No eggs Ingest cysts none No eggs Excystation in Sm int, trophoz

histolytica aerotolerant 1 nucleus, lysosomes, from feces sm int to 4 reencyst, or can

anaerobic crypton (remnant mito); trophoz, divide go to liver or

cyst: 12 m, up to 4 to 8, peristals to brain after int.

nuclei, some have colon, attach to wall

chromatoidal bar of epis, lyse them, penetration,

ribosomes divide by cysts pass out

binary fision with feces

Cryptosporidiu protozoa cyst: thick walled, 4 No eggs Ingest oocysts Sheep, No eggs Excyst in sm sporoz to type I

m parvum sporoz; meront: contains cows,bi int, to 4 sporoz, meront to 4

sporoz, make gamonts rds, attach to epis, meroz released,

rodents microvilli fuse attack new epi

,primat & elong, to Type II

es surround meronts

sporoz

Parasite Sex Length Detection Who at Pathology Endemic Treatment Comm.. Other

of risk areas prevention

cycle

Enterobius M&f, in colon 4-6 Sticky tape for kids Mild inflam, itching Pyrantel none

vermicularis wks eggs pamoate or meb

or alb, repeat

dose 2x



Trichuris M&f, in colon 3 mos Eggs in stool, kids Prolapsed rectum, Humid, Meb or alb Sanitation, Eggs survive in

trichiura Charcot-Leyden colitis, low IQ, warm but soil up to 3 years,

crystals seen in ?anemia reinfection Charcot-Leyden

stool common crystals seen in

stool

Ascaris M&f, in sm int 30-70 Eggs in stool Kids Pneumonitis, tropics Alb b/c extra- Sanitation, Eggs survive in

lumbriocoides days hepat/bil obstruct., GI stage soil up to 3 years

Cognitive, growth

impaired



Toxocara canis Not in stool, Glaucoma, eosin,

kids Steroids & Avoid dog

ELISA hep/splenmeg, thiobendazole poop

pneum

Necator M&f in sm int, 2 mos Eggs in stool, Kids,el Anemia, dermatitis Tropics, Alb + iron supp San, reinfect. Blood loss when

americanus 5-10000 eggs can’t disting. B/w derly China common they change

per day hooks location in gut.

Rhab long buccal

cavity



Ancylostoma M&f in sm int, 2 mos Eggs in stool, Kids, More severe than Tropics Alb + iron supp San, reinfect Blood loss when

duodenale 10-30000 eggs can’t disting. B/w elderly nec. Anemia, common they change

per day hooks dermatitis location in gut,

rhab long buccal

cavity

Strongyloides F only, parthen. 1 mo Larv in stool, Kids, Hyperinfect from Tropics, Thiabendazole, Rhab short buccal

stercoralis In sm int short bucc, notch elderly, autoinf causes App mtns ivermectin cavity; hyperinf

tail, do several imm.co ectopic CNS abcess, common in

tests, string test mprom bact. Sepsis b/c of immunocompromi

ised migrating larvae, sed people

diarrhea, dec growth,

malabsorption

Taenia saginata Each has m&f 3 mos Proglottids in Adult worms no Praziquantel, San, meat

organs but stool or on bed, pathology must get scolex cooked or

usually X mate >15 branches in out frozen

b/w segs, progravid or do

detach, hatch in sticky tape for

intermed host eggs but only

sm int know its taenia

Taenia solium Each has m&f 3 mos Proglottids in Adult worm no Praziquantel + San, meat

organs but stool or on bed, pathology antiemetic, cooked or

usually X mate <12 branches in must get scolex frozen

b/w segs, progravid or do out

detach, hatch in sticky tape for

intermed host eggs but only

sm int know its taenia

Cystircercosis Grow 3 x-ray extremities, Path of space-occ Praziquantel + San,

wks sticky tape if adult lesion, seizures, steroids for vaccines

then worms pres, shadows in eye inflam.

stop ELISA





Echinococcus Alive Hooks in sputum, shephe Anaphyl if rupture, Surgery – very Don’t feed No biopsy b/c of

granulosus for ELISA of hydatid rds spread; space-occ carefully, alb dogs inf metastasis

mos to fluid lesion meat

years

Parasite Sex Length Detection Who at Pathology Endemic Treatment Comm.. Other

of risk areas prevention

cycle

Schistosoma M&f in liver, Few Eggs in stool, Egg depos. in int & Near praziquantel San, but

mansoni eggs in mes days rectal snip, ELISA liver- fibrosis, dams, reinf.

