The patient is a middle-aged man who found the object below in his stool. He reports eating rare beef approximately 2 months earlier.
Identification?
Tuesday, November 10, 2015
Case of the Week 371
This week's case was generously donated by Dr. Zhenwen Zhou, MD, from the Department of Laboratory Medicine at Guangzhou Women and Children's Medical Center, Guangzhou Medical College, in Guangzhou, People's Republic of China.
The patient is a middle-aged man who found the object below in his stool. He reports eating rare beef approximately 2 months earlier.
Identification?
The patient is a middle-aged man who found the object below in his stool. He reports eating rare beef approximately 2 months earlier.
Identification?
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10 comments:
I've never seen a string of live proglottids... but, if I could imagine what they would look like, this is pretty close. So, I will go with Taenia saginata.
Wow. Taenia saginata.
BW in VT
Wow, the beast is still alive. From the history, this tape worm most likely is Toenia saginata. Given the geographic detail of the patient, could it be Toenia asiatica?
I'm torn between two lovers.
Florida Fan
Fantastic string of gravid proglottids belonging to Taenia saginata! The history and morphology hinted strongly at it being the beef tapeworm, which is transmitted through the ingestion of raw or rare beef containing cysticerci. It is also possible, as Florida Fan says, that this could be T.asiatica, since they are morphologically identical (and is becoming almost notorious on this blog as a confounding factor in taeniid identification!), however, the intermediate hosts for T.asiatica are pigs rather than cows. It seems to me that if the patient recalls consuming rare beef in the recent past, he would also likely recall eating raw pork liver; which is generally accepted as the most common route of infection in T.asiatica as it is a culinary delicacy in some areas of east Asia. Therefore I believe this to belong to T.saginata.
Most likely T saginata based on the clinical information but ones should check for the scolex and gravid uterus if any
Presumptive Taenia saginata
Lee
Speaking of looking for the scolex - one of the first additions to my personal collection of critters is about 3 feet of tapeworm from a 4yo girl who lived with her hippie artist parents in Mexico where they frequently ate poorly cooked/uncooked meat. Her only "symptom" was the finding of proglottids in her underwear. (I was a 3rd yr med student in 1970 in Boston and had to split the 6 foot worm with the intern as we both had to wade through the kid's poop after a dose of atabrine looking for the scolex which we never did find)
I guess it is Taenia sp. But don't know if it's T. saginata/T. solium.
WOW!
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