Teaching outline of Human Parasitology
人体寄生虫学教学大纲
适应专业：临床医学八年制
一、
基础医学
课程基本信息
课程名称：人体寄生虫学 Human Parasitology
课程号：50135720
课程类别：基础课
学时：32
学分：2
二、教学目的及要求
Human parasitology is one of the basic medical sciences. It is important
for students to study the morphology and life cycle of parasite. It is also
useful for them to study pathogenesis, diagnosis, epidemiology,
prevention and treatment of parasitic disease. To learn human
parasitology is indispensable not only for the study of successive courses,
but also for further potent of one’s professional ability during one’s
practice after graduation.
“master”is the stresses of lecture, which is necessary for students, others
is the comprehensive contents, which is also encouraged for students.
Some chapters and contents in the textbook do not included in this outline
because of a limited lecture hours for this course, these contents are also
encouraged for students to study on one’s own, which, however, will not
be included in the final exam.
三、教学内容
Introduction to Human parasitology
【AIM】
master： Five major parasitic diseases in China; parasite, host; definitive host,
intermediate host, reservoir host, paratenic host or transport host; binomial system;
pathogenic effects of parasites on hosts
comprehensive： classification of parasites; interaction between hosts and parasites；
resistance of hosts to parasites; immunology of parasitic infection, kinds of immune
response, antigens of parasites, immune response, immune evasion, hypersensitivity;
characters of parasitic infection, carrier, chronic infection & suppressive infection,
polyparasitism, larva migrans & ectopic parasitism; epidemiology; prevention and
treatment of parasitic disease
【CONTENT】
Preface
Five major parasitic diseases in China
Malaria, Schistosomiasis, Leishmaniasis, Filariasis, Hookworm disease
Parasitism and its evolvement
1. Commensalism
2. Mutualism
3. Parasitism
Parasite and host
Biology of parasite
The life cycle patterns
Classification of parasites
Classification of hosts: Definitive host, intermediate host, reservoir host,
paratenic host
Classification system of parasites
Three parts of medical parasitology
1. Medical protozoology
2. Medical helminthology
3. Medical arthropodology
Interaction between hosts and parasites
Pathogenic effects of parasites on hosts
Resistance of hosts to parasites
Immunology of parasitic infection
I. Kinds of immune response
1. Innate immunity (non-specific immunity)
2. Acquired immunity (specific immunity)
(1) Sterilizing immunity
(2) Non-sterilizing immunity
II. Antigens of parasites
III. Immune response
IV. Immune evasion
-2-
V. Hypersensitivity
Characters of parasitic infection
1. Carrier, chronic infection & suppressive infection
2. Polyparasitism
3. Larva migrans & ectopic parasitism
Epidemiology, prevention and treatment of parasitic disease
1. Epidemic factors
2. Epidemic characteristics
3. Principles for prevention and treatment
Nematodes
【AIM】
master：Type of life cycle: direct type, indirect type
comprehensive: Morphology: adult appearance, integument, pseudocoelom, internal
organs, egg
【CONTENT】
Ⅰ.Morphology
Adult appearance, integument, pseudocoelom, internal organs, egg
Ⅱ. Life cycle
Type of life cycle: Direct type, indirect type
Ascaris lumbricoides
【AIM】
master：Life cycle: adults habitat in small intestine, infective stage, infective route,
the life span of adult; pathology & symptomatology; diagnosis: detection of eggs,
detection of adult, detection of larvae
comprehensive: Morphology: adult, fertilized egg, infertilized egg, infective egg;
epidemiology; prevention & treatment
【CONTENT】
Ⅰ.Morphology
Adult, fertilized egg, infertilized egg, infective egg
Ⅱ. Life cycle
1. Adults habitat in small intestine.
2. Infective stage: infective egg
3. Infective route: mouth
4. The life span of adult is about 1 year.
Ⅲ. Pathology & Symptomatology
1. Larva stage
2. Adult stage
(1) Nutrition-robbing & absorptive disorder
(2) Allergic reaction
(3) Complications
Ⅳ. Diagnosis
1. Detection of eggs
-3-
(1) Direct smear method
(2) Precipitin method or saturated salt solution flotation method
2. Detection of adult
3. Detection of larvae in sputum
Ⅴ. Epidemiology
Ⅵ. Prevention & treatment
Hookworm
Ancylostoma duodenale
Necator americanus
【AIM】
master：Life cycle: the adults habitat in upper level of small intestine, infective stage,
infective route, host; pathology & symptomatology: ground itch, bronchitis and
pneumonitis, gastrointestinal symptoms, chronic anemia
comprehensive: Morphology: adult, egg; diagnosis: direct smear, saturated salt
solution floatation method; epidemiology: distribution of disease, factors concerning
the epidemiology; prevention & treatment
【CONTENT】
Ⅰ.Morphology
1. Adult
Differences between A. duodenale and N. americanus:
