Description
American Society for Microbiology Practical Guide To Diagnostic Parasitology 3rd Edition 2021 by Lynne Shore Garcia
In the 21st century the field of diagnostic medical parasitology continues to see dramatic changes, including newly recognized pathogens and the changing endemicity and classification of familiar organisms; neglected tropical diseases and the impact of global climate change; and new methodologies and risk management issues. This classic clinical laboratory parasitology reference, now in its third edition, has been extensively revised and updated in a new full-color format. Still organized to provide maximum help to the user, particularly from the bench perspective, every section has been expanded with new images and discussion. Specimen collection, preservation, and testing options are thoroughly discussed, from the routine ova and parasite examination to blood films, fecal immunoassays, and the newer molecular test panels. Specific test procedures, laboratory methods and reagents, and algorithms are provided. The ever-helpful 'FAQ' section of commonly asked questions now offers expanded information on stool specimen fixatives and testing, thorough coverage of new techniques, and advice on reporting and commenting on results. The heart of the Guide, covering identification of individual pathogens, has been expanded with more discussion and comparison of organisms and dozens of new color images. An entirely new section has been added that uses extensive figures and new tables to illustrate common problems with differentiating organisms from one another and from possible microscopic artifacts. The final section has been reorganized to include identification keys and dozens of tables summarizing organism characteristics to assist the bench microbiologist with routine diagnostic testing methods. Garcia 3e TOC draft from mssPreface 000Acknowledgments 000SECTION 1 Philosophy and Approach to Diagnostic ParasitologyNeglected Tropical DiseasesWhy Perform Diagnostic Parasitology Testing?TravelPopulation MovementsControl IssuesGlobal Climate ChangeEpidemiologic ConsiderationsCompromised Patients; Potential Sex Bias Regarding Infection Susceptibility, AgingApproach to TherapyWho Should Perform Diagnostic Parasitology Testing?Laboratory PersonnelNonlaboratory PersonnelWhere Should Diagnostic Parasitology Testing Be Performed?Inpatient SettingOutpatient or Referral SettingDecentralized TestingPhysician Office LaboratoriesOver-the-Counter (Home Care) TestingField SitesWhat Factors Should Precipitate Testing?Travel and Residence HistoryImmune Status of the PatientClinical SymptomsDocumented Previous InfectionContact with Infected IndividualsPotential Outbreak TestingOccupational TestingTherapeutic FailureWhat Testing Should Be Performed?Routine TestsSpecial Testing, Reference LaboratoriesSpecialized Referral Test Options: DPDx and Other SitesOther (Nonmicrobiological) TestingWhat Factors Should Be Considered When Developing Test Menus?Physical PlantClient BaseCustomer Requirements and Perceived Levels of ServicePersonnel Availability and Level of ExpertiseEquipmentBudgetRisk Management Issues Associated with Stat TestingPrimary Amebic Meningoencephalitis (PAM)Granulomatous Amebic Encephalitis and Amebic KeratitisRequest for Blood FilmsAutomated InstrumentationPatient InformationConventional MicroscopySECTION 2 Parasite Classification and Relevant Body SitesProtozoa (Intestinal)Amebae, Stramenopiles FlagellatesCiliatesApicomplexa (Including Coccodia)Microsporidia (Now Classified with the Fungi)Protozoa (Other Body Sites) AmebaeFlagellatesApicomplexa (Including Coccidia) Microsporidia (Now Classified with the Fungi)Protozoa (Blood and Tissue)Apicomplexa (Including Sporozoa)FlagellatesLeishmaniaeTrypanosomesNematodes (Intestinal)Nematodes (Tissue)Nematodes (Blood and Tissue) Cestodes (Intestinal)Cestodes (Tissue)Trematodes (Intestinal)Trematodes (Liver and Lungs)Trematodes (Blood)PentastomidsAcanthocephalaTable 2.1 Classification of human