Answer to Case 605
 Answer toParasite Case of the Week 605: Earthworm, an oligochaete. As a segmented annelid, these worms usually have a few setae (i.e., bristles) on their outer body surface, as seen in this case, which aid in their identification, and differentiation from large parasitic worms such asAscaris lumbricoides.As so nicely stated by Florida Fan, " Did we say “after the bowel movement”? Good thing the patient did not pass it out. Yes, we have seen this annelid a few times. (SeeCase 545,Case 344, andCase 234). It always shows the locomotive spicules on each ring of the body. A diligent, hardworking creature, it bores it ...
Source: Creepy Dreadful Wonderful Parasites - September 7, 2020 Category: Parasitology Source Type: blogs

Case of the Week 604
 This week ' s case was generously donated by Dr. Peter Gilligan, and features a histopathology section of an appendix from a patient with Crohn ' s disease. The pathologist was concerned when they saw the following object in the lumen of the appendix. Identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - August 31, 2020 Category: Parasitology Source Type: blogs

Answer to Case 604
 Answer toParasite Case of the Week 604: Plant material, not a parasite. Although the large size and round shape in section superficially resembles a cross-section of a large roundworm (i.e.,Ascaris lumbricoides), there are some key features that allow us to identify this as plant material. As nicely stated by Florida Fan, " There does not seem to be a layer of polymyarian muscle cells as well as the other anatomical components such as a digestive tube or reproductive organs and no excretory organs either " which would be seen inAscaris lumbricoides.He also adds: " when magnified enough we can see polygonal cells...
Source: Creepy Dreadful Wonderful Parasites - August 31, 2020 Category: Parasitology Source Type: blogs

Case of the Week 603
 Here ' s a fun case for us this week from my technical specialist, Emily Fernholz. The following objects were seen on a Giemsa-stained thick film from a patient with recent travel to the Western United States. Diagnosis? What additional testing would you recommend? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - August 18, 2020 Category: Parasitology Source Type: blogs

Answer to Case 603
Answer to Case of the Week 603:Borreliasp. spirochetes. The history is most consistent with a relapsing feverBorreliasp., and subsequent PCR showed this to beBorrelia hermsii. As Florida Fan mentioned, this case is a great reminder that when we examine a Giemsa-stained blood film, we may find things other than parasites. In addition to spirochetal bacteria such as in this case, we can find intracellular clusters (morulae) ofAnaplasma phagocytophilumandEhrlichicaspp. bacteria, and intracellular years (e.g.Histoplasma capsulatum, Talaromyces marneffei).Leishmaniaspp. amastigotes can also rarely be seen within phagocytic...
Source: Creepy Dreadful Wonderful Parasites - August 16, 2020 Category: Parasitology Tags: borrelia Source Type: blogs

Case of the Week 602
 This week ' s case was generously donated by Dr. Harsha Sheorey. The following object was submitted from a middle-aged man with hematuria. The specimen source is urine, and accompanying instructions asked the laboratory to rule out a fluke or cestode. The patient had traveled to Southeast Asia in the past.Identification? What are the clinical implications for this patient? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - August 10, 2020 Category: Parasitology Source Type: blogs

Answer to Case 602
 Answer toParasite Case of the Week 602: insect larva, consistent with a member of the Psychodidae (drain/sewer fly) larva. As Richard Pollack noted, this is " Not from patient but from commode. Upon their discovery, folks often jump to the conclusion that they derived from the bladder or intestine. There are reports in the literature of myiasis from these flies, but one should generally be skeptical. " It turns out that this is exactly what happened in this case. The specimen consisted of urine taken from the toilet water.Florida Fan added " Being not an entomologist, I would say latrine fly larva and leave the entom...
Source: Creepy Dreadful Wonderful Parasites - August 9, 2020 Category: Parasitology Source Type: blogs

Case of the Week 601
Here is our monthly case by Idzi Potters and theInstitute of Tropical Medicine, Antwerp. The following were seen in skin scrapings from a young immigrant male. Identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - August 4, 2020 Category: Parasitology Source Type: blogs

Answer to Case 601
 Answer:Sarcoptes scabei, the ' human itch mite 'As noted by Kosta, Patrik, and Anon, this is a larval mite, as evidenced by the presence of only 6 legs. Mites are arachnids and have 8 legs in their nymphal and adult stages. As noted by Old One in aprevious post,Sarcoptesare round to ovoid when viewed from the back; when viewed from the side they are ventrally flattened and dorsally rounded (similar to a turtle). They possess short stumpy legs, and have no internal or external respiration apparatus (stigmata or tracheae). The ventral surface contains a number of chitinized plates called apodemes, the dorsal ...
Source: Creepy Dreadful Wonderful Parasites - August 2, 2020 Category: Parasitology Source Type: blogs

Case of the Week 600
Wow, I can ' t believe we are up to Case of the Week 600! To celebrate, my awesome technical specialist, Emily Fernholz, made me this lovely composite image. Click on the image to enlarge and see all of the smaller pictures making up the larger image. Can you tell me what it is, and why it is appropriate for this week ' s case? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - July 27, 2020 Category: Parasitology Source Type: blogs

Answer to Case 600
Answer toParasite Case of the Week 600: Lovely ectoparasite collage of a larval tick ofRhipicephalussp., courtesy of my amazing technical specialist, Emily Fernholz.Note that the arthropod has 6 legs (to go with my 600th case), indicating that this is a larva rather than nymph or adult. One reader queried if the components of the collage were from all of my cases to date. Wow, what a great idea! There are more than 4000 images present, which might have been able to represent all of the images from my various cases. However, that is not the case here - the collage is made up of many different arthropods, including bed ...
Source: Creepy Dreadful Wonderful Parasites - July 26, 2020 Category: Parasitology Source Type: blogs

Case of the Week 599
This week ' s fun case is from Dr. Tess Karre, one of our former clinical microbiology fellows. The following structures were seen in a hematoxylin and eosin stained small bowel biopsy. Identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - July 13, 2020 Category: Parasitology Tags: helminth Parasite Source Type: blogs

Answer to Case 599
Answer toParasite Case of the Week 599: MaleEnterobius vermicularisCongratulations to all of you who got this one correct! This was actually an older case that I had posted back in 2014. I had forgotten that I already posted it! This case comes with an explanatory photo and a fun poem from Blaine Mathison:While the duodenum is an unusual place to find this worm,the morphologic features shouldn ' t cause you to squirmWith lateral alae pointing to the sidesand platymyarian musculature low and widea diagnosis of pinworm should be relatively firm! (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - July 13, 2020 Category: Parasitology Source Type: blogs

Case of the Week 598
Welcome to the first case of the month provided by Idzi Potters and theInstitute of Tropical Medicine, Antwerp. The following object was obtained during colonoscopy from a 35-year-old woman. It measures approximately 4 cm in length. Travel history is unknown. Identification? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - July 6, 2020 Category: Parasitology Source Type: blogs

Answer to Case 598
Answer to Parasite Case of the Week 598:Trichuris trichiura,the human whipworm. This is a beautiful classic case from Idzi. Notice the whip-like shape. Just don ' t be fooled by the anatomy - the anterior end is the skinny end! (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - July 5, 2020 Category: Parasitology Tags: helminth Parasite Source Type: blogs