Diagnostic medical parasitology:
Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Washington, DC
ASM Press
2007
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| Ausgabe: | 5. ed. |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIX, 1202 S. Ill., graph. Darst. |
| ISBN: | 9781555813802 1555813801 |
Internformat
MARC
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| 100 | 1 | |a Garcia, Lynne Shore |d 1938- |e Verfasser |0 (DE-588)138448698 |4 aut | |
| 245 | 1 | 0 | |a Diagnostic medical parasitology |c Lynne Shore Garcia |
| 250 | |a 5. ed. | ||
| 264 | 1 | |a Washington, DC |b ASM Press |c 2007 | |
| 300 | |a XIX, 1202 S. |b Ill., graph. Darst. | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b n |2 rdamedia | ||
| 338 | |b nc |2 rdacarrier | ||
| 650 | 4 | |a Diagnostic parasitology | |
| 650 | 4 | |a Parasitic Diseases |x diagnosis | |
| 650 | 0 | 7 | |a Humanparasitologie |0 (DE-588)4160784-3 |2 gnd |9 rswk-swf |
| 650 | 0 | 7 | |a Diagnostik |0 (DE-588)4113303-1 |2 gnd |9 rswk-swf |
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| 689 | 0 | 1 | |a Diagnostik |0 (DE-588)4113303-1 |D s |
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Datensatz im Suchindex
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| adam_text | Contents
Preface xv
Acknowledgments xix
PART I
Clinically Important Human Parasites I
1 Philosophy and Approach to Diagnostic
Parasitology 3
2 Intestinal Protozoa: Amebae 6
Entamoeba histolytica 6
Entamoeba dispar 19
Entamoeba moshkovskii 21
Entamoeba hartmanni 21
Entamoeba colt 22
Entamoeba polecki 23
Entamoeba gingivalis 24
Endolimax nana 25
Iodamoeba biitschlii 27
Blastocystis hominis 27
3 Intestinal Protozoa: Flagellates and Ciliates 33
Giardia lamblia 33
Dientamoeba fragilis 47
Pentatrichomonas hominis (Trichomonas
hominis) 49
Trichomonas tenax 50
Chilomastix mesnili 50
Enteromonas hominis 51
Retortamonas intestinalis 51
Balantidium coli 51
4 Intestinal Protozoa (Coccidia and Microsporidia)
and Algae 57
Coccidia 57
Cryptosporidium spp. 57
Cyclospora cayetanensis 73
Isospora (Cystoisospora) belli 80
Sarcocystis spp. 83
Microsporidia 87
Algae (Prototheca) 98
5 Free-Living Amebae 102
Naegleria fowleri 104
Acanthamoeba spp. 109
Balamuthia mandrillaris 118
Sappinia diploidea 121
6 Protozoa from Other Body Sites 123
Trichomonas vaginalis 123
Toxoplasma gondii 130
7 Malaria and Babesiosis 142
Malaria 142
Babesiosis 180
8 Leishmaniasis 190
Old World leishmaniasis: cutaneous
leishmaniasis 191
Old World leishmaniasis: visceral leishmaniasis 198
New World leishmaniasis: cutaneous
leishmaniasis 205
New World leishmaniasis: visceral
leishmaniasis 212
9 Trypanosomiasis 218
African trypanosomiasis 218
Trypanosoma brucei gambiense 218
Trypanosoma brucei rbodesiense 228
American trypanosomiasis 232
Trypanosoma cruzi 232
Trypanosoma rangeli 243
vii
viii Contents
10 Intestinal Nematodes 249
Ascaris lumbricoides 250
Enterobius vermicularis 258
Tricburis trichiura 261
Capillaria philippinensis 264
Hookworms {Ancylostoma duodenale and Necator
americanus) 266
Tricbostrongylus spp. 270
Strongyloides spp. 271
11 Tissue Nematodes 283
Trichinella spp. 283
Baylisascaris procyonis 294
Lagochilascaris minor 298
Toxocara canis and T. c zfr (visceral larva migrans
and ocular larva migrans) 298
Ancylostoma braziliense and A. caninum (cutaneous
larva migrans) 302
Human eosinophilic enteritis 303
Dracunculus medinensis 304
Angiostrongylus (Parastrongylus) cantonensis
(cerebral angiostrongyliasis) 307
Angiostrongylus {Parastrongylus) costaricensis
(abdominal angiostrongyliasis) 309
Gnatbostoma spinigerum 310
Gnathostoma doloresi, G. nipponicum,
G. hispidum, and G. binucleatum 312
Anisakis simplex, A. physeteris, P seudoterranova
decipiens, Contracaecum osculatum,
Hysterothylacium aduncum, and Porrocaecum
reticulatum (larval nematodes acquired from
saltwater fish) 312
Capillaria hepatica 315
Tbelazia spp. 315
12 Filarial Nematodes 319
Wucbereria bancrofti 321
Brugia malayi 332
Brugia timori 333
Zoonotic Brugia infections (American brugian
filariasis) 334
Tropical pulmonary eosinophilia 335
Loa loa 335
Mansonella ozzardi 338
Mansonella perstans 339
Mansonella streptocerca 340
Onchocerca volvulus 341
Dirofilaria Dirofilaria and Dirofilaria
Nocbtiella spp. 348
13 Intestinal Cestodes 357
Diphyllobothrium latum 357
Taenia solium 362
Taenia saginata 371
Taenia saginata asiatica (Asian Taenia or Taenia
asiatica) 373
Hymenolepis nana 374
Hymenolepis diminuta 376
Dipylidium caninum 377
14 Tissue Cestodes: Larval Forms 381
Echinococcus granulosus (cystic disease, hydatid
disease) 381
Echinococcus tnultilocularis (alveolar disease,
hydatid disease) 393
Echinococcus oligarthrus and Echinococcus vogeli
(polycystic hydatid disease) 399
Taenia (Multiceps) spp. (Taenia multiceps, Taenia
serialis) (coenurosis) 402
Spirometra mansonoides and Diphyllobothrium spp.
(sparganosis) 402
NOTE: Taenia solium (cysticercosis) is discussed in
chapter 13.
