Lynne Shore Garcia - Diagnostic Medical Parasitology

Cover: Dog tapeworm (Taenia pisiformis), photograph taken using a light microscope, showing scolex with hooks. Spike Walker, Wellcome Images.

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Library of Congress Cataloging-in-Publication Data

Names: Garcia, Lynne Shore, author.

Title: Diagnostic medical parasitology / by Lynne S. Garcia.

Description: 6th edition. | Washington, DC : ASM Press, [2016] | ?2016 | Includes bibliographical references and index.

Identifiers: LCCN 2015041826 (print) | LCCN 2015042284 (ebook) | ISBN 9781555818999 (alk. paper) | ISBN 9781683673309 ()

Subjects: LCSH: Diagnostic parasitology.

Classification: LCC QR255 .G37 2016 (print) | LCC QR255 (ebook) | DDC 616.9/6075--dc23

LC record available at http://lccn.loc.gov/2015041826

doi:10.1128/9781555819002

Printed in the United States of America

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Dedication

As with the first five editions, I dedicate this book to Marietta Voge, a truly rare individual who was widely recognized as one of the world’s leading parasitologists. During her years as a diagnostic and research parasitologist at the University of California, Los Angeles, she touched the lives of many students and staff in a very special way. She was always more than willing to share her expertise with all who asked and volunteered this help over the years whenever contacted. She was always willing to donate a considerable amount of her personal time as a volunteer for various medical projects throughout the world.

She was a very special individual to work with, always interested in the person as well as the problem at hand. Her areas of teaching extended far beyond science. Whatever subject she was interested in received her total enthusiasm and dedication, and she had an exceptional ability to deal with detailed work. Her sense of fairness and professional integrity were remarkable; these ideals were shared with all who came in contact with her.

Her contributions to the field of diagnostic parasitology were numerous and included many classes, seminars, papers, and textbooks. The importance of working with Dr. Voge is hard to put into words. She was unique in her ability to allow a student to grow, both scientifically and personally. She could guide without constraints, teach without formal lectures, counsel without being judgmental, challenge without being unrealistic, tease without being cruel, and always be supportive regardless of the situation. She expected much from her students and employees and yet always gave considerably more than she received.

Scientific information gained from our association with her was invaluable; however, her impact on our lives was considerably more than scientific. She was always available for consultations and just to talk. She left all of us with a sense of having personally matured as a result of knowing and working with her over the years. She is missed by all of us, and yet her contributions in terms of teaching, consultations, volunteer work, professionalism, and friendship will remain with us forever.

I would also like to dedicate the sixth edition of this book to the bench technologists, those of you who provide critical diagnostic information on a daily basis and contribute such valuable input for excellent patient care. Academic training provides key information in the field, but those who perform routine work at the bench often contribute much more than simple diagnostic identifications. Congratulations and thanks to all of you.

Finally, I also dedicate this book to John Lawrence. He was an extraordinary individual, and without his original encouragement and assistance, the first edition of the book would never have been written.

Contents

Dedication

Preface

Acknowledgments

PART I

Diagnostic Procedures

1 Philosophy and Approach to Diagnostic Parasitology

2 Collection, Preservation, and Shipment of Fecal Specimens

Safety

Fresh-specimen collection

Collection of the specimen

Number of specimens to be collected (standard recommendation)

Number of specimens to be collected (pros and cons of various options)

Collection times

Specimen type, specimen stability, and need for preservation

Preservation of specimens

Preservatives

Use of fixatives

Shipment of diagnostic specimens, biological products, etiologic agents, or infectious substances

3 Macroscopic and Microscopic Examination of Fecal Specimens

Macroscopic examination

Microscopic examination (ova and parasite examination)

Direct wet smear

Concentration (sedimentation and flotation)

Permanent stained smear

Specialized stains for coccidia (Cryptosporidium, Cystoisospora, and Cyclospora species) and the microsporidia

Modified Kinyoun’s acid-fast stain (cold method)

Modified Ziehl-Neelsen acid-fast stain (hot method)

Carbol fuchsin negative stain for Cryptosporidium (from W. L. Current)

Rapid safranin method for Cryptosporidium

Rapid safranin method for Cyclospora, using a microwave oven

Auramine O stain for coccidia (from Thomas Hänscheid)

Modified trichrome stain for the microsporidia (Weber—green)

Modified trichrome stain for the microsporidia (Ryan—blue)

Modified trichrome stain for the microsporidia (Kokoskin—hot method)

Acid-fast trichrome stain for Cryptosporidium and the microsporidia

4 Additional Techniques for Stool Examination

Culture of larval-stage nematodes

Harada-Mori filter paper strip culture

Filter paper/slant culture technique (petri dish)

Charcoal culture

Baermann technique

Agar plate culture for Strongyloides stercoralis

Egg studies

Estimation of worm burdens and Kato-Katz thick film

Hatching of schistosome eggs

Search for tapeworm scolex

India ink injection procedure for tapeworm proglottids

Qualitative test for fecal fat

Quantitation of reducing substances (Clinitest)

5 Examination of Other Specimens from the Intestinal Tract and the Urogenital System