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Practical Guide to Diagnostic Parasitology


Practical Guide to Diagnostic Parasitology


ASM Books, Band 141 3. Aufl.

von: Lynne Shore Garcia

76,99 €

Verlag: ASM Press
Format: EPUB
Veröffentl.: 30.04.2021
ISBN/EAN: 9781683673620
Sprache: englisch
Anzahl Seiten: 592

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Beschreibungen

<p>In the 21st century the field of diagnostic medical parasitology continues to see dramatic changes, including newly recognized pathogens and the changing endemicity and classification of familiar organisms; neglected tropical diseases and the impact of global climate change; and new methodologies and risk management issues. This classic clinical laboratory parasitology reference, now in its third edition, has been extensively revised and updated in a new full-color format. Still organized to provide maximum help to the user, particularly from the bench perspective, every section has been expanded with new images and discussion.</p> <p>Specimen collection, preservation, and testing options are thoroughly discussed, from the routine ova and parasite examination to blood films, fecal immunoassays, and the newer molecular test panels. Specific test procedures, laboratory methods and reagents, and algorithms are provided. The ever-helpful "FAQ" section of commonly asked questions now offers expanded information on stool specimen fixatives and testing, thorough coverage of new techniques, and advice on reporting and commenting on results.</p> <p>The heart of the <i>Guide</i>, covering identification of individual pathogens, has been expanded with more discussion and comparison of organisms and dozens of new color images. An entirely new section has been added that uses extensive figures and new tables to illustrate common problems with differentiating organisms from one another and from possible microscopic artifacts. The final section has been reorganized to include identification keys and dozens of tables summarizing organism characteristics to assist the bench microbiologist with routine diagnostic testing methods.<br /><br />If you are looking for online access to the latest clinical microbiology content, please visit <a href="http://www.wiley.com/learn/clinmicronow">www.wiley.com/learn/clinmicronow</a>.</p>
<p>Preface xix</p> <p>About the Author xxiii</p> <p><b>Section 1 Philosophy and Approach to Diagnostic Parasitology 1</b></p> <p>Neglected Tropical Diseases 2</p> <p>Why Perform Diagnostic Parasitology Testing? 3</p> <p>Travel 3</p> <p>Population Movements 3</p> <p>Control Issues 4</p> <p>Climate Change 4</p> <p>Epidemiologic Considerations 4</p> <p>Compromised Patients; Potential Sex Bias Regarding Infection Susceptibility; Aging 4</p> <p>Approach to Therapy 5</p> <p>Who Should Perform Diagnostic Parasitology Testing? 5</p> <p>Laboratory Personnel 5</p> <p>Nonlaboratory Personnel 5</p> <p>Where Should Diagnostic Parasitology Testing Be Performed? 6</p> <p>Inpatient Setting 6</p> <p>Outpatient or Referral Setting 6</p> <p>Decentralized Testing 6</p> <p>Physician Office Laboratories 6</p> <p>Over-the-Counter (Home Care) Testing 7</p> <p>Field Sites 7</p> <p>What Factors Should Precipitate Testing? 