PARASITOLOGY

AN AREA OF SCIENCE WHICH DEALS WITH THE STUDY OF ORGANISMS LIVING PERMANENTLY OR
TEMPORARILY ON OR WITHIN ANOTHER ORGANISM.

MEDICAL PARASITOLOGY
CONCERNED PRIMARILY WITH ANIMAL PARASITES OF HUMANS AS WELL AS THEIR MEDICAL IMPORTANCE.
BIOLOGICAL RELATIONSHIP
1. SYMBIOSIS – LIVING TOGETHER OF UNLIKE ORGANISMS.
2. PARASITISM – AN ASSOCIATION WHEREIN ONE ORGANISM DEPENDS ON ANOTHER ORGANISM
FOR SURVIVAL.
3. COMMENSALISM – AN ASSOCIATION WHEREIN ONE ORGANISM IS BENEFITED THE OTHER
ORGANISM IS NEITHER BENEFITED NOR HARMED.
4. MUTUALISM – AN ASSOCIATION BENEFICIAL TO BOTH ORGANISMS.

COMPONENTS OF PARASITISM
A. HOST – THE ORGANISM THAT HARBORS THE PARASITE.
TYPES OF HOSTS:
1. DEFINITIVE: TYPE OF HOST THAT HARBORS THE ADULT OR SEXUAL STAGE OF A CERTAIN PARASITE.
2. INTERMEDIATE: TYPE OF HOST THAT HARBORS THE LARVAL OR ASEXUAL STAGE OF THE PARASITE.
3. PARATENIC: HOST THAT HARBORS THE STAGE INFECTIVE TO MAN.
4. RESERVOIR: HOST THAT HARBORS THE SAME SPECIE.

PARASITE- THE ORGANISM THAT DEPENDS ON THE HOST FOR SURVIVAL.

Types of parasites
1. ACCORDING TO HABITAT:
1.1 ENDOPARASITE – THOSE THAT LIVES WITHIN THE BODY OF THE HOST
1.2 ECTOPARASITE – THOSE THAT LIVES ON BODY SURFACES e.g. SKIN
1.3 ERATIC – THOSE THAT LIVES IN AN ORGAN DIFFERENT FROM THE ONE IT USUALLY PARASITIZE.
2. ACCORDING TO THE EFFECT OF PARASITE TO THE HOST
2.1 PATHOGENIC – THOSE THAT CAN CAUSE INJURY TO THE HOST.
2.2 NON-PATHOGENIC/COMMENSAL – THOSE THAT CANNOT SET-UP A DISEASE PROCESS IN MAN.
3. OTHER TYPES
3.1 FACULTATIVE – THOSE THAT CAN SURVIVE EVEN WITHOUT A HOST.
3.2 OBLIGATORY – THOSE THAT CANNOT LIVE WITHOUT A HOST.
3.3 PERMANENT – THOSE THAT LIVES IN A HOST FROM EARLY LIFE MATURITY.
3.4 INCIDENTAL – THOSE THAT OCCURS IN AN UNUSUAL HOST.
3.5 INTERMITTENT – THOSE THAT SIMPLY VISITS THE HOST DURING FEEDING TIME.
3.6 PERIODIC – PARASITE WHOSE LARVA AND ADULT STAGES ARE PASSED IN TWO DIFFERENT HOSTS.
3.7 TRANSITORY – WHOSE LARVAL STAGE IS PASSED IN A HOST WHILE ADULT IS FREE-LIVING.
3.8 COPROZOIC/ SPURIOUS – THOSE THAT HAS PASSED THE ALIMENTARY TRACT W/O INF.THE HOST.
3.9 ZOONOTIC – NON-HUMAN PARASITES THAT MAY CAUSE HUMAN INFECTIONS.
3.10 PSEUDOPARASITE – ARTEFACT THAT MAYBE MISTAKEN FOR PARASITE.
3.11 ENTEROZOIC – INHABITING G.I.T/DIGESTIVE TRACT.
3.12 HEMATOZOIC – INFECTING THE RBC
3.13 CYTOZOIC – INFECTING CELLS; LIVE IN CELLS
3.14 COELOZOIC – INHABITING THE BODY CAVITIES.

