Case #332 - September, 2012
A 55-year-old man presented with complaints of abdominal pain, constipation, intermittent diarrhea with blood and mucus, and blurry vision accompanied by headaches. The patient had been taking prednisone and amoxicillin for other medical issues. A stool examination was performed for parasites and objects resembling tapeworm proglottids were observed and sent to the state health laboratory for diagnostic assistance. The specimens were in turn forwarded to the CDC-DPDx for additional assistance. Two objects were received at the CDC, measuring 30 and 15 millimeters in length. The object in Figure A shows part of the larger object. Figure B shows a close-up of one of the ends of the same object. Figure C shows the same object under higher magnification after clearing in lactophenol for two hours. Figure D shows the smaller of the two objects. What is your diagnosis? Based on what criteria?
The objects in this case were plant material and a diagnosis of No Parasites Found (NPF) was given. Figure C showed boxy, compartmentalized cells characteristic of plants. The object in Figure D showed banana seeds. It was suggested that the larger of the two objects represented a phloem bundle of a banana, but further identification was not warranted as the object was confirmed to be an artifact.
More on: Artifacts
This case and images, in part, were kindly provided by the South Carolina Department of Health and Environmental Control, Columbia, SC.
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/.