7</p> <p>Travel and Residence History 7</p> <p>Immune Status of the Patient 7</p> <p>Clinical Symptoms 7</p> <p>Documented Previous Infection 7</p> <p>Contact with Infected Individuals 8</p> <p>Potential Outbreak Testing 8</p> <p>Occupational Testing 8</p> <p>Therapeutic Failure 8</p> <p>What Testing Should Be Performed? 8</p> <p>Routine Tests 8</p> <p>Special Testing and Reference Laboratories 9</p> <p>Specialized Referral Test Options—DPDx and Other Sites 9</p> <p>Other (Nonmicrobiological) Testing 10</p> <p>What Factors Should Be Considered in Development of Test Menus? 10</p> <p>Physical Plant 10</p> <p>Client Base 10</p> <p>Customer Requirements and Perceived Levels of Service 10</p> <p>Personnel Availability and Level of Expertise 10</p> <p>Equipment 10</p> <p>Budget 11</p> <p>Risk Management Issues Associated with Stat Testing 11</p> <p>Primary Amebic Meningoencephalitis 11</p> <p>Granulomatous Amebic Encephalitis and Amebic Keratitis 14</p> <p>Request for Blood Films 15</p> <p>Automated Instrumentation 15</p> <p>Patient Information 16</p> <p>Conventional Microscopy 16</p> <p>Table 1.1 Common features of the neglected tropical diseases 18</p> <p><b>Section 2 Parasite Classification and Relevant Body Sites 19</b></p> <p>Protozoa (Intestinal) 20</p> <p>Amebae, Stramenopiles 20</p> <p>Flagellates 22</p> <p>Ciliates 22</p> <p>Apicomplexa (Including Coccidia) 23</p> <p>Microsporidia (Now Classified with the Fungi) 23</p> <p>Protozoa (Other Body Sites) 24</p> <p>Amebae 24</p> <p>Flagellates 24</p> <p>Apicomplexa (Including Coccidia) 24</p> <p>Microsporidia (Now Classified with the Fungi) 25</p> <p>Protozoa (Blood and Tissue) 26</p> <p>Apicomplexa (Including Sporozoa) 26</p> <p>Flagellates 26</p> <p>Nematodes (Intestinal) 29</p> <p>Nematodes (Tissue) 29</p> <p>Nematodes (Blood and Tissue) 30</p> <p>Cestodes (Intestinal) 31</p> <p>Cestodes (Tissue) 32</p> <p>Trematodes (Intestinal) 33</p> <p>Trematodes (Liver and Lungs) 33</p> <p>Trematodes (Blood) 35</p> <p>Pentastomids 35</p> <p>Acanthocephala 36</p> <p>Table 2.1 Classification of human parasites 37</p> <p>Table 2.2 Cosmopolitan distribution of common parasitic infections 39</p> <p>Table 2.3 Body sites and possible parasites recovered 40</p> <p><b>Section 3 Collection Options 43</b></p> <p>Safety 44</p> <p>Collection of Fresh Stool Specimens 44</p> <p>Collection Method 44</p> <p>Number of Specimens To Be Collected 45</p> <p>Collection Times 47</p> <p>Posttherapy Collection 47</p> <p>Specimen Type, Stability, and Need for Preservation 47</p> <p>Preservation of Stool Specimens 48</p> <p>Overview of Preservatives 48</p> <p>Formalin 49</p> <p>Sodium Acetate-Acetic Acid-Formalin (SAF) 50</p> <p>Schaudinn’s Fluid 51</p> <p>Schaudinn’s Fluid containing PVA (Mercury Base) 52</p> <p>Schaudinn’s Fluid containing PVA (Copper Base, Zinc Base) 52</p> <p>Single-Vial Collection Systems (Other than SAF) 53</p> <p>Universal Fixative (Total-Fix) 54</p> <p>Quality Control for Preservatives 54</p> <p>Procedure Notes for Use of Preservatives (Stool Fixative Collection Vials) 55</p> <p>Procedure Limitations for Use of Preservatives (Stool Fixative Collection Vials) 55</p> <p>Collection of Blood 56</p> <p>Collection and Processing 