November, 2002

Case 95:
A 45-year-old woman from northern Alberta, who grew up on a sheep farm and enjoyed hunting deer and moose, was seen at a university hospital in Canada for a cyst discovered in the right upper lobe of her lung during a routine chest x-ray.  Despite the presence of the cyst, the woman was asymptomatic.  The cyst was aspirated, examined in the pathology department, and reported as nondiagnostic.  Further diagnostic work-ups, which included a review of the original Quik Diff stained smears by a senior microbiologist, were initiated before consideration of surgery.  The image below shows one of two objects found on the smears.  What is your diagnosis?  Based on what criteria?  What, if any, follow-up course of action would you recommend?

A

Acknowledgement: The case history and image were kindly provided by the University of Alberta Hospitals, University of Alberta, Canada.

Click here for the answer to Case 95.

Case 96:
A 67-year-old man was admitted to a hospital due to acute diarrhea.  His stool specimen was sent to CDC for a confirmatory diagnosis.  The organism shown in the following image was seen in few to moderate numbers using UV fluorescence microscopy on a direct wet mount.  What is your diagnosis?  Based on what criteria?

A

Click here for the answer to Case 96.

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.