FACTORS INVOLVED IN THE TRANSMISSION OF PARASITES:

1. SOURCE OF INFECTION
2. SUSCEPTIBLE HOST
3. MODE OF TRANSMISSION
PARASITIC DAMAGE TO HOST:
1. TRAUMA- DAMAGE TO TISSUE, INTESTINE, LIVER, EYE.
2. LYTIC ACTION- ACTIVITY OF ENZYMES ELABORATED BY ORGANISM.
3. TISSUE RESPONSE- LOCALIZED INFLAMMATION, EOSINOPHILIA.
4. BLOOD LOSS- HEAVY INFECTION WITH HOOKWORM MAY CAUSE ANEMIA.
5. SECONDARY INFECTIONS- WEAKENED HOST SUSCEPTIBLE TO BACTERIAL INFECTION.
IMPORTANT TERMS:
1. VECTOR – RESPONSIBLE FOR TRANSMITTING THE PARASITE FROM ONE HOST TO ANOTHER.
TYPES OF VECTORS:
1.1 BIOLOGIC – TRANSMITS THE PARASITE ONLY AFTER THE LATTER HAS COMPLETED ITS DEVELOPMENT WITHIN
THE HOST
 1.2 MECHANICAL – RESPONSIBLE ONLY FOR TRANSPORTING PARASITE.

2. CARRIER – HARBORS A PARTICULAR PATHOGEN WITHOUT MANIFESTING ANY SIGNS AND SYMPTOMS
3. INFECTION- REFERS TO INVASION MADE BY ENDOPARASITES.
4. INFESTATION – REFERS TO INVASION MADE BY ECTOPARASITE.
5. AUTOINFECTION- RESULTS WHEN AN INFECTED INDIVIDUAL BECOME HIS OWN DIRECT SOURCE OF INFECTION.
6. SUPERINFECTION- OCCURS WHEN AN ALREADY INFECTED INDIVIDUAL IS RE-INFECTED WITH THE SAME SPECIES
LEADING TO MASSIVE INFECTION WITH THE PARASITE.
7. SPORADIC- DISEASE OCCURING OCCATIONALLY IN 1 OR FEW MEMBERS OF THE COMMUNITY.
8. ENDEMIC – CONSTANT OCCURRENCE OF A DISEASE.
9 EPIDEMIC- REGIONAL OUTBREAK OF A DISEASE AFFECTING MANY IBNDIVIDUALS.
10. PANDEMIC- WORLDWIDE EPIDEMIC.

DRUG TREATMENT OR THERAPEUTIC MEASURES

PROTOZOA INFECTIONS: METRONIDAZOLE

CHEMICAL PROPHYLAXIS FOR MALARIA: PRIMAQUINE, QUININE, CHLOROQUINE
NEMATODE INFECTIONS: ALBENDAZOLE, MEBENDAZOLE
TREMATODE AND CESTODE INFECTIONS: PRAZIQUANTEL, NICLOSAMIDE
FILARIASIS: DIETHYL CARBAMAZINE + IVERMECTIN

A. PROTOZOA
§ UNICELLULAR PARASITE
§ CONTAINS NUCLEUS AND CYTOPLASM
§ APPEARS LIKE CELLS IN MICROSCOPE
A. AMOEBA Life cycle
E. histolytica
Cyst and trophozoite are passed out in feces. Infectious cyst ingested, passes through the stomach unchanged.
Cyst wall dissolves thru the action intestinal juices of the small intestine. Liberates 4 nucleated metacyst which
further divides into 8 trophozoites in a process known as “excystation”. Vegetative forms are liberated passes thru
the large intestine. Trophozoite are passed out in feces but some may invade the mucosal tissue forming flask
shaped lesions and ulcerations. In many cases, trophozoite may remain confined in the large intestine, multiplies
one or more times then encyst.

