Ova and Parasite Examination
Test Mnemonic
OVAP
CPT Codes
- 87209 - QTY (1)
- 87177 - QTY (1)
LOINC ®
673-4
Aliases
- Trichrome Stain
- trematodes
- Amoeba
- cestodes
- ciliates
- cysts
- Egg
- flagellates
- Helminth
- nematodes
- O & P
- OAP
- Ova
- Parasite
- parasitic exam
- Protozoa
- Stool test
- STUL kit
- trophozoites
Performing Laboratory
Cleveland Clinic Laboratories
Specimen Requirements
| Volume | Type | Container | Collect Temperature | Transport Temperature | Special Instructions |
|---|---|---|---|---|---|
| 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 are concentrated to increase sensitivity of detection. For urine specimens, a 24-hour urine specimen collection is preferred for identification of Schistosoma. For CSF specimens, consider reaching out to the lab or microbiology medical director prior to collection. |
| 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/) |
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/) |
| 5 mL | Stool | Formalin 10% | Refrigerated | Refrigerated | Complete vial to fill line. |
| 5 mL | Stool | SAF | Refrigerated | Refrigerated | Complete vial to fill line. |
| Complete to fill line | Stool | AlcorFix | Refrigerated | Refrigerated |
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 |
| Refrigerated | Stool - Preserved: 2 months; Unpreserved: Preferred within 6 hours, acceptable within 12 hours. Body fluids - 72hours |
| Frozen | Stool and body fluids - Unacceptable |
Days Performed
Mon - Fri
Turnaround Time
1 - 8 days
Methodology
| Name | Description |
|---|---|
| Microscopy |
Reference Range
Special Info
Recommend sending a complete STUL kit for submission of all outpatient specimens for any additional add-on testing.
Clinical Info
This test can identify a variety of different parasites - protozoa and helminths. Infections by some parasites can be asymptomatic but can also cause gastrointestinal symptoms such as diarrhea, abdominal pain etc. Parasitic infections are not currently common within the United States and exposure, travel history to locations with poor sanitation are indicators for an ova and parasite examination. Within the United States Cryptosporidium and Giardia are the most common parasitic agents and OVAPSC is the test of choice in individuals with no international travel history or risk of exposure to unsanitary conditions. Disseminated parasitic infections to extraintestinal sites is possible and can present asymptomatically or with symptoms including but not limited to cough, fever, bloody sputum, skin lesions.
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. Staining procedures used in this test can not identify Cryptosporidium, Cyclospora and Cystoisospora (order CRYSPO), and microsporidia (order MICSPO). Presence of specific parasites are not indicative of active infection or causative agent of symptoms; clinical correlation needed.