56</p> <p>Stat Test Requests and Risk Management Issues 57</p> <p>Collection of Specimens from Other Body Sites 57</p> <p>Table 3.1 Fecal specimens for parasites: options for collection and processing 58</p> <p>Table 3.2 Approaches to stool parasitology: test ordering 61</p> <p>Table 3.3 Preservatives and procedures commonly used in diagnostic parasitology (stool specimens) 62</p> <p>Table 3.4 Advantages of thin and thick blood films 64</p> <p>Table 3.5 Advantages and disadvantages of buffy coat films 64</p> <p>Table 3.6 Potential problems of using EDTA anticoagulant for the preparation of thin and thick blood films 65</p> <p>Table 3.7 Body sites and possible parasites recovered (trophozoites, cysts, oocysts, spores, adults, larvae, eggs, amastigotes, and trypomastigotes) 66</p> <p><b>Section 4 Specimen Test Options: Routine Diagnostic Methods and Body Sites 69</b></p> <p>Ova and Parasite Examination of Stool Specimens 70</p> <p>Other Diagnostic Methods for Stool Specimens 72</p> <p>Culture of Larval-Stage Nematodes 72</p> <p>Estimation of Worm Burdens through Egg Counts 73</p> <p>Hatching Test for Schistosome Eggs 73</p> <p>Screening Stool Samples for Recovery of a Tapeworm Scolex 74</p> <p>Testing of Other Intestinal Tract Specimens 74</p> <p>Examination for Pinworm 74</p> <p>Sigmoidoscopy Material 75</p> <p>Duodenal Drainage Material 76</p> <p>Duodenal Capsule Technique (Entero-Test) 76</p> <p>Urogenital Tract Specimens 77</p> <p>Sputum 77</p> <p>Aspirates 78</p> <p>Biopsy Specimens 78</p> <p>Blood 79</p> <p>Thin Blood Films 79</p> <p>Thick Blood Films 80</p> <p>Blood Staining Methods 80</p> <p>Buffy Coat Films 80</p> <p>QBC Microhematocrit Centrifugation Method 80</p> <p>Knott Concentration 81</p> <p>Membrane Filtration Technique 81</p> <p>Culture Methods 81</p> <p>Animal Inoculation and Xenodiagnosis 82</p> <p>Antibody and Antigen Detection 82</p> <p>Antibody Detection 82</p> <p>Antigen Detection, Nucleic Acid-Based Tests, and Molecular Panels 84</p> <p>Intradermal Tests 84</p> <p>UV Autofluorescence 84</p> <p>Table 4.1 Body sites, procedures and specimens, recommended methods and relevant parasites, and comments 86</p> <p>Table 4.2 Serologic, antigen, and probe tests used in the diagnosis of parasitic infections 94</p> <p><b>Section 5 Specific Test Procedures and Algorithms 95</b></p> <p>Microscopy 96</p> <p>CALIBRATION OF THE MICROSCOPE 96</p> <p>Ova and Parasite Examination 99</p> <p>DIRECT WET FECAL SMEAR 99</p> <p>CONCENTRATION (Sedimentation and Flotation) 104</p> <p>SEDIMENTATION CONCENTRATION (Formalin-Ethyl Acetate) 105</p> <p>SEDIMENTATION CONCENTRATION USING THE UNIVERSAL FIXATIVE (Total-Fix) 109</p> <p>FLOTATION CONCENTRATION (Zinc Sulfate) 110</p> <p>PERMANENT STAINED SMEAR 114</p> <p>Stains Used in the Permanent Stained Smear 116</p> <p>TRICHROME STAIN (Wheatley’s Method) 116</p> <p>IRON HEMATOXYLIN STAIN (Spencer-Monroe Method) 122</p> <p>IRON HEMATOXYLIN STAIN (Tompkins-Miller Method) 127</p> <p>MODIFIED IRON HEMATOXYLIN STAIN (Incorporating the Carbol Fuchsin Step) 128</p> <p>CHLORAZOL BLACK E STAIN 131</p> <p>Specialized Stains for Coccidia and Microsporidia 132</p> <p>KINYOUN’S ACID-FAST STAIN (Cold Method) 132</p> <p>MODIFIED ZIEHL-NEELSEN ACID-FAST