Monday, June 11, 2018

Case of the Week 497

This week's case was generously donated by Florida Fan. The following bug were submitted by the physician of a 69-year-old woman. No further history is available. As Florida Fan says, "Here comes the summer, and with it comes the bugs."


Sunday, June 10, 2018

Answer to Case 497

Answer: Cimex species; bed bug
As Blaine mentioned: "B&B Bugs is back! Beautiful brown biting, blood-sucking bed bug! Boo-yeah!" William mentioned that the pronotal hairs are not long enough to be a bat bug - an important consideration since bat bugs can be found near human dwellings and may bite humans when their preferred (bat) host is not available.

See Case of the Week 395 for more information and photos.

B&B Bugs = Bobbi and Blaine!

Monday, June 4, 2018

Case of the Week 496

Welcome to the first Monday of June 2018, and our case from Idzi Potters and the Institute of Tropical Medicine, Antwerp.

The patient is a 65-year-old owner of a camel farm who presents to his primary care provider for a yearly check-up. As he has mild intestinal complaints, he submits a fecal sample to be checked for parasites. The following structures were observed, and measure approximately 85 x 45 microns. Diagnosis please?

Concentrated wet preparation, 400x
Concentrated wet preparation, 400x with Lugol's iodine

Sunday, June 3, 2018

Answer to Case 496

Answer: Trichostrongylus sp. egg
Congratulations to everyone who wrote in with the correct answer. Although this egg looks like those of the hookworms, Oesophagostomum spp., Ternidens spp., and Strongyloides stercoralis (latter only rarely seen in stool), the larger size (85 micrometers long) and tapered end points us towards Trichostrongylus.

This diagnosis is also supported by the history of camel exposure, as Trichostrongylus is primarily a parasite of ruminants. As Blaine mentioned, I should have posted this case on a Wednesday for 'hump' day!

William Sears also mentioned that the presence of eggs with well-developed larva indicates that the specimen likely sat for some time before being examined since the eggs are passed in human stool in an unembryonated state. Thanks again to Idzi Potters for donating this fascinating case.