Test Catalog

Test Id : OPE

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Ova and Parasite, Travel History or Immunocompromised, Feces

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Overview

Test Catalog

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

Detecting and identifying parasitic protozoa and eggs and larvae of parasitic helminths in stool specimens

Highlights

This test includes concentrated wet preparation and permanent (trichrome) stained preparation as well as an exam for fecal leukocytes.

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

Microscopic

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

Ova and Parasite, Microscopy, F

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

OAP

Amoeba, Ameba

Egg Cyst

Helminth

Isospora, Isospora belli, Cystoisospora

O and P (Ova and Parasites)

Ova

Parasites

Parasitic Exam

Protozoa

Trichrome Stain

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

Fecal

Ordering Guidance

This test should be ordered when suspicion of parasitic infection is based on travel history in endemic areas or when a patient is immunocompromised.

 

For non-fecal specimens, including duodenal aspirate and colonic washing, for ova and parasitic examination, order OAPNS / Ova and Parasite, Microscopy, Varies.

 

If possible adult worms or proglottids are identified in stool or the patient's undergarments, they should be placed in 70% alcohol and submitted for PARID / Parasite Identification, Varies.

 

If specific organisms or disease states are suspected, see below:

If Acanthamoeba is suspected, order ACARP / Acanthamoeba species Molecular Detection, PCR, Ocular.

If Cryptosporidium is suspected, order CRYPS / Cryptosporidium Antigen, Feces.

If Cyclospora is suspected, order CYCL / Cyclospora Stain, Feces.

If free-living amebae are suspected, order FLARP / Free-Living Amebae Molecular Detection, PCR, Varies.

If Giardia is suspected, order GIAR / Giardia Antigen, Feces.

If microsporidia are suspected, order LCMSP / Microsporidia species, Molecular Detection, PCR, Varies.

If pinworm is suspected, order PINW / Pinworm Exam, Perianal.

If scabies is suspected, order PARID / Parasite Identification, Varies.

If Schistosoma is suspected, order SHUR / Schistosoma Exam, Urine.

If Trichomonas vaginalis is suspected, order TVRNA / Trichomonas vaginalis, Nucleic Acid Amplification, Varies.

If worms or worm segments are submitted, order PARID / Parasite Identification, Varies.

If respiratory specimens or tissue are submitted, order OAPNS / Ova and Parasite, Microscopy, Varies.

Additional Testing Requirements

Parasites are shed irregularly in stool and examination of a single specimen does not guarantee detection. Therefore, it is strongly recommended that multiple stool specimens be submitted for ova and parasite analysis. At least 3 specimens should be collected. If multiple ova and parasite collections are requested, instruct patient to collect a specimen at least 12 hours after last collection.

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

Patient Preparation: Specimen collection should be delayed for 7 to 10 days after administration of barium, bismuth, kaolin, magnesia, castor oil or mineral oil, and 2 to 3 weeks after antibiotics have been given since these may interfere with identification of protozoa.

Specimen Type: Feces

Supplies: ECOFIX Stool Transport Vial (Kit) (T790)

Preferred: ECOFIX preservative

Acceptable: 10% Buffered Formalin Stool Transport plus Zinc Polyvinyl Alcohol (Zn PVA) Stool Transport (one of each)

Specimen Volume: Portion of stool: 2 g or 2 mL

Collection Instructions:

1. Follow instructions on the container as follows:

a. Place specimen into Ecofix preservative vial or one 10% formalin AND one Zn PVA preservative vial within 30 minutes of passage or collection. Refer to the fill line on the preservative vial. Do not fill above the line indicated on the container.

b. Mix the contents of the tube with the spoon, twist the cap to close tightly, and shake vigorously until the contents are well mixed.

Additional Information:

1. Stool placed in 10% buffered formalin can be accepted if accompanied by Zn PVA-preserved specimen; 10% buffered formalin-preserved specimens submitted without an accompanying Zn PVA-preserved specimen will be canceled.

2. Specimen submitted in low viscosity (LV)-PVA, mercury PVA or copper (Cu)-PVA will be rejected.

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

Forms

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

5 mL

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 Ambient (preferred) 21 days
Refrigerated 21 days

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

Detecting and identifying parasitic protozoa and eggs and larvae of parasitic helminths in stool specimens

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

A variety of different parasites may be found in fecal specimens, duodenal aspirates, and other intestinal specimens. These parasites may include protozoa (microscopic unicellular eukaryotes) and helminths (aka worms). Infection is often asymptomatic, but symptoms range from diarrhea and malnutrition, intestinal obstruction, and rarely, death.

 

The most common intestinal reported parasites in fecal specimens are Giardia intestinalis (aka Giardia duodenalis, Giardia lamblia) and Cryptosporidium species. Both parasites may cause watery diarrhea and are endemic in the United States. The best tests for these 2 common parasites are parasite-specific fecal antigen tests (GIAR / Giardia Antigen, Feces and CRYPS / Cryptosporidium Antigen, Feces).

 

Other parasites are less commonly seen in the United States, and this test is the appropriate test for their detection. See Parasitic Investigation of Stool Specimens Algorithm for determining which test should be ordered based on the patient's exposure history and risk factors. If evaluating a patient for diarrhea, see Laboratory Testing for Infectious Causes of Diarrhea 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, organism identified

Interpretation
Provides information to assist in interpretation of the test results

A positive result indicates the presence of the parasite but does not necessarily indicate that it is the cause of any symptoms. Some strains of protozoa are nonpathogenic, and some helminths cause little or no illness.

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

For optimal results, the specific test should be ordered for detection of Giardia, Cryptosporidium, microsporidia, Cyclospora, or pinworm. This test is not the optimal method for detecting these parasites. See Ordering Guidance.

 

Parasitic examination of a minimum of 3 stool specimens is indicated for detecting most intestinal protozoa and helminths with maximum sensitivity.

 

Parasitic infections are uncommonly acquired in the hospital setting. This test is not usually useful in patients hospitalized for more than 3 days.

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

1. Garcia LS. Diagnostic Medical Parasitology. 6th ed. AMS Press; 2016

2. Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. Clin Infect Dis. 2017;65(12):e45-e80. doi:10.1093/cid/cix669

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

A portion of the ECOFIX-preserved stool is concentrated and examined. A permanent trichrome-stained slide is prepared from the ECOFIX-preserved feces.(Package inserts: Mini Parasep Faecal Parasite Concentrator APACOR; APA176-V3.3, 11/2019; Para-Pak ECOSTAIN Catalog No. 801400. Meridian Bioscience, Inc; SN10695, REV. 08/2020)

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.

4 to 6 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.

87177-Concentration (any type), for infectious agents

87209-Smear, primary source with interpretation; complex special stain (eg, trichrome, iron hematoxylin) for ova and parasites

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
OPE Ova and Parasite, Microscopy, F 10704-5
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.
OPE Ova and Parasite, Microscopy, F 10704-5

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