Showing posts with label Parasitology. Show all posts

(late} CK Jayaram Paniker MD
Director and Professor
Department of Microbiology
Government Medical College, Kozhikode, Kerala
Dean, Faculty of Medicine
University of Calicut, Kera la, India
Emeritus Medical Scientist
Indian Council of Medical Research
New Delhi, India

Revised and Edited by
Sougata Ghosh MD ocH
Department of Microbiology
Government Medical College
Kol kata, West Bengal, India
Institute of Postgraduate Medical Education and Research (IPGMER) and
Calcutta School ofTropical Medicine
Kolkat a, West Bengal, India

Jagdish Chander
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Book Details
 271 p
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 66,704 KB
 File Type
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 Jaypee Brothers Medical Publishers 

This is a great pleasure to write the foreword to the eighth edition of Paniker's Textbook of Medical
Parasitology dealing with medically important parasites vis-a-vis human diseases caused by them.
The parasitic infections (protozoa! and helminthic) are still major cause of high morbidity as well
as mortality of substantial number of population residing in the developing world of tropical and
subtropical regions. The clinical presentations of parasit ic diseases have also significantly evolved
with the passage of time. Malaria caused by Plasmodium vivax has never been life-threatening but
now it is presenting with renal failure as well as acute respiratory distress syndrome (ARDS) thereby
leading to fatal consequences. On the other hand, some of the infections such as dracunculiasis
have been eradicated from India and others are the next targets being in the pipeline.
There are a number of novel diagnostic techniques, which are being designed for rapid
diagnosis of various parasitic diseases and accurate identification of their causative pathogens. 
The non-invasive imaging techniques, both MRI and CT scans, are proving to be very useful tools for an early diagnosis thereby delineating the extent of disease in a particular patient. Therefore, to cope up with the changing epidemiological scenario and newer diagnostic modalities, medical students and professionals involved in the patient care need updates from time to time. Dr Sougata Ghosh (Editor), has done a remarkable job of going through the voluminous information and presenting it in a very lucid, concise and reproducible manner.
This edition will ideally be suited for medical students and resident doctors, who are preparing for various examinations entrance tests. I feel the present edition will also be appreciated by students and teaching faculties in all disciplines of medicine. The chapter on pneumocystosis has been removed, however, on sporozoa dealing with diseases caused by
different species of microsporidia, traditionally retained in this edition, despite the fact that it has also been shifted now to the kingdom fungi like Pneumocystis jirovecii.
The unique feature of the textbook is that it has many illustrations, photographs of cl inical specimens and photomicrographs with an easy-to-read and understand format. This will help the students to memorize the information given in the text easily as well as to use the same in medical practice. Each chapter has key points with a set of multiple choice questions (MCQs), which will help a student for better understanding and preparation before the examination. Although it is meant for medical graduates, recent advances mentioned in this book will also be useful for the postgraduates.
The original author, Professor CK Jayaram Paniker, was an experienced and enthusiastic medical teacher, and we recently lost him. Moreover, he was a legendary microbiologist and the author of numerous valuable textbooks, part icularly co-author of Ananthanarayan's Textbook of Microbiology. His name has been retained as such in the title of the eighth edition of this textbook is a great honor and real tribute to him thereby continuing his legacy to attain more heights in the field of medical parasitology even in his physical absence. I hope that this textbook will continue to benefit the medical
students and faculties for many years as it has done during the last three decades.
Jagdish Chander
Professor and Head
Department of Microbiology
Government Medical College and Hospital
Chandigarh, India

The previous editions of Paniker's Textbook of Medical Parasitology have been widely accepted by the medical students and teachers across India and abroad for almost three decades.
Medical science is not a static art. Methods of diagnosis and treatment of parasitic infections change constantly. To keep pace with these developments, all the chapters of present edition have been thoroughly revised and expanded, providing up-to-date epidemiological data, new diagnostic methods and recent treatment guidelines of parasitic infections.
In the current edition, many new tables, flow charts and photographs of specimens and microscopic view pictures have been added for better comprehension of the subject.
Recent advances such as vaccinology of malaria and leishmaniasis, malarial drug resistance, new treatment protocols of different parasitic infections are the salient features of the book.
The aim of the contents of the book remains same in this edition, that is compact yet informative and useful for both graduate and postgraduate students.
Like the last edition, the present edition is also designed in a colorful format, which can be easily read and comprehended. Important points and terms have been highlighted by making them bold and italic. At the end of each chapter, the must-know facts are given as "Key Points" in box formats for quick recapitulation. Important multiple choice questions (MCQs) and review questions from various university examinations' papers have been added to test and reinforce understanding of the topics by the students.
Sougata Ghosh