Difference between amebic (amebiasis) and Bacillary dysentery (shigellosis)

Amebic Dysentery Bacillary Dysentery
ONSET Gradual onset Acute onset

Consistency of stool Bloody and diarrheic Bloody

Odor of stool Fishy Odorless
Microscopic 1. With numerous bacteria 5. With few bacteria
2. Red cells often in 6. With scattered red cells
rouleaux 7. With numerous pus cells
3. With scanty pus cells and macrophage
4. Charcot leyden crystal 8. No charcot leyden
present crystals

MORPHOLOGY OF CYST
SPECIES Size in Micra and Shape Number of Chromatoidal Body
Nuclei
E. histolytica 5-20 u/spherical 1-4 Cigar shaped/ barr shaped
E. coli 10-33 u/spherical or oval 1-8 Splinter like/broom stick appearance
E. nana 5-14 u/oval 4 Small/spherical
I. butschlii 5-18u/irregular uninucleated Usually absent, but with large glycogen mass that
stains deeply with iodine
MORPHOLOGY OF TROPHOZOITE
SPECIES SIZE IN PSEUDOPODIA MOTILITY NUCLEUS/ CYTOPLASMIC
MICRA KARYOSOME INCLUSION

E. histolytica 10-60u Long, finger like Progressive and Minute central karyosome “bull’s RBC’s and scanty
directional eye karyosome” food vacuoles

E. coli 10-50u Sluggish and Large eccenteric karyosome Trashy looking in

non- directional cytoplasm

E. nana 6-15u Bluntly rounded and Sluggishly Large irregular karyosome Bacteria, Debri and
mainly granular progressive food vacuoles

I. butschlii 6-20u Blunt and clear Central or eccentric and

sorrounded with large granules

E. gingivalis 10-20u/ With numerous blunt Moderately Central and distinct With numerous food
5-25u pseudopodia active and vacuoles and wbc’s
progressive

D. fragilis 5-12u Multiple/ Progressive and Fragmented/ tetrakaryosome Bacteria, debri and
hyaline leaflike directional food vacuoles

Other amoeba with the same stage as entamoeba histolytica

1. Entamoeba dispar
-morphologically similar to E.histolytica but their DNA and Ribosomal RNA are different
2. Entamoeba hartmanni
-most similar to E.histolytica but smaller and does not ingest RBC, more sluggish in its movement, cyst is 5-10u
with 4nucleus and chromatoidal bodies are short with tapered ends or thin and bar-like
3. Entamoeba polecki
-(zoonotic) parasite of pigs and monkey, rarely it may infect man, can be distinguished from E.histolytica cyst
because it has only one nuclei
Free-living amoeba
1. Acanthamoeba -Acanthamoeba castellani
2. Naegleria -Naegleria fowleri
B. CILIATE
§ Class Ciliatea (Ciliates)
§ Species: Balantidium coli
§ Characteristics:
o A common parasite of pigs and a tissue invader
o Parasitize the Large intestine and regarded as the largest intestinal protozoa
o It can develop cyst and trophozoite stage
o Cystic stage is the infective stage
o Can cause Balantidial dysentery which maybe acquired thru ingestion of food or water contaminated
with faecal material containing B.coli cyst.
o Direct fecal smear, concentration techniques and rectal biopsy are the usual means of detection in
laboratory
Morphology of cyst and trophozoite
CYST
1. Cyst measures 45x64u
2. Spherical or oval with thick wall
3. Cytoplasm with kidney or bean shaped macronucleus, contractile vacuoles and cilia
TROPHOZOITE
1. Measures 50x70u
2. It is sorrounded with hair-like cilia, exhibits a directional “TUMBLING MOTILITY”
3. With macronucleus and spherical micronucleus
4. Equipped with a cytosome and a cytopyge
5. Provided with 2 contractive vacuoles.

