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Sunday, June 7, 2015
Case of the Week 352
The following structures were seen in a hematoxylin and eosin-stained perianal skin biopsy from an Ethiopian man with recurrent colorectal fistulae and abscesses. Presumptive identification? What study would you recommend to confirm your diagnosis?
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100x total magnification
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8 comments:
The objects are morphologically suggestive of nematodes cross sections, possibly hook worm or Strongyloides stercoralis in an auto infection. O&P examinations of fecal material are suggested.
Florida Fan
Schistosoma mansoni egg?
I was thinking Schistosoma ova as well. Lee
Looks great for Schistosomiasis!- Jen
My vote is for Schistosoma mansoni.
Last two images have the lateral spine visible
I like for S mansoni too. Probably would do both stool O&P x several and serology depending on treatment history. [Most efficient testing I suspect is actually to ask a Pritt or similar actually and just treat.]
S.mansoni ova is the only thing that I feel it is reasonably likely to be. Bodies residing within granulomatous tissue, with a lateral spine (presumably) present on image 4; morphology is vaguely consistent but not definitive. Epidemiology is consistent as is presentation. Quite a tricky one to sign off.
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