Test Catalog

Test Id : CYCL

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Cyclospora Stain, Feces

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Identifying Cyclospora cayetanensis as a cause of infectious gastroenteritis

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

For other diagnostic tests that may be of value in evaluating patients with diarrhea; the following are available:

-Laboratory Testing for Infectious Causes of Diarrhea

-Parasitic Investigation of Stool Specimens Algorithm

Method Name
A short description of the method used to perform the test

Safranin Stain

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Cyclospora Stain

Aliases
Lists additional common names for a test, as an aid in searching

CLB

Coccidian like bodies

Cyanobacter like Bodies

Cyclospora cayetanensis

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

For other diagnostic tests that may be of value in evaluating patients with diarrhea; the following are available:

-Laboratory Testing for Infectious Causes of Diarrhea

-Parasitic Investigation of Stool Specimens Algorithm

Specimen Type
Describes the specimen type validated for testing

Fecal

Ordering Guidance

Cryptosporidium oocysts do not reliably stain with the modified safranin stain. If Cryptosporidium is suspected, the specific enzyme-linked immunosorbent assay for this organism is recommended; order CRYPS / Cryptosporidium Antigen, Feces. To detect this organism as well as other common infectious causes of diarrhea, order GIP / Gastrointestinal Pathogen Panel, PCR, Feces.

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
Q00M0017 Specimen Source

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Patient Preparation: Patient should avoid use of antidiarrheal medication (eg, loperamide [Imodium-AD] or Pepto-Bismol).

The presence of barium will interfere with this test.

 

Submit only 1 of the following specimens:

 

Preferred:

Specimen Type: Preserved stool

Supplies:

-ECOFIX Stool Transport Vial (Kit) (T219)

-Formalin-Meridian 10% Buffered Neutral (T466)

Container/Tube:

Preferred: ECOFIX Stool Transport Vial (Kit)

Acceptable: 10% Buffered Formalin Stool Transport (Kit), Sodium Acetate Formalin (SAF)

Specimen Volume: 10 g

Specimen Stability Information: Ambient 21 days (preferred)/Refrigerated 21 days

 

Acceptable

Specimen Type: Unpreserved stool

Supplies: Stool container, Small (Random), 4 oz (T288)

Container/Tube: Stool container

Specimen Volume: 5 g

Specimen Stability Information: Refrigerated 3 days (preferred)

Special Instructions
Library of PDFs including pertinent information and forms related to the test

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Microbiology Test Request (T244)

-Gastroenterology and Hepatology Test Request (T728)

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

Preserved stool: 1 g

Unpreserved stool: 2 g

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Fecal Varies

Useful For
Suggests clinical disorders or settings where the test may be helpful

Identifying Cyclospora cayetanensis as a cause of infectious gastroenteritis

Testing Algorithm
Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

For other diagnostic tests that may be of value in evaluating patients with diarrhea; the following are available:

-Laboratory Testing for Infectious Causes of Diarrhea

-Parasitic Investigation of Stool Specimens Algorithm

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Cyclospora cayetanensis is an apicomplexan protozoan parasite that causes watery diarrhea, anorexia, malaise, and weight loss.(1) The extent of symptoms depends on the age and health of the host and the infectious dose of oocysts. The infection is usually self-limited, but symptoms can be severe and prolonged, particularly in immunocompromised patients. Cyclosporal diarrheal disease is endemic in many parts of the world, including parts of Asia, India, Southeast Asia, and Latin America. Although most cases of cyclosporiasis have been seen in travelers to developing countries, outbreaks in the United States are now seen each year associated with contaminated fruits and vegetables from Latin America. Transmission is via ingestion of fecally contaminated food or water. If untreated, symptoms may last for several weeks and may follow a relapsing course. The infection usually responds to treatment with a sulfamethoxazole-trimethoprim drug combination.

 

C cayetanensis oocysts are traditionally detected by modified acid-fast staining in which the oocysts stain bright pink red.(1,2) However, the modified safranin stain has been shown to provide increased sensitivity over the modified acid-fast method and produces a more rapid result. It is the method used in the Mayo Clinic Parasitology Laboratory to detect C cayetanensis oocysts in fecal sediment.

 

For more information about diagnostic tests that may be of value in evaluating patients with diarrhea see the following:

-Laboratory Testing for Infectious Causes of Diarrhea

-Parasitic Investigation of Stool Specimens Algorithm

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Negative

If positive, reported as Cyclospora cayetanensis detected.

Interpretation
Provides information to assist in interpretation of the test results

A report of "Cyclospora cayetanensis detected" indicates the presence of this parasite in the patient's feces.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

The full spectrum of disease and the extent of carriage without disease have not been determined. In addition, the exact sensitivity and specificity of the stain have also not been determined.

 

Cryptosporidium oocysts do not reliably stain with the modified safranin stain. If Cryptosporidium is suspected, the specific enzyme-linked immunosorbent assay (CRYPS / Cryptosporidium Antigen, Feces) for this organism is recommended. Alternatively, the GIP / Gastrointestinal Pathogen Panel, PCR, Feces may be performed to detect this organism as well as other common infectious causes of diarrhea.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1.Centers for Disease Control and Prevention (CDC) Global Health, Division of Parasitic Diseases and Malaria. Parasites–Cyclosporiasis (Cyclospora infection). CDC; Updated March 12, 2020. Accessed October 31, 2022. Available at www.cdc.gov/parasites/cyclosporiasis/index.html

2. Garcia LS, Arrowood M, Kokoskin E, et al: Practical guidance for clinical microbiology laboratories: Laboratory diagnosis of parasites from the gastrointestinal tract. Clin Microbiol Rev. 2017 Nov 15;31(1):e00025-17

Method Description
Describes how the test is performed and provides a method-specific reference

A thin smear of the fecal concentrate is placed on a slide and allowed to air dry. The slide is then placed in acidic alcohol for 5 minutes, followed by washing with cold tap water. The slide is then placed in a Coplin jar containing safranin solution in acidified water and heated in a microwave at full power for 1 minute. Excess stain is washed off with tap water, and the slide is placed in a Coplin jar containing the counterstain (aqueous solution of either 1% methylene blue or 1% malachite green) for 1 minute. After a final rinse in tap water, the slide is dried, and a coverslip is applied. The slide is examined microscopically using high-power with oil immersion. The oocysts of Cyclospora will be clear to pink and have a somewhat refractile quality.(Visvesvara GS, Moura H, Kovacs-Nace E, Wallace S, Eberhard ML: Uniform staining of Cyclospora oocysts in fecal smears by a modified safranin technique with microwave heating. J Clin Microbiol 1997;35:730-733; Mathison BA, Pritt BS: Cyclosporiasis-Updates on clinical presentation, pathology, clinical diagnosis, and treatment. Microorganisms. 2021 Sep 2;9(9):1863. doi: 10.3390/microorganisms9091863)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Saturday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

2 to 4 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

3 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

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  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their account representative. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

87015

87207

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
CYCL Cyclospora Stain 50313-6
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
CYCL Cyclospora Stain 50313-6

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | PHP Pdf | CMS Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports