Stanford School of Medicine
Clinical Microbiology In the Department of Pathology
 Strongyloides sputum combined with Combi Stool DFA
 Parasites are detected using enzyme immunoassays, fluorescent stains and conventional methods.

Parasitology

Routine ova and parasite examination: Stools are concentrated, stained with special stains, and examined microscopically for ova and parasites.  Other samples (sputum, eye scrapings, liver aspirates, etc.) can also be examined or in some cases cultured (such as for Acanthamoeba) for parasites if the laboratory is notified in advance.  Two stools collected on two separate days are recommended.

Giardia antigen detection by enzyme immunoassay: Stool submitted in preservative is tested weekly for Giardia antigen in a microtiter format.  Giardia is the most common parasitic cause of diarrhea in the U.S. This test is at least twice as sensitive as conventional ova and parasite examinations for Giardia detection and should be ordered first if Giardia is in the differential.

Giardia and Cryptosporidian direct fluorescent antibody stain: Cryptosporidium causes travelers’ diarrhea and can cause protracted diarrhea in immunocompromised patients.  Both Giardia and Cryptosporidium cysts can be visualized with this stain, which is more sensitive than conventional examination methods.

Worm and tick identification: Worms and ticks submitted in a container with a moist cotton ball are identified based on visual macroscopic and microscopic characteristics.  In addition, ticks are sent to a public health laboratory for more specialized studies.

Microsporidium and Isospora special stains: These unusual parasitic agents of diarrhea, almost exclusively in immunocompromised patients, are detected using a modified acid fast/trichrome stain combination.

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