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Case of the Week 732
Welcome back to all of my US readers from the Thanksgiving holiday. Here is a fun case with the answer embedded - just listen to the audio with the video. Or if you ' d prefer, keep the volume down and give your best guess on what you think this is! This case is donated by Dr. Jessica Lin and her colleague who is field physician in Tanzania.  The patient is a 4 year old boy with anal pruritus and history of passing worms from his anus. Several white-tan worms measuring ~5mm long were examined: (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - November 27, 2023 Category: Parasitology Source Type: blogs

Answer to Case 732
 Answer to theParasite Case of the Week 732:Enterobius vermicularis(pinworm) adult female. As noted by Florida Fan, " Well, this is a classic situation. Children by nature are very altruistic, sharing their prize possessions (e.g., M&M ’s). The asymmetric eggs with a flat side and a convex side are commonly shared in this fashion. " The appearance of the eggs is also called planoconvex or " D " shaped. Anonymous mentioned that the extensive uterine reproductive system of the fertilized female worm is often completely filled with with these eggs.If you watched the video, you could see the movement of the egg...
Source: Creepy Dreadful Wonderful Parasites - November 26, 2023 Category: Parasitology Source Type: blogs

Case of the Week 731
 The following objects were seen in fluid aspirated from a cyst in the liver. Identification?Some were still moving! (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - November 16, 2023 Category: Parasitology Source Type: blogs

Answer to Case 731
Answer to theParasite Case of the Week 731:Echinococcussp. protoscolex. Hopefully you all got to look at it moving! Given that this is a single liver cyst, it would fit withE. granulosus. Correlation with radiologic and epidemiologic features would be helpful for confirmation.Here are some of the key diagnostic features: (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - November 14, 2023 Category: Parasitology Source Type: blogs

Case of the Week 730
 This week ' s case is generously donated by Idzi Potters and theInstitute of Tropical Medicine, Antwerp.The following were seen in used contact lens solution from a young woman with complaints of eye pain and blurry vision. The first two images are taken with light microscopy, and the third with phase-contrast microscopy. What is your diagnosis? Please describe the forms you are seeing. (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - November 9, 2023 Category: Parasitology Source Type: blogs

Answer to Case 730
 Answer tothe Parasite Case of the Week 730:Acanthamoebakeratitis.As noted by Anonymous, the pictures are a perfect rendition of the “thorny”Acanthamoeba trophozoite and its polygonal cyst (acanth is New Latin, from Greek akanthos, from akanthathorn, spine). Cysts have 2 layers: a wrinkled outer layer (ectocyst) and inner layer (endocyst) that can be polygonal, spherical, hexagonal, or star-shaped.Dr. Satishkumar Krishnam further described the trophozoite as " characterized by spine like pseudopodia (acanthopodia). " Chuck Blend noted that it looks like the first few seconds of a new proto-universe formi...
Source: Creepy Dreadful Wonderful Parasites - November 9, 2023 Category: Parasitology Source Type: blogs

Case of the Week 729
This week ' s case was generously donated by Drs. Jacob Rattin, Anisha Misra, and Hannah Wang, and originally identified by Marissa Roberts. The following objects were seen on a trichrome-stained stool specimen and measure approximately 15 micrometers in length. What is your identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - November 2, 2023 Category: Parasitology Source Type: blogs

Answer to Case 729
 Answer to theParasite Case of the Week 729: Trophozoites of Chilomastix mesniliBelow is an answer written by Dr. Jacob Rattin (@EternalStudying):This non-pathogenic flagellate has pear-shaped trophozoites that are 6 – 24 μm long with a longitudinal spiral groove running along the body (not seen in this specimen). If visualized in a fresh prep, the motility may allow the spiral groove to be seen as the organism turns (seeCase 475). The trophozoite has one nucleus (arrowhead), usually at the anterior end, with an eccentric karyosome and a cytostome (oral groove) close by.  The posterior end tapers to a poi...
Source: Creepy Dreadful Wonderful Parasites - November 1, 2023 Category: Parasitology Source Type: blogs