15 Intestinal Trematodes 411
Fasciolopsis buski 411
Echinostoma ilocanum 416
Heterophyes heterophyes 417
Metagonimus yokogawai 419
Gastrodiscoides hominis 420
16 Liver and Lung Trematodes 423
Liver flukes 423
Clonorchis sinensis 423
Opisthorchis viverrini 429
Opisthorchis felineus 431
Fasciola hepatica 432
Fasciola gigantica 435
Less common liver flukes 436
Dicrocoelium dendriticum, Dicrocoelium hospes, and
Eurytrema pancreaticum 436
Lung flukes 438
Paragonimus spp. 438
17 Blood Trematodes: Schistosomes 445
Schistosoma mansoni 446
Schistosoma japonicum 458
Schistosoma mekongi 463
Schistosoma haematobium 466
Schistosoma intercalatum 472
18 Unusual Parasitic Infections 478
Aquatic Protist 478
Rhinosporidium seeberi 478
Protozoa 482
Myxozoan parasites 482
Nematodes 483
Oesophagostomum spp. 483
Eustrongylides spp. 485
Mermis nigrescens 486
Micronema deletrix 487
Dioctophyma renale 487
Ternidens deminutus 488
Mammomonogamus laryngeus (Syngamus
laryngeus) 488
Ascaris suum 489
Gongylonema pulchrum 489
Haycocknema perplexum 490
Cestodes 490
Diplogonoporus spp. 490
Bertiella studeri 491
Inermicapsifer madagascariensis 491
Raillietina celebensis 491
Mesocestoides spp. 492
Taenia crassiceps 492
Trematodes 493
Alaria americana 493
Plagiorchis spp. 493
Neodiplostontum seoulense 494
Spelotrema brevicaeca 494
Brachylaima sp. 494
Troglotrema salmincola 494
Stellantchasmus falcatus 494
Phaneropsolus bonnet and Prosthodendrium
molenkempi 495
Phaneropsolus spinicirrus 495
Haplorchis taichui 496
Gymnophalloides seoi 496
Metorchis conjunctus (North American liver
fluke) 497
Schistosoma mattheei 498
Philophthalmus lacrintosus 498
Achillurbainia spp. 499
Pentastomids 499
Armillifer spp., Linguatula serrata, and Sebekia
spp. 499
Acanthocephalans 500
Macracanthorhynchus hirudinaceus and Moniliformis
moniliformis 500
19 Parasitic Infections in the Compromised
Host 506
Entamoeba histolytica 508
Free-living amebae 518
Contents ix
Giardia lamblia 522
Toxoplasma gondii 523
Cryptosporidium spp. 524
Cyclospora cayetanensis 528
Isospora (Cystoisospora) belli 530
Sarcocystis spp. 531
Microsporidia 532
Leishmania spp. 537
Strongyloides stercoralis 540
Crusted (Norwegian) scabies 540
20 Nosocomial and Laboratory-Acquired
Infections 549
Nosocomial infections 549
Nosocomial gastrointestinal infections 550
Cryptosporidium spp. 550
Giardia lamblia 553
Entamoeba histolytica 554
Microsporidia 555
Isospora (Cystoisospora) belli 555
Hymenolepis nana 555
Taenia solium 555
Nosocomial blood and tissue infections 556
Plasmodium spp. 556
Babesia spp. 556
Trypanosoma brucei gambiense and T. brucei
rhodesiense 556
Trypanosoma cruzi 556
Leishmania donovani 557
Toxoplasma gondii 557
Nosocomial infections with ectoparasites 557
Pediculus spp. and Phthirus pubis 557
Sarcoptes scabiei 557
Myiasis 557
Nosocomial infections in the pediatric patient 558
Cryptosporidium spp. 558
Giardia lamblia 558
Pediculus humanus capitis 558
Sarcoptes scabiei 558
Nosocomial infections in the compromised
patient 558
Laboratory infections 560
Intestinal protozoa 560
Free-living amebae 560
Plasmodium spp. 560
Trypanosoma brucei gambiense and T. brucei
rhodesiense 560
Trypanosoma cruzi 562
Leishmania spp. 562
Toxoplasma gondii 562
Specimen handling 563
Summary 563
x Contents
21 Immunology of Parasitic Infections 567
Amebiasis 570
Giardiasis 575
Toxoplasmosis 577
African trypanosomiasis 579
American trypanosomiasis 580
Malaria 582
Summary 586
22 Antibody and Antigen Detection in Parasitic
Infections 592
Protozoal infections 594
Amebiasis 594
Babesiosis 597
Chagas disease 597
Cryptosporidiosis 598
Cyclosporiasis 598
Giardiasis 598
Leishmaniasis 598
Malaria 600
Toxoplasmosis 601
Trichomoniasis 603
Helminth infections 604
Cysticercosis 604
Hydatid disease 605
Fascioliasis 605
Filariasis 606
Paragonimiasis 607
Schistosomiasis 608
Strongyloidiasis 609
Toxocariasis 610
Trichinellosis 610
Intradermal tests 611
Casoni test 611
Montenegro test 611
23 Histologic Identification of Parasites 616
24 Medically Important Arthropods 670
Arthropods and their relationship to disease 670
Biological vectors of microorganisms 670
Bites and envenomation 671
Tissue invasion 676
Entomophobia and delusory parasitosis 676
Class Insecta (insects) 678
Order Diptera (flies, mosquitoes, and midges) 679
Myiasis 683
Order Hemiptera (true bugs) 690
Order Coleoptera (beetles) 692
Order Siphonaptera (fleas) (Ctenocephalid.es spp.,
Xenopsylla cheopis, Pulex irritans [human flea],
Tunga penetrans, Nosopsyllus fasciatus, Echidnophaga
gallinacea, and sand fleas ) 693
Order Anoplura (sucking lice) 694
Order Mallophaga (biting and chewing lice) 696
Order Hymenoptera (bees, wasps, and ants) 696
Order Blattaria (cockroaches) 698
Class Arachnida (ticks, mites, spiders, and
scorpions) 699
Subclass Acari (ticks, mites, and chiggers) 699
Subclass Araneae (spiders) 708
Subclass Scorpiones (scorpions) 710
Other arthropods 711
Class Chilopoda (centipedes) 711
Class Diplopoda (millipedes) 712
Class Crustacea (copepods, crabs, crayfish, etc.) 712
Control of arthropods of medical importance 712
Physical control 712
Biological control 712
Chemical control 715
25 Treatment of Parasitic Infections 718
PART II
Diagnostic Procedures 759
26 Collection, Preservation, and Shipment of Fecal
Specimens 761
Safety 761
Fresh-specimen collection 762
Collection of the specimen 762
Number of specimens to be collected (standard
recommendation) 762
Number of specimens to be collected (pros and cons of
various options) 763
Collection times 764
Specimen type, specimen stability, and need for
preservation 764
Preservation of specimens 768
Preservatives 768
Formalin 768
MIF 769
SAF 771
Schaudinn s fluid 772
PVA 772
Modified PVA 773
Single-vial collection systems (other than SAF) 773
Use of fixatives 774
Quality control for stool fixatives 774
Procedure notes for use of preservatives 775
Procedure limitations for use of preservatives 775
Shipment of diagnostic specimens, biological products,