Balantidium suis – for pigs only

C. FLAGELLATES
§ Class Zoomastigophora (flagellates)
2groups:
1. Atrial and Luminal flagellates
Atrial Flagellates
-Trichomonas tenax
-Trichomonas vaginalis
Luminal Flagellates
-Giardia lamblia
 -Chilomastix mesnili
-Trichomonas hominis
-Enteromonas hominis
-Retortamonas intestinalis

2. Blood and Tissue Flagellates (Genus Leishmania and Trypanosoma)

Atrial and luminal flagellates

Morphology of cyst
Species Effect to the Habitat Developmental Infective Modes of transmission Specimen for
host Stage stage Diagnosis
G. Pathogenic Upper ileum, Can develop cyst Cyst and Ingestion of cyst from Stool
lamblia duodenum and and trophozoite trophozoite fecally contaminated food
jejenum and water
C. Non- Large intestine Trophozoite and Cyst and Fecal oral route/ Stool
masnili pathogenic/ cyst trophozoite Ingestion
commensal
T. Commensal Colon Trophozoite Trophozoite Ingestion of trophozoite Stool
hominis from fecally contaminated
food and water
T. tenax Commensal Buccal cavity Trophozoite Trophozoite Oral contact Oral
scrappings
T. pathogenic Genito urinary trophozoite Trophozoite Sexual contact Urine/
vaginalis Tract vaginal
urethral
discharge

MORPHOLOGY OF TROPHOZOITE

SPECIES SIZE AND SHAPE NUMBER OF NUMBER OF MOTILITY DISTINGUISHING CHARACTER

NUCLEI FLAGELLA
G. 14x7 um. With two Four pairs Kite like/ leaf With prominent sucking disk and distinct
lamblia Symmetrically pear shaped/ ovoidal nucleus like median line known as axostyle. Appears
tear drop shaped, pointed like old man with eyeglasses.
posteriorly
C. 15x7 um. uninucleated Four Cork screw/ With spiral groove and cytostome
mesnili Asymmetrically pear shaped spiral jerky Sheperd’s Crook appearance

Giardiasis/Lambliasis - caused by Giardia lamblia

- Incubation period is 1-4 weeks
- Usually there is dysentery but stool do not contain mucus and blood.

LABORATORY DIAGNOSIS:
1. examination of direct fecal smear
2. concentration techniques
3. string test/ Enterotest- CAPSULE tied with Yarn, Pulled out after 4 Hours
4. examination of duodenal contents for the presence of trophozoite
5. x-ray
6. Serologic Test (ELISA)

Retortamonis intestinalis
§ Colon
§ Can develop Cyst and Trophozoite
§ Cyst is the infective stage
§ Non-pathogenic
§ Said to assume bird’s beak fibrillar appearance (CYST)
Enteromonas hominis
§ Colon
§ Can develop cyst and trophozoite
§ Cyst maybe mistaken “YEAST”
§ Non- pathogenic

General characteristics of trichomonas species:

1. No cystic stage, Exist only as trophozoite. Infective stage is the trophozoite stage.
2. Trophozoite are pyriform in shape.
3. Their axostyle extends beyond their bodies.
4. Nucleus is located at the anterior pole
5. equipped with 4-5 flagella (4 anterior and 1 trailing along the undulating membrane)
6. vegetative form (trophozoite) have a “FAST JERKY TUMBLING MOTILITY”

Points of differences among the three species of genus trichomonas:

SPECIES SIZE/ AXOSTYLE UNDULATING MEMBRANE NUMBER OF CYTOPLASMIC INCLUSION
LENGTH FLAGELLA
T. tenax 5-12u Thick Almost as long as the costa 5 Granules few and discrete

T. 7-13u Semi- rigid As long as the costa (with the 5 With scattered fine granules
hominis longest undulating membrane)
T. 7-23u Split into Less than 2/3 of costa (with the 5 With siderophil granules which
vaginalis several fibrils shortest undulating membrane) can be stained with Giemsa