2. Egg
Ⅱ. Life cycle
1. The adults habitat in upper level of small intestine.
2. Infective stage: filariform larva
3. Infective route: mainly through skin
4. Definitive host: only man naturally
5. Paratenic host
Ⅲ. Pathology & Symptomatology
1. Larvae
(1) Ground itch
(2)Bronchitis and pneumonitis
2. Adult
(1) Gastrointestinal symptoms (2)Chronic anemia
Ⅳ. Diagnosis
1. Direct smear
2. Saturated salt solution floatation method
3. Incubation of eggs in feces
Ⅴ. Epidemiology
1. Distribution of disease
2. Factors concerning the epidemiology
Ⅵ. Prevention & treatment
1. Treatment of patients
2. Control of feces
3. Attention to individual protection
-4-
Enterobius vermicularis
【AIM】
master：Life cycle: adults habitat in cecum, colon and lower part of ileum. Infective
stage, infective route; pathology & symptomatology: anal itching, ectopic damage
comprehensive: Morphology: adult, egg; diagnosis: detection of egg, detection of
adult; epidemiology; prevention & treatment
【CONTENT】
Ⅰ.Morphology
1. Adult
2. Egg
Ⅱ. Life cycle
1. Adults habitat in cecum, colon and lower part of ileum.
2. Infective stage: infective egg
3. Infective route: mouth, respiratory tract, anas
4. Life span of female adult
Ⅲ. Pathology & Symptomatology
1. Anal itching
2. Ectopic damage
Ⅳ. Diagnosis
1. Detection of egg: adhesive cellophane swab method
2. Detection of adult
Ⅴ. Epidemiology
Ⅵ. Prevention & treatment
Filarial worm
Wuchereria bancrofti
Brugia malayi
【AIM】
master： Life cycle: location of adult, definitive host, intermediate host, infective
stage, infective route, nocturnal periodicity of mf.; pathology & symptomatology:
acute stage, chronic stage
comprehensive: Morphology: adult, microfilaria, diagnosis: fresh blood film, thick
blood film, detection of adult; immunological diagnosis; epidemiology: distribution,
factors concerning the epidemiology; prevention & treatment
【CONTENT】
Ⅰ.Morphology
1. Adult
2. Microfilaria
Differences between mf. of W. bancrofti and that of B. malayi
Ⅱ. Life cycle
1. Location of adult
2. Host
3. Infective stage: infective larva
4. Infective route: skin
5. Nocturnal periodicity of mf.
Ⅲ. Pathology & Symptomatology
-5-
1. Acute stage
2. Chronic stage
3. Tropical pulmonary eosinophilia (TPE)
Ⅳ. Diagnosis
Based on finding mf. in peripheral blood
1. Fresh blood film
2. Thick blood film
3. Detection of adult
4.Immunological diagnosis
Ⅴ. Epidemiology
1. Distribution
2. Factors concerning the epidemiology
Ⅵ. Prevention & treatment
1. Mass detection and treatment
2. Control of mosquitoes
3. Protection of susceptible population
Trichinella spiralis
【AIM】
master：Life cycle: locations of worm; infective stage, infective route, reservoir host,
two hosts are required to complete the life cycle; pathology & symptomatology:
intestinal invasion, muscle invasion, capsulation; diagnosis: muscle biopsy
comprehensive: Morphology: adult, encysted larvae in striated muscle; epidemiology;
prevention & treatment
【CONTENT】
Ⅰ.Morphology
1. Adult
2. Encysted larvae in striated muscle
Ⅱ. Life cycle
1. Locations of worm
2. Infective stage: encysted larvae
3. Infective route: mouth
4. Reservoir host
Ⅲ. Pathology & Symptomatology
1. Intestinal invasion
2. Muscle invasion
3. Capsulation
Ⅳ. Diagnosis
1. Muscle biopsy
2. Immunological method
Ⅴ. Epidemiology
1. There are many reservoir host.
2. High resistant ability of encysted larvae
3. Eating raw or insufficiently cooked pork containing encysted larvae
Ⅵ. Prevention & treatment
1. Treatment of patients
2. Thoroughly cook the pork, don’t eat raw meat.
-6-
3. Inspection of pork as a rule before selling.
Introduction to Trematodes
【AIM】
master：Life cycle: only in the water can eggs undergo their development. One or two
intermediate hosts are needed in the life cycle of the flukes, and snails are the main
first intermediate hosts. The infective stage of most flukes is metacercaria, infecting
through mouth, some is cercaria, through skin. Most species have reservoir hosts.
comprehensive: Morphology: adult appearance, body wall, incomplete digestive tract,
reproductive system, excretory system
【CONTENT】
I. Morphology
1. Adult appearance
2. Sucker: oral sucker & ventral sucker
3. Body wall
4. No body cavity
5.Digestive system: incomplete digestive tract
6. Reproductive system: Most are hermaphroditic.
7. Excretory system
8. Nervous system
II. Life cycle
1. Only in the water can eggs undergo their development.
2. One or two intermediate hosts are needed in the life cycle of the flukes, and snails
are the main first intermediate hosts.
3. The infective stage of most flukes is metacercaria, infecting through mouth
4. Most species have reservoir hosts.
Clonorchis sinensis
【AIM】
master： Life cycle: the adult worm resides in the bile ducts. The infective stage of C.
sinensis is metacercaria. Infective route, definitive host, the first intermediate host, the
second intermediate host, reservoir host, migration in human body; pathogenesis:
pathology, symptomatology
comprehensive: Morphology: adult, egg, metacercaria; lab diagonosis: detection of
eggs, immunodiagnosis, supersonic detection and CT; epidemiology: distribution,
transmission; prevention & treatment
【CONTENT】
I. Morphology
1. Adult
Appearance
Oral sucker & ventral sucker
Digestive tract
Reproductive system: monoecious
Excretory system
-7-
2. Egg
3. Metacercaria
II. Life cycle
Main points of life cycle
1. The adult worm resides in the bile ducts.
2. The infective stage of C. sinensis is metacercaria.
3. Infective route: eating raw or poorly cooked freshwater fish or shrimp containing
the metacercaria.
