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Case #440 – March, 2017

Stool specimens were collected from an asymptomatic 10-year-old boy from Panama as part of a refugee screening program. The stool was collected in 10% formalin and zinc PVA (Zn-PVA) and sent to the county health department for routine ova-and-parasite (O&P) examination. Figures A I show what was observed at 1000x magnification with oil on a trichrome-stained slide made from stool preserved in Zn-PVA.  Objects in Figures A and G measured approximately 10 micrometers; all other objects of interest ranged from 17-25 micrometers. Figures C E show different focal planes of the same object of interest to highlight internal structures. What is your diagnosis?  Based on what criteria?

Figure A

Figure A

Figure B

Figure B

Figure C  (Focal Plane 1)

Figure C (Focal Plane 1)

Figure C  (Focal Plane 2)

Figure C (Focal Plane 2)

Figure D  (Focal Plane 1)

Figure D (Focal Plane 1)

Figure D  (Focal Plane 2)

Figure D (Focal Plane 2)

Figure E  (Focal Plane 1)

Figure E (Focal Plane 1)

Figure E  (Focal Plane 2)

Figure E (Focal Plane 2)

Figure F

Figure F

Figure G

Figure G

Figure H

Figure H

Figure I

Figure I

Figure J

Figure J

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/.

Page last reviewed: April 19, 2017