etiologic agents, or infectious substances 775
27 Macroscopic and Microscopic Examination of
Fecal Specimens 782
Macroscopic examination 782
Microscopic examination (ova and parasite
examination) 783
Direct wet smear 783
Concentration (sedimentation and flotation) 788
Formalin-ethyl acetate sedimentation
concentration 789
Iodine-trichrome stain for sediment 792
Zinc sulfate flotation concentration 794
Commercial fecal concentration devices 796
Automated workstation for the microscopic analysis
of fecal concentrates 797
Permanent stained smear 797
Preparation of material for staining 798
Trichrome stain 802
Iron hematoxylin stain 807
Modified iron hematoxylin stain (incorporating the
carbol fuchsin step) 811
Polychrome IV stain 812
Chlorazol black E stain 813
Specialized stains for coccidia (Cryptosporidiwn,
Isospora, and Cyclospora species) and the
microsporidia 813
Modified Kinyoun s acid-fast stain (cold method) 813
Modified Ziehl-Neelsen acid-fast stain (hot
method) 816
Carbol fuchsin negative stain for Cryptosporidium (from
W. L. Current) 819
Rapid safranin method for Cryptosporidium 819
Rapid safranin method for Cyclospora, using a
microwave oven 819
Auramine O stain for coccidia (from Thomas
Hanscheid) 819
Modified trichrome stain for the microsporidia
(Weber—green) 821
Modified trichrome stain for the microsporidia (Ryan—
blue) 823
Modified trichrome stain for the microsporidia
(Kokoskin—hot method) 825
Acid-fast trichrome stain for Cryptosporidium and the
microsporidia 826
28 Additional Techniques for Stool Examination 831
Culture of larval-stage nematodes 831
Harada-Mori filter paper strip culture 832
Filter paper/slant culture technique (petri dish) 833
Charcoal culture 834
Baermann technique 835
Agar plate culture for Strongyloides stercoralis 837
Egg studies 840
Estimation of worm burdens 840
Hatching of schistosome eggs 842
Search for tapeworm scolex 844
Qualitative test for fecal fat 845
Quantitation of reducing substances (Clinitest) 847
Contents xi
29 Examination of Other Specimens from the
Intestinal Tract and the Urogenital System 850
Examination for pinworm 850
Cellulose tape preparations 851
Anal swabs 851
Sigmoidoscopy material 852
Direct saline mount 853
Permanent stained slide 853
Duodenal contents 854
Duodenal drainage 854
Duodenal capsule technique (Entero-Test) 854
Urogenital specimens 855
Trichomoniasis 855
Filariasis 856
Schistosomiasis 856
30 Sputum, Aspirates, and Biopsy Material 859
Expectorated sputum 859
Induced sputum 861
Aspirates 868
Lungs and liver 868
Lymph nodes, spleen, liver, bone marrow, spinal fluid,
eyes, and nasopharynx 869
Cutaneous ulcer 871
Biopsy material 871
Skin 876
Lymph nodes 876
Muscle 876
Rectum and bladder 877
31 Procedures for Detecting Blood Parasites 881
Preparation of thick and thin blood films 881
Thick blood films 882
Thin blood films 884
Combination thick and thin blood films (on the same
slide) 884
Combination thick and thin blood films (can be stained
as either) 884
Buffy coat blood films 886
Staining blood films 887
Giemsa stain 888
Wright s stain 889
General notes on staining procedures 891
Proper examination of thin and thick blood
films 891
Thin blood films 891
Thick blood films 893
Determination of parasitemia 893
Diagnosis of malaria: review of alternatives to
conventional microscopy 894
QBC microhematocrit centrifugation method 895
ParaSight F test 896
NOW malaria test 900
xii Contents
Flow anti-pLDH Plasmodium monoclonal
antibodies 901
PCR 902
Automated blood cell analyzers 903
Diagnosis of leishmaniasis: review of alternatives to
conventional microscopy 903
ICT for detection of anti-rK-39 antibodies 903
Concentration procedures 903
Cytocentrifugation technique 903
Knott concentration procedure 904
Membrane filtration technique 904
Gradient centrifugation technique 905
Triple-centrifugation method for trypanosomes 905
Special stain for microfilarial sheath 905
Delafield s hematoxylin 905
32 Parasite Recovery: Culture Methods,Animal
Inoculation, and Xenodiagnosis 910
Culture methods 910
Intestinal protozoa 911
Pathogenic free-living amebae 917
Pathogenic flagellates 922
Flagellates of blood and tissue 926
Toxoplasma gondii 931
Plasmodium and Babesia spp. 931
Cryptosporidium spp. 932
Microsporidia 932
Animal inoculation 932
Leishmania spp. 932
Trypanosoma spp. 933
Toxoplasma gondii 933
Xenodiagnosis 933
33 Fixation and Special Preparation of Fecal
Parasite Specimens and Arthropods 936
Fixation of parasite specimens and arthropods 936
Protozoa 937
Solutions to induce relaxation in adult helminths 938
Nematodes 939
Trematodes 940
Cestodes 940
Helminth eggs and larvae 940
Arthropods 940
Mounting and staining of parasite specimens for
examination 941
Nematodes 941
Trematodes 942
Cestodes 943
Mounting of arthropods for examination 944
Mites 944
Fleas and lice 944
Ticks 945
Miscellaneous arthropods 945
34 Artifacts That Can Be Confused with Parasitic
Organisms 947
Protozoa 947
Amebae 947
Flagellates 949
Ciliates 949
Coccidia and microsporidia 949
Cryptosporidium spp. and Cyclospora
cayetanensis 949
Isospora belli 950
Microsporidia 951
Blood and body fluids 951
Malaria parasites and Babesia spp. 951
Leishmaniae and trypanosomes 951
Microfilariae 951
Body fluids: ciliated epithelial cells 953
Helminths 953
Adult worms and larvae 953
Eggs 954
Human cells 954
Polymorphonuclear leukocytes 956
Eosinophils 956
Macrophages 956
Lymphocytes 957
Red blood cells 957
Charcot-Leyden crystals 957
Nonhuman elements seen in feces (yeast cells) 957
Insect larvae 958
Spurious infections 958
Delusory parasitosis 959
35 Equipment, Supplies, Safety, and Quality System
Recommendations for a Diagnostic Parasitology
Laboratory: Factors Influencing Future
Laboratory Practice 961
Equipment 961
Microscope 961
Centrifuge 965
Fume hood 965
Biological safety cabinet 965
Refrigerator-freezer 966
Supplies 966
Glassware 966
Miscellaneous supplies 967
ATCC quality control organisms 967
Safety: personnel and physical facilities 967