4. Hosts
5. Migration in human body
III. Pathogenesis: Clonorchiasis
1. Pathology
2. Symptomatology
IV. Lab diagonosis
1. Detection of eggs:
2. Immunodiagnosis
3. Supersonic detection and CT
Ⅴ. Epidemiology
1. Distribution
2. Transmission:
Ⅵ. Prevention & treatment
1. Praziquantel.
2. Thorough cooking of freshwater fish.
3. Suitable treatment of feces
Paragonimus westermani
【AIM】
master：Life cycle: location of adult, infective stage, infective route, host, migration
in human body; pathogenesis: acute period, chronic period, pathology
comprehensive: Morphology: adult, egg, metacercaria; lab diagonosis: detection of
eggs or worm, immunodiagnosis, X-ray and CT; epidemiology; prevention &
treatment
【CONTENT】
I. Morphology
1. Adult
Apperance
Suckers: The Oral and ventral suckers
Digestive tract
Reproductive system
2. Egg
3. Metacercaria
II. Life cycle
Main points of life cycle
1. Location of adult: chiefly in lung
-8-
2. Infective stage: metacercaria
3. Infective route: eating raw or poorly cooked freshwater crabs or crayfiah
containing the metacercaria.
4.Hosts
5. Migration in human body
III. Pathogenesis
1. Acute period
2. Chronic period
Pathology:
Stage of abscess
Encapsulated stage
Fibrous nodule formation
Symptoms: vary with the different involved organs
IV. Lab diagonosis
1. Detection of eggs or worm
2. Immunodiagnosis
3. X-ray and CT
Ⅴ. Epidemiology
1. Distribution
2. Transmission
Ⅵ. Prevention & treatment
Pagumogonimus skrjabini
【AIM】
master：Life cycle: hosts, human is the unsuitable host of P. skrjabini; pathogenesis:
cutaneous larva migrans; visceral larva migrans
comprehensive: Morphology: adult, differences between adults of P. westermani &
P. skrjabini, egg; lab diagonosis: subcutaneous nodule biopsy, immunodiagnosis;
epidemiology & treatment
【CONTENT】
I. Morphology
1. Adult
Differences between adults of P. westermani & P. skrjabini
2. Egg
II. Life cycle
1. Definitive hosts: Paguna larvata, cat, dog
2. The first intermediate host: snail
3. The second intermediate host: crab
4. Human is the unsuitable host of P. skrjabini.
III. Pathogenesis
Larva migrans: Cutaneous larva migrans, visceral larva migrans
IV. Lab diagonosis
1. Subcutaneous nodule biopsy
2. Immunodiagnosis
-9-
Ⅴ. Epidemiology & treatment
1. Distribution
2. Treatment
Faciolopsis buski
【AIM】
master：Life cycle; clinical aspect, attachment of these large worms to the mucosa
of the bowel causes local inflammation and ulceration, sometime accompanied by
hemorrhage
comprehensive: Morphological feature: adult, egg ; diagnosis: detection of the eggs
in the faces; prevention and treatment
【CONTENT】
I. Morphological feature
1. Adult worm
2. Eggs
II. Life cycle
Adult worms live attached to the bowel wall duodenum, jejunum.
The way of infection
III. Clinical aspect
IV. Diagnosis
detection of the eggs in the faces
Ⅴ. prevention and treatment
Schistosome
Schistosoma japonicum
【AIM】
master：Life cycle: adults inhabit the branches of the superior mesenteric vein
adjacent to the small intestion, the inferior mesenteries may also be invaded. The
infective stage of S. japonicum is cercaria. Infective route, definitive host, the
intermediate host, reservoir host; pathogenesis: a localized dermatitis induced by
cercaria, lesion induced by schistosomula migation, lesion induced by adul, lesion
induced by egg, acute schistosomiasis, chronic schistosomiasis, late schistosomiasis,
ectopic schistosomiasis
comprehensive: Morphology: adult, egg, miracidium, cercaria; immunity: antigen,
immune response , concomitant immunity , immune evasion; lab diagonosis: direct
smear, sedimentation and hatching method, proctoscopy and biopsy method,
immunodiagnosis; epidemiology: distribution, transmission, epidemic factor, three
types of epidemic foci in China; prevention & treatment: treatment of the source of
infection, blockade of the route of infection, protection of the susceptible population
【CONTENT】
Schistosome
The adult worms live in the blood vascular system of mammals.
Species parasitizing humans: Schistosoma japonicum, S. mansoni, S. haematobium
- 10-
S. intercalatum, S. mekongi, S. malayensis
Schistosoma japonicum
I. Morphology
1. Adult: Diecious
Two sexes are dissimilar in appearance.
2. Egg
3. Miracidium
4. Cercaria
II. Life cycle
Main points of life cycle
1. Adults inhabit the branches of the superior mesenteric vein adjacent to the small
intestion, the inferior mesenteries may also be invaded.
