Monday, September 29, 2014

Case of the Week 320

Multiple motile small white objects were found in the diaper of an infant.  The specimens were submitted to surgical pathology where they were fixed in formalin, sectioned, and the resultant slides were stained with H&E.  Below are representative sections taken at 20x to 1000x final magnification).  Identification?






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13 comments:

  1. AnonymousSeptember 29, 2014 at 11:54 AM

    No comments yet??? Case is too hard I guess haha -pacman

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  2. Ed MitreSeptember 29, 2014 at 12:18 PM

    This comment has been removed by the author.

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  3. Ed MitreSeptember 29, 2014 at 12:24 PM

    Dipylidium caninum? Looks like egg packets in a flatworm.

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  4. AnonymousSeptember 29, 2014 at 3:05 PM

    Enterobius vermicularis based on nothing other than ova shape.

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  5. AnonymousSeptember 29, 2014 at 3:09 PM

    looks like Dipylidium caninum eggs.

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  6. OSeptember 29, 2014 at 3:50 PM

    Hymenolepis, perhaps?

    Steven O MD
    Infectious Disease

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  7. AnonymousSeptember 29, 2014 at 6:24 PM

    The morphology is compatible with proglotids of D. caninum with its ova in packets.

    Florida Fan

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  8. Hans NausSeptember 30, 2014 at 7:42 AM

    Dipilydium caninum proglotid with egg packages, child must have eaten an infected flea

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  9. AnonymousSeptember 30, 2014 at 7:54 AM

    Yes, I was thinking Diplydium caninum egg packets as well. Lee

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  10. UnknownSeptember 30, 2014 at 11:38 AM

    description alone suggests either pinworm or a tapeworm proglottid,there are not many parasites that remain motile after being passed in the faeces (which is fairly unusual in most GI helminths anyway). Gross morphology and size vaguely consistent with a proglottid rather than a nematode. Internal morphology seems to show numerous ova-like bodies of variable sizes and shapes, disseminated throughout the specimen without conformity usually bestowed by a uterus. Probably Dipylidium caninum (very) gravid proglottids with visible egg packets. We see this in the lab from cat and dog samples every now and again but its fairly unusual for a human infection given the life cycle!

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  11. AnonymousOctober 1, 2014 at 5:58 AM

    Hello, I have an interesting case I am unable to identify...

    Is there a way to email you pictures of the specimens?

    Thank you!
    Chelsea

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    Replies
    1. ParasiteGalOctober 1, 2014 at 7:24 AM

      Hi Chelsea, is this a personal case? I don't accept consults directly from patients unfortunately

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  12. AnonymousOctober 3, 2014 at 4:54 AM

    Egg packets seen. Probably Dipylidium caninum eggs.
    Looking forward for the answer. :)

    Wan Hafiz

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