General precautions 967
Handwashing 968
Personal protective equipment (OSHA 2001 blood
borne) 969
Handling specimens 970
Processing specimens 970
Spills 972
Disposal of contaminated materials 973
Standard precautions 974
Hepatitis exposure protocol 976
Dangerous properties of industrial materials 976
Current OSHA regulations for the use of
formaldehyde 977
Latex allergy 978
Quality systems 979
Extent of services 979
Proficiency testing 979
In-house quality control 982
Patient outcome measures 986
Continuous quality improvement, total quality
management, or 10-step and FOCUS-PDCA for
performance improvement activities 987
CLIA 88 inspection process 989
New quality quidelines 989
ISO guidelines 989
CLSI (NCCLS) model 990
Factors influencing future laboratory practice 990
Managed care 992
Financial considerations 993
Decentralized testing 993
Laboratory services 993
Technological trends 994
Clinical decision support 994
Personnel issues 995
Changing demographics 995
Emerging diseases 995
36 Medical Parasitology: Case Histories 998
Protozoal infections 998
Helminth infections 1007
Blood parasite infections 1016
Diagnostic methods 1024
APPENDIXES 1027
APPENDIX I
Information Tables 1028
A 1.1 Classification of human parasites 1028
A1.2 Distribution of selected parasitic infections in the
Americas 1031
A 1.3 Distribution of selected parasitic infections in
Europe 1031
A 1.4 Distribution of selected parasitic infections in
Africa 1032
A1.5 Distribution of selected parasitic infections in
Asia 1033
A1.6 Distribution of selected parasitic infections in
Oceania 1033
A1.7 Cosmopolitan distribution of common parasitic
infections (North America, Mexico, Central
Contents xiii
America, South America, Europe, Africa, Asia,
and Oceania) 1034
A 1.8 Body sites and specimen collection 1035
A1.9 Body sites and possible parasites recovered
(trophozoites, cysts, oocysts, spores, adults,
larvae, eggs, amastigotes, and
trypomastigotes) 1036
A 1.10 Body site, specimen and procedures,
recommended methods, relevant parasites, and
comments 1037
A 1.11 Examination of tissue and body fluids 1042
AI.I2 Key characteristics of protozoa of the intestinal
tract and urogenital system 1044
A1. 13 Key characteristics of tissue protozoa 1047
A1. 14 Key characteristics of helminths 1049
A 1.15 Key characteristics of parasites found in
blood 1052
A 1.16 Diagnostic laboratory report information that
should be relayed to the physician 1054
A 1.17 Pros and cons of stool specimen collection and
testing options 1055
A1. 18 Approaches to stool parasitology: test
ordering 1057
A 1.19 Pros and cons of ova and parasite examination
options 1058
A 1.20 Laboratory test reports: optional
comments 1060
A 1.21 Estimated prevalence of parasitic diseases
worldwide 1061
APPENDIX 2
Flowcharts and Staining Tables for Diagnostic
Procedures 1062
Flowcharts
A2.1 Procedure for processing fresh stool for the ova
and parasite examination 1062
A2.2 Procedure for processing liquid specimens for the
ova and parasite examination 1063
A2.3 Procedure for processing preserved stool for
the ova and parasite examination by using the
traditional two-vial collection kit 1064
A2.4 Procedure for processing sodium acetate-acetic
acid-formalin (SAF)-preserved stool for the ova
and parasite examination 1065
A2.5 Use of various fixatives and their recommended
stains 1066
Tables
A2.1 Steps in the trichrome staining procedure
(mercuric chloride-based PVA-preserved stool
specimens) 1067
A2.2 Steps in the trichrome staining procedure
(non-mercuric chloride-based PVA-preserved stool
specimens) 1068
xiv Contents
A2.3 Steps in the iron hematoxylin staining procedure
(mercuric chloride-based PVA-preserved stool
specimens) (Spencer-Monroe method) 1069
A2.4 Steps in the iron hematoxylin staining procedure
(mercuric chloride-based PVA-preserved stool
specimens) (Tompkins-Miller method) 1070
A2.5 Steps in the iron hematoxylin staining procedure
(incorporating the carbol fuchsin step) 1071
A2.6 Oil-mounted permanent stained smears (no
Permount is used) 1072
A2.7 Tips on stool processing and staining 1073
APPENDIX 3
Common Problems in Parasite Identification 1074
Figures
A3.l-A3.25 Paired drawings of look alikes 1074
A3.26 Relative sizes of helminth eggs 1080
Table
A3.1 Adult nematodes and/or larvae found in stool
specimens: size comparisons 1081
APPENDIX 4
Quality Control Recording Sheets 1082
A4.I Diagnostic parasitology quality control (QC)
(reagents) 1083
A4.2 Diagnostic parasitology quality control (QC)
(reagents)—example for multiple reagents 1084
A4.3 Diagnostic parasitology quality control (QC)
(culture)—example of a worksheet 1085
A4.4 Equipment maintenance 1086
APPENDIX 5
Commercial Supplies and Suppliers 1089
Tables
A5.1 Sources of commercial reagents and
supplies 1090
A5.2 Addresses of suppliers listed in Table A5.1 1092
A5.3 Sources of available reagents for immunodetection
of parasitic organisms or antigens 1094
A5.4 Addresses of suppliers listed in Table A5.3 1095
A5.5 Commercial suppliers of diagnostic parasitology
products 1096
A5.6 Sources of parasitologic specimens 1099
A5.7 Sources of Kodachrome study slides (35 mm,
2 x 2) for rental 1100
A5.8 Sources of additional teaching materials, including
case histories 1100
APPENDIX 6
Reference Sources I 101
APPENDIX 7
Color Plates of Diagnostic Stages of Human
Parasites 1104
APPENDIX 8
Late-Breaking Published Information I 120
GLOSSARY 1151
INDEX 1165
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| adam_txt |
Contents
Preface xv
Acknowledgments xix
PART I
Clinically Important Human Parasites I
1 Philosophy and Approach to Diagnostic
Parasitology 3
2 Intestinal Protozoa: Amebae 6
Entamoeba histolytica 6
Entamoeba dispar 19
Entamoeba moshkovskii 21
Entamoeba hartmanni 21
Entamoeba colt 22
Entamoeba polecki 23
Entamoeba gingivalis 24
Endolimax nana 25
Iodamoeba biitschlii 27
Blastocystis hominis 27
3 Intestinal Protozoa: Flagellates and Ciliates 33
Giardia lamblia 33