2. The female usually migrate to smaller venule and deposite eggs in clusters.
3. The egg must penetrate the venule endothelium and then traverse the
intervening tissue and the mucosal lining before entering the lumen of the gut.
4. Hatching of miracidum
5. Development in intermediate host Oncomelania hupensis
6. Infective stage: cercaria
7. Infective route: through skin
8. Migration of schistosomule in human body
9. Definitive host: human and some mammals
10. Reservoir host: several species of mammals
III. Pathogenesis
1. A localized dermatitis induced by cercaria
2. Lesion induced by schistosomula migation
3. Lesion induced by adult
4. Lesion induced by egg
the most serious harm of schistosomiasis
Mechanism of egg granuloma formation: Type Ⅳ hypersensitivity
The advantage and disadvantage of egg granuloma formation
Hoeppli phenomenon
IV. Symptoms
1. Acute schistosomiasis
2. Chronic schistosomiasis
3. Late schistosomiasis:
4. Ectopic schistosomiasis
V. Immunity
1. Antigen
2. Immune response
3. Acquired immunity
Concomitant immunity
Antibody dependent cell-mediated cytotoxicity (ADCC)
4. Immune evasion
VI. Lab diagnosis
- 11 -
1. Detection of eggs
Direct smear
Sedimentation and hatching method
Proctoscopy and biopsy method
2. Immunodiagnosis
Detection of antibody
Detection of circulatory antigen
VII. Epidemiology
1. Distribution
2. Transmission
3. Epidemic factor
4. Three types of epidemic foci in China
VIII. Prevention & treatment
1. Treatment of the source of infection
2. Blockade of the route of infection
3. Protection of the susceptible population
Introduction to Cestodes
【AIM】
master：Differences between Pseudophyllidea and Cyclophyllidea; life cycle
comprehensive: General characteristics; morphology: adult appearance, body wall,
nervous system, excretory system, reproductive system
【CONTENT】
I. General characteristics
1.Most of adult tapeworms inhabit the small intestine of vertebrates.
2.Appearance: flat, ribbonlike, segmented, bilaterally symmetrical.
3.Anterior attachment organ
4.No procoele
5.No digestive system
6.Hermaphrodite
II. Morphology
1. Adult appearance: Scolex, neck, strobilus
2. Adult internal structure: Body wall, nervous system, excretory system,
reproductive system
III. Differences between Pseudophyllidea and Cyclophyllidea
IV. Life cycle
1. Cyclophyllidea
2. Pseudophyllidea
Taenia solium
【AIM】
master：Life cycle: definitive host, intermediate host, adult habitats in the upper part
of small intestine. Infective ways, life span of adult ; pathogenesis: taeniasis,
cysticercosis
- 12-
comprehensive: Morphology: adult, egg, cysticercus; diagnosis: taeniasis,
cysticercosis; epidemiology: source of infection, transmission modes, susceptible
person; prevention and treatment
【CONTENT】
I. Morphology
Adult, egg, cysticercus
II. Life cycle
1. Adult habitat in the upper part of small intestine.
2. Definitive host: man
3. Intermediate host: hog, boar and man etc.
4. Infective ways:
(1) Cysticercus is swallowed by man.
(2) Egg is swallowed by man.
a. Hetero-infection
b. External auto-infection
c. Internal auto-infection
5. Life span of adult
III. Pathogenesis
1.Taeniasis
2.Cysticercosis: the major lesion of T. solium.
IV. Diagnosis
1. Taeniasis
2. Cysticercosis
(1) Biopsy
(2) Detection by X-ray, CT, etc.
(3) Ophthalmoscopy
(4) Immunodiagnosis
V. Epidemiology
VI. Prevention and treatment
Taenia saginata
【AIM】
master：Main points of life cycle; pathogenesis
comprehensive: Morphological differences from the T. Solium; diagnosis: similar to T.
solium, anal swab is better for detecting eggs; epidemiology: cosmopolitan in beef
eating countries, some minorities are common in taeniasis in our country, factors of
epidemiology; prevention and treatment
【CONTENT】
I. Morphological differences from the T. Solium
II. Main points of life cycle
1. Adul
2. Intermediate host: cattle etc.
3. Man is infected by swallowing cysticercus within raw or insufficiently cooked
beef.
4. Life span of adult
- 13-
III. Pathogenesis
1. Asymptomatic patient in usual
2. Symptomatic patient: vague abdominal discomfort, hunger pains, chronic
indigestion and anal itching.
3. Occasional acute intestinal obstruction.
IV. Diagnosis
V. Epidemiology
VI.Prevention and treatment
Echinococcus granulosus
【AIM】
master：Life cycle: definitive host, intermediate host, infective stage , infective route;
pathogenesis: pressure of neighbour tissue cells, mass, allergic symptoms, toxication
and intestinal disturbance, secondary infection
comprehensive: Morphology: adult, egg, hydatid cyst; diagnosis: history of
contacting with dog, sheep, or their fur, X-ray, CT, supersonic detection, isotopic
