blood and tissue parasites practical

8/11/2019 Blood and Tissue Parasites Practical

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PRACTICAL

ON BLOOD

PARASITES


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The two methods common in use :

1: Light microscopy

2: Rapid diagnostic tests (RDTs).

Common methods for parasitological diagnosis of

malaria


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aboratory diagnosis of malaria

Rapid diagnostic tests detect

malaria antigens


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Rapid diagnostic tests detect malaria antigens


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Laboratory diagnosis of malaria

Light microscopy:1: Preparing blood film


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Light microscopy:1: Preparing blood film



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Light microscopy:1: Preparing blood filmLaboratory diagnosis of malaria


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Light microscopy: Thick and thin films



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Plasmodium falciparum (trophozoitestage in thick smear)

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Plasmodium falciparum (trophozoitestage in thin smear)



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13 Morphology of Malaria

3. Gametocyte

The Malaria Parasite

Three developmental

stages seen in blood

films:

1. Trophozoite

2. Schizont

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Trophozoites

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GametocyteSchizont

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Features of Plasmodium

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Nucleus/chromatin dot

Cytoplasm

Stippling

Vacuole


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Species of malaria is identified by itsmicroscopic appearance:

CCMOVBDPlasmodium falciparum

CCMOVBDPlasmodium vivax

CCMOVBDPlasmodium malariae

Malaria Tutorials, Wellcome Trust Plasmodium ovale


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PLASMODIUM FALCIPARUM (TROPHOZOITE STAGE)

Diagnostic Points:Small, regular, fine to

fleshy cytoplasm

Infected RBCs not

enlargedNumerous, multiple

infection is common

Ring, comma, marginal or

accole forms are seen;often have double

chromatin dots

Maurers dots not clearly

visible

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Multiple infection

Double chromatin

Marginal form


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Plasmodium falciparum(trophozoite stage in thin smear)

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Plasmodium falciparum(trophozoite stage in thick smear)


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Diagnostic Points:

Small, rarely fill the RBC

Rare in peripheral blood

16-32 or more merozoites

in compact cluster

Single dark pigment

Usually associated with

many young ring forms

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Plasmodium falciparum (schizont stage)


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Plasmodium falciparum(trophozoite and schizont stages in thin smear)

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Diagnostic Points:

Banana-shaped or rounded

Macrogametocyte

small, compact, central

chromatin dot

pigments closely adhereto the chromatin

Microgametocyte

broader, shorter and more

sausage-shaped loosely scattered chromatin

golden brown pigmentsscattered at the central half

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Plasmodium falciparum (gametocyte stage)

22 M h l f M l i


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Plasmodium falciparum(gametocyte stage in thin smear)

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23 M h l f M l i


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Diagnostic Points:

Infected red cells usually

enlarged

Irregular or fragmentedcytoplasm (amoeboid)

Mature ring forms tend to

be large and coarse

Schuffners dots (stippling)

are frequently visible

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Plasmodium vivax (trophozoite stage)

24 M h l f M l i


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Plasmodium vivax(trophozoite stages in thin smear)

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Ring form

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Developing trophozoite

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Mature Trophozoite



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Diagnostic Points:

Large, covering almost

or the entire enlarged RBC

Few to moderate1224 merozoites in

irregular cluster

Yellowish-brown loose

pigmentsCCMOVBD

Plasmodium vivax (schizont stage)


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Platelet

This RBC

has two

rings.

Schffners

dots are

present in

this cell.

This RBC is not as

enlarged as the

others. Schffners

dots are not visible.

In this malarial infection RBC is enlarged and oval, schuffner's

dot is present. Trophozoite ring is 1/3 diameter of cell with

heavy chromatin dot



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Diagnostic Points:

Round; large

Usually compact nucleus

the periphery

Chromatin is deep red

or magenta

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Plasmodium vivax (gametocyte stage)


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Diagnostic Points:

Small, few

Ring to rounded, compact,

vacuolated or non-

vacuolated,Band forms seen

Dark, scattered pigments

Ziemmans stipplings not

clearly visible

Infected red cell not

enlarged

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Plasmodium malariae (trophozoite stage)



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Diagnostic Points:

Small, compact, dark

Usually few

6-12 merozoites in

rosette formation, but

more often in irregular

cluster

Concentrated pigments

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Plasmodium malariae (schizont stage)



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Diagnostic Points:Smaller than P. vivax

Few

Ring to rounded, compactSingle, prominent chromatin

Schizonts with 4-12

merozoites

Reported in the PhilippinesMalaria Tutorials, Wellcome Trust

Plasmodium ovale


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Infection of an individual by

more than one species of

Plasmodium

Common in endemic areas

in the Philippines

P. falciparumand P. vivax

Can easily be overlooked

(blood films must be

studied carefully to rule outmixed infections)

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Mixed infections



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P. vivax trophozoite andP. falciparumgametocyte(Mixed infection, thin smear)

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Plasmodium falciparum

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p gy

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Plasmodium malariae



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p gy

Plasmodium vivax



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p gy

Plasmodium falciparum


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A 25 year-old male from India, who came 3 months ago was admitted in

KKUH with a history of severe anaemia and intermittent high grade fever

for the last two months not responding to antibiotics.

WHAT IS THE DIAGNOSIS?

Diagnosis: Plasmodium vivax


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A businessman who makes frequent trips to Thailand , presents with

intermittent fever .


Diagnosis: Plasmodium vivax


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A student in KSU who returned three weeks from vacation in Africa , he

developed intermittent fever last week and lost consciousness a short

time ago.


Diagnosis: Plasmodium falciparum


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A 7 year old child presented with anemia , hepatospenomegaly and

fever .Not responding to antimalarials and antibiotics . Bone marrow

smear is shown

ARE THERE ANY PARASITES? WHAT STAGE ?

Leishmania , amastigote stage

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