Sunday, August 26, 2012

Case of the Week 222

The following was passed in the stool of a toddler and sent to the lab for identification.  It measures approximately 20 cm in length. (CLICK ON IMAGES TO ENLARGE)




The following egg was also identified in the child's stool:

Identification?

This case was generously donated by P.D.
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10 comments:

  1. MicrobeManAugust 26, 2012 at 9:37 PM

    Hmmm. This is probably a case of acanthocephaliasis (thorny-headed worm infection), which I'm basing on what appears to be an armed proboscis protruding from the worm (figure 2). Based upon the egg morphology in figure 3, I'll go with Moniliformis moniliformis. I wouldn't be too surprised if this patient ate a cockroach or other beetle (intermediate hosts of these parasites) while orally sampling his/her environment. Good case!

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  2. AnonymousAugust 27, 2012 at 11:35 AM

    My guess is enterobius vernicularis given the child history and the egg looks like an early egg morphology. The worm, maybe the female mouth?

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  3. RosamundAugust 27, 2012 at 7:57 PM

    It is one of the Thorny-Headed worms or Acanthocephalids, I don't know which.

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  4. Lukus RobertsAugust 28, 2012 at 8:30 AM

    The worm is an acanthocephalan or 'thorny headed worm' - the prescence of the barded probocis is indicative of this. Im not sure about the species but I dont think it is Monliformis monliformis as this species has a segmented appearance given the horizontal markings on this species which I cant easily see on this specimen, so Ill go with Macracanthorhynchus hirudinaceus - the giant thorny headed worm of swine which can occasionaly infect humans and dogs and uses beetles of the Melolontha genus as intermidiate hosts.

    The egg could belong to the Acanthocephalan but i think this species has a thicker egg cuticle so therefore, I thin k the toddler is coinfected with E.verminicularis.

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  5. SColbyAugust 28, 2012 at 11:18 AM

    It looks like ascaris to me. Too big for a pinworm.

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  6. AnonymousAugust 29, 2012 at 10:51 AM

    i think that's enterobius vermicularis.

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  7. ZoranAugust 29, 2012 at 1:21 PM

    Looks like Moniliformis moniliformis.

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  8. BrentAugust 29, 2012 at 4:10 PM

    It is thorny headed worm and eggs like Moniliformis not Macracanthorhynchus eggs. Bolbosoma sp is antoher but I have not seen the eggs or adultsthansk for sharing

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  9. AnonymousAugust 30, 2012 at 1:30 AM

    I agree with Brent! Nice case!

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  10. AnonymousSeptember 12, 2012 at 4:36 AM

    Very nice case, never seen this one before

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