PARA/MYCO/VIRO

A. lumbricoides

Giant intestinal/ Eel worm
Ovoviparous; Embryonated egg on soil/ Heart-Lung Migration
Loeffler Syndrome
Vit A & Protein def.
Ectopic ascariasis (Wanderlust)
Adult: 1 dorsal; 2 ventrolateral teeth

Trichiuris trichiua

Whipworm
Oviparous; Embryonated egg on soil
Rectal prolapse
Sigmoidoscopy
Ova: Barrel;football;hyaline plug "Japanese Lantern ova"
Adult: capillary esophagus

E. vermicularis

Pinworm; Seatworm
Ovoviparous; Embryonated egg
Pruritis ani
Scotch tape method or NIH swab
Ova: D-shaped; tadpole shape embryo
Adult: Mouth - 3 winged like cuticulaar expansion /cervical alae
Esophagus - w/ double bulb

Hookworm

Oviparous; Skin penetration
Ground itch/Coolie itch/Dew itch
Microcytic Hypochromic Anemia
Harada Mori
↓RBC, MCV, MCHC
Ova: Blastomere:2-8; Morula balls
Rhabditiform larva: long buccal cavity; small genital primordium
Filariform larva: short esophagus
Adult: prominent posterior copulatory bursa

A. duodenale

short buccal cavity, lumen larger
faint striations
small refractile body
long & blunt tail
"C" shaped
4 ventral teeth
two separate spicules w/ dorsal ray single
Trigiditate

N. americanus

large buccal cavity, lumen shorter
prominent striations
w/ gap between esophagus
prominent esophageal spears
short & pointed tail
"S" shaped
semilunar cutting plate
two spicules fused, dorsal ray split
Bidigitate

A. braziliense

Hookworm of cats
1 pair of buccal teeth

A. caninum

Hookworm of dogs
3 pairs of buccal teeth

S. stercoralis

Threadworm
Ovoviparous, Skin penetration
Vietnam Diarrhea/Cochin China Diarrhea
Larva currens
Brochopneumonia
Beale String Test
Zinc Sulfate Flotation Method
Harada Mori; Baermann Technique
Ova: "Chinese Lantern Ova"
Rhabditiform: short buccal cavity; prominent genital pimorodium
Filariform: long esophagus & notched tail
Adult: short buccal cavity; long & slender esophagus

T. spiralis

Pork roundworm
Viviparous, Ingestion of inadequately cooked pork
Bachman Intradermal Test
Bentonite Flocculation Test
↑LDH, Aldolase, CK
Adult: small mouth; long slender digestive tract
Male - pear shaped clasping papillae

D. medinensis

Guinea worm/Serpent/Dragon worm
Viviparous, Ingestion of larvae w/in IH

C. philippinensis

Oviparous/Ovoviparous, Ingestion of larvae w/in IH
Reservoir: Piscivorous birds
IH: Hypselotris bipartita/Brackish water fishes
Mystery Disease or Borborygmus (Gurgling stomach)
Ova: Peanut-shaped, flattened bipolar plugs

Angiostrongylus cantonensis

Rat Lung worm
DH: Rat
IH: molluscs, slugs & snails
Eosinophilic meningoencephalitis/ Cerebral angiostrongyliasis
Egg: resemble hookworms
Adult: barber pole appearance

Angiostongylus costaricensis

intestinal angiostrongyliasis

Gnathostoma spinigerum

prominent cephalic bulb & body spines
eating undercooked fish, eels, frogs, reptiles w/ larva
DH: Dog. Cat
Paratenic: Snake, Birds, Human
1st IH: Copepods
2nd IH: Fish & Frogs
Migratory swellings in skin or indurated nodules

Aniskiasis

eating infective fish or squid containing larva
inflamed mass in esophagus, stomach, intestine

Filarial Worms

Viviparous, skin inoculation of vector w/ L3 larv
DH: Man
IH: Vector
Giemsa stained
Knott technique
Opthalmologic examination using slit lamp
Ultrasonography

W. bancrofti

Bancroft filarial
Lower lymphatics
Nocturnal
Vector: Culex, Aedes, Anopheles
Sheathed
Nuclei do not extend to the tip of the tail
Elephantiasis "Malabar leg"
Hyrocoele

B. malayi

Malayan filarial
Upper lymphatics
Nocturnal subperiodic
Vector: Aedes, Anopheles, Mansonia
Sheathed
2 nuclei at the tip of the tail

