May, 2004

Case 131:
A survey was conducted in several areas of Haiti to determine the prevalence of Cyclospora cayetenesis.  The presence of geohelminths was also recorded and infected participants were treated.  Stool samples were collected, preserved in 10% formalin, and processed using the formalin-ethyl acetate (FEA) concentration method.  UV fluorescence microscopy was used to screen for Cyclospora oocysts and bright-field examination was performed to screen for geohelminths.  The images below show what was found in one sample.  Figures A and B show the same object using different microscopy techniques; the object is approximately 64 micrometers long.  The object in Figure C is approximately 575 micrometers long (magnification 200×).  Figure D was taken at 400× magnification.  What is your diagnosis?  Based on what criteria?

A	B

C	D

Click here for the answer to Case 131.

Case 132:
A 2-year-old child was brought to a local hospital emergency room when his parents discovered a white worm in his diaper.  The child had no apparent symptoms at the time and did not develop symptoms later.  The worm was forwarded to CDC for identification via the state health department.  Figures A and B were taken with a hand-held digital camera; B was taken through the eyepiece of a dissecting microscope.  Figures C and D were taken with a digital camera mounted on a compound microscope and show the anterior end of the worm.  What is your diagnosis?  Based on what criteria?

A	B

C	D

Acknowledgement: This case was kindly provided by the Florid Department of Health, Bureau of Laboratories.

Click here for the answer to Case 132.

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.