Table of Contents
1. General Introduction: Parasitology
Parasites 1
Host 1
Zoonosis 2
Host-parasite Relationships 2
Life Cycle of Parasites 3
Sources of Infection 3
Modes of Infection 4
Pathogenesis 4
Immunity in Parasitic Infection 5
Immune Evasion 5
Vaccination 5
Laboratory Diagnosis 6
2. Protozoa General Features 10
Structure 10
Cytoplasm 10
Nucleus 10
Terminologies Used in Protozoology 10
Reproduction 11
Life Cycle 11
Classification of Protozoa 11
3. Amebae 15
Entamoeba histolytica 15
Nonpathogenic Intestinal Ameba 24
Pathogenic Free-living Amebae 26
4. Intestinal, Oral and Genital Flagellates Giardia lamblia 32
Trichomonas 36
Chilomastix mesnili 38
Enteromonas hominis 38
Retortamonas intestina/is 38
Dientamoeba fragilis 39
5. Hemoflagellates
Zoological Classification of Flagellates 41
General Characteristics 41
Trypanosomes 42
Leishmania 52
6. Malaria and Babesia Malaria 66
Classification 66
Causative Agents of Human Malaria 66
Malaria Parasite 66
Babesia Species 86
Classification 86
History and Distribution 86
Habitat 86
Morphology 86
Life Cycle 86
Pathogenicity and Clinical Features 87
Laboratory Diagnosis 87
Treatment 88
Prophylaxis 88
7. Coccidia Toxoplasma gondii 90
/sospora be/Ii 96
Cryptosporidium parvum 97
Cyclospora cayetanensis 100
8/astocystis hominis 101
Sarcocystis 102
8. Microspora 104
History and Distribution 104
Morphology 704
Life Cycle 105
Clinical Features 105
Laboratory Diagnosis 105
Treatment 106
Prophylaxis 706
9. Balantidium coli 107
History and Distribution 107
Habitat 107
Morphology 107
Life Cycle 108
Pathogenesis 108
Clinical Features 109
Laboratory Diagnosis 109
Treatment 109
Prophylaxis 109
10. Helminths: General Features 111
Phylum Platyhelminthes 111
Phylum Nemathelminthes (Nematoda) 112
Important Features of Helminths 112
Zoological Classification of Helminths 113
11. Cestodes: Tapeworms 115
Classification of Cestodes 115
Tapeworms: General Characteristics 115
Pseudophyllidean Tapeworms 117
Cyclophyllidean Tapeworms 122
12. Trematodes: Flukes 141
Classification ofTrematodes 141
Flukes: General Characteristics 747
Life Cycle 142
Blood Flukes 143
Hermaphroditic Flukes: Liver Flukes 150
Intestinal Flukes 156
Lung Flukes 160
13. Nematodes: General Features 164
General Characteristics 164
Life Cycle 164
Modes of Infection 165
Classification 165
Larva Migrans 165
14. Trichinella spiralis 170
Common Name 170
History and Distribution 170
Habitat 110
Morphology 110
Life Cycle 111
Pathogenicity and Clinical Features 112
Diagnosis 112
Treatment 114
Prophylaxis 114
15. Trichuris trichiura 115
Common Name 115
History and Distribution 115
Habitat 775
Morphology 175
Life Cycle 7 16
Pathogenicity and Clinical Features 117
Laboratory Diagnosis 118
Treatment 118
Prophylaxis 118
16. Strongyloides stercoralis 180
History and Distribution 180
Habitat 180
Morphology 180
Life Cycle 182
Pathogenicity and Clinical Features 783
Laboratory Diagnosis 184
Treatment 185
Prophylaxis 185
17. Hookworm 187
History and Distribution 187
Ancylostoma duodenale 187
Necator americanus 189
Pathogenicity and Clinical Features of Hookworm Infection 190
Laboratory Diagnosis 197
Treatment 192
Prophylaxis 793
Other Hookworms 193
Trichostrongyliasis 793
18. Enterobius vermicularis 195
Common Name 795
History and Distribution 795
Habitat 795
Morphology 795
Life Cycle 796
Pathogenicity and Clinical Features 196
Laboratory Diagnosis 797
Treatment 798
Prophylaxis 7 99
19. Ascaris /umbricoides 200
Common Name 200
History and Distribution 200
Habitat 200
Morphology 200
Life Cycle 201
Pathogenicity and Clinical Features 203
Laboratory Diagnosis 205
Treatment 205
Prophylaxis 205
20. Filarial Worms 208
Lymphatic Filariasis 210
Subcutaneous Filariasis 219
21. Dracunculus medinensis 225
Common Name 225
History and Distribution 225
Habitat 225
Morphology 225
Life Cycle 226
Pathogenicity and Clinical Features 227
Laboratory Diagnosis 227
Treatment 227
Prophylaxis 229
22. Miscellaneous Nematodes 230
Angiostrongylus cantonensis 230
Capillaria philippinensis 231
Gnathostoma spinigerum 231
Anisakiasis 232
23. Diagnostic Methods in Parasitology 234
Examination of Stool 234
Examination of Blood 240
Sputum Examination 242
Urine or Body Fluids Examination 243
Tissue Biopsy 243
Muscle Biopsy 243
Duodenal Capsule Technique {Enterotest) 243
Sigmoidoscopy Material 244
Urogenital Specimen 244
Cult ure Methods 244
Animal Inoculation 245
Xenodiagnosis 245
Immunological Diagnosis 246
Skin Tests 247
Molecular Methods 247
Index 249


