Diagnosis of parasitic infections
Parasite tests in Dnipro — comprehensive diagnostics for helminths and protozoa.
PARASITIC INFECTIONS
An Analytical Perspective for Physicians
Below the logic is simple: first the pharmacological core, then the practical treatment schemes, followed by the role of naturopathy, and finally the clinical signs that indicate when to consider parasitosis.
PHARMACOLOGICAL CORE:
1.1. Albendazole
Essentially the main working tool. Spectrum: roundworms, some tissue and systemic invasions. Role: first-choice medication for most suspected nematode infections, provided there are no special contraindications. A feature in Italian practice: dosages and duration of courses are often more conservative than in countries where parasitoses are more widespread. Physicians adhere to EMA-approved protocols rather than “aggressive” treatment regimens.
1.2. Mebendazole
A classic drug for enterobiasis and other intestinal nematode infections in both children and adults. Advantage: convenience of short courses and extensive experience regarding its safe use. Disadvantage: it is now somewhat less universal than albendazole and is more often considered a drug for a specific indication rather than as a basic broad-spectrum agent.
1.3. Pyrantel
A mild agent for typical “domestic” parasitoses. Practical niche: enterobiasis, ascariasis, especially in children and individuals with increased sensitivity to medications. Plus: excellent tolerability profile. Minus: practically ineffective for cestode infections and some more complex invasions, thus suitable only for simple scenarios.
1.4. Niclosamide
A niche drug against tapeworms. Mechanism: acts primarily within the intestinal lumen, with minimal absorption. Reality: it is used infrequently since diagnoses of taeniasis and diphyllobothriasis are rare. Nevertheless, for a physician considering cestodes, it is an important tool.
1.5. Praziquantel
A medication for a more complex spectrum of cestodes and trematodes. In practical use: it is most often prescribed in specialized infectious disease departments or tropical medicine centers, rather than at the “family doctor” level.
PRACTICAL TREATMENT SCHEMES:
The schemes below do not claim to be exhaustive but reflect typical approaches:
1. Enterobiasis: Pyrantel given once with a mandatory repetition after 14 days. Logic: to break the cycle of reinfestation.
2. Ascariasis: Albendazole 400 mg given once, with follow-up and repetition if necessary.
3. Trichuriasis (whipworm): Mebendazole 100 mg twice daily for 3 days.
4. Hookworm infection: Albendazole 400 mg daily for 3 days with monitoring of hemoglobin and iron levels.
5. Taeniasis: Niclosamide or Praziquantel, always by prescription and under supervision, with an assessment of the risk of obstruction and coexisting conditions.
6. Strongyloidiasis: Ivermectin only under medical supervision, taking into account the immune status, risk of hyperinfection, and concomitant therapies (especially glucocorticoids).
WHERE DOES NATUROPATHY FIT IN?
Naturopathic and nutraceutical products play an auxiliary role in the context of parasitoses.
Realistic functions include:
• Supporting liver function and detoxification
• Correcting micronutrient deficiencies
• Restoring the intestinal mucosa
• Working with the microbiota
Functions erroneously attributed to them include:
• "Complete dehelminthation" without medications
• "Elimination of all parasites" without prior diagnosis
• Replacing Albendazole, Mebendazole, Praziquantel, and other systemic drugs
The simple logic is: if there is a proven invasive process, the basis of therapy remains pharmacology. Nutraceuticals and phytotherapy can enhance recovery, but they should not replace medicinal molecules, especially in tissue and systemic parasitoses.
WHEN SHOULD ONE CONSIDER PARASITIC INFECTIONS?
Symptoms of parasitic infections are rarely “pure.” More often, they consist of a set of disparate complaints that only merge into a coherent picture upon careful analysis. It is useful to group the signs by system.
Systemic fatigue and deficiency states:
• Chronic weakness, sleepiness, reduced endurance
• Deficiencies of iron, zinc, copper, B vitamins, resistant to standard therapy
Mechanism: parasites deprive the body of nutrients, damage the mucosa and intestinal villi, thereby impairing absorption.
