TY - BOOK AU - Garcia,Lynne Shore ED - American Society for Microbiology. TI - Practical guide to diagnostic parasitology SN - 9781683670391 AV - QR255 U1 - 616.9/6075 23 PY - 2021/// CY - Hoboken, NJ PB - Wiley KW - Parasitic Diseases KW - diagnosis KW - Clinical Laboratory Techniques KW - Electronic books N1 - Lynne Shore Garcia is the director of LSG & Associates, a firm providing training, teaching, and consultation services for diagnostic medical parasitology and health care administration. A former manager of the UCLA Clinical Microbiology Laboratory, she is a sought-after speaker (nationally and internationally) and author of hundreds of articles, book chapters, and books including two ASM Press books, Clinical Laboratory Management, Second Edition and Diagnostic Medical Parasitology, Sixth Edition; Includes bibliographical references and index; TABLE OF CONTENTS Preface xix About the Author xxiii Section 1 Philosophy and Approach to Diagnostic Parasitology 1 Neglected Tropical Diseases 2 Why Perform Diagnostic Parasitology Testing? 3 Travel 3 Population Movements 3 Control Issues 4 Climate Change 4 Epidemiologic Considerations 4 Compromised Patients; Potential Sex Bias Regarding Infection Susceptibility; Aging 4 Approach to Therapy 5 Who Should Perform Diagnostic Parasitology Testing? 5 Laboratory Personnel 5 Nonlaboratory Personnel 5 Where Should Diagnostic Parasitology Testing Be Performed? 6 Inpatient Setting 6 Outpatient or Referral Setting 6 Decentralized Testing 6 Physician Office Laboratories 6 Over-the-Counter (Home Care) Testing 7 Field Sites 7 What Factors Should Precipitate Testing? 7 Travel and Residence History 7 Immune Status of the Patient 7 Clinical Symptoms 7 Documented Previous Infection 7 Contact with Infected Individuals 8 Potential Outbreak Testing 8 Occupational Testing 8 Therapeutic Failure 8 What Testing Should Be Performed? 8 Routine Tests 8 Special Testing and Reference Laboratories 9 Specialized Referral Test Options—DPDx and Other Sites 9 Other (Nonmicrobiological) Testing 10 What Factors Should Be Considered in Development of Test Menus? 10 Physical Plant 10 Client Base 10 Customer Requirements and Perceived Levels of Service 10 Personnel Availability and Level of Expertise 10 Equipment 10 Budget 11 Risk Management Issues Associated with Stat Testing 11 Primary Amebic Meningoencephalitis 11 Granulomatous Amebic Encephalitis and Amebic Keratitis 14 Request for Blood Films 15 Automated Instrumentation 15 Patient Information 16 Conventional Microscopy 16 Table 1.1 Common features of the neglected tropical diseases 18 Section 2 Parasite Classification and Relevant Body Sites 19 Protozoa (Intestinal) 20 Amebae, Stramenopiles 20 Flagellates 22 Ciliates 22 Apicomplexa (Including Coccidia) 23 Microsporidia (Now Classified with the Fungi) 23 Protozoa (Other Body Sites) 24 Amebae 24 Flagellates 24 Apicomplexa (Including Coccidia) 24 Microsporidia (Now Classified with the Fungi) 25 Protozoa (Blood and Tissue) 26 Apicomplexa (Including Sporozoa) 26 Flagellates 26 Nematodes (Intestinal) 29 Nematodes (Tissue) 29 Nematodes (Blood and Tissue) 30 Cestodes (Intestinal) 31 Cestodes (Tissue) 32 Trematodes (Intestinal) 33 Trematodes (Liver and Lungs) 33 Trematodes (Blood) 35 Pentastomids 35 Acanthocephala 36 Table 2.1 Classification of human parasites 37 Table 2.2 Cosmopolitan distribution of common parasitic infections 39 Table 2.3 Body sites and possible parasites recovered 40 Section 3 Collection Options 43 Safety 44 Collection of Fresh Stool Specimens 44 Collection Method 44 Number of Specimens To Be Collected 45 Collection Times 47 Posttherapy Collection 47 Specimen Type, Stability, and Need for Preservation 47 