Dientamoeba fragilis 47
Pentatrichomonas hominis (Trichomonas
hominis) 49
Trichomonas tenax 50
Chilomastix mesnili 50
Enteromonas hominis 51
Retortamonas intestinalis 51
Balantidium coli 51
4 Intestinal Protozoa (Coccidia and Microsporidia)
and Algae 57
Coccidia 57
Cryptosporidium spp. 57
Cyclospora cayetanensis 73
Isospora (Cystoisospora) belli 80
Sarcocystis spp. 83
Microsporidia 87
Algae (Prototheca) 98
5 Free-Living Amebae 102
Naegleria fowleri 104
Acanthamoeba spp. 109
Balamuthia mandrillaris 118
Sappinia diploidea 121
6 Protozoa from Other Body Sites 123
Trichomonas vaginalis 123
Toxoplasma gondii 130
7 Malaria and Babesiosis 142
Malaria 142
Babesiosis 180
8 Leishmaniasis 190
Old World leishmaniasis: cutaneous
leishmaniasis 191
Old World leishmaniasis: visceral leishmaniasis 198
New World leishmaniasis: cutaneous
leishmaniasis 205
New World leishmaniasis: visceral
leishmaniasis 212
9 Trypanosomiasis 218
African trypanosomiasis 218
Trypanosoma brucei gambiense 218
Trypanosoma brucei rbodesiense 228
American trypanosomiasis 232
Trypanosoma cruzi 232
Trypanosoma rangeli 243
vii
viii Contents
10 Intestinal Nematodes 249
Ascaris lumbricoides 250
Enterobius vermicularis 258
Tricburis trichiura 261
Capillaria philippinensis 264
Hookworms {Ancylostoma duodenale and Necator
americanus) 266
Tricbostrongylus spp. 270
Strongyloides spp. 271
11 Tissue Nematodes 283
Trichinella spp. 283
Baylisascaris procyonis 294
Lagochilascaris minor 298
Toxocara canis and T. c zfr (visceral larva migrans
and ocular larva migrans) 298
Ancylostoma braziliense and A. caninum (cutaneous
larva migrans) 302
Human eosinophilic enteritis 303
Dracunculus medinensis 304
Angiostrongylus (Parastrongylus) cantonensis
(cerebral angiostrongyliasis) 307
Angiostrongylus {Parastrongylus) costaricensis
(abdominal angiostrongyliasis) 309
Gnatbostoma spinigerum 310
Gnathostoma doloresi, G. nipponicum,
G. hispidum, and G. binucleatum 312
Anisakis simplex, A. physeteris, P seudoterranova
decipiens, Contracaecum osculatum,
Hysterothylacium aduncum, and Porrocaecum
reticulatum (larval nematodes acquired from
saltwater fish) 312
Capillaria hepatica 315
Tbelazia spp. 315
12 Filarial Nematodes 319
Wucbereria bancrofti 321
Brugia malayi 332
Brugia timori 333
Zoonotic Brugia infections (American brugian
filariasis) 334
Tropical pulmonary eosinophilia 335
Loa loa 335
Mansonella ozzardi 338
Mansonella perstans 339
Mansonella streptocerca 340
Onchocerca volvulus 341
Dirofilaria Dirofilaria and Dirofilaria
Nocbtiella spp. 348
13 Intestinal Cestodes 357
Diphyllobothrium latum 357
Taenia solium 362
Taenia saginata 371
Taenia saginata asiatica (Asian Taenia or Taenia
asiatica) 373
Hymenolepis nana 374
Hymenolepis diminuta 376
Dipylidium caninum 377
14 Tissue Cestodes: Larval Forms 381
Echinococcus granulosus (cystic disease, hydatid
disease) 381
Echinococcus tnultilocularis (alveolar disease,
hydatid disease) 393
Echinococcus oligarthrus and Echinococcus vogeli
(polycystic hydatid disease) 399
Taenia (Multiceps) spp. (Taenia multiceps, Taenia
serialis) (coenurosis) 402
Spirometra mansonoides and Diphyllobothrium spp.
(sparganosis) 402
NOTE: Taenia solium (cysticercosis) is discussed in
chapter 13.
15 Intestinal Trematodes 411
Fasciolopsis buski 411
Echinostoma ilocanum 416
Heterophyes heterophyes 417
Metagonimus yokogawai 419
Gastrodiscoides hominis 420
16 Liver and Lung Trematodes 423
Liver flukes 423
Clonorchis sinensis 423
Opisthorchis viverrini 429
Opisthorchis felineus 431
Fasciola hepatica 432
Fasciola gigantica 435
Less common liver flukes 436
Dicrocoelium dendriticum, Dicrocoelium hospes, and
Eurytrema pancreaticum 436
Lung flukes 438
Paragonimus spp. 438
17 Blood Trematodes: Schistosomes 445
Schistosoma mansoni 446
Schistosoma japonicum 458
Schistosoma mekongi 463
Schistosoma haematobium 466
Schistosoma intercalatum 472
18 Unusual Parasitic Infections 478
Aquatic Protist 478
Rhinosporidium seeberi 478
Protozoa 482
Myxozoan parasites 482
Nematodes 483
Oesophagostomum spp. 483
Eustrongylides spp. 485
Mermis nigrescens 486
Micronema deletrix 487
Dioctophyma renale 487
Ternidens deminutus 488
Mammomonogamus laryngeus (Syngamus
laryngeus) 488
Ascaris suum 489
Gongylonema pulchrum 489
Haycocknema perplexum 490
Cestodes 490
Diplogonoporus spp. 490
Bertiella studeri 491
Inermicapsifer madagascariensis 491
Raillietina celebensis 491
Mesocestoides spp. 492
Taenia crassiceps 492
Trematodes 493
Alaria americana 493
Plagiorchis spp. 493
Neodiplostontum seoulense 494
Spelotrema brevicaeca 494
Brachylaima sp. 494
Troglotrema salmincola 494
Stellantchasmus falcatus 494
Phaneropsolus bonnet and Prosthodendrium
molenkempi 495
Phaneropsolus spinicirrus 495
Haplorchis taichui 496
Gymnophalloides seoi 496
Metorchis conjunctus (North American liver
fluke) 497
Schistosoma mattheei 498
Philophthalmus lacrintosus 498
Achillurbainia spp. 499
Pentastomids 499
Armillifer spp., Linguatula serrata, and Sebekia
spp. 499
Acanthocephalans 500
Macracanthorhynchus hirudinaceus and Moniliformis
moniliformis 500
19 Parasitic Infections in the Compromised
Host 506
Entamoeba histolytica 508
Free-living amebae 518
Contents ix
Giardia lamblia 522
Toxoplasma gondii 523
Cryptosporidium spp. 524
Cyclospora cayetanensis 528
Isospora (Cystoisospora) belli 530
Sarcocystis spp. 531
Microsporidia 532
Leishmania spp. 537
Strongyloides stercoralis 540
Crusted (Norwegian) scabies 540
20 Nosocomial and Laboratory-Acquired
Infections 549
Nosocomial infections 549
Nosocomial gastrointestinal infections 550
Cryptosporidium spp. 550
Giardia lamblia 553
Entamoeba histolytica 554
Microsporidia 555
Isospora (Cystoisospora) belli 555
Hymenolepis nana 555
Taenia solium 555
Nosocomial blood and tissue infections 556
Plasmodium spp. 556
Babesia spp. 556
Trypanosoma brucei gambiense and T. brucei
rhodesiense 556
Trypanosoma cruzi 556
Leishmania donovani 557
Toxoplasma gondii 557
Nosocomial infections with ectoparasites 557
Pediculus spp. and Phthirus pubis 557