Trichomoniasis/ urethritis/ vaginitis

§ Caused by Trichomonas vaginalis.
§ Characterized by inflammation of vaginal mucosa. Inflammation results in the production of greenish or
yellow liquid vaginal secretion accompanied by inten itchiness.
§ Acquired through sexual contact but non-venereal transmission is possible. Those w/o sexual activities may
acquire from infectious toilet seats, bed linens and towels.
§ Infection in males maybe latent and symtomless.
Laboratory diagnosis
§ Examination of sedimented urine, urethral secretions, vaginal and cervical secfretions for the presence of
trophozoite. Unstained wet drop maybe fixed and stained with Giemsa, Acridine orange, PAP’s and
Romanowsky.
§ Culture using DIAMOND’S MEDIUM
Blood and tissue flagellates
§ GENUS LEISHMANIA
§ INTRACELLULAR PARASITE, INFECT CELLS, ENDOTHELIAL CELL, PMN’S MACROPHAGE, MONOCYTES.
§ ARTHROPOD TRANSMITTED
§ MOT: SKIN INOCULATION
§ OTHER MODE: TRANSFUSION, TRANSPLACENTAL
§ SMALLER THAN RBC
§ ONLY HAVE 2 STAGES: AMASTIGOTE AND PROMASTIGOTE

STAGES OF DEVELOPMENT
1.LEISHMANIA/ AMASTIGOTE
§ LIVES INTRACELLULARLY (MONOCYTE, PMN AND ENDOTHELIAL CELLS)
§ HAS AN OVAL SHAPE, LENGTH IS 2-3u AND HAS A DIAMETER OF 2u. NO FLAGELLUM, BUT WITH A
NUCLEUS AND A KINETOPLAST
§ MAN GIVEN TO VECTOR

2.LEPTOMONAS/ PROMASTIGOTE
§ STAGE THAT OCCURS IN TRANSMITTING FLY
§ ELONGATED, LENGTH IS 15u AND HAS A DIAMETER OF 1.5-3.5u. WITH FLAGELLUM AT THE ANTERIOR
END BUT NO UNDULATING MEMBRANE.
§ VECTOR GIVEN TO MAN.
LIFE CYCLE OF LEISHMANIAL PARASITES:
INTRODUCTION OF LEPTOMONAS/PROMASTIGOTE STAGE TO MAN BY AN INFECTIOUS SANDFLY.
LEPTOMONAS FORMS INVADES CIRCULATING RETICULO-ENDOTHELIAL CELLS. LEPTOMONAS TRANSFORMS INTO
LEISHMANIAL FORM/ AMASTIGOTE FORM WITHIN THE RETICULO-ENDOTHELIAL CELLS. MULTIPLICATION FOLLOWS,
RETICULO-ENDOTHELIAL CELLS RUPTURES RELEASING LEISHMANIAL FORMS. LEISHMANIAL FORM INVADES
ANOTHER RETICULO-ENDOTHELIAL CELL OR LEISHMANIAL FORM TAKEN BY SANDFLY DURING BLOOD MEALS.
LEISHMANIAL FORM TRANSFORMS INTO LEPTOMONAS FORM IN THE MIDGUT OF SANDFLY. LEPTOMONAS
MIGRATE TO THE SALIVARY GLANDS OF SANDFLY AND INTRODUCED INTO A HUMAN HOST.

POINTS OF DIFFERENCES AMONG THE THREE SPECIES OF GENUS LEISHMANIA:

SPECIES HABITAT MOT VECTOR PATHOGENESIS
“SANDFLIES”
(PHLEBOTOMUS)
L. donovani Visceral organs, liver, Skin P. papataci Visceral Leishmaniasis/ Kala-azar fever/ Dum-dum
spleen, lymph nodes and inoculation fever/ Black disease/ Death fever/ Tropical
bone marrow Splenomegaly
L. tropica Lymphoid tissues of the skin Skin P. papataci Cutaneous Leishmaniasis/ Oriental sore/ Aleppo/
inoculation Baghdad boil/ Delhi ulcer
L. Mucuos Skin P. intermedius Muco- cutaneous Leishmaniasis/ American
braziliense inoculation Leishmaniasis/ Espundia/ Chiclero ulcer

Other modes of transmission:

1. Through Blood transfusion
2. Congenitally, through transplacental transfer from an infected mother to fetus.
3. Contamination of bite wounds
4. By direct contact