Preservation of Stool Specimens 48 Overview of Preservatives 48 Formalin 49 Sodium Acetate-Acetic Acid-Formalin (SAF) 50 Schaudinn’s Fluid 51 Schaudinn’s Fluid containing PVA (Mercury Base) 52 Schaudinn’s Fluid containing PVA (Copper Base, Zinc Base) 52 Single-Vial Collection Systems (Other than SAF) 53 Universal Fixative (Total-Fix) 54 Quality Control for Preservatives 54 Procedure Notes for Use of Preservatives (Stool Fixative Collection Vials) 55 Procedure Limitations for Use of Preservatives (Stool Fixative Collection Vials) 55 Collection of Blood 56 Collection and Processing 56 Stat Test Requests and Risk Management Issues 57 Collection of Specimens from Other Body Sites 57 Table 3.1 Fecal specimens for parasites: options for collection and processing 58 Table 3.2 Approaches to stool parasitology: test ordering 61 Table 3.3 Preservatives and procedures commonly used in diagnostic parasitology (stool specimens) 62 Table 3.4 Advantages of thin and thick blood films 64 Table 3.5 Advantages and disadvantages of buffy coat films 64 Table 3.6 Potential problems of using EDTA anticoagulant for the preparation of thin and thick blood films 65 Table 3.7 Body sites and possible parasites recovered (trophozoites, cysts, oocysts, spores, adults, larvae, eggs, amastigotes, and trypomastigotes) 66 Section 4 Specimen Test Options: Routine Diagnostic Methods and Body Sites 69 Ova and Parasite Examination of Stool Specimens 70 Other Diagnostic Methods for Stool Specimens 72 Culture of Larval-Stage Nematodes 72 Estimation of Worm Burdens through Egg Counts 73 Hatching Test for Schistosome Eggs 73 Screening Stool Samples for Recovery of a Tapeworm Scolex 74 Testing of Other Intestinal Tract Specimens 74 Examination for Pinworm 74 Sigmoidoscopy Material 75 Duodenal Drainage Material 76 Duodenal Capsule Technique (Entero-Test) 76 Urogenital Tract Specimens 77 Sputum 77 Aspirates 78 Biopsy Specimens 78 Blood 79 Thin Blood Films 79 Thick Blood Films 80 Blood Staining Methods 80 Buffy Coat Films 80 QBC Microhematocrit Centrifugation Method 80 Knott Concentration 81 Membrane Filtration Technique 81 Culture Methods 81 Animal Inoculation and Xenodiagnosis 82 Antibody and Antigen Detection 82 Antibody Detection 82 Antigen Detection, Nucleic Acid-Based Tests, and Molecular Panels 84 Intradermal Tests 84 UV Autofluorescence 84 Table 4.1 Body sites, procedures and specimens, recommended methods and relevant parasites, and comments 86 Table 4.2 Serologic, antigen, and probe tests used in the diagnosis of parasitic infections 94 Section 5 Specific Test Procedures and Algorithms 95 Microscopy 96 CALIBRATION OF THE MICROSCOPE 96 Ova and Parasite Examination 99 DIRECT WET FECAL SMEAR 99 CONCENTRATION (Sedimentation and Flotation) 104 SEDIMENTATION CONCENTRATION (Formalin-Ethyl Acetate) 105 SEDIMENTATION CONCENTRATION USING THE UNIVERSAL FIXATIVE (Total-Fix) 109 FLOTATION CONCENTRATION (Zinc Sulfate) 110 PERMANENT STAINED SMEAR 114 Stains Used in the Permanent Stained Smear 116 TRICHROME STAIN (Wheatley’s Method) 116 IRON HEMATOXYLIN STAIN (Spencer-Monroe Method) 122 IRON HEMATOXYLIN STAIN (Tompkins-Miller Method) 127 MODIFIED IRON HEMATOXYLIN STAIN (Incorporating the Carbol Fuchsin Step) 128 CHLORAZOL BLACK E STAIN 131 Specialized Stains for Coccidia and Microsporidia 132 KINYOUN’S ACID-FAST STAIN (Cold Method) 132 MODIFIED ZIEHL-NEELSEN ACID-FAST STAIN (Hot Method) 136 CARBOL FUCHSIN NEGATIVE STAIN FOR CRYPTOSPORIDIUM (W. L. Current) 139 RAPID SAFRANIN METHOD FOR CRYPTOSPORIDIUM (D. Baxby) 139 RAPID SAFRANIN METHOD FOR CYCLOSPORA, USING A MICROWAVE OVEN (Govinda Visvesvara) 139 AURAMINE O STAIN FOR APLICOMPLEXA (INCLUDING COCCIDIA) (Thomas Hänscheid) 140 