bannermenu

2004 Monthly Case Studies

Monthly Case Studies – 2004

More Case Studies by Year

2019 | 2018 | 2017 | 2016 | 2015 | 2014 | 2013 | 2012 | 2011 | 2010 | 2009 | 2008 | 2007 | 2006 | 2005

December 2004

December - 2004 - Case #146
A 45-year-old man had coughing spells, typically in the morning, over a 2-year period. He decided to consult his primary care physician after noting blood in his sputum on a few occasions. The man said he did not have allergies but that he occasionally smoked cigars. He also mentioned that he traveled frequently for business to Asia and Africa. His physician requested a chest x-ray, and upon examination, cavitary lesions were observed in both lungs. A biopsy of lung tissue was obtained, sectioned, and stained with hematoxylin and eosin (H & E). Figure A shows what was observed in moderate numbers on the slide (200× magnification). What is your diagnosis? Based on what criteria?

A 45-year-old man had coughing spells, typically in the morning, over a 2-year period. He decided to consult his primary care physician after noting blood in his sputum on a few occasions. The man said he did not have allergies but that he occasionally smoked cigars. He also mentioned that he traveled frequently for business to Asia and Africa. His physician requested a chest x-ray, and upon examination, cavitary lesions were observed in both lungs. A biopsy of lung tissue was obtained, sectioned, and stained with hematoxylin and eosin (H & E). Figure A shows what was observed in moderate numbers on the slide (200× magnification). What is your diagnosis? Based on what criteria?

December - 2004 - Case #145
A 47-year-old woman traveled to the Dominican Republic. Upon her return she experienced fever and chills and went to see her doctor. A blood smear was ordered by her physician, stained with Wright's-Giemsa, and examined. The following images show what was seen at 1000× magnification. What is your diagnosis? Based on what criteria?

A 47-year-old woman traveled to the Dominican Republic. Upon her return she experienced fever and chills and went to see her doctor. A blood smear was ordered by her physician, stained with Wright's-Giemsa, and examined. The following images show what was seen at 1000× magnification. What is your diagnosis? Based on what criteria?

November 2004

November - 2004 - Case #144
A 29-year-old female from the West Indies was visiting relatives for a few months in the Midwest. After several weeks she began to experience fevers, headache, and occasionally insomnia. Her relatives took her to the emergency room of the local hospital where she explained that she had malaria about one year previous and thought that she may be experiencing a relapse. Thick and thin blood films were made, stained with Giemsa, and examined. Nothing reportable was observed on a thin film; the objects seen in Figures A-C were observed on the thick film at 1000× magnification. The objects were approximately 180–190 micrometers long. What is your diagnosis? Based on what criteria?

A 29-year-old female from the West Indies was visiting relatives for a few months in the Midwest. After several weeks she began to experience fevers, headache, and occasionally insomnia. Her relatives took her to the emergency room of the local hospital where she explained that she had malaria about one year previous and thought that she may be experiencing a relapse. Thick and thin blood films were made, stained with Giemsa, and examined. Nothing reportable was observed on a thin film; the objects seen in Figures A-C were observed on the thick film at 1000× magnification. The objects were approximately 180–190 micrometers long. What is your diagnosis? Based on what criteria?

November - 2004 - Case #143
A 45-year-old man, HIV positive, went to his health care provider with complaints of abdominal cramping, occasional watery diarrhea, and noticeable weight loss. The physician ordered an ova and parasites (O & P) examination. Fecal smears were prepared from formalin-fixed stools, stained by different techniques including Chromotrope 2R, and examined by a reference lab. The objects seen in Figures A-C are what was observed on the Chromotrope 2R stained smear at 1000× magnification. What is your diagnosis? Based on what criteria? What, if any, further examinations with other staining techniques would you recommend?

A 45-year-old man, HIV positive, went to his health care provider with complaints of abdominal cramping, occasional watery diarrhea, and noticeable weight loss. The physician ordered an ova and parasites (O & P) examination. Fecal smears were prepared from formalin-fixed stools, stained by different techniques including Chromotrope 2R, and examined by a reference lab. The objects seen in Figures A-C are what was observed on the Chromotrope 2R stained smear at 1000× magnification. What is your diagnosis? Based on what criteria? What, if any, further examinations with other staining techniques would you recommend?

October 2004

October - 2004 - Case #142
A 41-year-old man traveled to Tanzania and Kenya. Within two weeks of his return, he went to his health care provider with complaints of intermittent fevers, malaise, and headaches. His travel history also indicated he had visited several South American countries before his trip to Africa. The doctor ordered a blood smear and instructed the man to wait for the results. The smear was stained with Giemsa and examined. Figures A-D show what was observed on the smear. What is your diagnosis? Based on what criteria?

