Monday, October 7, 2019

Case of the Week 563

It's time for our first case of the month by Idzi Potters and the Institute of Tropical Medicine, Antwerp.   The patient is a 50 yo Belgian patient returning from Italy with intestinal complaints coughs up the following worm:



Martc Couturier said...

Very nice and clearly defined intestinal caecum. Lips are visible on the worm and the general size would point again to an Anisakidae member. Coughing up and the abdominal pain are helpful clinical correlates as well. Will go with Pseudoterranova considering the intestinal caecum.

Anonymous said...

Yes, I will go with Marc's identification. The lips are more consistent with Pseudoterranova. The clinical history agrees too.
Florida Fan

Bernardino Rocha said...

Agree with Pseudoterranova sp. The absence of an enlarged ventriculus rules out Contracaecum sp.

Old One said...

Three lips, anteriorly directed intestinal cecum (IC), ventriculus between esophagus and IC, no boring tooth. These characteristics are consistent with L4 Pseudoterronova.

The first photo appears to have numerous spheres looking like nematode eggs on the bottom of the petri dish.

Old One said...


Did you pipet some of those spheres and look at them under a compound scope?

Blaine A. Mathison said...

A agree with everyone so far, that the presence of an anterior [b]cecum[/b] and apparent lack of a posterior ventricular appendix, make Pseuoterranova the most likely possibility. Certainly Anisakis proper can be ruled out.

Not sure what those spheres are, but they would not be anisakid eggs; anisakids cannot reach sexual maturity in the human host. The worm presented here is an L3 larva.