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Stain, Isospora

Isospora Stain

Test Codes

EPIC: LAB5527

Department

Microbiology

Instructions

New restrictions are in place for ordering the Isospora Stain:

• All orders require a Comprehensive Ova and Parasite Review Approval Form to be completed and submitted with the specimen.

At least 2 weeks should elapse following barium administration before collection of the specimen.

Specimen Collection Criteria

Collect: Random stool specimen or duodenal aspirate placed in a transport vial with EcoFix preservative.

• Fill the vial until the fluid level reaches the red fill line.
• Unpreserved stool must be placed in EcoFix within 1 hour of collection.  

Physician Office/Draw Specimen Preparation

Maintain specimens in EcoFix preservative at room temperature (20-25°C or 68-77°F) prior to transport.

Preparation for Courier Transport

Transport: Stool in EcoFix preservative, at room temperature (20-26°C or 68-78.8°F).

Rejection Criteria

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 1 hour (Unpreserved)
Room Temperature (20-25°C or 68-77°F): 7 days (Preserved)
Refrigerated (2-8°C or 36-46°F): 7 days (Preserved)
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Room Temperature (20-26°C or 68-78.8°F): 7 days

Laboratory

Royal Oak Microbiology Laboratory
Dearborn, Farmington Hills, Grosse Pointe, Taylor, Trenton, Troy and Wayne sent to Royal Oak Microbiology Laboratory for testing. 

Performed

Monday – Friday, 7:00 am – 3:30 pm.
Results available within 24 hours.

Reference Range

No Isospora seen.

Test Methodology

Concentration, stain, microscopic examination.

Interpretation

Demonstration of oocysts in feces or in duodenal aspirates or finding developmental stages of the parasite in biopsy specimens of the small intestine is diagnostic of infection.

Clinical Utility

This assay aids in the diagnosis of isoporiasis.

Clinical Disease

Isoporiasis is caused by Isospora belli, a coccidian protozoan. The most common presenting symptom of isosporiasis is protracted watery diarrhea. Clinical manifestations are similar to those caused by Cryptosporidium and include abdominal pain, anorexia, and weight loss. Infection can be life threatening in immunocompromised patients, particularly those with AIDS. Fever, malaise, abdominal pain, nausea, and headache have all been reported (1). The disease may persist for months or years. Oocysts may be shed irregularly, so multiple stool specimens are recommended for testing (2).

Epidemiology

Humans are the only known host for I. belli. Frequency of this parasite, especially in asymptomatic persons, is unknown. Infection is more common in tropical and subtropical than in temperate climates and in areas of poor sanitary conditions (1). Infection can involve both adults and children, and compromised and immunocompetent individuals. Disease is usually self-limiting in the immunocompetent (2).

Incubation Period

Estimated to be 8-14 days, based on a small number of persons who had laboratory exposure to the organism (1).

Transmission

Human infection probably occurs by the oral-fecal route. Oocysts are resistant to most disinfectants and may remain viable for months in a cool, moist environment (1).

Reference

1. Garcia, L.S. 2007. Intestinal Protozoa (Coccidia Microsporida) and Algae. Diagnostic Medical Parasitalogy, 5^th edition. ASM Press. Washington, D.C.
2. Novak-Weekley, S., and A.L. Leber,. 2015. Cystoisospora, Cyclospora, and Sarcocystis. Jorgensen, J.H., et. al. (eds.), Manual of Clinical Microbiology, 11^th ed. ASM Press, Washington, D.C.

CPT Codes

87207, 87015.

Contacts

Last Updated

6/21/2023