Monday, June 4, 2018

Case of the Week 496

Welcome to the first Monday of June 2018, and our case from Idzi Potters and the Institute of Tropical Medicine, Antwerp.

The patient is a 65-year-old owner of a camel farm who presents to his primary care provider for a yearly check-up. As he has mild intestinal complaints, he submits a fecal sample to be checked for parasites. The following structures were observed, and measure approximately 85 x 45 microns. Diagnosis please?

Concentrated wet preparation, 400x
Concentrated wet preparation, 400x with Lugol's iodine


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14 comments:

  1. Dwight FerrisJune 4, 2018 at 5:05 PM

    Embryonated hookworm egg

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  2. Lyne CédilotteJune 4, 2018 at 5:08 PM

    I think it is an ova of Trichostrongylus spp.

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  3. William SearsJune 4, 2018 at 5:13 PM

    A little too big for hookworm and a little too elongated/tapered. Also on differential is oesophagostomum and ternidens. However, I think it is trichostrongylus species (t orientalis, colubriformis, axei, etc) given size of 75-95 by 40-50. Also, I can imagine that I see some wrinkling of the inner membrane. He likely acquired infection from his camels since known to occur in herbivores. Possibly it has been kept in solution for a while since the egg has a first stage larvae inside and this usually occurs once egg has reached the soil.

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  4. AnonymousJune 4, 2018 at 5:16 PM

    So far, I have only seen one egg found by a co-worker. The nematode is from vegetarian animals or other wise known as herbivores. These Trichostrongyle species as described in CDC/DPDX site can be difficult. And as such, I rather let it be.
    Florida Fan

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  5. Blaine A. MathisonJune 4, 2018 at 5:57 PM

    Trichostrongylus sp. Looks like hookworm but is a little longer and more pointed on one end. The 'camel' comment was a clue since these are primarily parasites of ruminants. Although, shouldn't you have posted this on Wednesday since that's 'hump' day? :-D
    -Blaine

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  6. David BCNJune 5, 2018 at 4:32 AM

    Hello I would say it is an Ancylostoma duodenale egg

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  7. Carlo AlbertoJune 5, 2018 at 7:22 AM

    Trichostrongylus spp.

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  8. Kamran KadkhodaJune 5, 2018 at 9:17 AM

    Trichostrongylus spp.

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  9. UnknownJune 5, 2018 at 10:49 AM

    Ancylostoma egg

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  10. AnonymousJune 5, 2018 at 12:16 PM

    I agree with most of my predecessors, this is Trichostrongylus spp.
    Luis

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  11. Sugar MagnoliaJune 6, 2018 at 9:54 AM

    I concur with most commenters here that these are ova of Trichostrongylus sp. The notation that the patient was an owner of a camel farm helps in consideration of this nematode vs. Ancylostoma sp (which occurs predominantly in canines and felines), as do the measurements given (Trichostrongylus ova are typically larger than those of Ancylostoma), and, lastly, the shape of the ova(Trichostrongylus has more pointed ends while Ancylostoma is more rounded and blunt). Very nice photography, by the way.

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  12. Atiya kausarJune 6, 2018 at 6:45 PM

    I agree with all..
    trichostrongylus sps similar in morphology to hookworm eggs but slightly eccentric egg ... Nice video of larval movements in egg

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    ReplyDelete