Printed at: Ajanta Offset & Packagings Ltd., Faridabad, Haryana

First Edition: 1988
Second Edition: 1989, Reprint: 1991
Third Edition: 1993
Fourth Edition: 1997, Reprint: 1999
Fifth Edition: 2002, Reprint: 2003, 2004
Sixth Edition: 2007, Reprint: 2011
Seventh Edition: 2013
Eighth Edition: 2018

Apurba Sankar Sastry MD (JIPMER),DNB, MNAMS, PDCR
Assistant Professor
Department of Microbiology
Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER)
Pondicherry, India

Sandhya Bhat K MD, DNB, MNAMS, PDCR
Assistant Professor
Department of Microbiology
Pondicherry Institute of Medical Sciences (PIMS)
(A Unit of Madras Medical Mission)
Pondicherry, India

Reba Kanungo

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Book Details
 358 p
 File Size 
 36,078 KB
 File Type
 PDF format
 2014, Jaypee Brothers Medical Publishers 

Our understanding of human diseases has been greatly benefited from the
rapid strides made in Medical Science. It is necessary to compile and document
these advances in textbooks for students who are pursuing medical and allied
courses. To add the existing resources of information on parasitic diseases,
Dr Apurba Sankar Sastry and Dr Sandhya Bhat k have conceptualized and
compiled this book entitled “Essentials of Medical Parasitology.” They have
addressed details of information required by a medical graduate to help him to
understand the subject and also keep abreast with latest developments in the
field of Medical Parasitology.
The book is divided into four sections that deal with Protozoa, Helminths,
etc that are of importance to human health and disease. Each section deals
with general concepts including commonly used terminologies and their
definitions which will help the reader to understand their implications when used later in the text. Every
chapter is designed in a thematic manner with a brief classification including classification based on the
habitat and site of infection. This is followed by description of the parasite’s morphology, epidemiology of the disease and pathogenesis. Clinical spectrum of the disease is described with emphasis on pathology, clinical features and stages of the parasite that are encountered in the human host. Life cycle outside the human host and natural habitat in the environment or animals have been explained in detail in the respective chapter.
Thee chapters are interspersed with relevant illustrations. Photomicrographs are clear emphasizing
the natural appearance in clinical material. Diagrams and flow charts of life cycles are clear and well
represented. The authors have collected original images from several sources to highlight the actual
microscopic images seen in the laboratory and in situ appearance in tissue sections.
Laboratory methods to detect the agents in relevant clinical material have been described in detail
in easy procedural steps. Several additional and supportive tests to diagnose the infections have been
mentioned in each chapter. Recent techniques and current tests including specific antigen and antibody
detection methods used in the laboratories have been described. This will help a fresh graduate in
clinical practice to use the information in day to day practice.
An interesting feature in each chapter is the preventive aspect of commonly encountered parasitic
diseases, with a note on vaccination. An additional feature of the book is an up-to-date information on
the parasitic diseases of public health importance in India including national programs for prevention
and control. Opportunistic parasitic infections in the immunocompromised patients including HIV
infected individuals have been described along with the specific indicators for detection.
Each chapter ends with a set of self assessment questions which will help a student to prepare for the
examination. This is a well planned and executed parasitology book which both MBBS undergraduate
students and postgraduates pursuing a course in Medical Microbiology will find useful. I congratulate
the authors for bringing out this comprehensive textbook on parasitology.
Reba Kanungo MD PhD
Dean Research and Professor and Head
Department of Clinical Microbiology
Pondicherry Institute of Medical Sciences
Past President, Indian Association of Medical Microbiologists
Former Editor-in-Chief, Indian Journal of Medical Microbiology

