Intestinal Parasitises
Introduction:
• Intestinal parasitoses represent a significant health problem, especially in developing countries
and temperate climates.
• They are most often few symptomatic.(Who has very few symptoms)
• They can cause very serious infections, especially in immunocompromised patients.
(not covered in this text)
• The diagnostic approaches and treatments available should be known
Protozoa pathogens: Helminths :
Entamoeba histolytica (amibiase) Schistosoma mansoni (bilharziasis)
Giardia intestinalis (giardiase) Ténias : (téniasis) T. saginata, bothriocéphale
Cryptosporidium (cryptosporidiose) Hymenolepis nana
Isospora belli (isosporose) Cyclospora Enterobius vermicularis (oxyurose) Ascaris
cayetanensis (cyclosporose) lumbricoides (ascaridiose) Ankylostomes
(ankylostomiase)
Epidemiology
–Intestinal parasitoses are infections cosmopolitan.
–Amoebiasis, l'ascaridiose, l'ankylostomiase And trichocephalosis are among the ten infestations
the busiest in the world
–We have some epidemiological surveys in Morocco:
→Amoebas representing almost 50% of the parasites encountered and Entamoeba histolytica is the
parasite the most widespread
→Parmi les helminthes: Ascaris lumbricoides -Trichuris trichiura -Enterobius vermicularis -Taenia
saginata and Strongyloides stercoralis
Clinical variable: Factors influencing clinical manifestations
–Host: Age -comorbidities and immune status
–Nutritional status of the population
–Infestation: quantity and type of pathogen
–Type of parasite-host interaction
Positive diagnosis: Role of interrogation
–the geographical origin of the patient
– concept of travel or stay in an endemic area (long-term stay, the longevity of certain species of
schistosomes reaches 20 years)
–the notion of possible swimming
–lifestyle
–the presence of domestic animals
–Immunosuppression situation: HIV-corticotherapy-chemotherapy…
–Similar cases in the surroundings.
Positive diagnosis: Clinical signs
• Transit disorders: diarrhea often caused by protozoa
• THE helminths : digestive disorders nonspecific
• Abdominal pain: colic – pain
• Malabsorption syndrome especially in children
• Other digestive signs: biliary symptoms in ascariasis
, • Extra-digestive signs: pruritus-respiratory signs-jaundice…
• Context: anorexia-fever
Positive diagnosis: Role of parasitological stool examination
• Indications :
-Hyper eosinophilia (> 500/mm3)
-Acute diarrhea persisting for more than three days despite symptomatic treatment
-Persistent (for 2 weeks) or chronic (> 4 weeks) diarrhea
-Abdominal pain
-Various digestive disorders (anorexia, bulimia, nausea, dyspepsia, tenesmus, anal pruritus)
-Anemia: microcytic or even macrocytic
-Anal pruritus: anal scotch test in addition to EPS
• Terms:
-On freshly passed stools , repeat 3 times
-macroscopic examination
-direct microscopic examination
-two enrichment techniques, a standard concentrating all parasitic forms (vegetative form; cyst; egg
and larva) and another specific for egg concentration.
-Other techniques or other parasites depending on the context and the clinic:
Ex :-Yes HIV positive And CD4 est < 200/μl, it is appropriate to request a search for cryptosporidies
and microsporidies.
-In case of eosinophilia, think about strongyloides
▪ If the EPS is negative , think of a helminthiasis in migration phase and repeat the coprological
examinations four to six weeks later.
Positive diagnosis: Role of other tests
–Asked depending on the context:
–Concerns certain parasitoses:
-Serologies
-Search for parasitic antigens in stools
-Test scotch anal si suspicion d’oxuyorose
–Standard biological assessment: CBC-CRP-Hepatic assessment-Kidney assessment…
Positive diagnosis Role of morphological examinations
–Indication: context – clinical presentations
–Gastroscopy:
-diagnosis of a giardiase on biopsies.
-diagnosis and treatment of anisakiasis , parasitosis resulting from the consumption of infested fish.