Sarcoptes scabiei 557
Myiasis 557
Nosocomial infections in the pediatric patient 558
Cryptosporidium spp. 558
Giardia lamblia 558
Pediculus humanus capitis 558
Sarcoptes scabiei 558
Nosocomial infections in the compromised
patient 558
Laboratory infections 560
Intestinal protozoa 560
Free-living amebae 560
Plasmodium spp. 560
Trypanosoma brucei gambiense and T. brucei
rhodesiense 560
Trypanosoma cruzi 562
Leishmania spp. 562
Toxoplasma gondii 562
Specimen handling 563
Summary 563
x Contents
21 Immunology of Parasitic Infections 567
Amebiasis 570
Giardiasis 575
Toxoplasmosis 577
African trypanosomiasis 579
American trypanosomiasis 580
Malaria 582
Summary 586
22 Antibody and Antigen Detection in Parasitic
Infections 592
Protozoal infections 594
Amebiasis 594
Babesiosis 597
Chagas' disease 597
Cryptosporidiosis 598
Cyclosporiasis 598
Giardiasis 598
Leishmaniasis 598
Malaria 600
Toxoplasmosis 601
Trichomoniasis 603
Helminth infections 604
Cysticercosis 604
Hydatid disease 605
Fascioliasis 605
Filariasis 606
Paragonimiasis 607
Schistosomiasis 608
Strongyloidiasis 609
Toxocariasis 610
Trichinellosis 610
Intradermal tests 611
Casoni test 611
Montenegro test 611
23 Histologic Identification of Parasites 616
24 Medically Important Arthropods 670
Arthropods and their relationship to disease 670
Biological vectors of microorganisms 670
Bites and envenomation 671
Tissue invasion 676
Entomophobia and delusory parasitosis 676
Class Insecta (insects) 678
Order Diptera (flies, mosquitoes, and midges) 679
Myiasis 683
Order Hemiptera (true bugs) 690
Order Coleoptera (beetles) 692
Order Siphonaptera (fleas) (Ctenocephalid.es spp.,
Xenopsylla cheopis, Pulex irritans [human flea],
Tunga penetrans, Nosopsyllus fasciatus, Echidnophaga
gallinacea, and "sand fleas") 693
Order Anoplura (sucking lice) 694
Order Mallophaga (biting and chewing lice) 696
Order Hymenoptera (bees, wasps, and ants) 696
Order Blattaria (cockroaches) 698
Class Arachnida (ticks, mites, spiders, and
scorpions) 699
Subclass Acari (ticks, mites, and chiggers) 699
Subclass Araneae (spiders) 708
Subclass Scorpiones (scorpions) 710
Other arthropods 711
Class Chilopoda (centipedes) 711
Class Diplopoda (millipedes) 712
Class Crustacea (copepods, crabs, crayfish, etc.) 712
Control of arthropods of medical importance 712
Physical control 712
Biological control 712
Chemical control 715
25 Treatment of Parasitic Infections 718
PART II
Diagnostic Procedures 759
26 Collection, Preservation, and Shipment of Fecal
Specimens 761
Safety 761
Fresh-specimen collection 762
Collection of the specimen 762
Number of specimens to be collected (standard
recommendation) 762
Number of specimens to be collected (pros and cons of
various options) 763
Collection times 764
Specimen type, specimen stability, and need for
preservation 764
Preservation of specimens 768
Preservatives 768
Formalin 768
MIF 769
SAF 771
Schaudinn's fluid 772
PVA 772
Modified PVA 773
Single-vial collection systems (other than SAF) 773
Use of fixatives 774
Quality control for stool fixatives 774
Procedure notes for use of preservatives 775
Procedure limitations for use of preservatives 775
Shipment of diagnostic specimens, biological products,
etiologic agents, or infectious substances 775
27 Macroscopic and Microscopic Examination of
Fecal Specimens 782
Macroscopic examination 782
Microscopic examination (ova and parasite
examination) 783
Direct wet smear 783
Concentration (sedimentation and flotation) 788
Formalin-ethyl acetate sedimentation
concentration 789
Iodine-trichrome stain for sediment 792
Zinc sulfate flotation concentration 794
Commercial fecal concentration devices 796
Automated workstation for the microscopic analysis
of fecal concentrates 797
Permanent stained smear 797
Preparation of material for staining 798
Trichrome stain 802
Iron hematoxylin stain 807
Modified iron hematoxylin stain (incorporating the
carbol fuchsin step) 811
Polychrome IV stain 812
Chlorazol black E stain 813
Specialized stains for coccidia (Cryptosporidiwn,
Isospora, and Cyclospora species) and the
microsporidia 813
Modified Kinyoun's acid-fast stain (cold method) 813
Modified Ziehl-Neelsen acid-fast stain (hot
method) 816
Carbol fuchsin negative stain for Cryptosporidium (from
W. L. Current) 819
Rapid safranin method for Cryptosporidium 819
Rapid safranin method for Cyclospora, using a
microwave oven 819
Auramine O stain for coccidia (from Thomas
Hanscheid) 819
Modified trichrome stain for the microsporidia
(Weber—green) 821
Modified trichrome stain for the microsporidia (Ryan—
blue) 823
Modified trichrome stain for the microsporidia
(Kokoskin—hot method) 825
Acid-fast trichrome stain for Cryptosporidium and the
microsporidia 826
28 Additional Techniques for Stool Examination 831
Culture of larval-stage nematodes 831
Harada-Mori filter paper strip culture 832
Filter paper/slant culture technique (petri dish) 833
Charcoal culture 834
Baermann technique 835
Agar plate culture for Strongyloides stercoralis 837
Egg studies 840
Estimation of worm burdens 840
Hatching of schistosome eggs 842
Search for tapeworm scolex 844
Qualitative test for fecal fat 845
Quantitation of reducing substances (Clinitest) 847
Contents xi
29 Examination of Other Specimens from the
Intestinal Tract and the Urogenital System 850
Examination for pinworm 850
Cellulose tape preparations 851
Anal swabs 851
Sigmoidoscopy material 852
Direct saline mount 853
Permanent stained slide 853
Duodenal contents 854
Duodenal drainage 854
Duodenal capsule technique (Entero-Test) 854
Urogenital specimens 855
Trichomoniasis 855
Filariasis 856
Schistosomiasis 856
30 Sputum, Aspirates, and Biopsy Material 859
Expectorated sputum 859
Induced sputum 861
Aspirates 868
Lungs and liver 868
Lymph nodes, spleen, liver, bone marrow, spinal fluid,
eyes, and nasopharynx 869
Cutaneous ulcer 871
Biopsy material 871
Skin 876
Lymph nodes 876
Muscle 876
Rectum and bladder 877
31 Procedures for Detecting Blood Parasites 881
