April, 2004

Case 129:
Twelve 6th grade students participated in an overnight astronomy field trip to a local dairy farm.  The owner of the farm provided deli sandwiches, fresh apple cider (made on the premises), and a berry fruit salad for the group's dinner.  Approximately one week after the trip, 10 of the 12 students developed moderate to severe diarrhea accompanied by intestinal cramping.  Stool specimens from all the students were collected by the local health department, processed by formalin ethyl-acetate concentration (FEA), and examined.  Figure A shows what was observed on a wet-mount slide of one of the concentrated specimens using UV fluorescence microscopy (500×).  Figures B and C show what was observed on a modified Kinyoun's acid-fast stained slide from the same specimen (1000×); Figure D is from a different specimen.  All twelve students had the same findings in their specimens, but with different frequency of the objects.  What is your diagnosis?  Based on what criteria?

A	B

C	D

Click here for the answer to Case 129.

Case 130:
A 32-year-old man visited his primary care physician complaining of fever that began approximately one month after his trip to Brazil and Venezuela.  Upon questioning, the patient confessed he had not taken any type of prophylaxis before, during, or after his trip.  The physician requested that a blood smear be made and examined.  Figures A-C show what was observed on a Wright-Giemsa stained thin smear (1000×).  What is your diagnosis?  Based on what criteria?

A	B

C

Click here for the answer to Case 130.

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.