This week's case has been generously donated by Blaine Mathison at ARUP. Two different types of objects were seen in a trichrome-stained stool specimen that was screened by a digital slide image and machine learning platform. How did it do? Did it find real parasites?
The following objects are approximately 8 to 13 micrometers in diameter:
These objects are 10 to 15 micrometers in greatest dimension.
Identification?
Top 2 - Blastocystis hominis, the others - Entamoeba coli
ReplyDeleteD. Otero
blastocystis and entamoeba trophozoite. Can't describe ameoba further
ReplyDeleteBlastocystis and Entamoeba troph
ReplyDeleteBlastocystis hominis and trophozoite of Entamoeba coli
ReplyDeleteBlastocystis hominis and Entamoeba sp.troph
ReplyDeleteAgree with others . . . but does this mean that our days as expert parasitology microscopists are numbered?
ReplyDeleteBlastocystis hominis and Entamoeba polecki
ReplyDeleteYes, the first two pictures show typical Blastocystis spp. with peripheral chromatin lumps. We need to keep in mind that parasites are three dimensional and as such, I usually keep the liking of Blastocystis spp. to a clear plastic bag studded with lumps of chewing gum.
ReplyDeleteThe two pictures of Entamoeba denote a vacuolated cytoplasm, large central chromatin and no chromatoidal rods or lumps, as such I would identify these as E. coli trophozoites.
Florida Fan
ReplyDeleteBlastocystis spp (fig. 1, 2); Entamoeba polechi, trofozoites ( fig. 3, 4, 5 e 6).
Blastocystis hominis and Entamoeba trophozoite
ReplyDeleteThis comment has been removed by the author.
ReplyDeleteBlastocystis for sure! But....
ReplyDeleteAs I don’t have a lot of experience with trichrome staining, I would play it safe and say Entamoeba sp. for the second one...
Yet... the small overall size annoys me as well as the relative fine central karyosome and the rather fine peripheral chromatine. Therefore I would almost dare say: not E. coli, but rather E. histolytica/E. dispar (or E. polecki, nutalli, moshokvskii,...)
I agree with Idzi. The structure is like that of E. histolytica. The ectoplasm contains what appears to be bacterial inclusions(Photo lower left). However, the size range fits with that of E. histolytica small nonpathogenic race (12-15um) although my reference is a bit on the old side (Levine,1985) it probably has a new name by now.
ReplyDeleteThe Blastocystis was an educational experience for me. Luckily I've been schooled by the very best.
I'm blowed away by this new fangled robot microscope. It didn't find parasites this time, but I believe it was because there were none in the sample. Blaine, can you make a living with your poetry?
Have no fear. We will all have jobs as expert parasitologists. This technology that Blaine and I have been working on will make our work MUCH easier, faster, and more accurate. And fun...because lets face it...no one likes sitting for 8 hours at a scope.
ReplyDeleteThe future is bright for parasitology.
The size and central chromatin do agree with E. histolytica, but with the vacuolated cytoplasm these trophozoites seems compatible with E. coli.
ReplyDeleteAgain the new technology gives us better methodology, in this case could it give us more details than necessary?
Florida Fan
Marc,
ReplyDeleteI hear you.
I haven't looked through a compound scope in 14 years. I do miss it, but I have suffered no ill effects. For the time being I will content myself with enjoying both your labs diagnostic and literary expertise.