Preparation of thick and thin blood films 881
Thick blood films 882
Thin blood films 884
Combination thick and thin blood films (on the same
slide) 884
Combination thick and thin blood films (can be stained
as either) 884
Buffy coat blood films 886
Staining blood films 887
Giemsa stain 888
Wright's stain 889
General notes on staining procedures 891
Proper examination of thin and thick blood
films 891
Thin blood films 891
Thick blood films 893
Determination of parasitemia 893
Diagnosis of malaria: review of alternatives to
conventional microscopy 894
QBC microhematocrit centrifugation method 895
ParaSight F test 896
NOW malaria test 900
xii Contents
Flow anti-pLDH Plasmodium monoclonal
antibodies 901
PCR 902
Automated blood cell analyzers 903
Diagnosis of leishmaniasis: review of alternatives to
conventional microscopy 903
ICT for detection of anti-rK-39 antibodies 903
Concentration procedures 903
Cytocentrifugation technique 903
Knott concentration procedure 904
Membrane filtration technique 904
Gradient centrifugation technique 905
Triple-centrifugation method for trypanosomes 905
Special stain for microfilarial sheath 905
Delafield's hematoxylin 905
32 Parasite Recovery: Culture Methods,Animal
Inoculation, and Xenodiagnosis 910
Culture methods 910
Intestinal protozoa 911
Pathogenic free-living amebae 917
Pathogenic flagellates 922
Flagellates of blood and tissue 926
Toxoplasma gondii 931
Plasmodium and Babesia spp. 931
Cryptosporidium spp. 932
Microsporidia 932
Animal inoculation 932
Leishmania spp. 932
Trypanosoma spp. 933
Toxoplasma gondii 933
Xenodiagnosis 933
33 Fixation and Special Preparation of Fecal
Parasite Specimens and Arthropods 936
Fixation of parasite specimens and arthropods 936
Protozoa 937
Solutions to induce relaxation in adult helminths 938
Nematodes 939
Trematodes 940
Cestodes 940
Helminth eggs and larvae 940
Arthropods 940
Mounting and staining of parasite specimens for
examination 941
Nematodes 941
Trematodes 942
Cestodes 943
Mounting of arthropods for examination 944
Mites 944
Fleas and lice 944
Ticks 945
Miscellaneous arthropods 945
34 Artifacts That Can Be Confused with Parasitic
Organisms 947
Protozoa 947
Amebae 947
Flagellates 949
Ciliates 949
Coccidia and microsporidia 949
Cryptosporidium spp. and Cyclospora
cayetanensis 949
Isospora belli 950
Microsporidia 951
Blood and body fluids 951
Malaria parasites and Babesia spp. 951
Leishmaniae and trypanosomes 951
Microfilariae 951
Body fluids: ciliated epithelial cells 953
Helminths 953
Adult worms and larvae 953
Eggs 954
Human cells 954
Polymorphonuclear leukocytes 956
Eosinophils 956
Macrophages 956
Lymphocytes 957
Red blood cells 957
Charcot-Leyden crystals 957
Nonhuman elements seen in feces (yeast cells) 957
Insect larvae 958
Spurious infections 958
Delusory parasitosis 959
35 Equipment, Supplies, Safety, and Quality System
Recommendations for a Diagnostic Parasitology
Laboratory: Factors Influencing Future
Laboratory Practice 961
Equipment 961
Microscope 961
Centrifuge 965
Fume hood 965
Biological safety cabinet 965
Refrigerator-freezer 966
Supplies 966
Glassware 966
Miscellaneous supplies 967
ATCC quality control organisms 967
Safety: personnel and physical facilities 967
General precautions 967
Handwashing 968
Personal protective equipment (OSHA 2001 blood
borne) 969
Handling specimens 970
Processing specimens 970
Spills 972
Disposal of contaminated materials 973
Standard precautions 974
Hepatitis exposure protocol 976
Dangerous properties of industrial materials 976
Current OSHA regulations for the use of
formaldehyde 977
Latex allergy 978
Quality systems 979
Extent of services 979
Proficiency testing 979
In-house quality control 982
Patient outcome measures 986
Continuous quality improvement, total quality
management, or 10-step and FOCUS-PDCA for
performance improvement activities 987
CLIA '88 inspection process 989
New quality quidelines 989
ISO guidelines 989
CLSI (NCCLS) model 990
Factors influencing future laboratory practice 990
Managed care 992
Financial considerations 993
Decentralized testing 993
Laboratory services 993
Technological trends 994
Clinical decision support 994
Personnel issues 995
Changing demographics 995
Emerging diseases 995
36 Medical Parasitology: Case Histories 998
Protozoal infections 998
Helminth infections 1007
Blood parasite infections 1016
Diagnostic methods 1024
APPENDIXES 1027
APPENDIX I
Information Tables 1028
A 1.1 Classification of human parasites 1028
A1.2 Distribution of selected parasitic infections in the
Americas 1031
A 1.3 Distribution of selected parasitic infections in
Europe 1031
A 1.4 Distribution of selected parasitic infections in
Africa 1032
A1.5 Distribution of selected parasitic infections in
Asia 1033
A1.6 Distribution of selected parasitic infections in
Oceania 1033
A1.7 Cosmopolitan distribution of common parasitic
infections (North America, Mexico, Central
Contents xiii
America, South America, Europe, Africa, Asia,
and Oceania) 1034
A 1.8 Body sites and specimen collection 1035
A1.9 Body sites and possible parasites recovered
(trophozoites, cysts, oocysts, spores, adults,
larvae, eggs, amastigotes, and
trypomastigotes) 1036
A 1.10 Body site, specimen and procedures,
recommended methods, relevant parasites, and
comments 1037
A 1.11 Examination of tissue and body fluids 1042
AI.I2 Key characteristics of protozoa of the intestinal
tract and urogenital system 1044
A1. 13 Key characteristics of tissue protozoa 1047
A1. 14 Key characteristics of helminths 1049
A 1.15 Key characteristics of parasites found in
blood 1052
A 1.16 Diagnostic laboratory report information that
should be relayed to the physician 1054
A 1.17 Pros and cons of stool specimen collection and
testing options 1055
A1. 18 Approaches to stool parasitology: test
ordering 1057
A 1.19 Pros and cons of ova and parasite examination
options 1058
A 1.20 Laboratory test reports: optional
comments 1060
A 1.21 Estimated prevalence of parasitic diseases
