LICEO DE CAGAYAN UNIVERSITY
COLLEGE OF MEDICAL LABORATORY SCIENCE
CLINICAL PARASITOLOGY – LABORATORY
CLASS INSTRUCTOR: TIMOTHY FRANK M. PACULABA, RMT
DIAGNOSING PARASITIC INFECTION
Methods for identifying parasite infections:
➢ Clinical Diagnosis
Physical examination: based on signs and ➢ Serologic test – individual lang iya ma detect.
symptoms of the patient/s exhibited. ➢ Microscopic – much better since microscopic can
detetct all of the parasite in one slide.
➢ Laboratory Diagnosis
Based significantly on laboratory reports or test Ova & Parasites (O&P) Examination
results. (what the doctor orders) the most common procedure performed in the area of
parasitology.
LABORATORY DIAGNOSIS
➢ Important procedure in evaluating a disease by 2 general components associated with routine
providing evidence of a new or unsuspected parasitology:
etiologic agent.
- etiologic agent- infectious material a. Macroscopic examination –color of the stool and
consistency Criteria for specimen rejection:
➢ Able to confirm a clinical impression that the ➢ Urine contamination
condition has a parasitic nature. b. Microscopic examination ➢ Water contamination
- Ma confirm ni doc na tungod sa parasite ang ➢ Stools retrieved from the toilet bowl.
sakit sa tiyan Collection and Transport ➢ Toilet paper in the stool specimen
➢ Specimen container has NO LABEL
➢ Aids the physician with the appropriate ➢ Typical stool collection protocol consists of three
medication and helps in monitoring the effect of a specimens, one specimen collected every other Sample handling:
treatment regimen. day or a total of three collected in 10 days. ➢ Gloves and a protective coat should be worn
➢ In the diagnosis of amebiasis, up to six specimens in at all times.
Successful laboratory identification of parasites 14 days is acceptable. ➢ Universal precautions
requires the knowledge and practice of laboratory ➢ Therapy that includes anti-diarrhea, laxatives, ALWAYS TREAT ALL SAMPLES AS INFECTIOUS
testing in the pre-analytic, analytic, and post-analytic barium, bismuth, or mineral oil should be collected
steps. before therapy or not until 5 to 7 days after the Time frame:
completion of therapy. ➢ Fresh specimen – to demonstrate the motility of
➢ Collection of specimens from patients who have the protozoan trophozoites.
taken antibiotics or antimalarial medications ➢ Liquid specimens should be examined within
should be delayed for 2 weeks following therapy.
30 minutes of passage.
PRE- ANALYTIC ERROR Collection: ➢ Semi-formed specimens may yield a mixture of
Specimen collection- not proper ang pag collect ➢ Specimens should be collected in a clean, protozoan cysts and trophozoites and should
sa specimen labeled as pre- analytic error nasiya. watertight container with a tight-fitting lid. be evaluated within 1 hour of passage.
➢ The acceptable amount of stool required for ➢ Formed stool (eggs ray makita) specimens are
Labeling – if walay label reject automatically.
parasite study is 2 to 5 g, often referred to as the size not likely to contain trophozoites; therefore,
of a walnut. they can be held for 24 hours following of
collection.
1 | AIZYL SUELLO
LICEO DE CAGAYAN UNIVERSITY
COLLEGE OF MEDICAL LABORATORY SCIENCE
CLINICAL PARASITOLOGY – LABORATORY
CLASS INSTRUCTOR: TIMOTHY FRANK M. PACULABA, RMT
Disadvantages:
Fixatives for preservation ➢ The biggest disadvantage of the use of PVA is that
➢ Fixatives are substances that preserve the the Schaudinn solution contains mercuric chloride.
morphology of protozoa and prevent further ➢ The recovery of certain parasites is not as effective as
development of certain helminth eggs and larvae. when formalin is used.
➢ Recommended ratio is three parts fixative to one
part stool (1:3 ratio) 3. Sodium Acetate Formalin (SAF)
➢ It is also important that the specimen be mixed well • Alternative to the use of PVA and Schaudinn
with the preservative to achieve thorough fixation. fixative.
➢ The specimen must be fixed in the preservative for at Advantage:
least 30 minutes before processing begins. ✓ Mercury-free
Fixatives for preservation Disadvantages:
1. Formalin ➢ The adhesive properties of SAF are not good, the
• An all-purpose fixative for the recovery of protozoa addition of albumin to the microscope slide may
and helminths. be necessary to ensure the adhesion of the
• 5% concentration ideally preserves protozoan cysts specimen to the slide.
• 10% concentration preserves helminth eggs and ➢ Protozoa morphology from SAF-preserved
larvae. specimens is not as clear in permanent stains as when
Advantages: mercury-containing preservatives are used.
✓ It is easy to prepare.
✓ It preserves specimens for up to several years. 4. Merthiolate-iodine Formalin (MIF)
Disadvantages: Advantage
➢ It does not preserve parasite morphology ✓ Merthiolate and Iodine act as staining
adequately for permanent smears. components
➢ Trophozoites usually cannot be recovered, ✓ Formalin acts as a preservative
and morphologic details of cysts and eggs Disadvantage
may fade with time. Short-shelf life
2. Polyvinyl Alcohol (PVA)
• Plastic powder that acts as an adhesive for the
stool specimen when preparing slides for staining.
• PVA is most often combined with Schaudinn
solution, which usually contains zinc sulfate, copper
sulfate, or mercuric chloride ( nerve damage)
Advantage:
✓ The greatest advantage of this preservative is that it
can be used for the preparation of a permanent
stained smear.
2 | AIZYL SUELLO
LICEO DE CAGAYAN UNIVERSITY
COLLEGE OF MEDICAL LABORATORY SCIENCE
CLINICAL PARASITOLOGY – LABORATORY
CLASS INSTRUCTOR: TIMOTHY FRANK M. PACULABA, RMT
3 | AIZYL SUELLO
LICEO DE CAGAYAN UNIVERSITY
COLLEGE OF MEDICAL LABORATORY SCIENCE
CLINICAL PARASITOLOGY – LABORATORY
CLASS INSTRUCTOR: TIMOTHY FRANK M. PACULABA, RMT
MOUTH SCRAPINGS AND NASAL DISCHARGE STOOL CONSISTENCY
➢ Associated with poor oral hygiene. Hard – cannot be punctured with an applicator
stick.
➢ Nasal discharge: N. Fowleri (Naegleria Fowleri)
➢ Infection of oral mucosa and gingival: Formed – maintains shape; can be punctured with
Entamoeba gingivalis/ Trichomonas tenax
applicator stick.
➢ Place in a sterile, airtight container or swab and Semi-formed – Bottom side fattens in the
examine by direct wet amount. container.
Soft – can be cut using applicator stick.
Mushy – Can be reshaped with an applicator stick.
Fluffy pieces w/ pudding-shaped consistency
Loose – stool shapes to the container.
Diarrheic – stool will flow slowly out of the
container.
Watery – fluid-like stool pours out of the
container.
GROSS EXAMINATION
-Stool specimens submitted for parasitic study should first
be examined macroscopically to determine the
consistency and color of the sample.
Fresh and unpreserved specimen
-Used to detect gastrointestinal (GI) bleeding, liver, and
biliary duct disorders,
malabsorption, syndromes, and infections.
4 | AIZYL SUELLO