Psycho-emotional and cognitive changes:
• Anxiety, irritability, unstable mood
• A feeling of “fog” in the head, reduced concentration
Connection: intestinal inflammation and dysbiosis alter the profile of neurotransmitters and the functioning of the gut-brain axis. Certain parasites are indeed capable of modifying behavior and responses.
Skin, hair, nails:
• Hair loss, brittle nails, dry skin
• Persistent subclinical dermatoses
Reason: chronic deficiency of microelements and vitamins combined with the constant impact of parasite toxins and immune complexes.
Digestive symptoms:
• Bloating, alternating constipation and diarrhea
• Colicky pain, especially after eating
• Episodes of partial intestinal obstruction in cases of massive invasion (ascariasis)
Note: While these symptoms are nonspecific, when combined with deficiencies and skin manifestations, they are a serious indication to consider parasitic infections.
Skin and allergic reactions:
• Rashes, eczema, urticaria
• Sudden or increasing allergic sensitivity
Logic: metabolic products of parasites constantly stimulate the immune system and shift it towards hyperreactivity.
Nocturnal symptoms:
• Itching in the perianal area, especially at night
• Sometimes teeth grinding during sleep
This is a classic sign of enterobiasis and several other nematode infections, contributing to sleep disturbances in children or adults.
Low-grade fever:
• Persistent temperatures around 37 – 37.5°C for no apparent reason
Interpretation: a slow, prolonged immune reaction to chronic antigenic load.
Pulmonary manifestations without a typical infection:
• Dry cough, episodes of shortness of breath
• Migratory infiltrates on imaging studies
A “migratory” phase is possible in the development of ascariasis and other helminth infections during transit through lung tissue.
Hepatobiliary signals:
• Heaviness or pain in the right hypochondrium
• Episodes of jaundice of the skin and sclera
Some parasites affect the bile ducts and liver parenchyma, requiring not just antiparasitic, but comprehensive gastroenterological management.
Changes in food preferences:
• A pronounced craving for sweets and fast carbohydrates
Explanation: parasites actively consume glucose, indirectly creating an unusual and persistent craving for sugar in the patient.
SUMMARY FOR THE PHYSICIAN:
1. The primary drug is Albendazole; the other molecules serve as specialized tools.
2. The success of therapy depends not on the number of available drugs, but on the accuracy of diagnosis and the correct linking of symptoms to possible invasions.
3. Naturopathy is appropriate as a means of support, restoration, and correction of deficiencies, but not as a substitute for antiparasitic medications.
4. Any “vague” clinical picture associated with deficiencies, skin, and digestive symptoms warrants at least one direct question: could chronic parasitosis be lurking behind the scene?
BLOOD DIAGNOSTICS:
2.1. Total Eosinophils:
An elevation in eosinophils is characteristic of tissue and migratory parasitoses: toxocariasis, hookworm infections, strongyloidiasis, schistosomiasis.
Comment: normal eosinophil levels do not rule out parasitosis, but a high level almost always necessitates a search for parasites.
2.2. Total IgE:
A nonspecific but useful marker. An elevation is characteristic of helminth infections and allergic reactions to their metabolic products.
2.3. Serology (ELISA):
• Toxocara
• Strongyloides
• Echinococcus
• Schistosoma
• Fasciola
Serology is used when tissue and systemic invasions are suspected and stool examinations are less informative.
STOOL DIAGNOSTICS:
Standard Coproparasitological Examination:
A threefold stool analysis with 48-hour intervals. It detects eggs of ascarids, pinworms, whipworms, hookworms, giardia, and amoebae.
Comment: sensitivity is higher when samples are provided in series. A single routine test often misses parasites in mild invasions.
Giardia and Cryptosporidium Antigen Detection:
An enzyme immunoassay for detecting antigens. High sensitivity for giardiasis and cryptosporidiosis.
Comment: these tests are performed regularly, especially in pediatrics.
Detection of Proglottids and Tapeworm Fragments:
Search for fragments of tapeworm parasites. Used when taeniasis or diphyllobothriasis is suspected.
