This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
..
Contents
Preface xv
Acknowledgments XIX
PART I
Clinically Important Human ParasitesI Philosophy and Approach to Diagnostic
Old World leishmaniasis: cutaneousleishmaniasis 191Old World leishmaniasis: visceralleishmaniasis 198New World leishmaniasis: cutaneousleishmaniasis 205New World leishmaniasis: visceralleishmaniasis 212
Control of arthropods of medical importance 712Physical control 712Biological control 712Chemical control 715
25 Treatment of Parasitic Infections 718
PART 11
Diagnostic Procedures 759
26 Collection, Preservation, and Shipment of FecalSpecimens 761
Safety 761
Fresh-specimen collection 762Collection of the specimen 762Number of specimens to be collected (standardrecommendation) 762Number of specimens to be collected (pros and cons ofvarious options) 763Collection times 764
Specimen type, specimen stability, and need forpreservarían 764
Rapid safranin method for Cryptosporidium 819Rapid safranin method for Cyclospora, using amicrowave oyen 819
Auramine O stain for coccidia (from ThomasHanscheid) 819Modified trichrome stain for the microsporidia(Weber-green) 821Modified trichrome stain for the microsporidia (Ryan-bluf) 823Modified trichrome stain for the microsporidia(Kokoskin-hot method) 825Acid-fast trichrome stain for Cryptosporidium and themicrosporidia 826
28 AdditionalTechniques for Stool Examination 83 I
Aspirates 868Lungs and liver 868Lymph nades, spleen, liver, baile marrow, spinal fluid,eres, and nasopharynx 869Cutaneous ulcer 871
Biopsy material 871Skin 876
Lymph nades 876Muscle 876Rectum and bladder 877
31 Procedures for Detecting Blood Parasites 881
Preparation of thick and thin blood films 881Thick blood films 882Thin blood films 884
Combination thick and thin blood films (on the sameslide) 884Combination thick and thin blood films (can be stainedas either) 884Buffy coat blood films 886
Staining blood films 887Giemsa sta in 888
Wright's stain 889General notes on staining procedures 891
Proper examination of thin and thick bloodfilms 891
Thin blood films 891Thick blood films 893
Determination of parasitemia 893
Diagnosis of malaria: review of alternatives toconventional microscopy 894
QBC microhematocrit centrifugation method 895ParaSight F test 896NOW malaria test 900
33 Fixation and Special Preparation of FecalParasite Specimens and Arthropods 936
Fixation of parasite specimens and arthropods 936Protozoa 937Solutions to induce relaxation in adult helminths 938Nematodes 939Trematodes 940Cestodes 940
Helminth eggs and larvae 940Arthropods 940
Mounting and staining of parasite specimens forexamination 941
Nematodes 941Trematodes 942Cesto des 943
Mounting of arthropods for examination 944Mites 944Fleas and lice 944Ticks 945
Miscellaneous arthropods 945
34 ArtifactsThat Can Be Confused with ParasiticOrganisms 947Protozoa 947
Amebae 947
Flagellates 949Ciliates 949
Coccidia and microsporidia 949Cryptosporidium spp. and Cyclosporacayetanensis 949Isospora belli 950Microsporidia 951
Blood and body fluids 951Malaria parasites and Babesia spp. 951Leishmaniae and trypanosomes 951Microfilariae 951
Body fIuids: ciliated epithelial cells 953Helminths 953
Nonhuman elements seen in feces (yeast cells) 957Insect larvae 958
Spurious infections 958
Delusory parasitosis 959
35 Equipment, Supplies, Safety, and Quality SystemRecommendations for a Diagnostic ParasitologyLaboratory: Factors Influencing FutureLaboratory Practice 96 I
Disposal of contaminated materials 973Standard precautions 974Hepatitis exposure protocol 976Dangerous properties of industrial materials 976Currellt OSHA regulations for the use offormaldehyde 977Latex allergy 978
Quality systems 979Extent of services 979