vessels, TNF granuloma, GI fresh

required for hemor, pipe stem water

eggs to survive fibrosis, portal HT,

hep/splmegaly; bact

assoc. with adult,

Katayama fever, cor

pulmonale

Schistosoma M&f in liver, Few Eggs in stool, Egg depos in int & Near praziquantel San, but

japonicum eggs in mes. days rectal snip, ELISA liver – fibrosis, dams, reinf

vessels, , TNF granuloma, GI fresh

required for hemor, pipe stem water

eggs to survive fibrosis, portal HT,

hep/splmegaly; bact

assoc. with adult,

Katayama fever, cor

pulmonale

Schistosoma M&f in liver, Few Eggs in urine, Egg depos in bladder Near praziquantel San, but

haematobium eggs in bladder. days ELISA – fibrosis, dams, reinf

vessels, , TNF granuloma, fresh

required for calcification, water

eggs to survive hematuria, sq cell

carc.; bact assoc.

with adult

Plasmodium Asexual in liver 10 All stages seen in Adults Anemia, fever, DIC, tropics Quinines (if not Kill mosq, Relapsing, 10000

vivax cells and blood days blood smear, and diarrhea resistant) prophylaxis meroz per schiz

schizonts, enlarged stippled kids 1- hep/splenomeg, artemisinum or

sexual RBCs 5, preg hemolysis, renal antibiotics,

gametocytes women failure Primaquine for

only in mosq liver

gut hypnozoites

Plasmodium Asexual in liver 11 All stages in Adults Anemia, fever, DIC, Africa, Quinines (if not Kill mosq, Relapsing, 15000

ovale cells and blood days smear and diarrhea W.Pacif. resistant) prophylaxis meroz per schiz

schizonts, kids 1- hep/splenomeg, artemisinum or

sexual 5, preg hemolysis, renal antibiotics

gametocytes women failure Primaquine for

only in mosq liver

gut hypnozoites

Plasmodium Asexual in liver 8 days Signet ring only in Adults Anemia, fever, DIC, Africa Quinines (if not Kill mosq, Most prevalent &

falciparum cells and blood blood smear, must and diarrhea resistant) prophylaxis worst form, non-

schizonts, find gametocytes kids 1- hep/splenomeg, artemisinum or relapsing, RBCs

sexual for definitive 5, preg hemolysis, cerebral antibiotics have knobs that

gametocytes diagnosis women malaria, renal failure, bind endothelium,

only in mosq coma (TNF incuces 30000 meroz per

gut NO  anaphylaxis) schiz



Plasmodium Asexual in liver 18 Same size RBCs, Adults Anemia, fever, DIC, World- Quinines (if not Kill mosq, Non-relapsing,

malariae cells and blood days all stages in smear and diarrhea wide resistant) prophylaxis 2000 meroz per

schizonts, kids 1- hep/splenomeg, artemisinum or schiz

sexual 5, preg hemolysis, renal antibiotics

gametocytes women failure

only in mosq

gut

Parasite Sex Length Detection Who at Pathology Endemic Treatment Comm.. Other

of risk areas prevention

cycle

Toxoplasma Asexual in PCR, look for Fetus, CNS cysts, World- Pyrimethamine Cook meat, Tachyz. prevents

gondii macs and other antibodies imm.co chorioretinitis in wide & sulfadiazine, avoid cat fusion of

cells, sexual in mprom fetus, hydrocephaly, spiramycin for poop, preg lysosome w/

cats ised most acquired inf. pregnant tests parasitic vesicle in

(pseudocyst asymptomatic, some women mac, IL-12

ruptures in lymphadenopathy upregulated to

sm.int, bradyz fight infection

invade epis,

become meroz,

then gamets,

which fuse to

oocyst, out w/

poop,

sporulates to

make sporoz

Pneumocystis

carinii

Giardia lamblia Binary fision in Trophoz or cyst in Day Diarrhea, steatorrhea, metronidazole sanitation environmental

sm int stool 3 times, or care malabsorption, resistance of cyst

ELISA for kids flattened, fused villi

antigen, string test of sm. int





Entamoeba Binary fision in Antigen in stool or Ulcer, diarrhea, Metronidazole sanitation Need galactose

