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Citation: Shimizu R, Grimm F, Garcia L, Deplazes P. .

Key Concept Ranking

Parasitic Diseases
Chagas' Disease
Indirect Immunofluorescence Assay
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11. Garcia, L. S.,, and R. Y. Shimizu. 2000. Detection of Giardia lamblia and Cryptosporidium parvum antigens in human fecal specimens using the ColorPAC combination rapid solid-phase qualitative immunochromatographic assay. J. Clin. Microbiol. 38:12671268.
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Body sites and possible parasites recovered

Parasites include trophozoites, cysts, oocysts, spores, adults, larvae, eggs, and amastigote and trypomastigote stages. This table does not include every possible parasite that could be found in a particular body site. However, the most likely organisms have been listed.

Disseminated in severely immunosuppressed individuals.

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Commercially available kits for immunodetection of parasitic organisms or antigens in stool samples

A number of the kits are manufactured by a single manufacturer but labeled under different company names; consequently, some of the data for sensitivity and specificity may be identical to those of kits produced under another name or by another company.

EIA, enzyme immunoassay; DFA, direct fluorescent antibody; IC, immunochromatography.

URLs are given only the first time the company name appears in the table.

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Commercially available test kits for immunodetection or molecular detection of parasitic organisms or antigens in serum, plasma, blood, or vaginal discharge

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Commercially available kits or antigens for immunodetection of specific serum antibodies

Bordier Affinity Products, Chatanerie 2, CH-1023 Crissier, Switzerland (http://www.bordier.ch); Hemagen, 34–40 Bear Hill Rd., Waltham, MA 02154 (http:// www.hemagen.com); Immunetics, 380 Green St., Cambridge, MA 02139 (http://www.immunetics.com); InBios, 562 1st Ave. South, Suite 600, Seattle, WA 98104 (http://www.inbios.com); IVD Research, 5909 Sea Lion Place, Suite D, Carlsbad, CA 92008 (http://ivd@ivdresearch.com), bioMérieux SA, F-69280 Marcy l'Etoile, France (http://bioMerieux-diagnostics.com); Millipore Coporation, 290 Concord Rd., Billerica, MA (http://millipore.com); NovaTec, Immunodiagnostica GmbH, Waldstrasse 23 a6, 63128 Dietzenbach, Germany (http://www.novatec-id.com).

Abbreviations: EIA, enzyme immunoassay; Rapid, rapid immunochromatographic (some are dipstick, cartridge, or other rapid test formats).

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Specimen preparation and procedures, recommended stain(s) and relevant parasites, and additional information

CSF, cerebrospinal fluid; EIA, enzyme immunoassay; EITB, enzyme-linked immunoelectrotransfer blot (Western blot); EM, electron microscopy; FA, fluorescent antibody; GAE, granulomatous amebic encephalitis; GI, gastrointestinal; H & E, hematoxylin and eosin; IFA, indirect immunofluorescence assay; PAM, primary amebic encephalitis; PAS, periodic acid-Schiff stain; PBS, phosphate-buffered saline; QBC, quantitative buffy coat.

Many parasites or parasite stages may be detected in standard histologic sections of tissue material. However, species identification is difficult and additional examinations may be required. Usually, these techniques are not considered first-line methods. Additional methods like EM are carried out only by specialized laboratories and are not available for standard diagnostic purposes. EM examination for species identification has largely been replaced by PCR.

Material/specimens suitable for PCR: native (unfixed), in saline, PBS (ethanol), or frozen; avoid formalin.

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Fecal specimens for parasites: options for collection and processing

See key references and .

It is difficult to recognize an early outbreak situation where screening of all specimens for either , spp., or both may be relevant. If it appears that an outbreak is in the early stages, then performing the immunoassays on request can be changed to screening all stools.

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Approaches to stool parasitology: test ordering

Modified from reference .

Depending on the particular immunoassay kit used, various single or multiple organisms may be included. Selection of a particular kit depends on many variables: clinical relevance, cost, ease of performance, training, personnel availability, number of test orders, training of physician clients, sensitivity, specificity, equipment, time to result, etc. Very few laboratories handle this type of testing in exactly the same way. Many options are clinically relevant and acceptable for patient care.

Two stool specimens should be tested using an immunoassay in order to rule out an infection with fecal immunoassays may also be negative in cases with a low parasite load.

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Fecal preservatives: pros and cons

Modified acid-fast and modified trichrome stains.


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