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Ovid: Oxford Handbook of Tropical Medicine

Editors: Eddleston, Michael; Pierini, Stephen; Wilkinson, Robert; Davidson, Robert Title: Oxford Handbook of Tropical Medicine, 2nd Edition Copyright ©2005 Oxford University Press (Copyright 2005 by M. Eddleston, S. Pierini, R. Wilkinson, and R. Davidson) > Table of Contents > Chapter 2 > Chapter 2D – Diarrhoeal diseases > How to make a direct faecal smear How to make a direct faecal smear

  • Write the patient’s name on a clean slide.
  • Place a drop of sterile saline in the centre of the left-hand side of the slide and place a drop of iodine in the centre of the right-hand side of the slide. Fig. 2D.1
  • With a match or applicator, pick up a small portion of faeces (~2 mg — or about the size of a match head) and add it to the drop of saline. Repeat and add to the iodine. Mix the faeces with the drops to form suspensions. Fig. 2D.2
  • Cover each drop with a coverslip. Fig. 2D.3
  • Examine each drop with the ×10 objective or, for identification, with the higher power objectives, searching in a systematic manner. When organisms are seen, switch to higher power for more detail. Fig. 2D.4
Fig. 2D.1
Fig. 2D.2
Fig. 2D.3
Fig. 2D.4
Table 2D.1
Formed stool Unformed/semi-solid/blood & mucus/liquid
Faecal concentration for ova/cysts With blood/mucus Saline suspension for exudate, Schistosoma mansoni ova, and amoebic trophozoites Bacteriological culture for Shigellosis, Campylobacter
Direct saline suspension for exudate/ova/cysts Without blood/mucus • Saline suspension for exudate, Protozoal trophozoites (Giardia, Trichomonas hominis, Chilomastix).
• Faecal concentration for ova/cysts/oocysts/larvae
• Faecal stain (modified Zn) for Cryptosporidia, Cyclospora cayetanensis
• Bacteriological culture
• Enteric viral screen(latex agglutination for rotavirus)
  Liquid As for ‘without blood/mucus’ with additional ‘hanging drop’ observation for Vibrio Cholera Bacteriological culture including V. Cholera.
  From HIV and immune- compromised patient As for ‘without blood/mucus’ with the addition of trichrome stain for Microsporidia sp.  

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