histolytica sm int and PCR, looks same dysentery, colitis, and iodoquinol moiety on epi cells

colon as enamoeba abd pain, ameboma, to attach, Charcot-

dispar in stool so liver abcess, lung, Leyden crystals

need PCR, occasionally brain seen in stool,

Charcot-Leyden environmental

crystals seen in resistance of cyst,

stool needs ILs to

survive

Cryptosporidiu Type II meronts Up to 1 PCR or acid fast- Kids, Diarrhea (lots), No drugs sanitation Looks like

m parvum make macro & mo stained oocytes in imm.su cramps cyclospora

microgamonts, stool pp. cayetanensis

they fuse to which is treatable

make thick

walled oocyst,

sporulates in

colon to make 4

sporoz, or

oocyst passes in

feces; also can

make thin

walled oocyst

that excyst and

autoinf.

Drug Mechanisms:



Quinines: inhibit stacking enzyme that deposits haemozoin



Praziquantel: blocks Ca2+ channels



Mebendazole/Albendazole: blocks microtubule polymerization



Metronidazole: interferes with anaerobic metabolism







Info frequently tested on past exams:



Parasitic stage of entry in humans:

1. Egg – E. vermicularis, T. trichiura, A. lumbricoides, T. canis, cysticercosis (via T. solium), E. granulosus

2. Cyst – T. gondii, G. lamblia, E. histolytica, C. parvum

3. Cercaria – schistosomes, T. saginata, T. solium

4. Larvae – N. americanus, A. duodenale, S. stercoralis, E. vermicularis (crawls back in anus)





Mode of transmission:

1. Fecal-oral: E. granulosus, T. canis, T. trichiura, cystercircosis, A. lumbricoides, C. parvum, G. lamblia, E. histolytica, T.

saginata, T. solium, A. duodenale (more commonly penetrates skin)

2. Skin penetration: schistosomes, N. americanus, A. duodenale, S. stercoralis, malaria (via mosquito)

3. Raw meat: T. solium, T. saginata, T. gondii



Drugs:

1. Praziquantel: T. saginata, T. solium, schistosomes, cysticercosis

2. Mebendazole: E. vermicularis, T. trichiura

3. Albendazole: A. lumbricoides, E. granulosus, N. americanus, A. duodenale

4. Thiobendazole: T. canis, S. stercoralis (with ivermectin)

5. Quinines: all malarias

6. Primaquine: P. ovale, P. vivax

7. Spiramycin: T. gondii (in pregnant women)

8. Metronidazole: E. histolytica, G. lamblia

9. Pyrimethamine & sulfadiazine: T. gondii

10. Untreatable with drugs: C. parvum



Method of detection:

1. Antibody (ELISA): cysticercosis (T. solium), E. granulosus, T. canis, G. lamblia, T. gondii, schistosomes

2. Stool: S. stercoralis, N. americanus, A. duodenale, T. trichiura, A. lumbricoides, S. mansoni, S. japonicum

3. Rectal snip: S. mansoni, S. japonicum

4. Sticky tape: E. vermicularis, T. saginata, T. solium

5. PCR: T. gondii, E. histolytica, C. parvum

6. String test: S. stercoralis, G. lamblia



Symptoms:

1. Anemia: malaria, N. americanus, A. duodenale

2. Diarrhea: G. lamblia, malarias, E. histolytica, C. parvum, S. stercoralis

3. Hydrocephalus: T. gondii

4. Hydatid cyst: E. granulosus

5. Malabsorption: S. stercoralis, G. lamblia

6. Hepatosplenomegaly: T. canis, S. mansoni, S. japonicum



Immuno stuff:

1. Much worse in immunocompromised: C. parvum, S. stercoralis, T. gondii, A. lumbricoides

2. Needs TNF for egg production: schistosomes

3. Charcot-Leyden crystals seen from eosinophilia: E. histolytica, T. trichiura

4. Needs IL for survival: E. histolytica



Mechanisms:

1. Needs galactose moiety on ECs: E. histolytica

2. Prevents lysosomal fusion: T. gondii

3. Hides from immune system: A. schwarzenegger, schistosomes

4. Latent liver stage: P. vivax, P. ovale

5. Environmental resistance: A. lumbricoides, T. trichiura, G. lamblia, E. histolytica

6. Enclosed in columnar cell membrane: C. parvum


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