–Colonoscopy or rectosigmoidoscopy carried out in the context of often lesional diarrhea, rectal
Introduction:
• Intestinal parasitoses represent a significant health problem, especially in developing countries
and temperate climates.
• They are most often few symptomatic.(Who has very few symptoms)
• They can cause very serious infections, especially in immunocompromised patients.
(not covered in this text)
• The diagnostic approaches and treatments available should be known
Protozoa pathogens: Helminths :
Entamoeba histolytica (amibiase) Schistosoma mansoni (bilharziasis)
Giardia intestinalis (giardiase) Ténias : (téniasis) T. saginata, bothriocéphale
Cryptosporidium (cryptosporidiose) Hymenolepis nana
Isospora belli (isosporose) Cyclospora Enterobius vermicularis (oxyurose) Ascaris
cayetanensis (cyclosporose) lumbricoides (ascaridiose) Ankylostomes
(ankylostomiase)
Epidemiology
–Intestinal parasitoses are infections cosmopolitan.
–Amoebiasis, l'ascaridiose, l'ankylostomiase And trichocephalosis are among the ten infestations
the busiest in the world
–We have some epidemiological surveys in Morocco:
→Amoebas representing almost 50% of the parasites encountered and Entamoeba histolytica is the
parasite the most widespread
→Parmi les helminthes: Ascaris lumbricoides -Trichuris trichiura -Enterobius vermicularis -Taenia
saginata and Strongyloides stercoralis
Clinical variable: Factors influencing clinical manifestations
–Host: Age -comorbidities and immune status
–Nutritional status of the population
–Infestation: quantity and type of pathogen
–Type of parasite-host interaction
Positive diagnosis: Role of interrogation
–the geographical origin of the patient
– concept of travel or stay in an endemic area (long-term stay, the longevity of certain species of
schistosomes reaches 20 years)
–the notion of possible swimming
–lifestyle
–the presence of domestic animals
–Immunosuppression situation: HIV-corticotherapy-chemotherapy…
–Similar cases in the surroundings.
Positive diagnosis: Clinical signs
• Transit disorders: diarrhea often caused by protozoa
• THE helminths : digestive disorders nonspecific
• Abdominal pain: colic – pain
• Malabsorption syndrome especially in children
• Other digestive signs: biliary symptoms in ascariasis
, • Extra-digestive signs: pruritus-respiratory signs-jaundice…
• Context: anorexia-fever
Positive diagnosis: Role of parasitological stool examination
• Indications :
-Hyper eosinophilia (> 500/mm3)
-Acute diarrhea persisting for more than three days despite symptomatic treatment
-Persistent (for 2 weeks) or chronic (> 4 weeks) diarrhea
-Abdominal pain
-Various digestive disorders (anorexia, bulimia, nausea, dyspepsia, tenesmus, anal pruritus)
-Anemia: microcytic or even macrocytic
-Anal pruritus: anal scotch test in addition to EPS
• Terms:
-On freshly passed stools , repeat 3 times
-macroscopic examination
-direct microscopic examination
-two enrichment techniques, a standard concentrating all parasitic forms (vegetative form; cyst; egg
and larva) and another specific for egg concentration.
-Other techniques or other parasites depending on the context and the clinic:
Ex :-Yes HIV positive And CD4 est < 200/μl, it is appropriate to request a search for cryptosporidies
and microsporidies.
-In case of eosinophilia, think about strongyloides
▪ If the EPS is negative , think of a helminthiasis in migration phase and repeat the coprological
examinations four to six weeks later.
Positive diagnosis: Role of other tests
–Asked depending on the context:
–Concerns certain parasitoses:
-Serologies
-Search for parasitic antigens in stools
-Test scotch anal si suspicion d’oxuyorose
–Standard biological assessment: CBC-CRP-Hepatic assessment-Kidney assessment…
Positive diagnosis Role of morphological examinations
–Indication: context – clinical presentations
–Gastroscopy:
-diagnosis of a giardiase on biopsies.
-diagnosis and treatment of anisakiasis , parasitosis resulting from the consumption of infested fish.
–Colonoscopy or rectosigmoidoscopy carried out in the context of often lesional diarrhea, rectal
