Contents -- Preface -- Acknowledgments -- SECTION 1 Philosophy and Approach to Diagnostic Parasitology -- Why Perform This Type of Testing? -- Travel -- Population Movements -- Control Issues -- Global Warming -- Epidemiologic Considerations -- Compromised Patients -- Approach to Therapy -- Who Should Perform Diagnostic Parasitology Testing? -- Laboratory Personnel -- Nonlaboratory Personnel -- Where Should Diagnostic Parasitology Testing Be Performed? -- Inpatient Setting -- Outpatient or Referral Setting -- Decentralized Testing -- Physician Office Laboratories -- Over-the-Counter (Home Care) Testing -- Field Sites -- What Factors Should Precipitate Testing? -- Travel and Residence History -- Immune Status of the Patient -- Clinical Symptoms -- Documented Previous Infection -- Contact with Infected Individuals -- Potential Outbreak Testing -- Occupational Testing -- Therapeutic Failure -- What Testing Should Be Performed? -- Routine Tests -- Special Testing -- Other (Nonmicrobiological) Testing -- What Factors Should Be Considered When Developing Test Menus? -- Physical Plant -- Client Base -- Customer Requirements and Perceived Levels of Service -- Personnel Availability and Level of Expertise -- Equipment -- Budget -- Risk Management Issues Associated with STAT Testing -- Primary Amebic Meningoencephalitis -- Granulomatous Amebic Encephalitis and Amebic Keratitis -- Request for Blood Films -- SECTION 2 Parasite Classification and Relevant Body Sites -- Protozoa (Intestinal) -- Amebae -- Flagellates -- Ciliates -- Coccidia -- Microsporidia -- Protozoa (Other Body Sites) -- Amebae -- Flagellates -- Coccidia -- Microsporidia -- Protozoa (Blood and Tissue) -- Sporozoa -- Flagellates -- Nematodes (Intestinal) -- Nematodes (Tissue) -- Nematodes (Blood and Tissue) -- Cestodes (Intestinal) -- Cestodes (Tissue) -- Trematodes (Intestinal).

Trematodes (Liver and Lungs) -- Trematodes (Blood) -- Pentastomids -- Acanthocephala -- Table 2.1 Classification of Human Parasites -- Table 2.2 Cosmopolitan Distribution of Common Parasitic Infections -- Table 2.3 Body Sites and Possible Parasites Recovered -- SECTION 3 Collection Options -- Safety -- Collection of Fresh Stool Specimens -- Collection Method -- Number of Specimens To Be Collected -- Collection Times -- Posttherapy Collection -- Specimen Type, Stability, and Need for Preservation -- Preservation of Stool Specimens -- Overview of Preservatives -- Formalin -- Sodium Acetate-Acetic Acid-Formalin (SAF) -- Schaudinn's Fluid -- Polyvinyl Alcohol (PVA) -- Modified PVA (Mercury Substitutes) -- Single-Vial Collection Systems (Other Than SAF) -- Quality Control for Preservatives -- Procedure Notes for Use of Preservatives (Stool Fixative Collection Vials) -- Procedure Limitations for Use of Preservatives (Stool Fixative Collection Vials) -- Collection of Blood -- Collection and Processing -- STAT Test Requests and Risk Management Issues -- Collection of Specimens from Other Body Sites -- Table 3.1 Fecal Specimens for Parasites: Options for Collection and Processing -- Table 3.2 Approaches to Stool Parasitology: Test Ordering -- Table 3.3 Preservatives and Procedures Commonly Used in Diagnostic Parasitology (Stool Specimens) -- Table 3.4 Advantages of Thin and Thick Blood Films -- Table 3.5 Advantages and Disadvantages of Buffy Coat Films -- Table 3.6 Potential Problems of Using EDTA Anticoagulant for the Preparation of Thin and Thick Blood Films -- Table 3.7 Body Sites and Possible Parasites Recovered -- SECTION 4 Specimen Test Options: Routine Diagnostic Methods and Body Sites -- Ova and Parasite Examination of Stool Specimens -- Other Diagnostic Methods for Stool Specimens -- Culture of Larval-Stage Nematodes.

Estimation of Worm Burdens through Egg Counts -- Hatching Test for Schistosome Eggs -- Screening Stool Samples for Recovery of a Tapeworm Scolex -- Testing of Other Intestinal Tract Specimens -- Examination for Pinworm -- Sigmoidoscopy Material -- Duodenal Drainage Material -- Duodenal Capsule Technique (Entero-Test) -- Urogenital Tract Specimens -- Sputum -- Aspirates -- Biopsy Specimens -- Blood -- Thin Blood Films -- Thick Blood Films -- Blood Staining Methods -- Buffy Coat Films -- QBC Microhematocrit Centrifugation Method -- Knott Concentration -- Membrane Filtration Technique -- Culture Methods -- Animal Inoculation and Xenodiagnosis -- Antibody and Antigen Detection -- Antibody Detection -- Antigen Detection and Nucleic Acid-Based Tests -- Intradermal Tests -- Table 4.1 Body Site, Procedures and Specimens, Recommended Methods and Relevant Parasites, and Comments -- Table 4.2 Serologic, Antigen, and Probe Tests Used in the Diagnosis of Parasitic Infections -- SECTION 5 Specific Test Procedures and Algorithms -- Microscopy -- CALIBRATION OF THE MICROSCOPE -- Ova and Parasite Examination -- DIRECT WET FECAL SMEAR -- SEDIMENTATION CONCENTRATION (Formalin-Ethyl Acetate) -- FLOTATION CONCENTRATION (Zinc Sulfate) -- PERMANENT STAINED SMEAR -- Stains Used in the Permanent Stained Smear -- TRICHROME STAIN (Wheatley's Method) -- IRON HEMATOXYLIN STAIN (Spencer-Monroe Method) -- IRON HEMATOXYLIN STAIN (Tompkins-Miller Method) -- MODIFIED IRON HEMATOXYLIN STAIN (Incorporating the Carbol Fuchsin Step) -- POLYCHROME IV STAIN -- CHLORAZOL BLACK E STAIN -- Specialized Stains for Coccidia and Microsporidia -- KINYOUN'S ACID-FAST STAIN (Cold Method) -- MODIFIED ZIEHL-NEELSEN ACID-FAST STAIN (Hot Method) -- CARBOL FUCHSIN NEGATIVE STAIN FOR CRYPTOSPORIDIUM (W. L. Current) -- RAPID SAFRANIN METHOD FOR CRYPTOSPORIDIUM (D. Baxby).

