February, 2002

Case 77
A 4-year-old boy was seen in a children’s hospital for fever, nausea, intermittent vomiting, anorexia, and diarrhea.  Five months earlier, the boy had traveled to South America with his parents.  The pediatrician ordered a complete blood count (CBC) and an O&P (ova and parasites) stool examination.  The results from the blood count indicated eosinophilia.  Three stool specimens from the boy were collected and preserved in formalin and PVA.  The images are trichrome stained smears from his stool specimens (Figures A and B).  The objects seen in the smears measured approximately 7 to 10 micrometers in length.  What is your diagnosis?  Based on what criteria?

A	B

Click here for the answer to Case 77.

Case 78
A 60-year-old woman with an extensive travel history to various Caribbean Islands, consulted an infectious disease specialist because of a persistent cough she had been experiencing for a few weeks.  Visual examination of the patient's throat revealed what appeared to be a worm or worms attached to the mucosa.  The objects were removed with forceps, mounted on glass slides (whole, not sectioned), and forwarded to the Florida Department of Health for identification.  The slides were subsequently forwarded to CDC for a consult.  The objects were in pieces and measured approximately 0.5 to 1 cm in length; other egg-like objects measured 70 to 80 micrometers in length.  Figures B, C, and D were captured using differential interference contrast microscopy to visually enhance diagnostic features.  What is your diagnosis?  Based on what criteria?

A	B

C	D

E

Click here for the answer to Case 78.

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.