MODIFIED TRICHROME STAIN FOR MICROSPORIDIA (Weber, Green Counterstain) 144 MODIFIED TRICHROME STAIN FOR MICROSPORIDIA (Ryan, Blue Counterstain) 146 MODIFIED TRICHROME STAIN FOR MICROSPORIDIA (Evelyn Kokoskin, Hot Method) 149 Fecal Immunoassays for Intestinal Protozoa 150 ENTAMOEBA HISTOLYTICA 150 CRYPTOSPORIDIUM SPP. 151 GIARDIA LAMBLIA 151 KITS UNDER DEVELOPMENT 151 COMMENTS ON THE PERFORMANCE OF FECAL IMMUNOASSAYS 151 ENZYME IMMUNOASSAYS (Antigen Detection, No Centrifugation Recommended) 152 FLUORESCENCE (Visual Identification of the Organisms, Centrifugation Recommended) 152 LATERAL-FLOW CARTRIDGES (Antigen Detection, No Centrifugation Recommended) 153 Larval Nematode Culture 153 HARADA-MORI FILTER PAPER STRIP CULTURE 153 BAERMANN CONCENTRATION 155 AGAR PLATE CULTURE FOR STRONGYLOIDES STERCORALIS 158 Other Methods for Gastrointestinal Tract Specimens 161 EXAMINATION FOR PINWORM (Cellulose Tape Preparations) 161 SIGMOIDOSCOPY SPECIMENS (Direct Wet Smear) 163 SIGMOIDOSCOPY SPECIMENS (Permanent Stained Smear) 166 DUODENAL ASPIRATES 168 Methods for Urogenital Tract Specimens 171 RECEIPT OF DRY SMEARS 171 DIRECT SALINE MOUNT 171 PERMANENT STAINED SMEAR 174 URINE CONCENTRATION (Centrifugation) 176 URINE CONCENTRATION (Nuclepore Membrane Filter) 179 Preparation of Blood Films 181 THIN BLOOD FILMS 182 THICK BLOOD FILMS 184 COMBINATION THICK-THIN BLOOD FILMS 186 RISK MANAGEMENT ISSUES ASSOCIATED WITH BLOOD FILMS 187 USE OF A REFERENCE LABORATORY FOR PARASITE BLOOD DIAGNOSTIC TESTING 188 BLOOD FILM REPORTING WITH ADDITIONAL REPORT COMMENTS 189 BUFFY COAT BLOOD FILMS 189 Blood Stains 190 STAIN OPTIONS 190 GIEMSA STAIN 190 Blood Concentration 194 BUFFY COAT CONCENTRATION 194 KNOTT CONCENTRATION 195 MEMBRANE FILTRATION CONCENTRATION 197 Algorithm 5.1 Procedure for processing fresh stool for the O&P examination 201 Algorithm 5.2 Procedure for processing liquid specimens for the O&P examination 202 Algorithm 5.3 Procedure for processing preserved stool for the O&P examination—two-vial collection kit 203 Algorithm 5.4 Procedure for processing SAF-preserved stool for the O&P examination 204 Algorithm 5.5 Procedure for the use of Total-Fix (universal fixative, single-vial system) (this fixative contains no mercury, no PVA, and no formalin) 205 ALTERNATE METHOD FOR SMEAR PREPARATION DIRECTLY FROM VIAL 206 Algorithm 5.6 Use of various fixatives and their recommended stains 207 Algorithm 5.7 Ordering algorithm for laboratory examination for intestinal parasites 208 Algorithm 5.8 Procedure for processing blood specimens for examination 209 Table 5.1 Body sites, specimens, and recommended stains 210 Table 5.2 Approaches to stool parasitology: test ordering 214 Table 5.3 Laboratory test reports: notes and optional comments 215 Table 5.4 Parasitemia determined from conventional light microscopy: clinical correlation 216 Section 6 Commonly Asked Questions about Diagnostic Parasitology 217 Stool Parasitology 218 Specimen Collection 218 Specimen Processing 221 Diagnostic Methods 222 Stool Immunoassay Options 227 MOLECULAR TEST PANELS (FDA CLEARED) 229 A. APTIMA Trichomonas vaginalis Assay 230 B. Affirm VPIII Microbial Identification Test 231 C. Cepheid Xpert TV Assay for Trichomonas vaginalis from Men and Women 232 D. BD MAX Enteric Parasite Panel 233 E. BioFire FilmArray Gastrointestinal Panel 234 F. Luminex (Verigene II GI Flex Assay; Includes Parasites) 236 G. Other Pending Molecular Tests 238 Organism Identification 238 Reporting 242 Proficiency Testing 245 Tissues or Fluids 245 Blood 246 Specimen Collection 246 Specimen Processing 248 Diagnostic Methods 249 Organism Identification 254 Reporting 256 Proficiency Testing 257 General Questions 258 Section 7 