From bone marrow aspirates, serum and blood. Can be used after antibiotics have been given.
Several methods with varying sensitivity (agglutination, ELISA).
Sensitivity depends on stage of disease and sample type, requires extended culture time as the bacteria grows slowly. Laboratory acquired cases can occur, careful handling is needed.
Requires IHC or immune-fluorescence for visualization.
Used for detection and defining species, in meta-analysis very high diagnostic odds ratio. Using skin formalin-fixed, paraffin-embedded samples detection rate is 97%.
Limited sensitivity which depends on assay used, type of disease (cuteanous versus visceral).
Can be done but not routine with 58% sensitivity.
Visualization with H&E, but when numbers of parasites are low, they may be difficult to diagnose. Enhanced with IHC to 88% sensitivity.
Can reach 89% sensitivity in specimens from patients with keratitis. Cyst formation decreases sensitivity. Species can be defined using PCR.
Not available.
Is done primarily for diagnosis of keratitis using a lawn of Escherichia coli.
Amoeba are visualized with H&E in patients with granulomatous meningo encephalitis or keratitis; enhanced diagnosis by use of immune assays (DFA or IHC).
PCR in urine can have up to 100% sensitivity and 91% specificity.
Detection of antibodies: may cross-react with other helminth infections, IgM may persist long after acute infection. Detection of antigen: in urine and serum. Sensitivity ranges from 41–78% and specificity between 76–100%.
Not available.
Detection of ova in stool or urine; quantification in a fixed amount of urine or stool allows to determine intensity of infestation. Adult worms and eggs can be seen in tissue sections.
PCR on fresh respiratory specimens has a sensitivity of 75 and specificity of 99%.
Antibodies can be measured using several methods. IgG response can be abrogated if treatment is started early.
Grows within 2 to 3 weeks. It is a select agent and it needs to be handled with care due to potential laboratory transmission.
Visualized with H&E, PAS and fungal silver stain (diagnostic structures are spherules with endospores; endospores on their own can be confused with Blastomyces and other yeasts).