STAIN (Hot Method) 136</p> <p>CARBOL FUCHSIN NEGATIVE STAIN FOR <i>CRYPTOSPORIDIUM </i>(W. L. Current) 139</p> <p>RAPID SAFRANIN METHOD FOR <i>CRYPTOSPORIDIUM </i>(D. Baxby) 139</p> <p>RAPID SAFRANIN METHOD FOR <i>CYCLOSPORA</i>, USING A MICROWAVE OVEN (Govinda Visvesvara) 139</p> <p>AURAMINE O STAIN FOR APLICOMPLEXA (INCLUDING COCCIDIA) (Thomas Hänscheid) 140</p> <p>MODIFIED TRICHROME STAIN FOR MICROSPORIDIA (Weber, Green Counterstain) 144</p> <p>MODIFIED TRICHROME STAIN FOR MICROSPORIDIA (Ryan, Blue Counterstain) 146</p> <p>MODIFIED TRICHROME STAIN FOR MICROSPORIDIA (Evelyn Kokoskin, Hot Method) 149</p> <p>Fecal Immunoassays for Intestinal Protozoa 150</p> <p><i>ENTAMOEBA HISTOLYTICA </i>150</p> <p><i>CRYPTOSPORIDIUM </i>SPP. 151</p> <p><i>GIARDIA LAMBLIA </i>151</p> <p>KITS UNDER DEVELOPMENT 151</p> <p>COMMENTS ON THE PERFORMANCE OF FECAL IMMUNOASSAYS 151</p> <p>ENZYME IMMUNOASSAYS (Antigen Detection, No Centrifugation Recommended) 152</p> <p>FLUORESCENCE (Visual Identification of the Organisms, Centrifugation Recommended) 152</p> <p>LATERAL-FLOW CARTRIDGES (Antigen Detection, No Centrifugation Recommended) 153</p> <p>Larval Nematode Culture 153</p> <p>HARADA-MORI FILTER PAPER STRIP CULTURE 153</p> <p>BAERMANN CONCENTRATION 155</p> <p>AGAR PLATE CULTURE FOR <i>STRONGYLOIDES STERCORALIS </i>158</p> <p>Other Methods for Gastrointestinal Tract Specimens 161</p> <p>EXAMINATION FOR PINWORM (Cellulose Tape Preparations) 161</p> <p>SIGMOIDOSCOPY SPECIMENS (Direct Wet Smear) 163</p> <p>SIGMOIDOSCOPY SPECIMENS (Permanent Stained Smear) 166</p> <p>DUODENAL ASPIRATES 168</p> <p>Methods for Urogenital Tract Specimens 171</p> <p>RECEIPT OF DRY SMEARS 171</p> <p>DIRECT SALINE MOUNT 171</p> <p>PERMANENT STAINED SMEAR 174</p> <p>URINE CONCENTRATION (Centrifugation) 176</p> <p>URINE CONCENTRATION (Nuclepore Membrane Filter) 179</p> <p>Preparation of Blood Films 181</p> <p>THIN BLOOD FILMS 182</p> <p>THICK BLOOD FILMS 184</p> <p>COMBINATION THICK-THIN BLOOD FILMS 186</p> <p>RISK MANAGEMENT ISSUES ASSOCIATED WITH BLOOD FILMS 187</p> <p>USE OF A REFERENCE LABORATORY FOR PARASITE BLOOD DIAGNOSTIC TESTING 188</p> <p>BLOOD FILM REPORTING WITH ADDITIONAL REPORT COMMENTS 189</p> <p>BUFFY COAT BLOOD FILMS 189</p> <p>Blood Stains 190</p> <p>STAIN OPTIONS 190</p> <p>GIEMSA STAIN 190</p> <p>Blood Concentration 194</p> <p>BUFFY COAT CONCENTRATION 194</p> <p>KNOTT CONCENTRATION 195</p> <p>MEMBRANE FILTRATION CONCENTRATION 197</p> <p>Algorithm 5.1 Procedure for processing fresh stool for the O&P examination 201</p> <p>Algorithm 5.2 Procedure for processing liquid specimens for the O&P examination 202</p> <p>Algorithm 5.3 Procedure for processing preserved stool for the O&P examination—two-vial collection kit 203</p> <p>Algorithm 5.4 Procedure for processing SAF-preserved stool for the O&P examination 204</p> <p>Algorithm 5.5 Procedure for the use of Total-Fix (universal fixative, single-vial system) (this fixative contains no mercury, no PVA, and no formalin) 205</p> <p>ALTERNATE METHOD FOR SMEAR PREPARATION DIRECTLY FROM VIAL 206</p> <p>Algorithm 5.6 Use of various fixatives and their recommended stains 207</p> <p>Algorithm 5.7 Ordering algorithm for laboratory examination for intestinal parasites 