2009 Monthly Case Studies
Monthly Case Studies – 2009
A 29-year-old man went to a local clinic with complaints of intermittent abdominal cramping and mild diarrhea. He explained that he had been diagnosed with roundworms (Ascaris lumbricoides) three months prior and was concerned that he may not have completely cleared the infection.
A 40-year-old man sought medical attention at a hospital one week after returning from a mining operation in Ghana. He presented with diarrhea, vomiting, and night fevers.
A 35-year-old man from Nepal presented at a hospital with recurring cholangitis; the patient had been experiencing symptoms for the previous six months. An MRI revealed two lesions in the liver, measuring approximately 5 centimeters long by 2 centimeters wide.
A five-year-old child went to a local clinic with complaints of abdominal cramping, excessive gas, diarrhea, and weight loss. Stool specimens were collected in formalin and polyvinyl alcohol (PVA) and sent to the local public health laboratory for routine ova-and-parasite (O&P) examination.
A Pathology laboratory in Australia received proglottids and eggs of a cestode that were recovered from the stool of a young female patient who had been living in Africa. The only other information given was that the patient had close contact with monkeys.
A 70-year-old man from the mid-western United States had complaints of fever and general malaise lasting for about one week. He was admitted to a hospital with evidence of hemolytic process (dark urine and low hemoglobin).
A four-year-old child was admitted to the hospital for sever abdominal pain mimicking appendicitis. A small section of bowel was removed and sent to the Pathology Department for work-up.
A 47-year-old woman presented a worm-like object to her doctor that she claims was found in the toilet following urination.
A 43-year-old man from Brazil traveled to Angola and other African countries for business for two weeks. Approximately one week after returning to Brazil, he noticed a small ulcerative lesion on his neck.
A biopsy was performed on a 23-year-old woman with no known travel history, presenting with a perianal ulcer. The specimen was preserved in formalin and sent to a pathology lab for work-up.
A 36-year-old man was admitted to the hospital with fever, chills, headache, and myalgia. The patient recently returned to the United States following a month-long trip to Rwanda to visit family.
A 25-year-old refugee from Myanmar was screened for parasites at a local clinic in Tennessee. Stool specimens were collected in 10% formalin and polyvinyl alcohol (PVA) and sent to the state health laboratory for ova and parasite (O&P) work-up.
A 30-month-old child born in China was recently adopted by a family in the Netherlands. Three consecutive stool specimens were obtained for ova and parasite (O&P) testing, as part of the standard procedure during child adoption. There were no complaints.
A 37-year-old man traveled to Senegal and The Republic of Gambia for two months. Upon his return, he went to his health care provider with complaints of fatigue, headache and fever.
A 45-year-old pig farmer from rural Georgia presented to his health care provider with abdominal pain, cramps and diarrhea. Stool specimens were collected in polyvinyl alcohol (PVA) and 10% formalin for ova and parasite (O&P) examination.
A 29-year-old man from Haiti had blood drawn for routine work-up, following hospitalization for complications with a congenital disorder. The blood was collected in EDTA tubes and sent to Hematology and Microbiology for evaluation.
A small worm approximately 2.5 cm in length was recovered from the stomach of a 38-year-old male. The anterior end had been damaged by the extraction but it was sent to the CDC to see if it could still be identified.
A 45-year-old man developed a few ulcerative lesions on his left forearm about one month after returning from a nature excursion in Costa Rica. He was referred to an infectious disease specialist by his primary care provider.
A patient, originally from Ethiopia but living in the United States for the past five years, presented to her primary care provider with complaints of abdominal pain. A computed tomography (CT) scan was performed, and cysts were observed in the liver.
A 36-year-old immigrant from Mozambique presented to his health care provider with heartburn and chronic right abdominal pain. All previous ova and parasite (O&P) examinations were negative.
A 64-year-old man returned from a trip to Africa with fever and chills. He went to a local hospital for medical assistance. A blood specimen was collected and sent to Hematology for work-up, including Parasitology.
A microbiologist at a public health laboratory contacted DPDx for diagnostic assistance for identifying a tapeworm proglottid received at their lab. A wet mount was prepared from some of the transport media, and eggs morphologically-consistent with those of Taenia were observed.
A ten-year-old child returned from summer camp with abdominal discomfort, nausea and diarrhea. He was taken to his pediatrician and a stool specimen was collected for routine work-up, including ova and parasite (O&P) examination.
An 80-year-old resident of a long-term care facility presented with a skin condition manifesting as thick crusts over the skin accompanied by slight itching. The patient was originally treated for impetigo, with no resolution, and was ultimately admitted to the hospital for further testing.
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/.