johdatus kliiniseen parasitologiaan - aki ronkainen-eng

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9/10/2015 INTRODUCTION TO CLINICAL parasitology

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SCOPE OF CONTENTS

0 Applications to examine the clinical laboratory diagnostics

tool

0 What is a parasite?

0 Amoeba and other protozoa

0 The worms

0 Diagnostic methods

0 Clinical parasitology special features

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REQUESTS FOR CLINICAL RESEARCH

LABORATORY Diagnostic Tool

0 Clinical laboratory tests are ordered

The request


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0 Research request comprises the subscriber survey,

the patient's personal data, the desired

laboratory examinations as well as the essential background information

0 The laboratory studies used

laboratory tests

0 Is intended for laboratory tests

to harmonize health care request and

Answer practices

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0 The study consists of Acronym:

0 systeemilyhenteest (= sample material)

0 tutkimusnimilyhenteest (= the analyte)

0 rear appendix (= method)

0 Each laboratory tests are defined in their own

the measuring unit or other response form

0 Laboratoriotutkimusnimikkeist maintained by Local and Regional Authorities


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0 Example:Helicobacter pyloridiagnostics

1) F -HepyAg (= antigen detection)

2) Pt Hepy-R (= breath test)

3) Ts-HepyVi (= culture)

4) -HepyAb S (= antibody assay)

(Note. The H. pyloriis a bacterium!) Helicobacter pylori.

Photo: Wikimedia Commons

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0 A little motivation ..

What is of particular benefit to the cultivation method (Ts-HepyVi)

could be? Think about it in terms of patient care.


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Klebsiella pneumoniaecolonies

CLED plate. Photo: Aki Ronkainen

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Sampling

DiagnosticMedical staff

Functioning and

effective treatment

condition:

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What is a parasite?

The parasitic organism is a parasite, using a second organism

(host) to produce this benefit.

In medicine, parasites usually be included in such

parasites which are not covered by viruses, bacteria or fungi

context.

Parasites can be categorized in many different ways.

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What is a parasite?

Traditional

distribution:

Protozoa

Worms

Sharing

habitat

According to:

Ihoparasiitit

Suolistoparasiitit

Veriparasiitit


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Arthropods

Kudosparasiitit

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What is a parasite?

On the basis of the traditional allocation may be

noted that the parasites are eukaryotes

and that they occur in numerous, very

distant taxonomic categories.

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What is a parasite?


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Eukaryotic phylogenetic tree.

Photo: Brock Biology of Microorganisms, 13th Edition

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What is a parasite?

Parasite characteristics

Each of your typical (complex)

life cycle

The host organism is in addition to any number of intermediate

hosts

A variety of protective hosts

Your immune system

Pathogenicity vs. apatogeenisuus All parasites

do not cause disease!

the virulence of parasites varies

There are endemic, ie the prevalence varies geographic


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Amoeba and other protozoa

Protozoa have traditionally been classified as

mode of travel:

Sarcodina(juurijalkaiset a amoeba):

cast legs, or pseudopodiat

Flagellata(dinoflagellates): flagella

cilia(ciliates): ie the cilia Cilia

Sporozoa(apicomplexa): incapable of movement

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Terminology


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trophozoite: Initial animal nutrition

accommodating, fertile form

Cysts: thick-walled, the host organism

external conditions for sustainable form

Many parasites also other forms of

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Entamoeba histolytica(amoeba)

pathogen, which causes

amebiaasia

Occurs worldwide

Infectious feces-foot pathway

The cause of diarrhea and / or

maksapaiseen

It can not be separated from the

microscopicallyEntamoeba

dispar-amebasta

Entamoeba histolytica.

Photo: CDC / Dr. George Healy

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E. histolytica'slife cycle.


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Giardia lamblia(flagellate protozoan)

pathogen, causing

giardiaasia

Occurs

worldwide


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Infectious feces-foot pathway

The cause of diarrhea

Giardia lamblia.Photo: CDC

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Giardia lamblia'slife cycle.


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Toxoplasma gondii(sporozoan)

The cause of toxoplasmosis

Human the most common latent

protozoal infections

Infectious cat faeces,

soil or meat

Pregnant women at risk

There is excreted in the faeces

Felix the cat Saturday night.

Photo: Aki Ronkainen

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Toxoplasma gondii,the life cycle.


