Informational Tables

- 1.1 Parasite Classification | - 1.2 Body Site, Specimens, Procedures, Parasites, Comments | - 1.3 STAT Testing in Parasitology | - 1.4 Test Issues and Reports: Computer Report Comments| - 1.5 Rapid Diagnostic Testing
- 2.1 Stool Testing Order Recommendations | - 2.2 Fecal specimens for parasites: options for collection and processinga² | - 2.3 Preservatives used for Stool Specimens
- 3.1 Body Sites and Specimen Collection | - 3.2 Body sites and the most common parasites recovered | - 3.3 Body Site, Specimens and Recommended Stain | - 3.4 Examination of tissues and body fluids | - 3.5 Parasitic Infections: Clinical Findings Healthy/Compromised Hosts | - 3.6 Microscope Calibration | - 3.7 Serologic, Antigen, and Probe Tests for Parasite Diagnosis
- 4.1 Protozoa: Intestinal Tract, Urogenital System: Key Characteristics | - 4.2 Tissue Protozoa: Characteristics | - 4.3 Tips on Performance of Fecal Immunoassays for Intestinal Protozoa
5.1 Helminths: Key Characteristics | 5.2 Helminth Parasites Associated with Eosinophilia
6.1 Reference Laboratory for Parasite Blood Testing | 6.2 Parasites Found in Blood: Characteristics
7.1 Malaria (5 Species) (2 P. ovale subspecies) | 7.2 Malaria (5 Species, Images) | 7.3 Rapid Malaria Testing (BinaxNOW Malaria Test) | 7.4 Malaria Parasitemia Method | 7.5 Malaria Parasitemia Interpretation
- USE OF A REFERENCE LABORATORY FOR PARASITE BLOOD DIAGNOSTIC TESTING (Including the Binax Rapid Test and Report Comments)
- HELMINTH PARASITES ASSOCIATED WITH EOSINOPHILIA | - Histology: Staining Characteristics - Table 1 | - Histological Identification of Parasites - Table 2 | - Microscope Calibration | - Figures for Histology Identification Table 2 |

3.4 Examination of tissues and body fluids
Suspect causative agent(s)	Disease(s)	Appropriate test(s)^a	Positive result
Protozoa
Naegleria fowleri	Primary amebic meningoencephalitis	1. Wet examination of CSF (not in counting chamber) 2. Stained preparation of CSF sediment	Trophozoites present and identified
Acanthamoeba spp.	Amebic keratitis, chronic meningoencephalitis	1. Culture or stained smears 2. Calcofluor (cysts only) 3. Biopsy or routine histology	Trophozoites and/or cysts present and identified
Balamuthia mandrillaris	Chronic/subacute meningoencephalitis (granulomatous amebic encephalitis)	1. Calcofluor (cysts only) 2. Biopsy for routine histology	Trophozoites and/or cysts present and identified
Entamoeba histolytica Giardia duodenalis (G. lamblia, G. intestinalis)	Amebiasis	Biopsy or routine histology
	Giardiasis	1. Duodenal aspirate 2. Duodenal biopsy or routine histology 3. Entero-Test capsule; availability varies 4. Immunoassays	Trophozoites present and identified Trophozoites and/or cysts present and identified
Leishmania spp. (cutaneous lesions)	Cutaneous leishmaniasis	1. Material from under bed of ulcer a. Smear b. Culture c. Animal inoculation 2. Punch biopsy at edge of lesion a. Routine histology b. Squash preparation c. Culture d. NAAT	Amastigotes recovered in macrophages of skin or from animal inoculation; other stages recovered in culture
Leishmania spp. (mucocutaneous lesions)	Mucocutaneous leishmaniasis	As for cutaneous leishmaniasis	Amastigotes recovered in macrophages of skin and mucous membranes or from animal inoculation; other stages recovered in culture
Leishmania spp. (visceral)	Visceral leishmaniasis (kala-azar)	1. Buffy coat a. Stain b. Culture c. Animal inoculation 2. Bone marrow a. Stain b. Culture c. Animal inoculation 3. Liver or spleen biopsy with routine histology a. Stain b. Culture c. Animal inoculation	Amastigotes recovered in cells of reticuloendothelial system
Toxoplasma gondii	Toxoplasmosis	1. Lymph node biopsy a. Routine histology b. Tissue culture isolation c. Animal inoculation 2. Serology /* 1. Lymph node biopsy a. Routine histology b. Tissue culture isolation c. Animal inoculation 2. Serology */	Identification of organisms plus appropriate serological test results
Cryptosporidium spp.	Cryptosporidiosis	1. Duodenal scrapin 2. Duodenal biopsy a. Stain b. Routine histology 3. Punch biopsy a. Routine histology b. Squash preparation 4. Sputum 5. Immunoassays	Identification of organisms in microvillus border or other tissues (lung and gallbladder have also been involved); routine stains or monoclonal antibody reagents to identify oocysts in stool
Microsporidia Brachiola spp. Nosema spp. Encephalitozoon spp Enterocytozoon spp. Pleistophora spp.	Microsporidiosis	NAAT, routine histology; modified trichrome, tissue Gram stains, silver, periodic acid-Schiff, and Giemsa stains recommended (spores); animal inoculation not recommended/latent infections	These organisms (spores) have been found as insect or other animal parasites; route of infection is probably ingestion. Human cases involve muscle, CSF (AIDS); other body sites have also been documented.
Trachipleistophora spp Anncaliia spp. Microsporidium spp. Vittaforma corneae	Microsporidiosis	Electron microscopy may be necessary for confirmation.
Helminths
Larvae (Ascaris and Strongyloides spp.)	“Pneumonia”	Sputum, wet preparation	This is an incidental finding but has been reported in severe infections.
Eggs (Paragonimus spp.)	Paragonimiasis	Sputum, wet preparation	Eggs will be coughed up and appear as “iron filings”; eggs could also be found in stool.
Hooklets (Echinococcus spp.)	Hydatid disease	Sputum, wet preparation	Rare finding, but protoscolices and hooklets can be found when the hydatid cyst is in the lung.
Onchocerca volvulus	Onchocerciasis	Skin snips Routine histology	Skin snips examined in saline; microfilariae may be present; presence of adult worms in routine histology of nodules
Mansonella streptocerca	Streptocerciasis	Skin snips	Skin snips examined in saline; microfilariae may be present.
Schistosoma spp.	Schistosomiasis	1. Rectal valve biopsy 2. Bladder biopsy	Eggs present and identified

a NAAT and other molecular tests are available for many of the organisms mentioned in this table; however, test options may be limited to research and/or reference laboratories.