Diagnostic Medical Parasitology. Lynne Shore Garcia
It is also important for the physician to know the efficacy of any diagnostic technique for parasite recovery and eventual diagnosis. Our approach to testing is undergoing continuous review, particularly within the current health care environment and cost-containment initiatives. The issue of patient care becomes particularly important when we begin to examine the number and types of compromised patients now being seen in all facilities. The increased publicity concerning immunocompromised patients has led to a greater awareness of parasitic infections in this patient population, regardless of the original cause of the immune deficiencies. Many of these patients with immune system defects are particularly at risk, whether because of previously acquired infections that have remained latent for many years or because of susceptibility to new infections. Many of these infections may present with unusual symptoms, and some are relatively new disease entities or those that are less commonly encountered (microsporidiosis, granulomatous amebic encephalitis, and infection with Cyclospora cayetanensis).
Often in other areas of microbiology, therapy is begun on the basis of patient history and symptoms. This approach is generally not recommended or used in cases of parasitic infection. Thus, the understanding of the characteristics of any parasitic infection (general geographic range, life cycle, clinical disease, diagnostic methods, therapy, epidemiology, and control) and the use of appropriate diagnostic procedures accompanied by a complete understanding of the limitations of each procedure become very important. Because of this approach to patient care, the general consensus among individuals within the field of diagnostic medical parasitology is that the use of certain incomplete procedures may result in incorrect information for the physician and may ultimately compromise patient care.
The main emphasis should be on the importance of understanding and recognizing potential parasitic infections, submitting the appropriate number and type of clinical specimens, knowing what procedures may provide confirmation of the diagnosis, and recognizing the implications and limitations of information provided to the physician. With the current emphasis on the development and use of molecular methods, understanding the benefits and limitations of these procedures will be critical to patient care outcomes. If there is an incomplete understanding of the requirements for high-quality diagnostic testing, incomplete information will be transmitted to the clinician. It is the responsibility of both the laboratory and the clinician to develop a greater awareness of the importance of these requirements.
References
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