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Case #235 – September, 2008

A 25-year-old man returned from three months of studying abroad in southeast Asia. Countries he visited during his studies included the Philippines, Indonesia and Thailand. Shortly after returning to the United States, he presented to his health care provider with abdominal pain, cramps and diarrhea. Due to the travel history, a routine ova and parasite (O&P) examination was performed on the patient’s stool. Objects AF show objects observed in the formalin-concentrated stool specimen. All images were captured at 400x magnification. The object in Figure A measured approximately 70 micrometers long by 47 micrometers wide and was seen in large numbers. The objects in Figures B and E measured approximately 75 micrometers long by 60 micrometers wide and were seen in moderate numbers. The object in Figure C measured approximately 67 micrometers long by 38 micrometers wide and was seen in moderate numbers. The objects in Figures D and F measured approximately 25 micrometers long by 13 micrometers wide and were seen in rare numbers. What is your diagnosis? Based on what criteria?

Case235_A

Figure A

Case235_B

Figure B

Case235_C

Figure C

Case235_D

Figure D

Case235_E

Figure E

Case235_F

Figure F

Images presented in the DPDx 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/.