Parasite Identification 265 Protozoa Amebae (Intestinal) 266 Entamoeba histolytica 266 Entamoeba histolytica/Entamoeba dispar 270 Comments on Entamoeba moshkovskii and Entamoeba bangladeshi 273 Entamoeba bangladeshi 274 Entamoeba hartmanni 275 Entamoeba coli 278 Entamoeba gingivalis 281 Entamoeba polecki 283 Endolimax nana 284 Iodamoeba bütschlii 287 Blastocystis spp. (formerly Blastocystis hominis) 290 Flagellates (Intestinal) Giardia lamblia (G. duodenalis, G. intestinalis) 295 Dientamoeba fragilis 298 Chilomastix mesnili 302 Pentatrichomonas hominis 304 Enteromonas hominis, Retortamonas intestinalis 307 Ciliates (Intestinal) 310 Balantidium coli 310 Apicomplexa (Intestinal) 315 Cryptosporidium spp. 315 Coccidia (Intestinal) 319 Cyclospora cayetanensis 319 Cystoisospora (formerly Isospora) belli 323 Microsporidia (Intestinal) 326 Enterocytozoon bieneusi 326 Encephalitozoon intestinalis, Encephalitozoon spp. 329 Sporozoa (Blood and Tissue) 334 Plasmodium vivax 334 Plasmodium falciparum 339 Plasmodium malariae 343 Plasmodium ovale wallickeri, Plasmodium ovale curtisi 346 Plasmodium knowlesi 350 Malaria 353 Babesia spp. (Babesia microti, B. duncani, B. divergens, B. venatorum) 355 Toxoplasma gondii 359 Flagellates (Blood and Tissue) 368 Leishmania spp. 368 Trypanosoma brucei gambiense (West), T. brucei rhodesiense (East) 372 Trypanosoma cruzi 376 Amebae (Other Body Sites) 381 Naegleria fowleri 381 Acanthamoeba spp., Balamuthia mandrillaris, Sappinia diploidea 385 Flagellates (Other Body Sites) 389 Trichomonas vaginalis 389 NEMATODES 392 Intestinal 392 Ascaris lumbricoides 392 Trichuris trichiura, Capillaria philippinensis 395 Necator americanus, Ancylostoma duodenale, Ancylostoma ceylanicum (Hookworms); Trichostrongylus spp. 398 Strongyloides stercoralis 401 Enterobius vermicularis 404 Tissue 407 Ancylostoma braziliense, Ancylostoma caninum, Uncinaria stenocephala (Dog and Cat Hookworms) 407 Toxocara canis, Toxocara cati (Dog and Cat Ascarid Worms) 410 Dracunculus medinensis 413 Trichinella spiralis 416 Blood and Tissue 419 Filarial Worms 419 CESTODES 425 Intestinal 425 Taenia saginata 425 Taenia solium 428 Diphyllobothrium latum 432 Hymenolepis (Rodentolepis) nana 435 Hymenolepis diminuta 438 Dipylidium caninum 440 Tissue 443 Echinococcus granulosus, Echinococcus multilocularis, Echinococcus vogeli, Echinococcus oligarthrus 443 TREMATODES 448 Intestinal 448 Fasciolopsis buski 448 Liver and Lungs 451 Paragonimus westermani, Paragonimus mexicanus, Paragonimus kellicotti 451 Fasciola hepatica 454 Clonorchis (Opisthorchis) sinensis (Chinese liver fluke) 457 Blood 460 Schistosoma spp. (Schistosoma mansoni, S. haematobium, S. japonicum, S. mekongi, S. malayensis, S. intercalatum) 460 Section 8 Common Problems in Parasite Identification 465 Table 8.1 Entamoeba sp. trophozoites versus macrophages 486 Table 8.2 Entamoeba sp. cysts versus PMNs 486 Table 8.3 Entamoeba histolytica versus Entamoeba coli precysts and cysts 487 Table 8.4 Endolimax nana versus Dientamoeba fragilis 488 Section 9 Identification Aids 489 DIAGNOSTIC CONSIDERATIONS 490 Table 9.1 Rapid diagnostic procedures 490 Table 9.2 Diagnostic characteristics for organisms in wet mounts (direct or concentration sediment) 491 Table 9.3 Diagnostic characteristics for organisms in permanent stained smears (e.g., Wheatley’s trichrome, iron-hematoxylin) 491 Identification Key 9.1 Identification of intestinal amebae (permanent stained smear) 491 Identification Key 9.2 Identification of intestinal flagellates 492 Identification Key 9.3 Identification of helminth eggs 493 Identification Key 9.4 Identification of microfilariae 494 PROTOZOA 495 Table 9.4 Intestinal protozoa: trophozoites of