A 41-year-old man traveled to Tanzania and Kenya. Within two weeks of his return, he went to his health care provider with complaints of intermittent fevers, malaise, and headaches. His travel history also indicated he had visited several South American countries before his trip to Africa. The doctor ordered a blood smear and instructed the man to wait for the results. The smear was stained with Giemsa and examined. Figures A-D show what was observed on the smear. What is your diagnosis? Based on what criteria?

October - 2004 - Case #141
An 10-year-old boy was taken to his pediatrician due to intestinal symptoms, including diarrhea, after he returned home from summer camp. The physician requested several exams, including an ova and parasite (O & P) examination; the stool specimen was tested at a commercial laboratory where a concentration method was performed and wet-mount slide examined. One of the exams ordered by the physician was positive for a bacterial agent. However the objects seen in Figures A and B (magnification 400×) were observed in the stool samples in low numbers. Please provide a complete identification of the objects in the images.

An 10-year-old boy was taken to his pediatrician due to intestinal symptoms, including diarrhea, after he returned home from summer camp. The physician requested several exams, including an ova and parasite (O & P) examination; the stool specimen was tested at a commercial laboratory where a concentration method was performed and wet-mount slide examined. One of the exams ordered by the physician was positive for a bacterial agent. However the objects seen in Figures A and B (magnification 400×) were observed in the stool samples in low numbers. Please provide a complete identification of the objects in the images.

September 2004

September - 2004 - Case #140
A 41-year-old female saw her doctor because she was experiencing diarrhea, abdominal pain, and fatigue. Her physician ordered an ova and parasites (O & P) examination. A stool specimen was collected and sent to the AZ State Public Health Laboratory where an FEA (formalin-ethyl acetate) concentration was performed and a modified Kinyoun's acid-fast stained smear made and examined. The laboratorian made a diagnosis and used a digital camera to capture images to send to CDC's DPDx for confirmation. Objects seen at 1000× magnification were 8-9 micrometers in diameter (shown in Figures A-C). Figure D shows what was observed using UV microscopy at 200× magnification; the object in D measured around 9 micrometers. What is your diagnosis? Based on what criteria?

A 41-year-old female saw her doctor because she was experiencing diarrhea, abdominal pain, and fatigue. Her physician ordered an ova and parasites (O & P) examination. A stool specimen was collected and sent to the AZ State Public Health Laboratory where an FEA (formalin-ethyl acetate) concentration was performed and a modified Kinyoun's acid-fast stained smear made and examined. The laboratorian made a diagnosis and used a digital camera to capture images to send to CDC's DPDx for confirmation. Objects seen at 1000× magnification were 8-9 micrometers in diameter (shown in Figures A-C). Figure D shows what was observed using UV microscopy at 200× magnification; the object in D measured around 9 micrometers. What is your diagnosis? Based on what criteria?

September - 2004 - Case #139
A 20-year-old man was sitting at his desk when he sneezed and noticed a small object fall from his nose onto his desk. He claimed the object was moving on the desk. He took the object to his health care provider, who thought that it was some type of worm. The object was 0.7 cm by 0.2 cm, somewhat flat, and whitish in color. It was sent to the pathology department where it was sectioned and stained with hematoxylin and eosin (H & E). The pathologist captured several digital images and submitted them to CDC's DPDx for diagnostic assistance. The object is shown in Figure A (200×) and Figures B and C (400×). A few round objects, such as the one in Figure D (600×), were also noted; they measured about 30 micrometers in diameter. What is your diagnosis? Based on what criteria? What kind of follow-up testing, if any, would you recommend and why?

A 20-year-old man was sitting at his desk when he sneezed and noticed a small object fall from his nose onto his desk. He claimed the object was moving on the desk. He took the object to his health care provider, who thought that it was some type of worm. The object was 0.7 cm by 0.2 cm, somewhat flat, and whitish in color. It was sent to the pathology department where it was sectioned and stained with hematoxylin and eosin (H & E). The pathologist captured several digital images and submitted them to CDC's DPDx for diagnostic assistance. The object is shown in Figure A (200×) and Figures B and C (400×). A few round objects, such as the one in Figure D (600×), were also noted; they measured about 30 micrometers in diameter. What is your diagnosis? Based on what criteria? What kind of follow-up testing, if any, would you recommend and why?

August 2004

Figure A

Figure A

Figure A

Figure A

July 2004

Figure A

Figure A

Figure A

Figure A

June 2004

Figure A

Figure A

Figure A

Figure A

May 2004

Figure A

Figure A

Figure A

Figure A

April 2004

Figure A

Figure A

Figure A

Figure A

March 2004

Figure A

Figure A

Figure A

Figure A

February 2004

Figure A

Figure A

Figure A

Figure A

January 2004

Figure A

Figure A

Figure A

Figure A

DPDx is an educational resource designed for health professionals and laboratory scientists. For an overview including prevention, control, and treatment visit www.cdc.gov/parasites/.

Page last reviewed: September 2, 2016