worldwide 1061
APPENDIX 2
Flowcharts and Staining Tables for Diagnostic
Procedures 1062
Flowcharts
A2.1 Procedure for processing fresh stool for the ova
and parasite examination 1062
A2.2 Procedure for processing liquid specimens for the
ova and parasite examination 1063
A2.3 Procedure for processing preserved stool for
the ova and parasite examination by using the
traditional two-vial collection kit 1064
A2.4 Procedure for processing sodium acetate-acetic
acid-formalin (SAF)-preserved stool for the ova
and parasite examination 1065
A2.5 Use of various fixatives and their recommended
stains 1066
Tables
A2.1 Steps in the trichrome staining procedure
(mercuric chloride-based PVA-preserved stool
specimens) 1067
A2.2 Steps in the trichrome staining procedure
(non-mercuric chloride-based PVA-preserved stool
specimens) 1068
xiv Contents
A2.3 Steps in the iron hematoxylin staining procedure
(mercuric chloride-based PVA-preserved stool
specimens) (Spencer-Monroe method) 1069
A2.4 Steps in the iron hematoxylin staining procedure
(mercuric chloride-based PVA-preserved stool
specimens) (Tompkins-Miller method) 1070
A2.5 Steps in the iron hematoxylin staining procedure
(incorporating the carbol fuchsin step) 1071
A2.6 Oil-mounted permanent stained smears (no
Permount is used) 1072
A2.7 Tips on stool processing and staining 1073
APPENDIX 3
Common Problems in Parasite Identification 1074
Figures
A3.l-A3.25 Paired drawings of "look alikes" 1074
A3.26 Relative sizes of helminth eggs 1080
Table
A3.1 Adult nematodes and/or larvae found in stool
specimens: size comparisons 1081
APPENDIX 4
Quality Control Recording Sheets 1082
A4.I Diagnostic parasitology quality control (QC)
(reagents) 1083
A4.2 Diagnostic parasitology quality control (QC)
(reagents)—example for multiple reagents 1084
A4.3 Diagnostic parasitology quality control (QC)
(culture)—example of a worksheet 1085
A4.4 Equipment maintenance 1086
APPENDIX 5
Commercial Supplies and Suppliers 1089
Tables
A5.1 Sources of commercial reagents and
supplies 1090
A5.2 Addresses of suppliers listed in Table A5.1 1092
A5.3 Sources of available reagents for immunodetection
of parasitic organisms or antigens 1094
A5.4 Addresses of suppliers listed in Table A5.3 1095
A5.5 Commercial suppliers of diagnostic parasitology
products 1096
A5.6 Sources of parasitologic specimens 1099
A5.7 Sources of Kodachrome study slides (35 mm,
2 x 2) for rental 1100
A5.8 Sources of additional teaching materials, including
case histories 1100
APPENDIX 6
Reference Sources I 101
APPENDIX 7
Color Plates of Diagnostic Stages of Human
Parasites 1104
APPENDIX 8
"Late-Breaking" Published Information I 120
GLOSSARY 1151
INDEX 1165 |
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| author | Garcia, Lynne Shore 1938- |
| author_GND | (DE-588)138448698 |
| author_facet | Garcia, Lynne Shore 1938- |
| author_role | aut |
| author_sort | Garcia, Lynne Shore 1938- |
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| bvnumber | BV023384944 |
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| callnumber-sort | QR 3255 |
| callnumber-subject | QR - Microbiology |
| classification_rvk | XD 8800 |
| classification_tum | MED 407f |
| ctrlnum | (OCoLC)466561920 (DE-599)BVBBV023384944 |
| dewey-full | 616.9 |
| dewey-hundreds | 600 - Technology (Applied sciences) |
| dewey-ones | 616 - Diseases |
| dewey-raw | 616.9 |
| dewey-search | 616.9 |
| dewey-sort | 3616.9 |
| dewey-tens | 610 - Medicine and health |
| discipline | Medizin |
| discipline_str_mv | Medizin |
| edition | 5. ed. |
| format | Book |
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| id | DE-604.BV023384944 |
| illustrated | Illustrated |
| index_date | 2024-07-02T21:17:48Z |
| indexdate | 2024-07-09T21:17:24Z |
| institution | BVB |
| isbn | 9781555813802 1555813801 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-016567978 |
| oclc_num | 466561920 |
| open_access_boolean | |
| owner | DE-Er8 DE-355 DE-BY-UBR |
| owner_facet | DE-Er8 DE-355 DE-BY-UBR |
| physical | XIX, 1202 S. Ill., graph. Darst. |
| publishDate | 2007 |
| publishDateSearch | 2007 |
| publishDateSort | 2007 |
| publisher | ASM Press |
| record_format | marc |
| spelling | Garcia, Lynne Shore 1938- Verfasser (DE-588)138448698 aut Diagnostic medical parasitology Lynne Shore Garcia 5. ed. Washington, DC ASM Press 2007 XIX, 1202 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Diagnostic parasitology Parasitic Diseases diagnosis Humanparasitologie (DE-588)4160784-3 gnd rswk-swf Diagnostik (DE-588)4113303-1 gnd rswk-swf Humanparasitologie (DE-588)4160784-3 s Diagnostik (DE-588)4113303-1 s DE-604 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016567978&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Garcia, Lynne Shore 1938- Diagnostic medical parasitology Diagnostic parasitology Parasitic Diseases diagnosis Humanparasitologie (DE-588)4160784-3 gnd Diagnostik (DE-588)4113303-1 gnd |
| subject_GND | (DE-588)4160784-3 (DE-588)4113303-1 |
| title | Diagnostic medical parasitology |
| title_auth | Diagnostic medical parasitology |
| title_exact_search | Diagnostic medical parasitology |
| title_exact_search_txtP | Diagnostic medical parasitology |
| title_full | Diagnostic medical parasitology Lynne Shore Garcia |
| title_fullStr | Diagnostic medical parasitology Lynne Shore Garcia |
| title_full_unstemmed | Diagnostic medical parasitology Lynne Shore Garcia |
| title_short | Diagnostic medical parasitology |
| title_sort | diagnostic medical parasitology |
| topic | Diagnostic parasitology Parasitic Diseases diagnosis Humanparasitologie (DE-588)4160784-3 gnd Diagnostik (DE-588)4113303-1 gnd |
| topic_facet | Diagnostic parasitology Parasitic Diseases diagnosis Humanparasitologie Diagnostik |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016567978&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
| work_keys_str_mv | AT garcialynneshore diagnosticmedicalparasitology |