parasitesTable 2.2 Cosmopolitan distribution of common parasitic infections (North America, Mexico, Central America, South America, Europe, Africa, Asia, and Oceania)Table 2.3 Body sites and possible parasites recovered (trophozoites, cysts, oocysts, spores, adults, larvae, eggs, amastigotes, and trypomastigotes)SECTION 3 Collection OptionsSafetyCollection of Fresh Stool SpecimensCollection MethodNumber of Specimens To Be CollectedStandard ApproachDifferent ApproachesCollection TimesPosttherapy CollectionSpecimen Type, Stability, and Need for PreservationPreservation of Stool SpecimensOverview of PreservativesFormalinSodium Acetate-Acetic Acid-Formalin (SAF)Schaudinn's FluidSchaudinn's Fluid containing PVA (mercury base)Schaudinn's Fluid containing PVA (copper base, zinc base)Single-Vial Collection Systems (Other Than SAF)Universal Fixative (TOTAL-FIX)Quality Control for PreservativesProcedure Notes for Use of Preservatives (Stool Fixative Collection Vials)Procedure Limitations for Use of Preservatives (Stool Fixative Collection Vials)Collection of BloodCollection and ProcessingStat Test Requests and Risk Management IssuesCollection of Specimens from Other Body SitesTable 3.1 Fecal specimens for parasites: options for collection and processingaTable 3.2 Approaches to stool parasitology: test orderingTable 3.3 Preservatives and procedures commonly used in diagnostic parasitology (stool specimens)Table 3.4 Advantages of thin and thick blood filmsTable 3.5 Advantages and disadvantages of buffy coat filmsTable 3.6 Potential problems of using EDTA anticoagulant for the preparation of thin and thick blood filmsTable 3.7 Body sites and possible parasites recovered (trophozoites, cysts, oocysts, spores, adults, larvae, eggs, amastigotes, and trypomastigotes)SECTION 4 Specimen Test Options: Routine Diagnostic Methods and Body SitesOva and Parasite Examination of Stool SpecimensOther Diagnostic Methods for Stool SpecimensCulture of Larval-Stage NematodesEstimation of Worm Burdens through Egg CountsHatching Test for Schistosome EggsScreening Stool Samples for Recovery of a Tapeworm ScolexTesting of Other Intestinal Tract SpecimensExamination for PinwormSigmoidoscopy MaterialDuodenal Drainage MaterialDuodenal Capsule Technique (Entero-Test)Urogenital Tract SpecimensSputumAspiratesBiopsy SpecimensBloodThin Blood FilmsThick Blood FilmsBlood Staining MethodsBuffy Coat FilmsQBC Microhematocrit Centrifugation MethodKnott ConcentrationMembrane Filtration TechniqueCulture MethodsAnimal Inoculation and XenodiagnosisAntibody and Antigen DetectionAntibody DetectionAntigen Detection, Nucleic Acid-Based Tests, and Molecular PanelsIntradermal TestsTable 4.1 Body site, procedures and specimens, recommended methods and relevant parasites, and commentsTable 4.2 Serologic, antigen, and probe tests used in the diagnosis of parasitic infectionsSECTION 5 Specific Test Procedures and AlgorithmsMicroscopyCALIBRATION OF THE MICROSCOPEOva and Parasite ExaminationDIRECT WET FECAL SMEARConcentration (Sedimentation and Flotation)SEDIMENTATION CONCENTRATION (Formalin-Ethyl Acetate)SEDIMENTATION CONCENTRATION USING THE UNIVERSAL FIXATIVE (TOTAL-FIX)FLOTATION CONCENTRATION (Zinc Sulfate)Permanent Stained SmearPREPARATION OF MATERIAL FOR STAININGFresh MaterialPreserved Material Containing PVASAF-Preserved MaterialUniversal Fixative (Total-Fix) Preserved MaterialAlternative Method for Smear Preparation Directly from Vial(Total-Fix) Stains Used in the Permanent Stained SmearTRICHROME 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 STAINCHLORAZOL BLACK E STAINSpecialized Stains for Coccidia and MicrosporidiaKINYOUN'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 Hanscheid)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 ProtozoaEntamoeba histolyticaCryptosporidium spp.Giardia lambliaKits under DevelopmentComments on the Performance of Fecal ImmunoassaysEnzyme Immunoassays (Antigen Detection, No Centrifugation Recommended)Fluorescence (Visual Identification of the