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The worms

A human pathogenic worms

divided into three groups

Nematodes,or nematodes

Trematoda,or trematodes

Cestodathat is, tapeworms

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The worms

Nematodes,or nematodes


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Long, narrow body, circular in cross-section

Advanced bowel, and foot-and anus

Moving actively

Several human pathogenic species

Depending on the species that infect the intestines as well as the

Tissues

Generally unisexual

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The worms

Ascaris lumbricoides,or Roundworm (nematode)

Appears across the planet

The infection is acquired by eating eggs food included

In the intestine, the egg is released from the caterpillar

Larva circulates in the body: the liver heart lungs

intestine

During the cycle a caterpillar develops a full-grown worm

Infection is usually asymptomatic, but can cause eg.

sappitietukoksen


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The worms

Ascaris lumbricoides.Left: a mature egg. Right: adult

worm. Photos: (. Right) Wikimedia Commons (. Left) and CDC

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The worms

Pathogenic nematode eggs:

Trichuris trichiura(whipworm).



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Enterobius vermicularis

(pinworm).


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The worms

Trematoda,or trematodes

Flat juotikasmainen body

Imukuppimainen mouth and forked

the gastrointestinal tract without anus

adhesive into the body by mouth and body

suction cups

Moving actively

Hermaphroditic (exception: Schistosoma)

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The worms


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Schistosoma mansoni(trematodes).

Photo: Wikimedia Commons.

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The worms

That is, tapeworms Cestoda

Jaokkeellinen body

Navigating low

Infectious intestinal wall special

gripping, by an extension of the

the neck portion are continuously created new jaokkeita


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hermaphroditic

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The worms

Taeniasp. (egg). Lugol-stained microscopy

formaliininytteest faeces.

Photo: Aki Ronkainen

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The worms

Diphyllobothrium latum(tapeworm).

Lugol-stained microscopy

formaliininytteest faeces. Infected


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can get badly cooked fish.

Right: larva. Bottom: the egg.

Photos: Aki Ronkainen

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Diagnostic methods

Parasites are phylogenetically very heterogeneous

Group Each parasite own requirements

used in the method

Finland six most common research covers 95%

parasite examinations

The remaining 5% of the range of special investigations


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Diagnostic methods

The most common parasite studies

F -Para-O (alkuelinkystat and worm eggs)

Fl TrHiVi (Trichomonasvaginalis)

-Enve-O (pinworm)

B -Plas-O (malariaplasmodit)

-PncaAg (Pneumocystiscarinii)

F -CrypVr (Cryptosporidiumparvum)

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Diagnostic methods

F -Para-O Requirements

Used to detect early organisms and worm eggs

Feces resuspended (1: 5) of 10% formalin parasites

to fix


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The sample is concentrated by filtration, and such.

etyyliasetaattiksittelyll

A drop of the sample is stained with Lugol's solution on a glass slide, and

mikroskopoidaan 100 - 400x magnification

Identification of parasites takes place on the basis of the morphology

The sample will be answered all findings, whether a pathogen

or apatogeeni

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Diagnostic methods

F -Para-O Challenges

Parasite excretion in the feces is intermittent,

recommended 2 to 3 samples

representativeness of the sample is important, well-mixed sample

imperative

Requires experience!

Entamoeba histolyticacan not be separated from aEntamoeba disparby

morphologically Recommendation F -EhistAg research

Dientamoeba fragilis:not kystamuotoa

coccidia Cryptosporidium, Isospora,and Cyclospora

(apicomplexa) may go unnoticed Recommendation F -CrypVr

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Diagnostic methods

Existing methods

of coloring: the modified Ziehl-Neelsen staining (F -

CrypVr) and May-Grnwald-Giemsa staining (B -

Plas-O)

Antibody Assays (S -AmebAb and S -ToxoAb)

PCR (-ToxoNhO)

antigen detection (F -EhistAg, F -GiCrAg)

Also, methods of cultivation (Fl-TrHiVi)

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Clinical parasitology special features

0 The prevalence of parasites varies greatly: some

found everywhere, others only in certain regions

0 In particular, the problem of developing countries (hygiene)

0 Traveling increased spread of diseases endemic

areas

0 All diseases are not lethal (the parasite ecology)

0 Immunosuppression predispose patients to infections, and can not do


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a life-threatening infection

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0 Parasitic infection is suspected, it is absolutely

matkustusanamneesi important to know the patient's symptoms and,

in order to know how to ask the right research

0 The discovery of a single parasite does not exclude other

(co-infection)

0 Clinical chemistry and hematology tests

parasitological diagnostic support

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Sampling

DiagnosticMedical staff

And yet as a reminder:

johdatus kliiniseen parasitologiaan - aki ronkainen-eng

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