RAPID SAFRANIN METHOD FOR CYCLOSPORA, USING A MICROWAVE OVEN (Govinda Visvesvara) -- AURAMINE O STAIN FOR COCCIDIA (Thomas Hänscheid) -- MODIFIED TRICHROME STAIN FOR MICROSPORIDIA (Weber, Green Counterstain) -- MODIFIED TRICHROME STAIN FOR MICROSPORIDIA (Ryan, Blue Counterstain) -- MODIFIED TRICHROME STAIN FOR MICROSPORIDIA (Evelyn Kokoskin, Hot Method) -- Fecal Immunoassays for Intestinal Protozoa -- Entamoeba histolytica -- Cryptosporidium spp. -- Giardia lamblia -- Kits under Development -- Comments on the Performance of Fecal Immunoassays -- Larval Nematode Culture -- HARADA-MORI FILTER PAPER STRIP CULTURE -- BAERMANN CONCENTRATION -- AGAR PLATE CULTURE FOR STRONGYLOIDES STERCORALIS -- Other Methods for Gastrointestinal Tract Specimens -- EXAMINATION FOR PINWORM (Cellulose Tape Preparations) -- SIGMOIDOSCOPY SPECIMENS (Direct Wet Smear) -- SIGMOIDOSCOPY SPECIMENS (Permanent Stained Smear) -- DUODENAL ASPIRATES -- Methods for Urogenital Tract Specimens -- RECEIPT OF DRY SMEARS -- DIRECT SALINE MOUNT -- PERMANENT STAINED SMEAR -- URINE CONCENTRATION (Centrifugation) -- URINE CONCENTRATION (Nuclepore Membrane Filter) -- Preparation of Blood Films -- THIN BLOOD FILMS -- THICK BLOOD FILMS -- COMBINATION THICK-THIN BLOOD FILMS -- BUFFY COAT BLOOD FILMS -- Blood Stains -- GIEMSA STAIN -- Blood Concentration -- BUFFY COAT CONCENTRATION -- KNOTT CONCENTRATION -- MEMBRANE FILTRATION CONCENTRATION -- Algorithm 5.1 Procedure for Processing Fresh Stool for the O&P Examination -- Algorithm 5.2 Procedure for Processing Liquid Specimens for the O&P Examination -- Algorithm 5.3 Procedure for Processing Preserved Stool for the O&P Examination-Two-Vial Collection Kit -- Algorithm 5.4 Procedure for Processing SAF-Preserved Stool for the O&P Examination -- Algorithm 5.5 Use of Various Fixatives and Their Recommended Stains.

Algorithm 5.6 Ordering Algorithm for Laboratory Examination for Intestinal Parasites -- Algorithm 5.7 Procedure for Processing Blood Specimens for Examination -- Table 5.1 Body Site, Specimen, and Recommended Stain(s) -- Table 5.2 Approaches to Stool Parasitology: Test Ordering -- Table 5.3 Laboratory Test Reports: Optional Comments -- Table 5.4 Parasitemia Determined from Conventional Light Microscopy: Clinical Correlation -- SECTION 6 Commonly Asked Questions about Diagnostic Parasitology -- Stool Parasitology -- Specimen Collection -- Specimen Processing -- Diagnostic Methods -- Stool Immunoassay Options -- Organism Identification -- Reporting -- Proficiency Testing -- Tissues or Fluids -- Blood -- Specimen Collection -- Specimen Processing -- Diagnostic Methods -- Organism Identification -- Reporting -- Proficiency Testing -- General Questions -- SECTION 7 Parasite Identification -- Protozoa -- Amebae (Intestinal) -- Flagellates (Intestinal) -- Ciliates (Intestinal) -- Coccidia (Intestinal) -- Microsporidia (Intestinal) -- Sporozoa (Blood and Tissue) -- Flagellates (Blood and Tissue) -- Amebae (Other Body Sites) -- Flagellates (Other Body Sites) -- Nematodes -- Intestinal -- Tissue -- Blood and Tissue -- Cestodes -- Intestinal -- Tissue -- Trematodes -- Intestinal -- Liver and Lungs -- Blood -- SECTION 8 Identification Aids -- Tables 8.1 to 8.37 -- Identification Keys 8.1 to 8.4 -- Figures 8.1 to 8.3 -- Plates 8.1 to 8.4 -- Index -- A -- B -- C -- D -- E -- F -- G -- H -- I -- K -- L -- M -- N -- O -- P -- Q -- R -- S -- T -- U -- V -- W -- X -- Y -- Z.