Medical parasitology is an interdisciplinary science that deals with the study of animal parasites which
infect and produce diseases in human beings. This book is designed specifically for undergraduate
medical and paramedical students as well as for postgraduate students.
Medical students always complain that there is no standard Indian textbook on parasitology at present
which can fulfil the need of the examination and for the management of the parasitic diseases.
Currently available Indian medical parasitology books are neither updated with recent advances nor
presented in a student‐friendly manner. Day-to-day developments in the field of parasitology and the
unavailability of a standard textbook fulfilling the needs and expectation of the students, motivated us
to write a book in an updated format with recent epidemiological data, laboratory techniques, treatment
strategies, etc in such a way that student can grasp it easily.
The whole content of the book has been arranged in a bulleted format and use of sub heads has
increased the readability. Entire book is divided into four sections—General introduction, Protozoology,
Helminthology and Miscellaneous. At the end, six appendices have been incorporated which will be of
immense use and initiate interest among the students. Expected questions including MCQs have been
added at the end of each chapter which will help to reinforce and understand the related topic in a
better way. Life cycles are drawn in lucid and easy-to-grasp manner, exactly according to the text. Real
microscopic images of parasites and specimens from various sources are being incorporated to correlate
their impressions with the related parasitic diseases. Laboratory diagnosis and treatment boxes are
introduced as a different entity for a quick review for students as well as for physicians.
Our endeavor will be successful, if the book is found to be useful for student as well as for the faculty.
Apurba Sankar Sastry
Sandhya Bhat K