Laboratory Diagnosis:
1. DEMONSTRATION OF LEISHMANIA/ AMASTIGOTE FORMS IN:
1.1 TISSUE BIOPSY – FOR L. braziliense
1.2 SKIN BIOPSY – FOR L. tropica 1.3 BONE MARROW, SPLEEN, LYMPH
1.3 NODE ASPIRATE – FOR L. donovani
2. SEROLOGIC TEST
2.2 COMPLIMENT FIXATION TEST
2.3 IMMUNOFLUORESCENT TEST
2.4 COUNTER CURRENT ELECTROPHORESIS

3. CULTURE USING NOVY, Mc NEAL AND NICOLLE MEDIA

4. MONTENEGRO INTRADERMAL TEST – for cutaneous and muco-cutaneous leishmaniasis
5. NON- SPECIFIC TESTS FOR THE DEMONSTRATION OF IgM LIKE NAPIER’S TEST AND CHOPRA.

GENUS TRYPANOSOMA
§ T. gambiense and T. rhodesiense
§ Extracellular of blood, lymph and CNS
§ Arthropod-borne: Tse Tse Flies (Glossina spp.)
§ MOT: skin inoculation/ bites

1. Crithidia/ Epimastigote (develop by vector)

-occurs in the transmitting fly
-changes into metacyclic trypanosome in the salivary gland
-length is 15u with free flagellum and undulating membrane originating anterior to the nucleus.

2. Trypanosomal/ Trypomastigote
-stage that develops in man
-15-20u long. With free flagellum and with an undulating membrane originating posterior to the nucleus.

NOTE: METACYCLIC TRYPANOSOME – INFECTIVE STAGE TO MAN.

LIFE CYCLE OF T. GAMBIENSE AND T. RHODISIENSE

TRYPOMASTIGOTE à INGESTED BY
TSE-TSE FLIES à TRYPOMASTIGOTE MIGRATE TO THE GUT AND MULTIPLY. AFTER 10DAYS,
TRYPOMASTIGOTE MIGRATE TO THE FORGUT, ESOPHAGUS,
AND PHARYNX THEN ENTER SALIVARY
GLANDS à TRYPOMASTIGOTE
DEVELOPS INTO EPIMASTIGOTE THEN TRANSFORMS INTO METACYCLIC TRYPANOSOME INJECTED TO MAN
THROUGH BITES.

CLINICAL MANIFESTATION OF SLEEPING SICKNESS

1. TRYPANOSOME CHANCRE – FIRM TENDER, PAINFUL NODULE AT THE BITE SITE
2. INVASION OF BLOOD – CHARACTERIZED BY REMITTENT FEVER AND HEADACHE
3. INVASION OF LYMPH NODES (WINTERBOTTOM SIGN) – ENLARGEMENT OF THE LYMPH NODES
4. INVASION OF CNS (KERANDEL’S SIGH)- NEUROLOGIC CHANGES CHARACTERIZED BY MENTAL DULLNESS
SEVERE HEADACHE AND EVENTUALLY DEATH.

TRYPANOSOMA CRUZI
§ VECTOR : BUG
§ INTRACELLULAR PARASITE
§ ARTHROPOD VECTOR: KISSING BUG/ ASSASIN BUG/ REDUVIID BUG/ TRIATOMA BUG
§ MOT: SKIN INOCULATION/ BITE
§ ONLY HAEMOFLAGELLATES THAT HAVE 4 STAGES AND INFECTIVE STAGE
-EPIMASTIGOTE
-PROMASTIGOTE
-TRYPOMASTIGOTE
-AMASTIGOTE
-Trypanosoma rangeli - Spp. Which may appear like T. cruzi but it is larger than T. cruzi.

