Macroscopic and Microscopic Exams

Parasite, Macro, IDPAR, Tick, Mite, Louse, Lice, Fly, Flea, Bed Bug, Larval, Helminth, Nematode, Arthropod, Worm, Midge, Tapeworm, Scabies Exam, Schistosome, Insect Identification

Test Codes

Macroscopic Exam Parasite, EPIC: LAB2111126
Microscopic Parasite Exam, Non-Stool, EPIC: LAB2111304
For suspected cases of pinworm, please see Pinworm Exam (LAB248). Do not submit stool samples.

Department

Microbiology

Specimen Collection Criteria

Collect: All suspected medically important worms, arthropods (lice, ticks, fleas, etc.) and larvae. May submit egg, larva, pupa, or adult stages. Place in a sterile collection container.

• Sources: Surface of the body, stool, sputum, etc.

• Suspected parasitic worms, larvae, and maggots are to be submitted in a tightly screw-capped container with 70% alcohol. Worms should be cleaned of stool prior to submission. 
• Arthropods (lice, ticks, fleas, etc.) are to be submitted in a tightly screw-capped container containing a few drops of saline to prevent desiccation.
• Skin scrapings (scabies)
  • To test for scabies, collect the specimen by vigorously scraping affected area with a scalpel blade to remove the top of the papule. Place the skin scrapings on a clean, glass microscope  slide. Cover with a clean slide and use a rubber band to hold the 2 slides together. Place in a cup large enough to hold the slides. Label the cup with patient information. 
• Urine
  • To test for Schistosomes, collect a random urine specimen. Preferred time of collection between the hours of 12 noon and 3 pm, but not required. A 24-hour urine collection is also acceptable.
  • Do not add preservative.
  • Minimum volume = 5.0 mL

Physician Office/Draw Specimen Preparation

Maintain specimen at room temperature (20-26°C or 68-78.8°F) prior to transport.

Preparation for Courier Transport

Transport: Insect/Larvae in a sterile collection container, at room temperature (20-26°C or 68-78.8°F).

For urine specimens, transport refrigerated (2-8°C or 36-46°F).

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): Indefinite (if specimen is placed in 70% alcohol or formalin)
Refrigerated (2-8°C or 36-46°F): Urine Only: 7 days
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

Performed

Monday – Sunday, 7:00 am – 3:30 pm.
Results available within 1 business day.

Reference Range

Not applicable.

Test Methodology

Macroscopic and microscopic examination.

Interpretation

When possible, a genus- or species-level identification of the submitted organism will be made.

Organisms submitted that do not transmit infections causing human diseases will be reported as non-parasites.

Physicians should determine if finding is coincidental or relevant to infection based on identification and origin of specimen.

Clinical Utility

To aid in the diagnosis of infection by medically important parasites and arthropods.

Clinical Disease

Varies with  the specific parasite or arthropod.

Reference

1. Teleford III, S.R. 2011. Arthropods of Medical Importance. Versalovic, J. et. al. (eds.) Manual of Clinical Microbiology, 10^th ed., ASM Press, Washington, D.C., pp. 2255-2274.
2. Garcia, L.S. 2007. Medically Important Arthropods. Diagnostic Medical Parasitology. 5^th ed. ASM Press, Washington, D.C., pp. 670-717.

CPT Codes

87220

Contacts

Last Updated

10/3/2025