Monday, March 30, 2015

Case of the Week 343

The following biopsies of small intestine are from a patient with chronic watery diarrhea.  Diagnosis? (CLICK ON IMAGES TO ENLARGE).

H&E, 200x

H&E, 400x

H&E, 1000x

I'd like to thank Dr. Duane Newton who allowed me to borrow his slides and take these photographs.

11 comments:

Patricia Lopez said...

Criptococco

Patricia Lopez said...

Criptococco

david sadler said...

Microsporidiosis

Anonymous said...

I have no experience reading HE stained sections, but it seems like the patient may be infected with giardiasis.

Florida Fan

Arthur Morris said...

Looks to me like Cyclospora cyetanensis with what looks to be meronts apparent in images 3-5 and potentially some microgamonts. This would be consistent with the symptom of chronic watery diarrhoea. It is often contracted during travels to endemic areas and brought back home.

Lukus Roberts said...

I think cyclospora too. a secondary feature of villous blunting/atrophy is also apparant which, in the abscence of successful identification of parasites (i believe cyclospora can be easily missed) could lead to a false diagnosis of , for instance, coeliac disease.

Justine said...

I wouldn''t know how to tell between cyclospora and isospora. Cryptococcus is usually located just on the surface I would say. Any tips?

Justine said...

I meant to say Cryptosporidium, not cryptococcus.

Anonymous said...

I am stuck between Cyclospora (I think too big) Cryptosporidia or Isospora..

Lee

Alan Higgins said...

Looks like Microsporidia to me. Looks too big to be Cryptosporidium or Cyclospora. Nice eosinophils! Is the patient immunocompromised?

Anonymous said...

Let's see a trichrome stain. O and p s are done with trichrome stains not HE.