screening, pathogenic detection, immunodiagnosis; epidemiology; prevention and
treatment
【CONTENT】
I. Morphology
Adult, egg, hydatid cyst
II. Life cycle
1. Definitive host: dog, wolf etc.
2. Intermediate host: man, sheep, cattle, camel etc.
3. Infective stage: egg
4. Infective route: mouth
III. Pathogenesis
1. Pressure of neighbour tissue cells
Commonly parasitized organs: liver and lung
2. Mass
3. Allergic symptoms: urticaria, allergic shock etc.
4. Toxication and intestinal disturbance
5. Secondary infection
IV. Diagnosis
1. History of contacting with dog, sheep, or their fur.
2. X-ray, CT, supersonic detection, isotopic screening.
3. Pathogenic detection
4. Immunodiagnosis
V. Epidemiology
VI. Prevention and treatment
1. Reducing the source of infection
2. Preventing infection of dog etc.
3. Attention to personal hygiene
- 14-
Spirometra mansoni
【AIM】
master：Life cycle: infective stage, infective route, host; pathogenesis : adult rarely
infects man, ocular sparganosis, subcutaneous sparganosis, oral and facial sparganosis,
brain sparganosis, visceral sparganosis
comprehensive: Morphology: adult, egg, plerocercoid; diagnosis: detecting egg,
biopsy, X-ray, CT etc.; epidemiology; prevention and treatment
【CONTENT】
I. Morphology
Adult, egg, plerocercoid
II. Life cycle
Infective stage, infective route, host
III. Pathogenesis
1. Adult
2. Plerocercoid: sparganosis
(1) Infective modes
Both procercoid and plerocercoid are infective.
(2) Clinical aspect
IV. Diagnosis
1. Adult: detecting egg
2. Sparganosis: biopsy, X-ray, CT etc.
V. Epidemiology
VI. Prevention and treatment
Hymenolepis nana
【AIM】
master：Life cycle: the adults parasitize in man and rodents, infective stage, infective
route; pathogenesis: anorexia, abdominal pain, diarrhea, headache, dizziness,etc.
comprehensive: Morphology: adult, egg; diagnosis: detecting eggs in the stool;
epidemiology ; prevention and treatment
【CONTENT】
I. Morphology
Adult, egg
II. Life cycle
1. The adults parasitize in man and rodents.
2. Infective stage: egg, cysticercoid
3. Infective route: mouth
III. Pathogenesis
1. Usually asymptomatic
2. Symptomatic: anorexia, abdominal pain, diarrhea, headache, dizziness,etc.
IV. Diagnosis
Detecting eggs in the stool
V. Epidemiology
- 15-
VI. Prevention and treatment
Introduction to Protozoa
【AIM】
master：Physiology: movement, nutrition, metabolism, reproduction; characteristics
of pathogenicity, proliferation, opportunistic pathogenesis
comprehensive: Morphology: plasma membrane, cytoplasm; nucleus; classification
【CONTENT】
I. Morphology
1. Plasma membrane
2. Cytoplasm: Matrix, organelles, contents
3. Nucleus: Vesicular nucleus, compact nucleus
II. Physiology
Movement
Trophozoite, cyst
Nutrition
Metabolism
Reproduction
(1) Asexual reproduction
(2) Sexual reproduction
III. Classification
IV. Characteristics of pathogenicity
1.Proliferation
2. Opportunistic pathogenesis
Opportunistic protozoa
Entamoeba histolytica
【AIM】
master ： Life cycle: infective stage, infective route; pathogenesis: intestinal
amoebiasis, extraintestinal amoebiasis
comprehensive: Morphology: trophozoite, cyst; diagnosis: fecal examination, culture,
sigmoidoscopy, immunodiagnosis; epidemiology: source of infection, infective route,
susceptible persons; prevention and treatment
【CONTENT】
I. Morphology
Trophozoite, cyst
II. Life cycle
Infective stage: mature cyst with 4 nuclei.
Infective route: mouth
III. Pathogenesis
Pathogenicity
Clinical aspects
(1) Asymptomatic: cyst-carrier
(2) Amoebiasis
- 16-
Basic pathology: cytolysis of tissue, causing necrosis and proliferation.
a. Intestinal amoebiasis
b. Extraintestinal amoebiasis
IV. Diagnosis
1. Detection of pathogen: Fecal examination, culture, biopsy
2. Immunodiagnosis
V. Epidemiology
VI. Prevention and treatment
Entamoeba coli
【AIM】
master：One of the non-pathogenic intestinal amoebae
comprehensive: Differences between cyst of E. coli and cyst of E. histolytica
【CONTENT】
Differences between cyst of E. coli and cyst of E. histolytica
Leishmania
Leishmania donovani
【AIM】
master：Life cycle: host, development in sandflies, development in man or mammal,
infective mode; pathogenesis: pathologic characteristics, clinical aspects
comprehensive: Morphology: amastigote, promastigote; diagnosis: smear, culture,
biopsy, immunodiagnosis, molecular biological method; epidemiology: source of
infection, infective route, susceptible person; prevention and treatment
【CONTENT】
Leishmania
Visceral leishmaniasis
Cutaneous leishmaniasis
Mucocutaneous leishmaniasis
Leishmania donovani
I. Morphology
Amastigote, promastigote
II. Life cycle
Host: man or mammal; sandflies
1. Development in sandflies
2. Development in man or mammal
III. Pathogenesis
1. Pathologic characteristics:
2. Clinical aspects
(1) Intermittent fever
(2) The liver, spleen and lymphoglandula become enlarged.
