A 9-year-old boy was taken to his pediatrician for sudden headaches, fatigue, and loss of muscle coordination. His
family lives on a ranch located approximately 80 miles northeast of San
Francisco, CA. Clinical laboratory tests indicated eosinophilia
and eosinophilic meningoencephalitis. Repeated stool tests were
all negative for parasites. Significant in the history provided
by the family was the fact that a family of raccoons had taken up residence
in a storage shed in the same area of the yard where the child often plays.
A brain biopsy was ordered and nematode larvae were found. Figure
A shows what the pathologist found in an H & E (hemotoxylin
and eosin) stained section obtained from a brain biopsy. An epidemiological investigation was
initiated as a result of the nematode found in the biopsy. As part
of this investigation, a pooled sample of raccoon feces was collected
and examined for intestinal parasites. Numerous eggs similar to
the one shown in the Figure B were seen. What is your diagnosis?
Based on what criteria?
here for the answer to Case 41.
A reference laboratory received one trichrome stained slide from a local
health care facility requesting an O & P (ova and parasites) examination on a 25-year-old
man whose symptoms included abdominal cramping and intermittent diarrhea.
The images below show the objects seen on the submitted slide. The
objects averaged 4.5 to 5.5 micrometers in diameter. What is your
diagnosis? Based on what criteria? What else would you recommend?
here for the answer to Case 42.
in the monthly case studies are from specimens submitted for diagnosis
or archiving. On rare occasions, clinical histories given may be