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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

Answer to Case 684
Answer to theParasite Case of the Week 684: Anisakid L3 larvaeThe following is our third and final discussion from our amazing guest author and 3rd year medical student, Hadel Go. I ' m sure you will all agree that her discussions have been among the best we ' ve ever had on this blog. Congratulations on the excellent work, Hadel!_____________________ Worm cases are always my favorite because the comments are either “They are so beautiful!!” (@Parasite_Power on Twitter) or “…That’s a wholelottanope” (Valmik in the comments).This is a nematode in the Anisakidae family, likelyPseudoterranovaorAnisakis spp., ...
Source: Creepy Dreadful Wonderful Parasites - May 30, 2022 Category: Parasitology Source Type: blogs

Case of the Week 683
 This week ' s case is from a 4 year old boy with sudden onset of ' explosive ' watery diarrhea, accompanied by low grade fever, nausea, vomiting, and loss of appetite. A stool specimen was obtained after 1 week of symptoms, and the following objects were noted on a modified acid fast stain. They measure approximately 5 micrometers in diameter. Here are some questions to consider:1. What parasite is shown?2. Name 3 common ways that infection is acquired.3. What is the typical recommended treatment?4. What are the risk factors for severe infection.As with last week, Hadel Go is serving as a guest author, and will ...
Source: Creepy Dreadful Wonderful Parasites - May 23, 2022 Category: Parasitology Source Type: blogs

Case of the Week 683
Answer to Case 683:Cryptosporidiumsp. oocystsThe following OUTSTANDING discussion is from our guest author, Hadel Go, a third year medical student with a strong interest in clinical parasitology._________________________________________We received some excellent feedback! Thank you all for leaving comments on the blog, on Twitter, and on LinkedIn.Yes, these areCryptosporidium oocysts. These protozoans can be identified by their size and consistent red color on modified acid-fast staining of stool samples. They can also be diagnosed from H&E stained tissue biopsies (see images here:Cryptosporidium, parasitewonders.com),...
Source: Creepy Dreadful Wonderful Parasites - May 22, 2022 Category: Parasitology Source Type: blogs

Case of the Week 682
This week we have a special guest author, Hadel Go, a medical student (Class of 2024) who is greatly interested in parasitology. I ' m very excited that Hadel will be our first ever guest author! The following is our case that she will be teaching us about later this week.The patient is a young man from Madagascar who presented with a 1-week history of chest pain, night sweats, and fever. Chest X-ray showed a right upper lobe peripheral cavitary lesion. Work up for tuberculosis including AFB stained smears of sputum and sputum PCR using the Xpert MTB/RIF assay were negative. Therefore, a wedge resection of the abscess was ...
Source: Creepy Dreadful Wonderful Parasites - May 18, 2022 Category: Parasitology Source Type: blogs

Answer to Case 682
 Answer to theParasite Case of the Week 682:Schistosoma mansoniegg.The following post is from our first ever guest author, Hadel Go. I think you will all agree that Hadel did an outstanding job writing up the answer to the case of the week, and that this is truly one of the best case answers we have had on this blog.__________________________________Hadel Go, Medical Student, Guest AuthorThis is aSchistosoma mansoniegg in lung tissue as many of you correctly identified in the comments. The large lateral spine is a dead giveaway and creates the “quote bubble” morphology mentioned by Jacob @eternalstudying on Twitte...
Source: Creepy Dreadful Wonderful Parasites - May 17, 2022 Category: Parasitology Source Type: blogs

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 Answer to theParasite Case of the Week 682:Schistosoma mansoniegg.The following post is from our first ever guest author, Hadel Go. I think you will all agree that Hadel did an outstanding job writing up the answer to the case of the week, and that this is truly one of the best case answers we have had on this blog.__________________________________Hadel Go, Medical Student, Guest AuthorThis is aSchistosoma mansoniegg in lung tissue as many of you correctly identified in the comments. The large lateral spine is a dead giveaway and creates the “quote bubble” morphology mentioned by Jacob @eternalstudying on Twitte...
Source: Creepy Dreadful Wonderful Parasites - May 17, 2022 Category: Parasitology Source Type: blogs

Case of the Week 681
This week ' s case was generously donated by Tracie Rose from Seattle. The following objects were seen in a Papanicolaou-stained preparation of aspirate fluid from a liver cyst. the patient is from Afghanistan. Identification?  (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - May 10, 2022 Category: Parasitology Source Type: blogs

Answer to Case 681
 Answer:Echinococcussp. invaginated protoscolicesGiven the clinical history of a cystic lesion in a patient from Afghanistan, the causative agent is probablyE. granulosus. The protoscolices are somewhat degenerated, but you can still make out the internal row of hooklets:The protoscolex will evert if ingested by the canine definitive host and form the scolex of the adult tapeworm. Thanks again to Tracie Rose and her lab for donating this case!If you liked seeing parasites stained with the Papanicolaou (pap) stain, you can also check outthis previous case ofSchistosoma haematobiumeggs in urine. The pap stain ...
Source: Creepy Dreadful Wonderful Parasites - May 9, 2022 Category: Parasitology Source Type: blogs

Case of the Week 680
 This week ' s case is from Drs. Harsha Sheorey and Lauren McShane from Australia. The following were seen in bronchial washings from an immunocompromised patient (fluorescent prep for fungi and wet preps):Here are the blood culture plates from the bronchial washings.The patient also has Gram negative bacteremia. Diagnosis? As a bonus, what forms are we seeing in the respiratory specimens? (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - May 2, 2022 Category: Parasitology Source Type: blogs

Answer to Case 680
 Answer:Strongyloides stercoralishyperinfectionThis impressive case shows numerous L3 (or possibly L4)S. stercoralislarvae from bronchial washings, and the accompanying culture plates showing bacterial colonies growing in the wake of migrating larvae. Thanks again to Harsha and Lauren for donating this case! (Source: Creepy Dreadful Wonderful Parasites)
Source: Creepy Dreadful Wonderful Parasites - May 1, 2022 Category: Parasitology Source Type: blogs