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Case of the Week 634
 This week ' s case was generously donated by Dr. Jos é Poloni. The following was found in a stool specimen. Identification? Significance? (you may need to click twice on the video below to play)  (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - April 12, 2021 Category: Parasitology Source Type: blogs

Answer to Case 634
 Answer toParasite Case of the Week 634: Free-living mite, likely contaminant during specimen collection/preparation.Note the 8 legs (consistent with a member of the arachnidae) and the long spines (setae). It is easier to appreciate all 8 legs by carefully watching the video in this case.As noted by Marc Couturier, " I mite have to say this is a contamination of the preparation and not coming from stool. "  I agree with this assessment! While this mite could have been ingested from a food source (e.g., mimolette cheese;see my previous post), I find it highly unlikely that the mite would still be alive and active...
Source: Creepy Dreadful Wonderful Parasites - April 11, 2021 Category: Parasitology Source Type: blogs

Case of the Week 633
 This week ' s case was generously donated by Dr. Neil Anderson. The following structure was retrieved from the common bile duct during endoscopic retrograde cholangiopancreatography (ERCP). The patient is a refugee from Tanzania who presented with intermittent abdominal pain, distended gallbladder and hepatosplenomegaly. This was one of many " worm like " structures noted on ERCP.  Unfortunately this object appeared to tear during removal. The portion submitted measures several centimeters in length. No identifying external structures were identified.Dr. Anderson ' s team tried to express eggs from this str...
Source: Creepy Dreadful Wonderful Parasites - April 6, 2021 Category: Parasitology Source Type: blogs

Answer to Case 633
 Answer toParasite Case of the Week 633:Fasciola hepatica Although the fluke was sadly torn in half during retrieval, it has all of the features that allows us to identify it:As a trematode - it has the flat, leaf-like body shape of a platyhelminth belonging to the Trematoda phylum. On histopathologic examination, trematodes have an outer tegument (with microvillus border, and often with spines), spongy parenchyma with no large cavities, and a digestive tract. Cestodes have a similar appearance, but may have a large cavity (depending on the species and stage), do NOT have a digestive tract or tegumental spin...
Source: Creepy Dreadful Wonderful Parasites - April 4, 2021 Category: Parasitology Source Type: blogs

Case of the Week 632
 This week ' s case has a fun little twist. The following structures were seen within the mucosa in an intestinal biopsy (hematoxylin and eosin stained) of a patient in sub-Saharan Africa. The largest of these measured>120 micrometers long.Then there was this...Diagnosis? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - March 29, 2021 Category: Parasitology Source Type: blogs

Answer to Case 632
Answer toParasite Case of the Week 632:Schistosoma mansonieggs. An adult fluke is also seen - yikes! Note that the eggs are very ' fresh ' appearing, with large viable-looking nuclei. This is very different than old calcified eggs that may also be seen in tissue sections. The egg has a prominent lateral spine present which allows us to provide a species-level identification:Remember that we must exercise caution when interpretingSchistosomaeggs in tissue since there is often a lot of distortion with production of spiky protrusions that occurs during tissue processing. A true spine should be thick and well-defined (such as ...
Source: Creepy Dreadful Wonderful Parasites - March 28, 2021 Category: Parasitology Source Type: blogs

Case of the Week 631
 Here is a nice straight-forward case from my laboratory. This worm was found on routine screening colonoscopy. It measures approximately 3.5 cm long. Identification? What are some of the key identifying features?  (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - March 23, 2021 Category: Parasitology Source Type: blogs

Answer to Case 631
 Answer:Trichuris trichiura (whipworm), maleAs nicely pointed out by Florida Fan, " No, this worm is not so straight. It ’s totally so convoluted like the whip of “Dr. Jones” in the movie . Such a beautiful sample with all the identification details including that curved tail and copulatory spicule specific to its sex. No trick, justTrichuris trichura. This is a classic case. "Here are some of the key identifying features:The male is slightly smaller than the female; males are 3.0 to 4.5 cm long, while females are 3.5 to 5.0 cm long. Note that the head is at the skinny end - not what you might think! (Sourc...
Source: Creepy Dreadful Wonderful Parasites - March 21, 2021 Category: Parasitology Source Type: blogs

Case of the Week 630
 The following are images from a stool agar culture after 3 days of incubation at room temperature. The patient has persistent peripheral eosinophilia and mild intestinal complaints.This appearance prompted further examination of the plate by light microscopy, which revealed the following (click on thumbnail for video):What is your differential diagnosis based on this information? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - March 15, 2021 Category: Parasitology Source Type: blogs

Answer to Case 630
 Answer to theParasite Case of the Week 630:  nematode larvae; primary differential isStrongyloidessp., hookworm,Trichostrongylus,and free-living nematodes (e.g.,Rhabditissp.). The agar plate culture (a.k.a., Koga plate) is a relatively safe and straight-forward method to increase detection ofS. stercoralisin feces, and can also be used to culture other nematodes by allowing the eggs in feces to hatch and mature. The procedure is performed by placing a small amount of stool (as shown here) in the center of a nutrient agar. Any agar that supports the growth of enteric bacteria will do, including sheep blood a...
Source: Creepy Dreadful Wonderful Parasites - March 15, 2021 Category: Parasitology Source Type: blogs

Case of the Week 629
 This week ' s case is from my laboratory. The following structures were found in a concentrated stool specimen from a middle-aged man from Ethiopia. They measure approximately 65 micrometers in length. What is the most-likely identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - March 9, 2021 Category: Parasitology Source Type: blogs

Answer to Case 629
 Answer toParasite Case of the Week 629: hookworm ova - eitherAncylostoma duodenaleorNecator americanus. As stated well by Sam, "Finally! An end to the " is this hookworm? " trilogy. Haha 😁 " You can see a couple of good examples of hookworm egg mimics in my last two cases.He and TheOracle also noted that the second image had Charcot-Leyden crystals, a breakdown product of eosinophils:Idzi commented that "If you would ask for the " most-likely " identification, I ' d dare guessing " Ancylostoma duodenale " - not per s é due to the fact that the patient is from the African continent (as migration and trav...
Source: Creepy Dreadful Wonderful Parasites - March 7, 2021 Category: Parasitology Source Type: blogs

Case of the Week 628
 This week ' s case if from Idzi Potters and theInstitute of Tropical Medicine, Antwerp. It looks somewhat similar tolast week ' s case, but it is very different! The following objects were seen in a stool specimen from a middle-aged male with recent travel to Senegal.Thoughts? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - March 1, 2021 Category: Parasitology Source Type: blogs

Answer to Case 628
 Answer to theParasite Case of the Week 628: Parasitic plant nematode eggs (e.g.,Heterodera sp.,Meloidogynesp., Meloidogyne sp.); not a human parasite. Sarah Sapp was the first to get this one (nice job Sarah!). She commented on ourCreepy Dreadful Wonderful Facebook page that " I suspect this could be spurious passage ofMeloidogyne (root knot nematode) eggs —size looks consistent, and also the very rounded ends with a concave broad side. "  While we didn ' t identify the actual genus of the nematode, we can say with confidence that this is a plant nematode based on the larger size and d...
Source: Creepy Dreadful Wonderful Parasites - February 28, 2021 Category: Parasitology Source Type: blogs

Case of the Week 627
This week ' s interesting case was donated by Dr. Karine Thievierge and Alexandra. The following structures were seen in a stool specimen. They measure between 110 - 140 micrometers in length, by 75 - 90 micrometers in width.  Identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - February 22, 2021 Category: Parasitology Source Type: blogs