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HelpTest Code LABCYCLS Cyclospora Stain, Feces
Additional Codes
| Test Name in EPIC | EPIC Test Code | Mnemonic | Mayo Test ID |
|---|---|---|---|
| CYCLOSPORA STAIN | LABCYCLS | CYCLS | CYCL |
Reporting Name
Cyclospora StainUseful For
Identifying Cyclospora cayetanensis as a cause of infectious gastroenteritis
Testing Algorithm
For other diagnostic tests that may be of value in evaluating patients with diarrhea; the following are available:
Method Name
Safranin Stain
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
FecalOrdering Guidance
Cryptosporidium oocysts do not reliably stain with the modified safranin stain. If Cryptosporidium is suspected, the specific enzyme-linked immunosorbent assay for this organism is recommended; order CRYPS / Cryptosporidium Antigen, Feces. To detect this organism as well as other common infectious causes of diarrhea, order GIP / Gastrointestinal Pathogen Panel, PCR, Feces.
Specimen Required
Patient Preparation: Patient should avoid use of antidiarrheal medication (eg, loperamide [Imodium-AD] or Pepto-Bismol).
The presence of barium will interfere with this test.
Submit only 1 of the following specimens:
Preferred:
Specimen Type: Preserved stool
Supplies:
-ECOFIX Stool Transport Vial (Kit) (T219)
-Formalin-Meridian 10% Buffered Neutral (T466)
Container/Tube:
Preferred: ECOFIX Stool Transport Vial (Kit)
Acceptable: 10% Buffered Formalin Stool Transport (Kit), Sodium Acetate Formalin (SAF)
Specimen Volume: 10 g
Specimen Stability Information: Ambient 21 days (preferred)/Refrigerated 21 days
Acceptable
Specimen Type: Unpreserved stool
Supplies: Stool container, Small (Random), 4 oz (T288)
Container/Tube: Stool container
Specimen Volume: 5 g
Specimen Stability Information: Refrigerated 3 days (preferred)
Specimen Type: Stool
Container/Tube: SAF Formalin (yellow top) preservative vial
Specimen Volume: Adequate specimen
Collection Instructions:
1. Add stool to preservative vial within 15 minutes of collection.
2. Mix contents of tube with spoon, twist cap tightly closed, and shake vigorously until contents are well mixed. Do not fill above line indicated on container.
3. Avoid contamination with water, urine, or other extraneous material.
Additional Information:
1. Anti-diarrheal compounds, antacids, bismuth, or barium should not be used prior to collection. Wait 7 to 10 days after barium or bismuth to collect specimen.
2. Patient should not be taking antibiotics as they often cause a temporary decrease or absence of organisms in the stool and reliable diagnosis may not be possible for 2 to 3 weeks or more.
3. Specimen should not be collected from patients receiving gallbladder dye until 3 weeks afterwards.
4. If more than 1 specimen is submitted, specimen must be collected at least 24 hours apart.
5. Hospital inpatients should not have stool submitted after 3 days of hospitalization.
Specimen Minimum Volume
Preserved stool: 1 g
Unpreserved stool: 2 g
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Fecal | Varies | |
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Special Instructions
Reference Values
Negative
If positive, reported as Cyclospora cayetanensis detected.
Day(s) Performed
Monday through Saturday
CPT Code Information
87015
87207
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| CYCL | Cyclospora Stain | 50313-6 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| CYCL | Cyclospora Stain | 50313-6 |
Test Classification
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.Clinical Information
Cyclospora cayetanensis is an apicomplexan protozoan parasite that causes watery diarrhea, anorexia, malaise, and weight loss.(1) The extent of symptoms depends on the age and health of the host and the infectious dose of oocysts. The infection is usually self-limited, but symptoms can be severe and prolonged, particularly in immunocompromised patients. Cyclosporal diarrheal disease is endemic in many parts of the world, including parts of Asia, India, Southeast Asia, and Latin America. Although most cases of cyclosporiasis have been seen in travelers to developing countries, outbreaks in the United States are now seen each year associated with contaminated fruits and vegetables from Latin America. Transmission is via ingestion of fecally contaminated food or water. If untreated, symptoms may last for several weeks and may follow a relapsing course. The infection usually responds to treatment with a sulfamethoxazole-trimethoprim drug combination.
C cayetanensis oocysts are traditionally detected by modified acid-fast staining in which the oocysts stain bright pink red.(1,2) However, the modified safranin stain has been shown to provide increased sensitivity over the modified acid-fast method and produces a more rapid result. It is the method used in the Mayo Clinic Parasitology Laboratory to detect C cayetanensis oocysts in fecal sediment.
For more information about diagnostic tests that may be of value in evaluating patients with diarrhea see the following:
Interpretation
A report of "Cyclospora cayetanensis detected" indicates the presence of this parasite in the patient's feces.
Cautions
The full spectrum of disease and the extent of carriage without disease have not been determined. In addition, the exact sensitivity and specificity of the stain have also not been determined.
Cryptosporidium oocysts do not reliably stain with the modified safranin stain. If Cryptosporidium is suspected, the specific enzyme-linked immunosorbent assay (CRYPS / Cryptosporidium Antigen, Feces) for this organism is recommended. Alternatively, the GIP / Gastrointestinal Pathogen Panel, PCR, Feces may be performed to detect this organism as well as other common infectious causes of diarrhea.
Method Description
A thin smear of the fecal concentrate is placed on a slide and allowed to air dry. The slide is then placed in acidic alcohol for 5 minutes, followed by washing with cold tap water. The slide is then placed in a Coplin jar containing safranin solution in acidified water and heated in a microwave at full power for 1 minute. Excess stain is washed off with tap water, and the slide is placed in a Coplin jar containing the counterstain (aqueous solution of either 1% methylene blue or 1% malachite green) for 1 minute. After a final rinse in tap water, the slide is dried, and a coverslip is applied. The slide is examined microscopically using high-power with oil immersion. The oocysts of Cyclospora will be clear to pink and have a somewhat refractile quality.(Visvesvara GS, Moura H, Kovacs-Nace E, Wallace S, Eberhard ML: Uniform staining of Cyclospora oocysts in fecal smears by a modified safranin technique with microwave heating. J Clin Microbiol 1997;35:730-733; Mathison BA, Pritt BS: Cyclosporiasis-Updates on clinical presentation, pathology, clinical diagnosis, and treatment. Microorganisms. 2021 Sep 2;9(9):1863. doi: 10.3390/microorganisms9091863)
Report Available
2 to 4 daysSpecimen Retention Time
3 daysForms
If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:
-Microbiology Test Request (T244)