Lynne Shore Garcia - Diagnostic Medical Parasitology

Examination for pinworm

Cellulose tape preparations

Anal swabs

Sigmoidoscopy material

Direct saline mount

Permanent stained slide

Duodenal contents

Duodenal drainage

Duodenal capsule technique (Entero-Test)

Urogenital specimens

Trichomoniasis

Filariasis

Schistosomiasis

6 Sputum, Aspirates, and Biopsy Material

Expectorated sputum

Induced sputum

Aspirates

Lungs and liver

Lymph nodes, spleen, liver, bone marrow, spinal fluid, eyes, and nasopharynx

Cutaneous ulcer

Biopsy material

Skin

Lymph nodes

Muscle

Rectum and bladder

7 Procedures for Detecting Blood Parasites

Preparation of thick and thin blood films

Thick blood films

Thin blood films

Combination thick and thin blood films (on the same slide)

Combination thick and thin blood films (can be stained as either)

Buffy coat blood films

Staining blood films

Giemsa stain

Wright’s stain

General notes on staining procedures

Proper examination of thin and thick blood films

Thin blood films

Thick blood films

Determination of parasitemia

Diagnosis of malaria: review of alternatives to conventional microscopy

QBC microhematocrit centrifugation method

ParaSight F testy

NOW malaria test

Flow anti-pLDH Plasmodium monoclonal antibodies

Molecular testing

Automated blood cell analyzers

Diagnosis of leishmaniasis: review of alternatives to conventional microscopy

ICT for detection of anti-rK-39 antibodies

Concentration procedures

Cytocentrifugation technique

Knott concentration procedure

Membrane filtration technique

Gradient centrifugation technique

Triple-centrifugation method for trypanosomes

Special stain for microfilarial sheath

Delafield’s hematoxylin

8 Parasite Recovery: Culture Methods, Animal Inoculation, and Xenodiagnosis

Culture methods

Intestinal protozoa

Pathogenic free-living amebae

Blastocystis spp. (Blastocystis hominis)

Pathogenic flagellates

Flagellates of blood and tissue

Toxoplasma gondii

Plasmodium and Babesia spp.

Cryptosporidium spp.

Microsporidia

Animal inoculation

Leishmania spp

Trypanosoma spp.

Toxoplasma gondii

Xenodiagnosis

9 Fixation and Special Preparation of Fecal Parasite Specimens and Arthropods

Fixation of parasite specimens and arthropods

Protozoa

Solutions to induce relaxation in adult helminths

Nematodes

Trematodes

Cestodes

Helminth eggs and larvae

Arthropods

Mounting and staining of parasite specimens for examination

Nematodes

Trematodes

Cestodes

Mounting of arthropods for examination

Mites

Fleas and lice

Ticks

Miscellaneous arthropods

10 Artifacts That Can Be Confused with Parasitic Organisms

Protozoa

Amebae

Flagellates

Ciliates

Coccidia and microsporidia

Cryptosporidium spp. and Cyclospora cayetanensis

Cystoisospora belli

Microsporidia

Blood and body fluids

Malaria parasites and Babesia spp.

Leishmaniae and trypanosomes

Microfilariae

Body fluids: ciliated epithelial cells

Helminths

Adult worms and larvae

Eggs

Human cells

Polymorphonuclear leukocytes

Eosinophils

Macrophages

Lymphocytes

Red blood cells

Charcot-Leyden crystals

Nonhuman elements seen in feces (yeast cells)

Insect larvae

Spurious infections

Delusory parasitosis (delusional infestation)

11 Equipment, Supplies, Safety, and Quality System Recommendations for a Diagnostic Parasitology Laboratory: Factors Influencing Future Laboratory Practice

Equipment

Microscope

Centrifuge

Fume hood

Biological safety cabinet

Refrigerator-freezer

Supplies

Glassware

Miscellaneous supplies

ATCC quality control organisms

Safety: personnel and physical facilities

General precautions

Handwashing

Personal protective equipment (OSHA 2001 blood borne)

Handling specimens

Processing specimens

Spills

Disposal of contaminated materials

Standard precautions

Hepatitis exposure protocol

Dangerous properties of industrial materials

Current OSHA regulations for the use of formaldehyde

Latex allergy

Quality systems

Extent of services

Proficiency testing

In-house quality control

Patient outcome measures

Continuous quality improvement, total quality management, or 10-step and FOCUS-PDCA for performance improvement activities

CLIA ’88 inspection process

New quality guidelines

ISO guidelines

CLSI (NCCLS) model

Factors influencing future laboratory practice

Managed care

Financial considerations

Current regulations

Decentralized testing

Laboratory services

Technological trends

Clinical decision support

Personnel issues

Changing demographics

Emerging diseases

Bioterrorism

12 Medical Parasitology: Case Histories

Protozoal infections

Case 1

Case 2

Case 3

Case 4

Case 5

Case 6

Case 7

Helminth infections

Case 8

Case 9

Case 10

Case 11

Case 12

Case 13

Case 14

Blood parasite infections

Case 15

Case 16

Case 17

Case 18

Case 19

Case 20

Diagnostic methods and proficiency testing

Case 21

Case 22

Case 23

Case 24

Case 25

PART II

Clinically Important Human Parasites

13 Intestinal Nematodes

Ascaris lumbricoides

Enterobius vermicularis

Trichuris trichiura

Capillaria philippinensis

Hookworms (Ancylostoma duodenale, Necator americanus, and Ancylostoma ceylanicum)

Trichostrongylus spp.

Strongyloides spp.

14 Tissue Nematodes

Trichinella spp.

Baylisascaris procyonis

Lagochilascaris minor

Toxocara canis and T. cati (visceral larva migrans and ocular larva migrans)

Ancylostoma braziliense and A. caninum (cutaneous larva migrans)

Human eosinophilic enteritis

Dracunculus medinensis

Angiostrongylus (Parastrongylus) cantonensis (cerebral angiostrongyliasis)

Angiostrongylus (Parastrongylus) costaricensis (abdominal angiostrongyliasis)

Gnathostoma spinigerum

Gnathostoma doloresi, G. nipponicum, G. hispidum, and G. binucleatum

Anisakis simplex, A. physeteris, Pseudoterranova decipiens, Contracaecum osculatum, Hysterothylacium aduncum, and Porrocaecum reticulatum (larval nematodes acquired from saltwater fish)

Capillaria hepatica

Thelazia spp.

15 Filarial Nematodes

Basic life cycle

The endosymbiont

Human pathogens

Wuchereria bancrofti

Brugia malayi

Brugia timori

Zoonotic Brugia infections (American brugian filariasis)

Tropical pulmonary eosinophilia

Loa loa

Mansonella ozzardi

Mansonella perstans

Mansonella streptocerca

Onchocerca volvulus

Dirofilaria Dirofilaria and Dirofilaria Nochtiella spp.

16 Intestinal Cestodes

Diphyllobothrium latum

Taenia solium

Taenia saginata

Taenia asiatica (Asian Taenia or Taenia saginata asiatica)

Hymenolepis (Rodentolepis) nana

Hymenolepis diminuta

Dipylidium caninum

17 Tissue Cestodes: Larval Forms

Echinococcus granulosus (cystic hydatid disease)

Echinococcus multilocularis (alveolar disease, hydatid disease)

Echinococcus vogeli (polycystic hydatid disease) and Echinococcus oligarthrus (unicystic hydatid disease): neotropical echinococcosis

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