LIVER BIOCHEMISTRY:
These tests do not look for the parasite directly but help to recognize its consequences:
• Elevated bilirubin and GGT in cases of opisthorchiasis or bile duct involvement
• Chronic low ferritin in giardiasis, hookworm infections, and strongyloidiasis
DIAGNOSTIC LOGIC:
1. If the main symptom is gastrointestinal, start with a threefold stool analysis.
2. If pronounced eosinophilia is present, immediately add serology for Toxocara, strongyloides, and schistosomiasis.
3. If symptoms are systemic and chronic, add IgE, liver biochemistry, and panels for tissue helminths.
4. If nothing is found in the stool but the clinical picture persists, proceed with serology and PCR.
-----------------------------------------------------
In our laboratory, comprehensive diagnostics of parasitic diseases is performed using modern methods—ELISA, PCR, and microscopy.
We determine the presence of antibodies and DNA of the main pathogens causing helminthiases and protozoal infections.
Serological tests (ELISA, blood):
• Giardiasis – Giardia lamblia – total antibodies (IgG + IgM + IgA)
• Ascariasis – Ascaris lumbricoides – IgG antibodies
• Toxocariasis – Toxocara canis – IgG antibodies
• Opisthorchiasis – Opisthorchis felineus – IgG antibodies
• Echinococcosis – Echinococcus granulosus – antibodies (IgG + IgA)
• Trichinellosis – Trichinella spiralis – antibodies (IgG + IgA)
PCR Panels for the Detection of Parasite DNA (qualitative determination, stool):
“Intestinal Helminths” Panel (9 pathogens):
Enterocytozoon spp./Encephalitozoon spp., Strongyloides spp., Hymenolepis spp., Ascaris spp., Taenia spp., Trichuris trichiura, Ancylostoma spp., Enterobius vermicularis, Necator americanus.
“Intestinal Protozoa” Panel (6 pathogens):
Giardia lamblia, Entamoeba histolytica, Cryptosporidium spp., Blastocystis hominis, Dientamoeba fragilis, Cyclospora cayetanensis.
Additionally, stool concentration analysis (Parasep) is performed for the microscopic detection of parasite eggs and cysts.
For a comprehensive evaluation of the organism’s condition, the following may be ordered:
• Complete blood count (with differential);
• Urinalysis;
• Eosinophilic cationic protein (ECP) – an indicator of allergic and parasitic reaction activity;
• Total Immunoglobulin E (IgE);
• Liver panel (total protein, albumin, bilirubin, ALT, AST, alkaline phosphatase, GGT).
Additional examinations (additional fee):
• Anisakis simplex or herring worm, antibodies / Anisakis simplex (by L. Redgera, Germany)
(Indirect Immunofluorescence Test (IIFT)) – a qualitative indirect immunofluorescence assay.
Indications: When symptoms of anisakiasis occur (abdominal pain, nausea, and vomiting, along with skin rashes and itching after consumption of raw fish);
Also indicated in patients with a relevant occupational history (fishermen, fish vendors, chefs) or dietary habits (consumption of raw marine fish or squid).
• Fecal Calprotectin (stool)
Calprotectin is a protein released by leukocytes during inflammation.
High levels in stool → indicate an inflammatory process in the intestines.
• Occult Blood in Stool
This test detects microscopic bleeding in the gastrointestinal tract that is not visible to the naked eye.
• Pancreatic Elastase (stool)
Used for diagnosing exocrine pancreatic insufficiency, chronic pancreatitis, and digestive disorders.
Research Methods:
• Microscopy – allows visual detection of parasite eggs and larvae.
• ELISA – detects antibodies to the most common pathogens.
• PCR diagnostics – identifies fragments of parasite DNA with high accuracy even at early stages of infection.
When is screening recommended?
• In cases of chronic fatigue, frequent allergies, skin rashes;
• When digestive disturbances and reduced immunity are present;
• Prior to pregnancy or elective surgeries;
• To monitor the effectiveness of administered treatment.
Our Advantages:
• Modern laboratory equipment and certified reagents;
• High accuracy, reliability, and rapid turnaround of tests;
• Convenient online access to results;
• The possibility to obtain a consultation with an infectious disease specialist and a comprehensive report.
