Stool Analysis

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 4

STOOL ANALYSIS

Unlike in bacterial infections were etiologic agents can readily be recovered in


culture, diagnosis of parasitic diseases are based mainly on demonstration of
adult or developing forms of the causative parasite in specimens sent to the
laboratory for investigations. The most commonly used specimen for the
detection of intestinal parasites is faeces. Faecal specimens are examined for the
presence of trophozoites and cysts of protozoa, and eggs and larva of helminths.
Whole adult worms or segments of some worms may also be seen.
Trophozoites, cysts eggs and larvae can be seen only with the microscope but
the adult worms or segments of tapeworms can be seen with the naked eye.
Samples of faeces must be properly collected, processed and examined for the
detection of parasites.

COLLECTION OF STOOL SPECIMENS

A normal stool consists of almost exclusively of faeces but in the diseased


intestine a portion of stool may consist of a bloody mucus discharge or there
may be a considerable amount of sloughed tissues. Care should be taken to
ensure a proper collection of sample. Specimens should be collected in a clean,
dry, screw cap container with a wide mouth and without a preservative. The
specimen must be contaminated with urine, water or dirt during collection.
These substances may destroy protozoan trophozoites or may contain free living
protozoans that can be mistaken for pathogenic microorganisms. The container
should be labelled with the patient’s name or number; and date and time of
collection.

EXAMINATION OF STOOL SPECIMENS

Specimens for examination must be, fresh, that is, promptly collected and
uncontaminated. Formed stool which cannot examined immediately, can be
refrigerated at 3-5OC and stored in close closed containers to prevent
desiccation. Watery stools and those containing mucus or blood should be
examined promptly, as they may contain motile amoebae. Proper processing of
stool sample involves both macroscopic (visual) and precedes microscopic
examination.
MACROSCOPIC EXAMINATION

Faecal samples are best described by their colour, consistency and presence or
absence of macroscopic blood, mucus and exudates. Presence of worm or worm
segments should also be noted.

a. Colour: The colour can be described as Black (occult blood), brown, pale
yellow and white
b. Consistency: The consistency can be described as formed, soft formed
and unformed or liquid (watery).

MICROSCOPIC EXAMINATION (WET MOUNTS)

The easiest and the simplest technique for the direct microscopic examination of
faces is wet mount. Wet can be prepared directly from the faecal material in
saline and iodine. Other useful wet mounts are buffered methylene blue and
eosin. The saline wet mount is mused for preliminary microscopic examination
of faeces to detect protozoan trophozoites and cysts; and helminth larvae and
eggs. A characteristic motility of a parasite can be used for its identification.
Excessive cellular exudate in the faeces in form of pus (white blood cells) or
blood (red blood cells), macrophages or any other significant material can be
detected in wet mount. In the iodine wet mount, most cysts can usually be
specifically identified because the iodine stains their nuclei and glycogen. If
present, however, the parasites are not motile in iodine.

PROCEDURE

Normal Saline Preparation

 A drop of normal saline was placed on a clean grease free slide.


 Using a clean wooden applicator stick homogenise/mix the stool sample
very well and take a small portion of the stool sample.
 Mix the stool sample with a drop of saline solution on the slide.
 Cover it with a cover slip avoiding air bubbles and overflow
 Examine the preparation under a microscope with x10 objective and
confirmed with x40 objective.

Result: No ova or cyst of parasite seen


Lugol,s iodine preparation

 A drop of lugol’s iodine (1%) is placed on a clean grease free slide.


 Using a clean wooden applicator stick homogenise/mix the stool sample
very well and take a small portion of the stool sample.
 Mix the stool sample with a drop of saline solution on the slide.
 Cover it with a cover slip avoiding air bubbles and overflow
 Examine the preparation under a microscope with x10 objective and
confirmed with x40 objective.

Result: No ova or cyst of parasite seen.

Concentration techniques for detecting stool parasites


Sometimes the routine examination of stool fails to reveal any parasite even
though symptoms of intestinal parasitic infection persist. This may be due, in
part, to the fact that some parasites shed their eggs in little amounts in the stool,
which makes them to be easily over-looked when sought by their routine
methods. The chances of spotting such parasites are increased by adopting
concentration techniques. By this method, the bulk of the materials in stool are
removed, leaving mainly the parasites.
Stool parasites can be concentrated by sedimentation or floatation or a
combination of two methods.

Floatation technique
The floatation technique utilizes a liquid suspending medium heavier than the
parasite, so they rise to the surface and can be skimmed out of the surface film.
The method is recommended for the detection of eggs of hookworm. A
lumbricoides, H. nana and Teania spp. Eggs or cysts of parasites, when
suspended in a fluid of higher relative density, float to the surface.

Procedure
 Place approximately 0.5g of stool sample in a wide-mouth bottle. Fill the
bottle 2.5ml mark with the brine
 Using a clean applicator stick, crush the portion of stool and mix well
with the solution. Then fill the bottle to the top with the brine; suspension
should be completely uniform.
 Place a coverslip over the mouth of the bottle. Ensure that the coverslip is
in contact with the liquid with no air bubbles.
 Leave for 10 minutes
 Remove the coverslip with care and place it on slide and examine at once
under the microscope using 10X and 40X objective lens.

Result: No ova or cyst of parasite seen

You might also like