Cryptosporidia, Cyclospora and Cystoisospora Examination
Test Mnemonic
CRYSPO
Primary CPT Codes
- 87015 - QTY (1), Processing, Fluid Concentration
- 87207 - QTY (1), Smear, Parasite Special Stain
LOINC ®
20781-1
Aliases
- CLB
- Coccidia
- Coccidiaan like bodies
- Cryptosporidia
- Cryptosporidium
- Cyclospora
- Cystoisospora
- Isospora
- Modified acid fast parasites
- Stool test
- STUL kit
- Cyclospora Examination
- Cystoisospora Examination
- Ova and parasite for Cryptosporidia
Performing Laboratory
Cleveland Clinic Laboratories
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| Complete to fill line | Stool | EcoFix fixative | Refrigerated | Refrigerated | Ecofix available in a STUL kit; submit stool using a STUL kit at refrigerated conditions. STUL kit can be purchased via oracle #1570140. Refer to Stool collection guide (https://clevelandcliniclabs.com/our-laboratories/laboratory-medicine/microbiology/plmi-collection-guidelines-resources/stool-specimen-collection-guide/) |
| 0.5 mL - 10 mL | Fluid, body | Sterile container | Refrigerated | Refrigerated | Body fluids (including but not limited to GI aspirates, respiratory secretions, CSF) should be submitted to the lab in a securely tightened sterile screw-top container. A minimum volume of 0.5ml needed, however larger volumes (1-10ml) are concentrated to increase sensitivity of detection. For CSF specimens, consider reaching out to the lab or microbiology medical director prior to collection. |
Alternate Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 5 mL | Stool | Sterile container | Refrigerated | Refrigerated | Unpreserved stool should be submitted to the lab in a securely tightened sterile screw-top container and should be limited to inpatient settings due to a significantly shorter stability window. Use of non-standard (eg. food containers) is discouraged. Refer to Stool collection guide (https://clevelandcliniclabs.com/our-laboratories/laboratory-medicine/microbiology/plmi-collection-guidelines-resources/stool-specimen-collection-guide/) |
Minimum Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 5 mL |
Stability
| Environmental Condition | Description |
|---|---|
| Ambient | Stool - Preserved: 2 months; Unpreserved: Preferred within 6 hours, acceptable within 12 hours. Body fluids - 72hours |
| Frozen | Stool and body fluids - Unacceptable |
| Refrigerated | Stool - Preserved: 2 months; Unpreserved: Preferred within 6 hours, acceptable within 12 hours. Body fluids - 72hours |
Days Performed
Mon - Fri
Turnaround Time
1 - 7 days
Methodology
| Name | Description |
|---|---|
| Modified Acid Fast Stain |
Special Info
Recommend sending a complete STUL kit for submission of all outpatient specimens for any additional add-on testing.
Clinical Info
Cryptosporidia, Cyclospora and Cystoisospora are protozoan parasites that cause infection in the intestinal tract resulting in diarrhea amongst other symptoms such as abdominal pain, weight loss. Infections can be self limited but can also cause prolonged infection depending on the exposure, age and immune compromise of the host. Transmission is via ingestion of fecally contaminated food or water. Waterborne transmission through swimming pools is a common route for exposure in outbreaks of Cryptosporidiosis. Due to the small size (Cryptosporidium and Cyclospora) and inability to be stained by trichrome stain, a modified acid-fast stain is required to detect these organisms.
Clinical Limitation
Due to intermittent shedding of parasites a single negative test does not rule out a parasitic infection. Recommend testing 3 different stool specimens collected in separate containers on different days (over 5-7 days), preferably at different times of day. This test does not detect other common infectious parasites that cause diarrhea; consider ordering OVAP (other parasites) and MICSPO (for microsporidia). The gastrointestinal pathogen panel (STGIPI) is a molecular test that can also be performed to detect Cryptosporidium and Cyclospora along with other common infectious causes of persistent diarrhea.