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Ova & Parasite, Stool Examination - specimen 3
MessagePerforming Lab: Central Lab
Test Code
0102
Alias/See Also
Sunquest: OP3
CPT Codes
87177; 87209
Preferred Specimen
Stool in SAF trasnport vial
Minimum Volume
>1.0 mL
Other Acceptable Specimens
Ecofix vial
Instructions
Orders: A routine order for an O & P exam would be for a total of three specimens, one collected every other day. If Entamoeba histolytica is suspected, up to six specimens may be collected. Order all three tests (OP1, OP2, OP3) receive separate access number labels. See the Health Education Resources link in the Central Laboratory Catalog General Information section for specific patient collection instructions.
All prompts must be answered when ordering:
SDES (Site Description) - Stool;
SPREQ (Special Requests) - add comments such as suspected parasite, use of barium (BAR), mineral oil (MOIL), magnesia (MAGN), kaolin drugs (KAO), antacids (ANTAC) or antibiodics (ANTIB), any foreign travel.
SPECI (Specimen number) - N13 (1 of 3 collections), N23 (2 of 3 collections), N33 (3 of 3 collections), etc.
Collection Instructions:
Stool must be put in SAF transport vial within 1 hour of collection. No more than one specimen per day is acceptable. Samples collected on the same day will be pooled for testing.
All prompts must be answered when ordering:
SDES (Site Description) - Stool;
SPREQ (Special Requests) - add comments such as suspected parasite, use of barium (BAR), mineral oil (MOIL), magnesia (MAGN), kaolin drugs (KAO), antacids (ANTAC) or antibiodics (ANTIB), any foreign travel.
SPECI (Specimen number) - N13 (1 of 3 collections), N23 (2 of 3 collections), N33 (3 of 3 collections), etc.
Collection Instructions:
Stool must be put in SAF transport vial within 1 hour of collection. No more than one specimen per day is acceptable. Samples collected on the same day will be pooled for testing.
Transport Temperature
Room temperature
Specimen Stability
Room temperature: several months
Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Expired transport vials. Urine or toiled bowl water with the stool sample is not acceptable for testing (urine/water will destroy trophozoites).
Methodology
Direct microscopic examination of a concentrated specimen by both wet mount with iodine and permanent modified trichrome stain
Setup Schedule
Monday - Friday
Report Available
3 business days
Limitations
The presence of barium, mineral oil, bismuth, magnesia, kaolin drugs, antacids and antibiotics may obscure or decrease the number of parasites present. Retesting 7 to 10 days after discontinuing these medications is recommended.
Cryptosporidium would not be found on a routine Ova and Parasite exam. If only Giardia lamblia is suspected, order a GSA test, If Cryptosporidium is suspected, order a CRYPT test.
If Pinworm is suspected, a PIN test is recommended. Only 5-10 % of people infected with pinworm have the worm or its eggs in their stool and seeing these on an Ova and Parasite test is incidental. Pinworm paddles collection is recommended.
Cyclospora, Microsporidium, Isospora, and Toxoplasma would not normally be found on a routine Ova and Parasite exam. Requests for these parasites should be ordered separately and sent to a reference laboratory.
Entamoeba histolytica can only be differentiated from Entamoeba disbar by observing red blood cells in the trophozoite stage of the amoeba. Absence of the red blood cells the organism will be reported with the code EHED, which translates into “Entamoeba histolytica/Entamoeba disbar.” Additional testing to distinguish between Entamoeba histolytica and Entamoeba disbar – order Entamoeba histolytica Antigen, EIA (EHAG)
Partial Ova and Parasite testing can be done on specimens collected in 10% Formalin, PVA-Zinc, or PVA-LA vials. No Ova and Parasite testing can be done on specimens collected in Modified Formalin or Cary-Blair vials.
Ova and Parasites most commonly found, but are not limited to, include: Ascaris lumbricoides ova, Blastocystis hominis, Chilomastix mesnili, Clonorchis sinensis ova, Dientamoeba fragilis trophozoites, Diphyllobothrium latum ova, Endolimax nana cysts and trophozoites, Entamoeba coli cysts and trophozoites,, Entamoeba hartmanni cysts and trophozoites, Entamoeba histolytica cysts and trophozoites, Enterobius vermicularis ova, Fasciola/Fasciolopsis ova, Giardia lamblia cysts and trophozoites, Hookworm ova and larvae, Hymenolepis diminuta ova, Hymenolepis nana ova, Iodamoeba buetschlii cysts and trophozoites, Paragonimus westermani ova, Schistosoma species ova, Strongyloides larvae, Taenia species ova, Trichostrongylus species ova, Trichuris trichiura ova
Cryptosporidium would not be found on a routine Ova and Parasite exam. If only Giardia lamblia is suspected, order a GSA test, If Cryptosporidium is suspected, order a CRYPT test.
If Pinworm is suspected, a PIN test is recommended. Only 5-10 % of people infected with pinworm have the worm or its eggs in their stool and seeing these on an Ova and Parasite test is incidental. Pinworm paddles collection is recommended.
Cyclospora, Microsporidium, Isospora, and Toxoplasma would not normally be found on a routine Ova and Parasite exam. Requests for these parasites should be ordered separately and sent to a reference laboratory.
Entamoeba histolytica can only be differentiated from Entamoeba disbar by observing red blood cells in the trophozoite stage of the amoeba. Absence of the red blood cells the organism will be reported with the code EHED, which translates into “Entamoeba histolytica/Entamoeba disbar.” Additional testing to distinguish between Entamoeba histolytica and Entamoeba disbar – order Entamoeba histolytica Antigen, EIA (EHAG)
Partial Ova and Parasite testing can be done on specimens collected in 10% Formalin, PVA-Zinc, or PVA-LA vials. No Ova and Parasite testing can be done on specimens collected in Modified Formalin or Cary-Blair vials.
Ova and Parasites most commonly found, but are not limited to, include: Ascaris lumbricoides ova, Blastocystis hominis, Chilomastix mesnili, Clonorchis sinensis ova, Dientamoeba fragilis trophozoites, Diphyllobothrium latum ova, Endolimax nana cysts and trophozoites, Entamoeba coli cysts and trophozoites,, Entamoeba hartmanni cysts and trophozoites, Entamoeba histolytica cysts and trophozoites, Enterobius vermicularis ova, Fasciola/Fasciolopsis ova, Giardia lamblia cysts and trophozoites, Hookworm ova and larvae, Hymenolepis diminuta ova, Hymenolepis nana ova, Iodamoeba buetschlii cysts and trophozoites, Paragonimus westermani ova, Schistosoma species ova, Strongyloides larvae, Taenia species ova, Trichostrongylus species ova, Trichuris trichiura ova
Clinical Significance
The stool specimen is examined for intestinal protozoa, larvae and eggs. Intestinal parasites may cause diarrhea, malnutrition, anemia, intestinal obstruction, malabsorption, blood loss, tissue destruction and inflammation.
