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Parasitology - protozoology (protozoa), helmintology(worms), enthomology(insects ). Laboratory diagnosis: - life cycle of parasits, material v laboratory dg Protozoa – intestinal, genital, urinary, blood, tissue
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Parasitology - protozoology (protozoa), helmintology(worms), enthomology(insects) • Laboratory diagnosis: - life cycle of parasits, material v laboratory dg • Protozoa – intestinal, genital, urinary, blood, tissue • Worms - Helmints: Nematodes, Cestodes,Trematodes • Ectoparasits: louse, ticks, flies – important as vectors
Diagnosis • Problematic, not ususals outside endematic areas • Nonspecific clinical manigestation • eosinophilia in helmintoses – not constant sign • Importance of history – personal, travellers, social, economic, food, therapy • Conditions for successful dg: • - think on parasitosis, • - také a good sample – right sample, with good method at right time, send it in appropriate conditions to the lab that is able to identify the parasit, good interpretation: • Knowledge of life cycle is principal
Laboratory diagnosis • Usually based on morphology (mikroscopic) • Demonstration of the parasit in different stages of life cycle in clinical material • Macroscopic examination of the sample (stool or tissue) • Microscopic examination – native smear, staining, concentration method • Serology – detection of antibodies, detection of antigénu • Genetic probes - detection, identification • Cultivation • Animal model
Life cycle of parasits -terminology • Complex life cycle – key to diagnosis • Host – hosts • Definitive host – parasit finishes the growing cycle and is becoming adult in it • Not typical host - parasit cannot develop in in • Transient host – larves are developing in it and not sexual multiplication is performed • Helmints : egg - larva - (cyste) – adult worm Protozoa :trofozoit - motile, cyste – non motile - sexual multiplication - zygota - asexual- schizonts, sporogons
Stool for parasitological examination • Macroscopy – blood, mucous, adult worms • Microscopy - native smear - FS, iode – motility, eggs of helmints, cysts of protozoa, ery, leu • Concentration methods – separation of cysts of protozoa and eggs of helmints from other material in the stool • Staining - identification – smear of native stool + hematoxylin eosin, trichrome
Other material acc.to clinical manifestation • Perianal - Enterobius vermicularis • Sigmoidoscopy - Entamoeba histolytica • Duodenal aspiration - Giardia lamblia • Biopsia of abscesse of liver - Entameba histolytica • Sputum - Ascaris lumbricoides, Strongyloides, • Urine - Schistosoma • Urogenital sample - Trichomonas • Blood - (malaria, trypanosomiaois, leishmaniosis, filariosis) smear, thick drop - staining Giemsa, HeO, • Serum
Protozoa • Amoeba - Entamoeba histolytica, Entamoeba coli, Naegleria fowleri, Acanthamoeba, Endolimax nana • Flagelata - Giardia lamblia, Trichomonas vaginalis,Leishmania, Trypanosoma • Ciliata - Balantidium coli • Coccidia a Sporosoa - Cryptosporidium, Blastocystis, Microsporidia, Plasmodia, Babesia,, Toxoplasma
Nematodes -worms • Enterobius vermicularis, Ascaris lumbricoides, Toxocara canis,cati, Trichuris trichiura, Ancylostoma duodenale, Strongyloides stercoralis, Trichinella spiralis, Wuchereria bancrofti, Dracunculus medinensis - aesculapova palica • Nonsegmented body, adult worms living in the GIT-e, - diagnosisa: identification of eggs in the stool (morphology of eggs) • Filariae – tin worms parasiting in eye, skin, tissue, transmitted by insects. Larval form- microfilariae penetrate to blood and are transmitted by suckling insect
Cestodes - • Head - scolex, segmented body • Hermafrodit, male and female organs are present in every segment - dif.dg. They have not GIT, absorbtion of food. Complex life cycle with transient host (sometimes - human – larval stage of cysticerkósis, echinococcosis) • Taenia solium, Taenia saginata, Diphylobotrium latum, Echinococcus granulosus, Hymenolepsis nana
Trematodes - • Usually hermafrodits (ex Schistosoma) • Need transient host • Fasciolopsis, Clonorchis, Paragonimus, Schistosoma
Enterobius vermicularis • Definitive host - human • transient - none • dg. – perianal sample – microscopy of eggs • fecal oral transmission - autoinfection
Ascaris lumbricoides • Definitive host: human • Larva migrans: intestin, colon - muc.membrane - blood- lung - cough - mouth - colon • dg. Egg in stool • Infection via contaminated food • Symptoms acc.to localisation of the larva
Toxocara canis, cati • Definitive host dog, cat • Transient host: rat • Human incidental: human (larves) • dg. serology • transmission: hand food
Taenia saginata • Definitive: human • transient: cattle • dg. Segments in stool • Transmission cysticercus in beef
Taenia solium • Definitive: pig • transient: rat • incidental: human in small intestin • dg. serology • Contaminated food
Echinococcus granulosus • definitive: dog • transient:sheep • incidental: human • dg serology • transmission: cyste in meat • infection: mechanic pressure from expanded cyst, prolonged growing, rupture of the cyst and dissemination
Entamoeba histolytica • definitive: human • dg.trofosoits in stool, serology • dysenteria – diarhea with blood
Naegleria fowleri, Acantamoeba • Free Living in water • Human (via nose) • dg.microscopy in CSF- identification of invasive strains) • disease: purulent peracute meningitis
Toxoplazma gondii • Definitive: cat • transient: rat • incidental: human • dg. serology KFR, IgA, IgG, IgM • transmission: food borne, hand, annimal • disease: - intrauterine primoinfection - generalised lymfadenopathy, encystation in organs – abortion, eye……..
Trichomonas vaginalis • Definitive: human • transient: none • dg. Cultivation - microscopy trophosoit - from vagina, urine • Sexual transmission • Therapy of both (all) partners
Giardia lamblia • definitive: human – small intestin,dog, cat • transient: non • dg.microscopy – cysts and trophosoits in stool, transient in duodenal secretion • Transmission contaminated food • malabsorption
Trypanosoma gambiensis (spavá choroba) • Definitive host: insect - fly tse tse • transient: human, monkey • dg.microscopy – thick drop • Transmission bite • Disease – sleeping disease, myalgia, artralgia, lymfadenopathy, hyperactivity in acute fase, lethargy, meningoencefalitis, coma
Plasmodium-malariae, falciparum • Definitive host:Anopheles • Transient host: human, monkey • dg.microscopy thick drop • Transmission insect bite • disease: malaria acc.to the rate of schizogonia- clinically as fever attacks - tercianna, quartana,