The two initial cases, reported in the June 28 issue of EPI Update, were diagnosed by a laboratorian at SHL who identified possible Cyclospora oocysts on microscopic examination of fresh stool and confirmed this diagnosis using a modified acid-fast stain
A modified acid-fast stain
is performed to identify parasites such as Cryptosporidium and Isospora, causing chronic diarrhoea in immunocompromised patients.
Gram stain (Figure, C) and a modified acid-fast stain
(Figure, D) revealed gram-positive, partially acid-fast filamentous organisms branching at right angles within the eosinophilic material consistent with Nocardia organisms.
The bug was considered a rare and exotic pathogen until the mid-1980s when a modified acid-fast stain
was employed to look for Cryptosporidium in stool specimens, especially from people with impaired immune systems who suffered from HIV disease.
They were stained with Kinyoun's carbol fuchsin modified acid-fast stain
and examined by oil immersion microscopy.
All state laboratories began routine testing with a modified acid-fast stain
However, with the modified acid-fast stain
, CLB may stain deep mottled red or pink; some resist staining and appear as glassy, membranous cysts.