During the past few years, the field of diagnostic medical parasitology has seen dramatic changes including newly recognized human parasites, alternative techniques required by new regulatory requirements, reevaluation of diagnostic test options and ordering algorithms, implementation of testing based on molecular techniques, reporting formats, coding and billing requirements, managed care relevancy, increased need for consultation and educational initiatives for clients, and an overall increased awareness of parasitic infections. We have seen organisms like the microsporidia change from the status of "unusual parasitic infection" to being widely recognized as one of the most important infections in both immunocompetent and compromised patients. More sensitive diagnostic methods for organism detection in stool specimens are now commercially available for Entamoeba histolytica, Entamoeba histolytica/E. dispar, Giardia lamblia, Cryptosporidium parvum, and Trichomonas vaginalis. We have seen Cyclospora cayetanensis coccidia become well recognized as the cause of diarrhea in immunocompetent and immunocompromised humans. We continue to see new disease presentations in the compromised patient; a good example is granulomatous amebic encephalitis caused by Acanthamoeba spp. and Balamuthia mandrillaris.

This section on CURRENT ISSUES will contain a discussion of specific topics that are timely and relevant for the field of diagnostic medical parasitology. The first topic that will be discussed is related to the ordering options for stool parasitology and how one incorporates the new immunoassays into the laboratory menu, along with the routine Ova and Parasite Examination.