March, 2004

Case 127:
An 81-year-old woman had pneumonia and respiratory failure.  A bronchial aspirate was collected and a wet mount examined.  The lower respiratory sample had heavy growth of natural flora.  Figures A-C were the objects seen in the aspirate.  Objects ranged from 17 to 22 µm in size.  What is your diagnosis?  Based on what criteria?

A	B	C

Acknowledgement: This case kindly provided by the Texas Department of Health.

Click here for the answer to Case 127.

Case 128:
A 10-year-old boy had fever, abdominal pain, and vomiting.  For over 2 years the boy and his family had lived in several Central American countries.  His dietary habits included eating ripe fruit found on the ground, and salad greens picked fresh from the garden.  The boy underwent an appendectomy as appendicitis was suspected.  Macroscopic and microscopic observation of the surgically removed sections showed lesions, thickening of the appendix wall, and granulomatous inflammation.  Figures A-C show what was observed during microscopic examination of the hematoxylin and eosin (H & E) stained slides.  What is your diagnosis?  Based on what criteria?

A

B	C

Acknowledgement: This case kindly provided by the Department of Parasitology at the University of Costa Rica.

Click here for the answer to Case 128.

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.