Monday, June 27, 2016

Case of the Week 402

This week's case was generously donated by Dr. Rocco LaSala. The specimen was retrieved from the stool of a 70 year-old-woman with approximately 12 months of diarrhea, abdominal cramping, and unintended weight loss (> 40 lbs). The structures are thin, brown, and 'thread-like', measuring approximately 0.7 mm in width.
 Specimens were also submitted for histology, which showed the following on H&E staining:


Identification?


14 comments:

Med Atlantic Corporation said...

I think this is classic presentation of “rope” human intestinal parasite.

Sheldon Campbell said...

Not a human parasite.

Anson Centeno said...

Strongyloides Stercoralis?

Anonymous said...

The pictures did not show any internal organization typical of real parasites, therefore I would vote for a pseudo parasite.

Florida Fan

Anonymous said...

Not a human parasite. Maybe the cause for the symptoms is not this structure.
It looks like bacon to me...

-HLCM fan

Anonymous said...

Looks like Bacon!!!!

Anonymous said...

Tungiasis

Anonymous said...


Or Fly, Flea, or louse morphology.

Anonymous said...

Not a parasite. It almost looks like a bone.
BW in VT

Sean Smith said...

Just had a lab lecture from Dr. LaSala in a Global Health course. at WVU... strong work!

MiKe QZ said...

please, but so many??
http://cdn.mdjunction.com/components/com_joomlaboard/uploaded/images/Unknown2.jpg

http://ropeworms.com/wp-content/uploads/2013/11/What-is-it-2.jpg

And they all have the same appearance.. ?

Chris Mathew said...

Found the same thing in my stool... I'm 100% positive that is Borrelia Burgdorferi (Lyme disease).

Bobbi Pritt said...

Borrelia burgdorferi is a microscopic bacterium, so it would not be visible by the naked eye. This was seen macroscopically, and therefore is definitely not a bacterium. Also, the histologic sections show that this is vegetable material. Therefore, this is food material found in stool. From my experience, it closely resembles banana seeds, but it could possibly be some other food material. Think of all the things that we eat as humans. Much of it is undigested and comes out in stool.

Bobbi Pritt said...

Yes, this is completely typical for food material. Not only does it microscopically look like partially digested food, but microscopically, there are plant structures and nothing to indicate that this is a microorganism. Think of what happens when you eat something like corn. You would see a lot of it in stool potentially. It's actually quite common to see partially digested food in stool. Therefore, the amount and appearance is perfectly consistent with this.