Hematoxylin and Eosin (H&E), 20x magnification
H&E, 40x
H&E, 400x
H&E, 400x
H&E, 1000x
Gomori Methenamine Silver (GMS), 1000x
Tuesday, February 18, 2014
Subscribe to:
Post Comments (Atom)
skip to main |
skip to sidebar
A parasitologist's view of the world
Welcome to Parasite Case of the Week
Every week I will post a new Case, along with the answer to the previous case. Please feel free to write in with your answers, comments, and questions. Also check out my image archive website at http://parasitewonders.com. Enjoy!
The Fine Print:
Please note that all opinions expressed here are mine and not my employer. Information provided is for educational purposes only. It is not intended as and does not substitute for medical advice. I do not accept medical consults from patients.
The Fine Print:
Please note that all opinions expressed here are mine and not my employer. Information provided is for educational purposes only. It is not intended as and does not substitute for medical advice. I do not accept medical consults from patients.
About Me
Top 50 Pathology Blog
7 comments:
The pictures at the highest magnifications point towards amoebic infection, in particular the interior hexagonal shape resembles those of Acanthamoeba cysts. The true etiology remains to be learned.
Florida Fan
The last 2 pictures show an amoebic form with wrinkled membrane suggestive of Acanthamoeba sp. it is well known as an agent of Granulomatous amoebic encephalitis. The location of the infection in this case the thigh is very unusual.
Jamal.
Acanthamoeba sp. or Balamuthia mandrillaris.
I never learned how to tell them apart.
-AMPc
could this be a histoplasma infection? would go hand in hand with the suppressed immunity from the chemo, Histoplasma can cause ulcerating lesions in immunosuppressed patients and it looks like a positive GMS stain which is supposed to be good for picking up carbohydrates such as those found in fungal cell walls, I think?
Well, the morphology is more consistent with an amebic infection, the polygonal shapes are those of the cyst stage and we did see some uni-nuclear trophozoite forms.
There are no small yeast form 2-4 micron size to prove a diagnosis of histoplasmosis.
Florida Fan
Considering the appearance of the typical "star-like" cysts I think it's Acanthamoeba sp. which may cause skin infections as well (though it's not so common).
First reaction was Acanthamoeba, but due to the unusual placement of the ulcer I considered Balamuthia mandrillaris as this is fairly similar to another case I have read about. However given the immunocomprimised state of the patient, the amoebae will pretty much run riot wherever they find themselves. With that in mind I am leaning towards a rather unusual Acanthamoeba infection.
Post a Comment