- Parasite Classification |
- Parasite, Body Site |
- Stool Testing Order Recommendations |
- STAT Testing |
- Fecal Fixatives |
- Stool Collection Options |
- Report Comments |
- Tips for Fecal ImmunoAssay |
- Malaria (5 Species) |
- Malaria (5 Species) Images |
- Rapid Malaria Testing |
- Malaria Parasitemia Method |
- Malaria Parasitemia Interpretation |
stool testing order recommendations (for physicians)
Patient and/or Situation |
Test Ordereda
|
Follow-up Test Ordered |
wPatient with diarrhea and AIDS or other cause of immune deficiency wPotential waterborne outbreak (municipal/city water supply) |
Cryptosporidium or Giardia/Cryptosporidium immunoassay
|
If immunoassays are negative and symptoms continue, special tests for microsporidia (modified trichrome stain) and other coccidia (modified acid-fast stain) and O&P exam should be performed
|
wPatient with diarrhea (nursery school, day care center, camper, backpacker) wPatient with diarrhea and potential waterborne outbreak (resort setting) wPatient with diarrhea from areas where Giardia is the most common parasite found
|
Giardia or Giardia/Cryptosporidium immunoassay (perform testing on two stools before reporting as negative)
Particularly relevant for areas of the U.S. where Giardia most common organism found |
If immunoassays are negative and symptoms continue, special tests for microsporidia and other coccidia (see above) and O&P exam should be performed
|
wPatient with diarrhea and relevant travel history wPatient with diarrhea who is a past or present resident of a developing country wPatient in an area of the United States where parasites other than Giardia are found
|
O&P exam, Entamoeba histolytica/E. dispar immunoassay; immunoassay for confirmation of E. histolytica; various tests for Strongyloides may be relevant (even in the absence of eosinophilia) |
If exams are negative and symptoms continue, special tests for coccidia and microsporidia should be performed |
wPatient with unexplained eosinophilia and possible diarrhea; if chronic, patient may also have history of respiratory problems (larval migration) and/or sepsis or meningitis (hyperinfection)
|
Although the O&P exam is a possibility, the agar plate culture for Strongyloides stercoralis (more sensitive than the O&P exam) is recommended |
If tests are negative and symptoms continue, additional O&P exams and special tests for microsporidia and other coccidia should be performed
|
wPatient with diarrhea (suspected food-borne outbreak) |
Test for Cyclospora cayetanensis (modified acid-fast stain, autofluorescence) |
If tests are negative and symptoms continue, special procedures for microsporidia and other coccidia and O&P exam should be performed
|
aDepending on the particular immunoassay kit used, various single or multiple organisms may be included. Selection of a particular kit depends on many variables: clinical relevance, cost, ease of performance, training, personnel availability, number of test orders, training of physician clients, sensitivity, specificity, equipment, time to result, etc. Very few laboratories will handle this type of testing exactly the same. Many options are clinically relevant and acceptable for good patient care. It is critical that the laboratory report indicate specifically which organisms could be identified using the kit; a negative report should list the organisms relevant to that particular kit.