(3) Anemia panto-hematopenia
(4) Hemorrhage
(5) Proteinuria and cruenturesis
(6) Reversal of albumin and globulin ratio
- 17-
(7) Dermal leishmanoid
(8) Lymphadenoid leishmaniasis
IV. Diagnosis
1. Detection of pathogen
(1) Smear
a. Bone marrow puncture
b. Lymphoglandula puncture
c. Spleen puncture
(2) Culture
(3) Biopsy
2. Immunodiagnosis
3. Molecular biological method
V. Epidemiology
VI. Prevention and treatment
1.To prevent and destroy sandflies
2.To eradicate source of infection
Trichomonas vaginalis
【AIM】
master：Life cycle: the trophozoite habitats in vagina and urinary duct etc., infective
mode, reproduction, nutrition; pathogenesis: trichomonal vaginitis, trichomonal
urethritis and prostatitis
comprehensive: Morphology: trophozoite; diagnosis: detection of the vaginal
secretion, detection of urine; epidemiology: source of infection are patients and
carriers, infective mode, susceptible person; prevention and treatment
【CONTENT】
I. Morphology
Trophozoite
II. Life cycle
1. The trophozoite habitats in vagina and urinary duct etc.
2. Infective mode
3. Reproduction
4. Nutrition
III. Pathogenesis
1. Trichomonal vaginitis
2. Trichomonal urethritis and prostatitis
IV. Diagnosis
1. Detection of the vaginal secretion: Smear, culture
2. Detection of urine
V. Epidemiology
VI. Prevention and treatment
Giardia lamblia
【AIM】
- 18-
master：Life cycle: the trophozoite habitats in the upper part of the small intestine,
infective stage , infective route; pathogenesis: gastrointestinal aspects, cholecystitis
comprehensive: Morphology: trophozoite, cyst ; diagnosis: fecal examination;
epidemiology: source of infection are carriers and patients, infective route, susceptible
person; prevention and treatment
【CONTENT】
I. Morphology
Trophozoite, cyst
II. Life cycle
1. The trophozoite habitats in the upper part of the small intestine.
2. Infective stage: mature cyst with 4 nuclei
3. Infective route: mouth
III. Pathogenesis
1. Asymptomatic: cyst-carrier
2. Gastrointestinal aspects
3. Cholecystitis
IV. Diagnosis
Fecal examination: cyst or trophozoite
V. Epidemiology
VI. Prevention and treatment
Plasmodium
【AIM】
master：Life cycle: infective stage, infective route, host, development in human,
development in female anopheline mosquito; pathology & symptomatology:
incubation, paroxysm, recrudescence and relapse, anemia, splenomegaly, severe
malaria, malarial nephropathy, congenital malaria, infant malaria and transfusion
malaria
comprehensive: Morphology: P. vivax ,
P. falciparum; physiology and
biochemistry: merozoite (under electron microscope), the process that merozoite
invades red cell, merozoite selects the red blood cell invaded; immunity: congenital
immunity, acquired immunity, premunition, immune evasion ; diagnosis: smear,
immunodiagnosis; epidemiology: source of infection, vector, susceptible person;
prevention and treatment
【CONTENT】
P. vivax; P. falciparum; P. malariae; P. ovale
Life cycle
1.Infective stage: sporozoite
2.Infective route: female anopheline mosquito bites
3.Hosts: man and anopheles
.Morphology
1. P.vivax: Ring form, trophozoite, schizont, gametocyte
2. P.falciparum
(1) Ring form
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(2) Gametocyte
(3) Trophozoite and schizont: rarely seen in peripheral blood, they usually lie in deep
capillary
Ⅲ.Physiology and biochemistry
1. Merozoite
2. The process that merozoite invades red cell
3. Merozoite selects the red blood cell invaded
Ⅳ. Pathology & Symptomatology
Malaria is induced by parasites in red blood cells.
1. incubation
2. Paroxysm:
3. Recrudescence and relapse
4. Anemia
5. Splenomegaly
6. Severe malaria
7. Malarial nephropathy
8. Others
Ⅴ.Immunity
1. Congenital immunity
2. Acquired immunity
(1) Antigen of plasmodium
(2) Humoral immunoresponse
(3) Cellular immunoresponse
(4) Premunition and immune evasion
Ⅵ.Diagnosis
1.Detection of pathogen: smear
(1) The thin film
(2) The thick film
2.Immunodiagnosis
Ⅶ.Epidemiology
Ⅷ.Prevention and treatment
1.Control the source of infection: to cure patient and carrier
2.Cut the spreading pathway: to destroy mosquito
3.Protect the susceptible person: protect person against mosquito
Toxoplasma gondii
【AIM】
master：Life cycle: definitive host, intermediate host, infective stage, infective
pathway, developing process in definitive host , developing process in intermediate
host; pathology & symptomatology: congenital toxoplasmosis, acquired
toxoplasmosis
comprehensive: Morphology: trophozoite, pseudocyst, cyst, schizont, gametocyte,
oocyst; diagnosis: smear, culture, animal inoculation, serological test; epidemiology:
source of infection, infective route, susceptible persons; prevention and treatmen
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【CONTENT】
I. Morphology
Trophozoite, pseudocystl, cyst, schizont, gametocyte, oocyst
Ⅱ.Life cycle
1. Definitive host: cat etc.
2. Intermediate host: man, sheep, cattle, pig etc.
3. Infective stage: oocyst, cyst or pseudocyst.
4. Infective pathway: human infection may be acquired in several ways. The two
major routes of transmission of Toxoplasma gondii to humans are oral and
congenital.
