Ova and Parasite Examination
Test Mnemonic
OVAP
CPT Codes
- 87209 - QTY (1)
- 87177 - QTY (1)
LOINC ®
673-4
Aliases
- Amoeba Examination
- Helminth Examination
- Parasite Examination
- Protozoa Examination
- Trichrome Stain
Performing Laboratory
Cleveland Clinic Laboratories
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| Unspecified | Respiratory | Sterile container | Ambient | Sterile leakproof container should be used with transport at room temperature. | |
| 3 - 5 mL | Fluid, body | Sterile container | Ambient | Sterile leakproof container should be used with transport at room temperature. | |
| 15 mL | Urine, random | Sterile container | Ambient | Urine specimens should be freshly voided and submitted in a sterile leakproof container. Transport at ambient temperature. | |
| 5 mL | Stool | EcoFix fixative | Ambient | Submit stool via the STUL kit. (Oracle). Recommended screening procedure is 3 stool specimens, 1 per day for each of 3 days. EcoFix preservative is required for OVAP testing. If an OVAPSC is ordered simultaneously 1 vial C/S/Cary-Blair is also needed. |
Alternate Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 5 mL | Sputum | Clean container | Ambient | Sterile leakproof container should be used with transport at room temperature. | |
| 5 mL | Stool | Clean container | If stool cannot be transported to the laboratory within 6 hours, stool should be placed into 1 vial EcoFix (OVAP) and 1 vial C/S/Cary-Blair (OVAPSC). Recommended screening procedure is 3 stool specimens, 1 per day for each of 3 days. | ||
| 5 mL | Stool | Other | Alternative Collection: 2 vial system: 1 vial of 10% formalin and 1 vial of PVA or 1 vial system: 1 vial of SAF. Recommended screening procedure is 3 stool specimens, 1 per day for each of 3 days. |
Minimum Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 5 mL |
Stability
| Environmental Condition | Description |
|---|---|
| Ambient | Preserved: 2 months; Unpreserved: 6 hours |
| Refrigerated | Preserved: 2 months; Unpreserved: 6 hours |
| Frozen | Preserved: Unacceptable; Unpreserved: Unacceptable |
Days Performed
5 days per week
Turnaround Time
1 - 8 days
Methodology
| Name | Description |
|---|---|
| Concentration Wet Mount | |
| Direct Wet Mount (if fresh) | |
| Permanent Stained Smear |
Reference Range
Special Info
The enzyme immunoassay (EIA) (i.e. ova & parasite screen; OVAPSC) for Cryptosporidium and Giardia is the recommended test for most patients thought to have enteritis caused by a parasite. Diagnostic testing is not recommended for traveler’s diarrhea unless it persists for 14 days. The potential etiology of diarrhea in immunocompromised patients encompasses a broad differential diagnosis. A full Ova & Parasitic exam (OVAP) should be reserved for individuals with significant risk factors for enteric parasitosis (eg, immigration from or travel to an endemic area). Requests for Ova and Parasite Exam on patients who have been hospitalized for >3 days will be blocked; requests for processing of specimens on such patients should be made through Client Services. Testing are performed weekdays on day shift. Special studies Cyclospora and Cystoisospora If Cyclospora, Cystoisospora are diagnostic considerations, then (CRYSPO) should be ordered; this assay also detects Cryptosporidium, but the OVAPSC is the preferred test for that parasite. Microsporidia PCR is the test of choice if a microsporidial infection is considered, but the less sensitive microscopic examination for microsporidia is available upon request (MICSPO). Pinworm Importantly, pinworm is not routinely detected on O&P examination, so pinworm exam (TAPE) should be ordered; the specimen should be collected with a pinworm collection kit, but cellophane tape, which has been used for collection that is adherent to a glass slide, is also acceptable. Parasitic Liver Cyst/Abscess Liver aspirates will be assessed for the presence of E. histolytica and Echinococcus. Paragonimus Sputum and bronchoalveolar lavage specimens will be assessed for the eggs of Paragonimus species. When paragonimiasis is considered, then a stool ova & parasite examination should also be ordered (OVAP). Worm Identification Worms and portions of worms may be submitted for identification (PARAID). Urinary Schistosomiasis Twenty four hour urine specimens for the diagnosis of urinary schistosomiasis are optimal, but single urine specimens are acceptable; serologic studies should be considered when this diagnosis is considered. Urine specimens >48 hrs. old and urine in preservative will be rejected.
Clinical Info
The Ova and Parasite screen (OVAPSC) is more sensitive than the Ova and Parasite exam (OVAP) for the detection of Giardia, the most commonly encountered enteric parasite in this locale. The Ova and Parasite screen (OVAPSC) should be used, rather than the Ova and Parasite exam (OVAP), unless other enteric parasites are suspected. The Ova and Parasite exam (OVAP) should be ordered to detect and identify the presence of enteric protozoa and the eggs of helminths. This test should be reserved for individuals with significant risk factors for enteric parasitosis (eg, immigration from or travel to an endemic area). In such cases, a minimum of 3 specimens collected over 3 - 10 days are recommended. Stool should be collected using the Cleveland Clinic Universal Stool Collection Kit available in Oracle (includes 1 EcoFix vial, 1 C/S vial, and 1 sterile container). Special studies are needed for the detection of Cryptosporidium, Cyclospora, Cystoisospora, microsporida, pinworm, worm identification, and parasites in unusual locations. Non-stool specimens should be collected using a sterile screw-top transport container.