Table of Contents
Section 1: Introducion
Chapter 1: General Introduction To Parasitology 3–15
• Taxonomy of parasites 3
• Parasite 3
• Host 4
• Host-parasite relationship 4
• Transmission of parasites 5
• Life cycle of the parasites 6
• Pathogenesis of parasitic diseases 6
• Immunology of parasitic diseases 8
• Laboratory diagnosis of parasitic diseases 9
• Treatment of parasitic diseases 10
Section 2: Protozoology
Chapter 2: Introduction to Protozoa 19–23
Chapter 3: Amoeba 24–48
• General features of protozoa 19 • Classification of protozoa 19
• Classification of amoeba 24
• Intestinal amoeba 24
hh Pathogenic intestinal amoeba 24
−− Entamoeba histolytica 24
hh Nonpathogenic intestinal amoeba 35
−− Entamoeba dispar 35
−− Entamoeba moshkovskii 36
−− Entamoeba coli 36
−− Entamoeba hartmanni 38
−− Entamoeba gingivalis 38
−− Entamoeba polecki 39
−− Endolimax nana 39
−− Iodamoeba butschlii 39
• Free-living (opportunistic) amoeba 40
hh Naegleria fowleri 40
hh Acanthamoeba species 43
hh Balamuthia mandrillaris 46
hh Sappinia diploidea 47
Chapter 4: Flagellates—I (Intestinal and Genital) 49–62
• Classification of flagellates 49
• Giardia lamblia 50
• Trichomonas vaginalis 55
• Pentatrichomonas hominis 58
• Trichomonas tenax 58
• Chilomastix mesnili 58
• Enteromonas hominis 59
• Retortamonas intestinalis 60
• Dientamoeba fragilis 60
Chapter 10: Cestodes 156–189
Chapter 5: Flagellates—II (Hemoflagellates) 63–89
Chapter 6: Sporozoa—I (Malaria and Babesiosis) 90–117
Chapter 7: Sporozoa—II (Opportunistic Coccidian Parasites) 118–139
Chapter 8: Miscellaneus Protozoa 140–150
• Introduction 63
• Morphology of hemofl agellates 63
• Leishmania 64
hh Old World Leishmaniasis 64
−− Leishmania donovani 64
−− Leishmania tropica complex 74
hh New World Leishmaniasis 76
−− Leishmania mexicana complex 77
−− Leishmania viannia braziliensis complex 77
−− Leishmania leishmania chagasi 78
• Trypanosoma 79
• Trypanosoma cruzi 79
• Trypanosoma brucei complex 85
• Classification 90
• Malaria parasite 90
• Babesia 114
• Introduction 118
• Toxoplasma gondii 118
• Cryptosporidium parvum 126
• Cyclospora cayetanensis 131
• Isospora belli 133
• Sarcocystis species 135
• Microsporidium species 140
• Balantidium coli 146
• Blastocystis hominis 149
• General characteristics of cestodes 156
hh Classification of cestodes 156
hh Morphology of cestodes 157
• Pseudophyllidean cestodes 160
hh Diphyllobothrium species 160
hh Spirometra species 163
• Cyclophyllidean cestodes 165
hh Taenia species 165, 175
hh Echinococcus species 176
hh Hymenolepis nana 184, 186
hh Dipylidium caninum 187
Section 3: Helminthology
Chapter 9: Introduction to Helminths 153–155
• General charactristics 153
• Morphology 154
• Life cycle 155
Chapter 14: Nematodes—III (Somatic Nematodes) 262–289
Chapter 13: Nematodes—II Nematodes of Lower Animals 248–261
that Rarely infect Man
Chapter 12: Nematodes—I (Intestinal Nematodes) 220–247
Chapter 11: Trematodes or Flukes 190–219
• Classification of trematodes 190
• General characteristics of trematodes 191
• Blood flukes 193
hh Schistosoma species 194, 201, 202
• Liver fluke 202
hh Fasciola species 202, 206
hh Clonorchis species 206
hh Opisthorchis species 208, 210
• Intestinal fluke 210
hh Fasciolopsis species 210
hh Gastrodiscoides species 213
hh Watsonius species 213
hh Heterophyes species 214
hh Metagonimus species 214
hh Echinostoma species 214
hh Lung fluke 215
hh Paragonimus species 215
• General properties of nematodes 220
• Classification 220
• General description 221
• Large intestinal nematodes 224
hh Trichuris trichiura 224
hh Enterobius vermicularis 227
• Small intestinal nematodes 230
hh Hookworm 230
hh Strongyloides species 237, 242
hh Ascaris species 242, 246
• Classification 262
• Filarial nematode 262
• Lymphatic filarial nematodes 265
hh Wuchereria bancrofti 265
hh Brugia speices 274, 275
• Other filarial nematodes 276
hh Loa loa 276
hh Onchocerca volvulus 277
hh Mansonella species 280, 281
hh Dirofilaria species 282
• Other Somatic nematodes 282
hh Dracunculus medinensis 282
hh Trichinella spiralis 285
• Classification 248
• Larva migrans 248
• Toxocariasis 250
• Angiostrongylus species 252
• Baylisascaris procyonis 253
• Lagochilascaris minor 253
• Anisakiasis 253
• Gnathostoma species 254
• Capillaria species 255, 256, 257
• Trichostrongylus species 257
• Dioctophyme renale 258
• Oesophagostomum species 259
• Ternidens deminutus 259
• Mammomonogamus laryngeus 260
• Thelazia species 260
Section 4: Miscellaneous
Chapter 15: Laboratory Diagnosis of Parasitic Diseases 293–313
• Introduction 293
• Morphological identification techniques 293
• Culture techniques in parasitology 303
• Immunodiagnostic methods 307
• Molecular methods 309
• Intradermal skin tests 310
• Xenodiagnostic techniques 311
• Animal inoculation methods 311
• Imaging techniques 311
Chapter 16: Medical Entomology 314–321
Appendices 325–333
• Medical entomology 314
• Vector 314
• Class insecta 314
• Class arachnida 319
• Class crustacea 320
• Control of Arthropods 320
• Appendix I Clinical syndromes in parasitology 325
• Appendix II Common tropical parasitic diseases 327
• Appendix III Romanowsky stains, composition and staining procedures 327
• Appendix IV Laboratory-acquired parasitic infections 329
• Appendix V Biomedical waste management in parasitology 330
• Appendix VI Morphological forms of parasites seen in the fecal sample 331
Index 335–341


First Edition: 2014

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