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Case #449 - August, 2017

A seven-year-old female from Sudan had a stool examination as part of a refugee screening.  Her blood workup also revealed elevated eosinophils. A formalin-ethyl acetate (FEA) concentration was performed on the stool specimen and Figures AD show what was found on a wet mount preparation.  What is your diagnosis? Based on what morphologic features?

This case was kindly contributed by the State Hygienic Laboratory, University of Iowa.

parasitic image

Figure A

parasitic image

Figure B

parasitic image

Figure C

parasitic image

Figure D

Case Answer

This was a case of schistosomiasis and giardiasis caused by Schistosoma mansoni and Giardia duodenalis. Diagnostic features included:

  • Eggs containing a miracidium and presenting a prominent lateral spine consistent with S. mansoni eggs
    (Figures B and C, slightly obscured in Figure A).
  • Oval to ellipsoidal cysts (Figure D) with fibrils and nuclei consistent with G. duodenalis.


For more on schistosomiasis:

For more on giardiasis:

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.

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  • Page last reviewed: October 25, 2017
  • Page last updated: October 25, 2017
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