Case of the Week 691
This week ' s case was generously donated by Dr. Nicole Brammer Hubbard. Several of the following objects were removed from ear of a child after the parents noticed a bloody discharge (!)  Identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - August 9, 2022 Category: Parasitology Source Type: blogs

Case of the Week 690
This week ' s case is in honor of @JMGardner who showed a beautiful example of this finding a little while ago. This one is not quite as good, but still diagnostic. The digital slide can be viewedHERE. This is a low power view:What information can be gleaned from this biopsy, and what would have been the preferred method for identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - August 1, 2022 Category: Parasitology Source Type: blogs

Answer to Case 690
 Answer: Embedded hard tick, partially engorged with blood. As noted by Florida Fan, it is unfortunate that this tick was sectioned for histopathology, since " we need to examine the anal groove, the shield, the palpi, and the basis capitulum " in order to identify the tick to the genus and species level. This level of identification is helpful for patient management, since different species serve as vectors for different microorganisms. Additionally, finding an engorgedIxodes scapularisin a region of high Lyme disease endemicity may prompt antibiotic prophylaxis in certain situations. Without being able to ...
Source: Creepy Dreadful Wonderful Parasites - July 31, 2022 Category: Parasitology Source Type: blogs

Case of the Week 689
 This week ' s case is from a middle-aged woman with unexplained small bowel perforation. Here is the section with the culprit. You can view the whole slide imageHERE. What is your diagnosis? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - July 18, 2022 Category: Parasitology Source Type: blogs

Answer to Case 689
 Answer to theParasite Case of the Week 689:  Anisakid, most consistent with anAnisakisspecies.Hopefully you all had a change to look at the whole slide imageHERE. From its location in the small intestine, deep in the submucosa, one can envision how it may have extended through the wall of the intestine and caused a perforation. Dr. Luca Fanasca noted that " we can clearly see features consistent with an anisakid infection: multilayered cuticle (from a portion which seems detached, in the upper part), polymyarian muscle cells, the beautiful Y shaped lateral chords and the banana-shaped excretory cell. From t...
Source: Creepy Dreadful Wonderful Parasites - July 17, 2022 Category: Parasitology Source Type: blogs

Bedtime Reading?
For those of you looking for some good (?) bedtime reading, you may be interested in two fun articles that Blaine Mathison and I recently wrote:Blaine A. Mathison, Bobbi S. Pritt, Sleeping with the Enemy: Everything You Need to Know about the Biology, Clinical Significance, and Laboratory Identification of Bed Bugs. Clinical Microbiology Newsletter, Volume 43, Issue 1, 2021, Pages 1-7,https://www.sciencedirect.com/science/article/pii/S019643992030091XBlaine A. Mathison, Bobbi S. Pritt,Don ' t Be a Nit Wit; Know Your Lousy Companions! Clinical Microbiology Newsletter, Volume 44, Issue 13, 2022, Pages 115-122,https...
Source: Creepy Dreadful Wonderful Parasites - July 12, 2022 Category: Parasitology Source Type: blogs

Case of the Week 688
This week ' s case features an object (of many) found in the hair of a 6-year-old girl. Identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - July 5, 2022 Category: Parasitology Source Type: blogs

Answer to Case 688
 Answer to theParasite Case of the Week 688: Nit (egg) ofPediculus humanus capitis. As noted by Kosta Mumcuoglu, " it is the egg of the head louse,Pediculus humanus capitiswith the embryo inside (legs visible) and the operculum still on the egg. We can also see the part of the glue which was used to attach the egg on the hair. The aeropyles are in a row while in case of the pubic louse eggs they are in a triangular order. Seehttps://www.veterinaryparasitology.com/pthirus-pubis.html but alsoCase 293 in Creepy Dreadful Wonderful Parasites. It is by the wayPthirusnotPhthirus pubis. " Kosta is correct on al...
Source: Creepy Dreadful Wonderful Parasites - July 5, 2022 Category: Parasitology Source Type: blogs

Case of the Week 687
 This week ' s case is generously donated by Dr. Ioana Bujila of the Public Health Agency of Sweden. The patient is a 67 year old woman from Gabon. Blood was examined by direct mount and Giemsa-stained blood films, and the following were identified:These objects are approximately 228 micrometers in length.What is your diagnosis? Are there any additional laboratory analyses that are recommended in this case?  (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - June 27, 2022 Category: Parasitology Source Type: blogs

Answer to Case 687
 Answer toParasite Case of the Week 687: Loa loaAs noted by Florida Fan, @JuanCGabaldon, Idzi P, Ulrike E. Zelck, Priyanka Gupta, and others, the video clearly shows this to be a sheathed microfilaria, and the Giemsa smear shows the column of nuclei extending all the way to the tip of the tail, thus allowing us to make an identification of Loa loa. The patient ' s travel history (Gabon) also fits with this identification. As Idzi P. mentioned, I like to teach my students that nuclei flow-a flow-a to the tip inLoa loa -a fun learning aid!  Also check out thisbeautiful infographic by @cullen_lilley f...
Source: Creepy Dreadful Wonderful Parasites - June 26, 2022 Category: Parasitology Source Type: blogs

Case of the Week 686
This week ' s case was generously donated by Dr. Mike Mitchell and Laura Derderian. The following structure was seen in a stool concentrated wet mount specimen. It measures 27.5 micrometers in length. This was the only structure present in this specimen. Identification? What additional testing might also be useful in this case? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - June 14, 2022 Category: Parasitology Source Type: blogs

Answer to Case 686
 Answer to theParasite Case of the Week 686:Cystoisospora bellisporulated oocystThis case shows a single - but classic - sporulated oocyst ofCystoisospora(formerlyIsospora)belli.Note that two sporoblasts are present in this case, which is unusual to see in freshly passed stool specimens. MostC. bellioocysts are shed in an immature state - either unsporulated or partially sporulated (with only one sporoblast). They mature further in the environment, with the sporoblast dividing in two so that the mature oocyst has 2 sporoblasts. The sporoblasts become sporocysts with a surrounding cyst wall, and the sporocysts divide t...
Source: Creepy Dreadful Wonderful Parasites - June 12, 2022 Category: Parasitology Source Type: blogs

Case of the Week 685
 This is week ' s case is from our long-time contributor, Idzi Potters from theInstitute of Tropical Medicine, Antwerp. The following structures were seen in a iodine wet preparation of concentrated stool. Identification?  (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - June 6, 2022 Category: Parasitology Source Type: blogs

Answer to Case 685
 Answer to theParasite Case of the Week 685:Raphides, i.e, needle-shaped crystals of calcium oxalate or calcium carbonate used by several plants such as pineapple, kiwi, and rhubarb as a defense against plant-eating animals. According to Idzi, " The weird feeling you get in your mouth when eating too much pineapple is apparently caused by these crystals. You can find them quite often in stools and they should not be confused with Charcot-Leyden (C-L) crystals! " They can be differentiated from C-L crystals by their long needle-like shape and uniform diameter:As a comparator, Idzi provided 2 nice photographs of C-L cry...
Source: Creepy Dreadful Wonderful Parasites - June 5, 2022 Category: Parasitology Source Type: blogs

Case of the Week 684
 For our last case of May, we have a fun submission from Dr. Megan Shaughnessy. She noted the following in some fresh monkfish she purchased from a small local grocery store. What is the likely identification? Also, what is the risk to humans if ingested? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - May 31, 2022 Category: Parasitology Source Type: blogs