Monday, November 2, 2009

Case of the Week 91

The following object was seen in the stool of a Mexican immigrant and brought to the lab for identification. (CLICK ON IMAGES TO ENLARGE)

The fluid expressed from the object contained the following:



Alasdair HIll said...

Taenia spp. Wow imagine trying to pass that worm!

Scott said...

Taenia spp. Love those "claws" in the eggs!
Because of the geographic location one could place a safe bet on T. solium...

Anonymous said...

Taenia solium of course!

Salbrent said...

Taenia sp adult worm and eggs with hooklets (taeniid species). great pics again
Are you using iodine in your wet mounts? I dont and sometimes iodine will obscure the hooklets. I would the measure the eggs, too.

Did you find a scolex? They are very small and not often not found. Were proglottids gravid? I would clear it using lactophenol and inject india ink to speciate it.

Lastly but should be first, all Taenia eggs and proglottids must be handled with extreme care b/c T solium eggs are infective to humans

Anonymous said...

Taenia too. VT.

ParasiteGal said...

Hi Salbrent,
No, aren't using iodine either. I was taught to use it at the London School of Hygiene and Tropical Medicine - that is how they do it in their lab - but we don't find it to be that useful. We use an eosin stain in our direct (fresh) preps, and no stain in our wet mounts from concentrated stool.

In this case, we didn't find a scolex. Most of the proglottids we received were gravid (or close to it), so I think we just received the distal end of the worm. The proximal portion with the scolex was probably still in the patient at that time. Unfortunately, the specimen was received in formalin and we weren't able to inject it with india ink, despite repeated attempts. I think the formalin coagulates the contents of the uterine branches so that the ink isn't able to fully penetrate through the branches.

Finally, that's a great point you make about the infectious risk. I'll address that in the answer on Monday.

Thanks for the comments!