TABLE 1

Examples of use recommendations for select tests

Test nameUse recommendation(s)
Giardia/Cryptosporidium enzyme immunoassayUse when Giardia infection is most likely (e.g., to test for infectious diarrhea in a patient without a travel history).
Use to detect Cryptosporidium, which is a pathogen in immunocompetent and immunocompromised patients.
Ova and parasite examinationUse predominantly when the patient has visited an area where parasites other than Giardia are endemic.
Modified acid-fast stainUse when Cryptosporidium, Cyclospora, or Cystoisospora is suspected based on exposure and immunologic status.
Modified trichrome stainUse for the detection of microsporidiosis, which is primarily a disease of immunocompromised hosts.
Pin worm prepUse to collect eggs from the perianal skin. Do not order an O&P for the diagnosis of enterobiasis.
Baermann, agar plate culture, or Harada-MoriUse when a negative O&P result is obtained from a symptomatic immunocompromised patient for whom there is a high suspicion of Strongyloides infection.
Multiplex molecular panelsAssays for gastrointestinal pathogens include some parasite pathogens, such as Giardia lamblia (G. duodenalis, G. intestinalis), Cryptosporidium, and E. histolytica (34). These are moderately or highly complex tests and represent options for expanded testing in smaller laboratories that may lack parasitology expertise.