November, 2000

Case 47
A 4-year-old girl from Mexico City was seen by her pediatrician for chronic diarrhea of three months duration.  Her mother is HIV-positive and was undergoing therapy for HIV at the time of the examination.  A smear of the girl's stool was stained with Chromotrope 2R and examined for ova and parasites.  In the smear, oval-shaped objects were observed (1000×, indicated by arrows in Figure A).  The objects averaged 1.3 to 2.7 micrometers in diameter.  What is your diagnosis?  Based on what criteria?  Would you recommend any other laboratory tests?

A

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Case 48
A 38-year-old HIV-positive man was seen at a local AIDS clinic for chronic cough and hemoptysis (blood in sputum).  A bronchoalveolar lavage (BAL) was performed and an object believed to be nematode larva was observed in one of the stained smears of the BAL.  A single object was seen and is shown below at 100×, 400×, and 1000× magnification.  The object measured approximately 440 micrometers in length by 30 micrometers in maximum diameter.  What is your diagnosis?  Based on what criteria?

A	B

C

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Images presented in the monthly case studies are from specimens submitted for diagnosis or archiving.  On rare occasions, clinical histories given may be partly fictitious.