An Analytical Perspective for Physicians
Below the logic is simple: first the pharmacological core, then the practical treatment schemes, followed by the role of naturopathy, and finally the clinical signs that indicate when to consider parasitosis.
PHARMACOLOGICAL CORE:
1.1. Albendazole
Essentially the main working tool. Spectrum: roundworms, some tissue and systemic invasions. Role: first-choice medication for most suspected nematode infections, provided there are no special contraindications. A feature in Italian practice: dosages and duration of courses are often more conservative than in countries where parasitoses are more widespread. Physicians adhere to EMA-approved protocols rather than “aggressive” treatment regimens.
1.2. Mebendazole
A classic drug for enterobiasis and other intestinal nematode infections in both children and adults. Advantage: convenience of short courses and extensive experience regarding its safe use. Disadvantage: it is now somewhat less universal than albendazole and is more often considered a drug for a specific indication rather than as a basic broad-spectrum agent.
1.3. Pyrantel
A mild agent for typical “domestic” parasitoses. Practical niche: enterobiasis, ascariasis, especially in children and individuals with increased sensitivity to medications. Plus: excellent tolerability profile. Minus: practically ineffective for cestode infections and some more complex invasions, thus suitable only for simple scenarios.
1.4. Niclosamide
A niche drug against tapeworms. Mechanism: acts primarily within the intestinal lumen, with minimal absorption. Reality: it is used infrequently since diagnoses of taeniasis and diphyllobothriasis are rare. Nevertheless, for a physician considering cestodes, it is an important tool.
1.5. Praziquantel
A medication for a more complex spectrum of cestodes and trematodes. In practical use: it is most often prescribed in specialized infectious disease departments or tropical medicine centers, rather than at the “family doctor” level.
PRACTICAL TREATMENT SCHEMES:
The schemes below do not claim to be exhaustive but reflect typical approaches:
1. Enterobiasis: Pyrantel given once with a mandatory repetition after 14 days. Logic: to break the cycle of reinfestation.
2. Ascariasis: Albendazole 400 mg given once, with follow-up and repetition if necessary.
3. Trichuriasis (whipworm): Mebendazole 100 mg twice daily for 3 days.
4. Hookworm infection: Albendazole 400 mg daily for 3 days with monitoring of hemoglobin and iron levels.
5. Taeniasis: Niclosamide or Praziquantel, always by prescription and under supervision, with an assessment of the risk of obstruction and coexisting conditions.
6. Strongyloidiasis: Ivermectin only under medical supervision, taking into account the immune status, risk of hyperinfection, and concomitant therapies (especially glucocorticoids).
WHERE DOES NATUROPATHY FIT IN?
Naturopathic and nutraceutical products play an auxiliary role in the context of parasitoses.
Realistic functions include:
• Supporting liver function and detoxification
• Correcting micronutrient deficiencies
• Restoring the intestinal mucosa
• Working with the microbiota
Functions erroneously attributed to them include:
• "Complete dehelminthation" without medications
• "Elimination of all parasites" without prior diagnosis
• Replacing Albendazole, Mebendazole, Praziquantel, and other systemic drugs
The simple logic is: if there is a proven invasive process, the basis of therapy remains pharmacology. Nutraceuticals and phytotherapy can enhance recovery, but they should not replace medicinal molecules, especially in tissue and systemic parasitoses.
WHEN SHOULD ONE CONSIDER PARASITIC INFECTIONS?
Symptoms of parasitic infections are rarely “pure.” More often, they consist of a set of disparate complaints that only merge into a coherent picture upon careful analysis. It is useful to group the signs by system.
Systemic fatigue and deficiency states:
• Chronic weakness, sleepiness, reduced endurance
• Deficiencies of iron, zinc, copper, B vitamins, resistant to standard therapy
Mechanism: parasites deprive the body of nutrients, damage the mucosa and intestinal villi, thereby impairing absorption.
