Test Catalog

Test Id : MTBS

Microsporidia Stain, Varies

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

Diagnosis of extra-intestinal microsporidiosis involving the lung, skin, and other organs, particularly in immunocompromised hosts

 

Diagnosis of ocular microsporidiosis

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

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

Trichrome-Blue Stain (Ryan Modification)

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

Microsporidia Stain

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

Encephalitozoon

Entercytozoon

Nosema

Pleistophora

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

Specimen Type
Describes the specimen type validated for testing

Varies

Ordering Guidance

This test is intended to be ordered on specimens other than stool and urine.

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
Q00M0042 Specimen Source

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

Submit only 1 of the following specimens:

 

Specimen Type: Duodenal aspirate (small intestinal aspirate, jejunal aspirate, small bowel aspirate)

Container/Tube: Sterile container

Specimen Volume: 0.5 mL

Additional Information: ECOFIX and 10% formalin are acceptable preservatives.

Specimen Stability Information: Preserved Ambient (preferred) <10 days/Refrigerated <3 days

 

Specimen Type: Respiratory secretions (bronchoalveolar lavage [BAL], sputum, bronchial wash, pleural fluid)

Container/Tube: Sterile container

Specimen Volume: 0.5 mL

Specimen Stability Information: Refrigerated <3 days (preferred)/Frozen <10 days

 

Specimen Type: Eye (vitreous fluid, corneal scraping, ocular fluid)

Container/Tube: Sterile container

Specimen Volume: 0.5 mL

Specimen Stability: Refrigerated <3 days

 

Specimen Type: Fresh tissue (lung, eye, bladder, rectal, intestinal, colon, skin, muscle, kidney)

Container/Tube: Sterile container

Specimen Volume: 3-mm biopsy in 0.1-mL sterile saline

Specimen Stability: Refrigerated <3 days

 

Specimen Type: Gallbladder aspirate/Bile aspirate

Container/Tube: Sterile container

Specimen Volume: 0.5 mL

Specimen Stability: Refrigerated <3 days/Frozen <10 days

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

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

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

See Specimen Required

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
Varies Varies

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

Diagnosis of extra-intestinal microsporidiosis involving the lung, skin, and other organs, particularly in immunocompromised hosts

 

Diagnosis of ocular microsporidiosis

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

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

Microsporidia are highly specialized fungi that cause a wide variety of clinical syndromes in humans. The most common microsporidia are Enterocytozoon bieneusi and Encephalitozoon intestinalis, which infect the gastrointestinal tract and cause a diarrheal illness, and Encephalitozoon cuniculi and Encephalitozoon hellem, which can infect the conjunctiva, respiratory tract, and genitourinary system. Human infections have been reported most frequently in patients with AIDS, but also can occur in other immunocompromised patients, including solid organ allograft recipients and, sporadically, immunocompetent hosts. Less commonly, other microsporidia such as Vittaforma corneae and Brachiola species can cause disseminated or organ-specific disease. Diagnosis of microsporidiosis is traditionally performed by light microscopic examination of stool, urine, and other specimens using a strong trichrome (chromotrope 2R) stain for detection of the characteristic spores. Unfortunately, microscopic identification can be challenging due to the small size of the spores (1-4 micrometer) and their resemblance to yeast. Molecular detection using species-specific polymerase chain reaction  offers improved sensitivity and specificity and is available for the microsporidia that cause the majority of intestinal and renal infections (ie, Encephalitozoon species and Enterocytozoon bieneusi). The microsporidia stain is reserved for use with other (nonstool and nonurine) specimen sources due to the variety of other species that may be detected outside of the intestinal tract and kidney.

 

The antihelmintic drug, albendazole has been found effective in some infections due to Enterocytozoon bieneusi and Encephalitozoon (Septata) intestinalis.

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 Microsporidia detected

Interpretation
Provides information to assist in interpretation of the test results

A positive result suggests an active or recent infection. Results should be correlated with the patient's clinical presentation and immune status.

 

A negative result indicates absence of detectable microsporidial spores in the specimen but does not always rule out ongoing microsporidiosis since the organism may be present at very low levels or shed sporadically.

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

These organisms are very difficult to identify among the multitude of organisms and artifactual debris present in feces.

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

1. Weber R, Bryan RT, Schwartz DA, Owen RL. Human microsporidial infections. Clin Microbiol Rev. 1994;7:426-461

2. Goodgame RW. Understanding intestinal spore-forming protozoa: cryptosporidia, microsporidia, isospora, and cyclospora. Ann Intern Med. 1996;124:429-441

3. Wanke CA, DeGirolami P, Federman M. Enterocytozoon bieneusi infection and diarrheal disease in patients who were not infected with human immunodeficiency virus: case report and review. Clin Infect Dis. 1996;23:816-818

4. Special Stains for Microsporidia: Modified Trichrome-Ryan Blue. American Society of Microbiology. Updated December 19, 2022. Accessed August 31, 2023. Available at www.clinmicronow.org/doi/10.1128/9781683670438.CMPH.ch9.4-4

5. Special Stains for Microsporidia: Modified Trichrome-Ryan Blue. Center for Disease Control and Prevention. Updated May 29, 2019. Accessed August 31, 2023. Available at www.cdc.gov/dpdx/microsporidiosis/index.html

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

Specimen concentrates are stained by the trichrome-blue method.(DeGirolami PC, Ezratty CR, Desai G, et al. Diagnosis of intestinal microsporidiosis by examination of stool and duodenal aspirate with Weber's modified trichrome and Uvitex 2B stains. J Clin Microbiol. 1995;33:805-810)

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 Friday

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

7 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.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • 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-Concentration

87207-Stain

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
MTBS Microsporidia Stain 10857-1
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.
MTBS Microsporidia Stain 10857-1

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