208</p> <p>Algorithm 5.8 Procedure for processing blood specimens for examination 209</p> <p>Table 5.1 Body sites, specimens, and recommended stains 210</p> <p>Table 5.2 Approaches to stool parasitology: test ordering 214</p> <p>Table 5.3 Laboratory test reports: notes and optional comments 215</p> <p>Table 5.4 Parasitemia determined from conventional light microscopy: clinical correlation 216</p> <p><b>Section 6 Commonly Asked Questions about Diagnostic Parasitology 217</b></p> <p>Stool Parasitology 218</p> <p>Specimen Collection 218</p> <p>Specimen Processing 221</p> <p>Diagnostic Methods 222</p> <p>Stool Immunoassay Options 227</p> <p>MOLECULAR TEST PANELS (FDA CLEARED) 229</p> <p>A. APTIMA <i>Trichomonas vaginalis </i>Assay 230</p> <p>B. Affirm VPIII Microbial Identification Test 231</p> <p>C. Cepheid Xpert TV Assay for <i>Trichomonas vaginalis </i>from Men and Women 232</p> <p>D. BD MAX Enteric Parasite Panel 233</p> <p>E. BioFire FilmArray Gastrointestinal Panel 234</p> <p>F. Luminex (Verigene II GI Flex Assay; Includes Parasites) 236</p> <p>G. Other Pending Molecular Tests 238</p> <p>Organism Identification 238</p> <p>Reporting 242</p> <p>Proficiency Testing 245</p> <p>Tissues or Fluids 245</p> <p>Blood 246</p> <p>Specimen Collection 246</p> <p>Specimen Processing 248</p> <p>Diagnostic Methods 249</p> <p>Organism Identification 254</p> <p>Reporting 256</p> <p>Proficiency Testing 257</p> <p>General Questions 258</p> <p><b>Section 7 Parasite Identification 265</b></p> <p><b>Protozoa</b></p> <p>Amebae (Intestinal) 266</p> <p><i>Entamoeba histolytica </i>266</p> <p><i>Entamoeba histolytica/Entamoeba dispar </i>270</p> <p>Comments on <i>Entamoeba moshkovskii </i>and <i>Entamoeba bangladeshi </i>273</p> <p><i>Entamoeba bangladeshi </i>274</p> <p><i>Entamoeba hartmanni </i>275</p> <p><i>Entamoeba coli </i>278</p> <p><i>Entamoeba gingivalis </i>281</p> <p><i>Entamoeba polecki </i>283</p> <p><i>Endolimax nana </i>284</p> <p><i>Iodamoeba bütschlii </i>287</p> <p><i>Blastocystis </i>spp. (formerly <i>Blastocystis hominis</i>) 290</p> <p>Flagellates (Intestinal) <i>Giardia lamblia </i>(<i>G</i>. <i>duodenalis</i>, <i>G</i>. <i>intestinalis</i>) 295</p> <p><i>Dientamoeba fragilis </i>298</p> <p><i>Chilomastix mesnili </i>302</p> <p><i>Pentatrichomonas hominis </i>304</p> <p><i>Enteromonas hominis</i>, <i>Retortamonas intestinalis </i>307</p> <p>Ciliates (Intestinal) 310</p> <p><i>Balantidium coli </i>310</p> <p>Apicomplexa (Intestinal) 315</p> <p><i>Cryptosporidium </i>spp. 315</p> <p>Coccidia (Intestinal) 319</p> <p><i>Cyclospora cayetanensis </i>319</p> <p><i>Cystoisospora </i>(formerly <i>Isospora</i>) <i>belli </i>323</p> <p>Microsporidia (Intestinal) 326</p> <p><i>Enterocytozoon bieneusi </i>326</p> <p><i>Encephalitozoon intestinalis</i>, <i>Encephalitozoon </i>spp. 329</p> <p>Sporozoa (Blood and Tissue) 334</p> <p><i>Plasmodium vivax </i>334</p> <p><i>Plasmodium falciparum </i>339</p> <p><i>Plasmodium malariae </i>343</p> <p><i>Plasmodium ovale wallickeri</i>, <i>Plasmodium ovale curtisi </i>346</p> <p><i>Plasmodium knowlesi </i>350</p> <p>Malaria 353</p> <p><i>Babesia </i>spp. (<i>Babesia microti</i>, <i>B</i>. <i>duncani</i>, <i>B</i>. <i>divergens</i>, <i>B</i>. <i>venatorum</i>) 