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Monthy Case Studies - 2000
Case #28 - January, 2000
Two couples attended a business conference in Florida for one week. They shared supper meals catered by the hotel, but ate separate lunches outside the hotel. One week after their trip, both couples sought medical attention for abdominal cramping and diarrhea. Both couples submitted stool specimens. The following composite images are from acid-fast smears of formalin-ethyl acetate concentrations of those specimens. The first couple are patients 1 and 2, and the second couple are patients 3 and 4. What is your diagnosis? Based on what criteria?
Figure A
Figure B
Figure C
Figure D
Answer to Case #28
Patients 1 and 2 had cyclosporiasis caused by Cyclospora cayetanensis; patients 3 and 4 had cryptosporidiosis caused by Cryptosporidium sp. The key factor in this diagnosis was size: the Cyclospora oocysts were larger (7.7 to 10.0 µm) than the Cryptosporidium oocysts (four to six µm). The Cyclospora oocysts from patients 1 and 2 showed variable staining in contrast to the more uniform staining of the Cryptosporidium oocysts from patients 3 and 4. Other important morphological features included the wrinkled appearance of the unstained Cyclospora oocyst (patient 2) and the presence of sporozoites in a few of the Cryptosporidium oocysts (patient 3).
More on: Cyclosporiasis
More on: Cryptosporidiosis
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.
