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GENERAL STOOL EXAMINATION BY: MUHAMMMAD ALI HASSAN. INSTAGRAM : M7HAMM8D TELEGRAM: M7HAMM8D NOTE : THE MOST COMMON STOOL COMPONENTS ACCORDING TO THE GEOGRAPHY OF KURDISTAN

STOOL ANALYSIS: Ø A stool analysis: is a series of tests done on a stool (feces)sample for differential diagnosis of certain diseases ofdigestive system. Ø Stool analysis procedure is divided into: 1.

1-Physical Examination.

2.

Chemical Examination.

3.

Microscopic Examination.

1-PHYSICAL EXAMINATION. 1.

The color of stool

2.

Odor

3.

Consistencv of stool

4.

Naked eye parasite

5.

Gross blood

6.

Mucus

2-CHEMICAL EXAMINATION. 1.

PH.

2.

Sugar content.

3.

Fat content.

4.

Occult blood.

3-MICROSCOPIC EXAMINATION. Microscopic examination is a diagnostic tool for defining protozoa, helminths, and fecal leukocytes. Erythrocytes and leukocytes are not observed in normal stool. In order to see leukocytes, examinations should be performed in stool samples obtained from the area with mucus. Leukocytes are generally observed in bacterial infections. They are not observed in diarrheas caused by viruses and parasites.

RBC Normal RBC in the stool is 0_3 H.P.F Ø Common cause of blood in stool . 1.

Hemorrhoids .

2.

Inflammation in the colon .

3.

Colon polyps .

4.

Constipation .

5.

Untreated bowel infections .

6.

Colon cancer .

RBC

RBC

RBC

PUS CELLS Normal pus cell in the stool is 0_4 H.P.F . Ø pus cell only appear in infection or inflammation. Ø Their presence is important in case of diarrhea or dysentery. Ø >3 pus cell /high fields are seen in ulcerative colitis and bacterial infection. Ø Greater numbers of pus cell indicate invasive pathogens.

PUS CELLS Ø Note : Viruses and parasites don’t cause pus cells in the stool. Increased number of pus cells seen in the stool: 1. Bacillary dysentery. 2. Chronic ulcerative colitis. 3. Shigellosis. 4. Salmonella infection. 5. Yersinia infection. 6. Invasive E.coli diarrhea. 7. Fistula of anus or rectum. 8. Localized abscess.

PUS CELLS

PUS CELLS

BACTERIA

BACTERIA

BACTERIA

MONILIA

MONILIA

SOME OF COMMON PARASITES 1.

Entamoeba histolytic

2.

Giardia lamblia

3.

Entrobius vermicularis

4.

Ascaris lumbricoides

5.

Trichuris trichiuria

6.

Echinococcus granulosus

7.

Hymenolepis nana

8.

Schistosoma mansoni

9.

Toxoplasma gondii

1-ENTAMOEBA HISTOLYTIC Ø Habitat : live in mucus and submucus layer of the large intestine in man. Ø Cause ( disease ): amoebic dysentery in man. Ø Infection stage : cyst 4 nuclei . Ø Route of infection: eat or drink contaminated food or water .

ENTAMOEBA HISTOLYTIC THROPHOZOITE

ENTAMOEBA HISTOLYTIC CYST

2-GIARDIA LAMBLIA Ø Habitate : duodenum and upper part of intestine Ø Cause ( disease ): Diarrhea. Ø Infection stage : cyst . Ø route of infection: Cyst is ingested through water.

GIARDIA LAMBLIA THROPHOZOITE

GIARDIA LAMBLIA CYST

3-ENTROBIUS VERMICULARIS

Ø habitate: Adult worm (gravid female) live in the Caecum. Ø cause(disease): Enterobiasis , oxyurasis . Ø infection stage: Embryonated egg . Ø route of infection: by mouth egg contaminated food and water.

ENTROBIUS VERMICULARIS MALE

ENTROBIUS VERMICULARIS FEMALE

ENTROBIUS VERMICULARIS EGG

4-ASCARIS LUMBRICOIDES Ø habitate: Adult worm live in the lumen of the small intestine. Ø Cause (disease): biliary ascariasis the most common complication peritonitis, pneumonia, obstruction of the intestine . Ø infection stage: for human Embryonated egg. Ø route of infection: by mouth egg contaminated food or drink or finger.

ASCARIS LUMBRICOIDES MALE & FEMALE

ASCARIS LUMBRICOIDES UNFERTILIZED EGG 🔬

ASCARIS LUMBRICOIDES FERTILIZED EGG 🔬

5-TRICHURIS TRICHIURA Ø Habitate:Adult worm live in cecum and ascending colon of human. Ø Infective stage: emberyonated egg. Ø Rout of infection: by mouth. (Ingestion of embryonated egg).

TRICHURIS TRICHIURA MALE

TRICHURIS TRICHIURA FEMALE

TRICHURIS TRICHIURA EGG

6-ECHINOCOCCUS GRANULOSUS Ø habitate: Adult worm is found in the small intestine of Canines like Dog. Ø intermediate host: Man - Cattle - Horse. Ø final host: Dog - pigs. Ø Cause (disease): Depend up on (number-sizeposition) of Hydatid cyst. Ø infection stage for Human and sheep :(Egg). Ø Infection stage for final host ( dog_pigs) : Hydatid cyst . Ø route of infection: By Mouth ingestion of contaminated by food and finger.

ECHINOCOCCUS GRANULOSUS EGG

HYDATID CYST ECHINOCOCCUS GRANULOSUS

7- HYMENOLEPIS NANA

Ø habitate: Small intestine in man. Ø intermediate host: Arthropod various species of beetles and fleas man serve as intermediate hosts. Ø final host: Human, Mice,Rats . Ø Cause (disease): Hymenolepiasis . Ø infection stage: Eggs (direct) or Cysticercoid larvae (indirect) Ø Route of infection: eating food contaminated with eggs of autoinfection.

HYMENOLEPIS NANA EGG

HYMENOLEPIS NANA EGG

HYMENOLEPIS NANA SEGMENT

8-SCHISTOSOMA MANSONI Ø Habitate : veins of large intestine, colon(lower mesentric vein) . Ø Intermediate host: Biomphalaria alexandrina . Ø final host: Man . Ø Cause (disease) : Intestinal Bilharziasis . Ø Infective stage : cercariae . Ø route of infection: direct skin penetration ofcercariae during swimming .

SCHISTOSOMA MANSONI EGG

SCHISTOSOMA MANSONI EGG

DIFFERENT BETWEEN TYPE OF SCHISTOSOMA

CERCARIAE CERCARIAE RELEASED FROM SNAIL INTO WATER

9-TOXOPLASMA GONDII Ø habitat: found in tissue human and animal . Ø intermediate host: Human and animal . Ø final host: CAT . Ø Cause (disease): abortion but if infection occur in the second half cause Congenital defects . Ø infection stage: Sporolated Oocyst . Ø route of infection: Contamination food and water .

TOXOPLASMA GONDII OOCYST

TOXOPLASMA GONDII TACHYZOITES

UNDIGESTED FOOD IN STOOL 🔬

MUSCLE FIBER

FAT

VEGETABLE CELLS

STARCH

STARCH

VEGETABLE FIBER

LAB ASSISTANT : MUHAMMMAD ALI HASSAN

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