Monday, August 27, 2018

Case of the Week 508

Happy Monday everyone! I'm on vacation this week, so here is a nice straight-forward identification for your viewing pleasure. A trichrome-stained stool specimen:


Images courtesy of Emily Fernholz. Identification?

11 comments:

Anonymous said...

Looks like Giardia to me.

Idzi P. said...

Looks like Giardia “looking back at” me
:-)

Joe Camp said...

Giardia...

William Sears said...

Happy giardia

ali mokbel said...
This comment has been removed by the author.
ali mokbel said...

Magnificient shots of trichrome-stained Giardia intestinals trophozoites.

Old One said...

In days gone past, when it took our state health department a month to diagnose Giardia infections, our lab was using a ZnSO4 centrifugal flotations. This is a rapid and effective method for diagnosing Giardia cysts (except in avian giardiasis cases). This saved a few of our students a months worth of suffering while waiting for results so that they could be treated.

This flotation method is very successful at levitating Giardia cysts in fresh feces but rarely levitates trophs , however once feces are fixed with formalin the trophs will levitate nicely.

Anonymous said...

With time, things change. My first Parasitology Lab session, we made direct smears in Saline and Iodine from raw stool samples. We examined these Giardia lamblia cysts and trophozoites with monocular microscopes (mind you the brass one of Dr. Alexander Yersin was still in perfectly functioning condition when I looked through it in 1973 at the Pasteur Institute in Nha Trang, Vietnam).
Then we did the formalin ether concentration with centrifugation on Formalin specimens and a Mercury PVA trichrome smear (these are still the best and most long lasting). Now we only use mercury free and formalin free fixatives, the Trichrome smears are good, but the wet mounts do alter the morphology quite a lot. The Giardia Direct Fluorescence does give us a beautiful green fluorescence. Yet the most sensitive has to be the Giardia antigen EIA. The draw back: yes the antigen is there, but are the organisms alive?
Even now, when the cysts stand up like eggs in a carton, it still throw us into a loop. Another scenario is when the trophozoites stand up on their tails, they only look like a half moon with two eyes or the mischievious kid next door sticking only his forehead and eyes over the privacy fence.
Very nicely captured photographs.
Florida Fan

nema said...

Yes, but... unfortunately, Gardia's name appears as soon as we display the snapshots in the browser so that this weekly challenge is not at all one. Dear Bobbi, May I suggest an anonymization of the clich├ęs posted in the future

Anonymous said...

Giardia duodenalis ( = intestinalis) trophozoites

Carlo Alberto Varlani

Lyne said...

Giardia lamblia trophozoites. Trichrome stain.