Tuesday, July 30, 2013

Case of the Week 267

The following were seen in a fresh stool specimen from a patient with chronic watery diarrhea.


Identification?

The video can also be seen here:
http://youtu.be/gD0FtgV8KeY
Many many thanks to Dr. Tom Grys and his parasitology staff who donated this video! 

14 comments:

  1. Beautiful case of giardiasis. The general shape of the flagelate, its motility are so obvious, in particular the concave underside of the body are the give away clues.

    Florida Fan

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  2. My residents will love this one. It is so much better than my doing the Giardia dance for them in the lab. They will thank you for sparing them. We just never get fresh stool to demonstrate.

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  3. Giardia lamblia and adorable! I would love to show this to my 5 year grandchild. It would certainly open up her world.

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  4. Agree. Typical "falling leaf" of Giardia

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  5. How is the smooth zoom of the image accomplished? Is that a feature of the microscope or the camera?
    --bks

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  6. beautiful Giardia video!

    never heard it called 'falling leaf' before - such perfect descriptive imagery!

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  7. Gardia intestinalis previously G. lamblia and prior to that G. duodenale.
    Great video! I love how you can visualize both the spoon/cupped shape of the trophozoites and the characteristic "falling leaf" motility!

    PJS

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  8. Excellent video! Nice example of "falling leaf" motility as has already been discussed. Will be suggested viewing for our pathology residents.

    -BHS

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  9. Giardia!

    And I thought we were going to have a Cyclospora this week LOL!

    Lee

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  10. Don't you wish for it Lee. We have been finding 3-4 Cyclospora every day for at least a month now.

    Florida Fan

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  11. Yikes FF, I am in NJ, and have not seen any yet..won't be sure until they come up off the name of the implicated salad..GRRR.

    Question: What is the quantity you see in a typical infected stool sample after concentration? I have only seen 1 in a CAP sample, and it was very scant.

    Lee

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  12. Hi all,
    To answer your questions:
    The smooth zoom was done using video editing software. I wish I could zoom that smoothly using my video camera, but I just don't have that much luck with it! It helps to have a husband who is a audio/video guy.

    Agree about the cyclospora! Yikes! We ran over 80 Cyclospora tests yesterday, and we're at a ~10% positivity rate. Sometimes the specimens are loaded and sometimes it's just a few. We're picking them up on our modified safranin stain for Cyclospora (they stain red like on a modified acid fast stain) as well as on the O&P wet prep. When we see them on wet prep, we confirm them using the safranin stain. Perhaps I will include a Cyclospora case for you in the weeks :)

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  13. I tossed it off last year, because I was fearful of missing one, just not good enough, still taking a peek of anyone ordered for one, LOL, I would like to be better!

    Lee

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