5. Life cycle
(1) Developing process in definitive host
(2) Developing process in intermediate host
III. Pathology & Symptomatology
1. Pathogenicity
2. Clinical aspects
(1) Congenital toxoplasmosis
(2) Acquired toxoplasmosis
Ⅳ.Diagnosis
1. Detection of pathogen: Smear, culture, animal inoculation
2. Serological test
Ⅴ.Epidemiology
Ⅵ.Prevention and treatment
Introduction to medical arthropods
【AIM】
master：Mechanisms of injury: direct effects, indirect effects
comprehensive: Biological characteristics of arthropods; classification of medical
arthropods; vector control: mechanical, chemical, physical, biological
【CONTENT】
A．BIOLOGICAL CHARACTERISTICS OF ARTHROPODS
B．CLASSIFICATION OF MEDICAL ARTHROPODS • Medical arthropods
mainly belong to following five classes:
Insecta, Arachnida, Crustacea, Chilopoda, Diplopoda
*General structure features of insects
*General structure features of acarines
C．MECHANISMS OF INJURY
1.Direct effects
(1)Annoyance (and blood loss)
(2)Envenomation
(3)Allergic reactions
(4)Tissue invasion and parasitism
2. Indirect Effects：Transmission of infectious agents
(1) Mechanical transmission:
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(2) Biological transmission
a) Only multiplication
b) Only development
c) Multiplication and development
d) Transovarial transmission
D．VECTOR CONTROL
Mechanical, hemical, physical, biological control
Mosquitoes
【AIM】
master：Life cycle: complete metamorphosis; mosquitoes and diseases: annoyance
and blood loss, mosquito-borne diseases, malaria, filariasis, viral encephalitis,
dengue fever , yellow fever
comprehensive: Morphology: head, thorax, abdomen; the differences among the
three genera of mosquitoes, ecology; main species; control: elimination or reduction
of breeding grounds, destruction of the larvae, destruction of the adult mosquitoes
【CONTENT】
1. Morphology
Head, thorax, abdomen
2. Life cycle
Complete metamorphosis: egg-larva-pupa-adult
*The differences among the three genera of mosquitoes:
Eggs, larvae, pupae, adults
3. Ecology
Breeding places, food habits, time of activity, mating, hibernation, length of life
4. Main species
(1) Anopheles sinensis, An. Anthropophagus, An. minimus
(2) Culex pipiens pallens, Cx, P. quinquefasciatus, Cx. tritaeniorhynchus
Aedes albopictus, Ae aegypti
5. Mosquitoes and diseases
(1) Annoyance and blood loss
(2) Mosquito-borne diseases:
a. Malaria: Anopheles
b. Filariasis:
Wuchereria bancrofti: Anopheles, Culex
Brugia malayi: Anopheles
c. Viral encephalitis:
d. Dengue fever
e. Yellow fever
6. Control;
(1) Elimination or reduction of breeding grounds
(2) Destruction of the larvae
(3) Destruction of the adult mosquitoes
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Flies
【AIM】
master ： Life cycle: complete metamorphosis; flies and diseases: mechanical
transmission, biological transmission, myiasis
comprehensive: Morphology: head, thorax, abdomen; ecology; main species; control
【CONTENT】
1. Morphology
Head, thorax,abdomen:
2. Life cycle: complete metamorphosis
Eggs, larvae, pupae, adults
3. Ecology
Habits of larvae, feed habits of adults, hibernation
4. Main species:
(1) Musca domestica vicina
(2) Chrysomyia megacephala
(3) Lucilia sericata
(4) Boettcherisca peregrina
(5) Stomoxys calcitrans
5. Flies and diseases:
(1) Mechanical transmission:
(2) Biological transmission
(3) Myiasis
6. Control:
Sand flies
【AIM】
master：Life cycle and ecology: complete metamorphosis; sand flies and diseases:
leishmaniasis, phlebotomus fever, bartonellosis
comprehensive: Morphology: head; thorax; abdomen; main species; chemical control
【CONTENT】
1. Morphology:
Head, thorax, abdomen
2. Life cycle and ecology:
Complete metamorphosis: egg—larva—pupa—adult
3. Main species:
(1) Phlebotomus chinensis chinensis
(2) Ph.c. longiductus
4. Sand flies and diseases:
(1) Leishmaniasis
(2) Phlebotomus fever
(3) Bartonellosis
5. Control: Chemical control
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Fleas
【AIM】
master：life cycle and ecology: complete metamorphosis, feeding habits, activity;
fleas and diseases: annoyance and blood loss, be parasites, serve as disease
transmitters, plague, murine typhus, hymenolepiasis nana, hymenolepiasis diminuta
comprehensive: Morphology: head, thorax, abdomen; main species; control
【CONTENT】
1. Morphology:
Head, thorax, abdomen
2. Life cycle and ecology:
(1) Complete metamorphosis: egg—larva—pupa—adult
(2) Feeding habits: Males and females are all bloodsucks
(3) .Activity
3. Main species:
(1) Pulex irritans
(2) Xenopsylla cheopis
(3) Ctenocephalalides felis
4. Fleas and diseases:
(1) Annoyance and blood loss:
(2) Be parasites:
(3) Serve as disease transmitters
Plague, murine typhus, hymenolepiasis nana, hymenolepiasis diminuta
5. Control
Lice
【AIM】
master：Life cycle and habits: egg—nymph—adult, parasitic position, feed habits,
transmitting ways; lice and diseases: be bloodsuckers, be disease-transmitters,
epidemic typhus, relapsing fever, trench fever
comprehensive: Morphology: head, thorax, abdomen; control: personal protection,
elimination of lice, physical control, chemical control
【CONTENT】
1. Morphology:
(1) Pediculus humanus:
Head, thorax, abdomen
(2) Pthirus pubis: crab-like appearance , body shape is oval and broader
2. Life cycle and habits:;
(1) Imcomplete metamorphosis: egg—nymph—adult
(2) Parasitic position
(3) Feed habits
(4) Be sensitive to temperature and moisture.
