Monday, September 28, 2015

Case of the Week 366

The following ova were found in a stool specimen from a patient with weight loss and chronic abdominal pain.  Identification? (CLICK ON IMAGES TO ENLARGE)



As a bonus, what is the structure seen inside the egg below?



9 comments:

Anonymous said...

This is a large operculated egg, from the given size the morphology is compatible with Fasciola hepatica or Fasciolopsis buski. The internal stage is a miracidium.

Florida fan

Unknown said...

Agree with florida tan

Unknown said...

Agree with florida tan

RastaBob said...

Agree with Fasciola/Fasciolopsis - no knob or shouldered operculum - broadly oval. Love the flukes - and love the look on my students faces when I show them what a water caltrop nut looks like.

M. Prochazka said...

What about Diphyllobothrium latum or D. pacificum? The internal structure looks like it has a scolex, it may be a plerocercoid larvae.

Arthur Morris said...

Presentation and morphology is consistent with Fasciola hepatica or Fasciolopsis buski. The Eggs are large and operculate, the size would discount diphyllobothrium which, although similar in morphology, are smaller (between about 55 - 75uM). The first egg appears to be unembryonated, the second is hatched and in the third you can clearly see a (rather small) miracidium waiting to hatch. It is sometimes worth looking for flame cells in the miracidium while it is unhatched (they are highly motile once hatched) to establish whether they are still alive, though this is largely just for scientific interest! We culture F.hepatica at our lab and maintain a fair few strains for research purposes.

M. Prochazka said...

I stand corrected! They are too large for Diphyllobothrium sp. (overlooked the 100um size guide). Most Fasciola hepatica eggs I've seen are slightly more elongated than the ones shown here, so my guess would be Fasciolopsis buski.

mona said...

fasciola spp. eggs

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