Loa loa

Eye worm
Diurnal
Vector: Chrysops, Deer Fly, Mango Fly
Sheathed
Nuclei form continous row in the tip of the tail
Fugitive Swelling or Calabar swelling

Onchocerca volvolus

Convoluted filarial/Blinding filarial
Non periodic
Vactor: Simulium, Black Fly
Unsheathed
Nuclei do not extend to the tip of the tail
River blindess; Onchocercomata; Sowdah/Onchodermatitis; Nodding Syndrome

Mansonella streptocerca

Acanthocheilonema, Dipetalonema, Tetrappetalonema streptocerca
Non periodic
Vector: Culicoides
Unsheathed
skin disease

Mansonella ozzardi

Ozzard filarial, New world filaria
Non periodic
Vector: Culicoides, Simulium
Unsheathed
Nuclei do not extend to the tip of the tail

Mansonella perstans

Persistent filarial
Non Periodic
Vector: Culicoides
Unsheathed
Nuceli extend to the tip of the tail

Dirofilaria immitis

Dog Heart Worm
DH: Dog
IH: Aedes, Culex, Anopheles & Mansonia
Partial nocturnal
Unsheathed
Pulmonary infarct
Coin lesion on x-ray

Blood Flukes

Dioecious; Not leaf like
IS: Cercaria
MOT: Skin penetration
Adult female lays non-opeculated embryonated egg
Male w/ gynecophoric canal/schist
DH: Man
IH: Snail
Circumoval precipitation test
Fairley's skin test

Schistosoma japonicum
(Superior Mesenteric Vein)

Oriental Blood fluke
Oriental Schistosomiasis/Katamayas Disease
Clay pipe stem fibrosis
Ova: roundish, small lateral spine
Adult Male: Finely tuberculated, 4-5 testes in groups
Adult Female: Posterior ovary, Long uterus
IH: Bulinus; Physopsis

Schistosoma mansoni
(Inferior mesenteric vein)

Manson's blood fluke
Intestinal Bilharziasis/Schistosomal dysentery
Ova: Oblong; large lateral spine
Adult Male: Grossly tuberculated, 8-9 testes in zigzag
Adult Female: Anterior ovary, short uterus
IH: Biomphalaria, Planorbis, Tropicorbis

Schistosoma haematobium
(Vesical vein)

Vesical blood fluke
Urinary Bilharziasis/ Schistosoma hematuria
Sandy patches in vesicle
Carcinoma of the urinary bladder
Ova: somewhat oblong, large terminal spine
Adult Male:Smooth, 6-8 testes in a single file
Adult Female: Median ovary, long & well developed uterus
IH: Oncomelania quadrasi

Leaf Flukes

Hermaphroditic, leak-like
IS: Metacercaria
MOT: Ingestion
DH: Man
IH: Snail
2nd IH: Fish, Aquatic vegetables, Fresh montain crabs
2 suckers/Distomata: Oral & Ventral (Acetabulum)

Clonorcis sinensis

Chinese/Oriental Liver fluke
Far East Asia
Ova: distinct shoulders, small knob, Broadly ovoid "Old Fashion Electric Bulb"
Adult: Granular vitellaria, branched testes

Opistorchis felineus

Cat/Siberial Liver fluke
Siberia, Russia
Ova: prominent opercular 'shoulders', abopercular knob, Elongately ovoid
Adult: Lancet shaped; Transverse vitellaria & lobed testes

Opistorchis viverrini

Southeast asian liver fluke
RH: Civet cat
May lead to Cholangiocarcinoma

Fasciola hepatica

Sheep Liver fluke
Worldwide
Adult: w/ cephalic cone & branched intestinal, ovarian & testes seca
"Liver rot" in sheep
Halzuon

Fasciolopsis buski

Giant intestinal fluke
Far East Asia
Largest trematode to infect man
Adult: w/o cephalic cone & non-branched intestinal, ovarian & testes ceca

Heterophyes heterophyes

Von-Siebold Fluke / Dwarf fluke
Ova: thick shell
Adult: pyriform grayish, fine spines; genital sucker/Gonotyl
smallest trematode to infect man
autoinfection; most deadly trematode

Metagonimus yokogawai

Yokogawa's Fluke
Ova: thin shell
Adult: pyriform, scaly spines

Echinostoma ilocanum

Garrison's blood fluke
Egg resembles Fasciola hepatica
Crown of spine disks or Circum oral disk