D. SPOROZOA

Genus Plasmodium (MALARIAL PARASITES)

1. Plasmodium falciparum
2. Plasmodium vivax
3. Plasmodium malariae
4. Plasmodium ovale

GENERAL CHARACTERISTICS OF MALARIAL PARASITES:

-INTRAERYTHROCYTIC PARASITE W/IN RBC’S
-ARTHROPOD TRANSMITTED VECTOR: “FEMALE ANOPHELES MOSQUITOES”
-MOT: SKIN INOCULATION/BITES, BLOOD TRANSFUSION, TRANSPLACENTAL

TWO PHASES OF LIFE CYCLE:

1. ASEXUAL/SCHIZOGONY – DEVELOPS IN AN INTERMEDIATE HOST; HAPPENING IN MAN.
2. SEXUAL/SPOROGONY – DEVELOPS IN A DEFINITIVE HOST ; HAPPENING IN VECTOR

HOST REQUIREMENT:
1. MAN – CONSIDERED AS THE INTERMEDIATE HOST (VERTEBRATE HOST)
2. FEMALE ANOPHELES MOSQUITO- CONSIDERED AS THE DEFINITIVE HOST (INVERTEBRATE HOST)
DEVELOPMENTAL STAGES IN MALARIAL PARASITE:
1. CRYPTOZOITE – STAGE THAT INITIALLY DEVELOPS IN HEPATIC CELLS.
2. TROPHOZOITE – VEGETATIVE STAGE CONTAINING ONE NUCLEUS AND DEVELOPS W/IN RBC.
3. SCHIZONT – TROPHOZOITE IN WHICH THE NUCLEUS HAS DIVIDED
4. MEROZOITE – CELLS RESULTING FROM THE FINAL DIVISION OF SCHIZONT OR CRYPTOZITE
5. HYPNOZOITE – DORMANT STAGE THAT PERSIST IN THE LIVER CELLS BUT ONLY IN THE CASE OF P. vivax
AND P. ovale
6. GAMETOCYTE – SEXUALLY DIFFERENTIATED BUT IMMATURE CELLS
7. GAMETE – MATURE SEX CELLS
8. ZYGOTE – CELLS RESULTING FROM THE UNION OF MALE AND FEMALE GAMETE (NON-MOTILE)
9. OOKINETE – A MOTILE ZYGOTE
10. OOCYST – AN ENCYSTED FORM OF OOKINETE
11. SPOROCYST – AN OOCYST IN WHICH SPOROZOITES HAVE DEVELOPED
12. SPOROZOITES – FORM WHICH DEVELOPS WITHIN SPOROCYST AND INFECTS THE SALIVARY GLANDS OF
MOSQUITO
 SPECIES P. falciparum P. Vivax P. malariae P. Ovale

Asexual cycle 36 hours 48 hours 72 hours 48 hours

Sexual cycle 10-12 days 8-12 days 18-21 days 8-12 days

Alteration on Normal, multiple infection Larger than normal. Pale, often Normal or slightly smaller, sometimes, Somewhat larger than normal rbc. Often with fringed or
infected RBC very common bizarre, Multiple infection of RBC sometimes darker in early stages. Multiple irregular edge. Oval in shape and stains more readily
(effect in size and not common infection of RBC rare and deeply than P. vivax
shape of RBC)

Number of 8-24 12-24 6-12 average of 8-10. “rosette” or “daisy” 8 and arranged around a central block of pigment
merozoites formation

Stages seen in the Ring and gametocyte ALL ALL ALL

peripheral Blood

Cytoplasmic inclusion Maurer’s dot Schuffner’s granules Ziemann’s dot Schuffner’s granules or james dot

Trophozoite Aplique or acole Small hyaline ring that appears Assumes a band shape Amoeboid
amoeboid

Gametocyte Crescent/ sausage/ banana Round to oval Round to oval Round to ovale
shaped

Type of malaria Malignant tertian/ Estivo- Benign tertian malaria Quartan malaria Ovale malaria
autumnal malaria/ Black
water Fever

Geographical Asia and Africa Latin america, India and Pakistan Asia and Africa Exclusively found in Africa
distribution

Laboratory Diagnosis
1. examination of thick and thin blood film - provides deifinte diagnosis.
-thick film – used for rapid diagnosis -thin film – used for specie identification