Ordering Guidance

This test should be ordered when suspicion of parasitic infection is based on travel history in endemic areas or when a patient is immunocompromised.

For non-fecal specimens, including duodenal aspirate and colonic washing, for ova and parasitic examination, order OAPNS / Ova and Parasite, Microscopy, Varies.

If possible adult worms or proglottids are identified in stool or the patient's undergarments, they should be placed in 70% alcohol and submitted for PARID / Parasite Identification, Varies.

If specific organisms or disease states are suspected, see below:

If Acanthamoeba is suspected, order ACARP / Acanthamoeba species Molecular Detection, PCR, Ocular.

If Cryptosporidium is suspected, order CRYPS / Cryptosporidium Antigen, Feces.

If Cyclospora is suspected, order CYCL / Cyclospora Stain, Feces.

If free-living amebae are suspected, order FLARP / Free-Living Amebae Molecular Detection, PCR, Varies.

If Giardia is suspected, order GIAR / Giardia Antigen, Feces.

If microsporidia are suspected, order LCMSP / Microsporidia species, Molecular Detection, PCR, Varies.

If pinworm is suspected, order PINW / Pinworm Exam, Perianal.

If scabies is suspected, order PARID / Parasite Identification, Varies.

If Schistosoma is suspected, order SHUR / Schistosoma Exam, Urine.

If Trichomonas vaginalis is suspected, order TVRNA / Trichomonas vaginalis, Nucleic Acid Amplification, Varies.

If worms or worm segments are submitted, order PARID / Parasite Identification, Varies.

If respiratory specimens or tissue are submitted, order OAPNS / Ova and Parasite, Microscopy, Varies.

Additional Testing Requirements

Parasites are shed irregularly in stool and examination of a single specimen does not guarantee detection. Therefore, it is strongly recommended that multiple stool specimens be submitted for ova and parasite analysis. At least 3 specimens should be collected. If multiple ova and parasite collections are requested, instruct patient to collect a specimen at least 12 hours after last collection.

Specimen Required

Patient Preparation: Specimen collection should be delayed for 7 to 10 days after administration of barium, bismuth, kaolin, magnesia, castor oil or mineral oil, and 2 to 3 weeks after antibiotics have been given since these may interfere with identification of protozoa.

Specimen Type: Feces

Supplies: ECOFIX Stool Transport Vial (Kit) (T790)

Preferred: ECOFIX preservative

Acceptable: 10% Buffered Formalin Stool Transport plus Zinc Polyvinyl Alcohol (Zn PVA) Stool Transport (one of each)

Specimen Volume: Portion of stool: 2 g or 2 mL

Collection Instructions:

1. Follow instructions on the container as follows:

a. Place specimen into Ecofix preservative vial or one 10% formalin AND one Zn PVA preservative vial within 30 minutes of passage or collection. Refer to the fill line on the preservative vial. Do not fill above the line indicated on the container.

b. Mix the contents of the tube with the spoon, twist the cap to close tightly, and shake vigorously until the contents are well mixed.

Additional Information:

1. Stool placed in 10% buffered formalin can be accepted if accompanied by Zn PVA-preserved specimen; 10% buffered formalin-preserved specimens submitted without an accompanying Zn PVA-preserved specimen will be canceled.

2. Specimen submitted in low viscosity (LV)-PVA, mercury PVA or copper (Cu)-PVA will be rejected.