Monday, October 21, 2019

Case of the Week 565

This week's case was generously donated by Professor Agnes Kurniawan from the University of Indonesia. The following motile structure was reported to emerge from the anus of a man from rural Indonesia. He had no other gastrointestinal symptoms.
You can see its subtle movement here:

This structure was expressed from the submitted object:
Identification?

16 comments:

Eagleville said...

Is this a proglottid (?taenia sp) with an embryonated egg?

Sam said...

I am unsure, but based on the resemblance of the structure to ova of Hymenolepis, I would submit that as my answer. There are no measurements provided, but as I cannot see polar filaments, I would say maybe this is Hymenolepis diminuta.

Jose Q said...

It is a Hymenolepsis diminuta egg and progottid

Sheldon Campbell said...

I believe this is Hymenolepis nana; the polar filaments start at about 3 o-clock and work their way around to insert back around 9.

Old One said...

The shape of the segments (flattened anterior to posterior and wide from side to side) also I believe I see a pyriform apparatus within the egg.

I believe the egg and segments are parts of a non human primate cestode, Bertiella which rarely infects humans

Dr. 'Wale said...

Highly educative!

Blaine A. Mathison said...

I agree with Old One (I was waiting for a correct answer before I chimed in). This is indeed Bertiella, and yes the pyriform apparatus is visible in the oncosphere.

I have seen a couple cases from my CDC days; these cestodes are usually parasites of non-human primates.

Anonymous said...

I agree with Old One and Blaine. I also think that this is Bertiella sp.
Luis.

Bernardino Rocha said...

Agree with Bertiella sp. This is a unusual case and the pyriform apparatus it´s not obvious for the untrained eye. Few clinical cases have been reported, both from Bertiella studeri and Bertiella mucronata. Very informative.

Anonymous said...

Some sort of cestode egg? I have not seen a "bow tie macaroni" proglottid yet, even after half a century of examining human waste.
I trust that Old One and Blaine as well as others have more insight into this "monkey" business than I do.
Thank you all for the lesson on this exotic parasite,
Florida Fan

Idzi P. said...

Indeed a very informative case! Many thanks Prof. Kurniawan! I will remember this one next time I eat “farfalle”... ;-)

Sir Galahad said...

Bertiella studeri, proglottides and ova

Santiago said...

The proglottids and egg point towards a cestode, but they do not fit any of the ones I am familiar with... however, after reading the other comments and doing some research, Bertiella spp seems like a good fit for the morphology shown (characteristic pyriform apparatus seen inside the egg). Very graphic and educative case!
Santiago

Dr Sourav Maiti said...

Taenia sp. Most possibly Taenia saginata.

SOURAV MAITI said...

Cestode proglottid...suggestive of Bertiella sp.

Unknown said...

Taenia saginata ?