Organisms, Centrifugation Recommended)Lateral-Flow Cartridges (Antigen Detection, No Centrifugation Recommended)Larval Nematode CultureHARADA-MORI FILTER PAPER STRIP CULTUREBAERMANN CONCENTRATIONAGAR PLATE CULTURE FOR STRONGYLOIDES STERCORALISOther Methods for Gastrointestinal Tract SpecimensEXAMINATION FOR PINWORM (Cellulose Tape Preparations)SIGMOIDOSCOPY SPECIMENS (Direct Wet Smear)SIGMOIDOSCOPY SPECIMENS (Permanent Stained Smear)DUODENAL ASPIRATESMethods for Urogenital Tract SpecimensRECEIPT OF DRY SMEARSDIRECT SALINE MOUNTPERMANENT STAINED SMEARURINE CONCENTRATION (Centrifugation)URINE CONCENTRATION (Nuclepore Membrane Filter)Preparation of Blood FilmsTHIN BLOOD FILMSTHICK BLOOD FILMSCOMBINATION THICK-THIN BLOOD FILMSRISK MANAGEMENT ISSUES ASSOCIATED WITH BLOOD FILMSUSE OF A REFERENCE LABORATORY FOR PARASITE BLOOD DIAGNOSTIC TESTINGBLOOD FILM REPORTING WITH ADDITIONAL REPORT COMMENTSBUFFY COAT BLOOD FILMSBlood StainsSTAIN OPTIONSGIEMSA STAINBlood ConcentrationBUFFY COAT CONCENTRATIONKNOTT CONCENTRATIONMEMBRANE FILTRATION CONCENTRATIONAlgorithm 5.1 Procedure for processing fresh stool for the O&P examinationAlgorithm 5.2 Procedure for processing liquid specimens for the O&P examinationAlgorithm 5.3 Procedure for processing preserved stool for the O&P examination-two-vial collection kitAlgorithm 5.4 Procedure for processing SAF-preserved stool for the O&P examinationAlgorithm 5.5 Procedure for the use of Total-Fix (Universal Fixative, single vial system) (Alternate Method for Smear Preparation Directly from Vial)Algorithm 5.6 Use of various fixatives and their recommended stainsAlgorithm 5.7 Ordering algorithm for laboratory examination for intestinal parasitesAlgorithm 5.8 Procedure for processing blood specimens for examinationTable 5.1 Body site, specimen, and recommended stain(s)Table 5.2 Approaches to stool parasitology: test orderingTable 5.3 Laboratory test reports: optional commentsTable 5.4 Parasitemia determined from conventional light microscopy: clinical correlationSection 6 Commonly Asked Questions about Diagnostic ParasitologyStool ParasitologySpecimen CollectionIntestinal TractFixativesSpecimen ProcessingO&P ExamDiagnostic MethodsDirect Wet ExaminationsConcentrationsPermanent StainsStool Immunoassay OptionsMolecular Test Panels (FDA Approved)APTIMA Trichomonas vaginalis AssayAffirm VPIII Microbial Identification TestCepheid Xpert TV Assay for Trichomonas vaginalis from men and womenBD MAX Enteric Parasite PanelBioFire FilmArray Gastrointestinal panelLuminex (VERIGENE II GI Flex Assay, includes Parasites) Other Pending Molecular TestsOrganism IdentificationProtozoaHelminthsReportingOrganism IdentificationQuantitationProficiency TestingWet PreparationsPermanent Stained SmearsTissues or FluidsBloodSpecimen CollectionSpecimen ProcessingDiagnostic MethodsOrganism IdentificationReportingProficiency TestingGeneral QuestionsSECTION 7 Parasite Identification ProtozoaAmebae (Intestinal)Entamoeba histolyticaEntamoeba histolytica/Entamoeba disparComments on Entamoeba moshkovskii and Entamoeba bangladeshiEntamoeba bangladeshiEntamoeba hartmanniEntamoeba coliEntamoeba gingivalis Entamoeba poleckiEndolimax nanaIodamoeba butschliiBlastocystis spp. (formerly Blastocystis hominis)Flagellates (Intestinal)Giardia lamblia (G. duodenalis, G. intestinalis)Dientamoeba fragilisChilomastix mesniliPentatrichomonas hominisEnteromonas hominis, Retortamonas intestinalisCiliates (Intestinal)Balantidium coliApicomplexa (Intestinal)Cryptosporidium spp.Coccidia (Intestinal)Cyclospora cayetanensisCystoisospora (Isospora) belliMicrosporidia (Intestinal)Enterocytozoon bieneusiEncephalitozoon intestinalis, Encephalitozoon spp.Sporozoa (Blood and Tissue)Plasmodium vivaxPlasmodium falciparumPlasmodium malariaePlasmodium ovale wallickeri, Plasmodium ovale curtisiPlasmodium knowlesiMalaria: Key Diagnostic Points Babesia spp. (B. microti, B. duncani, B. divergens, B. venatorum)Toxoplasma gondiiFlagellates (Blood and Tissue)Leishmania spp.Trypanosoma brucei gambiense (West), T. brucei