Ova and Parasites, Stool Concentrate and Permanent Smear [681X]

CPT Code(s)

87177, 87209

Patient Preparation

Patient preparation: Interfering substances-bismuth, barium (wait 7-10 days), antimicrobial agents (wait 14 days), gall bladder dye (wait 21 days after procedure).

Preferred Specimen(s)

Fresh stool preserved in 10% Formalin AND in PVA, room temperature

Minimum: 1 gram EACH vial

Room temperature: 6 months

Refrigerated: Not recommended

Frozen: Unacceptable

Alternative Specimen(s)

Fresh stool preserved in formalin and in PVA is acceptable.

   •

25 mL urine in a sterile, screw-capped container is acceptable.

Stool in sodium acetate-acetic acid formalin (SAF) transport vial or Ecofix is only acceptable in place of 10% formalin (Ecofix is not validated for NYS clients).



Stool in sodium acetate-acetic acid formalin (SAF) transport vial AND in PVA, room temperature

Minimum: 1 g

   •

Stool in ECOFIX transport vial AND in PVA, room temperature

Minimum: 1 g

Room temperature: 6 months

Refrigerated: Not recommended

Frozen: Unacceptable

   •

Minimum: 25 mL of an unpreserved urine, submitted in a sterile, screw-capped container, refrigerated (cold packs)

Please note: Trichrome stain is not performed on urine.

Room temperature: Unacceptable

Refrigerated: 48 hours

Frozen: Unacceptable

Collection Instructions

Place fresh stool in 10% formalin transport vial, as well as in PVA transport medium, within 1 hour of collection. Add stool to bring the liquid level to the "fill to here" line on the vial. Mix well. Send both specimens at room  temperature in the same shipping container.

Urine may be submitted unpreserved for exam for Schistosoma. Trichrome stain is not performed on urine. Do not submit first morning specimen. Peak egg secretion occurs between noon and 3 p.m. Deliver urine to laboratory as soon as possible, but before 48 hours.

Specimen Stability

Stool:

Room temperature: 6 months

Refrigerated: Not recommended

Frozen: Unacceptable

Urine:

Room temperature: Unacceptable

Refrigerated: 48 hours

Frozen: Unacceptable

Reject Criteria

Rejection Criteria: Unpreserved stool; Specimens containing barium; Stool not in 10% Formalin, PVA, SAF, MIF, Ecofix; Stool received frozen; Stool submitted in expired transport vial; Preserved urine.

Methodology

Microscopic Examination of Concentrate Permanent Stained

Performing Laboratory

Quest Diagnostics Nichols Institute

14225 Newbrook Drive

Chantilly, VA 20153

Setup Schedule

Set up: Mon-Fri p.m. and night shift, Sat, Sun p.m.; Report available: 5 days

Reference Range(s)

No ova and parasites seen



If parasitic infestation is strongly suspected, collect up to 3 stool specimens over a 1-3 day period, since a single specimen can be negative. If Giardia is strongly suspected, please see Giardia Specific Antigen, Test Code 8625X [3471]. Routine Ova and Parasite Concentration and Stain may not be adequate for the detection of Cryptosporidium, Cyclospora, or Isospora. Test code(s) 37213 (Cryptosporidium AG., DFA) and/or 10018 (Cyclospora and Isospora exam) should be ordered to detect these parasites.

Clinical Significance

Diseases caused by human parasites remain, on a worldwide
basis, among the principle causes of morbidity and
mortality. Correct diagnosis of intestinal parasitic
infection depends on proper collection, transport,
detection and identification of parasites in stool
specimens. Symptoms range from malaise to death.
Diagnosis is dependent upon examining multiple stool
exams, due to the erratic shed rates of some parasites.