Case of the Week 728
This week ' s case was donated by Drs. Meredith Kavalier, Megan Shaughnessy, and David Cartwright. The patient has a history of treated urothelial cell carcinoma and remote travel to Asia. The cytopathologist was concerned by the presence of the following structures seen in a routine screening urine sample. How would you interpret these findings? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - October 11, 2023 Category: Parasitology Source Type: blogs

Answer to Case 728
 Answer to theParasite Case of the Week 728: Not a parasite egg; uric acid crystals.Uric acid crystals are a very convincing mimic ofSchistosoma haematobiumeggs! They are both found in urine, and they both have a terminal spine. However, there are a number of features that can be used to easily differentiate the two:Uric acid crystals vary in size and shape and are often much smaller thanS. haematobiumeggs. In contrast, S. haematobium eggs are regular in size and shape, and quite large (approximately 150 micrometers in length).Uric acid crystals commonly have points on both ends instead of the single ' pinched-off ' s...
Source: Creepy Dreadful Wonderful Parasites - October 10, 2023 Category: Parasitology Source Type: blogs

Case of the Week 727
his week ' s case was generously donated by Dr. Richard Bradbury. The following structure was seen in a concentrated wet prep of stool. It measures approximately 80 micrometers in diameter. Check out the video to see this structure in multiple planes. Identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - September 26, 2023 Category: Parasitology Source Type: blogs

Answer to Case 727
 Answer to theParasite Case of the Week 727:Hymenolepis diminutaAs noted by Lamia Gala on LinkedIn, " The distance between the outer and the inner shell is large with no polar filaments " which is consistent withH. diminuta.This is in contrast toRodentolepis(formerlyHymenolepis)nana, which does have polar filaments between the outer and inner shell.H. diminutais also slightly larger thanR. nana, measuring 70-85 micrometers in greatest dimension (compared to 30-50 forR. nana). Florida Fan provided the helpful memory aid that the word " diminuta " is larger in size than " nana " , which also applies to their eggs (thank...
Source: Creepy Dreadful Wonderful Parasites - September 25, 2023 Category: Parasitology Source Type: blogs

Case of the Week 726
This weeks case features the following small, oval-shaped, red-staining objects seen in a bronchoalveolar specimen from an immunocompromised patient. The stain is a strong trichrome (chromatrope 2R method). Identification? What is the significance of this finding? (CLICK ON IMAGES TO ENLARGE) (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - September 18, 2023 Category: Parasitology Source Type: blogs

Answer to Case 726
 Answer to theParasite Case of the Week 726: Microsporidia spores; genus and species not determinedThese small spores stain deep red with the chromotrope 2R method and its modifications. They are oval shaped and often have a darker-staining equatorial band in the middle of the spore. Spores ofEnterocytozoon bieneusiare very small (0.8 to 1.4 micrometers long), whereas other species such asEncephalitozoonspp.,Vittaforma cornea,andAnncaliia algeraeare a little larger. Some (e.g.,Anncaliia) are up to 4 micrometers long and may be mistaken for small years such asHistoplasma capsulatum(especially because they are focally G...
Source: Creepy Dreadful Wonderful Parasites - September 17, 2023 Category: Parasitology Source Type: blogs

Case of the Week 725
This week ' s interesting case is generously donated by Dr. Justin Juskewitch. Hopefully all of you have been able to avoid this so far this summer! The patient is a young girl who developed this very itchy rash about 30 minutes after a swim in a fresh water lake in Maine (Northeastern United States). The rash developed to what is shown below over a period of several hours. Her two siblings had a similar presentation. All three children had resolution of itching with benadryl, corticosteroid cream, and oatmeal body wash baths over the next few hours, but the rash lasted for 5-7 days.What is the most likely diagno...
Source: Creepy Dreadful Wonderful Parasites - September 5, 2023 Category: Parasitology Source Type: blogs