rhodesiense (East)Trypanosoma cruziAmebae (Other Body Sites)Naegleria fowleriAcanthamoeba spp., Balamuthia mandrillaris, Sappinia diploideaFlagellates (Other Body Sites)Trichomonas vaginalisNEMATODESIntestinalAscaris lumbricoidesTrichuris trichiura;General Comments on Capillaria philippinensisNecator americanus, Ancylostoma duodenale, A. ceylanicum (Hookworms); General comments on Trichostrongylus spp.Strongyloides stercoralisEnterobius vermicularisTissueAncylostoma braziliense, Ancylostoma caninum, Uncinaria stenocephala (Dog and Cat Hookworms)Toxocara canis, Toxocara cati (Dog and Cat Ascarid Worms)Dracunculus medinensis Trichinella spiralisBlood and TissueFilarial WormsCESTODESIntestinalTaenia saginataTaenia soliumDiphyllobothrium latumHymenolepis (Rodentolepis) nanaHymenolepis diminutaDipylidium caninumTissueEchinococcus granulosus, E. multilocularis, E. vogeli, E. oligarthrusTREMATODESIntestinalFasciolopsis buskiLiver and LungsParagonimus westermani, Paragonimus mexicanus, Paragonimus kellicottiFasciola hepaticaClonorchis sinensis (Chinese liver fluke) (Opisthorchis sinensis)BloodSchistosoma spp. (S. mansoni, S. haematobium, S. japonicum, S. mekongi, S. malayensis, S. intercalatum)SECTION 8 Common Problems in Parasite IdentificationTable 8.1 Entamoeba spp., trophozoites versus macrophages Table 8.2 Entamoeba spp., cysts versus polymorphonuclear leukocytesTable 8.3 Entamoeba histolytica versus Entamoeba coli precysts and cystsTable 8.4 Endolimax nana versus Dientamoeba fragilisSECTION 9 Identification AidsDiagnostic ConsiderationsTable 9.1 Rapid diagnostic proceduresTable 9.2 Diagnostic characteristics for organisms in wet mounts (direct or concentration sediment)Table 9.3 Diagnostic characteristics for organisms in permanent stained smearsKey 9.1 Identification of intestinal amebae (permanent stained smear)Key 9.2 Identification of intestinal flagellatesKey 9.3 Identification of helminth eggsKey 9.4 Identification of microfilariaeProtozoaTable 9.4 Intestinal protozoa: trophozoites of common amebaeTable 9.5 Intestinal protozoa: cysts of common amebaeTable 9.6 Intestinal protozoa: trophozoites of less common amebaeTable 9.7 Intestinal protozoa: cysts of less common amebaeTable 9.8 Morphologic criteria used to identifyBlastocystisspp.Table 9.9 Intestinal protozoa: trophozoites of flagellatesTable 9.10 Intestinal protozoa: cysts of flagellatesTable 9.11 Intestinal protozoa: ciliatesTable 9.12 ApicomplexaTable 9.13 Microsporidia (related to the fungi), general informationTable 9.14 Microsporidia: recommended diagnostic techniquesTable 9.15 Comparison of Naegleria fowleri, Acanthamoeba spp., Balamuthia mandrillaris, and Sappinia diploideaTable 9.16 Characteristics of Trichomonas vaginalisTable 9.17 Key characteristics of intestinal tract/urogenital system protozoaHelminthsTable 9.18 Normal life spans of the most common intestinal nematodesTable 9.19 Characteristics of the most common intestinal nematodesTable 9.20 Tissue nematodesTable 9.21 Trichinella spiralis: life cycle stages and clinical conditionsTable 9.22 Characteristics of human microfilariaeTable 9.23 Characteristics of cestode parasites (intestinal)Table 9.24 Tissue cestodesTable 9.25 Characteristics of intestinal trematodesTable 9.26 Characteristics of liver and lung trematodesTable 9.27 Human paragonimiasisTable 9.28 Characteristics of blood trematodesTable 9.29 Key characteristics of helminthsBlood ParasitesTable 9.30 Malaria characteristics with fresh blood or blood collected using EDTA with no extended lag timeTable 9.31 Potential problems using EDTA anticoagulant for the preparation of thin and thick blood filmsTable 9.32 Plasmodia in Giemsa-stained thin blood smearsTable 9.33 Relevant issues for handling requests for blood parasite infectionsTable 9.34 Features of human leishmanial infectionsaTable 9.35 Characteristics of American trypanosomiasisTable 9.36 Characteristics of East and West African trypanosomiasisTable 9.37 Key characteristics of blood parasitesIndexshow more