Paragonimus wstermani

Oriental lung fluke
Ova: prominent operculum w/ shoulders; terminal shell thickening
Eggs are similar w/ Diphylobptrium latum
Adult: coffee bean-shaped, outer skin w/ spikes; Paralobate testes

Fasciola gigantica

most common in ruminant of Asia & Africa
Tropical fasciolopsis

Gastodiscoides hominis

found upon contact to water vegetation "Night soil"

Eurythrema pancreaticum

1st IH: snail
2nd IH: grasshoppers (locust)

Cestodes

Flat & segmented ribbon-like bodies
Hermaphroditic
All are Heteroxenous except H. nana
Biopsy - E. granulosus
Perianal swab - Taenia eggs

Pseudophyllidea

Diphyllobotrium latum
Spirometra spp

Cyclophyllidea

Taenia solium, saginata
Hymenlepis nana, diminuta
Dipyldium caninum
Echinococcus granulosus

Diphylobothrium latum

Broad Fish Tapeworm/ Russian Broad Tapeworm
Longest cestode to infect man
Vit. B12 def
Scolex: Almond shape/Spatulate; 2 false cuplike suckers/grooves (Bothria)
Proglottis: Wider than long; Rosette
Ova: coracidium; operculum, terminal knob
Ova is similar w/ Paragonimus wstermani
DH: Man
1st IH: Cyclops copepod
2nd IH: Fresh Water Fish
IS to Man: Plerocercoid
IS to 2nd IH: Procercoid
IS to 1st IH: Coracidium

Spirometra (mansoni, theleri, erinacei)

Southeast Asia
DH: Cats, Dogs
1st IH: Cyclops
2nd IH: Snakes, Frogs, Fishes
Sparganosis - consumption of procercoid

Taenia solium

Pork Tapeworm/Armed Tapeworm
Worldwide
DH: Man
IH: Pig
IS: Cysticercus cellulose; eggs
Scolex: small globular; Rostellum w/ hooks (Double crown)
Neck: Short
Proglottid:

Taenia saginata

Beef Tapeworm/Unarmed Tapewworm
Cosmopolitan
DH: Man
IH: Cow
IS: Cysticercus bovis
Scolex: large globular; w/o rostellum nor hooks
Neck: long
Proglottid: 1,000-2,000
Uterus: Lateral uterine branches; 15-30; rectangular
(+) Vaginal sphincter

Taenia saginata asiatica

smaller than T. saginata
w/ sunken rostellum & 2 row of hooks
Consumption of pig's liver

Taenia multiceps

Taenia serialis/ Multiceps multiceps
DH: Dog, Wolf, Fox
IH: Sheep, Cattles, Horses
Coenurus usually found in CNS; also called as bladder worms
"Staggers" in sheep

Hymenolepis diminuta

Rat Tapeworm
Scolex: rudimentary apical rostellum w/o hooks
Proglottid: Saclike uterus filled w/ eggs
Ova: 3 pairs hooklets, hexacanth embryo, colorless embryophore, polar thickening "Fried Egg Appearance"
IS: Cysticercoid larva

Hymenolepis nana

Dwarf Tapeworm
smallest cestode to infect human; most common cestode in human
Scolex: small rostellum w/ one row of Y-shaped hooks
Proglottid: Sac-like uterus filled w/ eggs
Ova: filament emerge from polar thickenings
IS: Egg(Homoxenous); Cysticercoid (Heteroxenous)

Dipyldium caninum

Dog or Cat Tapeworm/ Pumpkin seed tapeworm
Scolex: club shaped armed rostellum w/ up to seven circlets
Proglottid: Pumpkin seed resemble rice grains; "Egg packet"
Ova: six-hooked oncosphere
IS: Cysticercoid larva

Echinococcus granulosus

Dog Tapeworm / Hydatid Tapeworm
DH: Dogs
IH: Sheep, Man
Scolex: 4 suckers & approximately 36 hooks
Uterus: twisted or coiled
Ova: Indistinguishable to Taenia eggs
Hyadtid cyst fluid - may lead to anaphylactic shock
Casoni skin test
Ultrasonography
IS: Echinococcus eggs

Entamoeba histolytica

Trophozoite: Ground glass appearance, Bull's eye karyosome, Finger like pseudopodia, Rapid unidirectional progressive motility, w/ ingested RBC
Cyst: Cigar/rod shape
Amoebiasis; Hepatic Ameobiasis
Flask-shaped ulcer, Amoebic liver abcess (anchovy-sauce asprate), Amoebic colitis
Moan Hemagglutination Test