355</p> <p><i>Toxoplasma gondii </i>359</p> <p>Flagellates (Blood and Tissue) 368</p> <p><i>Leishmania </i>spp. 368</p> <p><i>Trypanosoma brucei gambiense </i>(West), <i>T. brucei rhodesiense </i>(East) 372</p> <p><i>Trypanosoma cruzi </i>376</p> <p>Amebae (Other Body Sites) 381</p> <p><i>Naegleria fowleri </i>381</p> <p><i>Acanthamoeba </i>spp., <i>Balamuthia mandrillaris</i>, <i>Sappinia diploidea </i>385</p> <p>Flagellates (Other Body Sites) 389</p> <p><i>Trichomonas vaginalis </i>389</p> <p>NEMATODES 392</p> <p>Intestinal 392</p> <p><i>Ascaris lumbricoides </i>392</p> <p><i>Trichuris trichiura</i>, <i>Capillaria philippinensis </i>395</p> <p><i>Necator americanus</i>, <i>Ancylostoma duodenale</i>, <i>Ancylostoma ceylanicum </i>(Hookworms); <i>Trichostrongylus </i>spp. 398</p> <p><i>Strongyloides stercoralis </i>401</p> <p><i>Enterobius vermicularis </i>404</p> <p>Tissue 407</p> <p><i>Ancylostoma braziliense</i>, <i>Ancylostoma caninum</i>, <i>Uncinaria stenocephala </i>(Dog and Cat Hookworms) 407</p> <p><i>Toxocara canis</i>, <i>Toxocara cati </i>(Dog and Cat Ascarid Worms) 410</p> <p><i>Dracunculus medinensis </i>413</p> <p><i>Trichinella spiralis </i>416</p> <p>Blood and Tissue 419</p> <p>Filarial Worms 419</p> <p>CESTODES 425</p> <p>Intestinal 425</p> <p><i>Taenia saginata </i>425</p> <p><i>Taenia solium </i>428</p> <p><i>Diphyllobothrium latum </i>432</p> <p><i>Hymenolepis </i>(<i>Rodentolepis</i>) <i>nana </i>435</p> <p><i>Hymenolepis diminuta </i>438</p> <p><i>Dipylidium caninum </i>440</p> <p>Tissue 443</p> <p><i>Echinococcus granulosus</i>, <i>Echinococcus multilocularis</i>, <i>Echinococcus vogeli</i>,</p> <p><i>Echinococcus oligarthrus </i>443</p> <p>TREMATODES 448</p> <p>Intestinal 448</p> <p><i>Fasciolopsis buski </i>448</p> <p>Liver and Lungs 451</p> <p><i>Paragonimus westermani</i>, <i>Paragonimus mexicanus</i>, <i>Paragonimus kellicotti </i>451</p> <p><i>Fasciola hepatica </i>454</p> <p><i>Clonorchis </i>(<i>Opisthorchis</i>) <i>sinensis </i>(Chinese liver fluke) 457</p> <p>Blood 460</p> <p><i>Schistosoma </i>spp. (<i>Schistosoma mansoni</i>, <i>S</i>. <i>haematobium</i>, <i>S</i>. <i>japonicum</i>,</p> <p><i>S</i>. <i>mekongi</i>, <i>S</i>. <i>malayensis</i>, <i>S</i>. <i>intercalatum</i>) 460</p> <p><b>Section 8 Common Problems in Parasite Identification 465</b></p> <p>Table 8.1 <i>Entamoeba </i>sp. trophozoites versus macrophages 486</p> <p>Table 8.2 <i>Entamoeba </i>sp. cysts versus PMNs 486</p> <p>Table 8.3 <i>Entamoeba histolytica </i>versus <i>Entamoeba coli </i>precysts and cysts 487</p> <p>Table 8.4 <i>Endolimax nana </i>versus <i>Dientamoeba fragilis </i>488</p> <p><b>Section 9 Identification Aids 489</b></p> <p>DIAGNOSTIC CONSIDERATIONS 490</p> <p>Table 9.1 Rapid diagnostic procedures 490</p> <p>Table 9.2 Diagnostic characteristics for organisms in wet mounts (direct or concentration sediment) 491</p> <p>Table 9.3 Diagnostic characteristics for organisms in permanent stained smears (e.g., Wheatley’s trichrome, iron-hematoxylin) 491</p> <p>Identification Key 9.1 Identification of intestinal amebae (permanent stained smear) 491</p> <p>Identification Key 9.2 Identification of intestinal flagellates 492</p> <p>Identification Key 9.3 