Case of the Week 600

Wow, I can't believe we are up to Case of the Week 600! To celebrate, my awesome technical specialist, Emily Fernholz, made me this lovely composite image. Click on the image to enlarge and see all of the smaller pictures making up the larger image. Can you tell me what it is, and why it is appropriate for this week's case?

Answer to Case 600

Answer to Parasite Case of the Week 600: Lovely ectoparasite collage of a larval tick of Rhipicephalus sp., courtesy of my amazing technical specialist, Emily Fernholz.

Note that the arthropod has 6 legs (to go with my 600th case), indicating that this is a larva rather than nymph or adult. 

One reader queried if the components of the collage were from all of my cases to date. Wow, what a great idea! There are more than 4000 images present, which might have been able to represent all of the images from my various cases. However, that is not the case here - the collage is made up of many different arthropods, including bed bugs, ticks, fleas and lice. There is even a pubic louse and a Tunga penetrans flea in there if you look closely (good catch, Florida Fan!). 

Old One came up with some additional ideas on how this collage was related to my 600th case:

1.) Wikipedia writes of an unengorged tick gaining 200-600 times its weight after feeding.

2.) King Solomon made a shield of 600 golden shekels. Hard ticks have a scutum (which is a word derived from the latin word scuta which is an oblong shield used by Roman soldiers).

3.) Angel number 600 champions the ideals of family, learning and growing together. We have all grown together with the bounty of knowledge shared over the years on this blog. I also believe that creations, like this wonderful collage (Brava Emily) are like a familial act of kindness.

Finally, Nema reminds us that "This collage of several ectoparasites, implicated in various diseases, should remind us that this week, on July 30th 2020, is the week of the 8th annual ISNTD Bites conference, on vector-borne diseases & vector control, an event that will be held all online."

Case of the Week 599

This week's fun case is from Dr. Tess Karre, one of our former clinical microbiology fellows. The following structures were seen in a hematoxylin and eosin stained small bowel biopsy. Identification?

Answer to Case 599

Answer to Parasite Case of the Week 599: Male Enterobius vermicularis

Congratulations to all of you who got this one correct! This was actually an older case that I had posted back in 2014. I had forgotten that I already posted it! This case comes with an explanatory photo and a fun poem from Blaine Mathison:

While the duodenum is an unusual place to find this worm,

the morphologic features shouldn't cause you to squirm

With lateral alae pointing to the sides

and platymyarian musculature low and wide

a diagnosis of pinworm should be relatively firm!

Case of the Week 598

Welcome to the first case of the month provided by Idzi Potters and the Institute of Tropical Medicine, Antwerp. The following object was obtained during colonoscopy from a 35-year-old woman. It measures approximately 4 cm in length. Travel history is unknown. Identification?

Answer to Case 598

Answer to Parasite Case of the Week 598: Trichuris trichiura, the human whipworm. This is a beautiful classic case from Idzi. Notice the whip-like shape. Just don't be fooled by the anatomy - the anterior end is the skinny end!