Monday, November 14, 2011

Case of the Week 184

The following images are from a Papanicolaou-stained bronchoalveolar lavage obtained from a 70 year old man with increasing respiratory distress. His medical history is significant for hemodialysis-dependent end-stage renal disease and vasculitis (treated with cytoxan).

Any thoughts on what the last image represents?

x400 original magnification

x600 original magnification

Many thanks to Dr. Steven Goodman for donating this case!


Anonymous said...

The first thing that comes to mind for wormy things in the sputum and immunocompromise is Strongyloides; not familiar with what they look like on a Pap stain, though, and only #2 really resembles what I think of as Strongy larvae, while there's insuifficient resolution to see things like the buccal canal and the genital primordium. It's still my guess.

Neuro_Nurse said...

Strongyloides stercoralis

Slide 5 shows the genital primordium.

Parasite Spy said...

Roundworm:Strongyloidiasis. The filariform larval stage.