Case #155 - May, 2005
An 8-year-old boy complained of bloating and intermittent diarrhea, and he told his mother he had passed a worm when he went to the bathroom. They went to a physician and reported that the boy had a history of chronic stomach problems and gastrointestinal reflux. No travel history or date of symptom onset was given. The physician ordered an ova and parasite (O & P) examination. A stool specimen was collected at a local medical facility and submitted for testing. Figures A and B show objects that were seen on a wet mount smear, at 100× and 200× magnification respectively, from an FEA concentration performed at the California State Department of Health Services laboratory. What is your diagnosis? Based on what criteria?
The objects in this case are artifacts (plant hairs) which may be confused with nematode larvae, and a diagnosis was made of No Parasites Found (NPF). The objects lacked internal structures, such as a digestive or reproductive tract. There appeared to be a tube or canal that runs almost the entire length of the objects, but it is refractile with no identifiable changes representing an esophagus, intestine, etc. A true digestive tract would not appear refractile and would have clearly identifiable components. The objects also lacked any discernable external structures such as a mouth, lips, or papilliae, etc.
More on: Artifacts
This case was kindly contributed by the California State Department of Health Services laboratory.
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.
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/.