Monday, February 28, 2011

Case of the Week 151

The following were seen microscopically (4x objective) on a non-nutrient agar plate containing stool. The patient was from Cambodia and presented with abdominal pain and eosinophilia.

video

Here is a macroscopic image of the agar plate with the stool specimen.




Diagnosis?

6 comments:

Alasdair Hill said...

Strongoloides. great video!!

Anonymous said...

I agree Strongoloids.

Ranjana said...

Strongyloides larvae typically showing displacement of bacterial colonies on the agar plate

MicrobeMan said...

Given the patient's nationality of origin, signs, and symptoms, I agree that this is most likely a case of strongyloidiasis (S. stercoralis).

The non-nutrient agar plate very nicely demonstrates the production of furrows left in the wake of the migrating larvae, which emanate away from the central "dollop" of feces. The bacteria drug along by the migrating worms grow in the furrows, which acts as an indicator for larval migration. As a side note, this particular scenario can play out in vivo, as well. In the host, gut flora can be introduced outside of the intestinal lumen by larvae that have penetrated the intestine.

Would you mind if I used the "culture" photograph for a lecture that I might be giving in the not-so-distant future, Dr. Pritt? I will, of course, acknowledge that this photograph is yours. Thanks!

Parasite Gal said...

Dear MicrobeMan,
Of course! Feel free to use any of these cases for educational purposes. The nice thing is that they are on the web, so you can easily access them from multiple computers. Thanks for the great comment!
Bobbi

MicrobeMan said...

Thank you, doctor! I greatly appreciate it!