Monday, July 30, 2012

Case of the Week 218

The following were seen on stool agar culture from a patient treated with steroids for another condition.  The patient presented with recurrent enterococcal meningitis and was being treated with antibacterial agents. (CLICK ON THE BOTTOM RIGHT OF THE MOVIE VIEWER TO ENLARGE)

video


A wet prep of the preserved stool specimen showed similar rhabdiform worms with a short buccal cavity.

Identification?

Note:  for those of you who aren't familiar with the stool agar culture, here is the general gist of the assay:
Stool is placed on a clear nutrient agar (standard sheep blood agar for bacterial culture also works but is harder to see through).  The Petri dish is then taped shut and the plate is examined over a period of 4 or more days for any evidence of bacterial growth patterns consistent with migrating worms in the stool.

4 comments:

Eagleville said...

strongyloides L3

David said...

Larva of strongyloïdes stercoralis, i suppose

Matt and Kristi said...

Strongyloides! Can cause systemic infection secondary to coloform bacteria due to intestinal microperforations, especially in the setting of immunocompromise status such as steroid use.

mpate3 said...

strongyloides stercoralis hyperinfection due to steroid use with resultant enterococcus meningitis from worms migrating into the CNS