Entamoeba dispar

morphologically similar to E. histolytica; can differentiate by PCR
w/ RNA & DNA contents

Entamoeba motcschovskii

Osmotolerant - 0-41C
similar to E. histolytica & E.coli but biochemically & genetically different

Entamoeba polecki

pigs & monkeys
can be distinguished from E. histolytica cyst because it has only ONE NUCLEI
w/ angular/pointed chromatoidal bodies

Entamoeba hartmanni

"small-race E. histolytica"; most similar to E. histolytica
w/o RBC

Etamoeba coli

Trophozoite: Trashy cytoplasm, Eccentric karyosome, Blunt & rounded pseudopodia, Sluggish non-directional, w/ bacteria & debris
Cyst: Broomstick

Endolimax nana

Trophozoite: Blot like karyosome, Sluggish progressive motility
Cyst: 4 nuclei "Cross-eyed cyst"

Iodamoeba butschlii

Trophozoite: Central karyosome w/ Achromatic granules; Blunt & clear psudopodia
Cyst: prominent Glycogen mass, "Iodine cyst"; "Basket nucleus" arrangement of chromatin

Entamoeba gingivalis

Trophozoite: central & distinct karyosome; w/ ingested WBC, bacteria & epithelial cell; Blunt pseodopodia
NO Cyst

Naegleria fowleri

Pear shape flagellate w/ 2 whiplike structure
jerky or spinning movement
MOT: Intranasal instillation
Primar Meningoencephalitis (PAM)
stagnant water - thermophilic
IS & DS: Ameboid Trophozoite

Acanthamoeba

Trophozoite: Acanthopodia, Large eccentric karyosome
Cyst: doubel cell wall w/ ragged edges
Both stages are infective
Primary Amoebic Keratits
Granulomatous Encephalitis
Malt Pharyngitis
contaminated contact lens

Balantidium coli

Largest intestinal protozoa
Occupational hazard
Trophozoite: Cytosome, Cytopyge
Cyst: kidney or bean shaped macronucleus, spherical micronucleus contractile vacuoles
Directional tumbling motility/Thrown ball
Balantisial dysentery

Giardia lamblia/Giardia intestinalis

most common protozoan pathogen worldwide
Trophozoite: sucking disk, 2 axonemes, 2 parabasal bodies, 4 pairs flagella; Pear-shaped/Teardrop, Falling leaf-like motility "Old's man face w/ eyeglasses"
Cyst: Cytoplasm retracted in cell wall; football shaped
Traveler's Diarrhea
Gay Bowel Syndrome
Malabsorption Syndrome/Steatorrhea
Duodenal Crypts
String Test/Enterotest

Trichomonas tenax

buccal scrapings
Trophozoite: 2/3 undulating membrane, axostyle curved around nucleus, small cytostome
Nervous jerky movement

Trichomonas hominis

Trophozoite: full body undulating membrane, axostyle extends beyond posterior part, clonical cytostome cleft
Nervous jerky movement

Trichomonas vaginalis

vaginal discharge, urine
Trophozoite: Undulating membrane half of the body, axostylr coiled around nucleus, absence of cytostome but w/ granules
Rapid jerky movement
Pingpong Disease, Strawberry cervix

Chilomastix mesnili

Trophozoite: Asymmetrically pear shaped, w/ spiral groove & cytostome "Shepherd's crook"
Cyst: "lemon cyst/nipple cyst"
Cork screw/ spiral jerky motility

Enteromonas hominis

Trophozoite: body flattened on one side; 4 flagella
Cyst: Quadrinucleated in Binucleate condition

Retortomonas intestinalis

Trophozoite: Cytostome extending halfway w/ well defined fibril
Cyst: Bird's beak nucleus

Dientamoeba fragilis

Trophozoite: Broad hyaline-like Pseudopodia, Tetrakaryosome; Rosette shaped nucleus
Progressive & Directional Motility
NO CYST

Leishmania

IH: Phlebotomus (Sandflies)
Developmental Stages: Amastigote, Promastigote
IS: Promastigote
DS: Amastigote
NNN, Montenegro Intradermal test, Napier's test & Chopra

Trypanosoma brucei

IH: Glossnia (Tse-Tse Fly)
Developmental stages: Epimastigote, Trypomastigote, Metacyclic Trypomastigote
IS: Metacylic Trypomastigote
DS: Trypomastigote

