Case #337 – December, 2012

A five-year-old boy developed loose, watery stools approximately one week after attending a birthday party for a friend. The parents took the child to their health care provider for medical attention. The parents told the physician that at the party, the child played in splash pads. A stool specimen was collected in 10% formalin and submitted for laboratory testing. A formalin-ethyl acetate concentration was performed and a wet mount of the sediment was examined for ova and parasites. Objects shown in Figures A and B, measuring 5-6 micrometers on average, were observed in moderate numbers at 1000x magnification. The laboratory recommended to the attending physician that a modified acid-fast stain be done. It was ordered and Figure C shows what was observed. What is your diagnosis? Based on what criteria? What further testing, if any, would you recommend?

Figure A

Figure B

Figure C

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.

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