The following objects were seen in the stool from a 30-year-old woman from Canada. No travel history is available. They measure approximately 50 micrometers in length. Identification?
Tuesday, December 8, 2015
Case of the Week 375
This week's case is a bit of a challenge, and not something that has been featured on this blog before. It was generously donated by Dr. Kamran Kadkhoda.
The following objects were seen in the stool from a 30-year-old woman from Canada. No travel history is available. They measure approximately 50 micrometers in length. Identification?
The following objects were seen in the stool from a 30-year-old woman from Canada. No travel history is available. They measure approximately 50 micrometers in length. Identification?
I am only going to post a guess because I am interested in the answer. Liver fluke?
ReplyDeleteI am not sure why my post is not posting... lol
ReplyDeleteLooks like a Henneguya myxospore. Probably from eating an infected fish... maybe undercooked? Most likely just passing through.
ReplyDeleteWell this is a bit of a coincidence, as I was just yesterday reading about the presence of the parasite in the faeces and how they can confound a diagnosis. I believe it is a spore of the myxozoan Henneguya salminicola (species presumed) judging by its very unorthodox morphology. There are no flagellates (that I am aware of) that bear similar morphology and are likely to present in the faeces, however, a case detailed in the paper below resulted in a diagnosis of human spermatozoa by the family physician which lead to a preliminary investigation into possible sexual abuse. Luckily the diagnosis was revised. Thank you for a fascinating case!
ReplyDeleteMcClelland, R. S., D. M. Murphy, and D. K. Cone. "Report of Spores of Henneguya Salminicola (Myxozoa) in Human Stool Specimens: Possible Source of Confusion with Human Spermatozoa." Journal of Clinical Microbiology 35.11 (1997): 2815-818.
In Sweden Henneguya spores are sometimes found in stool samples referred for parasitology examination. The patients, most of them from northern Sweden, have usually been eating common whitefish (sik in Swedish), but also other fishes could be involved. Interestingly the spores are acid fast when stained with Ziehl-Neelsen stain. Nice Photos!
ReplyDeleteThis is my first encounter with this fish parasite. It is an eye opening since we did not find the animalcule in fish of The Gulf of Mexico. (I admit being an avid salt water fisherman). Thank you all for the learning opportunity.
ReplyDeleteFlorida Fan
Really great case! Thanks Lee
ReplyDeleteHenneguya
myxobolus (myxozoa)
ReplyDeleteYes Myxobolus! Great case. thanks.
ReplyDelete