Case #425 – August 2016

The mother of a four-year-old autistic boy found a worm in her son’s stool while changing his diaper. The family lives on a farm in rural Iowa. The worm and a stool specimen were examined by the Iowa State Hygienic Laboratory, and the images sent to the DPDx Team for confirmation/identification of one or more parasites. Figure A shows the worm next to a ruler for size; Figures B shows a composite of two images that were taken with a dissecting microscope to highlight detail. Figures C D show objects that were observed in the stool specimen; the larger in Figure C was approximately76 micrometers and the smaller objects (Figures C and D) ranged from 45–60 micrometers. The DPDx Team requested an aliquot of the stool specimen for further testing. The objects in Figures E and F, which measured 65 and 67 micrometers respectively, show what was observed by the DPDx Team. What is your diagnosis?  Based on what criteria?

Figure A

Figure B

Figure C

Figure D

Figure E

Figure F

This case and images were kindly provided by the Iowa State Hygienic Laboratory Coralville, IA.

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