(5) Transmitting ways
3. Lice and diseases:
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(1) Be bloodsuckers:
(2) Be disease-transmitters:
Epidemic typhus, relapsing fever, trench fever
4. Control
Ticks
【AIM】
master：Life cycle and ecology: egg—larva—nymph—adult, breeding habits,
feed habits, length of life; ticks and diseases: blood-sucking, tick paralysis, tick-borne
diseases, forest encephalitis, Xingjiang haemorrhagic fever, tick-borne relapsing fever,
lyme disease, Q fever, tick-borne rickettsiosis in northern Asia, bacterial diseases
comprehensive: Morphology: gnathosoma (capitulum), idiosoma; control:
environment control, chemical control, personal protection
【CONTENT】
1. Morphology:
(1) Hard ticks:
a. Gnathosoma (Capitulum) b. Idiosoma: (2) Soft ticks:
2. Life cycle and Ecology
(1) Life cycle: egg—larva—nymph—adult
(2) Breeding habits
(3) Feed habits
(4) Length of life
3. Ticks and diseases:
(1) Direct effects: blood-sucking, Tick paralysis
(2) Tick-borne diseases
a. Forest encephalitis
b. Xingjiang haemorrhagic fever
c. Tick-borne relapsing fever
d. Lyme disease
e. Q feveri
f. Tick-borne rickettsiosis in Northern Asia
4. Control
Itch mites
【AIM】
master：Life cycle and ecology: egg—larva—nymph—adult, parasitic position,
mating and egg-laying; pathogenesis: scabies, intense itch, lesions, secondary
infection
comprehensive: Morphology: short ovoid, males are smaller, 4 pairs of legs;
diagnosis: the type of lesion and an itching rash are suggestive, conclusive evidence is
obtained by removing the mites from its burrow with a needle; transmission: contact;
treatment
【CONTENT】
1. Morphology:
(1) short ovoid, 0.3~0.5mm×0.25~0.4mm in females, males are smaller
(2) 4 pairs of legs
2. Life cycle and Ecology:
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(1) Life cycle: egg—larva—nymph—addult
(2) Parasitic position
(3) Mating and egg-laying
3. Pathogenesis: scabies
Intense itch, lesions, secondary infection
4. Diagnosis
(1) The type of lesion and an itching rash are suggestive.
(2) Conclusive evidence is obtained by removing the mites from its burrow with a
needle.
5. Transmission: contact
6. Treatment
7. Control:
Follicle mites
【AIM】
master：Demodex folliculorum
【CONTENT】
Demodex folliculorum
Small, elongated,wormlike parasite.
Live in hair follicles and the sebaceous glands around the face.
The mites present themselves in blackheads, acnes, or a localized keratitis,
Dust mites
【AIM】
master：Symptoms: stuffy or runny nose, sneezing, coughing or watery eyes, or even
bronchial asthma, accompanied by wheezing, shortness of breath, and perhaps even
death
comprehensive: The most common allergenic components of house dust; control
【CONTENT】
The most common allergenic components of house dust .
Symptoms :stuffy or runny nose, sneezing, coughing or watery eyes, Or even
bronchial asthma, accompanied by wheezing, shortness of breath, and perhaps even
death .
Control :
1) treatment of the patient
2) modification of the patients' environment to minimize exposure to the mites
四、教材
1 . 人体寄生虫学（七、八年制用书）。詹希美
人民卫生出版社,2005
2. Textbook of medical microbiology and parasitology ,汪世平，叶嗣颖;科学出版社
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五、主要参考资料
Medical Parasitology ,
Markell. Voge. John,
W.B.Saunders Company（1999）
Human Parasitology. 2nd Ed. Bogitsh BJ, Cheng TC. USA: Academic Press,
1998
Parasitology & vector biology. 2nd ed.Marquardt WC, Demaree RS. San Diego:
Academic Press, 2000
Wernsdorfer WH. 疟疾学. 王钊等编译. 青岛: 青岛海洋大学出版社, 1992
现代寄生虫病学,陈兴保等.人民军医出版社，2002.5
现代感染性疾病与传染病学.彭文伟. 北京: 科学出版社, 2000
寄生虫与临床. 第 2 版.沈一平等. 北京: 人民卫生出版社, 1999
临床寄生虫病学.谢醒民. 天津科学技术出版社, 1999
六、成绩评定
期末考试：理论考核 100%
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