June, 2003

Case 109:
A 29-year-old man was seen by his primary care physician for intermittent abdominal pain and traces of blood in his stool.  The man had traveled to Mexico on a camping vacation 1 week prior to the onset of symptoms.  He reported that he was careful about what he ate and drank during the trip.  The man submitted a stool specimen for ova and parasites (O & P) examination.  The images below show what was seen in large numbers on a trichrome stained smear of his PVA preserved stool (Figures A and B, 1000× and Figure C, 500×).  What is your diagnosis?  Based on what criteria?

A	B

C

Click here for the answer to Case 109.

Case 110:
A U.S. citizen traveled to the West Indies and stayed there for a month.  About two weeks after returning from the region, the patient was seen by a physician for a high fever.  The fever lasted for only a couple of days.  Blood was collected, smears prepared, and stained with Giemsa.  The objects in Figures A-D represent what was observed in very low numbers on the stained blood smear.  What is your diagnosis?  What kind of diagnostic tests would you recommend to confirm the microscopic examination?

A	B

C	D

Click here for the answer to Case 110.

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.