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Stool
Testing Recommendations
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- Patient
with diarrhea and AIDS (or immunocompromised from other
causes) or potential waterborne outbreak situation (municipal
water supply). ORDER:
Cryptosporidium or Giardia/Cryptosporidium
immunoassay. FOLLOWUP: If immunoassay is negative
and the patient continues to be symptomatic, perform
special procedures for the microsporidia and other coccidia;
perform the O&P examination.
- Patient
with diarrhea (nursery school, day care center, camper,
backpacker) or potential waterborne outbreak (resort setting).
ORDER: Giardia or Giardia/Cryptosporidium
immunoassay. FOLLOWUP: If immunoassay is
negative and the patient continues to be symptomatic,
perform special procedures for the microsporidia and other
coccidia; perform the O&P exam.
- Patient
with diarrhea and relevant travel history; past or present
resident of a developing country; within an area of the
U.S. where parasites other than Giardia are found;
or has unexplained eosinophilia (suspicious of Strongyloides).
ORDER: O&P exam; immunoassay for Entamoeba
histolytica/E. dispar group; confirmation for E.
histolytica. FOLLOWUP: If the O&P exams
are negative and the patient continues to be symptomatic,
perform special procedures for coccidia and microsporidia.
- Patient
with diarrhea (suspected foodborne outbreak). ORDER:
Special stains for the detection of Cyclospora cayetanensis.
FOLLOWUP: If the modified acid-fast smears are
negative and the patient continues to be symptomatic,
perform special procedures for the microsporidia and other
coccidia; perform the O&P exam.
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