STUDY HANDOUT

(Based on Belizario)

MACROSCOPIC EXAMINATION

Aspect Description

Purpose To assess the physical characteristics of the specimen before

microscopic examination

Parameters Assessed - Color

●​ Consistency
●​ Presence of blood or mucus
●​ Adult worms or worm segments
●​ Presence of larvae or eggs visible to the naked eye |

SPECIMEN EVALUATION

Type of Specimen Evaluation Criteria

Stool - Assess color, consistency, and presence of adult worms, segments, or

larvae

●​ Presence of blood or mucus may indicate gastrointestinal bleeding or inflammation |​

| Urine | - Check for hematuria, cloudiness, and color
●​ Schistosoma eggs may be seen in sediment |​
| Sputum | - Look for presence of larvae or eggs
●​ Blood-streaked sputum may suggest Paragonimus infection |​
| Blood | - Used for detection of microfilariae
●​ Examine thick and thin smears for parasites |

MISTAKEN OBJECTS

Object Description Common Misidentification

Red Blood Cell Biconcave, non-nucleated cell, approximately Protozoan cysts, small helminth eggs
7.2 µm in diameter

White Blood Cell Larger than RBCs, with a nucleus and granular Parasitic structures or trophozoites
cytoplasm

Vegetable Cell Irregular shapes, with cellulose walls and no Helminth eggs or protozoan cysts
defined nucleus

Vegetable Spiral Spiral or coiled plant structures Larvae or helminth structures

Plant Hair Elongated, tapering structure with a thick wall Nematode larvae

Starch Cell Round, refractile, with a central hilum Protozoan cysts or eggs

Pollen Grain Spherical with spiny or smooth surface Protozoan cysts

Yeast Small, round, budding cells Protozoan cysts or trophozoites

 Muscle Fiber Long, striated, and multinucleated Helminth larvae or filarial worms

PERIANAL SWAB

| Purpose | Detection of Enterobius vermicularis eggs |​

| Procedure | - Collect sample using adhesive tape or swab applied to the perianal region

●​ Examine under a microscope for the presence of eggs |​

| Timing | Best done early morning before bathing or defecation |​
| Interpretation | Positive result confirms Enterobius infection |

HARADA-MORI TECHNIQUE

| Purpose | Detection of hookworm and Strongyloides larvae |​

| Procedure | 1. Place fecal sample on filter paper inside a test tube with sterile water​
2. Incubate at room temperature for 5–7 days​
3. Larvae migrate toward the water surface and can be collected for microscopic examination |​
| Results | - Positive: Presence of hookworm or Strongyloides larvae

●​ Negative: No larvae detected |​

| Common Findings | - Necator americanus – Buccal cavity visible
●​ Ancylostoma duodenale – Larger buccal cavity
●​ Strongyloides stercoralis – Short buccal cavity and prominent genital primordium |

PROTOZOANS

Parasite Name Morphology Diagnostic Stage Infective Stage Mode of Clinical

Transmission Manifestation

Entamoeba histolytica Round, with 1–4 Cyst Cyst Fecal-oral Amoebiasis –

– Cyst nuclei (contaminated diarrhea, dysentery,
food/water) liver abscess

Entamoeba histolytica Motile, single nucleus, Trophozoite Cyst Fecal-oral Amoebiasis

– Trophozoite with ingested RBCs

Entamoeba coli – Round, with up to 8 Cyst Cyst Fecal-oral Non-pathogenic

Cyst nuclei

Entamoeba coli – Irregular shape, Trophozoite Cyst Fecal-oral Non-pathogenic

Trophozoite sluggish movement

Giardia lamblia – Cyst Oval, with 4 nuclei Cyst Cyst Fecal-oral Giardiasis – diarrhea,
and axoneme malabsorption

Giardia lamblia – Pear-shaped, 2 Trophozoite Cyst Fecal-oral Giardiasis

Trophozoite nuclei, 4 pairs of
flagella

Blastocystis hominis– Round with central Cyst Cyst Fecal-oral Diarrhea, abdominal
Cyst vacuole and multiple pain
nuclei

Trichomonas vaginalis Pear-shaped, single Trophozoite Trophozoite Sexual contact Vaginitis, urethritis
– Trophozoite nucleus, 4 anterior
flagella
Balantidium coli – Large, ciliated, with Trophozoite Cyst Fecal-oral Balantidiasis –
Trophozoite kidney-shaped diarrhea, dysentery
nucleus

NEMATODES

Parasite Name Diagnostic Stage Infective Stage Mode of Transmission Clinical Manifestation

Ascaris lumbricoides – Fertilized egg Embryonated egg Fecal-oral Intestinal obstruction,

Fertilized Egg malnutrition

Ascaris lumbricoides – Unfertilized egg Not infective Fecal-oral No infection from

Unfertilized Egg unfertilized egg

Hookworm spp. (Necator Egg in stool Filariform larva Skin penetration Iron-deficiency anemia,
americanus, Ancylostoma ground itch
duodenale) – Egg

Trichuris trichiura – Egg Lemon-shaped, bipolar Embryonated egg Fecal-oral Rectal prolapse, chronic
plugs diarrhea

Capillaria philippinensis – Peanut-shaped, with Embryonated egg Fecal-oral Severe diarrhea,

Egg striated shell malnutrition

Enterobius vermicularis – Flattened on one side, with Embryonated egg Fecal-oral (autoinfection) Perianal itching
Egg a thick shell

Trichinella spiralis – Larva Larvae in muscle biopsy Larva in undercooked meat Ingestion of undercooked Trichinosis – muscle pain,
meat fever, periorbital edema