Case #473 – August, 2018

A 67-year-old female presented with a 2-3 day history of lower back pain. She also reported a burning sensation all over her body. The patient’s history included emphysema of the lungs, history of smoking, pancreatitis, and cholelithiasis. She underwent endoscopic retrograde cholangio-pancreatography (ERCP) at which time a worm was detected in the common bile duct and removed. The worm was damaged during retrieval but images were taken of what was obtained and sent to the DPDx Team for diagnostic assistance. Figures A and B shows the portion of the worm recovered. What is your diagnosis? Based on what morphologic features?

This case and images were kindly provided by St Joseph’s Hospital – HealthEast, St Paul, Minnesota.

parasitic image

Figure A

parasitic image

Figure B

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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