Identification of helminth eggs 493</p> <p>Identification Key 9.4 Identification of microfilariae 494</p> <p>PROTOZOA 495</p> <p>Table 9.4 Intestinal protozoa: trophozoites of common amebae 495</p> <p>Table 9.5 Intestinal protozoa: cysts of common amebae 497</p> <p>Table 9.6 Intestinal protozoa: trophozoites of less common amebae 499</p> <p>Table 9.7 Intestinal protozoa: cysts of less common amebae 499</p> <p>Table 9.8 Morphologic criteria used to identify <i>Blastocystis </i>spp. 500</p> <p>Table 9.9 Intestinal protozoa: trophozoites of flagellates 501</p> <p>Table 9.10 Intestinal protozoa: cysts of flagellates 502</p> <p>Table 9.11 Intestinal protozoa: ciliate (<i>Balantidium coli</i>) 503</p> <p>Table 9.12 Apicomplexa 503</p> <p>Table 9.13 Microsporidia (related to the Fungi): general information 504</p> <p>Table 9.14 Microsporidia: recommended diagnostic techniques 505</p> <p>Table 9.15 Comparison of <i>Naegleria fowleri, Acanthamoeba </i>spp., <i>Balamuthia mandrillaris, </i>and <i>Sappinia diploidea </i>506</p> <p>Table 9.16 Characteristics of <i>Trichomonas vaginalis </i>507</p> <p>Table 9.17 Key characteristics of intestinal tract and urogenital system protozoa 508</p> <p>HELMINTHS 512</p> <p>Table 9.18 Normal life spans of the most common intestinal nematodes 512</p> <p>Table 9.19 Characteristics of the most common intestinal nematodes 513</p> <p>Table 9.20 Tissue nematodes 515</p> <p>Table 9.21 <i>Trichinella spiralis</i>: life cycle stages and clinical conditions 517</p> <p>Table 9.22 Characteristics of human microfilariae 518</p> <p>Table 9.23 Characteristics of cestode parasites (intestinal) 519</p> <p>Table 9.24 Tissue cestodes 521</p> <p>Table 9.25 Characteristics of intestinal trematodes 523</p> <p>Table 9.26 Characteristics of liver and lung trematodes 524</p> <p>Table 9.27 Human paragonimiasis 526</p> <p>Table 9.28 Characteristics of blood trematodes 527</p> <p>Table 9.29 Key characteristics of helminths 528</p> <p>BLOOD PARASITES 532</p> <p>Table 9.30 Malaria characteristics with fresh blood or EDTA-blood 532</p> <p>Table 9.31 Potential problems with using EDTA anticoagulant for the preparation of thin and thick blood films 533</p> <p>Table 9.32 Plasmodia in Giemsa-stained thin blood smears 534</p> <p>Table 9.33 Relevant issues for handling requests for identification of infectious blood parasites 537</p> <p>Table 9.34 Features of human leishmanial infections 540</p> <p>Table 9.35 Characteristics of American trypanosomiasis 541</p> <p>Table 9.36 Characteristics of East and West African trypanosomiasis 541</p> <p>Table 9.37 Key characteristics of blood parasites 541</p> <p>Index 547</p>
<p><b>Lynne Shore Garcia</b> is the director of LSG & Associates, a firm providing training, teaching, and consultation services for diagnostic medical parasitology and health care administration. A former manager of the UCLA Clinical Microbiology Laboratory, she is a sought-after speaker (nationally and internationally) and author of hundreds of articles, book chapters, and books including two ASM Press books, <i>Clinical Laboratory Management</i>, Second Edition and <i>Diagnostic Medical Parasitology</i>, Sixth Edition.</p>

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