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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.
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15 comments:
Are they sarcopte's eggs ? ( Happy Easter )
Are they sarcopte ' s eggs ? (happy easter)
The morphology with a peripheral ring of nuclei of variable size is compatible to Blastocystis hominis. Actually the nuclei are rather on the cellular membrane. I often liken these to a clear membrane onto which someone has affixed a few dabs of play dough.
Florida Fan
Acanthamoeba
LDD or little dot disease! But the differential for LDD is pretty small in my mind ( I am a simple clinician so excuse my ignorance) Leishmaniasis, T. cruzi, amoeba and that non pathogen (unless you're the one sick with it) B hominis. Given the nuclei in the cytoplasmic rim, I agree with B hominis. And yes I'd treat it even if it just got there with all the bacteria from the gut from poor hygiene or a fistula that caused the gangrene.
I thought Blastocystis hominis as well.
Lee
I agree with B. Homs.
Jacque
Beautiful images! Blastocystis of course! But why? Probably secondary "invasion", although invasion should be used with caution here, since bacteria may have paved the way for the parasite. The interesting thing is that it says "perineal" and not "perianal"... if the abscess had been "perianal", the finding might have been quite unsurprising; however, the fact that it's a "perineal" abscess makes it a bit more tricky and interesting. Was any anal fistula involved that could facilitate passage of Blastocystis from the rectum to the perineal abscess?
Sure looks like Blasto. However, the source information makes me nervous to call it that though, since I have never heard of Blasto in an abscess.
~Micro Michigan
Acanthamoeba skin infection; cysts and trophs
Well, based on morphology alone my differential is Acanthamoeba and Blastocystis. On morphology, Blastocystis gets it. The peripheral nuclei and vacuole are very clear in these pictures. The presentation is perhaps more in line with an invasive Acanthamoeba infection, and there are some bodies in the third image which look a little like they bear the 'rippled star edges' that you see in Acanthamoeba cysts. Having said all of this though, the diagnosis must go to Blastocystis in morphology alone. As for it causing the infection and gangrene, I doubt that. I have not heard of this kind of presentation in Blasto before, but it is possible that whatever means Blasto used to infiltrate the peripheral tissue could have been utilised by pyogenic bacteria too.
Great case, I am very interested to hear what you have to say on it Bobby.
Blastocystis sp.
Blastocystis hominis.
I agree with others. B. hominis
blastocystis hominins ?!!!
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