2006 DPDx Case Studies

DPDx Case Studies – 2006

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December 2006

Images from a trichrome stained fecal smear were submitted to DPDx telediagnosis assistance from a public health laboratory. Parasites were suspected and further confirmation was needed. The patient was a 32-year-old male who had diarrhea; no travel history was known.

A 45-year-old woman had a nodule approximately 1 cm in diameter located near a scar from a previous mastectomy. The patient had traveled to several western and central European countries within the past year.

November 2006

A request for confirmation of an identification was submitted to DPDx Telediagnosis Assistance. Figures A and B were captured from a hematoxylin and eosin (H & E) stained histological section of a liver abscess found during an autopsy.

DPDx Telediagnosis Assistance received a request for confirmation of an identification by the Vermont Department of Health Laboratory. Figures A and B show an object that was extracted from a chest wound of a patient.

October 2006

The DPDx Team received a telediagnosis request asking for confirmation of an identification made by the Wisconsin State Laboratory of Hygiene. The patient had a travel history to India.

A 4-year-old boy's parents discovered a worm that they thought had been spit out by their child. They submitted the worm to their physician, along with the information that the boy had some exposure to raw seafood and that the family had a dog.

September 2006

A hospital submitted blood films to CDC's reference laboratory for identification of the microfilariae that were seen on the films. The object in Figure A was seen on a Wright-Giemsa stained blood film and measured approximately 180 µm.

A 35-year-old man was seen by a physician for diarrhea and abdominal pain. An ova and parasites (O & P) examination was ordered, along with other tests.

August 2006

A man went to a local hospital with abdominal pain and weight loss. He reported that he frequently travels to South America and had previously been diagnosed with ascariasis, although recent stool specimens were negative.

A worm measuring approximately 11 mm in length was sent to CDC for identification by a laboratory in the Southeastern United States. The following images were obtained by placing the worm on a 1" × 3" glass slide and gently "floating" a 24 × 30 mm glass coverslip on top of it with water.

July 2006

A patient went to a local hospital with fevers and thrombocytopenia after recent travel to Haiti. A blood smear examination was requested by the attending physician.

A family visited different U.S. states during a one week vacation. Approximately eight days after their trip, two family members began experiencing diarrhea.

June 2006

A researcher was studying parasites of public health concern found in snails and slugs. A small portion of one specimen had tissue removed and placed in a small dish with a HCl/pepsin solution.

A patient was admitted to a hospital with a one-day history of fever and persistent headache on the right side. Approximately 10 days prior to the onset of symptoms, the individual swam in a small swimming hole, associated with a river.

May 2006

A 27-year-old woman who had been working in Laos, Thailand, and Vietnam for one and a half years was visiting relatives in the U.S. While she was in the U.S., she visited a physician for recurring abdominal discomfort, bloating, and frequent bowel movements that she had experienced over the last two months.

A group of refugees from Southeast Asia were being screened for parasites as part of a medical evaluation. Stool specimens were collected and processed.

April 2006

A 29-year-old man went to a local health clinic with complaints of intermittent diarrhea for a few months. He did not report any other symptoms but said he had difficulty sleeping sometimes.

A 43-year-old man went to his physician complaining of fatigue. The man reported that he hiked and camped a lot throughout the northeastern United States weeks before the symptoms started.

March 2006

A CDC microbiologist was looking through slide boxes that had been archived to determine whether the slide quality was good enough to continue storing them. He came across a pathology slide of heart tissue that was dated "1929."

An elderly patient underwent a colonoscopy for polyps. A worm was seen near the appendiceal orifice and a biopsy was taken, fixed in formalin, and sent to histology.

February 2006

A teenager underwent surgery for a traumatic injury to his abdominal cavity. Apart from the injury, the surgeon noticed some necrosis around the youth's appendix.

A 29-year-old missionary lived in Gabon and Cameroon for one year. Eight months into her stay, she went to a medical clinic with complaints of headache, fever, chills, and some diarrhea.

January 2006

A 45-year-old female noticed a long, worm-like object in her stool. The object was collected and, along with tissue sections prepared by the hospital where she was seen, submitted to the Florida public health laboratory for examination.

Recently DPDx telediagnosis inquiries received a request for assistance from the Medical College of Wisconsin. Images from a thin blood smear were submitted along with the patient's history of traveling to Honduras.

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