Monday, September 21, 2020

Case of the Week 607

 This week's case was donated by my colleague, Dr. Tom Grys. Tom and I did our Clinical Microbiology fellowship together and had a lot of fun! 

The following specimen was brought in by a patient after finding it near his eye upon wakening. He is concerned that it might be an ectoparasite or vector of human pathogens, and is hoping that the laboratory can provide this information. What is your identification, and how would you counsel the patient or patient's clinician?






9 comments:

John Markantonis DO said...

Looks like a beetle of some sort.

Anonymous said...

An incidental innocent little beetle....

Anonymous said...

This insect though mangled up still retains some characteristics such as hard wings, most likely having a second set of membranous flying wings underneath. This would fit it in the Coleopteras or hard wing insects, the types of beetles. The apparently serrated mandible is commonly found on these insects.
There was no clinical symptoms associated with the finding, as such we can say this is an incidental finding, not a clinical one.
Beetles are an economic disaster for coconut farmers in my country, a single larva the size of a fingertip can kill a coconut tree or palm tree by eating the growth tip. Farmers are forced to cut the tree and with surgical skill, they carefully dissect the damaged tip to catch the culprit. The trophy is immersed in pure fish sauce so it would release the dirt out. A quick roasting on red hot charcoal will emanate a smell so intense as to make the entire neighborhood salivate with envy. Pay back can only be so sweet. By the way, the undamaged part of the growth tip will beat the best bamboo shoots in flavor, texture or sweetness.
Florida Fan

Anonymous said...

To Blaine Mathison,
I believe this one belongs to your specialty Blaine. Would you do us the favor of shedding some light on this case?
Many thanks for such blessings,
Florida Fan

nema said...

In my opinion it is not an ectoparasite. It looks like a fragment of a cockroach.

Dhanalakshmi said...

More likely seen as adult form of African black beetle (Heteronychus arator), subfamily as Dynastinae

Identification features:

1. Shiny blackish brown colour
2. An oval head and oval body with no antennae and short jaggy-looking feet.
3. Rusty brown markings in the ventral side

Unknown said...

I think our friend is too sleek to be Heteronychus. Those guys are more dome shaped and rounded.

I think this beetle is the humble carpophilus beetle, specifically carpophilus dimidiatus. The whole family is known as sap beetles, and they are pests of a variety of agricultural products, as noted by Florida Fan.

So not a vector and not an ectoparasite. A splendid beetle, though!

-Josh

Blaine A. Mathison said...

I have been summoned to comment. I think everyone can agree this is a beetle, and not an ectoparasite of otherwise of public health or medical concern. I was actually on the original consult for this case.

As far as the identification goes, I am pretty sure it is a sap beetle in the family Nitidulidae. Josh said Carpophilus, which is a really good thought. Carpophilus species are household 'pests' of dried or overripe fruit and other dried foodstuffs. As such, they can be ubiquitous in homes and are therefore likely to make their way into a clinical specimen.

Kosta Y. Mumcuoglu said...

A beetle broken in the area between thorax and abdomen, and missing parts in the legs and antennae. The uppper wings (elytra) are relatively short and do not cover the entire abdomen, while long hairs are visible just under the wings. I asked an entomologist colleague and I received the following answer: The beetle belongs to the Nitidulidae family, the sap beetles. I am not sure about the genus, but Carpophilus and Epuraea are most commonly associated with human surroundings and are considered minor agricultural and store pests. They are often attracted to lights, like many other insects. If many of them develop in stored commodities, for example dry fruit or jam, they definitely can cause some health problems to the consumer. However, they are completely harmless in direct contact with a man, even if they get accidentally in the eye, they do not bite and cannot transmit anything to humans......(Mr. Ariel-Leib Friedman, MSc, Coleoptera Collection Manager, The Steinhardt Museum of Natural History, Tel Aviv University, Israel).
What should be advised to the patient?....Perhaps it is time to change the bed sheets!!
What should be advised to the physician? To smile and start examining the next patient with REAL health problems.