Psycho-emotional and cognitive changes:
• Anxiety, irritability, unstable mood
• A feeling of “fog” in the head, reduced concentration
Connection: intestinal inflammation and dysbiosis alter the profile of neurotransmitters and the functioning of the gut-brain axis. Certain parasites are indeed capable of modifying behavior and responses.
Skin, hair, nails:
• Hair loss, brittle nails, dry skin
• Persistent subclinical dermatoses
Reason: chronic deficiency of microelements and vitamins combined with the constant impact of parasite toxins and immune complexes.
Digestive symptoms:
• Bloating, alternating constipation and diarrhea
• Colicky pain, especially after eating
• Episodes of partial intestinal obstruction in cases of massive invasion (ascariasis)
Note: While these symptoms are nonspecific, when combined with deficiencies and skin manifestations, they are a serious indication to consider parasitic infections.
Skin and allergic reactions:
• Rashes, eczema, urticaria
• Sudden or increasing allergic sensitivity
Logic: metabolic products of parasites constantly stimulate the immune system and shift it towards hyperreactivity.
Nocturnal symptoms:
• Itching in the perianal area, especially at night
• Sometimes teeth grinding during sleep
This is a classic sign of enterobiasis and several other nematode infections, contributing to sleep disturbances in children or adults.
Low-grade fever:
• Persistent temperatures around 37 – 37.5°C for no apparent reason
Interpretation: a slow, prolonged immune reaction to chronic antigenic load.
Pulmonary manifestations without a typical infection:
• Dry cough, episodes of shortness of breath
• Migratory infiltrates on imaging studies
A “migratory” phase is possible in the development of ascariasis and other helminth infections during transit through lung tissue.
Hepatobiliary signals:
• Heaviness or pain in the right hypochondrium
• Episodes of jaundice of the skin and sclera
Some parasites affect the bile ducts and liver parenchyma, requiring not just antiparasitic, but comprehensive gastroenterological management.
Changes in food preferences:
• A pronounced craving for sweets and fast carbohydrates
Explanation: parasites actively consume glucose, indirectly creating an unusual and persistent craving for sugar in the patient.
SUMMARY FOR THE PHYSICIAN:
1. The primary drug is Albendazole; the other molecules serve as specialized tools.
2. The success of therapy depends not on the number of available drugs, but on the accuracy of diagnosis and the correct linking of symptoms to possible invasions.
3. Naturopathy is appropriate as a means of support, restoration, and correction of deficiencies, but not as a substitute for antiparasitic medications.
4. Any “vague” clinical picture associated with deficiencies, skin, and digestive symptoms warrants at least one direct question: could chronic parasitosis be lurking behind the scene?
BLOOD DIAGNOSTICS:
2.1. Total Eosinophils:
An elevation in eosinophils is characteristic of tissue and migratory parasitoses: toxocariasis, hookworm infections, strongyloidiasis, schistosomiasis.
Comment: normal eosinophil levels do not rule out parasitosis, but a high level almost always necessitates a search for parasites.
2.2. Total IgE:
A nonspecific but useful marker. An elevation is characteristic of helminth infections and allergic reactions to their metabolic products.
2.3. Serology (ELISA):
• Toxocara
• Strongyloides
• Echinococcus
• Schistosoma
• Fasciola
Serology is used when tissue and systemic invasions are suspected and stool examinations are less informative.
STOOL DIAGNOSTICS:
Standard Coproparasitological Examination:
A threefold stool analysis with 48-hour intervals. It detects eggs of ascarids, pinworms, whipworms, hookworms, giardia, and amoebae.
Comment: sensitivity is higher when samples are provided in series. A single routine test often misses parasites in mild invasions.
Giardia and Cryptosporidium Antigen Detection:
An enzyme immunoassay for detecting antigens. High sensitivity for giardiasis and cryptosporidiosis.
Comment: these tests are performed regularly, especially in pediatrics.
Detection of Proglottids and Tapeworm Fragments:
Search for fragments of tapeworm parasites. Used when taeniasis or diphyllobothriasis is suspected.
