July, 2008

Case 231
A 25-year-old man, who recently returned from a trip to Brazil, presented to his health care provider with a festering lesion on his forehead.  The patient also complained of feeling things moving under his skin.  Surgical removal of the outer surface of the lesion revealed several maggot-like organisms (Figure A) beneath the skin.  Specimens were sent to the CDC for diagnostic assistance.  Figure B shows a close-up of the anterior end of one of the organisms; Figure C shows a close-up of the posterior end. Figures D and E show structures dissected out of the anterior end of one of the organisms.  What is your diagnosis?  Based on what criteria?

 

A

 

B	C

 

D	E

Click here for the answer to Case 231.

Case 232
A study was conducted on herding dogs in a sheep-raising region of northeastern Arizona to determine the prevalence of Echinococcus granulosus.  Public health officials wanted to determine the risk for hydatid cyst disease in the local people.  Stool specimens from the dogs were collected and taken back to a laboratory for analysis.  Figures A and B show objects recovered from the stool of several of the dogs.  The objects varied in length from 10-13 centimeters and measured approximately 2 millimeters wide.  What is your diagnosis?  Based on what criteria?

A	B

Click here for the answer to Case 232.

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.