June, 2004

Case 133:
A 32-year-old female from the Northeastern United States moved to Jamaica but returned to the U.S. for a visit of several months.  During the first month of her visit, she saw a physician due to a viral-like illness with fevers and body aches.  She also reported that some of the people she was visiting had similar symptoms.  She continued to have intermittent episodes of warm flushing, burning feet, and anorexia.  She had no history of blood transfusions or IV drug use.  Blood smears were requested, stained with Giemsa, and examined.  Figures A-D show what was observed on the smears.  What is your diagnosis?  Based on what criteria?

A	B

C	D

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

Click here for the answer to Case 133.

Case 134:
A 42-year-old female saw her primary care physician for an annual check-up.  She had experienced intermittent loss of appetite, weight loss, and abdominal pain over a 3-4 month period.  Over the past 25 years, she had not traveled outside the U.S. and had lived in several cities on the West Coast.  She stated that she had not changed her eating habits but commented on a recently opened Asian seafood market where she often purchased a type of pickled fish.  The physician requested that she submit a stool specimen for an ova and parasites (O & P) examination.  The specimen was processed by formalin ethyl-acetate (FEA) concentration from which a wet mount was made and examined.  Figures A-C show what was seen in moderate numbers, with objects averaging 20 to 33 micrometers in length.  What is your diagnosis?  Based on what criteria?

A	B

C

Click here for the answer to Case 134.

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.