Читать книгу Practical Guide to Diagnostic Parasitology - Lynne Shore Garcia - Страница 5

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

Automated Instrumentation

Patient Information

Conventional Microscopy

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

Leishmaniae

Trypanosomes

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

Standard Approach

Different Approaches

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

Intestinal Tract

Fixatives

Specimen Processing

O&P Exam

Diagnostic Methods

Direct Wet Examinations

Concentrations

Permanent Stains

Stool Immunoassay Options

Organism Identification

Protozoa

Helminths

Reporting

Organism Identification

Quantitation

Proficiency Testing

Wet Preparations

Permanent Stained Smears

Tissues or Fluids

Blood

Specimen Collection

Specimen Processing

Diagnostic Methods

Organism Identification

Reporting

Proficiency Testing

General Questions

SECTION 7 Parasite Identification

Protozoa

Amebae (Intestinal)

Entamoeba histolytica

Entamoeba dispar

Entamoeba hartmanni

Entamoeba coli

Entamoeba gingivalis, Entamoeba polecki

Endolimax nana

Iodamoeba bütschlii

Blastocystis hominis

Flagellates (Intestinal)

Giardia lamblia

Dientamoeba fragilis

Chilomastix mesnili

Pentatrichomonas hominis

Enteromonas hominis, Retortamonas intestinalis

Ciliates (Intestinal)

Balantidium coli

Coccidia (Intestinal)

Cryptosporidium spp.

Cyclospora cayetanensis

Isospora (Cystoisospora) belli

Microsporidia (Intestinal)

Enterocytozoon bieneusi

Encephalitozoon intestinalis, Encephalitozoon spp.

Sporozoa (Blood and Tissue)

Plasmodium vivax

Plasmodium falciparum

Plasmodium malariae

Plasmodium ovale

Babesia spp.

Toxoplasma gondii

Flagellates (Blood and Tissue)

Leishmania spp.

Trypanosoma brucei gambiense (West), T. brucei rhodesiense (East)

Trypanosoma cruzi

Amebae (Other Body Sites)

Naegleria fowleri

Acanthamoeba spp., Balamuthia mandrillaris, Sappinia diploidea

Flagellates (Other Body Sites)

Trichomonas vaginalis

Nematodes

Intestinal

Ascaris lumbricoides

Trichuris trichiura

Necator americanus, Ancylostoma duodenale (Hookworms)

Strongyloides stercoralis

Enterobius vermicularis

Tissue

Ancylostoma braziliense, Ancylostoma caninum (Dog and Cat Hookworms)

Toxocara canis, Toxocara cati (Dog and Cat Ascarid Worms)

Trichinella spiralis

Blood and Tissue

Filarial Worms

Cestodes

Intestinal

Taenia saginata

Taenia solium

Diphyllobothrium latum

Hymenolepis nana

Hymenolepis diminuta

Dipylidium caninum

Tissue

Echinococcus granulosus

Trematodes

Intestinal

Fasciolopsis buski

Liver and Lungs

Paragonimus westermani, Paragonimus mexicanus, Paragonimus kellicotti

Fasciola hepatica

Clonorchis sinensis (Opisthorchis sinensis)

Blood

Schistosoma spp. (S. mansoni, S. haematobium, S. japonicum, S. mekongi, S. intercalatum)

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