Proficiencytesting 979In-house quality control 982Patient outcome measures 986
Continuous quality improvement, total qualitymanagement, or lO-step and FOCUS-PDCA forperformance improvement activities 987CLlA '88 inspection process 989
New qua lity quidelines 989ISO guidelines 989CLSI (NCCLS) model 990
Faetors influeneing future laboratory praetiee 990Managed care 992Financial considerations 993
A 1.1OBody site, specimen and procedures,reeommended methods, relevant parasites, andeomments 1037
A 1.11 Examination of tissue and body fluids 1042Al .12 Key eharacteristics of protozoa of the intestinal
traet and urogenital system 1044A 1.13 Key characteristics of tissue protozoa 1047Al. 14 Key characteristics of helminths 1049A 1.15 Key characteristies of parasites found in
blood 1052
A 1.16 Diagnostic laboratory report information thatshould be relayed to the physician 1054
A 1.17 Pros and eons of stool speeimen eollection andtesting options 1055
A 1.18 Approaches to stool parasitology: testordering 1057
A 1.19 Pros and eons of ova and parasite examinationoptions 1058
A 1.20 Laboratory test reports: optionalcomments 1060
A 1.21 Estimated prevalenee of parasitic distasesworldwide 1061
APPENDIX 2Flowcharts and Staining Tables for DiagnosticProcedures 1062
Flowcharts
A2.1 Proeedure for processing fresh stool for the ovaand parasite examination 1062
A2.2 Procedure for processing liquid speeimens for theova and parasite examination 1063
A2.3 Procedure for processing preserved stool forthe ova and parasite examination by using thetraditional two-vial colleetion kit 1064
A2.4 Procedure for processing sodium acetate-aceticacid-formalin (SAF)-preserved stool for the ovaand parasite examination 1065
A2.5 Use of various fixatives and their recommendedstains 1066
Tables
A2.1 Steps in the trichrome staining procedure(mereurie ehloride-based PVA-preserved stoolspecimens) 1067
A2.2 Steps in the trichrome staining proeedure(non-mercurie ehloride-based PVA-preserved stoolspecimens) 1068
xiv Contents
A2.J Steps in the iron hematoxylin staining procedure(mercuric chloride-based PVA-preserved stoolspecimens) (Spencer-Monroe method) 1069
A2.4 Steps in the iron hematoxylin staining procedure(mercuric chloride-based PVA-preserved stoolspecimens) (Tompkins-Miller method) 1070
A2.S Steps in the iron hematoxylin staining procedure(incorporating the carbol fuchsin step) 1071
A2.6 Oil-mounted permanent stained smears (noPermount is used) 1072
A2.7 Tips on stool processing and staining 1073
APPENDIX3Common Problems in Parasite Identification
FiguresAJ.I-AJ.2S Paired drawings of "look alikes"AJ.26 Relative sizes of helminth eggs 1080TableAJ.I
1074
1074
Adult nematodes and/or larva e found inÚool
specimens: size comparisons 1081
APPENDIX4Quality Control Recording Sheets 1082A4.1 Diagnostic parasitology quality control (QC)
(reagents) 1083A4.2 Diagnostic parasitology quality control (QC)
(reagents)-example for multiple reagents 1084A4.J Diagnostic parasitology quality control (QC)
(culture)-example of a worksheet 1085A4.4 Equipment maintenance 1086
APPENDIX5Commercial Supplies and Suppliers 1089Tables
AS.I Sources of commercial reagents andsupplies 1090
AS.2 Addresses of suppliers listed in Table A5.1 1092AS.J Sources of available reagents for immunodetection
of parasitic organisms or antigens 1094AS.4 Addresses of suppliers listed in Table A5.3 1095AS.S Commercial suppliers of diagnostic parasitology
products 1096AS.6 Sources of parasitologic specimens 1099AS.7 Sources of Kodachrome study slides (35 mili,
2 x 2) for rental 1100AS.8 Sources of additional teaching materials, including
case histories 1100
~
~.
I
APPENDIX 6Reference Sources 1101
APPENDIX 7Color Plates of Diagnostic Stages of HumanParasites I I04