LIVER BIOCHEMISTRY:
These tests do not look for the parasite directly but help to recognize its consequences:
• Elevated bilirubin and GGT in cases of opisthorchiasis or bile duct involvement
• Chronic low ferritin in giardiasis, hookworm infections, and strongyloidiasis
DIAGNOSTIC LOGIC:
1. If the main symptom is gastrointestinal, start with a threefold stool analysis.
2. If pronounced eosinophilia is present, immediately add serology for Toxocara, strongyloides, and schistosomiasis.
3. If symptoms are systemic and chronic, add IgE, liver biochemistry, and panels for tissue helminths.
4. If nothing is found in the stool but the clinical picture persists, proceed with serology and PCR.
-----------------------------------------------------
In our laboratory, comprehensive diagnostics of parasitic diseases is performed using modern methods—ELISA, PCR, and microscopy.
We determine the presence of antibodies and DNA of the main pathogens causing helminthiases and protozoal infections.
Serological tests (ELISA, blood):
• Giardiasis – Giardia lamblia – total antibodies (IgG + IgM + IgA)
• Ascariasis – Ascaris lumbricoides – IgG antibodies
• Toxocariasis – Toxocara canis – IgG antibodies
• Opisthorchiasis – Opisthorchis felineus – IgG antibodies
• Echinococcosis – Echinococcus granulosus – antibodies (IgG + IgA)
• Trichinellosis – Trichinella spiralis – antibodies (IgG + IgA)
PCR Panels for the Detection of Parasite DNA (qualitative determination, stool):
“Intestinal Helminths” Panel (9 pathogens):
Enterocytozoon spp./Encephalitozoon spp., Strongyloides spp., Hymenolepis spp., Ascaris spp., Taenia spp., Trichuris trichiura, Ancylostoma spp., Enterobius vermicularis, Necator americanus.
“Intestinal Protozoa” Panel (6 pathogens):
Giardia lamblia, Entamoeba histolytica, Cryptosporidium spp., Blastocystis hominis, Dientamoeba fragilis, Cyclospora cayetanensis.
Additionally, stool concentration analysis (Parasep) is performed for the microscopic detection of parasite eggs and cysts.
For a comprehensive evaluation of the organism’s condition, the following may be ordered:
• Complete blood count (with differential);
• Urinalysis;
• Eosinophilic cationic protein (ECP) – an indicator of allergic and parasitic reaction activity;
• Total Immunoglobulin E (IgE);
• Liver panel (total protein, albumin, bilirubin, ALT, AST, alkaline phosphatase, GGT).
Additional examinations (additional fee):
• Anisakis simplex or herring worm, antibodies / Anisakis simplex (by L. Redgera, Germany)
(Indirect Immunofluorescence Test (IIFT)) – a qualitative indirect immunofluorescence assay.
Indications: When symptoms of anisakiasis occur (abdominal pain, nausea, and vomiting, along with skin rashes and itching after consumption of raw fish);
Also indicated in patients with a relevant occupational history (fishermen, fish vendors, chefs) or dietary habits (consumption of raw marine fish or squid).
• Fecal Calprotectin (stool)
Calprotectin is a protein released by leukocytes during inflammation.
High levels in stool → indicate an inflammatory process in the intestines.
• Occult Blood in Stool
This test detects microscopic bleeding in the gastrointestinal tract that is not visible to the naked eye.
• Pancreatic Elastase (stool)
Used for diagnosing exocrine pancreatic insufficiency, chronic pancreatitis, and digestive disorders.
Research Methods:
• Microscopy – allows visual detection of parasite eggs and larvae.
• ELISA – detects antibodies to the most common pathogens.
• PCR diagnostics – identifies fragments of parasite DNA with high accuracy even at early stages of infection.
When is screening recommended?
• In cases of chronic fatigue, frequent allergies, skin rashes;
• When digestive disturbances and reduced immunity are present;
• Prior to pregnancy or elective surgeries;
• To monitor the effectiveness of administered treatment.
Our Advantages:
• Modern laboratory equipment and certified reagents;
• High accuracy, reliability, and rapid turnaround of tests;
• Convenient online access to results;
• The possibility to obtain a consultation with an infectious disease specialist and a comprehensive report.