Trypanosoma cruzi

IH: Reduviid bug/Triatomine/Kissing Bug/Assassin bug
Developmental stages: Epimastigote, Trypomastigote, Metacyclic Trypomastigote, Amastigote
IS: Metacyclic Tryposmatigote
DS: Trypomastigote & Amastigote

Trypanosoma gambiense

MOT: Salivary skin inocculation
West African Sleepins Sickness
Winterbottom sign
Kerandel sign

Trypanosoma rhodesiense

MOT: Salivary skin inocculation
East African Sleeping Sickness

Trypanosoma cruzi

MOT: Fecal transmission after skin inocculation
South American Trypanosomiasis
CHAGA'S Disease
Chagoma & Romana Sign

Leishmania donovani

Spx: Aspiration
Visceral Leishmaniasis
Dumdum Fever/Black Disease/Kalazar Fever/Tropical Splenomegaly

Leishmania tropica

Spx: Skin biopsy
Cutaneous leishmaniasis
Aleppo/Delhi ulcer/Oriental sore/Baghdad ulcer

Leishmania braziliensis

Spx: tissue biopsy
Mucocutaneous leishmaniasis
American leishmaniasis/Chiclero ulcer/Espundia

Apicomplexa

IH: Man (IS: Sporozoite)
DH: Mosquito (IS: Gametocyte)

P. falciparum
Malignant tertian malaria

RBC infected: All satges
Schizont: 8-36
Gametocyte: sausage/crescent shaped
Inclusion: Maurer's
Paroxysmic cycle: 36-48 hrs
Blackwater Fever
Sickle cell trait - resistant to P. falciparum

P. vivax
Benign tertian malaria

RBC infected: young & immature
Trophozoid: Ameboid appearance
Schizont: 12-24
Inclusion: Shuffner's
Paroxysmic cycle: 48 hrs
Duffy (-) resistant to P. vivax

P. malariae
Quartan malaria

RBC infected: Old RBCs
Trophozoite: Band trophozoite
Schizont: 6-12; in rosettes/fruit pie
Inclusion: Ziemann's
Paroxysmal cycle: 72 hrs

P. ovale
Benign tertian malaria

RBC infected: young & immature
Trophozoite: resembles P. malariae but larger
Schizont: 8
Inclusion: James, Shuffner
Paroxysmal cycle: 48

P. knowlesi

5th malaria
Similar to P. malariae; differentiated by PCR
Early stage resembles: P. falciparum
Inclusion: Sinton & Mulligan's
Paroxysmic Cycle: 24 hrs

Babesia spp

DH: Animals (deers)
MOT: tick bite (Ixodes spp)
Maltese-cross formation on RBCs
Mistaken as P. falciparum ring
Nantucket Fever

Toxoplasma gondii

DH: Cats
IH: Man
MOT: Ingestion of Oocyst
Retinochorditis, Stillbirth, Mental retardation
Sabin-Feldman dye test, IFA, TORCH test

Cryptosporidium hominis

MOT: Ingestion of Oocyst
Diarrhea in AIDS px
Sheather sugar flotation, Modified acid fast

Cyclospora cayetensis

MOT: Ingestion of Oocyst
Autofluoroscence
Cyanobacteria-like body
Modified acid fast

Candida albicans

most common yeast isolate
#1 opportunistic pathogen in AIDS Px
Candidiasis/Moniliasis
Germ tube test (+) - no constriction
Cornmeal agar
Chlamydospore & Blastoconidia

Cryptococcus neoformans

MOT: Inhalation of spores; pigeon droppings
Torulosis/European Blastomycoses/Buschke's Disease; Meningitis
"Star burst pattern in CSF"
India Ink (yeast w/ halo)
Niger seed agar - brown-black colonies
Blastoconidia
Inositol, Urease, Nitrate assimilation, Phenol oxidase (+)

Aspergillus

2nd most isolated after Candida
long, dichotomous non-septate hyphae/condiophore
Farmer's Lung Disease; fungus ball appearance
Aflatoxin (Hepatoxin)

Mucorales fungi
Rhizopus spp
Absidia
Mucor spp

MOT: Inhalation of conidia
tissue form: Nonseptate hyphae (coenocytic)

Penicillum spp

"Penicillus" or brush-like conidiophore

Fusarium

Sickle/canoe shaped, multiseptate macroconidia
Cottony/wooly frequently becoming pink or purple colony