MICROSCOPY
OF FECAL SPECIMENS
Trichuris trichiura
Necator americanus
Ancylostoma duodenale
General Lab Objectives
1. To familiarizes the student with the most widely
used techniques for detection of parasites.
2. To be able to identify the parasite stages.
3. To learn the student, how to deal with risk samples.
Fecal Specimen
• Fecal specimen are examined for protozoa, helminthes
larvae or eggs. PH-L/E
• The stages of protozoa found in stool samples are
trophozoites and cysts or oocysts. T-C/O
• The stages of helminthes usually found in the stool
samples are eggs and larvae, through whole adult worms
or segment of worms may also be seen. EL
• Adult worms and segment of tape worms are usually
visible to naked eye, but eggs, larvae, cyst, oocyst and
trophozoites can be seen only with the microscope.
• In order to see these structure, the fecal material must be
properly collected and examined.
Collection of Fecal Specimen (cont.)
• The container with the specimen should be clearly labeled
with the following:
o Patient’s name
o Age
o Gender
o Date and time of collection.
Collection of Fecal Specimen (cont.)
• Formed samples can be kept in a refrigerator at 4 C° for a
short time, but not in incubator.
• Any whole worms or segments passed should be placed in
a separate container
Stool Analysis (cont.)
• Laboratory analysis includes macroscopic, microscopic
examination, chemical tests, and microbiologic tests.
• The stool will be checked for color, consistency, weight
(volume), shape, odor, and the presence of mucus and
parasites stages.
• The pH of the stool also may be measured.
• A stool culture is done to find out if bacteria may be
causing an infection.
Fecal Sample Examination
1. Macroscopic Examination
▪ Color ▪ abnormal features
▪ Consistency ▪ adult worm or segment
2. Microscopic Examination
▪ WBC/ HPF ▪ Yeast
▪ RBC/ HPF ▪ Cyst, trophozoite, or both
▪ Mucus ▪ Larvae, egg, or both
3. Chemical Examination
▪ Fecal pH test ▪ Stool reducing substances
▪ Fecal fatty acid testing testing
▪ Testing feces for Occult Blood
Macroscopic Examination
Color:
• Brown is normal color
• Bright red to dark red to black stools occur when iron or
bismuth is taken or when there is intestinal hemorrhage.
• Pale yellow stools indicate with excess fat and also
associated with diagnostic procedures that use barium
sulfate.
• Bright yellow stool bottle fed babies
rare in older children and adults.
– Green stool excess bile, cause diarrhea
Raed Z. Ahmed, Medical Parasitology Lab.,2012
Macroscopic Examination (cont.)
Consistency: degree of moisture, will be a
guide as to whether the trophozoite stage or the
cyst stage of protozoa is likely to present.
❑ Formed, write “F”
❑ Soft , write “S”
❑ Loose , write “L”
❑ Watery , write “W”
Raed Z. Ahmed, Medical Parasitology Lab.,2012
Macroscopic Examination (cont.)
Abnormal features:
• If mucus is present writ “M”, and “B” if blood is present.
• The presence of mucus coated stool is indicative for
intestinal inflammation or irritation.
Adult worm or segments
• The feces may have adult helminthes or segments present
such as Ascaris lumbricoides, Entrobius vermicularis, or
Taenia spp. gravid segment, these can be seen by naked
eye.
• And frequently motile for several days and may migrate
to the top of the container.
Raed Z. Ahmed, Medical Parasitology Lab.,2012
➢Formed stool: take the portion of stool from an area
to include inside and outside parts of the specimen.
➢Stool with mucus: if mucus is present, label a second
slide with the patient’s name or number. Put a drop of
saline on the slide, pick up a small portion of mucus
and mix with the saline. Trophozoites, if present, are
sometimes more readily found in mucus than in the
solid parts of the stool.
➢Loose watery stool: if mucus is not present, pick up a
small portion of the stool (any part) and mix with the
saline.
Raed Z. Ahmed, Medical Parasitology Lab.,2012
Making Direct smear Microscopy
❑ Materials and reagents:
➢ Microscopic slides.
➢ Cover slips.
➢ Applicator sticks.
➢ Marker or pen for labeling.
➢ Reagent/emulsion
▪ Saline solution(NSS, isotonic)
Raed Z. Ahmed, Medical Parasitology Lab.,2012
Wet mount procedures
Examine the slide on microscope:
o 10X
o 40X
Raed Z. Ahmed, Medical Parasitology Lab.,2012
Result of Examination
• If no parasites are found:
▪ “No ova or parasites seen”, and specify
whether this result was obtained by direct
examination or by a concentration method
(name method used).
▪ Never state categorically: “No parasites”
• If any parasites are seen, write the scientific name
of the parasite with stages
• Example: Giardia lambilia cyst
Raed Z. Ahmed, Medical Parasitology Lab.,2012