common amebae 495 Table 9.5 Intestinal protozoa: cysts of common amebae 497 Table 9.6 Intestinal protozoa: trophozoites of less common amebae 499 Table 9.7 Intestinal protozoa: cysts of less common amebae 499 Table 9.8 Morphologic criteria used to identify Blastocystis spp. 500 Table 9.9 Intestinal protozoa: trophozoites of flagellates 501 Table 9.10 Intestinal protozoa: cysts of flagellates 502 Table 9.11 Intestinal protozoa: ciliate (Balantidium coli) 503 Table 9.12 Apicomplexa 503 Table 9.13 Microsporidia (related to the Fungi): general information 504 Table 9.14 Microsporidia: recommended diagnostic techniques 505 Table 9.15 Comparison of Naegleria fowleri, Acanthamoeba spp., Balamuthia mandrillaris, and Sappinia diploidea 506 Table 9.16 Characteristics of Trichomonas vaginalis 507 Table 9.17 Key characteristics of intestinal tract and urogenital system protozoa 508 HELMINTHS 512 Table 9.18 Normal life spans of the most common intestinal nematodes 512 Table 9.19 Characteristics of the most common intestinal nematodes 513 Table 9.20 Tissue nematodes 515 Table 9.21 Trichinella spiralis: life cycle stages and clinical conditions 517 Table 9.22 Characteristics of human microfilariae 518 Table 9.23 Characteristics of cestode parasites (intestinal) 519 Table 9.24 Tissue cestodes 521 Table 9.25 Characteristics of intestinal trematodes 523 Table 9.26 Characteristics of liver and lung trematodes 524 Table 9.27 Human paragonimiasis 526 Table 9.28 Characteristics of blood trematodes 527 Table 9.29 Key characteristics of helminths 528 BLOOD PARASITES 532 Table 9.30 Malaria characteristics with fresh blood or EDTA-blood 532 Table 9.31 Potential problems with using EDTA anticoagulant for the preparation of thin and thick blood films 533 Table 9.32 Plasmodia in Giemsa-stained thin blood smears 534 Table 9.33 Relevant issues for handling requests for identification of infectious blood parasites 537 Table 9.34 Features of human leishmanial infections 540 Table 9.35 Characteristics of American trypanosomiasis 541 Table 9.36 Characteristics of East and West African trypanosomiasis 541 Table 9.37 Key characteristics of blood parasites 541 Index 547 N2 - "As we move forward into the 21st century, the field of diagnostic medical parasitology continues to see some dramatic changes, including newly recognized pathogens, changing endemicity of familiar pathogens, disease control challenges, geographic and climate changes that support the spread of parasitic disease, new methodologies, expansion of diagnostic testing, and an ongoing review of the approach to and clinical relevance of this type of diagnostic testing on patient care within the managed care environment, as well as the world as a whole. The third edition of the Practical Guide to Diagnostic Parasitology is organized to provide maximum help to the user, particularly from the bench use perspective. New aspects of the field have been addressed in these sections, and many new figures and plates have been added, including extensive color images. Section 1 on the philosophy and approach to diagnostic parasitology has been expanded to include discussions on neglected tropical diseases, the impact of global climate change, population movements, potential outbreak testing, the development of laboratory test menus, and the risk management issues related to "stat" testing. The Section 2 discussion of organism classification and relevant tables has been expanded and updated to provide the user with current information related to changes in nomenclature and overall importance of the various parasite categories to human infection"-- UR - https://onlinelibrary.wiley.com/doi/book/10.1128/9781683673637 ER -